Implications of Fatigue and Sleep Loss on Medical Professionals and Countermeasures to Prevent Fatigue

The number of hours worked per individual has long been limited by the law in many professional industries. Recent increases in the incidence of medical and diagnostic errors related to fatigue has led to an increased interest in health care worker fatigue. For human beings, functioning on a 24-hour basis poses unique physiological challenges. Acknowledging and managing these challenges can promote performance, productivity, and safety in 24-hour operations. Ignoring these factors can lead to decrements in human capability and to the potential for incidents and accidents that can result in tremendous societal and individual costs. Long duty hours, reduced sleep periods with limited recovery time, and shift work all contribute to impairments in physical, cognitive, and emotional functioning. Fatigue affects a healthcare provider\u27s personal health and well-being, patient health and safety, performance of job-related tasks, and professionalism. As the incidence of medical errors due to fatigue increases, it is important to educate medical professionals on the effects of fatigue and measures that can be used to prevent or treat fatigue. Information regarding the impact of fatigue and countermeasures to prevent fatigue in medical professionals will be gathered using a systematic literature review and published case studies. The areas of focus will include sleep cycles, the effects on provider and patient health, and ways to manage sleep loss and fatigue both for the healthcare provider and among management personnel. The goal of this independent project is to provide information to currently practicing medical professionals in an attempt to increase the awareness of fatigue among the healthcare field. Primarily focusing on Certified Registered Nurse Anesthetists and Student Registered Nurse Anesthetists this project will be used to increase the knowledge base on how to prevent or treat fatigue that may lead to serious medical errors affecting healthcare provider and patient safety

Rethinking Reiche

Part I of the study examines the differences between two environmental assessment methods for the K‐12 education sector: the United States Green Building Council’s (USGBC) LEED Schools Version 3.0 and the British Research Establishment’s (BRE) BREEAM Education issue 2.0. Credit requirements are compared side‐by‐side and against recommendations from researchers in areas such as acoustics, lighting and indoor environment quality. Strengths in the two schemes and areas for improvement are highlighted, with acknowledgement that each scheme offers components and techniques from which the other could benefit. Part II of the study introduces the Howard C. Reiche Community School in Portland, Maine. Designed as an open‐plan school in the 1970’s this configuration is currently seen as a barrier to teaching and learning in the school which is slated for renovation by the Portland Public School District. Part III of the study looks towards precedents in education which have followed either the LEED or BREEAM assessment methods and Part IV of the study provides a design proposal for the Howard C. Reiche Community School’s renovation

Curriculum Decisions: Assessing and Updating IS Curriculum

The increased level of accountability in higher education has prompted many vomputer-related programs to seek accreditation. As accrediting agencies continue to define and refine exactly what these degrees should entail, institutions struggle with the decisions of aligning their curriculum with a dynamic set of standards set by an outside agency, focusing on the needs identified by their own assessment data, or attempting to marry the two. This paper details how one institution completed comprehensive reviews of their curriculum under two different projects: Expanding Pathways for Educational Development and Information Technology Experiences, an NSF-funded research project investigation and examination of curriculum and regional needs and an ABET evaluation and site visit. The focus of this report is to inform others of local efforts that may be replicated on their campuses, share findings that may be of use to others in similarly situated circumstances, and add to the assessment and accreditation dialog

Influence of wing span on the aerodynamics of wings in ground effect

A computational fluid dynamics study of the influence of wing span has been conducted for an inverted wing with endplates in ground effect. Aerodynamic coefficients were determined for different spans at different ground clearances, highlighting a trend for shorter spans to delay the onset of both separation and resulting loss of negative lift. The vortices at the wing endplates were not observed to change significantly in terms of strength and size; thus, at shorter spans, their influence over a larger percentage of the wing helped the flow stay attached and reduced the severity of the adverse pressure gradient which invokes separation at greater spans. Consequently, it was shown that, compared to a large-span wing, a wing with a shorter span may have a lower lift coefficient but can operate closer to the ground before performance is adversely affected

Implications of compressibility effects for Reynolds-scaled testing of an inverted wing in ground effect

The influence of compressibility around an isolated inverted wing at a fixed Reynolds number was examined as relevant to the issue of wind tunnel scaling effects. Three-dimensional simulations were conducted for low ground clearances, at: full scale and a Mach number of 0.088, at 50% scale at Mach 0.176, and at 25% scale at Mach 0.352. As the scale was reduced, the increasing peak local Mach number between the wing and the ground resulted in a higher propensity of the flow to separate towards the trailing edge, and for incompressible or full-scale CFD to underestimate the lift and drag coefficients by an ever-increasing margin. The lower vortex path was less affected. The results suggest that compressible CFD of a scale experiment ought to be conducted at the same Reynolds number and Mach number as the tunnel test for the best possible correlation at free-stream Mach numbers beyond 0.15

Antibiotic resistance in a changing North: unearthing the effects of disturbance-induced permafrost thaw on the Alaskan soil resistome

