Ridgewater College

Through an ambitious change management initiative titled "No One Waits (NOW)," Bluewater Health leaders enlisted staff to take ownership of reducing wait times by identifying barriers to transitions within the hospital and to the community. The approach shifted the hospital's culture to overcome those impediments and succeed in reducing wait times dramatically, including compared with peers. Meanwhile, overall patient experience ratings improved and staff trust increased. These changes have been maintained over several years and have resulted in better management of patient volumes during the COVID-19 pandemic and the current health human resources crisis.

Visitor restrictions in long-term care (LTC) have had many consequences for residents, their families and care providers. The value of family presence in LTC was obscured during the COVID-19 pandemic until the designation of essential care partners (ECPs) was introduced to support the re-entry of family caregivers into LTC. Three ECPs share their personal experiences of caring for a loved one in LTC before and during the pandemic. Partnerships with LTC homes, residents, families and ECPs are identified as a unifying way forward to bolster future pandemic preparedness and ensure that current and future residents receive safe and high-quality care.

Opioid Use Disorder (OUD) is one of the most severe health care problems in the USA. People addicted to opioids need various treatments, including Medication-Assisted Treatment (MAT), proper counseling, and behavioral therapies. However, during the peak time of the COVID-19 pandemic, the supply of emergency medications was disrupted seriously. Patients faced severe medical care scarcity since many pharmaceutical companies, drugstores, and local pharmacies were closed. Import-export was also canceled to consent to the government emergency law, i.e., lockdown, quarantine, and isolation. These circumstances and their negative effects on OUD patient’s psychology could have led them to a drop out of MAT medications and persuaded to resume illicit opioid use. This project involves collecting and analyzing a large volume of Twitter data related to MAT medications for OUD patients. We discover the Active MAT Medicine Users (AMMUs) on twitter. For this, we build a seed dictionary of words related to OUD and MAT and apply association rules to expand it. Further, AMMUs’ tweet posts are studied ‘before the pandemic’ (BP) and ‘during the pandemic’ (DP) to understand how the drug behaviors and habits have changed due to COVID-19. We also perform sentiment analysis on Tweets to determine the impact of the COVID-19 pandemic on the psychology of AMMUs. Our analysis shows that the use of MAT medications has decreased around 30.54%, where the use of illicit drugs and other prescription opioids increased 18.06% and 12.12%, respectively, based on AMMUs’ tweets posted during the lockdown compared with before the lockdown statistics. The COVID-19 pandemic and lockdown may result in the resumption of illegal and prescription opioid abuse by OUD patients. Necessary steps and precautions should be taken by health care providers to ensure the emergency supply of medicines and also psychological support and thus prevent patients from illicit opioid use.

Abstract NOTE: The first page of text has been automatically extracted and included below in lieu of an abstract A Middle School Project for Science and Math Enhancement through Engineering Abstract This study is focused on the impact of curricular and extra curricular engineering-based instructional activities on middle students’ perceptions of their ability to become engineers. Middle school students are at an age where high interest activities are essential for motivation and relevant learning. This is also the age where students’ interest can be piqued to consider careers in STEM fields. This study also looks at math content knowledge, attitudes toward math and science, and perceptions of technology, engineering, and what defines engineering. In 2007, the Stillwater Middle School received a $15,000 grant from the Stillwater Public Education Foundation to start an engineering program for sixth- and seventh-grade students. The grant allowed the middle school to partner with Oklahoma State University to develop a multi- faceted engineering program. Through this partnership between the middle school and local university, three primary instructors have developed, coordinated, and conducted the majority of the components of the program. The ideas and initiative behind the program were proposed and enacted by a chemical engineering professor at Oklahoma State University, who is also highly involved in the pre-service teacher program at the university as well as several engineering education initiatives at her university. She has partnered with two middle school science instructors to develop, fund, conduct, and expand the engineering program at the middle school. The Enriching Science and Math through Engineering project consists of the following three components for students with an embedded teacher professional development program for middle school teachers. A Curriculum Integration project has sixth and seventh grade core team teachers (math, science, social studies, and language arts) using existing and new integrated engineering modules during school. The new modules were developed by the teachers working with engineering and education professors. A Summer Camp is an engineering project based program for 6th and 7th grade students delivered by two science teachers with support from an engineering professor. An After School Mentoring Program that meets once a week for 45 sixth and seventh grade girls. The College of Engineering provided mentors to support the students in understanding engineering and to encourage them to consider engineering careers. Middle school students participate in engineering projects that were age appropriate and encouraged problem solving, creativity and collaborative learning, as well as meet professional engineering women. Seventh grade girls served as cross-age mentors for sixth grade girls in addition to the college level mentors. In 2007, the engineering professor was the lead for the project. In 2008, the two middle school science teachers are providing project leadership. A variety of instruments were administered to determine mathematics and science content knowledge changes, knowledge about engineering and technology and the impact the instructional activities had on overall student perceptions. Results have shown positive impact of the interventions.

