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Deescelating PPI Prescriptions in Older Adults: A Systematic Review [paper]
No full textIntroduction: up to two-thirds of patients taking proton pump inhibitors, commonly prescribed for gastroesophageal reflux symptoms, lack a clear indication for continued use. Prolonged therapy has been associated with many adverse outcomes, including the potential for fracture risk, in older adults. This systematic review evaluates the effects of deprescribing proton pump inhibitors, compared with continued use, on fracture risk in adults ages 60 years and older.
Methods: a systematic search of CINAHL, MEDLINE Complete, and Web of Science was conducted for studies published within the last five years in the United States. Inclusion criteria included peer-reviewed primary research and systematic reviews evaluating proton pump inhibitor use, deprescribing interventions, and fracture outcomes in older adults. Seven studies met the criteria and were appraised using Melnyk and Fineout-Overholt’s Rapid Critical Appraisal Tools. The review was guided by Donabedian’s Quality of Care Model.
Results: Structured pharmacist- and provider-led deprescribing efforts consistently reduced inappropriate proton pump inhibitor use without adverse gastrointestinal side effects. Electronic health record alerts, deprescribing algorithms, and interprofessional collaboration aided in sustained success. One study found a modest decline in hip fracture admissions after large-scale deprescribing.
Discussion: deprescribing proton pump inhibitors in older adults is safe, feasible, and effective in reducing unnecessary use and potential fracture risk. Integrating pharmacist-led deprescribing algorithms, provider education, and system-level supports into primary care can enhance safety and quality of care for older adults.Nursin
Supercoloniality in Ants
No full textSupercolonial animals are species that form immense colonies holding up to millions of individuals that are connected over large plots of land. Most of these supercolonies are found in ant species, such as the Argentine ant (Linepithema humile), tawny crazy ants (Nylanderia fulva), and red imported fire ants (Solenopsis invicta). One of the most important characteristics of supercolonies is that the individuals do not show aggression to each other, to allow the colony to grow to momentous size, which may have allowed ant supercolonies to become invasive. This work aims to compare the behavioral differences between the invasive red imported fire ant in Texas to the native Smith’s pyramid ant (Dorymyrmex smithi) in Georgia from previously published literature, to determine if there is any contrast from the way they interact within their nest. We would also aim to determine the evolutionary causes of supercolony formation, and how supercolonial ants affect the ecosystems they live in. We would expect to see a difference in behavior between the invasive and native species, and hope to continue this research to determine any possible genetic differences that could be modified to allow the red imported fire ant, and other invasive supercolonial ants, to show aggression towards their own nestmates, decreasing their populations.Biolog
Effect of Aluminum Substitution Ratio on the Structure and Electrochemistry of Nickel Hydroxide Cathodes for Nickel-Zinc Batteries
No full textRechargeable alkaline nickel–zinc batteries are an attractive alternative to the industry-standard lithium-ion batteries that are used in many aspects of our lives. Combining high gravimetric and volumetric energy density with safe, reversible redox chemistry, Ni-Zn can reach performance levels comparable to Li-ion batteries. Aluminum substitution into the α-phase of Ni(OH)2 and effective electrical wiring results in cathode materials that have high capacities and stable cycling. However, the impact the aluminum substitution has on three-dimensionally electrically wired Ni(OH)2 cathodes for Ni-Zn batteries is not fully known, and further improvements to the capacity and cell performance are still needed. The project investigated the effect of changes to the aluminum substitution ratio within nickel hydroxide (Ni1-xAlx(OH)2, (x = 0, 0.05, 0.10, 0.20) on structure, morphology and electrochemical properties. Chemical and structural characterization was determined using atomic absorption spectroscopy, X-ray diffraction, Raman spectroscopy, and scanning electron microscopy. Galvanostatic cycling of the cathodes against Zn sponge anodes was performed under device-relevant conditions to determine the effect of Al substitution ratio on the charge-storage behavior. The results show that for all aluminum substitution ratios, the microwave-assisted hydrothermal synthesis method produced α-phase nanosheets grown onto the 3D carbon substrate. The addition of Al results in nickel hydroxide nanosheet aggregates being closer to the conductive carbon substrate providing a better electrically wired cathode. In addition to the morphological changes, the increasing aluminum content resulted in increasing the interlayer distance and the relative concentration of ‘free’ and ‘bound’ nitrate anions within the material. From electrochemical testing, the Ni0.95Al0.05(OH)2 composition with 5 atomic % Al displayed the highest discharge capacity and maintained stable cycling, while the higher concentration of 20 atomic % Al, Ni0.80Al0.20(OH)2, resulted in capacity fade upon cycling. Understanding how the aluminum substitution affects α-Ni(OH)2 deposited on a 3D conductive carbon matrix furthers the development of Ni-Zn batteries that have high electrochemical performance, improved safety and lower cost compared to current lithium-ion batteries.Chemistry and Biochemistr
