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Regional Public Universities: building thriving communities, creating a stronger Michigan, 2023
No full textAssessment of Taxon Sampling on Phylogenetic Reconstructions and Timetrees: A New Methodology And Application
No full textOver the past three decades, computational capabilities have grown at such a rapid rate that they have given rise to many computationally heavy science fields such as phylogenomics. As increasingly more genomes are sequenced in the three domains of life, larger and more species-complete phylogenetic tree reconstructions are leading to a better understanding of the Tree of Life and the evolutionary histories in deep times. However, these large datasets pose unique challenges from a modeling and computational perspective: accurately describing the evolutionary process of thousands of species is still beyond the capability of current evolutionary models while the computational burden limits our ability to exhaustively explore and test multiple hypotheses. These limitations become even more problematic when attempting to estimate the absolute times within these phylogenetic reconstructions (timetrees). These time estimations are not only constrained computationally by run times and resource requirements but also bound by the availability of fossil data to estimate divergence times for the evolution of species (primary calibrations). All of these issues are particularly severe in prokaryotes, because of the high number of species available in databases, their large evolutionary variability, and the few primary calibrations available. Yet, they represent two out of the three domains of life and are therefore key to reconstructing the Tree of Life. This combination of computational and data constraints is forcing researchers to make choices on the datasets being analyzed without a clear understanding of the consequences of these choices on the accuracy of the results obtained. This work presents an in-depth analysis of the effects of dataset choices on the reconstruction of phylogenetic histories using a newly developed tool (Phylogenetic Assessment of Taxon Sampling) that will enable fast, simple, and reproducible testing of taxon sampling. The PATS pipeline is available on GitHub: https://github.com/BlabOaklandU/PAT
Developing, Implementing, and Evaluating a Dexmedetomidine Infusion Protocol as an Opioid Sparing Technique in Spine Surgery
No full textBackground: Opioids have been the cornerstone treatment for surgical pain despite their negative side effects including the development of chronic postsurgical pain. Enhanced Recovery After Surgery helps to improve patient outcomes by using multimodal analgesics and limiting opioid administration. Dexmedetomidine is a sedative with notable opioid-sparing capabilities.
Purpose: This quality improvement project aimed to develop and implement an evidence-based protocol that incorporated a dexmedetomidine infusion for patients undergoing spine surgery. Data was collected to analyze whether the results were consistent with the literature.
Methods: Baseline data was collected prior to implementation of the protocol for 50 patients. An educational briefing regarding the protocol implementation was then completed for the anesthesia providers at Kalamazoo Anesthesiology to ensure familiarity with the protocol and benefits of dexmedetomidine as an analgesic. Post-implementation data was collected for all patients who received the full protocol correctly as well as any patients who received the correct dosage of dexmedetomidine.
Results: Only 11 patients received the protocol in full while another 19 received at least the correct total dosage of dexmedetomidine. Out of all of the outcomes assessed, none reached statistical significance. However, time to rescue analgesic (p = .835) as well as PACU discharge time (p = .50) was shortest in the full protocol group. Interestingly, average opioid administration in each area was lowest among the partial protocol group.
Conclusion: This quality improvement project’s results did not align with the current evidence likely in part due to lack of provider adherence. This project did however show a possibility of a decreased time to rescue analgesic and PACU discharge times which could be a reflection of a more balanced anesthetic when a dexmedetomidine infusion is utilized
Exploration of the Economic Repercussions of Climate Change
No full textGlobal climate change has been largely amplified by human influences and can now be linked to more than just the changing weather conditions and worsening natural disasters. Research gathered and analyzed over the past several decades is now able to connect shifts in climate to changes in global economies through various economic factors. This paper will look at recent studies and model data spanning those economic factors to determine if there is a visible link showing responses of global economies to climate change. Through this data analysis there is evidence to support the claim that the climate change effects span farther than increased severity of weather conditions and often dip into varying sectors of economies. This information will help policy makers determine the best course of action in fighting the effects of climate change. In addition, it will also allow policy makers to curate proper prevention methods to suppress further damage from occurring. Helping the countries most affected by climate change will benefit all economies by protecting trade and supply chains on a global scale
Implementing Sepsis Recognition Education for Undergraduate Nursing Students
