Recent Earthquakes in Western Ohio

Author Institution: Department of Geology, Ohio State Universit

An exploration of function analysis and function allocation in the commercial flight domain

The applicability is explored of functional analysis methods to support cockpit design. Specifically, alternative techniques are studied for ensuring an effective division of responsibility between the flight crew and automation. A functional decomposition is performed of the commercial flight domain to provide the information necessary to support allocation decisions and demonstrate methodology for allocating functions to flight crew or to automation. The function analysis employed 'bottom up' and 'top down' analyses and demonstrated the comparability of identified functions, using the 'lift off' segment of the 'take off' phase as a test case. The normal flight mission and selected contingencies were addressed. Two alternative methods for using the functional description in the allocation of functions between man and machine were investigated. The two methods were compared in order to ascertain their relative strengths and weaknesses. Finally, conclusions were drawn regarding the practical utility of function analysis methods

Improved genome editing in human cell lines using the CRISPR method

The Cas9/CRISPR system has become a popular choice for genome editing. In this system, binding of a single guide (sg) RNA to a cognate genomic sequence enables the Cas9 nuclease to induce a double-strand break at that locus. This break is next repaired by an error-prone mechanism, leading to mutation and gene disruption. In this study we describe a range of refinements of the method, including stable cell lines expressing Cas9, and a PCR based protocol for the generation of the sgRNA. We also describe a simple methodology that allows both elimination of Cas9 from cells after gene disruption and re-introduction of the disrupted gene. This advance enables easy assessment of the off target effects associated with gene disruption, as well as phenotype-based structure-function analysis. In our study, we used the Fan1 DNA repair gene as control in these experiments. Cas9/CRISPR-mediated Fan1 disruption occurred at frequencies of around 29%, and resulted in the anticipated spectrum of genotoxin hypersensitivity, which was rescued by re-introduction of Fan1

Outcomes of Induction vs Prelabor Cesarean Delivery at \u3c33 Weeks for Hypertensive Disorders of Pregnancy

BACKGROUND: Hypertensive disorders of pregnancy are the leading cause of indicated preterm birth; however, the optimal delivery approach for pregnancies complicated by preterm hypertensive disorders of pregnancy remains uncertain. OBJECTIVE: This study aimed to compare maternal and neonatal morbidity in patients with hypertensive disorders of pregnancy who either went induction of labor or prelabor cesarean delivery at \u3c33 \u3eweeks\u27 gestation. In addition, we aimed to quantify the length of induction of labor and rate of vaginal delivery in those who underwent induction of labor. STUDY DESIGN: This is a secondary analysis of an observational study which included 115,502 patients in 25 hospitals in the United States from 2008 to 2011. Patients were included in the secondary analysis if they were delivered for pregnancy associated hypertension (gestational hypertension or preeclampsia) between 23 RESULTS: A total of 471 patients met inclusion criteria, of whom 271 (58%) underwent induction of labor and 200 (42%) underwent prelabor cesarean delivery. Composite maternal morbidity was 10.2% in the induction group and 21.1% in the cesarean delivery group (unadjusted odds ratio, 0.42 [0.25-0.72]; adjusted odds ratio, 0.44 [0.26-0.76]). Neonatal morbidity in the induction group vs the cesarean delivery was 51.9% and 63.8 %, respectively (unadjusted odds ratio, 0.61 [0.42-0.89]; adjusted odds ratio, 0.71 [0.48-1.06]). The frequency of vaginal delivery in the induction group was 53% (95% confidence interval, 46.8-58.7) and the median duration of labor was 13.9 hours (interquartile range, 8.7-22.2). The frequency of vaginal birth was higher in patients at or beyond 29 weeks (39.9% at 24 CONCLUSION: Among patients delivered for hypertensive disorders of pregnancy \u3c3

Obstacles to Optimal Antenatal Corticosteroid Administration to Eligible Patients

Background Administration of antenatal corticosteroids (ANCS) is recommended for individuals expected to deliver between 24 and 34 weeks of gestation. Properly timed administration of ANCS achieves maximal benefit. However, more than 50% of individuals receive ANCS outside the recommended window. Objective To examine maternal and hospital factors associated with suboptimal receipt of ANCS among individuals who deliver between 24–34 weeks gestation. Study Design Secondary analysis of the Assessment of Perinatal Excellence (APEX), an observational study of births to 115,502 individuals at 25 hospitals in the US from March 2008–February 2011. Data from 3123 individuals who gave birth to a non-anomalous live-born infant between 240/7 to 340/7 weeks gestation, had prenatal records available at delivery, and data available on the timing of ANCS use were included in this analysis. Eligible individuals’ ANCS status was categorized as optimal (full course completed \u3e24 hours after ANCS but not \u3e7 days before birth) or suboptimal (none, too late, or too early). Maternal and hospital-level variables were compared using optimal as the referent group. Hierarchical multinomial logistic regression models, with site as a random effect, were used to identify maternal and hospital-level characteristics associated with optimal ANCS use. Results Overall, 83.6% (2612/3123) of eligible individuals received any treatment: 1216 (38.9%) optimal and 1907 (61.1%) suboptimal. Within suboptimal group495 (15.9%) received ANCS too late, 901 (28.9%) too early and 511 (16.4%) did not receive any ANCS. Optimal ANCS varied depending on indication for hospital admission (p\u3c0.001). Individuals who were admitted with intent to deliver were less likely to receive optimal ANCS while individuals admitted for hypertensive diseases of pregnancy were most likely to receive optimal ANCS (10% vs 35%). The median gestational age of individuals who received optimal ANCS was 31.0 weeks. Adjusting for hospital factors, hospitals with electronic medical records and who receive transfers had fewer eligible individuals who did not receive ANCS. ANCS administration and timing varied substantially by hospital; optimal frequencies ranged from 9.1 to 51.3%, and none frequencies from 6.1% to 61.8%. When evaluating variation by hospital site, models with maternal and hospital factors, did not explain any of the variation in ANCS use. Conclusions Optimal ANCS use varied by maternal and hospital factors and by hospital site, indicating opportunities for improvement

