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Background: Cardiac stress tests for diagnosis of coronary artery disease (CAD) are incompletely sensitive and specific.Objective: We examined the frequency of significant CAD in patients presenting to the emergency department (ED) with chest pain who have had a recent negative or inconclusive (

Somatic growth rate is an important determinant of population growth and recruitment in marine fish species (Kerns and Lombardi-Carlson, 2017). Clupeoids have an opportunistic life history strategy, which is characterized [...]

The purpose of this study was to identify potential signature pedagogies used by business education teachers in their programs and to what extent specific demographics impacted business education teachers' use of classroom instructional strategies. The research presented in this study used a random convenience sampling of business teachers from across the United States. This study found signature pedagogies of business education by frequency are lecture, guided practice, and project-based learning. The top three business education instructional strategies by mean are questioning, guided practice, and whole group questioning. This study identified differences of instructional strategy usage based on various demographic categories. These categories included participant location, setting, school type, teaching certification method, and years of experience. Of these categories, years of experience was linked to significant differences.

Purpose Early accurate diagnosis of infection ± organ dysfunction (sepsis) remains a major challenge in clinical practice. Utilizing effective biomarkers to identify infection and impending organ dysfunction before the onset of clinical signs and symptoms would enable earlier investigation and intervention. To our knowledge, no prior study has specifically examined the possibility of pre-symptomatic detection of sepsis. Methods Blood samples and clinical/laboratory data were collected daily from 4385 patients undergoing elective surgery. An adjudication panel identified 154 patients with definite postoperative infection, of whom 98 developed sepsis. Transcriptomic profiling and subsequent RT-qPCR were undertaken on sequential blood samples taken postoperatively from these patients in the three days prior to the onset of symptoms. Comparison was made against postoperative day-, age-, sex- and procedure- matched patients who had an uncomplicated recovery (n =151) or postoperative inflammation without infection (n =148). Results Specific gene signatures optimized to predict infection or sepsis in the three days prior to clinical presentation were identified in initial discovery cohorts. Subsequent classification using machine learning with cross-validation with separate patient cohorts and their matched controls gave high Area Under the Receiver Operator Curve (AUC) values. These allowed discrimination of infection from uncomplicated recovery (AUC 0.871), infectious from non-infectious systemic inflammation (0.897), sepsis from other postoperative presentations (0.843), and sepsis from uncomplicated infection (0.703). Conclusion Host biomarker signatures may be able to identify postoperative infection or sepsis up to three days in advance of clinical recognition. If validated in future studies, these signatures offer potential diagnostic utility for postoperative management of deteriorating or high-risk surgical patients and, potentially, other patient populations., Author(s): Roman A. Lukaszewski [sup.1] [sup.4], Helen E. Jones [sup.1], Vivian H. Gersuk [sup.2], Paul Russell [sup.1] [sup.3], Andrew Simpson [sup.1], David Brealey [sup.4] [sup.5], Jonathan Walker [sup.6], Matt Thomas [...]

Objectives: Mercapto acetyl tri‐glycine renogram (MAG3) scan has been the gold standard assessment of pediatric ureteropelvic junction obstruction (UPJO) but requires intravenous access and radiation exposure. While Doppler ultrasound measurements of resistive indices (RI) of the arcuate arteries have been proposed as an alternative assessment of obstruction, they have not been widely adopted in the pediatric population. We hypothesized that RI of the main renal artery (RA) is more strongly correlated with MAG3 findings than arcuate RI. Methods: Pediatric patients with unilateral Society for Fetal Urology grade 3–4 hydronephrosis undergoing concomitant RUS and MAG3 were recruited. Doppler ultrasound peak systolic velocity (PSV); RI of bilateral RA at the origin, middle, and hilum; and RI of the superior, middle, and lower pole arcuate arteries were obtained. MAG3 differential renal function (DRF) and T½ were recorded. Differences in RI measurements (DRI) between the affected and normal kidney were calculated and compared with DRF and T½. Results: 31 patients (median 4.6‐month‐old) were enrolled. Only RA RI at the origin differed between affected and normal kidneys (p <.001). DRI RA at the origin showed weak evidence for an association with MAG3 DRF < 40% (p.07). DRI was not associated with T½ > 20 minutes. Conclusion: There was weak evidence for an association between RA DRI at the origin and DRF but not with T½. These findings suggest that RA DRI may provide additional data in the evaluation of patients with UPJO to tailor the use of MAG3 and associated risk of radiation exposure to those patients most at risk for concomitant renal function impairment. [ABSTRACT FROM AUTHOR]

Background: Cardiac stress tests for diagnosis of coronary artery disease (CAD) are incompletely sensitive and specific.Objective: We examined the frequency of significant CAD in patients presenting to the emergency department (ED) with chest pain who have had a recent negative or inconclusive (

Living-Learning Communities (LLCs) have proven to be a successful high impact practice at institutions across the nation. Norfolk State University (NSU), a Historically Black University, recently established a formal LLC program as a part of the University's Quality Enhancement Plan (QEP). Through a strong partnership with Academic and Student Affairs, NSU implemented and invented LLCs all within one academic year. Similar to the collaborative nature of LLCs, this paper examines the lessons learned from various perspectives (LLC director, teaching dean, faculty liaison, faculty) during the rapid inventing and implementing of LLCs.

Purpose: To develop a deep image prior (DIP) reconstruction for B1+‐corrected 2D cine MR fingerprinting (MRF). Methods: The proposed method combines low‐rank (LR) modeling with a DIP to generate cardiac phase‐resolved parameter maps without motion correction, employing self‐supervised training to enforce consistency with undersampled spiral k‐space data. Two implementations were tested: one approach (DIP) for cine T1, T2, and M0 mapping, and a second approach (DIP with effective B1+ estimation [DIP‐B1]) that also generated an effective B1+ map to correct for errors due to RF transmit inhomogeneities, through‐plane motion, and blood flow. Cine MRF data were acquired in 14 healthy subjects and four reconstructions were compared: LR, low‐rank motion‐corrected (LRMC), DIP, and DIP‐B1. Results were compared to diastolic ECG‐triggered MRF, MOLLI, and T2‐prep bSSFP. Additionally, bright‐blood and dark‐blood images calculated from cine MRF maps were used to quantify ventricular function and compared to reference cine measurements. Results: DIP and DIP‐B1 outperformed other cine MRF reconstructions with improved noise suppression and delineation of high‐resolution details. Within‐segment variability in the myocardium (reported as the coefficient of variation for T1/T2) was lowest for DIP‐B1 (2.3/8.3%) followed by DIP (2.7/8.7%), LRMC (3.5/10.5%), and LR (15.3/39.6%). Spatial homogeneity improved with DIP‐B1 having the lowest intersegment variability (2.6/4.1%). The mean bias in ejection fraction was −1.1% compared to reference cine scans. Conclusion: A DIP reconstruction for 2D cine MRF enabled cardiac phase‐resolved mapping of T1, T2, M0, and the effective B1+ with improved noise suppression and precision compared to LR and LRMC. [ABSTRACT FROM AUTHOR]