interAdapt -- An Interactive Tool for Designing and Evaluating Randomized Trials with Adaptive Enrollment Criteria

The interAdapt R package is designed to be used by statisticians and clinical investigators to plan randomized trials. It can be used to determine if certain adaptive designs offer tangible benefits compared to standard designs, in the context of investigators' specific trial goals and constraints. Specifically, interAdapt compares the performance of trial designs with adaptive enrollment criteria versus standard (non-adaptive) group sequential trial designs. Performance is compared in terms of power, expected trial duration, and expected sample size. Users can either work directly in the R console, or with a user-friendly shiny application that requires no programming experience. Several added features are available when using the shiny application. For example, the application allows users to immediately download the results of the performance comparison as a csv-table, or as a printable, html-based report.Comment: 14 pages, 2 figures (software screenshots); v2 includes command line function descriptio

Ganglioside Detection from Formalin Fixed Human Brain Tissue Utilizing MALDI Imaging Mass Spectrometry

Matrix assisted laser desorption ionization (MALDI) imaging mass spectrometry (IMS) is largely performed on fresh frozen tissue whereas clinical tissue samples stored long term are fixed in formalin, and the fixation process is thought to cause signal suppression for lipid molecules. Studies show that fresh frozen brain tissue sections washed with ammonium formate (AF) solution prior to matrix application in the MALDI-IMS procedure display an increase in signal intensity and sensitivity for lipid molecules while maintaining molecular spatial distribution. Work in this thesis compares MALDI data of ganglioside molecules from fresh frozen and post-fixed rat brain samples, and post-fixed human brain samples washed with AF. Results demonstrate that MALDI-IMS spectra for gangliosides are significantly enhanced in fresh frozen rat brain, formalin-fixed rat brain and formalin fixed human brain samples washed with AF. This method will allow for analysis of gangliosides from formalin-fixed clinical samples, which can open additional avenues for neurodegenerative disease research

The Outcomes of COPE, a Cognitive Behavioral Therapy Program, in Patients Awaiting LVAD Implantation

PURPOSE: The purpose of the Doctor of Nursing Practice (DNP) project was to pilot Creating Opportunities for Personal Empowerment (COPE), an evidence based cognitive behavioral therapy (CBT) intervention, with patients diagnosed with advanced heart failure who are awaiting Left Ventricular Assist Device (LVAD) implantation or those who have had one recently implanted before they are discharged home. METHODS: A cross-sectional study design was used for this Pilot project. Patients were identified for potential participation by LVAD coordinators and represent a convenience sample. The patients were screened for anxiety and depression using the GAD-7 and PHQ-9 screening tools. If patients scored a 5 or greater on either tool, they received the COPE CBT intervention. COPE is a 7 session CBT intervention with each session lasting 20-30 minutes, delivered every three to four days during the patient’s hospitalization following LVAD implantation when patient was able to participate. After the sessions were completed, patients were re-evaluated for depression and anxiety symptoms with GAD-7 and PHQ-9 tools. RESULTS: Five patients were able to participate during the timeframe of this Pilot Project. The average scores for depression and anxiety symptoms pre-intervention were 10.6 and 10.2, respectively. Post intervention, the scores decreased to an average of 5.4 and 3.2, respectively. Due to the small sample size the results did not reach statistical significance. Qualitative data reported from the participants suggests that they felt the intervention was helpful. CONCLUSION: Though the results did not achieve statistical significance, the decreases in average score represent clinically-significant decreases in depression and anxiety symptoms. More research is needed to confirm statistical and clinical significance of these findings. This COPE with LVAD Patients project does show that it is possible to implement a multi-session CBT intervention with advanced heart failure patients who have recently received LVAD implantation

Implications of an Iterative Design Experiment in Transcendental and Polynomial Functions Within a Flipped Classroom

