Optimizing Anesthesia Providers’ Timing of Administration of Dexamethasone for the Prevention of Post-Operative Nausea and Vomiting: Translating Clinical Guidelines Into Practice

Research has shown that post-operative nausea and vomiting (PONV) is a significant contributing factor to extended recovery times and unwanted hospital admissions following ambulatory surgery. The purpose of this DNP project was to assess current practice regarding administration of dexamethasone for the prevention of PONV, provide information based on best practice guidelines, and assess willingness to change practice based on the guidelines set forth by the Society for Ambulatory Anesthesia (SAMBA). Administration of dexamethasone is aimed at decreasing the incidence of PONV, optimizing PACU times, and increasing patient satisfaction regarding perioperative care. An electronic presentation and survey were emailed to members of the Mississippi Association of Nurse Anesthetists (MANA) for the purpose of educating anesthesia providers about current evidence guiding PONV prevention as well as assess current practice of members. Results were analyzed using descriptive statistics. The majority of CRNAs surveyed were found to administer dexamethasone in accordance with the guidelines set forth by SAMBA. It was also found that the CRNAs surveyed displayed a willingness to change their current practice when provided with an evidence based alternative aimed at optimizing patient outcomes. The results in combination with the guidelines set forth by the Society for Ambulatory Anesthesia were used to make recommendations meant to improve patient outcomes following surgery. These recommendations were disseminated to members of The Mississippi Association of Nurse Anesthetists (MANA) through email as well as the MANA website

Hemp Production Network Effects: Are Producers Tipped Toward Suboptimal Varietal Selection by Their Neighbors?

The 2018 farm bill removed industrial hemp from the Schedule 1 Controlled Substance List. In response, states scrambled to enact hemp legislation. Some hemp flower producers report their hemp fields were cross- pollinated by a neighbor growing a different hemp cultivar. For hemp flower crops, cross- pollination reduces cannabinoid concentration levels within the flower; these concentration levels dictate flower price. We show that in a repeated game, once a sufficiently large percentage of growers decide to plant hemp fiber/seed crops, cross-pollination forces flower growers to convert to fiber/seed to avoid the negative network externality. Over time, a stable, suboptimal Nash equilibrium of reduced flower production results. The most important factor driving this tip to reduced flower production is pollen transmission rates between fields. This factor can be effectively reduced through either an auction-style quota system directed at seed and fiber cultivars or intertemporal zoning laws that dictate when a particular cultivar can be planted. As applications for hemp growing licenses swell, cross- pollination between farmers becomes increasingly likely. If left unchecked by policy, farm-level income and rural economic development will be suppressed

In deciding how to deliver public services, bureaucrats, not citizens, often have the loudest voice

Recent years have seen a growing movement for citizens to have a greater voice in how government services are designed and delivered – known as New Public Governance. In new research which examines regional advisory boards in the Department of Energy, James Tanner and Sarah L. Young find that when citizens and bureaucrats had similar political ideologies, citizens’ views had an influence on decision making, but when they disagreed, the agency favored bureaucrats’ opinions over citizens’ recommendations. They argue that while citizen participation matters, it may not be the holistic solution for governments that New Public Governance purports it to be

Adapting network theory for spatial network externalities in agriculture: A case study on hemp cross-pollination

Growers have increasingly expressed frustration over the negative externalities created by their neighbor\u27s production practices. These spatial agricultural network problems include issues such as cross-pollination and herbicide drift. We develop novel methods for estimating parameters that allow us to adapt and apply general network diffusion models to these spatial agricultural network problems. Doing so allows us to calculate externality damage within a region and calculate cost-effective policies for alleviating that externality. We empirically illustrate, motivate, and test this approach by applying it to hemp. We find that network structure is an important factor in externality size and cost-effective policy response for spatial agricultural network problems. We also find that policies that are implemented early and proactively are more likely to be successful and cost effective than policies implemented retroactively. Finally, we find that in our application of limiting the cross-pollination damage experienced by growers of feminized hemp from non-feminized hemp growers, the most cost-effective policy is to establish a regional quota on non-feminized production combined with intertemporal cultivar spacing. This policy response will likely change across time and region as economic and network variables evolve

Mentally Healthy and Happy Exercise Your Mind

https://scholarworks.moreheadstate.edu/student_scholarship_posters/1014/thumbnail.jp

Sex and Age Differences in Trail Half Marathon Running

International Journal of Exercise Science 11(6): 281-289, 2018. Female participation is growing in trail running races. The purpose was to evaluate sex and age differences in top finishers of a trail running half marathon. Velocity differences between males (M) and females (F) were determined for the top 10 finishers of the Moab Trail Half Marathon from 2012 - 2015 across age, and by finishing place. Differences between age category and between sexes were determined through ANOVA with significance accepted at P \u3c 0.05. A significant difference for running velocity was present between sexes at each age category (20-29 yr F = 2.9±0.3, M = 3.4±0.4 m·sec-1; 30-39 yr F = 2.8±0.3, M = 3.3±0.3; 40-49 yr F = 2.7±0.3, M = 3.0±0.5; 50-59 yr F = 2.3±0.2, M = 2.8±0.3; 60-69 yr F = 1.6±0.3, M = 2.2±0.4; P \u3c 0.0001). Sex difference in trail running velocity was consistent (~13%) among all age categories with exception of the oldest group (33%, P = 0.0001). There were significantly greater female finishers in every age category (20 - 29 yr F = 107±18, M = 56±1;, 30 - 39 yr F = 150±34, M = 84±21; 40 - 49 yr F = 112±17, M = 64±16; P \u3c 0.01) until 50 - 59 yr (F = 48±13, M = 41±14; P = 0.50). These data indicate that the widening gap in sex differences observed in road races are ameliorated in a trail running environment that has a larger number of female participants

