Motivated2Move: ICU Liberation and Early Progressive Mobility in Ventilated Patients

The Motivated2Move: ICU Liberation and Early Progressive Mobility in Ventilated Patients project was implemented in a 24-bed intensive care unit (ICU) in a 241-bed general care, stroke certified not-for-profit community hospital in northern California. The primary purpose of this project was to educate the nurses on the structure and implementation of the Society of Critical Care Medicine’s evidence-based ICU Liberation (ABCDEF) Bundle (Society of Critical Care Medicine, n.d.). A secondary purpose of this project was to coordinate an early progressive exercise and mobility protocol for all ventilated patients. The primary goal of the project is 100% compliance with the ICU Liberation Bundle elements and documentation and 100% compliance with the early and progressive exercise and mobility protocol as evidenced by all eligible ventilated patients on a documented mobility regimen beginning with bed mobility and leading to a minimum mobility level of out of bed to a reclining chair. ICU-acquired delirium, post-intensive care syndrome (PICS), and ICU-acquired weakness are manageable conditions all critically ill patients are at risk for. Studies show that 20-50% of all critically ill patients and 50-80% of mechanically ventilated patients are at risk for ICU-acquired delirium, weakness, and PICS. Negative outcomes include increased length of ICU and hospital stay, higher cost, increased mortality, and long-term cognitive, social, and physical deficits (Society of Critical Care Medicine, 2018). Early progressive mobility of ventilated patients shows a decrease in ICU-acquired delirium and PICS, and increase in function, and decrease in overall ventilator days and length of ICU stay (Hopkins et al., 2016). The global goal of this project is to develop a structured early mobility program with a strong multi-disciplinary team to champion early mobility with measurable outcomes

Preschool Children's Attention to Environmental Messages about Groups: Social Categorization and the Origins of Intergroup Bias

This is the authors' accepted manuscript, post peer-review. The publisher's official version is available electronically from: http://dx.doi.org/10.1111/j.1467-8624.2006.00906.x .The present study was designed to examine the effects of adults’ labeling and use of social groups on preschool children’s intergroup attitudes. Children (N = 87, aged 3 to 5) attending daycare were given measures of classification skill and self-esteem and assigned to membership in a novel (“red” or “blue”) social group. In experimental classrooms, teachers used the color groups to label children and organize the classroom. In control classrooms, teachers ignored the color groups. After three weeks, children completed multiple measures of intergroup attitudes. Results indicated that children in both types of classrooms developed ingroup-biased attitudes. As expected, children in experimental classrooms showed greater ingroup bias on some measures than children in control classrooms

Postbaccalaureate STEM Students’ Perceptions of their Training: Exploring the Intersection of Gender and Nativity

The number of international students in graduate school within STEM fields at US institutions has risen dramatically over the last few decades, whereas the numbers of US women attending graduate school in STEM fields has largely stagnated. These trends suggest the importance of intersectionality to understanding individuals’ pursuit of STEM careers. Here we examined doctoral (N = 270) and postdoctoral (N = 27) students\u27 satisfaction with their graduate training at a large, research focused institution in the US as a function of the intersection of participants’ gender and nativity. Participants completed measures of occupational values, perceived fit of their values with STEM research careers, perceptions of discrimination, mentor support, and satisfaction with their graduate training. Results indicated that both international and US-born women both valued family flexibility more than did international and US-born men. Importantly, international, but not US-born, women viewed careers in STEM research as affording, or providing a means of fulfilling, their values. Furthermore, US women were more likely than international women to perceive their gender as the target of discrimination. Stronger belief that research careers do not provide a means for fulfilling one’s values and greater perceptions of gender discrimination were associated with lower ratings of satisfaction with graduate training among women but not men

Effects of Physical Atypicality on Children's Social Issues and Intergroup Attitudes

This is the authors' accepted manuscript, post-peer review. The publisher's official version is available electronically from: http://dx.doi.org/10.1177/0165025407081472.Individuals vary in the degree to which they are representative, or typical, of their social groups. To investigate the effects of atypicality on intergroup attitudes, elementary-school-age children (N = 97) attending a summer school program were assigned to novel color groups that included typical (blue or green) and atypical (light blue or light green) members. Children’s state self-esteem, ingroup identification, and intergroup attitudes (e.g., trait ratings, evaluations, peer preferences) were assessed following several weeks in the classroom. Results indicated that atypicality primarily affected children’s views of their ingroup. Among younger (but not older) children, atypical group members viewed themselves as more similar to—but less happy being a member of—their ingroup than typical group members

Ultra-low phase noise all-optical microwave generation setup based on commercial devices

