Years Of Support Research Articles

Engineering a Pathway to Glucose-Responsive Therapeutics.

In 2014, the American Diabetes Association instituted a novel funding paradigm to support diabetes research through its Pathway to Stop Diabetes® Program. Pathway took a multifaceted approach to provide key funding to diabetes researchers in advancing a broad spectrum of research programs centered on all aspects of understanding, managing, and treating diabetes. Herein the personal perspective of a 2019 Pathway Accelerator awardee is offered, describing a research program seeking to advance a materials-centered approach to engineering glucose-responsive devices and new delivery tools for better therapeutic outcomes in treating diabetes. This is offered alongside a personal reflection on five years of support from the ADA Pathway Program.

Engineering a Pathway to Glucose-Responsive Therapeutics.

In 2014, the American Diabetes Association instituted a novel funding paradigm to support diabetes research through its Pathway to Stop Diabetes® Program. Pathway took a multifaceted approach to provide key funding to diabetes researchers in advancing a broad spectrum of research programs centered on all aspects of understanding, managing, and treating diabetes. Herein the personal perspective of a 2019 Pathway Accelerator awardee is offered, describing a research program seeking to advance a materials-centered approach to engineering glucose-responsive devices and new delivery tools for better therapeutic outcomes in treating diabetes. This is offered alongside a personal reflection on five years of support from the ADA Pathway Program.

Novel Integration of a Health Equity Immersion Curriculum in Medical Training.

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice.

To save a cultural heritage: Lessons from a volunteer network’s support to Ukrainian cultural heritage institutions

This paper is a short summary of the experiences from the first one and a half years of support to the Ukrainian cultural heritage sector from the international volunteer network SUCHO (Saving Ukrainian Cultural Heritage Online). The paper first outlines the current situation in Ukraine in the shadow of the full-scale Russian invasion and then focuses on the role of grassroots movements and the different forms of support provided by SUCHO. Finally, the paper discusses some key experiences from these efforts and addresses ideas for further support.

Celebrating 20 Years of JGR Earth Surface

AbstractDecember 2023 marks the 20th anniversary of the first issue of the Journal of Geophysical Research: Earth Surface. The past 20 years have brought rapid growth in the field of Earth‐surface processes, changes in AGU's structure and objectives, and new practices across the scientific publishing landscape. In recent years our mission has evolved to focus increasingly on science for the benefit of society and the global environment. The growth and diversification of the international Earth‐surface scientific community has enriched the science immeasurably, and we continue to reach out to scientists in parts of the globe that have remained under‐represented in the scientific literature. JGR Earth Surface strives to provide peer review that is rigorous, constructive, efficient, and with an increasing emphasis on also being civil and free of bias. As preferences and practices for publishing science change, the journal explores new opportunities, including publishing rigorous, insightful case studies and leading cross‐journal Special Collections. The Editorial Board thanks AGU for 20 years of support and the Earth‐surface scientific community for their continued dedication to moving our field forward.

Clinical Outcomes With a Fully Magnetically Levitated Left Ventricular Assist Device Among Women and Men

BackgroundLeft ventricular assist devices (LVADs) are underused among women with advanced heart failure, but reasons remain unclear. Outcomes in women compared with men with contemporary fully magnetically levitated LVADs remain uncertain. ObjectivesThe authors examined differences in characteristics, 2-year outcomes, and risk for key adverse events among women and men. MethodsIn 2,200 HeartMate3 (HM3) (Abbott Cardiovascular) LVAD recipients in the MOMENTUM 3 study (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3), survival free of disabling stroke or reoperation to replace or remove a malfunctioning pump at 2 years was analyzed between women and men. Other outcomes included overall 2-year survival, adverse events, and functional measures. ResultsWomen comprised 20.4% (n = 448 of 2,200) of the study population and were younger, with nonischemic cardiomyopathy, and more often were Black persons compared with men. The primary endpoint (women 79.4% vs men 75.5% (adjusted [a]HR: 0.96 [95% CI: 0.75-1.24]; P = 0.66) or survival at 2 years (women 82.4% vs men 80.2%; aHR: 1.06 [95% CI: 0.81-1.40]; P = 0.66) was no different. Women had an increased rate of stroke (adjusted incidence rate ratio [aIRR]: 1.52 [95% CI: 1.09-2.11]; P = 0.012), major bleeding (aIRR: 1.28 [95% CI: 1.15-1.42]; P < 0.0001) and infection (aIRR 1.14 [95% CI: 1.03-1.55]; P = 0.01), but these differences were not seen among older (>65 years) patients. Both groups had similar gains in 6-minute walk distance and quality-of-life measurements. ConclusionsThere were no differences in the primary composite endpoint or overall survival in women compared with men at 2 years of support. Reasons underlying increase in hemocompatibility-related events and infection-related morbidity in younger women deserves further study. (MOMENTUM 3 IDE [HM3], NCT02224755; MOMENTUM 3 Continued Access Protocol [MOMENTUM 3 CAP], NCT02892955)