Regulation and Molecular Basis of Environmental Muropeptide Uptake and Utilization in Fastidious Oral Anaerobe Tannerella forsythia

Tannerella forsythia is a Gram-negative oral anaerobe associated with periodontitis. This bacterium is auxotrophic for the peptidoglycan amino sugar N-acetylmuramic (MurNAc) and likely relies on scavenging peptidoglycan fragments (muropeptides) released by cohabiting bacteria during their cell wall recycling. Many Gram-negative bacteria utilize an inner membrane permease, AmpG, to transport peptidoglycan fragments into their cytoplasm. In the T. forsythia genome, the Tanf_08365 ORF has been identified as a homolog of AmpG permease. In order to confirm the functionality of Tanf_08365, a reporter system in an Escherichia coli host was generated that could detect AmpG-dependent accumulation of cytosolic muropeptides via a muropeptide-inducible β-lactamase reporter gene. In trans complementation of this reporter strain with a Tanf_08365 containing plasmid caused significant induction of β-lactamase activity compared to that with an empty plasmid control. These data indicated that Tanf_08365 acted as a functional muropeptide permease causing accumulation of muropeptides in E. coli and thus suggested that it is a permease involved in muropeptide scavenging in T. forsythia. Furthermore, we showed that the promoter regulating the expression of Tanf_08365 was activated significantly by a hybrid two-component system regulatory protein, GppX. We also showed that compared to the parental T. forsythia strain a mutant lacking GppX in which the expression of AmpG was reduced significantly attenuated in utilizing free muropeptides. In summary, we have uncovered the mechanism by which this nutritionally fastidious microbe accesses released muropeptides in its environment, opening up the possibility of targeting this activity to reduce its numbers in periodontitis patients with potential benefits in the treatment of disease

Bayesian Hypothesis Testing in Latent Variable Models

Hypothesis testing using Bayes factors (BFs) is known not to be well defined under the improper prior. In the context of latent variable models, an additional problem with BFs is that they are difficult to compute. In this paper, a new Bayesian method, based on decision theory and the EM algorithm, is introduced to test a point hypothesis in latent variable models. The new statistic is a by-product of the Bayesian MCMC output and, hence, easy to compute. It is shown that the new statistic is easy to interpret and appropriately defined under improper priors because the method employs a continuous loss function. The method is illustrated using a one-factor asset pricing model and a stochastic volatility model with jumps

Characterization of Carbonyl Compounds in the Ambient Air of an Industrial City in Korea

The purpose of this study was to characterize spatial and temporal variations of carbonyl compounds in Gumi city, where a number of large electronic-industrial complexes are located. Carbonyl samples were collected at five sites in the Gumi area: three industrial, one commercial, and one residential area. Sampling was carried out throughout a year from December 2003 to November 2004. At one industrial site, samples were taken every six days, while those of the other sites were for seven consecutive days in every season. Each sample was collected for 150 minutes and at intervals of three times a day (morning, afternoon, and evening). A total of 476 samples were analyzed to determine 15 carbonyl compounds by the USEPA TO-11A (DNPH-cartridge/HPLC) method. In general, acetaldehyde appeared to be the most abundant compound, followed by formaldehyde, and acetone+acrolein. Mean concentrations of acetaldehyde were two to three times higher in the industrial sites than in the other sites, with its maximum of 77.7 ppb. In contrast, ambient levels of formaldehyde did not show any significant difference between the industrial and non-industrial groups. Its concentrations peaked in summer probably due to the enhanced volatilization and photochemical reactivity. These results indicate significant emission sources of acetaldehyde in the Gumi industrial complexes. Mean concentrations of organic solvents (such as acetone+acrolein and methyl ethyl ketone) were also significantly high in industrial areas. In conclusion, major sources of carbonyl compounds, including acetaldehyde, are strongly associated with industrial activities in the Gumi city area

The enigmatic core L1451-mm: a first hydrostatic core? or a hidden VeLLO?

We present the detection of a dust continuum source at 3-mm (CARMA) and 1.3-mm (SMA), and 12CO(2-1) emission (SMA) towards the L1451-mm dense core. These detections suggest a compact object and an outflow where no point source at mid-infrared wavelengths is detected using Spitzer. An upper limit for the dense core bolometric luminosity of 0.05 Lsun is obtained. By modeling the broadband SED and the continuum interferometric visibilities simultaneously, we confirm that a central source of heating is needed to explain the observations. This modeling also shows that the data can be well fitted by a dense core with a YSO and disk, or by a dense core with a central First Hydrostatic Core (FHSC). Unfortunately, we are not able to decide between these two models, which produce similar fits. We also detect 12CO(2-1) emission with red- and blue-shifted emission suggesting the presence of a slow and poorly collimated outflow, in opposition to what is usually found towards young stellar objects but in agreement with prediction from simulations of a FHSC. This presents the best candidate, so far, for a FHSC, an object that has been identified in simulations of collapsing dense cores. Whatever the true nature of the central object in L1451-mm, this core presents an excellent laboratory to study the earliest phases of low-mass star formation.Comment: 15 pages, 9 figures, emulateapj. Accepted by Ap