In this paper, we present a very simple design based on commercial devices for the all-optical generation of ultra-low phase noise microwave signals. A commercial, fibered femtosecond laser is locked to a laser that is stabilized to a commercial ULE Fabry-Perot cavity. The 10 GHz microwave signal extracted from the femtosecond laser output exhibits a single sideband phase noise $\mathcal{L}(f)=-104 \ \mathrm{dBc}/\mathrm{Hz}$ at 1 Hz Fourier frequency, at the level of the best value obtained with such "microwave photonics" laboratory experiments \cite{Fortier2011}. Close-to-the-carrier ultra-low phase noise microwave signals will now be available in laboratories outside the frequency metrology field, opening up new possibilities in various domains.Comment: 8 pages, 3 figures. To be published in Applied Optics, early posting version available at http://www.opticsinfobase.org/ao/upcoming_pdf.cfm?id=23114

Acute transverse myelitis in Lyme neuroborreliosis

Introduction: Acute transverse myelitis (ATM) is a rare disorder (1-8 new cases per million of population per year), with 20% of all cases occurring in patients younger than 18years of age. Diagnosis requires clinical symptoms and evidence of inflammation within the spinal cord (cerebrospinal fluid and/or magnetic resonance imaging). ATM due to neuroborreliosis typically presents with impressive clinical manifestations. Case presentation: Here we present a case of Lyme neuroborreliosis-associated ATM with severe MRI and CSF findings, but surprisingly few clinical manifestations and late conversion of the immunoglobulin G CSF/blood index of Borrelia burgdorferi sensu lato. Conclusion: Clinical symptoms and signs of neuroborrelial ATM may be minimal, even in cases with severe involvement of the spine, as shown by imaging studies. The CSF/blood index can be negative in the early stages and does not exclude Lyme neuroborreliosis; if there is strong clinical suspicion of Lyme neuroborreliosis, appropriate treatment should be started and the CSF/blood index repeated to confirm the diagnosi

Acute transverse myelitis in Lyme neuroborreliosis

Introduction: Acute transverse myelitis (ATM) is a rare disorder (1-8 new cases per million of population per year), with 20% of all cases occurring in patients younger than 18years of age. Diagnosis requires clinical symptoms and evidence of inflammation within the spinal cord (cerebrospinal fluid and/or magnetic resonance imaging). ATM due to neuroborreliosis typically presents with impressive clinical manifestations. Case presentation: Here we present a case of Lyme neuroborreliosis-associated ATM with severe MRI and CSF findings, but surprisingly few clinical manifestations and late conversion of the immunoglobulin G CSF/blood index of Borrelia burgdorferi sensu lato. Conclusion: Clinical symptoms and signs of neuroborrelial ATM may be minimal, even in cases with severe involvement of the spine, as shown by imaging studies. The CSF/blood index can be negative in the early stages and does not exclude Lyme neuroborreliosis; if there is strong clinical suspicion of Lyme neuroborreliosis, appropriate treatment should be started and the CSF/blood index repeated to confirm the diagnosi

A review of human sensory dynamics for application to models of driver steering and speed control.

In comparison with the high level of knowledge about vehicle dynamics which exists nowadays, the role of the driver in the driver-vehicle system is still relatively poorly understood. A large variety of driver models exist for various applications; however, few of them take account of the driver's sensory dynamics, and those that do are limited in their scope and accuracy. A review of the literature has been carried out to consolidate information from previous studies which may be useful when incorporating human sensory systems into the design of a driver model. This includes information on sensory dynamics, delays, thresholds and integration of multiple sensory stimuli. This review should provide a basis for further study into sensory perception during driving.This work was supported by the UK Engineering and Physical Sciences Research Council (EP/P505445/1) (studentship for Nash).This is the published version. It first appeared from Springer at http://dx.doi.org/10.1007/s00422-016-0682-x

In vivo testing of a novel adjustable glaucoma drainage device.

PURPOSE: We report on the in vivo testing of a novel noninvasively adjustable glaucoma drainage device (AGDD), which features an adjustable outflow resistance, and assess the safety and efficiency of this implant. METHODS: Under general anesthesia, the AGDD was implanted on seven white New Zealand rabbits for a duration of 4 months under a scleral flap in a way analogous to the Ex-PRESS device and set in an operationally closed position. The IOP was measured on a regular basis on the operated and control eyes using a rebound tonometer. Once a month the AGDD was adjusted noninvasively from its fully closed to its fully open position and the resulting pressure drop was measured. The contralateral eye was not operated and served as control. After euthanization, the eyes were collected for histology evaluation. RESULTS: The mean preoperative IOP was 11.1 ± 2.4 mm Hg. The IOP was significantly lower for the operated eye (6.8 ± 2 mm Hg) compared to the nonoperated eye (13.1 ± 1.6 mm Hg) during the first 8 days after surgery. When opening the AGDD from its fully closed to fully open position, the IOP dropped significantly from 11.2 ± 2.9 to 4.8 ± 0.9 mm Hg (P < 0.05). CONCLUSIONS: Implanting the AGDD is a safe and uncomplicated surgical procedure. The fluidic resistance was noninvasively adjustable during the postoperative period with the AGDD between its fully closed and fully open positions