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A Preliminary Study on Assessing Optimization of Surgically Frail Patients Comparing Multiple Variables Effecting Prognosis, Outcome, Mortality, and Future Considerations
No full textResearch Question: Which components of the Edmonton Frailty Scale are most associated with surgical optimization and clinical outcome?Background and Significance: Surgical optimization is an underused, but highly effective method for preparing patients to undergo procedures in the operating room, which inevitably bear significant stressors upon the body. In addition to the actual time in the operative room, post-operative management of a patient presents an additive variable on the prognosis, recovery, and outcome of patients. There have been scales and calculators that have been implemented in an effort to grasp some objectivity in the management and optimization of patients prior to surgery, one of which is the Edmonton Frailty Scale (EFS). There are several variables that could be potentially correlated, and as a result, controlled and measured using the EFS. The problem facing surgical optimization is determining which factors have measurable differences in the overall outcomes and improvement of patients.Materials and Methods: We, therefore, hope to address a foundational question that can be built-on by future studies asking, within the realm of cognitive, therapeutic, functional, risk factor assessment, neurological, and psychiatric, which, if any, can be feasibly implemented into surgical optimization with a high enough patient adherence that there can be a measurable difference on prognosis, outcomes, and mortality and morbidity. Several Optimization Components (OC) were implemented with available data including (1) home health physical therapy, (2) cognitive exercises, (3) neuropsychiatric evaluation, and (4) medical management. Individuals who were referred to the optimization clinic for surgery were given a neuropsychiatric evaluation, cognitive exercises, and home health physical therapy, based on their needs and requirements as established by their past medical history, upcoming surgery, and EFS score. With these points of control, the selected population was compared with outcome surrogates for effectiveness and overall outcomes for the implemented OC¿s. The overarching themes for comparison were (1) rate of proceeding to surgery, (2) number of post-operative infections, (3) number of same-day cancellations, and (3) mortality rate. The statistical analysis was separated into several components: (1) EFS compared to length of stay, (2) time between optimization and surgery, (3) proceeding to surgery vs. cancellation of surgery, (4) age and sex, (5) intensive care unit admission, and (6) prior health history and risk factor stratification. By isolating these aspects of the study, the authors hope to lay a foundation for deeper investigation into the implementation and use of the Edmonton Frailty Scale for surgical optimization for patients in a surgical setting.Results: A total of 167 patients were enrolled in this study and selected as the sample from patients referred to the optimization clinic by surgical subspecialties, including general surgery, orthopedic surgery, vascular surgery, orthopedic surgery, surgical oncology, gynecologic surgery, urology, ophthalmology, and oral maxillofacial surgery. Each patient was evaluated and assessed with standardized lab work, EFS scoring, and committee meeting to determine if patients were eligible and safe to proceed to surgery.Conclusion: The results and analysis of this data hope to serve as foundation for continued research on the matter
Effect of annealing on the room temperature luminescence of coumarin 106 in PVA films
No full textWe studied the effect of annealing on the luminescence of Coumarin 106 (C106) in poly (vinyl alcohol) films (PVA films). The samples and reference polymer films were treated at temperatures between 100 ¿C and 150 ¿C (212 F and 302 F) for various times. After cooling and smoothing, the samples and references were measured at room temperature. We observed that the PVA polymer (reference films) changes its optical properties with annealing at higher temperatures, affecting the baselines in absorption and the backgrounds in emission measurements. This requires precise background subtractions and control of the signal-to-noise ratio. Whereas the fluorescence intensity of C106 in PVA films modestly decreases with annealing, the phosphorescence depends dramatically and progressively increases by many folds. The fluorescence quantum yields and lifetimes decrease with the annealing, which suggests an increase in the non-radiative processes in the singlet excited state S 1 . The increase in the phosphorescence intensities results from increased intersystem crossing (ISC), which also decreases fluorescence. We also studied the effect of annealing on phosphorescence with the directly excited triplet state of C106. In this case, two processes are affected by annealing, S 0 ?T 1 absorption and T 1 ?S 0 phosphorescence. The long-wavelength excitation (475 nm) avoids PVA polymer excitation. The phosphorescence lifetime decreases with annealing while the phosphorescence intensity increases. These changes suggest that the radiative rate of T 1 ? S 0 increases with annealing
In Search of a Choreographic Identity: An Anecdotal Reflection of Finding Oneself as a Choreographer