The Passive Heat Removal Facility: Testing and Demonstrating an Innovative Decay Heat Removal System

Innovative reactor concepts are being studied by several research institutions and private entities for their role against climate change and energy poverty. The Generation IV International Forum, committed for more than 20 years in support of advanced reactors, has drawn up a series of objectives for the new class of nuclear plants, among which is an improvement in safety and economy through passive safety systems for the removal of decay heat. One of the most studied technologies is the lead fast reactor (LFR), whose coolant has a high boiling point, excellent shielding capabilities, and good heat transfer in forced and natural circulation, as well as neutron properties suitable for a hard spectrum. These allow for designing systems with high simplification and wide safety margins. On the other hand, opacity, corrosion, and innovative design choices require demonstration of the technology in experimental campaigns before using it in the industrial field. In recent years, Westinghouse Electric Company has begun the conceptual study of an intermediate size LFR [~460 MW(electric)] which, by exploiting the opportunities of the technology, aims at marketability over the next decade. One of the features is a passive heat removal system that allows, through different heat exchange mechanisms including conduction, convection, and radiation, for the transfer of decay heat from the reactor block to a pool of water inside the containment. The system is designed for indefinite heat removal thanks to channels that allow outside air to replace water following complete boiling. For the geometry of the system, the size, the materials, and the heat transfer mechanisms, an experimental activity is required to validate the prediction of the calculation codes and potentially support design optimization. The UK Department for Business, Energy & Industrial Strategy has recently subsidized the design, procurement, installation, and operation of the Passive Heat Removal Facility, an experimental facility to study the innovative safety system. This paper presents the activities of scaling, design, pretesting, and installation of that facility.

The Genetic Testing Reference Materials Coordination Program: Over 10 Years of Support for Pharmacogenomic Testing

The Genetic Testing Reference Materials Coordination Program: Over 10 Years of Support for Pharmacogenomic Testing

Outcomes With Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Suspected Acute Myocarditis: 10-Year Experience From the Extracorporeal Life Support Organization Registry.

Acute myocarditis can result in severe hemodynamic compromise requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO). Outcomes and factors associated with mortality among myocarditis patients are not well described in the modern ECMO era. We queried the Extracorporeal Life Support Organization registry from 2011 to 2020 for adults with suspected acute myocarditis undergoing peripheral VA-ECMO support. The primary outcome was in-hospital mortality and was compared to all-comers receiving VA-ECMO in the registry over the same period. Secondary outcomes were rates of bridging to advanced therapies and ECMO complications. We used multivariable logistic regression to examine factors associated with in-hospital mortality. Among 850 patients with suspected acute myocarditis receiving peripheral VA-ECMO, the mean age was 41 years, 52% were men, 39% Asian race, and 14.8% underwent extracorporeal cardiopulmonary resuscitation. During the study period, in-hospital mortality steadily declined and was 58.3% for all all-comers receiving VA-ECMO compared with 34.9% for patients with myocarditis (P<0.001). After multivariable modeling, risk factors for mortality were earlier year of support, older age, higher weight, Asian race, need for extracorporeal cardiopulmonary resuscitation, sepsis, and lower mean arterial pressure and pH prior to ECMO initiation. ECMO complications including bleeding, limb ischemia, infections and ischemic stroke were more common among nonsurvivors and significantly declined during the study period. Compared with all-comers supported with VA-ECMO, in-hospital mortality for patients with acute myocarditis is significantly lower, with nearly two-thirds of patients surviving to discharge. Major modifiable risk factors for mortality were ongoing cardiopulmonary resuscitation requiring ECMO and markers of illness severity prior to ECMO.