AI and Its Effects on Criminal Law
No full textThe quick progression of artificial intelligence (AI) has begun to alter the history of criminal law, specifically trial procedures. Traditionally, the discovery process, presentation of arguments, and closing arguments were tasks tediously done by lawyers. However, with AI-programs being implemented into these steps, debates are naturally sparked about the pros and cons. While some argue the programs will improve efficiency, assist with legal research, and reduce mistakes, the opposing side has a different angle on AI programs. AI programs can cause privacy issues, cause an unfair trial, and there are additional ethical issues. This paper will explore the latest research about the implementation of AI into criminal law. By looking into previous legal precedents, the pros and cons of AI, and current guidelines on the use of AI, it will be evident why this is such a hot topic right now and what the future of legal procedures could look like.Political Scienc
Using Ice Packing and the Polar Life Pod to Treat Hyperthermia
No full textContext: Exertional heat stroke (EHS) is a life-threatening condition that occurs when body temperature is greater than 40.5°C (105°F), and the patient displays central nervous system dysfunction. Cold water immersion (CWI) is the gold standard method of treating EHS. However, large water volumes used in CWI can create challenges (e.g., drainage, slipping) for medical staff in emergency rooms (ER) and ambulances. Medical professionals have recently noted that using only ice to cool EHS patients has shown favorable prognoses. The Polar Life Pod (PLP), a body bag like device, is a tool that can contain ice and water, but there is a lack of research on the use of just ice for cooling. We determined the cooling rates of 3 different ice masses and no water (9kg, 27kg, 53kg) in the PLP, and if they met the ‘acceptable’ (>0.08°C/min) and ‘ideal’ (>0.15°C/min) minimum cooling rate thresholds.
Methods: Twelve subjects (8 males, 4 females) participated in 3 trial days, consisting of either 9kg, 27kg, or 53kg of nugget ice used for cooling. Subjects exercised within a hot room (heat chamber) set to ~40°C (~104°F) and ~40% humidity on a treadmill in a plastic rain poncho. Subjects walked for 3 minutes (3mph and 0% incline) followed by sprinting for 2 minutes at 90% of age-predicted maximum heart rate (Max Potential HR = 220-age * 0.9). They repeated intervals until core body temperature reached 39.75°C (~103.55°F). Subjects then entered the PLP and cooled with the designated amounts of ice across the three separate trials. Upon reaching rectal temperature (TREC) of 38.25°C (~100.85°F), subjects were removed from the PLP and recovered within the heat chamber for 15 minutes.
Results: The highest cooling rates were displayed with larger ice masses (53kg) in the PLP. All ice masses met the ‘ideal’ threshold for cooling (9kg:0.15±0.05°C/min; 27kg:0.19±0.07°C/min; 53kg:0.27±0.10°C/min, P<0.001) with minimal water created from melting of the ice (9kg: 3.8±1.1L; 27kg: 5.3±2.1L; 53kg: 4.9±2.2L, P=0.07).
Conclusion: All three ice masses (9kg, 27kg, 53kg) utilized in the PLP for cooling proved to sufficiently reduce TREC at ideal rates. Using just ice may be effective for reducing the challenges that are faced when using CWI in ambulance and hospital settings. Using just ice can also be effective in the event of patient emesis or incontinence.Health and Human Performanc
Oral history interview: James Richard Neal
No full textTranscript file (.pdf) and closed captioning available.Interview with Ernest Banasau. Ernest speaks of his time in combat with his battle buddy James during the Vietnam War
Reading, Writing, and Belonging: A Qualitative Study Exploring Academic Self-Efficacy Among First-Year, First-Generation Students at a Hispanic-Serving Institution
No full textThis qualitative multicase study explores how first-year, first-generation college students at a Hispanic-Serving Institution (HSI) perceive their academic self-efficacy for reading and writing. The study focuses on students who were concurrently enrolled in a First-Year Seminar (FYS) course and a developmental literacy course. Grounded in Bandura’s (1986, 1998) social cognitive theory, specifically the model of triadic reciprocal determinism (TRD), this study examines how personal, behavioral, and environmental sources of efficacy information shape students’ confidence in academic literacy practices. Drawing on Lea and Street’s (1998, 2006) Academic Literacies Model, the study also considers how students’ identities, institutional power dynamics, and literacy practices interact in postsecondary contexts.
