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.

Fluorine atom plays a very important role in pharmaceuticals, agricultural chemicals, and medical imaging and it has become one of the most popular area in organic chemistry. For example, in modern medicinal chemistry introducing fluorine atom could potentially improve absorption, metabolism and potency of drug candidates. As a result, methods that allow the selective and efficient formation of the carbon-fluorine bond are highly desirable. An evolving approach is the utilization of transition-metals to catalyze the nucleophilic substitution of fluoride ion. This thesis described several novel and efficient methods to generate allylic and benzylic C-F bonds using rhodium/iridium catalyst.

Creatures of the sea, creating wearable adornment to protect the body and unique materials, inspire my artwork. Through research and examination of sea creatures, I look to their defense mechanisms and imagine what it would be like if humans had similar qualities or if we could borrow from these beings and transform the way we physically protect our bodies. Through mixed materials I form adornment that acts as armor and the human being and the sea creature merge. The following pages will give you access to my thought process, accounts of technical experimentation, and my body of work.

Hematite (α-Fe2O3) is a common, naturally occurring iron oxide, found throughout the earth's crust and atmosphere. Hematite is of interest to the scientific community because it is able to incite a reaction that produces hydrogen gas (H2), which is a form of clean energy (Bora et al., 2013). The composition of hematite in nature is also used to make inferences about conditions on early earth's surface (Guo et al., 2013). Hematite is useful for clean energy production and as an environmental indicator partly because of its apparent stability. However, some evidence suggests that hematite might not be as stable as previously thought. Many iron oxides undergo Fe atom exchange when they come into contact with aqueous Fe(II), as often occurs in nature (Pedersen et al., 2005, Jones et al., 2009, Gorski et al., 2012, Handler et al., 2009). This atom exchange can result in elements and nutrients being taken up or released from the iron oxides as they recrystallize (Frierdich & Catalano, 2012, Cwiertny et al., 2008, Boland et al., 2014). Although atom exchange has not been directly shown in hematite, it has been demonstrated that trace metals are released from hematite in the presence of aqueous Fe(II), implying that exchange may be occurring (Frierdich et al., 2011). Here, we directly demonstrate Fe atom exchange between hematite and aqueous Fe(II). This work provides knowledge concerning the surface chemistry of hematite that has important implications for clean energy production and the environment.

The Florentine Jew Mario Castelnuovo-Tedesco (1895-1968), garnered international acclaim as a composer and performer in the 1920s and 1930s. He studied composition with Ildebrando Pizzetti and became associated with the International Society for Contemporary Music. Castelnuovo-Tedesco received particular attention for his operas, winning the Concorso Lirico Nazionale in 1925 for La Mandragola, and his concertos, with prominent performances by Jascha Heifetz and Andrés Segovia. During the 1930s, Castelnuovo-Tedesco and his family were negatively affected by the Fascist government’s racial laws restricting the rights of Italian Jews. In 1938, after public performances of his music were canceled and his children were forbidden from attending public school, Castelnuovo-Tedesco and his wife Clara decided to immigrate to the United States. They sailed for the U.S. in 1939, settled in Beverly Hills, and gained citizenship in 1946. In 1949, at the end of that turbulent decade, Castelnuovo-Tedesco completed his first oratorio, The Book of Ruth. This study features a new edition of The Book of Ruth, the first complete publication of the work in full score. The edition is accompanied by a musical analysis that examines melody, harmony, rhythm, text setting, vocal texture, orchestration, and formal design in The Book of Ruth, comparing it with his other works. Furthermore, selected passages from Castelnuovo-Tedesco’s autobiography, newly translated into English, provide insight into the eventful decade preceding the work’s composition and uncover several personal connections that exist between Castelnuovo-Tedesco and the story of The Book of Ruth.