This study explores an iterative design research experiment of a flipped mathematics classroom over the span of five curricular units involving big ideas of transcendental and polynomial functions. Transcendental and polynomial functions involve an algebraic, analytic, and graphical approach to the concepts and procedures of exponential, logarithmic, power, cubic, quadratic, linear, and rational functions. The Compleat design research methodology (Middleton, Gorard, Taylor, & Bannan-Ritland, 2008) was used to explore a series of instructional sequences that an instructor implemented in a flipped classroom while teaching big ideas of transcendental and polynomial functions. The experiment occurred over the course of a sixteen-week semester. Data analysis was constructed from a triangulation of relevant data from student constructions in the form of written documents, whole-group and small-group discussions from the video recordings, and the instructor’s personal reflective notes. The hypothetical learning trajectory served as the empirical basis upon which reflections occurred and meaningful modifications were made to the original prototype. Segmenting the content helped decrease the extraneous cognitive load by reducing the burden on students’ working memory in order to make instructional activities more meaningful and effective. More time was allocated in class for basic algorithmic processes prior to the implementation of the higher-order instructional tasks in phase five to account for the increasing intrinsic cognitive load in the instructional tasks. Micro-level practice-based concerns and improvements to the prototype as well as the creation of a theoretical and empirically-based instructional model were natural consequences to the design experiment

Fatigue Testing of Defective Weld Samples

Steel truss bridge gusset plates have been difficult to inspect and can potentially hide damage, which could accumulate and lead to collapse. Recently, bridge design methods have evolved to address the problems of traditional gusset plates. These new designs eliminate the plated connections altogether and instead rely on built-up steel connections that provide a smooth transition zone between the cords and diagonal members. Consequently, the gusset-less connections rely heavily on the performance of the welds that hold their elements together. Given the increased role of welding on these new gusset-less truss connections, the question of the impact of the welding quality on the overall structural performance of these members had to be addressed. To investigate the effect of weld quality on the new connections, a laboratory experiment was conducted. This experiment consisted of comparing the fatigue performance of perfectly intact and defective weld samples. The samples were cyclically loaded and unloaded until they fractured. It was then determined if there was a relationship between how many cycles each sample endured before failing and the level of defect present on each sample. Ultimately, an exponentially decaying relationship was observed to exist between the quality of welds and the fatigue performance of the samples

Single-particle imaging reveals intraflagellar transport–independent transport and accumulation of EB1 in \u3cem\u3eChlamydomonas\u3c/em\u3e flagella

The microtubule (MT) plus-end tracking protein EB1 is present at the tips of cilia and flagella; end-binding protein 1 (EB1) remains at the tip during flagellar shortening and in the absence of intraflagellar transport (IFT), the predominant protein transport system in flagella. To investigate how EB1 accumulates at the flagellar tip, we used in vivo imaging of fluorescent protein–tagged EB1 (EB1-FP) in Chlamydomonas reinhardtii. After photobleaching, the EB1 signal at the flagellar tip recovered within minutes, indicating an exchange with unbleached EB1 entering the flagella from the cell body. EB1 moved independent of IFT trains, and EB1-FP recovery did not require the IFT pathway. Single-particle imaging showed that EB1-FP is highly mobile along the flagellar shaft and displays a markedly reduced mobility near the flagellar tip. Individual EB1-FP particles dwelled for several seconds near the flagellar tip, suggesting the presence of stable EB1 binding sites. In simulations, the two distinct phases of EB1 mobility are sufficient to explain its accumulation at the tip. We propose that proteins uniformly distributed throughout the cytoplasm like EB1 accumulate locally by diffusion and capture; IFT, in contrast, might be required to transport proteins against cellular concentration gradients into or out of cilia

Sowing Seeds of Tradition! Applying Traditional Family Values and Adaptive Reuse to Resurrect a Community.

There are problems in every community, including South Memphis, Tennessee. Issues that need to be addressed include teen pregnancies, school drop-outs, crime, childhood obesity, and lack of parental guidance. Traditional family characteristics such as spiritual life, caring and appreciation, commitment, flexibilty and openness to change were once guiding forces that have been lost in our current culture. The response has been to provide community centers, which have often failed because they do not teach the basic skills necessary for a productive life. One solution is to convert the Turner Dairy Warehouse on South Bellevue into a facility that will provide education, enrichment, and encouragement. The Family Educational Exchange & Development Center (F.E.E.D) will be an educational facility instilling family values, teaching integrated life skills, and giving back to the community. The skills taught will include horticulture, home-economics, parenting, and general education. This facility will bring life to a dying community