Micrometeoroid infall onto Saturn's rings constrains their age to no more than a few hundred million years.

There is ongoing debate as to whether Saturn's main rings are relatively young or ancient- having been formed shortly after Saturn or during the Late Heavy Bombardment. The rings are mostly water-ice but are polluted by non-icy material with a volume fraction ranging from ∼0.1 to 2%. Continuous bombardment by micrometeoroids exogenic to the Saturnian system is a source of this non-icy material. Knowledge of the incoming mass flux of these pollutants allows estimation of the rings' exposure time, providing a limit on their age. Here we report the final measurements by Cassini's Cosmic Dust Analyzer of the micrometeoroid flux into the Saturnian system. Several populations are present, but the flux is dominated by low-relative velocity objects such as from the Kuiper belt. We find a mass flux between 6.9 · 10-17 and 2.7 · 10-16 kg m-2s-1 from which we infer a ring exposure time ≲100 to 400 million years in support of recent ring formation scenarios.

The Emergent Literacy Activities Through the Storytelling Method with Flashcard Media for Early Childhood Education

Teachers have an important role in the development of children's language at school. The study period at Early Childhood Education is an excellent opportunity to improve literacy skills when children are experiencing a sensitive language learning period. Language skills have a role in improving social aspects and developing emotional and cognitive aspects. Children aged 2-4 years go through a concrete learning period. Using storytelling teaching methods with flashcard media can create a fun learning atmosphere and encourage children to learn optimally. This study aims to look at the application of the flashcard storytelling method to the language skills of children aged 2-4 years in support of an emergent literacy program.

An Accidental Historian

An Accidental Historian

A Review of Social Media Efficiency Over a 3-Year Period to Promote a Hospitality Management Program at a Southwestern University

Social media is utilized in marketing to maximize outreach, and within higher education, its use has been growing to engage a variety of stakeholders and recruit students. This paper compared the efficiency of three marketing campaigns using Facebook and Google Search Engine Management (SEM) over three years in support of promoting a new hospitality management program at a southwestern university. The findings may provide insights into a better understanding of the attitudes and consumption behaviors of students and parents, and the efficiency of utilizing social media through the lens of a comparative 3-year timeline in the period before and during the Covid-19 pandemic.

A multicenter evaluation of external outflow graft obstruction with a fully magnetically levitated left ventricular assist device

BackgroundThe HeartMate 3 (HM 3; Abbott) left ventricular assist device (LVAD) has improved hemocompatibility-related adverse outcomes. In sporadic cases, external compression of the outflow graft causing obstruction (eOGO) can result from substance accumulation between the outflow graft and its bend relief. We sought to evaluate the prevalence, course, and clinical implications of eOGO in an international study. MethodsA multicenter retrospective analysis of HM 3 LVADs implanted between November 2014 and April 2021 (n = 2108) was conducted across 17 cardiac centers in 8 countries. We defined eOGO as obstruction >25% in the cross-sectional area in imaging (percutaneous angiography, computed tomography, or intravascular ultrasound). The prevalence and annual incidence were calculated. Serious adverse events and outcomes (death, transplantation, or device exchange) were analyzed for eOGO cases. ResultsOf 2108 patients, 62 were diagnosed with eOGO at a median LVAD support duration of 953 (interquartile range, 600-1267) days. The prevalence of eOGO was 3.0% and the incidence at 1, 2, 3, 4, and 5 years of support was 0.6%, 2.8%, 4.0%, 5.2%, and 9.1%, respectively. Of 62 patients, 9 were observed, 27 underwent surgical revision, 15 underwent percutaneous stent implantation, 8 received a heart transplant, and 2 died before intervention. One patient underwent surgical revision and later stent implantation. The mortality with therapeutic intervention was 9/53 (17.0%). ConclusionsAlthough uncommon, HM 3 LVAD-supported patients might develop eOGO with an increasing incidence after 1 year of support. Although engineering efforts to reduce this complication are under way, clinicians must maintain a focus on early detection and remain vigilant.