Thesis (M.S.) University of Alaska Fairbanks, 2021The evolution of antibiotic resistance in pathogenic bacteria is a major threat at the forefront of public health today. By studying soils, one of the ancestral origins of antibiotic production and resistance, we can gain insight into how antibiotic resistance genes (ARGs) from the environment have contributed to the evolution and emergence of resistance in pathogens. These studies are particularly important in soils where polar amplification and human expansion has already impacted the frequency and intensity of soil disturbance events (e.g., wildfires, deglaciation, land-use). In Alaska these disturbances augment permafrost thaw shifting the biogeochemical properties of active layer soils that structure microbial community composition and hypothetically the resistome (i.e., summation of ARGs). Thus, the goal of this thesis was to assess how soil disturbance, and the subsequent shift in community composition, will affect the types, abundance, and mobility of ARGs that comprise the subarctic soil resistome. In the first chapter I cultured bacteria from a permafrost thaw gradient in Interior Alaska, tested the isolates for susceptibility to antibiotics, annotated their genomes for ARGs, and compared their resistance profiles to a global database of soil bacteria genomes. I found that phylogenic and ecological factors structured the resistome. Additionally, antibiotic resistance phenotypes and genotypes were widespread in the soil isolates suggesting resistance is an intrinsic component of bacterial evolution. In the second chapter, I used long read metagenomics to identify predominant ARGs, ARG host taxa, and the relationship between community composition and ARG abundance. From the long read data, I unearthed major trends in the types of ARGs at our study site and determined ARG abundance had a quadratic relationship with disturbance and negative relationship temporally by year highlighting the complex interplay soil conditions have in structuring the taxa that enrich ARGs in the community. To analyze how individual bacteria contribute to ARGs in the community, I generated metagenome assembled genomes (MAGs) using Hi-C proximity ligation. From the MAGs, I found a significant difference in ARGs per genome between phyla that emphasized how an enrichment of specific bacteria can affect the abundance of ARGs in subarctic soils. I also identified several plasmid-borne ARGs highlighting the potential for horizontal gene transfer. Overall, this thesis provides evidence that ARGs in permafrost-associated soil are structured by disturbance-induced community shifts. Thus, as climate change increases t the frequency of disturbance events that shift the microbial communities in active layer soils, One Health can be impacted by alterations to ARGs comprising the resistome.Institute of Arctic Biology, Alaska Institutional Development Award (IDeA) Network of Biomedical Research Excellence (INBRE), and UAF Biomedical Learning and Student Training (BLaST) program, National Institute of General Medical Sciences of the National Institutes of Health under awards UL1GM118991, TL4GM118992, and RL5GM118990, National Institute of General Medical Sciences of the National Institutes of Health grant 2P20GM103395Introduction -- Chapter 1: Unearthing antibiotic resistance associated with disturbance-induced permafrost thaw in Interior Alaska -- Chapter 2: Disturbance to subarctic soils shapes the resistome via shifts in microbial community composition -- Overall conclusion -- Appendix

Techniques for aerodynamic analysis of cornering vehicles

When a vehicle travels through a corner it can experience a significant change in aerodynamic performance due to the curved path of its motion. The yaw angle of the flow will vary along its length and the relative velocity of the flow will increase with distance from the central axis of its rotation. Aerodynamic analysis of vehicles in the cornering condition is an important design parameter, particularly in motorsport. Most racing-cars are designed to produce downforce that will compromise straight-line speed to allow large gains to be made in the corners. Despite the cornering condition being important, aerodynamicists are restricted in their ability to replicate the condition experimentally. Whirling arms, rotary rigs, curved test sections and bent wind tunnel models are experimental techniques capable of replicating some aspects of the cornering condition, but are all compromised solutions. Numerical simulation is not limited in the same way and permits investigation into the condition. However, cornering introduces significant change to the flowfield and this must be accommodated for in several ways. Boundary conditions are required to be adapted to allow for the curved flow occurring within a non-inertial reference frame. In addition, drag begins to act in a curved path and variation in Re occurs within the domain. Results highlight the importance of using correct analysis techniques when evaluating aerodynamic performance for cornering vehicles

The Aerodynamics of a Cornering Inverted Wing in Ground Effect

For racing car configurations an inverted wing produces negative lift that allows increased levels of acceleration to be maintained through corners. Routine aerodynamic analysis, however, will typically be in the straight-line condition. A numerical analysis of the inverted T026 wing geometry through the curved path of a constant radius corner was conducted. The asymmetrical properties of the oncoming flow resulted in the introduction of a rolling and yawing moment along the span, as well as side-force. Yaw angle, flow curvature and a velocity gradient resulted in changes to the pressure distribution over the wing surface. Primary vortex behaviour was observed to differ significantly in both direction and structure

ISM In-Space Manufacturing

Develop and enable the technologies, materials, and processes required to provide affordable, sustainable on-demand manufacturing, recycling, and repair during Exploration Missions