Designing a Free Academic Early Alert System

This manuscript describes the development and implementation of a cloud-based, academic early alert system using Google Sheets. It was written for a non-computer savvy person to be able to develop the early alert system. By creating a Master Sheet and using the syntax from the share function of Google Sheets, a unique sheet can be created for each advisor that limits information sharing of their specific advisees. By adding a Google Form to the sheet, advisor interventions can be captured that reflect interventions made as a result of the early alert sheet. Approximately 52% of students were identified on the early alert sheet by having at least one non-passing score on an exam. There were 35-50% of faculty advisors who documented their interventions in the sheet. The template and coding used to develop this academic early alert sheet may be applied to other central documentation needs, such as professionalism early alert. Conflict of Interest Dr. Welch reports owning stock in Alphabet, Inc, however, was not involved in the selection of Google as the preferred platform at this institution.   Type: Not

Using Mock Interviews to Evaluate an Interprofessional Education (IPE) Curriculum

The aim of this study was to evaluate the influence of targeted team care training in our institution’s interprofessional practice and education (IPE) program on medical and pharmacy students\u27 expression of knowledge and attitudes about team care as measured in a mock interview. Medical and Pharmacy students were recruited to participate in a 20-minute mock interview for an advanced placement position

Duplex assessment of venous reflux and chronic venous insufficiency: The significance of deep venous reflux

AbstractPurpose: This study was undertaken to examine the role of superficial and deep venous reflux, as defined by duplex-derived valve closure times (VCTs), in the pathogenesis of chronic venous insufficiency.Methods: Between January 1992 and November 1995, 320 patients and 500 legs were evaluated with clinical examinations and duplex scans for potential venous reflux. VCTs were obtained with the cuff deflation technique with the patient in the upright position. Imaging was performed at the saphenofemoral junction, the middle segment of the greater saphenous vein, the lesser saphenous vein, the superficial femoral vein, the profunda femoris vein, and the popliteal vein. Not all patients had all segments examined because tests early in the series did not examine the profunda femoris or lesser saphenous vein and because some patients had previous ligation and stripping or venous thrombosis. VCTs were examined for individual segment reflux, grouped into superficial and deep systems, and then correlated with the clinical stage as defined by the SVS/ISCVS original reporting standards in venous disease. Segment reflux was considered present if the VCT was greater than 0.5 seconds, and system reflux was considered present if the sum of the segments was greater than 1.5 seconds. Between-group differences were analyzed with analysis of variance and post hoc tests where appropriate.Results: Sixty-nine limbs studied were in class 0, 149 limbs were in class 1, 168 limbs were in class 2, and 114 limbs were in class 3. VCTs in the superficial veins were significantly lower in class 0 than in the other clinical classes. There was no difference in superficial reflux in the symptomatic limbs (classes 1 to 3). Reflux VCTs in the superficial femoral and popliteal veins increased as the clinical symptoms progressed, with a significant increase in class 3 ulcerated limbs when compared with nonulcerated limbs. The incidence of deep venous reflux was 60% in class 3 limbs, compared with 29% in class 2 limbs, whereas the incidence of superficial venous reflux did not differ among the symptomatic limbs. Isolated superficial femoral and popliteal vein reflux was uncommon, even in class 3 limbs, but combined superficial femoral and popliteal vein reflux was found in 53% of class 3 limbs, compared with 18.5% of class 2 limbs.Conclusions: Reflux in the deep venous system plays a significant role in the progression of chronic venous insufficiency. Deep system reflux increases as clinical changes become more severe, with significant axial reflux contributing to ulcer formation. (J Vasc Surg 1996;24:755-62.

Effects of Arp2 and Arp3 nucleotide-binding pocket mutations on Arp2/3 complex function

Contributions of actin-related proteins (Arp) 2 and 3 nucleotide state to Arp2/3 complex function were tested using nucleotide-binding pocket (NBP) mutants in Saccharomyces cerevisiae. ATP binding by Arp2 and Arp3 was required for full Arp2/3 complex nucleation activity in vitro. Analysis of actin dynamics and endocytosis in mutants demonstrated that nucleotide-bound Arp3 is particularly important for Arp2/3 complex function in vivo. Severity of endocytic defects did not correlate with effects on in vitro nucleation activity, suggesting that a critical Arp2/3 complex function during endocytosis may be structural rather than catalytic. A separate class of Arp2 and Arp3 NBP mutants suppressed phenotypes of mutants defective for actin nucleation. An Arp2 suppressor mutant increased Arp2/3 nucleation activity. Electron microscopy of Arp2/3 complex containing this Arp2 suppressor identified a structural change that also occurs upon Arp2/3 activation by nucleation promoting factors. These data demonstrate the importance of Arp2 and Arp3 nucleotide binding for nucleating activity, and Arp3 nucleotide binding for maintenance of cortical actin cytoskeleton cytoarchitecture

Mechanisms of breast cancer metastasis

Invasive breast cancer tends to metastasize to lymph nodes and systemic sites. The management of metastasis has evolved by focusing on controlling the growth of the disease in the breast/chest wall, and at metastatic sites, initially by surgery alone, then by a combination of surgery with radiation, and later by adding systemic treatments in the form of chemotherapy, hormone manipulation, targeted therapy, immunotherapy and other treatments aimed at inhibiting the proliferation of cancer cells. It would be valuable for us to know how breast cancer metastasizes; such knowledge would likely encourage the development of therapies that focus on mechanisms of metastasis and might even allow us to avoid toxic therapies that are currently used for this disease. For example, if we had a drug that targeted a gene that is critical for metastasis, we might even be able to cure a vast majority of patients with breast cancer. By bringing together scientists with expertise in molecular aspects of breast cancer metastasis, and those with expertise in the mechanical aspects of metastasis, this paper probes interesting aspects of the metastasis cascade, further enlightening us in our efforts to improve the outcome from breast cancer treatments

Exome sequencing of Finnish isolates enhances rare-variant association power.

