Pillars Of Prosperity: Leveraging Regional Assets To Grow Minnesota's Economy

Minnesota has always been rich with assets -- a skilled labor force, good jobs in diverse industries, globally competitive companies, and abundant lakes and parks that provide a high quality of life for the people who call it home.However, to maintain its strong economy and quality of life, Minnesota must adapt to fast-changing trends in the global economy, trends that affect each of the state's regions and communities differently.This report explores how the state of Minnesota -- the governor's administration together with the Minnesota Legislature -- can partner with regional networks to foster economic growth and extend prosperity to greater numbers of Minnesotans

Critical Practice Study of Nursing Evaluated by Teachers

Purpose: Competent nursing care is essential to positive patient outcomes and quality patient care. Graduate nurses begin practice as novices in knowledge and experience often entering an environment where patients have several disease processes complicating their care. A strong foundation of educational competencies prior to entering practice is vital for the development and growth of graduate nurses into the role of RN. The purpose of this study was to examine the use of the Nurse Competence Scale among nursing faculty.Method: Nursing faculty were surveyed to determine which competencies were a priority in nursing practice. The Nurse Competence Scale was used to identify and categorize nurse competences. Brenner’s novice to expert theoretical framework was used to apply findings to curricular programs. IRB approval was granted from each educational institution. SPSS statistical analysis was used to analyze survey results.Results: Among the categories of the Nurse Competence Scale, nursing faculty identified Acting appropriately in life-threatening situations in the Managing Situations section as most important to practice. In the category of Helping, Planning patient care according to individual needs was identified as most important. Additionally the nursing faculty surveyed rated Contributing to further development of multidisciplinary clinical paths in the Therapeutic Interventions category as the lowest.Conclusion: This study contributes to the discussion on nursing competence. Priorities for nursing faculty aligned with register nurses in practice. This study helps pair nursing education with practice in several ways including aligning current practice with education. Nurse Educators may use these findings to help join curricular outcomes with practice. Evaluating each item on the Nurse Competence Scale using the critical to practice scale provides insight to the necessary skills and knowledge needed to be competent in nursing. In addition the results may be compared to current practice guidelines to ensure best practice. Further research linking education and practice using nursing competence is needed

Outcomes in patients with cirrhosis evaluated through routine healthcare data

Background: Mortality from liver disease is rising. Recent efforts have been focussed on early detection and prevention of disease progression. Transient elastography (TE) is commonly used in clinical practice to diagnose fibrosis and is an accurate predictor of mortality, decompensation, and hepatocellular carcinoma (HCC). Electronic health records (EHR) have been used to observe ‘real world’ data in large cohorts of patients with liver disease. Method: EHR data was used to observe outcomes in patients with advanced fibrosis. This included a systematic review followed by synthesis and validation of a code set to identify cirrhosis and complications in EHR data. Data extracted from EHR was used to assess survival and competing risk of liver and non-liver related events in a cohort of patients with advanced chronic liver disease defined by TE. Data was analysed to examine patterns of screening and surveillance for complications of cirrhosis in accordance with current practice guidelines. Results: The developed consensus code set showed improved performance characteristics for identifying cirrhosis in comparison to previously used codes. In the analysis of over 3000 patients with advanced fibrosis, liver stiffness was associated with the development of varices, the transition from compensated cirrhosis to decompensated cirrhosis, and the development of hepatocellular carcinoma. Only a minority of patients had undergone the recommended surveillance interventions. Conclusion: Electronic health databases can be used to evaluate screening and surveillance strategies, and to accurately define clinical progression and outcomes in large patient cohorts and estimates of disease progression in EHR cohorts are comparable to landmark studies of patients diagnosed using liver vi biopsy. Transient elastography is strongly associated with outcomes in patients with advanced fibrosis. This study highlights the utility of EHR data in contemporary research practice in cirrhosis, highlighting the potential for a registry to impact on patient care and to improve outcomes for patients with cirrhosis

Evaluation of Isokinetic Single-Leg Cycling as a Rehabilitation Exercise Following Anterior Cruciate Ligament Reconstruction Surgery

