Decoding Student Speech Rights: Clarification and Applica-tion of Supreme Court Principles to Online Student Speech Cases

This Comment identifies the underlying principles of Supreme Court precedent governing student speech rights and applies those principles, as appropriate, to analyze online student speech. Part I provides a background of the four Supreme Court cases governing student speech. Four factors are identified from the Supreme Court decisions that continue to guide the analysis of student speech rights: sponsorship, location, effect, and content. Part II explores lower courts’ confusion in applying the four factors to online student speech cases. Finally, Part III examines the factors applicable to online student speech and provides guidance for future courts to analyze online student speech rights. As the predominant Supreme Court precedent, the Tinker standard should be used to analyze online student speech cases because it correctly addresses the effect of a student’s speech felt within the school. Further, three categories are presented that should guide courts’ assessment of the content of online student speech: outrageous or inherently offensive speech; speech that is focused or targeted toward the school, students, or faculty; and general school-related speech. Lower courts need a standard to analyze student speech, but until the Supreme Court specifically rules on online student speech, the principles set forth in previous rulings must be consistently applied

Reducing Urinary Tract Infections in Adult Hospitalized Patients during the COVID-19 Pandemic: A Quality Improvement Project

Background: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections, leading to increased morbidity and mortality in hospitalized adult patients. Methods: An interdisciplinary team initiated a quality improvement project to help reduce CAUTIs in a South Florida hospital. The project included using a CAUTI bundle consisting of indwelling catheter protocols, electronic bladder management order sets, nursing staff education, and implementation of external urinary catheters during the years 2020 through 2022. Results: The CAUTI bundle demonstrated positive outcomes in decreasing CAUTI rates. During our fiscal year 2022, there were 63% fewer CAUTIs (n = 23) compared to 2020 (n = 62). Conclusion: We reached our organizational goals of decreasing CAUTI rates to 10% below the national benchmark and improving patient outcomes

Detrimental effects of duplicate reads and low complexity regions on RNA- and ChIP-seq data

Background Adapter trimming and removal of duplicate reads are common practices in next-generation sequencing pipelines. Sequencing reads ambiguously mapped to repetitive and low complexity regions can also be problematic for accurate assessment of the biological signal, yet their impact on sequencing data has not received much attention. We investigate how trimming the adapters, removing duplicates, and filtering out reads overlapping low complexity regions influence the significance of biological signal in RNA- and ChIP-seq experiments. Methods We assessed the effect of data processing steps on the alignment statistics and the functional enrichment analysis results of RNA- and ChIP-seq data. We compared differentially processed RNA-seq data with matching microarray data on the same patient samples to determine whether changes in pre-processing improved correlation between the two. We have developed a simple tool to remove low complexity regions, RepeatSoaker, available at https://github.com/mdozmorov/RepeatSoaker, and tested its effect on the alignment statistics and the results of the enrichment analyses. Results Both adapter trimming and duplicate removal moderately improved the strength of biological signals in RNA-seq and ChIP-seq data. Aggressive filtering of reads overlapping with low complexity regions, as defined by RepeatMasker, further improved the strength of biological signals, and the correlation between RNA-seq and microarray gene expression data. Conclusions Adapter trimming and duplicates removal, coupled with filtering out reads overlapping low complexity regions, is shown to increase the quality and reliability of detecting biological signals in RNA-seq and ChIP-seq data

The Creation of a Critical Care Admission Pressure Injury Prevention Cart to Reduce Hospital-Acquired Pressure Injuries

The goal of this process improvement initiative is to reduce hospital-acquired pressure injuries related to Covid-19 with Critical Care patients. Critically ill and ventilated patients require prone position therapy and prolonged ventilator times place the patient at risk for hospital acquired conditions and pressure injuries. The Critical Care team created a Critical Care Admission Pressure Injury Prevention Cart that contains preventative dressings for all pressure areas at risk. The Critical Care Admission Pressure Injury Prevention Cart has significantly reduced the pressure injury rate. With the emergence of the pandemic and additional surges, pressure injuries continued to be on the rise due to prone position therapy. The Critical Care team worked with the system and developed prone position protocols, which included preventative dressings for all areas at risk. Prior to the implementation of the admission cart, Critical Care ended fiscal year 2022, quarter one, with fifty-three hospital acquired pressure injuries. Last December and early January 2022 there was another surge of Covid-19. The Critical Care team implemented the admission cart in January 2022. From January 2022 through September 2022, there has been an 98% reduction. The cart has been successful for Critical Care, and Baptist Hospital implemented the cart in all high acuity areas. This cart was a multidisciplinary practice, which consists of nursing, the wound and skin team, respiratory care, and leadership working together towards the goal of patient safety and pressure injury prevention

The ACER pollen and charcoal database: a global resource to document vegetation and fire response to abrupt climate changes during the last glacial period

