Review of Non-Invasive and Non-Pharmacological Interventions for the Prevention of Gestational Diabetes Mellitus

Gestational Diabetes Mellitus (GDM) affects around 7% of pregnant women in America. Prevalence is increasing just as obesity is in the general population. Adverse effects of GDM for both mother and baby include the mother having a greater chance of needing C-section, preterm delivery, and hypoglycemia, and, for the newborn, hypoglycemia. Both have greater risk of developing Type 2 Diabetes Mellitus. The purpose of this study is to review the evidence for the most effective non-invasive and non-pharmacological interventions to reduce GDM

Towards healthier Indigenous health policies? Navigating the labyrinth for answers

This research is based on two years of community-based participatory research that draws on Indigenous understandings of health policy in five First Nations in Ontario, Canada. While a number of policies have been put in place to increase Indigenous control over community health services, we argue that policies enacted to promote Indigenous self-determination in health care have been counterproductive and detrimental to Indigenous health and wellbeing. Instead, we suggest that Indigenous health policy exists on a continuum and aim to balance the need for including diverse Indigenous groups with comprehensive control from program funding and design to implementation. This poses some difficult questions: How do Indigenous peoples perceive the concept of self-determination, community-controlled health care and the efforts of the Canadian government to form collaborative arrangements between Indigenous communities, organisations and government? What does an inclusive and comprehensive Indigenous community-controlled health care system look like? The purpose of this article is to explore how Indigenous people and community stakeholders in Canada understand terms such as self-determination and health and draw conclusions about collaborative efforts between the government and Indigenous communities to support community-controlled health care. It further explores participant narratives and describes their experiences, particularly, the strengths and weaknesses of community-government health policy developments

LibParlor Online Learning: Shared Knowledge for the Library Research Community

Learning how to conduct research in library and information science is not always a requirement in LIS graduate programs. The result of uneven training impacts librarianship and the ways in which certain voices and research are privileged in our scholarship. This work in progress poster will share the results of an IMLS grant funded national needs assessment wherein we learned about the experiences, educational needs, and institutional constraints of MLIS students and academic library workers pursuing research through a survey and focus groups. The poster will share insights on the experiences of academic library workers and their needs for institutional, educational, and financial support for training and advocacy in LIS research. We will share information about what LIS researchers feel they benefited from their graduate coursework in research methods, as well as ideas for improvement for these courses

Can the Use of Art and Active Learning Improve Retention and Observational Skill Confidence Among Audiology Graduate Students

Human anatomy and physiology is considered one of the most difficult courses a student can take in a pre-health professional major in the US (Slominski, et. al., 2017). Research has revealed benefits of the use of art and anatomy within medical education, including improved clinical observational skills, greater understanding of disease and patient perspectives, and greater ability to empathize (Bell & Evans, 2014). Bell and Evans (2014) argue that observational skills are often overlooked in medical education. Use of art assignments in a graduate anatomy and physiology course will be discussed with reference to design and learning outcomes. The purpose of this study was to evaluate the relationship between art and medical education for audiology students. This study aimed to incorporate STEAM education (art assignments, the teaching effect, and community outreach) into audiology curriculum. Auburn University’s Au.D. class of 2022 participated in this study, consisting of 10 students. The Student Assessment of Learning Gains (SALG) questionnaire was conducted and provided qualitative and quantitative evidence supporting the integration of art in the Doctor of Audiology curriculum. BASE (pre) and SALG (post) outcomes assessed that the use of STEAM assignments can help improve the retention of the anatomy and physiology within of the auditory system. Cross-tabulations of pre and post course responses show a positive increase in student understanding of course material. A positive perception that art assignments enhanced student confidence and clinical observation skills related to the course was observed.  Many students felt they had a great gain in understanding covered topics. The effects of utilizing the teaching effect and community outreach were also positively seen by student participants. Students’ opinions following coursework and cross-tabulations support a place for art in health education and healthcare

In newborn babies, what are the risks of developing Vitamin K deficiency bleeding disorders if not provided IM Vitamin K injection at birth?

Vitamin K, which is produced in the large intestines of adults, is naturally lacking in neonates. It is a crucial part in the clotting cascade for activating clotting factors II, VII, IX, and X. For the past several decades, it has been a standard in Western Medicine to give an IM Vitamin K injection to neonates post birth. In recent years, statistics of refusal have continued to grow creating an increased prevalence of Vitamin K Deficiency Bleeding Disorders. This study is aimed at exploring the statistics of injection refusal, reasons for refusal, alternative methods to injections, and the importance behind parent education. The studies analyzed demonstrate that there are higher rates of refusal in birth centers and home births as opposed to hospital births. Alternative methods studied, such as breast feeding and mother supplementation, have not been shown to be an equivalent to the IM injection, however, there is promising research regarding an oral method of Vitamin K administration. Based on the research conducted, it is imperative that providers ensure proper patient education throughout the entire pregnancy regarding screenings and preventions, such as a Vitamin K injection and what it prevents, so that parents can make informed decisions when their child is born

Evaluating How Well Active Fault Mapping Predicts earthquake surface-rupture locations

Earthquake surface-fault rupture location uncertainty is a key factor in fault displacement hazard analysis and informs hazard and risk mitigation strategies. Geologists often predict future rupture locations from fault mapping based on the geomorphology interpreted from remote-sensing data sets. However, surface processes can obscure fault location, fault traces may be mapped in error, and a future rupture may not break every fault trace. We assessed how well geomorphology-based fault mapping predicted surface ruptures for seven earthquakes: 1983 M 6.9 Borah Peak, 2004 M 6.0 Parkfield, 2010 M 7.2 El Mayor–Cucapah, 2011 M 6.7 Fukushima-Hamadori, 2014 M 6.0 South Napa, 2016 M 7.8 Kaikoura, and 2016 M 7 Kumamoto. We trained geoscience students to produce active fault maps using topography and imagery acquired before the earthquakes. A geologic professional completed a “control” map. Mappers used a new “geomorphic indicator ranking” approach to rank fault confidence based on geomorphologic landforms. We determined the accuracy of the mapped faults by comparing the fault maps to published rupture maps. We defined predicted ruptures as ruptures near a fault (50–200 m, depending on the fault confidence) that interacted with the landscape in a similar way to the fault. The mapped faults predicted between 12% to 68% of the principal rupture length for the studied earthquakes. The median separation distances between predicted ruptures and strong, distinct, or weak faults were 15–30 m. Our work highlights that mapping future fault ruptures is an underappreciated challenge of fault displacement hazard analysis—even for experts—with implications for risk management, engineering site assessments, and fault exclusion zones

Genome-wide analysis of heterogeneous nuclear ribonucleoprotein (hnRNP) binding to HIV-1 RNA reveals a key role for hnRNP H1 in alternative viral mRNA splicing

Alternative splicing of HIV-1 mRNAs increases viral coding potential and controls the levels and timing of gene expression. HIV-1 splicing is regulated in part by heterogeneous nuclear ribonucleoproteins (hnRNPs) and their viral target sequences, which typically repress splicing when studied outside their native viral context. Here, we determined the location and extent of hnRNP binding to HIV-1 mRNAs and their impact on splicing in a native viral context. Notably, hnRNP A1, hnRNP A2, and hnRNP B1 bound to many dispersed sites across viral mRNAs. Conversely, hnRNP H1 bound to a few discrete purine-rich sequences, a finding that was mirrore

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707