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Planned venoarterial extracorporeal membrane oxygenation (VA ECMO) is increasingly used during bilateral orthotopic lung transplantation (BOLT) and may be superior to off-pump support for patients without pulmonary hypertension. In this single-institution study, we compared rates of textbook outcome between BOLTs performed with planned VA ECMO or off-pump support for recipients with no or mild pulmonary hypertension. Patients with no or mild pulmonary hypertension who underwent isolated BOLT between 1/2017 and 2/2021 with planned off-pump or VA ECMO support were included. Textbook outcome was defined as freedom from intraoperative complication, 30-day reintervention, 30-day readmission, post-transplant length of stay >30 days, 90-day mortality, 30-day acute rejection, grade 3 primary graft dysfunction at 48 or 72 hours, post-transplant ECMO, tracheostomy within 7 days, inpatient dialysis, reintubation, and extubation >48 hours post-transplant. Textbook outcome achievement was compared between groups using multivariable logistic regression. Two hundred thirty-seven BOLTs were included: 68 planned VA ECMO and 169 planned off-pump. 14 (20.6%) planned VA ECMO and 27 (16.0%) planned off-pump patients achieved textbook outcome. After adjustment for prior BOLT, lung allocation score, ischemic time, and intraoperative transfusions, planned VA ECMO was associated with higher odds of textbook outcome than planned off-pump support (odds ratio 3.89, 95% confidence interval 1.58-9.90, p = 0.004). At our institution, planned VA ECMO for isolated BOLT was associated with higher odds of textbook outcome than planned off-pump support among patients without pulmonary hypertension. Further investigation in a multi-institutional cohort is warranted to better elucidate the utility of this strategy. [ABSTRACT FROM AUTHOR]

Background: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients.Methods: We enrolled 140 English-speaking patients ≥60 yr old scheduled for noncardiac surgery under general anaesthesia in an observational cohort study, of whom 52 underwent neuroimaging. We measured cognition; Aβ, tau, p-tau levels in CSF; and resting-state intrinsic functional connectivity in six Alzheimer's disease-risk regions before and 6 weeks after surgery.Results: There were no significant APOE4-related differences in cognition or CSF biomarkers, except APOE4 carriers had lower CSF Aβ levels than non-carriers (preoperative median CSF Aβ [median absolute deviation], APOE4 305 pg ml-1 [65] vs 378 pg ml-1 [38], respectively; P=0.001). Controlling for age, APOE4 carriers had significantly greater preoperative functional connectivity than non-carriers between several brain regions implicated in Alzheimer's disease, including between the left posterior cingulate cortex and left angular gyrus (β [95% confidence interval, CI], 0.218 [0.137-0.230]; PFWE=0.016). APOE4 carriers, but not non-carriers, experienced significant connectivity decreases from before to 6 weeks after surgery between several brain regions including between the left posterior cingulate cortex and left angular gyrus (β [95% CI], -0.196 [-0.256 to -0.136]; PFWE=0.001). Most preoperative and postoperative functional connectivity differences did not change after controlling for preoperative CSF Aβ levels.Conclusions: Postoperative change trajectories for cognition and CSF Aβ, tau or p-tau levels did not differ between community dwelling older APOE4 carriers and non-carriers. APOE4 carriers showed greater preoperative functional connectivity and greater postoperative decreases in functional connectivity in key Alzheimer's disease-risk regions, which occur via Aβ-independent mechanisms. [ABSTRACT FROM AUTHOR]

Small class size is often used as an indicator of quality in higher education, and some research suggests that instructors in smaller classes more often use activities that are learner-centered and that involve physical and mental activity on the part of learners, such as group work, simulations, and case studies. However, we have little information on how instructors change their pedagogical practice when they teach in large- versus small-class settings. In this study, we examine alignment between intended and enacted teaching strategies, or initial plans and specific ways in which instructors reported altering their teaching in the context of a university policy shift to smaller classes. Furthermore, we examine instructional challenges in this shift to call attention to professional development needs of small-class teaching and to best leverage the benefits of such activities for student performance and retention. [ABSTRACT FROM AUTHOR]

The article discusses the role of Centers for Teaching and Learning (CTL) as higher education is shifting from a learning-centered to de-centered educational environment. Topics covered include the need to adjust Robert Barr and John Tagg's "Learning Paradigm" to a "De-centered Paradigm to allow for a more democratic or reciprocal relationship between instructor, learner and material, and examples of what this shift means in both concept and practice.