Papilledema is a particular type of optic disc swelling caused by elevated intracranial pressure. By observing the visible features from fundus images or direct funduscopic examination, a typical method of assessing papilledema (i.e., the six-stage Fris\'en grading system) is qualitative and frequently suffers from low reproducibility. Compared to fundus images, spectral-domain optical coherence tomography (SD-OCT) is a relatively new imaging technique and enables the cross-sectional information of the retina to be acquired. Using SD-OCT images, quantitative measurements like evaluating the retinal volume or depth are intuitively more robust than the traditional qualitative approach to evaluate papilledema. Also, multiple studies suggest that the deformation of the peripapillary retinal pigment epithelium and/or Bruch's membrane (pRPE/BM) may reflect the intracranial pressure change. In other words, modeling/quantifying the pRPE/BM shape can potentially be another indicator of papilledema. However, when the optic disc is severely swollen, the retinal structure is dramatically deformed and often causes the commercial SD-OCT devices to fail to segment the retinal layers. Without appropriate layer segmentation, all the retinal measurements are not reliable. To solve the current issue of inconsistently assessing papilledema severity, a comprehensive machine-learning framework is proposed in this doctoral work to achieve the goal by accomplishing following four aims. First, robust approaches are developed to automatically segment the retinal layers in 2D and 3D SD-OCT images, even though the optic discs can be severely swollen. Second, the semi- and fully automated methodologies are designed to segment the pRPE/BM opening under the swollen inner retina in these SD-OCT images. Third, the pRPE/BM shape models are constructed using both 2D and 3D SD-OCT images, and then the 2D/3D pRPE/BM shape measures are computed. Finally, based on the previously segmented retinal layers, eight OCT 2D/3D global/local measurements of retinal structure are reliably computed. Considering both the 2D/3D pRPE/BM shape measures and these eight OCT features as an input set, a machine-learning framework using the random forest technique is proposed to compute a papilledema severity score (PSS) on a continuous scale. The newly proposed PSS is expected to be an alternative to the traditional qualitative method to provide a more objective measurement of assessing papilledema severity.

The use of computational simulation to study the dynamics and interactions of macromolecules has become an important tool in the field of biochemistry. A common method to perform these simulations is to use all-atom explicit-solvent molecular dynamics (MD). However, due to the limitations in computational power currently available, this method is not practical for simulating large-scale biomolecular systems on long timescales. An alternative is to perform implicit-solvent Brownian dynamics (BD) simulations using a coarse grained (CG) model that allows for increased computational efficiency. However, if simulations using the CG model are not realistic, then the gain in computational efficiency from using a CG model is not worthwhile. This thesis describes the derivation of a set of bonded and nonbonded CG potential functions for use in implicit-solvent BD simulations of proteins derived from all-atom explicit-solvent MD simulations of amino acids. To determine which force field and water model to use in the MD simulations, Chapter II describes 1 Μs all-atom explicit-solvent MD simulations of glycine, asparagine, phenylalanine, and valine solutions at 50, 100, 200 and 300 mg/ml concentrations performed using eight different force field and water model combinations. To evaluate the accuracy of the force fields at high solute concentrations, the density, viscosity, and dielectric increments of the four amino acids were calculated from the simulations and compared to experimental results. Additionally, the change in the strength of hydrophobic and electrostatic interactions with increasing solute concentration was calculated for each force field and water model combination. As a result of this study, the Amber ff99SB-ILDN force field and TIP4P-Ew explicit-solvent water model were chosen for all subsequent MD simulations. Chapter III describes the derivation of CG bonded potential functions from 1 Μs all-atom explicit-solvent MD simulations of each of the twenty amino acids, including a separate simulation for protonated histidine. The angle and dihedral probability distributions sampled during the MD simulations were used to optimize the bonded potential functions using the iterative Boltzmann inversion (IBI) method. Chapter IV describes the derivation of CG nonbonded potential functions from 1 Μs all-atom explicit-solvent MD simulations of every possible pairing of the amino acids (231 different systems). The radial distribution functions calculated from these MD simulations were used to optimize a set of nonbonded CG potential functions using the IBI method. The optimized set of bonded and nonbonded potential functions, which is termed COFFDROP (COarse-grained Force Field for Dynamic Representation Of Proteins), quantitatively reproduced all of the calculated MD distributions. To determine if COFFDROP would be useful for simulations of bimolecular systems, Chapter V describes the testing of the transferability of the force field. First, COFFDROP was used to simulate concentrated amino acid solutions. The clustering of the solutes in these simulations was directly compared with results from corresponding all-atom explicit-solvent MD simulations and found to be in excellent agreement. Next, BD simulations of 9.2 mM solutions of the small protein villin headpiece were performed. The proteins aggregated during these simulations, which is in agreement with results from MD simulation but in disagreement with experiment. After scaling the strength of COFFDROP's nonbonded potential functions by a factor of 0.8 and rerunning the BD simulations, the amount of aggregation was comparable to experimental observations. Based on these results, COFFDROP is likely to be applicable in CG BD simulations of large, highly concentrated, biomolecular systems.

