Implementing Technological Change: Effects on Student Learning Through Implementation of a Learning Management System for Enhanced Two-Way Communication between School, Students and Parents

The purpose of this project was to determine whether or not a blended learning environment that focuses mainly on incorporating core-subject standards into a current 7th grade Fundamentals of Information Technology (FIT) course can help to increase 7th grade student core-subject, academic performance. If such performance is distinguishable, the curriculum materials used to develop this project may then be used for curriculum development within the Bethel School District, 7th grade FIT program. The product or end result of this project is an online curriculum guide titled: Fundamentals of Information Technology Project: An Online Curriculum Guide for Bethel School District Middle School Technology Teachers. The curriculum guide is categorized into six teachable units and contains all original work produced from this project. The end result of the FIT Project is published online and contains: an overview of the results of the two project studies, lesson plans, instructional materials, materials for measuring student learning, materials for connecting teachers with parents and materials for connecting students with the community

Institutional practices and planning for walking: A focus on built environment audits

Built environment audits, part of the “toolbox” for planning multi-modal urban transport systems, are used to evaluate the walkability of streets. Whereas the methodological features of audits have attracted attention from planning research, little attention has been paid to the institutional contexts where audits are developed and used. Drawing on literature on audit culture in contemporary institutions and on expert interviews with audit developers and professionals in Australia and New Zealand working with walking audits, three questions are addressed: Who uses walkability audits? How are they used? What substantive changes emerge from auditing practice? The knowledge of practice of auditing the built environment for walking is underdeveloped. While planners, engineers and advocates consider built environment audits useful in different ways, of concern is the use of audits to rationalise limited resources already devoted to infrastructure for walking, rather than produce substantive changes to the quality of the built environment for walking

Electrolysing mud: Membraneless electrolysis of water for hydrogen production using montmorillonite-rich marine mud

This paper describes a design for a low-cost membraneless water electrolyser for the production of green hydrogen that used a viscous electrolyte of naturally abundant montmorillonite-rich marine mud in a DEFT (divergent electrode flow through) geometry with stainless steel (304) mesh electrodes. The ratio of smectite to non-swelling clays in the mud was 1:2. The electrolyte was prepared by resuspending the mud in tap-water to remove the salt, and NaOH 1 M added to enhance the ionic conductivity, as measured by both Electrochemical Impedance Spectroscopy (EIS) and by the slope of DC current/voltage curves. Successful separation and collection of the hydrogen and oxygen gas was inferred from the ratio of 2:1 in the volumes of hydrogen and oxygen collected. Both acid and alkali treatments were trialled and it was found that, whereas acid treatment flocculated the mud, adding NaOH increased the dispersion, conductivity and viscosity, and reduced clogging. The conductivity of both the 24% dry mass alkali mud and a control 4% dry mass alkali bentonite suspension increased to that of pure NaOH 1 M when repeatedly electrolysed. Hydrogen and oxygen gas was collected for 10% and 24% dry mass muds. The less viscous 10% dry mass mud showed turbulent liquid-like behaviour which led to gas mixing but the 24% mud showed stable, solid-like flow and reliable gas separation. Three components of the energy efficiency of the electrolysis process are reported and discussed – the voltage efficiency of 42%, a gas collection efficiency of 50% and the auxiliary power efficiency of 60%. The overall energy efficiency due to these three contributing efficiencies, was 13% of the Higher Heating Value of 142 MJ/kg H2 for a current density of 45 mA/cm2. This mud electrolyser may still be considered worth developing for an off-grid, low budget site with a low-power source of renewable energy

Enhancing the rates of advance directive documentation to improve the quality of patient care

Introduction Advance Directives (AD) allow patients to maintain autonomy during incapacitation. Patients and their caregivers benefit from these documents in times of crisis. Overcoming barriers to AD completion and documentation can improve patient care quality. Methods A retrospective chart review was performed initially, after consolidation of the electronic health record (EHR) and after alteration of the EHR, to evaluate the availability of a patient’s medical power of attorney (MPOA), living will (LW), and code status. Results Baseline documentation of MPOA (7.33%), LW (6.00%), and code status (5.33%) within the outpatient EHR was low. After 2 cycles, this improved to 13.10%, 13.10%, and 36.55%, respectively. Improvement in code status documentation was statistically significant (p=\u3c0.00001). Conclusion Altering the EHR can improve the rates of AD documentation. Further interventions in the EHR should include easily accessible documents and address other barriers, including educating both patients and providers

Wnt Signaling in Zebrafish Fin Regeneration: Chemical Biology Using GSK3b Inhibitors

poster abstractBone growth can be impaired due to disease, such as osteoporosis, and Wnt signaling pathways regulate bone growth. The parathyroid hormone (PTH) is therapeutic for anabolic bone growth (bone building), which activates Wnt signaling, leading to bone growth. GSK3b (glycogen synthetase kinase 3 beta) protein inhibitors activate Wnt signaling, including in bone growth models. Our study utilized a zebrafish model system to study Wnt activated fin regeneration and bone growth. Wnt signaling is the first genetically identified step in fin regeneration, and bony rays are the main differentiated cell type in fins. Thus, zebrafish fin regeneration may be a useful model to study Wnt signaling mediated bone growth. Fin regeneration experiments were conducted using various concentrations of GSK3b inhibitor compound for different treatment periods and regenerative outgrowth was measured at 4 and 7 days post amputation. Experiments revealed continuous low concentration (5-6 nM) treatment to be most effective at increasing regeneration. Higher concentrations inhibited fin growth, perhaps by excessive stimulation of differentiation programs. In situ hybridization experiments were performed to examine effects of Gsk3b inhibitor on Wnt responsive gene expression. Initial experiments show temporal and spatial changes on individual gene markers following GSK3b inhibitor treatment. Additionally, confocal microscopy and immunofluorescence labeling data indicated that the Wnt signaling intracellular signal transducer, betacatenin, accumulates throughout Gsk3b inhibitor treated tissues. Finally, experiments are underway to quantify phosphohistone-3 staining in regenerating tissue to measure effects of Gsk3b inhibitor on cell proliferation. Together, these data indicate that bone growth in zebrafish fin regeneration is improved by activating Wnt signaling. Zebrafish Wnt signaling experiments provide good model to study bone growth and bone repair mechanisms, and may provide an efficient drug discovery platform