Quaternary records provide an opportunity to examine the nature of the vegetation and fire responses to rapid past climate changes comparable in velocity and magnitude to those expected in the 21st-century. The best documented examples of rapid climate change in the past are the warming events associated with the Dansgaard–Oeschger (D–O) cycles during the last glacial period, which were sufficiently large to have had a potential feedback through changes in albedo and greenhouse gas emissions on climate. Previous reconstructions of vegetation and fire changes during the D–O cycles used independently constructed age models, making it difficult to compare the changes between different sites and regions. Here, we present the ACER (Abrupt Climate Changes and Environmental Responses) global database, which includes 93 pollen records from the last glacial period (73–15 ka) with a temporal resolution better than 1000 years, 32 of which also provide charcoal records. A harmonized and consistent chronology based on radiometric dating (14C, 234U∕230Th, optically stimulated luminescence (OSL), 40Ar∕39Ar-dated tephra layers) has been constructed for 86 of these records, although in some cases additional information was derived using common control points based on event stratigraphy. The ACER database compiles metadata including geospatial and dating information, pollen and charcoal counts, and pollen percentages of the characteristic biomes and is archived in Microsoft AccessTM at https://doi.org/10.1594/PANGAEA.870867

Decoding Student Speech Rights: Clarification and Applica-tion of Supreme Court Principles to Online Student Speech Cases

This Comment identifies the underlying principles of Supreme Court precedent governing student speech rights and applies those principles, as appropriate, to analyze online student speech. Part I provides a background of the four Supreme Court cases governing student speech. Four factors are identified from the Supreme Court decisions that continue to guide the analysis of student speech rights: sponsorship, location, effect, and content. Part II explores lower courts’ confusion in applying the four factors to online student speech cases. Finally, Part III examines the factors applicable to online student speech and provides guidance for future courts to analyze online student speech rights. As the predominant Supreme Court precedent, the Tinker standard should be used to analyze online student speech cases because it correctly addresses the effect of a student’s speech felt within the school. Further, three categories are presented that should guide courts’ assessment of the content of online student speech: outrageous or inherently offensive speech; speech that is focused or targeted toward the school, students, or faculty; and general school-related speech. Lower courts need a standard to analyze student speech, but until the Supreme Court specifically rules on online student speech, the principles set forth in previous rulings must be consistently applied

Efficient design and utilization of rainfall networks

Issued as final repor

Differential kinetics and specificity of EBV-specific CD4+ and CD8+ T cells during primary infection

The generation and maintenance of virus-specific CD4(+) T cells in humans are not well understood. We used short in vitro stimulation assays followed by intracellular cytokine staining to characterize the timing, magnitude, and Ag specificity of CD4(+) T cells over the course of primary EBV infection. Lytic and latent protein-specific CD4(+) T cells were readily detected at presentation with acute infectious mononucleosis and declined rapidly thereafter. Responses to BZLF-1, BMLF-1, and Epstein-Barr nuclear Ag-3A were more commonly detected than responses to Epstein-Barr nuclear Ag-1. Concurrent analyses of BZLF-1-specific CD4(+) and CD8(+) T cells revealed differences in the expansion, specificity, and stability of CD4(+) and CD8(+) T cell-mediated responses over time. Peripheral blood EBV load directly correlated with the frequency of EBV-specific CD4(+) T cell responses at presentation and over time, suggesting that EBV-specific CD4(+) T cell responses are Ag-driven

Zika Virus Exhibits Lineage-Specific Phenotypes in Cell Culture, in Aedes aegypti Mosquitoes, and in an Embryo Model

Zika virus (ZIKV) has quietly circulated in Africa and Southeast Asia for the past 65 years. However, the recent ZIKV epidemic in the Americas propelled this mosquito-borne virus to the forefront of flavivirus research. Based on historical evidence, ZIKV infections in Africa were sporadic and caused mild symptoms such as fever, skin rash, and general malaise. In contrast, recent Asian-lineage ZIKV infections in the Pacific Islands and the Americas are linked to birth defects and neurological disorders. The aim of this study is to compare replication, pathogenicity, and transmission efficiency of two historic and two contemporary ZIKV isolates in cell culture, the mosquito host, and an embryo model to determine if genetic variation between the African and Asian lineages results in phenotypic differences. While all tested isolates replicated at similar rates in Vero cells, the African isolates displayed more rapid viral replication in the mosquito C6/36 cell line, yet they exhibited poor infection rates in Aedes aegypti mosquitoes compared to the contemporary Asian-lineage isolates. All isolates could infect chicken embryos; however, infection with African isolates resulted in higher embryo mortality than infection with Asian-lineage isolates. These results suggest that genetic variation between ZIKV isolates can significantly alter experimental outcomes