Ventricular assist devices in transposition and failing systemic right ventricle: role of tricuspid valve replacement.

Ventricular assist device (VAD) for systemic right ventricular (RV) failure patients post-atrial switch, for transposition of the great arteries (TGA), and those with congenitally corrected TGA has proven useful to reduce transpulmonary gradient and bridge-to-transplantation. The purpose of this study is to describe our experience of VAD in systemic RV failure and our move towards concomitant tricuspid valve replacement (TVR). This is a single-centre retrospective study of consecutive adult patients receiving HeartWare VAD for systemic RV failure between 2010 and 2019. From 2017, concomitant TVR was performed routinely. Demographic, clinical variables and echocardiographic and haemodynamic measurements pre- and post-VAD implantation were recorded. Complications on support, heart transplantation and survival rates were described. Eighteen patients underwent VAD implantation. Moderate or severe systemic tricuspid regurgitation was present in 83.3% of patients, and subpulmonic left ventricular impairment in 88.9%. One-year survival was 72.2%. VAD implantation was technically feasible and successful in all but one. Post-VAD, transpulmonary gradient fell from 16 (15-22) to 10 (7-13) mmHg (P = 0.01). Patients with TVR (n = 6) also demonstrated a reduction in mean pulmonary and wedge pressures. Furthermore, subpulmonic left ventricular end-diastolic dimension (44.3 vs 39.6 mm; P = 0.03) and function improved in this group. After 1 year of support, 72.2% of patients were suitable for transplantation. VAD is an effective strategy as bridge-to-candidacy and bridge-to-transplantation in patients with end-stage systemic RV failure. Concomitant TVR at the time of implant is associated with better early haemodynamic and echocardiographic results post-VAD.

30 years of support.

2022 sees the 30th anniversary of the Vetlife Helpline. To mark this milestone, the charity is launching Vetlife Day - a fundraising effort which will stretch across the year.

A Ten-Year Analysis of Recent National Institutes of Health Funding for Anesthesiology Research in United States Medical Schools

The characteristics of recent National Institutes of Health (NIH) grant funding to anesthesiology researchers in United States (US) medical schools have not been systematically quantified. NIH funding to cardiac anesthesiologists has also not been estimated. The author conducted an internet-based analysis of NIH awards to anesthesiology researchers from 2011-2020 to identify the types, duration of funding, and amount of grants, and the terminal degree(s), faculty rank, gender, board certification status, and type of appointment of the grant recipients including those with an interest in cardiac anesthesiology. Observational study. Internet analysis. NIH grants recipients. None. NIH grant recipients affiliated with anesthesiology departments were identified from the Blue Ridge Institute for Medical Research website. The number of grants, years of support, and total amount of funding were quantified for research project grants (R series), mentored career development awards (K series), and other grants (U and P series) using NIH Research Portfolio Online Reporting Tools. The terminal degree(s), faculty rank, gender, and type of appointment of grant recipients were identified using department web pages. American Board of Anesthesiology (ABA) certification, National Board of Echocardiography Advanced Perioperative Transesophageal Echocardiography (TEE) certification, and previous or current Foundation for Anesthesia Education and Research (FAER) awards to NIH grant recipients were obtained from each organization's website. A total of 532 researchers received 1250 grants with 3844 cumulative years of funding amounting to $1,676,482,440. R series grants accounted for three-quarters of all funding. PhDs were awarded more than one-half of NIH grants. MDs had lower median numbers of projects, R01 grants, and total R series grants than their colleagues with PhD or MD PhD degrees, but MDs received more K awards. One hundred ninety-eight MD and MD PhD NIH grant recipients were ABA diplomates. These physician-scientists received 26.0% and 53.1% of R and K series grants, respectively. Thirty physician-scientists also held TEE certification; these individuals with an interest in cardiac anesthesiology were awarded 4.8% of all NIH grants. Full Professors were awarded more than three-quarters of R grants and amassed more than $1.3 billion in funding, whereas assistant and associate professors received the majority of K series grants. Male investigators received greater median R grants but fewer median K awards than female researchers. One hundred-fifteen previous or current holders of FAER grants were identified; these individuals earned a total of 240 NIH awards totaling $357.7 million. PhDs, Professors, and male researchers receive the majority of R01 and other R series grants to anesthesiology departments at US medical schools. Physician-scientists, including those interested in cardiac anesthesiology, are awarded a minority of R series grants. FAER continues to provide an important stimulus for subsequent NIH funding of physician-scientists in anesthesiology.

