Hollow Fiber Membranes for Artificial Lung Applications

Artificial lungs are in use, but difficult issues remain in the field of membrane development related to fouling issues. Currently there are external artificial lungs circulating blood outside the body, taking out the carbon dioxide, and inserting oxygenated blood back into the body. An example of this type of machine is the ExtraCorporeal Membrane Oxygenation (ECMO) machine currently used in hospitals. The ECMO takes over the functions for both the lungs and the heart but is only available for short term use by patients with respiratory failure due to infections [1]. The fibers in the machine develop fouling due to the fibers’ small surface areas coupled with their long term exposure to proteins in the blood. These factors continuously decrease the gas transfer abilities of the fibers until the machine is no longer effective at exchanging gases with the blood. The goal of this research is to create materials to use in a lung that can function within the body until an actual lung becomes available using hollow fiber membranes with proteins attached to prevent fouling. A fouling study was performed on 17.8% polysulfone hollow fiber membranes with polydopamine and peptoid attached. Unmodified, polydopamine modified, and polydopamine and peptoid modified fibers were placed in a diffusion chamber with Bovine Serum Albumin (BSA) flowing on the outside of the fibers and oxygen flowing on the inside. Evapoporometry was run on the fibers to determine the pore size distribution of the fibers before and after the run. The evapoporometry of the fibers shows that the pores for the fibers after being in the chamber fouling for 72 hours were smaller overall and was easier to distinguish for the higher concentration BSA solution. The oxygen concentration of the BSA was also measured while the BSA was run outside of the fibers in the chamber. The fibers were considered to be completely fouled when no more oxygen was able to diffuse into the BSA. The fouling was shown to take longer to occur in the protein coated fibers than in the unmodified fibers. The fouling of BSA on the PSF fibers was characterized by different methods including FTIR, SEM images, and tensile strength

Dancing With the Gods; Santeria\u27s Historical Context in Eastern Cuba

Santeria is a religion that originated in Cuba in the 1600\u27s and grew out of the tensions between two ethnic groups: Spanish slave masters and West African slaves. Their religions- Catholicism and Ifa, respectively- coalesced to create a syncretism, or amalgamation of multiple concepts. This syncretism, Santeria, is an extraordinarily complex religion through which adherents communicate with God and deities called orishas using prayer, music, dance, divination, and rituals. Though many claim certain truths about Santeria, they are often contradictory and unfounded, making it difficult to accurately understand the religion. However, with effort, these truths can be pieced together to describe a religion completely engrained in present day Cuban society

Implementation of the Columbia-Suicide Severity Rating Scale at an Outpatient Mental Health Practice to Increase Provider Confidence in Identifying Suicide Risk

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan. Background: Approximately 57% of individuals who die by suicide had at least one contact with mental health providers during their lifetime, and 21% had contact within 1 month of dying. Early detection of suicidal ideation and behavior is key to reducing the occurrence of suicide in patients receiving mental health care. Traditionally, mental health clinicians use a variety of techniques to assess for the presence of suicidal ideation, but comprehensive suicide assessments should also determine whether an individual has intent or a plan to attempt suicide, as well as whether any suicide attempts have been made previously. The C-SSRS has been proven to be an effective tool to reliably screen for suicide risk in a variety of patient populations, with a focus on stratifying risk based on a number of contributing client factors, including previous suicidal behavior, current intent to commit suicide, and the presence of a method and/or plan for suicide. Methods: A small outpatient mental health practice in La Jolla, California was partnered with for this implementation project. From 12/5/2022-2/5/2023, all new patients at the practice received an online version of the C-SSRS to complete prior to their initial evaluation. Those who screened positive for any degree of suicide risk continued to complete the C-SSRS prior to each subsequent visit. Data collected from this intervention period were compared to data collected via chart review for all new patient intakes that occurred over a 2-month preintervention period in fall 2022 to compare and contrast suicide screening rates and processes, as well as to identify themes in suicide assessment between the two samples. Providers at the practice also completed a modified version of the Zero Suicide Workforce Survey prior to receiving a recorded presentation on the C-SSRS and project overview; these providers then completed the same survey at the end of the intervention phase to assess for changes in their confidence in assessing for suicidal behavior. Results: Adding the C-SSRS to new patient intake forms resulted in increased screening for suicidal ideation for new patients and improvements in suicide risk stratification. Providers also reported increased confidence in assessing and treating suicidal behavior. Qualitative evaluation led to identification of several opportunities to improve provider workflows in assessing, documenting, and treating suicide risk in the course of routine outpatient treatment. Evaluation: Implementation of suicide screening with the C-SSRS at the project site led to an increase in suicide risk identification and elevated provider confidence in assessing for suicide risk factors. Accurate and standardized suicide screening is the first step in preventing suicide in outpatient settings. Future projects should be implemented to develop treatment protocols based on identified suicide risk levels and standardize documentation of completed suicide risk assessments

Norepinephrine Use In Septic Patients Undergoing General Anesthesia

Anesthesia providers are frequently confronted by the problem of caring for patients presenting with sepsis in the operating room. Sepsis is associated with high healthcare costs and a significant mortality rate despite advancements in the understanding of its complicated pathophysiology. The 2016 Surviving Sepsis Campaign recommends norepinephrine as the first-choice vasopressor in septic patients. Its mild beta-adrenergic effects, in addition to its alpha-adrenergic effects, make it an attractive agent for the vasoplegia and myocardial dysfunction associated with sepsis. Earlier achievement of adequate perfusion pressures, earlier lactate clearance, and higher in-hospital survival have all been associated with norepinephrine use in the septic patient. However, it remains underutilized in the perioperative setting. Peripheral intravenous administration of norepinephrine has been associated with very low complication rates and norepinephrine, as an alternative to other vasopressors in patients undergoing general anesthesia, is showing promising results. In patients with sepsis requiring surgical source control, anesthesia providers should see themselves as key players in the critical care continuum and should be encouraged to consider the use of norepinephrine

