The Gray Fossil Site is a rich Hemphillian (North American Land Mammal Age) locality located in northeastern Tennessee which has produced tens-of-thousands of fossils of multiple taxa including hundreds of individual snake skeletal remains. Analyzed here are cranial and vertebral fossils identified as belonging to various colubrid taxa including Carphophis sp., Gyalopion sp., Heterodon sp., Natricinae indeterminate, Thamnophis sp., and a new, undescribed genus and species. In addition, multiple new features of snake vertebrae are described, some of which question the validity of the genus Neonatrix. Finally, the distribution and paleoecology of the listed genera allows an interpretation of how snake biogeography have transformed in the southern Appalachians since the Hemphillian.

Analysis of the Gray Fossil Site peccary material indicates the presence of up to three species. Comparisons with the tayassuid material known from the Tyner Farm and Bone Valley Formation of Florida allows the identification of Mylohyus elmorei and at the GFS. Within the GFS material, Prosthennops cf. P. serus and cf. Catagonus sp. are also tentatively recognized but further verification is required. The known range for Prosthennops is expanded into the Appalachian region. Presence of M. elmorei at the Gray Fossil Site provides the first known occurrence of this species outside of the Palmetto fauna of Florida, indicating that the species once exhibited a larger range within the southeastern United States than previously known. Overall, the presence of M. elmorei.indicates another parallel to the Palmetto Fauna of the Bone Valley Formation whereas Prosthennops cf. P. serus may indicate a connection to the Hemphillian of the western United States.

Tese de mestrado. Tecnologia Multimédia. Faculdade de Engenharia. Universidade do Porto, Faculdade de Belas Artes. Universidade do Porto. 2007

The Heart of the Park works to expose, preserve, and interpret the many layers of social history, fact, and fiction within Iowa City's City Park. This exhibition is a result of archival research, interviews, and on-site investigation. As a guide, I followed the path of Enoch Emery, a park-haunting voyeur featured in Flannery O'Connor's first novel, Wise Blood, which she wrote after graduating from the Iowa Writers' Workshop. Details of O'Connor's fictional version of City Park, in Chapter 5 of Wise Blood, as well as Enoch's relationship with the park, led to further discoveries regarding the park's history, and ultimately, a reinterpretation of these seemingly disparate layers of fact and fiction. While the contemporary archive claims depoliticized and anonymous reasons and methods for preservation, my hybrid practice creates a role for the subjective, idiosyncratic archivist, who suffuses factual research with myth-making. The Heart of the Park is one glimpse into an ongoing collection of interpreted sites, in which I attempt to prevent the loss of local histories, and enact the inevitable chain of reinterpretations of site.

The type Iα cGMP-dependent protein kinase (PKG Iα) is an essential regulator of vascular tone and systemic blood pressure. Located in the smooth muscle of resistance vessels, PKG Iα stimulates vasodilation through the phosphorylation of multiple intracellular substrates. Its primary regulator is the small molecule, 3',5'-cyclic guanosine monophosphate (cGMP); however, the Iα isoform can also be activated by oxidation. Despite the established physiological importance of PKG Iα, the structural underpinnings of these two activation mechanisms are largely unknown. The work presented in this dissertation demonstrates the importance of the cGMP-binding domain A (CBD-A) in regulating both of these mechanisms of PKG Iα activation. Using a monomeric, N-terminally truncated form of PKG Iα (Δ53), Chapter 2 investigates the mechanism of inhibition through the autoinhibitory domain and the influence of dimerization on cooperative cGMP-dependent activation and cyclic nucleotide selectivity. We observed that autoinhibition occurs in cis, whereas cooperativity requires interprotomer contacts facilitated by the N-terminal dimerization domain. Furthermore, the loss of selectivity for cGMP over cAMP of this construct suggests the dimerization domain plays a critical role in preventing cross-reactivity with cAMP-dependent signaling. These observations culminate into an overarching model wherein binding of cGMP to CBD-A is necessary and sufficient for activation and cooperativity is driven by the dimerization domain. Chapter 3 investigates the cysteine residues that mediate oxidation-dependent activation of PKG Iα. Using PKG Iα constructs with point mutations at specific cysteine residues, it was found that oxidation-dependent activation is driven by C117 in CBD-A. Furthermore, the interprotomer disulfide bond that forms in the dimerization domain at C42 does not contribute to this mechanism. Finally, we propose a model wherein the disulfide bond that forms between C117 and the adjacent cysteine at position 195 acts as a protective mechanism to prevent activation and higher oxidation states form contacts with nearby residues in the linker region of PKG Iα to disrupt binding of the adjacent autoinhibitory domain to the catalytic domain. Finally, Chapter 4 provides a discussion of the results presented herein in context with previous studies and suggests future directions for the PKG field.