In the summer of 2018, six dogs exposed to a harmful algal bloom (HAB) of Microcystis in Martin County Florida (USA) developed clinicopathological signs of microcystin (MC) intoxication (i.e., acute vomiting, diarrhea, severe thrombocytopenia, elevated alanine aminotransferase, hemorrhage). Successful supportive veterinary care was provided and led to survival of all but one patient. Confirmation of MC intoxication was made through interpretation of clinicopathological abnormalities, pathological examination of tissues, microscopy (vomitus), and analytical MC testing of antemortem/postmortem samples (vomitus, blood, urine, bile, liver, kidney, hair). Gross and microscopic examination of the deceased patient confirmed massive hepatic necrosis, mild multifocal renal tubular necrosis, and hemorrhage within multiple organ systems. Microscopy of a vomitus sample confirmed the presence of Microcystis. Three analytical MC testing approaches were used, including the MMPB (2-methyl-3-methoxy-4-phenylbutyric acid) technique, targeted congener analysis (e.g., liquid chromatography tandem-mass spectrometry of MC-LR), and enzyme-linked immunosorbent assay (ELISA). Total Adda MCs (as MMPB) were confirmed in the liver, bile, kidney, urine, and blood of the deceased dog. Urinalysis (MMPB) of one surviving dog showed a high level of MCs (32,000 ng mL−1) 1-day post exposure, with MCs detectable >2 months post exposure. Furthermore, hair from a surviving dog was positive for MMPB, illustrating another testable route of MC elimination in canines. The described cases represent the first use of urine as an antemortem, non-invasive specimen to diagnose microcystin toxicosis. Antemortem diagnostic testing to confirm MC intoxication cases, whether acute or chronic, is crucial for providing optimal supportive care and mitigating MC exposure.

Head and neck masses are usually indicative of infectious, neoplastic, or congenital entities. Most head and neck masses are related to local or regional disease, although systemic neoplastic disease can present in the cervical area. We present an interesting case report of a young woman with a neck mass caused by an organism most commonly associated with sexually transmitted infections, and not with the more common causes of cervical head and neck masses.

Anyone who has studied American presidential assassinations is well aware of the pitfalls involved, since the landscape is littered with outlandish theories espoused by those who are convinced that they have uncovered some sensational truth. Therefore, it is refreshing to see an academic historian turn his attention to the assassination of John F. Kennedy. Michael L. Kurtz admits that he offers nothing new nor is this a definitive account of the assassination. Rather, he attempts to utilize the most up-to-date materials as he surveys the arguments for Lee Harvey Oswald both as a lone gunman or as a conspirator. He also examines Oswald's life and his possible connections with organized crime or government intelligence agencies. There are a number of virtues to Kurtz's approach, not the least of which is that additional research caused him to change his mind about some issues. He concedes that Oswald's rifle could have inflicted the head wounds and that the assassin had time to fire the shots that struck both Kennedy and Gov. John Connally. It is almost unprecedented for an assassination author to admit that he has changed his mind about anything.

Processive replication is achieved by tethering the polymerase to the DNA template by a circular sliding clamp protein. Clamps are loaded onto primer‐template DNA by clamp loaders in a reaction fueled by ATP hydrolysis. Clamp loaders are pentameric AAA+ protein complexes conserved across all domains of life. Replication Factor C, the S. cerevisiae clamp loader, is a hetero‐pentameric protein with 4 intact ATPase sites. Our analysis of RFC ATP binding indicates that RFC alone binds 2 ATP molecules and in the presence of PCNA clamp and/or primer‐template DNA, it binds 3–4 ATP molecules, which indicates a link between the ATP binding and PCNA/DNA binding activities. According to results from our pre‐steady state kinetic analysis, RFC alone hydrolyzes ATP at a limiting rate of 0.025 second −1 , which increases to 0.05 second −1 in the presence of PCNA clamp. PCNA stimulates formation of an “active” RFC‐ATP‐PCNA complex within 2 seconds while it takes 5–7 second for an RFC‐ATP binary complex alone to achieve the same “active” conformation. The binding of double‐stranded DNA to this complex, as well as primer‐template DNA with either recessed 3′ or 5′ends, triggers rapid hydrolysis of 3 ATP molecules at a rate of 7–10 second −1 while binding of single‐stranded DNA does not trigger rapid ATP hydrolysis. This suggests that RFC “recognizes” the duplex portion of primer‐template DNA for clamp assembly.