Simulation to Application. The Use of Computer Simulations to Improve Real-World Application of Learning

Simulations have been used in training and education for years to aid students in gaining the skills needed to complete a task in a low risk environment. However, students can have trouble connecting the skills used in the simulated working environments to skills that are needed to be applied in the real-world environment, referred to as adaptive transfer. The simulations referred to in this study are simulated environments that mirror students kill application, not a simulation of an event that is meant to aid students in the development of concept knowledge around the demonstrated event. This study examines students\u27 ability to transfer skills learned during a simulation activity to that of a real-world application setting. The study is situated within an introductory engineering computing course in which students are required to work within MyITLab to gain familiarity with using Microsoft Office Software, specifically Microsoft Excel. In this setting, students are expected to use high fidelity simulations, complete online course work based upon these simulations, and then complete a comprehensive exam to demonstrate skills learned with the real-world application. Guided by Kolb\u27s experiential learning theory, end of course surveys were implemented to investigate student self-efficacy, the adaptive transfer process, and students\u27 perceived ability to successfully use this software for real world productivity outside of the classroom environment. Survey questions focused upon the student experience when working with simulation software and how using the software enabled them to use Microsoft Excel effectively. Survey results were correlated with course grades from preparation simulation activities and the final application exam. The implementation of simulated activities within the course was found to reflectively engage students with the content of the activity and provide students with a true experimental environment in order to create a real-world project. By gaining a better understanding of how students transfer knowledge from the simulated activity environment to the application environment, while capturing individual learning preferences, instructors will be able to better aid students to more effectively transition skills between different types of environments and create a more holistic learning environment that converts theoretical understanding into practical application

Poll Everywhere! Even in the Classroom: An Investigation into the Impact of Using PollEverwhere in a Large-Lecture Classroom

Over the past several years, there has been a call in higher education to move from traditional lecturing to a more active classroom. However, many faculty members face multiple challenges when attempting to make a large lecture (over 100 students) an active learning environment. One way researchers have suggested engaging a large lecture is through Concept Tests and Peer Instruction, which can require additional resources to be purchased by students, such as electronic response systems or clickers. This study will investigate the applicability of utilizing the free software PollEverywhere, which can be accessed using student cell phones (Text messages and Twitter) or personal laptop computers (www.pollev.com), as a potential method to improve student engagement by open-ended, reflective, multiple-choice, and content specific questions in a more efficient manner as perceived by students in a large-lecture classroom. The purpose of this study is to investigate the impact of implementing polling software (PollEverywhere) on student engagement in an introductory computer science large lecture classroom (n = 291). The ease of use of this technology can help with the adoption of this active learning strategy. Research needs to be done to measure the impact of this software. During the fall semester of 2013, a pilot study was completed in an introductory computing course for non-computer science majors. During lecture, students were regularly asked to use the PollEverywhere software to respond to open-ended, reflective, multiple-choice, and content specific questions. At the end of the semester, students were asked to complete the survey to gauge if using the PollEverywhere software specifically changed their views of the course or about using response systems int he class. The results were generally positive with many of the students stating they enjoyed using PollEverywhere and felt more engaged when PollEverywhere was used. More students felt more engaged with the open-ended questions than with multiple choice questions. Being able to ask open-ended questions is a benefit of using PollEverywhere over a traditional clicker system as well. The pilot study results uncovered a number of supportive elements for using PollEverywhere which will be investigated further in the next stage of the study

Training and Resources for Gender Inclusive Teamwork

TARGIT (Training and Resources for Gender Inclusive Teamwork) is a collaborative development and content project for a new, open-access, online training tool. TARGIT was created by a team of engineering education researchers and faculty development specialists. The researchers summarized and condensed the body of literature about teamwork into four areas: team formation, team roles, team facilitation, and team evaluation. These areas were then turned into 4 modules by the faculty development specialists. The modules guide users through various ways in which teamwork can be problematic for women and other underrepresented groups. Users then complete interactive activities in which they apply their newly gained knowledge to situations they might encounter in the classroom