Prediction of Spontaneous Preterm Birth Among Nulliparous Women With a Short Cervix

To evaluate whether demographic and sonographic factors associated with spontaneous preterm birth (sPTB) among nulliparous women with a cervical length (CL) < 30 mm could be combined into an accurate prediction model for sPTB

Connecting the dots in pharmacy education: The FIP International Pharmaceutical Federation Global Competency Framework for Educators and Trainers in Pharmacy (FIP-GCFE)

The FIP (International Pharmaceutical Federation) Global Competency Framework for Educators and Trainers in Pharmacy (FIP-GCFE) is an ongoing project of the Academic Pharmacy Section of FIP in cooperation and collaboration with Sections, Special Interest Groups and Working Groups across the Federation. It was developed by a group of experts in pharmaceutical education to enable and promote the continuing professional development of pharmacists and pharmaceutical scientists who plan to advance their competence as educators and trainers in pharmacy and the pharmaceutical sciences, whether in a formal or informal context, and at all levels of education and professional development. The FIP-GCFE will be an essential resource for multiple stakeholders including individual educators, faculties of pharmacy, and accreditation agencies. This article presents the introductory text of the GCFE first version, connecting previously launched concepts and tools and explaining the integration with all other FIP workforce support frameworks, to provide a holistic approach to global workforce development

The Association of Race and Ethnicity with Severe Maternal Morbidity among Individuals Diagnosed with Hypertensive Disorders of Pregnancy

Objective: To examine whether there are racial disparities in severe maternal morbidity in patients with hypertensive disorder of pregnancy (HDP). Study Design: Secondary analysis of an observational study of 115,502 patients who had a live birth at ≥ 20 weeks in 25 hospitals in the US from 2008 to 2011. Only patients with HDP were included in this analysis. Race and ethnicity were categorized as non-Hispanic White, non-Hispanic Black and Hispanic and were abstracted from the medical charts. Patients of other races and ethnicities were excluded. Associations were estimated between race and ethnicity and the primary outcome of severe maternal morbidity, defined as any of the following: blood transfusion ≥4 units, unexpected surgical procedure, need for a ventilator ≥ 12 hours, intensive care unit (ICU) admission, or failure of ≥ 1 organ system, were estimated by unadjusted logistic and multivariable backward logistic regressions. Multivariable models were run classifying HDP into 3 levels: 1) gestational hypertension; 2) preeclampsia (mild, severe or superimposed); and 3) eclampsia or HELLP. Results: A total of 9,612 individuals with HDP met inclusion criteria. No maternal deaths occurred in this cohort. In univariable analysis, non-Hispanic White patients were more likely to present with gestational hypertension whereas non-Hispanic Black and Hispanic patients were more likely to present with preeclampsia. The frequency of the primary outcome, composite severe maternal morbidity, was higher in NHB patients compared with that in non-Hispanic White or Hispanic patients (11.8% vs. 4.5% in non-Hispanic White and 4.8% in Hispanic, p\u3c0.001). This difference was driven by a higher frequency of blood transfusions and ICU admissions among non-Hispanic Black individuals. Prior to adjusting the analysis for confounding factors, the odds ratio (OR) of primary composite outcomes in non-Hispanic black individuals was 2.85 (95% CI 2.38, 3.42) compared to non-Hispanic white. After adjusting for sociodemographic and clinical factors, hospital site, and the severity of HDP, the odds ratios of composite severe maternal morbidity did not differ between the groups (adjusted OR 1.26, 95% CI 0.95, 1.67 for non-Hispanic Black and adjusted OR 1.29, 95% CI 0.94, 1.77 for Hispanic, compared to non-Hispanic White patients). Sensitivity analysis was done to exclude one single site that was an outliner with the highest ICU admissions and demonstrated no difference in ICU admission by maternal race and ethnicity. Conclusions: Non-Hispanic Black patients with HDP had higher rates of the composite severe maternal morbidity compared with non-Hispanic White patients, driven mainly by a higher frequency of blood transfusions and ICU admissions. However, once severity and other confounding factors were taken into account, the differences did not persist