9 research outputs found
Story#11 - A meal in Tibet
No full textDr. SueLin Hilbert is faculty member in the Department of Emergency Medicine. She shared a personal story of sharing a meal in Tibet.
Excerpt:
….As my mom and I picked through our caches of food and admired the tiny blue flowers that were scattered amongst the rocks, the group of women we had seen off in the distance had now made their way over and were speaking with our guide. They were particularly curious about why my mom looked “definitely” Chinese and I looked “sort of Chinese”, but clearly neither of us was from China. Of course, my mom and I also had questions for them, so with the help of our guide, we asked if they would like to share our lunch
Polymer-coated iron oxide nanoparticles for medical imaging
No full textThesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Materials Science and Engineering, 2010.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student submitted PDF version of thesis.Includes bibliographical references (p. 144-157).One of the most versatile and safe materials used in medicine are polymer-coated iron oxide nanoparticles. This dissertation describes several formulations for in vivo imaging applications. The paramagnetic polymer-coated iron oxide nanoparticle aminoSPARK is used as a fluorescence-mediated tomography (FMT) imaging agent for stratification of prostate cancer tumors. This is achieved by conjugating it to a peptide that targets SPARC (secreted protein acidic rich in cysteine), a biomarker protein associated with aggressive forms of prostate cancer. Several types of polymer coatings for iron oxide nanoparticles have been systematically explored using a novel high-throughput screening technique to optimize coating chemistries and synthetic conditions to produce nanoparticles with maximum stability and ability to lower T2 contrast for MR imaging (R2, or relaxivity). Carboxymethyl dextran emerged from the screen as an ideal coating for superparamagnetic iron oxide nanoparticles. A commercially available, FDA-approved nanoparticle with similar surface chemistry, Feraheme, was chosen as a platform nanoparticle for further development. This work presents the first instance of chemical modification of Feraheme, making it more amenable to bioconjugation by converting its free carboxyl groups to free amine groups. This amine-functionalized Feraheme nanoparticle (amino-FH) is then used as a base nanoparticle to which various targeting and reporting functionalities can be added. A FH-based nanoparticle that can be used for cell loading is synthesized by covalently combining Feraheme with protamine, a pharmaceutical that also acts as a membrane translocating agent. A rhodamine-protamine conjugate is synthesized and then covalently bound to amino-FH using carbodiimide (CDI) chemistry. This results in a magnetofluorescent cell-labeling nanoparticle (ProRho-FH) that is readily taken up by mouse mesenchymal stem cells and U87 glioma cells. ProRho-FH can be used to non-invasively track cells for development and monitoring of cell-based therapies or for further investigation of biological mechanisms such as cell migration, tumor growth, and metastasis. This combination of two FDA-approved, commercially available materials to yield a superparamagnetic and fluorescent cell labeling nanoparticle is an excellent alternative to the recently discontinued Feridex. All polymer-coated iron oxide nanoparticles used in this dissertation were thoroughly characterized to fully understand their physicochemical and magnetic properties.by Suelin Chen.Ph.D
Análise e priorização estratégica em uma pequena empresa de construção civil
No full textA strategic analysis enables the identification of a company's current situation and prepares it
to develop strategies and action plans aimed at maintaining competitiveness in its market.
Synthesizing this analysis results in a SWOT matrix, which outlines the company's strengths,
weaknesses, opportunities, and threats. However, while the SWOT matrix is valuable, it does
not determine the importance of these factors or evaluate alternatives for prioritization among
potential strategies. In an effort to surpass traditional methods, this study endeavors to conduct
a strategic analysis of a small construction company, setting priorities among strategic
alternatives. Alongside conventional tools for analyzing internal and external environments, the
study employs the Analytic Network Process (ANP) to quantify strategic priorities. Through
the action research approach, the author undertook the entire analysis and prioritization process,
gathering data from the company and engaging its owner in discussion and assessment of
alternatives. The results revealed the priorities the company should adopt based on its market
position and competencies. Notably, these priorities underscored the necessity to enhance
communication with customers, upgrade workforce qualifications, and improve agility in
project management. Moreover, the study corroborated the feasibility and utility of applying
ANP in the strategic analysis and prioritization process.Através de uma análise estratégica é possível identificar a situação atual de uma empresa e
prepará-la para formular estratégias e planos de ação que buscam mantê-la competitiva no
mercado que atua. Quando sintetizada, essa análise gera uma matriz de forças, fraquezas,
oportunidades e ameaças, denominada matriz SWOT. Embora útil, essa matriz não permite
determinar a importância dos fatores encontrados e avaliar alternativas estratégicas a partir
deles, de forma a permitir uma priorização entre as potenciais estratégias. Indo além do
procedimento tradicional, este trabalho tem como objetivo realizar uma análise estratégica de
uma pequena empresa do setor de construção civil, de modo determinar alternativas estratégicas
prioritárias. Além da utilização das ferramentas normalmente aplicadas para análise dos
ambientes interno e externo, este trabalho utiliza o processo de análise em rede (ANP) de forma
a possibilitar uma quantificação de prioridades estratégicas. O trabalho de campo adotou a
abordagem de pesquisa-ação, na qual a autora do trabalho conduziu todo o processo de análise
e priorização, coletando dados da empresa e envolvendo seu proprietário na discussão e
julgamento de alternativas. Os resultados demonstraram as prioridades que a empresa deve
adotar em função de seu mercado e de suas competências, destacando a necessidade de
aprimoramento da comunicação com os clientes, qualificação da mão-de-obra e agilidade na
gestão de projetos. Além disso, este trabalho confirmou a viabilidade e a utilidade da aplicação
do ANP no processo de análise e priorização estratégic
A not-so-Sweet syndrome: A case report of a male presenting with acute febrile neutrophilic dermatosis
No full textPhysicians often encounter patients who present with a chief complaint of skin changes or lesions in both acute and primary care settings. Early initiation of appropriate treatment and pharmacotherapy in patients who present with rash is crucial to prevent decompensation, morbidity, and further downstream utilization of hospital resources. Acute febrile neutrophilic dermatosis, more commonly known as Sweet syndrome, is a rare and highly symptomatic inflammatory skin condition. Early recognition of Sweet syndrome is important as it requires specific treatment considerations and often can be a sign of an underlying pro-inflammatory condition, malignancy, or reaction to new medication that must be identified. This article discusses the presentation and management of a 50-year-old male who presented with a classic presentation of Sweet syndrome
The revised Approved Instructional Resources score: An improved quality evaluation tool for online educational resources.