Overlap subtype of chronic graft-versus-host disease is associated with an adverse prognosis, functional impairment, and inferior patient-reported outcomes: A Chronic Graft-versus-Host Disease Consortium study

Background The National Institutes of Health Consensus Conference proposed the term “overlap” graft-versus-host disease to describe the situation when both acute and chronic graft-versus-host disease are present. Design and Methods We examined whether the overlap subtype of graft-versus-host disease was associated with a different prognosis, functional limitations, or patient-reported outcomes compared to “classic” chronic graft-versus-host disease without any acute features. Results Prospective data were collected from 427 patients from nine centers. Patients were classified as having overlap (n=352) or classic chronic (n=75) graft-versus-host disease based on reported organ involvement. Overlap cases had a significantly shorter median time from transplantation to cohort enrollment (P=0.01), were more likely to be incident cases (P\u3c0.001), and had a lower platelet count at onset of the graft-versus-host disease (P\u3c0.001). Patients with overlap graft-versus-host disease had significantly greater functional impairment measured by a 2-minute walk test, higher symptom burden and lower Human Activity Profile scores. Quality of life was similar, except patients with overlap graft-versus-host disease had worse social functioning, assessed by the Short Form-36. Multivariable analysis utilizing time-varying covariates demonstrated that the overlap subtype of graft-versus-host disease was associated with worse overall survival (HR 2.1, 95% CI 1.1–4.7; P=0.03) and higher non-relapse mortality (HR 2.8, 95% CI 1.2–8.3; P=0.02) than classic chronic graft-versus-host disease. Conclusions These findings suggest that the presence of acute features in patients with chronic graft-versus-host disease is a marker of adverse prognosis, greater functional impairment, and higher symptom burden

Mucositis after Allogeneic Hematopoietic Stem Cell Transplantation: A Cohort Study of Methotrexate- and Non-Methotrexate-Containing Graft-versus-Host Disease Prophylaxis Regimens

AbstractOral mucositis occurs in up to 75% of recipients of high-dose chemoradiotherapy conditioning regimens used for allogeneic hematopoietic stem cell transplantation (HSCT). As a result of mucositis, narcotic analgesia and total parenteral nutrition (TPN) are commonly required after HSCT. Methotrexate, an antiproliferative graft-versus-host disease (GVHD) prophylaxis agent, impairs mucosal regeneration and worsens and prolongs mucositis. We assessed the effect of substituting sirolimus for methotrexate as GVHD prophylaxis on outcomes associated with mucositis. Two patient cohorts undergoing allogeneic HLA-matched related donor peripheral blood stem cell transplantation with cyclophosphamide/total body irradiation conditioning were prospectively analyzed for mucositis severity and retrospectively reviewed for correlative outcomes. GVHD prophylaxis consisted of sirolimus/tacrolimus (ST) in the study group and tacrolimus/methotrexate (TM) in the control group. Thirty patients received ST and 24 patients received TM as GVHD prophylaxis between October 2000 and May 2003. Mild, moderate, and severe mucositis was noted in 37%, 57%, and 7% of the ST group and 8%, 42%, and 50% of the TM group (P = .0002). Less TPN was used in the ST group than the TM group (17% versus 43% of posttransplantation hospital days; P = .02). The total number of narcotic days was lower in the ST group in comparison with the TM group (median, 13.5 versus 17 days; P = .08). The time to first hospital discharge was shorter in the ST group compared with the TM group (median, 18 versus 22 days; P = .07). The substitution of sirolimus for methotrexate as GVHD prophylaxis is associated with a reduction in mucositis severity. As a result, TPN and narcotic use are reduced, and hospitalization duration is shortened. Less toxic GVHD prophylaxis regimens without methotrexate may have a significant effect on patient quality of life, patient outcomes, and economic outcomes associated with allogeneic stem cell transplantation

Crime in College Park: understanding crime levels, perceptions, and environmental design in an off-campus student-occupied neighborhood

