A Childhood Experience

Non-fiction by Lucy Turecek

Are Independent Double-Checks Vital Prior to Safe Subcutaneous Insulin Administration?

BACKGROUND: With the epidemic of diabetes mellitus projected to rise from 1 in 10 U.S. adults (year 2010) to 1 in 3 by the year 2050, there is a need for health care organizations to prepare nurses to manage the complexity of meeting the needs of patients with diabetes, especially in the timely administration of subcutaneous insulin. The traditionally accepted practice of double-checking subcutaneous insulin before administration, albeit non-evidence-based, poses a clinical problem by imposing an unnecessary demand on nurses’ workload, which places an obstacle to their timely administration of time-critical subcutaneous insulin. PURPOSE: This project aimed to examine if there would be a difference in medication errors surrounding nurses’ subcutaneous insulin administration when their system is altered from an independent double-checking to a single-checking environment. METHODS: This quasi-experimental project was composed of a two-phase pilot study, with the first (double-checking) acting as the control and the second (single-checking) acting as the interventional phase. RESULTS: Over a seven-week period, there were a total of 1,528 opportunities for subcutaneous insulin administration and omission in both phases among the 92 patients included in the sample. There was no significant difference in the “any one error” rates between the double-checking and single-checking phases. Of administration error types, “wrong-time” was predominant and more prevalent during the double-checking phase, which took an average of 11.7 minutes longer. CONCLUSIONS: The traditional double-checking process did not significantly reduce medication error rates and contributed to a longer time lapse from blood glucose check to insulin administration

Electron Capture in Charge-Tagged Peptides. Evidence for the Role of Excited Electronic States

International audienceElectron capture dissociation (ECD) was studied with doubly charged dipeptide ions that were tagged with fixed-charge tris-(2,4,6-trimethoxyphenyl)phosphonium-methylenecarboxamido (TMPP-ac) groups. Dipeptides GK, KG, AK, KA, and GR were each selectively tagged with one TMPP-ac group at the N-terminal amino group while the other charge was introduced by protonation at the lysine or arginine side-chain groups to give (TMPP-ac-peptide + H)2+ ions by electrospray ionization. Doubly tagged peptide derivatives were also prepared from GK, KG, AK, and KA in which the fixed-charge TMPP-ac groups were attached to the N-terminal and lysine side-chain amino groups to give (TMPP-ac-peptide-ac-TMPP)2+ dications by electrospray. ECD of (TMPP-ac-peptide + H)2+ resulted in 72% to 84% conversion to singly charged dissociation products while no intact charge-reduced (TMPP-ac-dipeptide + H)+• ions were detected. The dissociations involved loss of H, formation of (TMPP + H)+, and N–C(alpha) bond cleavages giving TMPP-CH2CONH2+ (c0) and c1 fragments. In contrast, ECD of (TMPP-ac-peptide-ac-TMPP)2+ resulted in 31% to 40% conversion to dissociation products due to loss of neutral TMPP molecules and 2,4,6-trimethoxyphenyl radicals. No peptide backbone cleavages were observed for the doubly tagged peptide ions. Ab initio and density functional theory calculations for (Ph3P-ac-GK + H)2+ and (H3P-ac-GK + H)2+ analogs indicated that the doubly charged ions contained the lysine side-chain NH3+ group internally solvated by the COOH group. The distance between the charge-carrying phosphonium and ammonium atoms was calculated to be 13.1-13.2 Å in the most stable dication conformers. The intrinsic recombination energies of the TMPP+-ac and (GK + H)+ moieties, 2.7 and 3.15 eV, respectively, indicated that upon electron capture the ground electronic states of the (TMPP-ac-peptide + H)+• ions retained the charge in the TMPP group. Ground electronic state (TMPP-ac-GK + H)+• ions were calculated to spontaneously isomerize by lysine H-atom transfer to the COOH group to form dihydroxycarbinyl radical intermediates with the retention of the charged TMPP group. These can trigger cleavages of the adjacent N–C(alpha) bonds to give rise to the c1 fragment ions. However, the calculated transition-state energies for GK and GGK models suggested that the ground-state potential energy surface was not favorable for the formation of the abundant c0 fragment ions. This pointed to the involvement of excited electronic states according to the Utah-Washington mechanism of ECD

Warum Ruhm?

nicht angegebe

Using a Bayesian network to predict barrier island geomorphologic characteristics

© The Author(s), 2015. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Journal of Geophysical Research: Earth Surface 120 (2015): 2452–2475, doi:10.1002/2015JF003671.Quantifying geomorphic variability of coastal environments is important for understanding and describing the vulnerability of coastal topography, infrastructure, and ecosystems to future storms and sea level rise. Here we use a Bayesian network (BN) to test the importance of multiple interactions between barrier island geomorphic variables. This approach models complex interactions and handles uncertainty, which is intrinsic to future sea level rise, storminess, or anthropogenic processes (e.g., beach nourishment and other forms of coastal management). The BN was developed and tested at Assateague Island, Maryland/Virginia, USA, a barrier island with sufficient geomorphic and temporal variability to evaluate our approach. We tested the ability to predict dune height, beach width, and beach height variables using inputs that included longer-term, larger-scale, or external variables (historical shoreline change rates, distances to inlets, barrier width, mean barrier elevation, and anthropogenic modification). Data sets from three different years spanning nearly a decade sampled substantial temporal variability and serve as a proxy for analysis of future conditions. We show that distinct geomorphic conditions are associated with different long-term shoreline change rates and that the most skillful predictions of dune height, beach width, and beach height depend on including multiple input variables simultaneously. The predictive relationships are robust to variations in the amount of input data and to variations in model complexity. The resulting model can be used to evaluate scenarios related to coastal management plans and/or future scenarios where shoreline change rates may differ from those observed historically.U.S. Geological Survey (USGS) Coastal and Marine Geology Program; U.S. Fish and Wildlife Servic

