Improved Veteran Outcomes Diagnosed with Myocardial Infarction

Kentucky’s veteran population is approximately 295,390 with most veterans being sixty-five years of age or older (National Center for Veterans Analysis and Statistic, 2018). Due to Kentucky’s veteran population being sixty-five years and older, and since the leading cause of death in Kentucky is heart disease, tracking quality measures for coronary artery disease benefits the veteran population. The purpose of this scholarly project was to perform a chart review for every patient within the inpatient hospital that has had an ST-elevation myocardial infarction and non-ST elevated myocardial infarction, identified key areas of improvement, and implemented evidence-based American Heart Association\u27s Get with the Guidelines CAD protocol to improve outcomes. Data was collected from charts with a diagnosis of STEMI and NSTEMI for the 2021 year. Two areas of focus were found for improvement. ECG within 10 minutes of arrival and cardiac rehabilitation orders from the inpatient setting was under expected benchmarks. Re-education of Emergency Department staff on identifying which patients to bring back for immediate ECG took place. Identification of which cardiology fellows are responsible for placing the cardiac rehab order and educated fellows on this need. Quarterly meetings among key stakeholders discussed patient data documenting implementation of the Get with the Guidelines CAD protocol and evaluated for benchmark achievements and implementation change needs. Quarter four data showed all benchmarks were met for a consecutive 90 days earning this inpatient hospital, the Mission: Lifeline NSTEMI Bronze award for 2021

A Clean Electricity Future: Assessing the Role of Wide-Area Power System Operations in Supporting Weather-Driven Renewable Energy in the U.S.

Over the coming decades, renewable energy sources, namely wind and solar, will need to play a larger role in our nation’s energy mix as we seek to lower greenhouse emissions and respond to renewable energy policies and the EPA’s Clean Power Plan. This thesis assesses the role of wider-area power system operations in the U.S. as a powerful solution in supporting the integration of these weather-driven, variable energy resources that pose substantial challenges to grid reliability. The expansion and integration of organized electricity markets and transmission networks over wider geographic areas can (1) help reduce net-variability in wind and solar power generation while improving reliability; (2) provide an outlet for over-generation while reducing curtailment; (3) improve resource utilization while enabling resource sharing and lowering electricity costs; and (4) enable low-cost pollution reduction by providing a cheap alternative to fossil-fuel generation. Through power industry assessment, case-study analyses, and modeling research using NOAA’s National Energy with Weather System Simulator to compare scenarios of regional expansion versus a nation power system, this paper evaluates the feasibility and role of wide-area expansion and integration in achieving higher levels of variable renewable energy than our current system is capable of supporting

Online Learning, COVID-19, and the Future of the Academy: Implications for Faculty Governance and Collective Bargaining

The purpose of this article is to speculate on the future of higher education as online technology, including adaptive learning (also referred to as personalized learning) infused by artificial intelligence software, develops and matures. This is a risky undertaking since predicting the future, and in this case the evolution of technology, is difficult. While many try to predict what will happen and sometimes get it right, predicting when something will happen is far more challenging. Online and blended learning have already advanced within education, but the most significant changes are yet to come. Evolving technologies have the potential to change the traditional roles in our schools, colleges and universities to the point that many educators are reconsidering their purposes and roles as teachers, researchers and administrators

Big Data and Learning Analytics in Blended Learning Environments: Benefits and Concerns

The purpose of this article is to examine big data and learning analytics in blended learning environments. It will examine the nature of these concepts, provide basic definitions, and identify the benefits and concerns that apply to their development and implementation. This article draws on concepts associated with data-driven decision making, which evolved in the 1980s and 1990s, and takes a sober look at big data and analytics. It does not present them as panaceas for all of the issues and decisions faced by higher education administrators, but sees them as part of solutions, although not without significant investments of time and money to achieve worthwhile benefits

Flight data analysis of power subsystem degradation at near synchronous altitude Quarterly report

Flight data analysis of spacecraft power subsystem degradation at near synchronous altitud

The Human Factors of Algorithms and Sensor Design

Human-operated systems often suffer from designers’ limited consideration of user capacities and how they impact system performance. In many instances, technological capabilities and constraints drive design decisions. There is often a sense that if it can be done technologically, it will be done. However, this approach can prove to be an unwise appropriation of funds, time, and other resources. Justification should not simply rest on satiating a technology craving

Durability enhancement of half-joints in RC bridges through external prestressed tendons: The Musmeci Bridge's case study

This paper numerically investigates the effect of post-tension interventions to strengthen the deteriorated half-joints of the Musmeci Bridge in Potenza (Italy), with the primary objective of increasing the ultimate load-bearing capacity and monitoring the secondary effects in terms of preventing or limiting cracking patterns. Bearing this in mind, the study aims to investigate the role of the reinforcement detailing, of the post-tension stress and of the corroding time in the presence of chlorides, outlining the intervention ability to improve the structure's durability. To this end, nonlinear finite element models are provided with chloride ions diffusion analysis to investigate corrosion initiation and progress in reinforced concrete elements and account for deterioration due to two scenarios (45 and 95 years). Results show the significant impact of reinforcement layout as the presence of inclined bars increases the ultimate load by about 86 %. The ultimate load improvement is in the range 50–55 % when the intervention is carried out after 45 years while it is equal to about 30–35 % if a period of 95 years is last since the construction. This latter highlights the significant influence of the intervention timeliness on structural durability

Durability of gerber saddles in RC bridges: Analyses and applications (Musmeci Bridge, Italy)

Guaranteeing adequate safety levels in critical infrastructures such as bridges is essential to modern societies and their vital services. Bridges with reinforced concrete structures are subject to deterioration, especially due to corrosion effects. Gerber saddles are among the key components of bridges which are especially exposed to environmental actions due to their position and reduced possibility of inspection. In this paper, a framework for the durability analysis of these components is proposed, considering the simultaneous presence of permanent loads and environmental actions under the form of chloride ions. Nonlinear numerical simulations adopting the finite element code ATENA are performed, accounting for chloride ingress analyses. The presence of cracks (due to applied loads and/or design/construction defects) which may speed-up corrosion propagation, steel reinforcement loss, cracking and spalling, and their effects on the load-bearing capacity is considered. This framework has been applied to the Gerber saddles of a prominent reinforced concrete (RC) bridge, namely the Musmeci bridge in Potenza, Italy. Durability analyses made it possible to evaluate the saddles’ strength capacity (i) at the time of construction, (ii) after forty-five years since the construction, and (iii) at an extended time of fifty years. The results show that corrosion can influence both the ultimate load capacity and the collapse mechanism