Gemstone Team Crime Prevention and PerceptionDespite recently decreasing crime rates in College Park, fear of crime remains high. Additionally, while the crime rate on the University of Maryland campus is relatively low compared to the national average, crime in off-campus areas continues to be a problem. Crime mapping using spatial analysis techniques allowed the researchers to identify Old Town College Park as a student-occupied, off-campus residential area with a relatively high rate of larcenies, burglaries, and robberies. Through a longitudinal case study, quantitative and qualitative data about crime and students' perceptions of crime in the target were collected. These data were used to identify trends in how the rate of crime and perception changed in response to the implementation of CCTV cameras in Old Town. These data were also used to identify the correlation between crime level and the existing environmental design of the neighborhood's housing properties

Targeting tumour re-wiring by triple blockade of mTORC1, epidermal growth factor, and oestrogen receptor signalling pathways in endocrine-resistant breast cancer

Background Endocrine therapies are the mainstay of treatment for oestrogen receptor (ER)-positive (ER+) breast cancer (BC). However, resistance remains problematic largely due to enhanced cross-talk between ER and growth factor pathways, circumventing the need for steroid hormones. Previously, we reported the anti-proliferative effect of everolimus (RAD001-mTORC1 inhibitor) with endocrine therapy in resistance models; however, potential routes of escape from treatment via ERBB2/3 signalling were observed. We hypothesised that combined targeting of three cellular nodes (ER, ERBB, and mTORC1) may provide enhanced long-term clinical utility. Methods A panel of ER+ BC cell lines adapted to long-term oestrogen deprivation (LTED) and expressing ESR1wt or ESR1Y537S, modelling acquired resistance to an aromatase-inhibitor (AI), were treated in vitro with a combination of RAD001 and neratinib (pan-ERBB inhibitor) in the presence or absence of oestradiol (E2), tamoxifen (4-OHT), or fulvestrant (ICI182780). End points included proliferation, cell signalling, cell cycle, and effect on ER-mediated transactivation. An in-vivo model of AI resistance was treated with monotherapies and combinations to assess the efficacy in delaying tumour progression. RNA-seq analysis was performed to identify changes in global gene expression as a result of the indicated therapies. Results Here, we show RAD001 and neratinib (pan-ERBB inhibitor) caused a concentration-dependent decrease in proliferation, irrespective of the ESR1 mutation status. The combination of either agent with endocrine therapy further reduced proliferation but the maximum effect was observed with a triple combination of RAD001, neratinib, and endocrine therapy. In the absence of oestrogen, RAD001 caused a reduction in ER-mediated transcription in the majority of the cell lines, which associated with a decrease in recruitment of ER to an oestrogen-response element on the TFF1 promoter. Contrastingly, neratinib increased both ER-mediated transactivation and ER recruitment, an effect reduced by the addition of RAD001. In-vivo analysis of an LTED model showed the triple combination of RAD001, neratinib, and fulvestrant was most effective at reducing tumour volume. Gene set enrichment analysis revealed that the addition of neratinib negated the epidermal growth factor (EGF)/EGF receptor feedback loops associated with RAD001. Conclusions Our data support the combination of therapies targeting ERBB2/3 and mTORC1 signalling, together with fulvestrant, in patients who relapse on endocrine therapy and retain a functional ER