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments, with over 250,000 injuries per year in the United States. Previous studies have found that ACL-deficient individuals avoid use of the quadriceps in the injured limb as a means of limiting anterior movement of the tibia in the absence of a functioning ACL. From these results, a study was designed to investigate the effectiveness of isokinetic single-leg cycling in increasing quadriceps muscle recruitment and activation. Ten control and seven ACL-reconstructed subjects completed a series of 15 s cycling trials in isokinetic mode at 75 rpm, while kinematic, kinetic, and electromyographic data of the lower limbs were collected, with the trials including both double-leg and single-leg cycling. It was hypothesized that there would be an increase in quadriceps muscle activity, peak knee extensor moment, and knee joint power in single-leg cycling when compared to double-leg cycling. The results of the study suggest that single-leg cycling may be an effective exercise in increasing the strength of the quadriceps following anterior cruciate ligament reconstruction surgery. Although no significant changes occurred, the results indicate that, given a specific limb power, more muscle force will be generated from the quadriceps muscle group in single-leg cycling than double-leg cycling

Seasonal cues induce phenotypic plasticity of Drosophila suzukii to enhance winter survival

Additional file 7: Table S6. Table of differentially expressed genes in bodies of winter morphs of D. suzukii relative to those of summer morphs. Fold change represents the ratio of expression levels of winter to summer morphs

Fluorescence Correlation Spectroscopy in Drug Discovery: Study of Alexa532-Endothelin 1 Binding to the Endothelin ETA Receptor to Describe the Pharmacological Profile of Natural Products

Fluorescence correlation spectroscopy and the newly synthesized Alexa532-ET1 were used to study the dynamics of the endothelin ETA receptor-ligand complex alone and under the influence of a semisynthetic selective antagonist and a fungal extract on living A10 cells. Dose-dependent increase of inositol phosphate production was seen for Alexa532-ET1, and its binding was reduced to 8% by the selective endothelin ETA antagonist BQ-123, confirming the specific binding of Alexa532-ET1 to the endothelin ETA receptor. Two different lateral mobilities of the receptor-ligand complexes within the cell membrane were found allowing the discrimination of different states for this complex. BQ-123 showed a strong binding affinity to the “inactive” receptor state characterized by the slow diffusion time constant. A similar effect was observed for the fungal extract, which completely displaced Alexa532-ET1 from its binding to the “inactive” receptor state. These findings suggest that both BQ-123 and the fungal extract act as inverse agonists

Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach

Background: The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) is a federal nutrition program that provides nutritious food, education, and health care referrals to low-income women, infants, and children up to the age of 5 years. Although WIC is associated with positive health outcomes for each participant category, modernization and efficiency are needed at the clinic and shopping levels to increase program satisfaction and participation rates. New technologies, such as electronic benefits transfer (EBT), online nutrition education, and mobile apps, can provide opportunities to improve the WIC experience for participants. Objective: This formative study applies user-centered design principles to inform the layout and prioritization of features in mobile apps for low-income families participating in the WIC program. Methods: To identify and prioritize desirable app features, caregivers (N=22) of the children enrolled in WIC participated in individual semistructured interviews with a card sorting activity. Interviews were transcribed verbatim and analyzed using constant comparative analysis for themes. App features were ranked and placed into natural groupings by each participant. The sum and average of the rankings were calculated to understand which features were prioritized by the users. Natural groupings of features were labeled according to participant descriptions. Results: Natural groupings focused on the following categories: clinics/appointments, shopping/stores, education/assessments, location, and recipes/food. Themes from the interviews triangulated the results from the ranking activity. The priority app features were balance checking, an item scanner, and appointment scheduling. Other app features discussed and ranked included appointment reminders, nutrition training and quizzes, shopping lists, clinic and store locators, recipe gallery, produce calculator, and dietary preferences/allergies. Conclusions: This study demonstrates how a user-centered design process can aid the development of an app for low-income families participating in WIC to inform the effective design of the app features and user interface

An intergenerational androgenic mechanism of female intrasexual competition in the cooperatively breeding meerkat.

