Providence Milwaukie Hospital

What could a tabletop role-playing game like Dungeons & Dragons possibly have in common with IT in higher education? As it turns out, quite a lot! Both rely on strategic thinking, collaboration, adaptability, and a willingness to navigate the unknown. In both worlds, plans are made, risks are taken, and outcomes are shaped as much by teamwork as by chance. The roll of a die in D&D can determine whether a player achieves a “natural 20” success or faces a “critical failure” and in IT the same spectrum of outcomes plays out daily through system roll-outs, infrastructure challenges, and unexpected victories. What matters most isn’t the roll itself, but how teams respond, adapt, and carry the story forward.

This project presents the development and validation of high-fidelity numerical models for fin-tube heat exchangers to enable accurate performance prediction and informed design optimization. The modeling framework integrates detailed geometric specifications, thermophysical property data, and system-level constraints to simulate the heat exchanger’s behavior under a range of operating conditions. The model is calibrated using real-world product specifications and validated against experimental data collected from controlled cooling and heating tests. In cooling mode, the model captures the overall trends in capacity and outlet air temperature but tends to underpredict latent effects, especially at lower air flow rates. In heating mode, the simulation consistently overestimates both the thermal capacity and outlet air temperature, indicating the need for refinement in air-side heat transfer assumptions. Despite these deviations, the model provides a solid foundation for optimization, allowing key design variables to be tuned within physical and performance-based constraints. This research advances the ability to simulate, validate, and optimize fin-tube heat exchanger designs with greater confidence and efficiency.

BackgroundRecent USDA Economic Research Service Population Survey cites a stabilization of food insecurity overall in the USA between 2019 and 2020, but Black, Hispanic, and all households with children cited increases — underscoring that the COVID-19 pandemic caused severe disruptions to food insecurity for historically disenfranchised populations.AimDescribe lessons learned, considerations, and recommendations from the experience of a community teaching kitchen (CTK) in addressing food insecurity and chronic disease management among patients during the COVID-19 pandemic.SettingThe Providence CTK is co-located at Providence Milwaukie Hospital in Portland, Oregon.ParticipantsProvidence CTK serves patients who report a higher prevalence of food insecurity and multiple chronic conditions.Program DescriptionProvidence CTK has five components: chronic disease self-management education, culinary nutrition education, patient navigation, a medical referral-based food pantry (Family Market), and an immersive training environment.Program EvaluationCTK staff highlight that they provided food and education support when it was needed most, leveraged existing partnerships and staffing to sustain operations and Family Market accessibility, shifted delivery of educational services based-on billing and virtual service considerations, and repurposed roles to support evolving needs.DiscussionThe Providence CTK case study provides a blueprint for how healthcare organizations could design a model of culinary nutrition education that is immersive, empowering, and inclusive.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07931-5.

Heart failure is a leading cause of mortality, yet our understanding of the genetic interactions underlying this disease remains incomplete. Here, we harvest 1352 healthy and failing human hearts directly from transplant center operating rooms, and obtain genome-wide genotyping and gene expression measurements for a subset of 313. We build failing and non-failing cardiac regulatory gene networks, revealing important regulators and cardiac expression quantitative trait loci (eQTLs). PPP1R3A emerges as a regulator whose network connectivity changes significantly between health and disease. RNA sequencing after PPP1R3A knockdown validates network-based predictions, and highlights metabolic pathway regulation associated with increased cardiomyocyte size and perturbed respiratory metabolism. Mice lacking PPP1R3A are protected against pressure-overload heart failure. We present a global gene interaction map of the human heart failure transition, identify previously unreported cardiac eQTLs, and demonstrate the discovery potential of disease-specific networks through the description of PPP1R3A as a central regulator in heart failure.

The oclacitinib therapy is used to reduce effect of itching in dogs and cats. In Valerie Fadok's experience, dogs on concurrent immunotherapy have a better response on oclacitinib. Wayne Rosenkrantz stated that oclacitinib has a very rapid onset of activity compared to corticosteroids and that its effect is much more rapid than that of ciclosporin. There are several references supporting oclacitinib being highly effective in treating pruritus. The Cosgrove study showed a greater than 50% reduction in pruritus within 90 days in 63.4% of cases. Regarding oclacitinib, when people look at the current literature the reports of adverse events are relatively low. Looking at the Cosgrove study, urinary tract infections, pyoderma, otitis, weight gain, vomiting and diarrhoea were the most commonly noted adverse events. Less common adverse events reported in the literature or anecdotally include pneumonia, interdigital cysts, demodicosis, lethargy, tremors, haematological abnormalities, neoplasia, seizures and aggression.

In the last thirty years the number of Latinos attending college has increased dramatically. According to the U. S. Department of Education (2001) approximately nine (8.6) percent (i.e., 1,200,100) of all students enrolled in our nation's colleges and universities during the 1997 fall semester were of Hispanic/Latino heritage. Although this number reflects a slight increase over previous years, persistence to graduation among Latino students however, remains a significant problem, as Latinos continue to still experience higher attrition rates than white Americans. Approximately twenty percent of Latinos are reported to complete their college studies within six years, compared to more than 40 percent of whites and Asian Americans (Porter 1990).