Abstract: In this chapter, we describe strategies teaching and learning centers can use in partnering with programs to conduct action‐oriented assessment projects. We illustrate these strategies with examples from an evaluation of a social engagement requirement for art and design students. [ABSTRACT FROM AUTHOR]

This paper presents a quasi-experimental evaluation of a required, teaching-focused, new faculty program at a large research university. The study makes use of institutional data, including student evaluations of teaching and faculty participation in educational development activities, which are available on many campuses yet rarely used in program evaluation. Results show positive impacts. Faculty found the program valuable and reported increases in their preparation for a range of teaching tasks. In comparison to earlier cohorts, program participants received stronger student evaluations on two global items, and demonstrated significantly more connections with the teaching center in their early careers. [ABSTRACT FROM AUTHOR]

In the eyes-closed, awake condition, EEG oscillatory power in the alpha band (7–13 Hz) dominates human spectral activity. With eyes open, however, EEG alpha power substantially decreases. Less alpha attenuation with eyes opening has been associated with inattention; thus, we analysed whether reduced preoperative alpha attenuation with eyes opening is associated with postoperative inattention, a delirium-defining feature. Preoperative awake 32-channel EEG was recorded with eyes open and eyes closed in 71 non-neurological, noncardiac surgery patients aged ≥ 60 years. Inattention and other delirium features were assessed before surgery and twice daily after surgery until discharge. Eyes-opening EEG alpha-attenuation magnitude was analysed for associations with postoperative inattention, primarily, and with delirium severity, secondarily, using multivariate age- and Mini-Mental Status Examination (MMSE)-adjusted logistic and proportional-odds regression analyses. Preoperative alpha attenuation with eyes opening was inversely associated with postoperative inattention (odds ratio [OR] 0.73, 95% confidence interval [CI]: 0.57, 0.94; P =0.038). Sensitivity analyses showed an inverse relationship between alpha-attenuation magnitude and inattention chronicity, defined as 'never', 'newly', or 'chronically' inattentive (OR 0.76, 95% CI: 0.62, 0.93; P =0.019). In addition, preoperative alpha-attenuation magnitude was inversely associated with postoperative delirium severity (OR 0.79, 95% CI: 0.65, 0.95; P =0.040), predominantly as a result of the inattention feature. Preoperative awake, resting, EEG alpha attenuation with eyes opening might represent a neural biomarker for risk of postoperative attentional impairment. Further, eyes-opening alpha attenuation could provide insight into the neural mechanisms underlying postoperative inattention risk. [ABSTRACT FROM AUTHOR]

Inger Bergom, Mary C. Wright, Marie Kendall Brown, and Michael Brooks describe an innovative academic approach to collaborative learning in a large lecture class. [ABSTRACT FROM AUTHOR]

Data interpretation and theory building are two key skills often taught in health sciences qualitative methods courses. However, little is known about how novice researchers make sense of data, as well as how their thought processes differ from those of expert researchers. In this classroom research project, the author explores how qualitative methods students in a public health graduate program describe their processes of making sense of data and building theory. She then compares these processes with "expert" guidelines to draw implications for how to enhance teaching in a qualitative research class. [ABSTRACT FROM AUTHOR]

This article investigates the women's lodge as a place and as space in understanding how gender was constructed for Pacific Northwest Plateau. Gender and all manner of status and societal roles have come to be seen as constructed. People help define the categories of human groupings by their behavior, their expectations, their ideas, their resistance, and by the way they treat each other. Female gender construction began at the woman's lodge among the indigenous peoples inhabiting the Pacific Northwest Plateau at the beginning of the nineteenth century. A constellation of gender definitions, beliefs, and behaviors radiated from that place. The Plateau is an arid, often mountainous region drained by the Columbia, Fraser. and Snake rivers, or roughly occupying a region defined today by eastern British Columbia, Washington, and Oregon, all of Idaho, and parts of Alberta and Montana. A wide range of indigenous peoples made their home in the region, such as the Nez Perce in Idaho state, the Yakama of Washington state, and the Thompson, Lillooet, and the Okanagan in Canada. In a 1930's project defining the Plateau as a distinct cultural area, anthropologist Verne F. Ray found menstrual seclusion and girls' puberty rites, both sited in the woman's lodge, universal in the region.

Identifies key areas in which the expansion of the American system of higher education significantly has influenced the growth of prison education. Rise of public and community colleges; Liberal arts curriculum; Implementation of federal funding systems such as the Pell grant program.

The article discusses importance of advising practices, university discussions on its course drop policy, and departmental efforts at diversity and inclusion to identify characteristics of the students and courses involved in drops. Topics include that too many concentration requirements in one semester was overwhelming and stressful; mentions the importance of academic advising; and also mentions the external health circumstances in the students.

Objectives: Traditionally, medical students on clinical rotations receive instruction on principles of mental health only during the psychiatry clerkship. We used emails to insert teaching of psychiatric concepts beyond the psychiatry clerkship into other rotations using the method of spaced learning, the delivery of brief morsels of information repeated over time intervals. We predicted that the intervention would improve attitudes and confidence towards the integration of psychiatry and knowledge retention. Methods: We developed and distributed a series of emails relating key psychiatric concepts targeted to the other core clerkships. Results: In a cluster-randomized trial over one academic year (intervention groupn = 71, control groupn = 61), scores on the Attitudes and Confidence in the Integration of Psychiatry scale and on the knowledge quiz did not differ significantly. Students who actively engaged with the emails demonstrated significantly higher scores on the knowledge test. Email users valued the timing, format of delivery and application of psychiatric principles outside the psychiatric setting. Participants recommended simplifying the format and previewing the benefits of spaced learning to increase utilization. Conclusion: Delivering spaced learning through emails, within a curriculum designed to foster engagement, may provide an efficient means of addressing the widely-recognized but elusive goal of integrating teaching across medical disciplines. [ABSTRACT FROM PUBLISHER]