No full textIn this anecdotal reflection, I reflect upon and analyze my journey as a choreographer through four lenses: what led me to be a choreographer, my choreographic influences, an analysis of past trends in my work, and how I predict my choreographic identity will evolve moving forward. Though I did not grow up as a competition dancer, my high school and early college training provided an excellent base upon which my choreographic journey could grow. After a key opportunity presented itself in my third year of college, my career as a choreographer truly took off. Several choreographers, whose styles can be described by Laban Movement Analysis, have shaped me as the choreographer I am. Matt Steffanina and the Royal Family have both served as key influences in my hip-hop choreography due to their sharpness, isolations, and cohesiveness on stage. During my time at TCU, theatre professors Merrill West and Kelsey Milbourn have served as key influences on my tap in spite of their contrasting styles. Upon reflection of my past work, my use of stage stands out as a central defining factor; especially in large group numbers, I gravitate towards utilizing the majority of the stage to tell a story. I also heavily appreciate complexity within a piece. In tap, this manifests itself in terms of several sounds compressed into a short period of time whereas in hip-hop, this manifests itself in terms of several isolations compressed into a short period of time. Looking beyond graduation, I can continue to grow as an artist through continued education in Laban Movement Analysis and Alba Emoting. Additionally, by training as an assistant choreographer or dance captain under established Dallas-Fort Worth choreographers, I can both strengthen my working vocabulary of weaker dance styles and choreograph deeper, more meaningful stories. I am very pleased with the growth of my choreographic identity thus far and strongly look forward to strengthening it in the future
Synthesis of a beta-sheet analog derived from a 26-atom macrocycle incorporating leucine
No full textPharmaceutical development maintains a disproportionate focus on the synthesis of small molecules. This emphasis is based on historical research about bioavailability of molecules and the position that small molecule synthesis is cheaper and more efficient than the synthesis of large molecules. Macrocycles challenge these beliefs vis-a-vis the viability of large molecule pharmaceuticals. With availability in a simple three step process, macrocycles demonstrate the potential to be bioavailable and maintain biologically useful conformations in solution, representing a new frontier in pharmaceutical development. The previous synthesis of the 26-atom G-G macrocycle indicates that these molecules can maintain a beta-sheet like structure which could be utilized in antagonizing protein-protein interactions like the formation of beta-amyloid plaques in Alzheimer's disease.1
The synthesis of the leucine 26-atom macrocycle in this project investigates how the addition of leucine, a bulky hydrophobic amino acid, affects the formation of the planar structure as adopted by the G-G macrocycle. The macrocycle is obtained through a three-step reaction pathway. BOC-hydrazine, leucine, and dimethylamine (DMA) are added sequentially to a triazine core in a one-pot reaction. This acid then has a four-carbon acetal group installed using conventional coupling reagents to create the monomer. Dimerization of monomer is induced using a 1:1 mixture of dichloromethane (DCM) and trifluoracetic acid (TFA). Upon evaporation of solvent, this reaction is found to be qualitative in its yield of macrocycle.
Both 13C and 1H NMR spectra are used to confirm the resulting macrocycle's formation. COSY and rOesy two-dimensional NMR are utilized to assign structure. Downfield shifts of critical resonances in the 1H NMR spectra confirm that the macrocycle adopts a beta-sheet conformation
Garden-based learning as a professional development tool for educator experiential learning
No full textAs a form of learning outdoors at schools, garden-based learning has benefits that show increased academic outcomes, mental health, and scientific literacy among student participants. However, there is a gap in the literature on the impact of garden-based learning on educators. This exploratory study sought to understand the perspectives of educators on garden-based learning through Professional Development (PD) designed using the Experiential Learning Cycle. Fifteen educators from North Texas participated in at least one of the following: pre- /post-PD surveys and semi-structured interviews. Using phenomenologic methodology, all data points collected were pooled for meanings. Qualitative analysis indicated that educators experienced the PD in four main ways: to build community, share resources, acquire knowledge, and develop personal skills. Data analysis further indicated a connection between past experiences in the outdoors and higher educator self-efficacy
Small towns limit dispersal and reduce genetic diversity in populations of Texas horned lizards
No full textThere is a general expectation that urban populations will be fragmented and the movement of individuals will be restricted leading to low effective population sizes, low genetic diversity, higher inbreeding, and higher differentiation than populations living in more continuous habitat. In this study, we compare the genetic diversity and differentiation of Texas horned lizards that are found in four small towns (Kenedy, Karnes City, Rockdale, and Smithville) in Texas and at Tinker Air Force Base, Oklahoma to populations that occur in 16 natural areas and to an introduced population in South Carolina. We also present more detailed spatial genetic data and home range data for several of the towns. Texas horned lizards (Phrynosoma cornutum) living in small towns have lower genetic diversity, higher differentiation, and smaller effective population sizes than populations located in more natural areas. There was evidence for human-mediated movement of lizards into town; however, it has not been enough to counteract the effects of drift. Home range size is smaller in town than in more natural areas. Genetic patterns suggest dispersal occurs over short distances and is inhibited across areas with a high percent of impervious surface and major roads. These data suggest that effective planning to maintain suitable habitat and corridors to facilitate movement is critical to maintaining small terrestrial species like the Texas horned lizard and must be integrated into the early stages of urban development
Trans-forming PK-12 schools to increase inclusivity