Female intrasexual competition can be intense in cooperatively breeding species, with some dominant breeders (matriarchs) limiting reproduction in subordinates via aggression, eviction or infanticide. In males, such tendencies bidirectionally link to testosterone, but in females, there has been little systematic investigation of androgen-mediated behaviour within and across generations. In 22 clans of wild meerkats (Suricata suricatta), we show that matriarchs 1) express peak androgen concentrations during late gestation, 2) when displaying peak feeding competition, dominance behaviour, and evictions, and 3) relative to subordinates, produce offspring that are more aggressive in early development. Late-gestation antiandrogen treatment of matriarchs 4) specifically reduces dominance behaviour, is associated with infrequent evictions, decreases social centrality within the clan, 5) increases aggression in cohabiting subordinate dams, and 6) reduces offspring aggression. These effects implicate androgen-mediated aggression in the operation of female sexual selection, and intergenerational transmission of masculinised phenotypes in the evolution of meerkat cooperative breeding

Validation of an algorithm using inpatient electronic health records to determine the presence and severity of cirrhosis in patients with hepatocellular carcinoma in England: an observational study.

OBJECTIVES:Outcomes in hepatocellular carcinoma (HCC) are determined by both cancer characteristics and liver disease severity. This study aims to validate the use of inpatient electronic health records to determine liver disease severity from treatment and procedure codes. DESIGN:Retrospective observational study. SETTING:Two National Health Service (NHS) cancer centres in England. PARTICIPANTS:339 patients with a new diagnosis of HCC between 2007 and 2016. MAIN OUTCOME:Using inpatient electronic health records, we have developed an optimised algorithm to identify cirrhosis and determine liver disease severity in a population with HCC. The diagnostic accuracy of the algorithm was optimised using clinical records from one NHS Trust and it was externally validated using anonymised data from another centre. RESULTS:The optimised algorithm has a positive predictive value (PPV) of 99% for identifying cirrhosis in the derivation cohort, with a sensitivity of 86% (95% CI 82% to 90%) and a specificity of 98% (95% CI 96% to 100%). The sensitivity for detecting advanced stage cirrhosis is 80% (95% CI 75% to 87%) and specificity is 98% (95% CI 96% to 100%), with a PPV of 89%. CONCLUSIONS:Our optimised algorithm, based on inpatient electronic health records, reliably identifies and stages cirrhosis in patients with HCC. This highlights the potential of routine health data in population studies to stratify patients with HCC according to liver disease severity

Evaluating Global Health Partnerships: A Case Study of a Gavi HPV Vaccine Application Process in Uganda

Background: Global health partnerships have grown rapidly in number and scope, yet there has been less emphasis on their evaluation. Gavi, the Vaccine Alliance, is one such public-private partnership; in Gavi-eligible countries partnerships are dynamic networks of immunization actors who work together to support all stages and aspects of Gavi support. This paper describes a conceptual framework – the partnership framework – and analytic approach for evaluating the perceptions of partnerships’ added value as well as the results from an application to one case in Uganda. Methods: We used a mixed-methods case study design embedded in the Gavi Full Country Evaluations (FCE) to test the partnership framework on Uganda’s human papillomavirus (HPV) vaccine application partnership. Data from document review, interviews, and social network surveys enabled the testing of the relationships between partnership framework domains (context, structure, practices, performance, and outcomes). Topic guides were based on the framework domains and network surveys identified working together relationships, professional trust, and perceptions of the effectiveness, efficiency, and legitimacy of the partnership’s role in this process. Results: Data from seven in-depth interviews, 11 network surveys and document review were analyzed according to the partnership framework, confirming relationships between the framework domains. Trust was an important contributor to the perceived effectiveness of the process. The network was structured around the EPI program, who was considered the leader of this process. While the structure and composition of the network was largely viewed as supporting an effective and legitimate process, the absence of the Ministry of Education (MoE) may have had downstream consequences if this study’s results had not been shared with the Ministry of Health (MoH) and acted upon. The partnership was not perceived to have increased the efficiency of the process, perhaps as a result of unclear or absent guidelines around roles and responsibilities. Conclusion: The health and functioning of global health partnerships can be evaluated using the framework and approach presented here. Network theory and methods added value to the conceptual and analytic processes and we recommend applying this approach to other global health partnerships to ensure that they are meeting the complex challenges they were designed to address