Die „Anderen“ im Klassenzimmer: Othering im Kontext von DaZ in der Lehrer/innenbildung

Der folgende Beitrag ist dem Thema „Othering“ - im Sinne der Herstellung von sozial wirksamer Differenzierung zwischen Menschen „mit und ohne Migrationshintergrund“ gewidmet und bezieht sich auf die schulische Situation in Österreich. Die Auseinandersetzung mit der Thematik erfolgt im Kontext eines Seminars im Rahmen der österreichischen Pflichtschullehrer/innenausbildung an der Pädagogischen Hochschule Wien. Zu Beginn des Beitrags werden wesentliche Fragestellungen der Migrationspädagogik erörtert: Anhand welcher Parameter erfolgt eine gesellschaftliche Grenzziehung zwischen Menschen mit und ohne Migrationsgeschichte? Wie wird diese gesellschaftliche Ordnung produziert und in welchen Bereichen leistet das Schulsystem Vorschub für die (Re-)Produktion? Die Sensibilisierung für die Thematik soll (angehenden) Pädagog/innen helfen, angemessen und professionell im Schulalltag zu agieren. An die theoretische Auseinandersetzung schließt die dramapädagogische Didaktisierung eines literarischen Texts an. Anhand der autobiografischen Erzählung „In Between. Mein Leben in zwei Kulturen“ der jungen österreichischen Autorin Amina Mahdy soll die Dimension der gesellschaftlichen Praxis des „Othering“ ein Stück weit erlebbar gemacht werden. Der Originaltext ist im Anhang nachzulesen und wird durch ein kurzes Interview mit der Autorin ergänzt.Abschließende Bemerkungen zur didaktischen Aufbereitung des Themas „Othering“ im Rahmen des Seminars runden den Beitrag ab

Biological mechanisms underlying inter‐individual variation in factor VIII clearance in haemophilia

Previous studies have highlighted marked inter‐individual variations in factor VIII (FVIII) clearance between patients with haemophilia (PWH). The half‐life of infused FVIII has been reported to vary from as little as 5.3 hours in some adult PWH, up to as long as 28.8 hours in other individuals. These differences in clearance kinetics have been consistently observed using a number of different plasma‐derived and recombinant FVIII products. Furthermore, recent studies have demonstrated that half‐life for extended half‐life (EHL‐) FVIII products also demonstrates significant inter‐patient variation. Since time spent with FVIII trough levels <1% has been shown to be associated with increased bleeding risk in PWH on prophylaxis therapy, this variability in FVIII clearance clearly has major clinical significance. Recent studies have provided significant novel insights into the cellular basis underlying FVIII clearance pathways. In addition, accumulating data have shown that endogenous plasma VWF levels, ABO blood group and age, all play important roles in regulating FVIII half‐life in PWH. Indeed, multiple regression analysis suggests that together these factors account for approximately 34% of the total inter‐individual variation in FVIII clearance observed between subjects with severe haemophilia A. In this review, we consider these and other putative modulators of FVIII half‐life, and discuss the biological mechanisms through which these factors impact upon FVIII clearance in vivo.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156160/2/hae14078.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156160/1/hae14078_am.pd

Data Processing Engine (DPE): Data Analysis Tool for Particle Tracking and Mixed Radiation Field Characterization with Pixel Detectors Timepix

Hybrid semiconductor pixelated detectors from the Timepix family are advanced detectors for online particle tracking, offering energy measurement and precise time stamping capabilities for particles of various types and energies. This inherent capability makes them highly suitable for various applications, including imaging, medical fields such as radiotherapy and particle therapy, space-based applications aboard satellites and the International Space Station, and industrial applications. The data generated by these detectors is complex, necessitating the development and deployment of various analytical techniques to extract essential information. For this purpose, and to aid the Timepix user community, it was designed and developed the "Data Processing Engine" (DPE) as an advanced tool for data processing designed explicitly for Timepix detectors. The functionality of the DPE is structured into three distinct processing levels: i) Pre-processing: This phase involves clusterization and the application of necessary calibrations and corrections. ii) Processing: This stage includes particle classification, employing machine learning algorithms, and the recognition of radiation fields. iii) Post-processing: Involves various analyses, such as directional analysis, coincidence analysis, frame analysis, Compton directional analysis, and the generation of physics products, are performed. The core of the DPE is supported by an extensive experimental database containing calibrations and referential radiation fields of typical environments, including protons, ions, electrons, gamma rays and X-rays, as well as thermal and fast neutrons. To enhance accessibility, the DPE is implemented into various user interface platforms such as a command-line tool, an application programming interface, and as a graphical user interface in the form of a web portal.Comment: 9 pages, proceedings IWORI

Modulating patterns of two-phase flow with electric fields

This paper describes the use of electro-hydrodynamic actuation to control the transition between three major flow patterns of an aqueous-oil Newtonian flowin a microchannel: droplets, beads-on-a-string (BOAS), and multi-stream laminar flow. We observed interesting transitional flow patterns between droplets and BOAS as the electric field was modulated. The ability to control flow patterns of a two-phase fluid in a microchannel adds to the microfluidic tool box and improves our understanding of this interesting fluid behavior