No full textThe experience of transgender students in Texas public school environments is a difficult journey. Policies and procedures are often contradictory and confusing for school leaders who hold decision-making power. This research examined the lived experiences of PK-12 public school leaders as they work with transgender students to create an inclusive school environment. Additionally, the purpose of this project is to provide insights into how school leaders navigate decision-making processes regarding transgender students in Texas schools. Data were collected through semi-structured interviews with eight PK-12 public school leaders in Texas through a phenomenological approach. Capper’s Queer Theory epistemology was used as a guiding lens to decipher the emerging themes. Findings revealed that school leaders are often confused by the various policies and procedures impacting transgender students. Each school leader has their own opinion on what could make the school environment more inclusive for transgender students. Finally, even though students are the focus for school leaders, it is personal job security and legal protection that impacts decision making. Educational opportunities for school leaders and staff on policies and procedures that impact transgender students are needed. It is also imperative that school districts and the state of Texas align transgender student guidelines with
United States federal policy
Effect of polyploidy on stomata morphology in Vaccinium section Cyanococcus
No full textPolyploidy, a widespread phenomenon in vascular plants, plays a fundamental role in plant evolution and adaptation. Vaccinium sect. Cyanococcus, including blueberry species, comprises species of diploids, tetraploids, and hexaploids, making it an excellent model for studying the effect of polyploidy on morphology. Although stomata size has been shown to be correlated with ploidy level in a limited set of cultivated plants and one species pair of this group from herbarium specimens collected from the wild, the extent to which the pattern holds across the section in natural populations of the section is unknown. I investigated leaf stomatal size (length and width) and density across 18 species of Vaccinium sect. Cyanococcus. Sampling comprised four herbarium specimens for each species from individuals with ploidy level determined through flow cytometry and included diploids, tetraploids, and hexaploids. I found significant differences between stomatal density and ploidy level, with diploids having higher stomatal density compared to tetraploids and hexaploids. Conversely, stomatal size were found to increase significantly with higher ploidy levels, with hexaploids exhibiting the largest stomata. Principal component and discriminant analyses based on the stomatal traits distinctly clustered diploids, tetraploids, and tetraploids. I also demonstrate the utility of stomatal traits as a substitute for determining ploidy levels in V. sect. Cyanococcus, providing a cost-effective, efficient, and accessible method for studying polyploidy in plants as compared with, e.g., the squash method or flow cytometry
Fiber-optics based fluorescence detection. Part I: Basic concepts.
No full textContinuous in-line detection and process monitoring are essential for industrial, analytical, and biomedical applications. Lightweight, highly flexible, and low-cost fiber optics enable the construction of compact and robust hand-held devices for in situ chemical and biological species analysis in both industrial and biomedical in vitro/in vivo detection. Despite the broad range of fiber-optic based applications, we lack a good understanding of the parameters that govern the efficiency of light collection or the sensitivity of detection. Consequently, comparing samples of different optical density and/or geometry becomes challenging and can lead to misinterpretation of results; especially when we lack the approaches necessary to correct the detected signal (spectra) for artifacts such as inner-filter effect or scattering. Hence, in this work, we discuss factors affecting the signal detected by the fiber optic in the bare and lens-coupled flat-tipped configurations that lead to signal/spectral distortions. We also present a simple generic model describing the excitation profile and emission collection efficiency that we verify with experimental data. Understanding the principles governing the signal collected by the fiber will provide rationales for correcting the measured emission spectra and recovering the true emission profile of optically dense samples
Mercury Transfer From Aquatic Insects to Arctic Food Webs: Assessing Insect Mediated Methyl Mercury Flux and Mercury Contamination Risks
No full textMercury (Hg) is a global contaminant of significant ecological concern, particularly in aquatic systems. While inorganic mercury (IHg) is relatively nontoxic and does not bioaccumulate, microbial processes in aquatic environments convert IHg to methylmercury (MeHg), a highly toxic and bioavailable form that readily accumulates in organisms. Aquatic insects, which feed on primary producers such as algae during their larval stages, can accumulate substantial MeHg levels. Upon emerging as adults, these insects transport MeHg from aquatic ecosystems to adjacent terrestrial environments, facilitating cross-ecosystem mercury transfer.
This study quantified dipteran-mediated Hg flux in five ponds and one lake in the high Arctic (NW Greenland) during the summer of 2023. Emergent dipterans were collected weekly, and Hg flux was calculated based on biomass and mercury concentrations. Results revealed that Hg flux varied significantly by location and insect taxon, influenced by variation in both biomass and Hg concentrations. Risk analyses for Snow Bunting (Plectrophenax nivalis) and Lapland Longspur (Calcarius lapponicus) chicks consuming emergent aquatic insects indicated no direct risk from this dietary exposure. However, previous research highlights the significant role of emerging insects in Hg bioaccumulation within riparian spiders, raising concerns about secondary risks to arachnivorous birds