In response to improving quality patient care, combined with the growing rates of surgical site infections (SSIs) in vascular patients, the need to explore current practice trends with current evidence has been identified. SSIs affect quality patient care and compromise patient safety. Empirical evidence has recommended the use of a chlorhexidine wash preoperatively to reduce SSIs. Despite this recommended practice, vascular patients were not receiving it in their routine plan of care within a hospital organization in southern Ontario. Guided by Lewin's theory of planned change, this project explored how the planning of a chlorhexidine preoperative surgical skin preparation protocol impacted progress toward improved care of vascular patients. The project was designed as a quality improvement project examining approximately 110 vascular surgical procedures over a 1-month period and staff surveys that were provided to staff in the preoperative (n = 88), same day surgery (n = 68), and inpatient (n = 47) units. These data were analyzed and demonstrated a reduction in vascular SSIs from 4.9% pre-implementation to 2.8% 1-month post-implementation. Major themes generated from the staff surveys demonstrated the nursing staff had a good understanding of the content that was presented in the in-service provided. These findings have implications for social change by highlighting the benefits of incorporating evidence in to practice and further informing the preoperative practice in other surgical specialties.

Few investigators have used robust analytic methods to assess risk factors and outcomes for surgical site infections (SSIs) after craniotomy and craniectomy (CRANI) procedures. We performed a retrospective study among patients undergoing CRANI procedures between 2006 and 2010 at the University of Iowa Hospitals and Clinics (UIHC) to assess the effect of an intervention (e.g., limiting Gliadel wafer use among patients with malignant brain tumors) on the trend of SSI rates, to identify independent risk factors for SSIs, and to evaluate one-year postoperative patient outcomes associated with these SSIs. We abstracted demographic data and clinical data from medical records or from the UIHC's Health information Management System. We identified 104 patients with SSIs and selected 312 controls. Of SSIs, 88% were deep incisional or organ space infections, 70% were identified after patients were discharged from their initial hospitalizations, 32% were caused by Staphylococcus aureus alone or in combination with other organisms, and 27% were caused by Gram-negative organisms alone or in combination with other organisms. Significant independent risk factors for SSIs were: previous chemotherapy (odds ratio [OR], 10.0; 95% confidence interval [CI] 1.1, 92.1), preoperative length of stay ≥ 1 day (OR, 2.1; 95% CI 1.3, 3.5), preoperative serum glucose ≥ 100 mg/dL (OR, 1.7; 95% CI, 1.0, 3.0), Gliadel® wafer use (OR, 8.6; 95% CI 3.2, 23.1), and postoperative cerebrospinal fluid leak (OR, 4.0; 95% CI, 1.6, 10.3). Gliadel® wafer use was the strongest risk factor; however, limiting Gliadel® wafer use did not decrease SSI rate significantly among patients with brain tumors. Perioperative ventricular drains or lumbar drains were not independently associated with an increased risk of SSIs, but drains may have clinical significance. An SSI risk index that included the significant preoperative patient-related risk factors had a better predictive power than the National Healthcare Safety Network (NHSN) risk index. After adjusting for preoperative length of stay, age, comorbidity score, severity of illness score, the reason for the procedure, and procedure month, patients with SSIs were hospitalized longer postoperatively than were controls during their readmissions (2.3 days; P < 0.0001). After controlling for the same covariates and treating SSI as a time-varying factor, patients with SSIs were more likely than controls to: die (hazard ratio [HR], 3.3; 95% CI, 1.8, 5.8), be readmitted (HR, 4.1; 95% CI, 2.9, 5.8), and have reoperations (HR, 56.6; 95% CI, 38.1, 84.0). In conclusion, surgeons could predict patients' risk of SSIs based on their preoperative risk factors and surgeons could modify some processes of care to lower the SSI risk. Preventing SSIs after CRANI procedures could improve patient outcomes and decrease healthcare utilization.