Exome-sequencing studies have generally been underpowered to identify deleterious alleles with a large effect on complex traits as such alleles are mostly rare. Because the population of northern and eastern Finland has expanded considerably and in isolation following a series of bottlenecks, individuals of these populations have numerous deleterious alleles at a relatively high frequency. Here, using exome sequencing of nearly 20,000 individuals from these regions, we investigate the role of rare coding variants in clinically relevant quantitative cardiometabolic traits. Exome-wide association studies for 64 quantitative traits identified 26 newly associated deleterious alleles. Of these 26 alleles, 19 are either unique to or more than 20 times more frequent in Finnish individuals than in other Europeans and show geographical clustering comparable to Mendelian disease mutations that are characteristic of the Finnish population. We estimate that sequencing studies of populations without this unique history would require hundreds of thousands to millions of participants to achieve comparable association power

Structural-Thermal-Optical-Performance (STOP) Model Development and Analysis of a Field-widened Michelson Interferometer

An integrated Structural-Thermal-Optical-Performance (STOP) model was developed for a field-widened Michelson interferometer which is being built and tested for the High Spectral Resolution Lidar (HSRL) project at NASA Langley Research Center (LaRC). The performance of the interferometer is highly sensitive to thermal expansion, changes in refractive index with temperature, temperature gradients, and deformation due to mounting stresses. Hand calculations can only predict system performance for uniform temperature changes, under the assumption that coefficient of thermal expansion (CTE) mismatch effects are negligible. An integrated STOP model was developed to investigate the effects of design modifications on the performance of the interferometer in detail, including CTE mismatch, and other three- dimensional effects. The model will be used to improve the design for a future spaceflight version of the interferometer. The STOP model was developed using the Comet SimApp'TM' Authoring Workspace which performs automated integration between Pro-Engineer, Thermal Desktop, MSC Nastran'TM', SigFit'TM', Code V'TM', and MATLAB. This is the first flight project for which LaRC has utilized Comet, and it allows a larger trade space to be studied in a shorter time than would be possible in a traditional STOP analysis. This paper describes the development of the STOP model, presents a comparison of STOP results for simple cases with hand calculations, and presents results of the correlation effort to bench-top testing of the interferometer. A trade study conducted with the STOP model which demonstrates a few simple design changes that can improve the performance seen in the lab is also presented

Survey of Collective Instabilities and Beam-Plasma Interactions in Intense Heavy Ion Beams

This paper presents a survey of the present theoretical understanding based on advanced analytical and numerical studies of collective processes and beam-plasma interactions in intense heavy ion beams for applications to ion-beam-driven high energy density physics and heavy ion fusion. The topics include: discussion of the conditions for quiescent beam propagation over long distances; and the electrostatic Harris instability and the transverse electromagnetic Weibel instability in highly anisotropic, intense one-component ion beams. In the longitudinal drift compression and transverse compression regions, collective processes associated with the interaction of the intense ion beam with a charge-neutralizing background plasma are described, including the electrostatic electron-ion two-stream instability, the multispecies electromagnetic Weibel instability, and collective excitations in the presence of a solenoidal magnetic field. The effects of a velocity tilt on reducing two-stream instability growth rates are also discussed. Operating regimes are identified where the possible deleterious effects of collective processes on beam quality are minimized

The science of clinical practice: disease diagnosis or patient prognosis? Evidence about "what is likely to happen" should shape clinical practice.

BACKGROUND: Diagnosis is the traditional basis for decision-making in clinical practice. Evidence is often lacking about future benefits and harms of these decisions for patients diagnosed with and without disease. We propose that a model of clinical practice focused on patient prognosis and predicting the likelihood of future outcomes may be more useful. DISCUSSION: Disease diagnosis can provide crucial information for clinical decisions that influence outcome in serious acute illness. However, the central role of diagnosis in clinical practice is challenged by evidence that it does not always benefit patients and that factors other than disease are important in determining patient outcome. The concept of disease as a dichotomous 'yes' or 'no' is challenged by the frequent use of diagnostic indicators with continuous distributions, such as blood sugar, which are better understood as contributing information about the probability of a patient's future outcome. Moreover, many illnesses, such as chronic fatigue, cannot usefully be labelled from a disease-diagnosis perspective. In such cases, a prognostic model provides an alternative framework for clinical practice that extends beyond disease and diagnosis and incorporates a wide range of information to predict future patient outcomes and to guide decisions to improve them. Such information embraces non-disease factors and genetic and other biomarkers which influence outcome. SUMMARY: Patient prognosis can provide the framework for modern clinical practice to integrate information from the expanding biological, social, and clinical database for more effective and efficient care