Feasibility and acceptability of a rural, pragmatic, telemedicine‐ delivered healthy lifestyle programme

Background: The public health crisis of obesity leads to increasing morbidity that are even more profound in certain populations such as rural adults. Live, two‐way video‐conferencing is a modality that can potentially surmount geographic barriers and staffing shortages. Methods: Patients from the Dartmouth‐Hitchcock Weight and Wellness Center were recruited into a pragmatic, single‐arm, nonrandomized study of a remotely delivered 16‐week evidence‐based healthy lifestyle programme. Patients were provided hardware and appropriate software allowing for remote participation in all sessions, outside of the clinic setting. Our primary outcomes were feasibility and acceptability of the telemedicine intervention, as well as potential effectiveness on anthropometric and functional measures. Results: Of 62 participants approached, we enrolled 37, of which 27 completed at least 75% of the 16‐week programme sessions (27% attrition). Mean age was 46.9 ± 11.6 years (88.9% female), with a mean body mass index of 41.3 ± 7.1 kg/m2 and mean waist circumference of 120.7 ± 16.8 cm. Mean patient participant satisfaction regarding the telemedicine approach was favourable (4.48 ± 0.58 on 1‐5 Likert scale—low to high) and 67.6/75 on standardized questionnaire. Mean weight loss at 16 weeks was 2.22 ± 3.18 kg representing a 2.1% change (P \u3c .001), with a loss in waist circumference of 3.4% (P = .001). Fat mass and visceral fat were significantly lower at 16 weeks (2.9% and 12.5%; both P \u3c .05), with marginal improvement in appendicular skeletal muscle mass (1.7%). In the 30‐second sit‐to‐stand test, a mean improvement of 2.46 stands (P = .005) was observed. Conclusion: A telemedicine‐delivered, intensive weight loss intervention is feasible, acceptable, and potentially effective in rural adults seeking weight loss

Timing of CGM initiation in pediatric diabetes: The CGM TIME Trial.

OBJECTIVE: To determine whether timing of CGM initiation offering low glucose suspend (LGS) affects CGM adherence in children and youth starting insulin pump therapy. METHODS: A 5-site RCT of pump-naïve subjects (aged 5-18 years) with type 1 diabetes (T1D) for at least 1 year compared simultaneous pump and CGM initiation offering LGS vs standard pump therapy with CGM initiation delayed for 6 months. Primary outcome was CGM adherence (hours per 28 days) (MiniMed™ Paradigm™ Veo™ system; CareLink Pro™ software) over 6 months after CGM initiation. Secondary outcome HbA1c was measured centrally. Linear mixed-models and ordinary least squares models were fitted to estimate effect of intervention, and covariates baseline age, T1D duration, HbA1c, gender, ethnicity, hypoglycemia history, clinical site, and association between CGM adherence and HbA1c. RESULTS: The trial randomized 144/152 (95%) eligible subjects. Baseline mean age was 11.5 ± 3.3(SD) years, T1D duration 3.4 ± 3.1 years, and HbA1c 7.9 ± 0.9%. Six months after CGM initiation, adjusted mean difference in CGM adherence was 62.4 hours per 28 days greater in the Simultaneous Group compared to Delayed Group (P = .007). There was no difference in mean HbA1c at 6 months. However, for each 100 hours of CGM use per 28-day period, HbA1c was 0.39% (95% CI 0.10%-0.69%) lower. Higher CGM adherence was associated with reduced time with glucose \u3e10 mmol/L (P \u3c .001). CONCLUSION: CGM adherence was higher after 6 months when initiated at same time as pump therapy compared to starting CGM 6 months after pump therapy. Greater CGM adherence was associated with improved HbA1c

Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases.

Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, affect several million individuals worldwide. Crohn's disease and ulcerative colitis are complex diseases that are heterogeneous at the clinical, immunological, molecular, genetic, and microbial levels. Individual contributing factors have been the focus of extensive research. As part of the Integrative Human Microbiome Project (HMP2 or iHMP), we followed 132 subjects for one year each to generate integrated longitudinal molecular profiles of host and microbial activity during disease (up to 24 time points each; in total 2,965 stool, biopsy, and blood specimens). Here we present the results, which provide a comprehensive view of functional dysbiosis in the gut microbiome during inflammatory bowel disease activity. We demonstrate a characteristic increase in facultative anaerobes at the expense of obligate anaerobes, as well as molecular disruptions in microbial transcription (for example, among clostridia), metabolite pools (acylcarnitines, bile acids, and short-chain fatty acids), and levels of antibodies in host serum. Periods of disease activity were also marked by increases in temporal variability, with characteristic taxonomic, functional, and biochemical shifts. Finally, integrative analysis identified microbial, biochemical, and host factors central to this dysregulation. The study's infrastructure resources, results, and data, which are available through the Inflammatory Bowel Disease Multi'omics Database ( http://ibdmdb.org ), provide the most comprehensive description to date of host and microbial activities in inflammatory bowel diseases