Background. Surgical site infections (SSIs) cause many adverse outcomes for patients including increased length of hospital stay, hospital costs, morbidity, and psychological distresses. Staphylococcus aureus is one of the most common causes of SSIs in the United States. Objective. Identify risk factors for Staphylococcus aureus SSIs following breast operations. Design. Retrospective nested case-control study of SSIs among women undergoing breast operations. Setting. An academic health center. Patients. We studied patients undergoing breast operations at the University of Iowa Hospitals and Clinics from 7/1/2004 through 9/30/2015. Cases were patients who acquired SSIs meeting the National Healthcare Safety Network definition and whose SSIs were caused by S. aureus. We randomly selected two controls for each case from patients who had breast operation during the study period and did not meet the SSI definition. Controls were selected randomly from uninfected patients whose operations occurred during the same month and year as a case. Results. Forty two (1.2%) patients acquired S. aureus SSIs after 3494 breast operations. SSIs were identified a mean of 27.8 days after the breast operations; 54.76% were deep incisional infections. Poisson regression analysis revealed that S. aureus SSIs following breast operations at UIHC have been increasing at a statistically significant rate. Bivariable analysis identified several patient and procedure related risk factors that increased the risk for S. aureus SSIs. Patient-related factors included a diabetes mellitus, active skin disease, prior chemotherapy, breast cancer, hypertension, and preoperative hemoglobin. Procedure-related factors included ASA score > 2, a mastectomy followed by immediate reconstruction, sentinel lymph node biopsy (SLN), drain placement, procedure time, and estimated blood loss. A multivariable analysis of patient factors found only breast cancer maintained significance. A similar analysis of procedure factors found that drain placement remained significant. The combined model contained breast cancer, drain placement, and mastectomy followed by immediate reconstruction as significant variables. Conclusions. S. aureus SSIs following breast operations have been increasing at UIHC. Possible remediable risk factors include blood glucose levels, blood pressure, timing of chemotherapy, and drain placement and care. These results will help doctors at UIHC design interventions to prevent S. aureus SSIs following these procedures.

Scholars have suggested that landscape become the main ordering device in the development of the built environment. Traditional methods of urban planning have categorized landscape as a cosmetic application, the purpose of which is to beautify the urban environment after the planning and development phases. The problems associated with globalization and rapid urbanization at present includes the commoditization of urban form. As a result of this trend, many cities are becoming less and less distinguishable from one another, as urban form is generated without considering the particularities of site and context. The lack of a more specific understanding of a site in its environmental, social and cultural dimensions, has led to the phenomenon of "universal" urban form. Landscape has new found relevance in contemporary urbanism becoming the medium that defines urban form; inserting the built environment within the context of complex natural, social and cultural environments. Landscape has the potential to design relationships between dynamic environmental processes and urban form, and become more of a functional system. In the island of Trinidad there exists the opportunity to explore the potential of landscape as a driver of urban form. The island is currently experiencing rapid urbanization and dynamic growth due to a boost in the economy, and an unprecedented government agenda to take the island to a developed nation status by the year 2020. Due to this emerging urbanity, there is the need to implement urban development approaches that protect the environmental integrity of the island, and preserve the social and cultural influences that give identity to the island. The investigation led to the development of a landscape infrastructure that is implemented in an effort to achieve sustainable urban development and preserve the natural integrity of the site. Through an in-depth analysis of the landscape, identifying the natural, social and cultural processes occurring, a plan of intervention is developed that is integrated with the dynamics of the site, and serves as an example of the potential of landscape in urbanism.

This project aimed to reanalyse two large historical data sets from two different locations in New Zealand (Fiordland in the South Island and Pureora Forest Park in the North Island). The data describe populations of mice (Mus musculus), rats (Rattus rattus and R. norvegicus), and stoats (Mustela erminea) collected using standard monitoring techniques from five distinct types of forest habitat. The new analysis methods selected were an index of patchiness and Site Occupancy analysis. The objectives of the analysis were (1) to evaluate whether the patchiness index and Site Occupancy analysis methods might contribute to improved protocols for monitoring small mammal populations in the future, and (2) to use formal tests of five hypotheses to evaluate two of the assumptions made by the conventional density index often used in small mammal studies. I describe the results of the analyses for each species, including any problems encountered (such as the inability of the Site Occupancy method to analyse very sparse data sets). I also describe the results pooled from each of the two study locations and potential consequences for small mammal monitoring and control. This analysis has suggested that in most cases the density index is not a rigorous measure of small mammal populations. However, both the index of patchiness and Site Occupancy analysis provided useful, new information about these populations of rodents and stoats, despite the fact that these historical data sets were not designed for use with modern methods of analysis. Please note: some figures and tables were printed separately and added to the thesis as unnumbered pages. These can be found in the file 03Plates_and_Tables.pdf.