Grants and Acquisitions

The University of Pittsburgh Library System (ULS) has received a $1 million grant from the Henry L. Hillman Foundation to support the final preparation of the August Wilson Archive for its opening to the public followed by two years of support for in-depth public engagement with the archive. This is the biggest grant in the history of ULS and builds upon the many other charitable donations and grants supporting this project. ULS acquired the archive of Pittsburgh native August Wilson in 2020. Wilson is one of the greatest American playwrights and is most widely known for his American Century Cycle.

Bleeding and thrombotic events in adults supported with venovenous extracorporeal membrane oxygenation: an ELSO registry analysis.

This study aimed at analyzing the prevalence, mortality association, and risk factors for bleeding and thrombosis events (BTEs) among adults supported with venovenous extracorporeal membrane oxygenation (VV-ECMO). We queried the Extracorporeal Life Support Organization registry for adults supported with VV-ECMO from 2010 to 2017. Multivariable logistic regression modeling was used to assess the association between BTEs and in-hospital mortality and the predictors of BTEs. Among 7579 VV-ECMO patients meeting criteria, 40.2% experienced ≥ 1 BTE. Thrombotic events comprised 54.9% of all BTEs and were predominantly ECMO circuit thrombosis. BTE rates decreased significantly over the study period (p < 0.001). The inpatient mortality rate was 34.9%. Bleeding events (1.69 [1.49-1.93]) were more strongly associated with in-hospital mortality than thrombotic events (1.23 [1.08-1.41]) p < 0.01 for both. The BTEs most strongly associated with mortality were ischemic stroke (4.50 [2.55-7.97]) and medical bleeding, including intracranial (5.71 [4.02-8.09]), pulmonary (2.02 [1.54-2.67]), and gastrointestinal (1.54 [1.2-1.98]) hemorrhage, all p < 0.01. Risk factors for bleeding included acute kidney injury and pre-ECMO vasopressor support and for thrombosis were higher weight, multisite cannulation, pre-ECMO arrest, and higher PaCO2 at ECMO initiation. Longer time on ECMO, younger age, higher pH, and earlier year of support were associated with bleeding and thrombosis. Although decreasing over time, BTEs remain common during VV-ECMO and have a strong, cumulative association with in-hospital mortality. Thrombotic events are more frequent, but bleeding carries a higher risk of inpatient mortality. Differential risk factors for bleeding and thrombotic complications exist, raising the possibility of a tailored approach to VV-ECMO management.

Program-wide implementation of the Pyramid Model: Supporting fidelity at the program and classroom levels

Many early childhood programs are not prepared to meet the needs of children who have significant social, emotional, and behavioral challenges. Program-Wide Supports for Pyramid Model Implementation (PWS-PMI) provides a systematic approach to supporting early childhood programs using Pyramid Model practices and enhancing children's social-emotional outcomes that is grounded in implementation science. We designed the current study to test the PWS-PMI intervention and examine its feasibility of implementation in community-based early childhood programs serving children from low-income environments. In this study, we found programs increased their implementation of PWS-PM and improved classroom practices after only one year of support. Our findings indicate a program-wide approach is effective, although more time and support will be necessary to sustain high fidelity implementation and produce robust effects on children.