No full textBACKGROUND: Free Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context. It has yet to be evaluated in other populations.
OBJECTIVES: We assessed the AAT\u27s usability in a diverse population of practicing emergency medicine (EM) physicians, residents, and medical students; solicited feedback; and developed a revised tool.
METHODS: As part of the Medical Education Translational Resources: Impact and Quality (METRIQ) study, we recruited medical students, EM residents, and EM attendings to evaluate five FOAM posts with the AAT and provide quantitative and qualitative feedback via an online survey. Two independent analysts performed a qualitative thematic analysis with discrepancies resolved through discussion and negotiated consensus. This analysis informed development of an initial revised AAT, which was then further refined after pilot testing among the author group. The final tool was reassessed for reliability.
RESULTS: Of 330 recruited international participants, 309 completed all ratings. The Best Evidence in Emergency Medicine (BEEM) score was the component most frequently reported as difficult to use. Several themes emerged from the qualitative analysis: for ease of use-understandable, logically structured, concise, and aligned with educational value. Limitations include deviation from questionnaire best practices, validity concerns, and challenges assessing evidence-based medicine. Themes supporting its use include evaluative utility and usability. The author group pilot tested the initial revised AAT, revealing a total score average measure intraclass correlation coefficient (ICC) of moderate reliability (ICC = 0.68, 95% confidence interval [CI] = 0 to 0.962). The final AAT\u27s average measure ICC was 0.88 (95% CI = 0.77 to 0.95).
CONCLUSIONS: We developed the final revised AAT from usability feedback. The new score has significantly increased usability, but will need to be reassessed for reliability in a broad population
The revised Approved Instructional Resources score: An improved quality evaluation tool for online educational resources
No full textBACKGROUND: Free Open‐Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context. It has yet to be evaluated in other populations. OBJECTIVES: We assessed the AAT’s usability in a diverse population of practicing emergency medicine (EM) physicians, residents, and medical students; solicited feedback; and developed a revised tool. METHODS: As part of the Medical Education Translational Resources: Impact and Quality (METRIQ) study, we recruited medical students, EM residents, and EM attendings to evaluate five FOAM posts with the AAT and provide quantitative and qualitative feedback via an online survey. Two independent analysts performed a qualitative thematic analysis with discrepancies resolved through discussion and negotiated consensus. This analysis informed development of an initial revised AAT, which was then further refined after pilot testing among the author group. The final tool was reassessed for reliability. RESULTS: Of 330 recruited international participants, 309 completed all ratings. The Best Evidence in Emergency Medicine (BEEM) score was the component most frequently reported as difficult to use. Several themes emerged from the qualitative analysis: for ease of use—understandable, logically structured, concise, and aligned with educational value. Limitations include deviation from questionnaire best practices, validity concerns, and challenges assessing evidence‐based medicine. Themes supporting its use include evaluative utility and usability. The author group pilot tested the initial revised AAT, revealing a total score average measure intraclass correlation coefficient (ICC) of moderate reliability (ICC = 0.68, 95% confidence interval [CI] = 0 to 0.962). The final AAT’s average measure ICC was 0.88 (95% CI = 0.77 to 0.95). CONCLUSIONS: We developed the final revised AAT from usability feedback. The new score has significantly increased usability, but will need to be reassessed for reliability in a broad population
The Social Media Index as an Indicator of Quality for Emergency Medicine Blogs: A METRIQ Study
No full textStudy objective: Online educational resources such as blogs are increasingly used for education by emergency medicine clinicians. The Social Media Index was developed to quantify their relative impact. The Medical Education Translational Resources: Indicators of Quality (METRIQ) study was conducted in part to determine the association between the Social Media Index score and quality as measured by gestalt and previously derived quality instruments. Methods: Ten blogs were randomly selected from a list of emergency medicine and critical care Web sites. The 2 most recent clinically oriented blog posts published on these blogs were evaluated with gestalt, the Academic Life in Emergency Medicine Approved Instructional Resources (ALiEM AIR) score, and the METRIQ-8 score. Volunteer raters (including medical students, emergency medicine residents, and emergency medicine attending physicians) were identified with a multimodal recruitment methodology. The Social Media Index was calculated in February 2016, November 2016, April 2017, and December 2017. Pearson's correlations were calculated between the Social Media Index and the average rater gestalt, ALiEM AIR score, and METRIQ-8 score. Results: A total of 309 of 330 raters completed all ratings (93.6%). The Social Media Index correlated moderately to strongly with the mean rater gestalt ratings (range 0.69 to 0.76) and moderately with the mean rater ALiEM AIR score (range 0.55 to 0.61) and METRIQ-8 score (range 0.53 to 0.57) during the month of the blog post's selection and for 2 years after. Conclusion: The Social Media Index's correlation with multiple quality evaluation instruments over time supports the hypothesis that it is associated with overall Web site quality. It can play a role in guiding individuals to high-quality resources that can be reviewed with critical appraisal techniques