In this dissertation I consider the problem of external world skepticism and attempts at providing an argument to the best explanation against it. In chapter one I consider several different ways of formulating the crucial skeptical argument, settling on an argument that centers on the question of whether we're justified in believing propositions about the external world. I then consider and reject several options for getting around this issue which I take to be inadequate. I finally conclude that the best option available to us at the moment is to argue that the antiskeptical view is the best explanation of our ordinary experiences In chapter two I argue that, if we hope to ground what counts as defending antiskepticism in common sense, there is an argument against the possibility of ever knowing one has succeeded in defending antiskepticism. After showing that common sense is no place to look in setting a goal for our antiskeptical project, I present the view that what will be crucial to settling on our antiskeptical goal is coming to a successful analysis of the nature of physical objects. I suggest some minimal criteria that must be met by a view in order to be antiskeptical based on our intuitions about core skeptical cases, but acknowledge that a fully successful response to external world skepticism will require the antiskeptic to engage in some much more difficult analysis. In chapter three I consider various views of the nature of explanation and conclude, tentatively, that explanation as it interests the antiskeptic is fundamentally causal. In chapter four I consider and reject some of the core views on which best explanation facts are so fundamental that a project of attempting to vindicate probabilistically the virtues which make explanations epistemically good. In this chapter I show that views which analyze justification in terms of best explanation factors fail. In chapter five I attempt to vindicate the various explanatory virtues probabilistically. In doing so I attempt to express or translate the various explanatory virtues in terms of probabilities in order to show that having those virtues makes a view at least prima facie more probable. In chapters six and seven I explain and evaluate the various arguments to the best explanation against skepticism present in current philosophical literature. I attempt to show that extant arguments fail to appreciate the virtues possessed by classical (and some new) skeptical scenarios. In chapter eight I briefly consider some options that may be open to the antiskeptic moving forward. All routes forward contain considerable obstacles, but there are some fruitful areas of research to pursue.

It's about living It's about feeling incomplete It's about nostalgia It's about culture It's about joy It's about how life flashes before our lives It's about sorrow It's about what's hidden under the rug It's about fitting in It's about getting away It's about a journey It's about language It's about class It's about how something clean can leave a stain It's about goodbyes It's about fiction It's about place It's about blame It's about obsession It's about feeling stranded It's about itching a scratch It's about holding on It's about being found It's about how we all settle eventually It's about desire It's about conflict It's about you It's about me It's about future It's about community It's about failure It's about wondering which one of us is next It's about the American dream It's about right now It's about the people we will become It's about the search It's about routine It's about finding It's about change It's about living

This study examines the effect of first-year college student participation in cooperative learning activities on the development of need for cognition, using pre-test and post-test data from the Wabash National Study of Liberal Arts Education (WNSLAE). I used Pascarella's (1985) General Causal Model for Assessing the Effects of Differential Environments on Student Learning and Cognitive Development as the theoretical foundation for my study. I examined whether cooperative learning (students teaching each other, faculty encouraging students to work together outside of class, participation in study groups, and students working together outside of class) influenced the development of need for cognition among first-year college students while controlling for student background characteristics, institutional characteristics, academic experiences, and other college student experiences. The results of my study indicate that participation in cooperative learning activities positively influenced the development of need for cognition among first-year college students. This study adds to the literature because it is the first to demonstrate the relationship between cooperative learning and need for cognition. The results are relevant to higher education policy because the study provides evidence that cooperative learning helps students develop a propensity to engage in the thinking process, which will likely impact them throughout their lives. Cooperative learning is considered a good practice in liberal education, so the result of this study provides evidence that liberal education supports positive outcomes related to cognitive processing, which is critical to higher education.