Biomarker Panel for Chronic Graft-Versus-Host Disease

PURPOSE: To identify diagnostic and prognostic markers of chronic graft-versus-host disease (cGVHD), the major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). PATIENTS AND METHODS: Using a quantitative proteomics approach, we compared pooled plasma samples obtained at matched time points after HCT (median, 103 days) from 35 patients with cGVHD and 18 without cGVHD (data are available via ProteomeXchange with identifier PXD002762). Of 105 proteins showing at least a 1.25-fold difference in expression, 22 were selected on the basis of involvement in relevant pathways and enzyme-linked immunosorbent assay availability. Chemokine (C-X-C motif) ligand 9 (CXCL9) and suppression of tumorigenicity 2 (ST2) also were measured on the basis of previously determined associations with GVHD. Concentrations of the four lead biomarkers were measured at or after diagnosis in plasma from two independent verification cohorts (n = 391) to determine their association with cGVHD. Their prognostic ability when measured at approximately day +100 after HCT was evaluated in plasma of a second verification cohort (n = 172). RESULTS: Of 24 proteins measured in the first verification cohort, nine proteins were associated with cGVHD, and only four (ST2, CXCL9, matrix metalloproteinase 3, and osteopontin) were necessary to compose a four-biomarker panel with an area under the receiver operating characteristic curve (AUC) of 0.89 and significant correlation with cGVHD diagnosis, cGVHD severity, and nonrelapse mortality. In a second verification cohort, this panel distinguished patients with cGVHD (AUC, 0.75), and finally, the panel measured at day +100 could predict cGVHD occurring within the next 3 months with an AUC of 0.67 and 0.79 without and with known clinical risk factors, respectively. CONCLUSION: We conclude that the biomarker panel measured at diagnosis or day +100 after HCT may allow patient stratification according to risk of cGVHD

Durable discontinuation of systemic therapy in patients affected by chronic graft-<i>versus</i>-host disease

Successful treatment of chronic graft-versus-host disease (GvHD) often requires long-term systemic therapy (ST). Durable discontinuation of ST reflects the resolution of active chronic GvHD. We evaluated the factors associated with durable ST discontinuation, defined as cessation of all ST for ≥12 months, using data from two prospectively followed cohorts from the Chronic GvHD Consortium (n=684). Transplant sources were peripheral blood (89%), bone marrow (6.6%), and cord blood (4.4%) from HLA matched related (37.6%), HLA matched unrelated (45%), and other donor types (18%). Half of the patients received non-myeloablative conditioning. The median time from transplantation to chronic GvHD diagnosis was 7.7 months (range, 1.0–141.3) and the median time from chronic GvHD onset to enrollment into the cohorts was 0.9 months (range, 0.0-12.0). The cumulative incidence estimate of durable ST discontinuation was 32% (95% confidence interval: 28%-37%) at 10 years after enrollment into the cohort. Among patients who discontinued ST, the median time from chronic GvHD diagnosis to durable ST discontinuation was 3.6 years (range, 1.2-10.5). In multivariate analysis, patients who received myeloablative conditioning, had chronic GvHD manifested as moderate/severe lower gastrointestinal involvement, and had a higher (worse) Lee symptom overall score were less likely to attain durable ST discontinuation. In contrast, mild lower gastrointestinal involvement and cord blood (vs. peripheral blood) as the graft source were associated with a greater likelihood of ST discontinuation. Although a minority of patients can discontinue ST permanently, most patients require prolonged ST. Viewing chronic GvHD in this way has implications for management approaches

Whey protein mouth drying influenced by thermal denaturation

Whey proteins are becoming an increasingly popular functional food ingredient. There are, however, sensory properties associated with whey protein beverages that may hinder the consumption of quantities sufficient to gain the desired nutritional benefits. One such property is mouth drying. The influence of protein structure on the mouthfeel properties of milk proteins has been previously reported. This paper investigates the effect of thermal denaturation of whey proteins on physicochemical properties (viscosity, particle size, zeta-potential, pH), and relates this to the observed sensory properties measured by qualitative descriptive analysis and sequential profiling. Mouthcoating, drying and chalky attributes built up over repeated consumption, with higher intensities for samples subjected to longer heating times (p < 0.05). Viscosity, pH, and zeta-potential were found to be similar for all samples, however particle size increased with longer heating times. As the pH of all samples was close to neutral, this implies that neither the precipitation of whey proteins at low pH, nor their acidity, as reported in previous literature, can be the drying mechanisms in this case. The increase in mouth drying with increased heating time suggests that protein denaturation is a contributing factor and a possible mucoadhesive mechanism is discussed