Data were collected through focus groups, individual interviews, and participant-provided documents, and analyzed using thematic analysis within and across cases. Findings indicate that students’ perceived academic self-efficacy is constructed through mastery experiences, support from peers and instructors, and development of academic identity. Participation in FYS and developmental literacy provided opportunities for feedback, modeling, and emotional regulation, which are key sources of self-efficacy. However, institutional barriers and inconsistent instructional practices sometimes hindered participants’ confidence and literacy development.
This study contributes to the limited body of qualitative research on self-efficacy among first-year, first-generation students in developmental education. The findings offer implications for educators, researchers, and policymakers on how to design and implement FYS and developmental literacy curricula that meaningfully support the academic confidence and success of first-year, first-generation college students.Curriculum and Instructio
An Exploration of the Protein Kinase p38ɑ: Competent Cell Troubleshooting and Protein Expression
No full textMany autoimmune diseases are caused by an overactive immune system, resulting in the attack of healthy tissues and produces extreme inflammatory responses. There are natural remedies that present some relief to symptoms, including the African potato plant (Hypoxis hemerocallidea). The compound rooperol is attributed to the plant’s medicinal properties. The overall goal of this project is to investigate if rooperol inhibits the mitogen-activated protein kinase (MAPK) p38α. Previous research suggests that there are interactions between rooperol and p38α, which leads to the inhibition of the extracellular regulated kinase (ERK) pathway. This inhibition consequently reduces the stress responses induced by the pathway. This report is preliminary and includes partial results to a greater project. Research was conducted by inserting the MKK6, p38, and AFT2 plasmid DNAs into the DH5α ultra-competent cells to be cloned. The cloned plasmids were then isolated to be transformed into Rosetta competent cells. During this process, a challenge with the competent cells arose and halted the advancement of the project. After some trial and error, successful competent cells were prepared, and transformations were achieved. The cells were then expressed on a small-scale, using isopropyl ß-D-1-thiogalactopyranoside (IPTG). The results indicated that the initial preparation of Rosetta cells was unsuccessful, but the with the second preparation of Rosetta cells, competency was achieved. Additionally, the p38 plasmid exhibited atypically growth in bacteria culture, while the MKK6 and ATF2 plasmids produced expected results.Chemistry and Biochemistr
Evaluating the Feasibility of Cenosphere-Based Geopolymers for Sustainable Construction Materials
No full textThe construction sector's search for better, greener alternatives to ordinary portland cement (OPC) primarily arises from OPC's carbon dioxide (CO2) emissions during its production process. Geopolymers are innovative materials that could address this issue by using industrial waste materials as an OPC total replacement, thereby not only reducing the environmental impacts of certain industrial activities but also decreasing CO2 emissions from OPC production. In this regard, this dissertation focuses on developing and testing geopolymer materials from cenospheres (which are hollow particles derived from fly ash) as a sustainable alternative to OPC. This dissertation was completed in three phases. The first phase of this work aimed to look at how different molarities of NaOH would affect properties such as strengths, water absorption, density, and other durability indicators. For that purpose, in addition to Na2SiO3, three levels of sodium hydroxide (NaOH) (i.e., 6M, 9M, and 12M) activators were employed. The cenosphere was substituted at different proportions (25%, 50%, and 75%) in place of ground granulated blast furnace slag (GGBFS) in the geopolymer mixture. It was found that up to 50% of GGBFS substituted by cenospheres exhibited better performance than conventional cement mortar. The addition of cenospheres also increased the CO2 absorption capacity, which would be beneficial to the environment in non-steel reinforcement elements. In the second phase, the long-term durability of the GGBFS-cenosphere geopolymer was tested. The study looked at properties such as strength, elasticity, drying shrinkage, resistance to sulfate attack, fire resistance, and CO₂ sequestration through carbonation. While higher cenosphere content lowered strength compared to 100% GGBFS, mixes with up to 50% cenosphere still performed better than OPC mortar. Cenospheres helped improve resistance