No full textSepsis has been a significant cause of morbidity and mortality for millennia. There is a vital need for skilled assessment and rapid intervention for septic patients. Substantial evidence shows that sepsis knowledge is lacking for nursing students and practicing nurses. This DNP project will examine the effectiveness of undergraduate sepsis nursing education. The project will develop, implement, and evaluate an educational module for undergraduate nursing students to improve their knowledge of sepsis and confidence in identifying patients at risk of sepsis with a focus on older adults. Six participants began the module by completing the demographics and the pre-quiz sections. Four participants completed the entire module. Barriers to implementation included low recruitment and participation. Project implementation resulted in six participants, with four students completing the module. Half of the participants had prior experience with sepsis, and all were in their fourth year of post-high-school education. Half the participants answered the same pre-quiz question incorrectly: “Less than 17% of nurses have current sepsis knowledge.” Half of the participants responded incorrectly to the same post-quiz question, “Sepsis recognition tools include,” with the response of “SIRS” instead of the correct response, “All of the above.” The satisfaction survey results indicated that all participants felt the module improved their sepsis knowledge. Sepsis education is vital for students and practicing nurses. Future recruitment to participate in the sepsis education module of undergraduate students at different stages in their education would allow comparison of knowledge and could assist in curriculum development. Practicing nurses in many clinical areas may benefit from sepsis education
Model Predictive Anti-Jerk Control of an Electrified Drivetrain with Backlash
No full textThis thesis addresses an optimal anti-jerk control law of an electrified drivetrain based on a model predictive control scheme. Due to a flexible driveshaft and gear clearance in the electrified drivetrain, when the vehicle traction torque changes drastically, it undergoes torsional vibration made more severe by the lack of external damping elements compared to the drivetrain in a gas-powered vehicle. This leads to unpleasant longitudinal vibration of a vehicle, so called jerk. This longitudinal vibration adversely affects driving comfort of an occupant which is undesirable with the growing trend toward automotive electrification. Although excessive damping can mitigate the torsional vibration of the drivetrain and improve driving comfort, it deteriorates vehicle responsiveness to the driver’s torque demand. Therefore, an optimal control law compromising these two conflicts is important. Toward this end, this thesis aims to develop the model predictive anti-jerk control law to find a trade-off between driving comfort and vehicle responsiveness
Implementation and Evaluation of an Evidence Based Handoff Tool for Use by Anesthesia During Transfer of Care of Post-CABG Patients to the Intensive Care Unit
No full textPoor communication is a contributing factor to medical errors and increased costs within healthcare. The handoff period between teams is a prime opportunity for communication failure. According to The Joint Commission, inadequate handoffs are estimated to contribute to 80% of all adverse events. To address the issue, they added a new National Patient Safety Goal in 2006 calling for standardization of the handoff process. The aim of this project was to improve the communication and interdepartmental transition of care between heart team CRNAs (HTCRNAs) and heart team ICU nurses (HTICU-RNs) using a standardized handoff tool at UP-Health System Marquette (UPHSM).
This evidence-based quality improvement project incorporated a pre-test/post-test design to explore provider satisfaction and assess the functionality of an evidence-based standardized handoff tool developed collaboratively with an interprofessional team. Eleven providers completed the pre-intervention survey and eight completed the post-intervention survey. There was a statistically significant improvement in satisfaction with the transfer of care process following the implementation of the standardized handoff tool (Z = -2.23, p = 0.26). Participants also found the new handoff tool to be more comprehensive (Z = -2.33, p = 0.02); less likely to lead to mistakes (Z = -2.45, p = 0.014); and a better mechanism to communicate important patient information during transfer of care (Z = -2.04, p = 0.041).
An opportunity was identified to improve and standardize the hand-off process between HTCRNA’s and HTICU-RN’s at UPHSM. Findings from this project demonstrate an improvement in the process as well as provider satisfaction during transfer of care between the ICU and anesthesia department using a standardized handoff to
The Design of Tiny Homes and Their Significance Within Our Environment and Communities
No full textThis research examined the design of tiny homes and the significant impact they have on the people within in our communities and the environment around us through the works of a creative visual project using collage. The research focused on The Tiny House Movement through the creation of an informational magazine, social media campaign, and posters while highlighting the overall benefits and disadvantages. Tiny houses are typically less than 400 square feet which make them a much more sustainable option compared to a regular-sized home as they require fewer materials to construct and use less energy. They are also considered to be more affordable and can be constructed within a couple months, allowing people to save money. They have also been of use as a quick solution to help solve the issue of homelessness in many high poverty neighborhoods. While tiny houses have become increasingly popular, it is still a foreign concept to many, as most people are generally unaware of the tiny house movement. Also, many don’t have access to the opportunity of owning one due to zoning restrictions and building codes. The hopes for this project were to present the advantages and disadvantages of owning a tiny home in order to promote further growth of The Tiny House Movement, and to help spark legalization of tiny homes nationwide. The main goal was to create a work of graphic design that would communicate what I learned from the research in a visually appealing and informative manner