Vertical Examination of Reading Environment and Student Engagement in 1st-3rd Grade Classrooms

The purpose of this study was to examine the relationship between instructional environment and student engagement during reading instruction. Environment is composed of three key elements: teacher attributes, instructional methods, and the physical classroom setting (Blair, Rupley, & Nichols, 2007; De Naeghel, Van Keer, Vansteenkiste, & Rosseel, 2012; Guthrie, Hoa, Wigfield, Tonks, & Perencevich, 2006; Housand & Reis, 2008). This study examined a first, second, and third grade classroom in one East Tennessee school. Qualitative data was collected using a combination of instructional observation and teacher interviews in order to examine existing practices for successfully engaging young readers. Teachers for each of the classrooms were interviewed; following the interview, each teacher’s classroom was observed three times to examine the teacher’s attributes and most frequently used instructional methods, the physical classroom setting, and the expressed level of engagement of the student body in the classroom. The findings indicate that environment in terms of teacher attributes, instructional methods, and physical classroom setting affects student reading engagement; classrooms with high levels of organization, novel reading areas, and opportunity for students to select reading material were found particularly effective for reading engagement

The Effects of a Tiered-Training Intervention on Teachers\u27 Use of Behavior Specific Praise During the Reading Instruction of Elementary Students with Emotional Disabilities

Despite longstanding acknowledgement regarding the effectiveness of behavior specific praise for students with emotional disabilities, there continues to be an underuse of this strategy with this population. The purpose of this study was to investigate the effectiveness of a tiered training intervention on teachers\u27 use of behavior specific praise during the small group reading instruction of elementary students with emotional disabilities. A multiple baseline design was used across two groups of teacher and student participants as the means of investigating the effectiveness of the training model on teachers\u27 use of behavior specific praise and the associated student outcomes. Similar to previous studies, results indicated that a brief approach to teacher training may be effective in increasing teachers\u27 use of behavior specific for students with emotional disabilities during small group reading instruction. Future research is needed to explore increasing teachers\u27 maintenance of this strategy, the effect of behavior specific praise on the academic achievement of students with emotional disabilities, and the challenges of conducting research in an applied setting for students with emotional disabilities

Sign Languages of Western Highlands, Papua New Guinea, and their Challenges for Sign Language Typology

The diverse sign languages (SLs) between established deaf community SLs and homesign have been called the “grey area” of SL linguistics, by virtue of their resistance to classification and the fact that they are understudied (Nyst, 2010, p. 416). This thesis investigates the languages of 12 deaf people living in the Nebilyer/Kaugel region of the rural Papua New Guinea highlands, with the view to situating them within the extant sociodemographic typology of SLs. I do this by considering sociodemographic data of deaf individuals, comparison of sign bases to determine lexical consistency, and emic perspectives of users. As a result of these analyses, I find that the diverse but interrelated languages of these 12 deaf people are not well classified within the existing sociodemographic taxonomy of SLs. In order to expand that taxonomy, I first present the concept of a sign network, which is a network of strong and weak sign ties, with strength defined as the presence of fluent, regular signed communication between individuals, irrespective of deaf/hearing status. I offer the new category of a nucleated network SL, the sign network of which is characterised by a central deaf individual with multiple strong sign ties to other individuals, who prototypically are all hearing. This is differentiated, I argue, from a canonical homesign language such as David’s (Goldin-Meadow, 2003), which is characterised by only weak sign ties to other individuals, either deaf or hearing. As such, I advocate for the extension of Horton’s (in press) typological category of “individual homesign” to account for regular contact not only with deaf signers, but hearing ones as well. In determining the degree of lexical consistency between SLs, I present the metric of sign base comparison, predicated on the idea that even in iconic signs, there is a measure of arbitrariness underlying which aspect of a referent is selected (cf. Planer & Kalkman, 2019). This is a useful tool for work with SLs whose users exhibit a high degree of intra-signer variation in form, and thus cannot be well compared using the standard model of sublexical parameter comparison (cf. McKee & Kennedy, 2000; Guerra Currie, Meier, & Walters, 2002). I account for the high level of lexical consistency between Nebilyer/Kaugel SLs with the notion of a regional sign network, which is a sign network characterised by an abundance of weak sign ties between individuals in a larger region. I propose that signs diffuse along these weak sign ties, which accounts for lexical consistency between the languages of largely unconnected deaf people and their networks. The regional sign network model provides an explanation for similarly reported degrees of lexical consistency in other rural SL situations, where this cannot be explained wholly in terms of independent invention or recruitment of majority community gesture (e.g. Osugi, Supalla, & Webb, 1999). This research enriches the sociodemographic typology of SLs, filling in missing links in the “grey area”, and offering tools to continue to do so (Nyst, 2010, p. 416). More broadly, it also contributes to our understanding of how patterns of human sociality condition language shape

The effective use of music and branding in shaping consumer behavior

The research examined elements of narrative advertising and how they influenced post exposure behavior. In a 2 (Music) x 2 (Branding) x 3 (Ad) repeated measures design, participants watched 12 video ads that varied in type of music (popular music and needle drop) and level of branding. Results showed that varying levels of music and branding in narrative video ads influenced cognitive resources allocated to encoding, arousal, and attitude toward the ad and brand. Both music and branding impacted the physiological variables of encoding and arousal. However, the self report measures, attitude toward the ad and attitude toward the brand, were influenced only by branding, not music. The findings suggest that the right combination of music and branding could potentially improve the effectiveness of television and digital advertising