to sulfate and fire, but also led to more shrinkage and deeper carbonation. The deeper carbonation, however, meant more CO₂ was captured, supporting the environmental viability of cenosphere-based systems for non-structural applications. The third phase studied how cenospheres affect the microstructure of the material. Tests on fresh properties like flowability, setting time, and heat generation were conducted, along with SEM and XRD analysis. Cenospheres improved flow and setting time due to their smooth, round shape, and reduced the heat release during the chemical reaction. The microstructure investigation revealed that incorporating cenosphere can also help prevent harmful silica phases from forming, which improves resistance to alkali-silica reaction (ASR). Overall, using 25–50% cenospheres made the material easier to work with and improved some important durability features. River sand was replaced with waste spent garnet (WSG) in the geopolymer composite in the fourth phase. Excessive reliance on river sand can have adverse effects on ecosystems, making it important to explore sustainable alternatives. In this phase, 25% and 50% replacement of river sand with WSG were studied. Replacing 25% river sand with WSG improved the microstructure, mechanical strength, and durability of the resulting material. At 50% WSG replacement, most of the properties reduced slightly in comparison to 25% substitution. But the mixtures (i.e., with 50% WSG) still performed comparably to regular sand-based mixes. Furthermore, 50% WSG improved ASR resistance and thermal stability of the resulting mixtures, making it a promising sustainable option. However, the optimal dosage depends on the prioritized performance criteria. For instance, if the target is mechanical strength, 25% WSG can be beneficial, while 50% can enhance thermal stability. The life cycle assessment (LCA) was the final phase of this dissertation, in which the objective was to determine and compare the environmental impact of GGBFS-cenosphere geopolymer with that of conventional cement mortar. This investigation evaluated the carbon footprint, energy use, as well as other ecological impact categories. Geopolymers with GGBFS and cenospheres reduced global warming potential (GWP) by 24–33% compared to cement mortar. The inclusion of cenospheres between 25 and 75% also reduced energy consumption by 5%. The acidification and eutrophication of cenosphere (25%-75%) incorporated geopolymer mortars also declined by 5–15% and 3–10%, respectively. Results show that cenosphere-based geopolymers possess a higher sustainability potential than purely GGBFS-based geopolymers in all studied trades and OPC (GWP), highlighting their suitability for the environment. In conclusion, this dissertation demonstrates that cenosphere-based geopolymers, and particularly those blended with WSG, are a durable, strong, and sustainable substitute for conventional cement-based materials. The strategic use of industrial by-products in geopolymers results in reduced CO2 emissions, conservation of natural resources, and more sustainable construction.Materials Science, Engineering, and Commercializatio
Taking Cover: Finding a Connection between the Education of Teachers and Students on Illnesses and How it Impacts their Lives
Get PDFThe use of non-pharmaceutical interventions (NPIs) in daily life plays a vital role in preventing and slowing the spread of germs, illnesses, and diseases. These measures include covering coughs and sneezes with an elbow, using tissues properly, washing hands frequently with soap and water, and regularly using hand sanitizer. In a classroom setting, NPIs are especially important for protecting students and those around them from illness. There has been extensive research on the effectiveness of NPIs to reduce the spread of illness, but my literature review highlights the gap in post-COVID studies focusing on their use in the primary classroom. My literature review proposes an observational analysis of primary school-aged children’s willingness to use NPIs on their own volition. Specifically, I will suggest collecting data on whether they use an NPI independently, use an NPI only after being prompted (e.g., by a teacher), or do not use an NPI at all, even after prompting. I anticipate that primary-aged children will use NPIs inconsistently, likely neglecting them more often than using them. I believe this is due to a lack of understanding about how these simple actions help prevent illness and protect those around them. The findings of a study like this will contribute to future research on effective strategies for educating young children about NPIs. By improving awareness and reinforcing these habits in the classroom, we can work toward reducing illness-related absences, especially during cold and flu season.Health and Human Performanc