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https://digitalcommons.library.umaine.edu/mmb-vp/2377/thumbnail.jp

Human embryos from overweight and obese women display phenotypic and metabolic abnormalities

STUDY QUESTION Is the developmental timing and metabolic regulation disrupted in embryos from overweight or obese women? SUMMARY ANSWER Oocytes from overweight or obese women are smaller than those from women of healthy weight, yet post-fertilization they reach the morula stage faster and, as blastocysts, show reduced glucose consumption and elevated endogenous triglyceride levels. WHAT IS KNOWN ALREADY Female overweight and obesity is associated with infertility. Moreover, being overweight or obese around conception may have significant consequences for the unborn child, since there are widely acknowledged links between events occurring during early development and the incidence of a number of adult disorders. STUDY DESIGN, SIZE, DURATION We have performed a retrospective, observational analysis of oocyte size and the subsequent developmental kinetics of 218 oocytes from 29 consecutive women attending for ICSI treatment and have related time to reach key developmental stages to maternal bodyweight. In addition, we have measured non-invasively the metabolic activity of 150 IVF/ICSI embryos from a further 29 consecutive women who donated their surplus embryos to research, and have related the data retrospectively to their body mass index (BMI). PARTICIPANTS/MATERIALS, SETTING, METHODS In a clinical IVF setting, we compared oocyte morphology and developmental kinetics of supernumerary embryos collected from overweight and obese women, with a BMI in excess of 25 kg/m2 to those from women of healthy weight. A Primovision Time-Lapse system was used to measure developmental kinetics and the non-invasive COnsumption/RElese of glucose, pyruvate, amino acids and lactate were measured on spent droplets of culture medium. Total triglyceride levels within individual embryos were also determined. MAIN RESULTS AND THE ROLE OF CHANCE Human oocytes from women presenting for fertility treatment with a BMI exceeding 25 kg/m2 are smaller (R2 = −0.45; P = 0.001) and therefore less likely to complete development post-fertilization (P < 0.001). Those embryos that do develop reach the morula stage faster than embryos from women of a BMI < 25 kg/m2

Obtaining and Enforcing a Security Interest in Local Currency under Article 9 of the UCC

Community currency is known by many names including complementary currency, alternative currency, and parallel currency. Community currency operates alongside an official or national currency (e.g., dollars or euros) with the purpose of circulating within a small geographic area to facilitate the sale of goods and services. In other words, community currency refers to a privatized form of currency that is not backed by a government entity. With the increased use of community currency, it has the potential to serve as collateral for a security interest under the Article 9 of the Uniform Commercial Code. Although there are several types of community currency, this article will focus on obtaining and enforcing a security interest in local currency. After analyzing local currency under the UCC in its current form, this comment will offer several suggestions to better handle a security interest in local currency under the UCC

A Friendly Introduction to Mathematical Logic

At the intersection of mathematics, computer science, and philosophy, mathematical logic examines the power and limitations of formal mathematical thinking. In this expansion of Leary’s user-friendly 1st edition, readers with no previous study in the field are introduced to the basics of model theory, proof theory, and computability theory. The text is designed to be used either in an upper division undergraduate classroom, or for self study. Updating the 1st Edition’s treatment of languages, structures, and deductions, leading to rigorous proofs of Gödel’s First and Second Incompleteness Theorems, the expanded 2nd Edition includes a new introduction to incompleteness through computability as well as solutions to selected exercises. Available on Lulu.com, IndiBound.com, and Amazon.com, as well as wholesale through Ingram Content Group.https://knightscholar.geneseo.edu/geneseo-authors/1005/thumbnail.jp

The Cassandra Project- building a sustainable workload activity model for future community and district nursing workforce capacity planning

Purpose This paper presents work in progress from a two year mixed methods study in the UK to evaluate the impact of a community nursing workload activity tool as a mechanism for modelling optimum caseloads to underpin decisions about safe staffing levels. Current methods of measuring workload and output in the community context are not robust enough to capture the complexity of care differences in rural and urban populations. Many teams have heavy caseloads, poor/inappropriate referrals, and an inability to state when capacity has been reached. . Research Aim To develop and evaluate a robust model to predict and plan for optimum community nursing caseload activity within a whole system. Research Objectives 1. To develop a taxonomy and associated database that provides a consistent language for describing community nursing interventions that can be used to provide reliable and comparable metrics. 2. To determine the utility of the Cassandra tool in capturing community nursing interventions. 3 To use the data collected to build an inter-relational model of community nursing practice that can be used to determine, case-load, activity and develop a predictive model. 4. To evaluate the usability of the model in assisting managers and local decision-makers in workforce planning. 5. To assess the effectiveness of the model in capturing community nursing care left undone or missed 6. To explore how the model interrelates community nursing caseload activity with other care provision in a whole system. Methods Informed by critical realism, which attempts to understand real world issues, the design is guided by optimum caseload modelling, and given the multivariate nature of the environment in which workload activity takes place, a multiple case study evaluation across six NHS Pilot sites in England. Full ethical approval is in place. Results Results from case study sites demonstrated we have created a robust tool that captures an accurate picture of the multidimensional complexity of community nursing intervention, context of care, users of care and care left undone and are beginning to mine the data to identify patterns and relationships to build and test more accurate predictive optimum caseload activity tools to support workforce planning around patient acuity and skill mix, and provide an economic analysis of the cost of care left undone. Application in international contexts will be considered. Conclusions The tool can accurately capture a representative picture of how community and district nurses spend their time by generating both individual and organisational level reports. This reporting is speedy and enables workforce planners to work with robust evidence to make decisions about commissioning education for nurses, identifying skills shortages to target recruitment and retention activities, and to underpin decision making about commissioning services and the workforce required to provide high quality care

Developing a caseload model to reflect the complexity of district and community nursing

A study by the England Centre for Practice Development proposes to develop and evaluate an optimum caseload model for district and community nursing, building on two rounds of funded pilot research in the south east of England using the Cassandra MatrixTM. It addresses national calls for a strategic capacity-and-demand model to measure and reflect the multidimensional complexity of the community nursing workload, maximising the potential of the workforce to meet the needs of clients with increasingly complex comorbidities and interdependencies. It also addresses the ambitions of the NHS Five Year Forward View to enable planned growth of the workforce for the future