Kapiolani Community College

Let <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="upper A"> <mml:semantics> <mml:mi>A</mml:mi> <mml:annotation encoding="application/x-tex">A</mml:annotation> </mml:semantics> </mml:math> </inline-formula> be an <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="n times n"> <mml:semantics> <mml:mrow> <mml:mi>n</mml:mi> <mml:mo> × </mml:mo> <mml:mi>n</mml:mi> </mml:mrow> <mml:annotation encoding="application/x-tex">n \times n</mml:annotation> </mml:semantics> </mml:math> </inline-formula> matrix whose elements are independent random variables with standard normal distributions. As <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="n right-arrow normal infinity"> <mml:semantics> <mml:mrow> <mml:mi>n</mml:mi> <mml:mo stretchy="false"> → </mml:mo> <mml:mi mathvariant="normal"> ∞ </mml:mi> </mml:mrow> <mml:annotation encoding="application/x-tex">n \to \infty</mml:annotation> </mml:semantics> </mml:math> </inline-formula> , the expected number of real eigenvalues is asymptotic to <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="StartRoot 2 n slash pi EndRoot"> <mml:semantics> <mml:msqrt> <mml:mn>2</mml:mn> <mml:mi>n</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mo>/</mml:mo> </mml:mrow> <mml:mi> π </mml:mi> </mml:msqrt> <mml:annotation encoding="application/x-tex">\sqrt {2n/\pi }</mml:annotation> </mml:semantics> </mml:math> </inline-formula> . We obtain a closed form expression for the expected number of real eigenvalues for finite <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="n"> <mml:semantics> <mml:mi>n</mml:mi> <mml:annotation encoding="application/x-tex">n</mml:annotation> </mml:semantics> </mml:math> </inline-formula> , and a formula for the density of a real eigenvalue for finite <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="n"> <mml:semantics> <mml:mi>n</mml:mi> <mml:annotation encoding="application/x-tex">n</mml:annotation> </mml:semantics> </mml:math> </inline-formula> . Asymptotically, a real normalized eigenvalue <inline-formula content-type="math/mathml"> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="lamda slash StartRoot n EndRoot"> <mml:semantics> <mml:mrow> <mml:mi> λ </mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mo>/</mml:mo> </mml:mrow> <mml:msqrt> <mml:mi>n</mml:mi> </mml:msqrt> </mml:mrow> <mml:annotation encoding="application/x-tex">\lambda /\sqrt n</mml:annotation> </mml:semantics> </mml:math> </inline-formula> of such a random matrix is uniformly distributed on the interval [-1, 1]. Analogous, but strikingly different, results are presented for the real generalized eigenvalues. We report on numerical experiments confirming these results and suggesting that the assumption of normality is not important for the asymptotic results.

States that in the new developing economy of the millennium knowledge is an asset that should be valued, developed and managed, since it is a component of the intellectual capital of an organization. Reveals that knowledge is increasingly being regarded as a corporate asset in an age when data and information help sustain competitive advantage. Remarks that knowledge is, however, an intangible asset and so managing it creates a number of challenges in the area of human resource development, especially when workers are more concerned with their employability. Concludes that if a company values knowledge it must value its knowledge workers.

Human development has ushered in an era of converging crises: climate change, ecological destruction, disease, pollution, and socioeconomic inequality. This review synthesizes the breadth of these interwoven emergencies and underscores the urgent need for comprehensive, integrated action. Propelled by imperialism, extractive capitalism, and a surging population, we are speeding past Earth's material limits, destroying critical ecosystems, and triggering irreversible changes in biophysical systems that underpin the Holocene climatic stability which fostered human civilization. The consequences of these actions are disproportionately borne by vulnerable populations, further entrenching global inequities. Marine and terrestrial biomes face critical tipping points, while escalating challenges to food and water access foreshadow a bleak outlook for global security. Against this backdrop of Earth at risk, we call for a global response centered on urgent decarbonization, fostering reciprocity with nature, and implementing regenerative practices in natural resource management. We call for the elimination of detrimental subsidies, promotion of equitable human development, and transformative financial support for lower income nations. A critical paradigm shift must occur that replaces exploitative, wealth-oriented capitalism with an economic model that prioritizes sustainability, resilience, and justice. We advocate a global cultural shift that elevates kinship with nature and communal well-being, underpinned by the recognition of Earth's finite resources and the interconnectedness of its inhabitants. The imperative is clear: to navigate away from this precipice, we must collectively harness political will, economic resources, and societal values to steer toward a future where human progress does not come at the cost of ecological integrity and social equity.

Nearly half of all undergraduates are enrolled at community colleges (CCs), including the majority of U.S. students who represent groups underserved in the sciences. Yet only a small minority of studies published in discipline-based education research journals address CC biology students, faculty, courses, or authors. This marked underrepresentation of CC biology education research (BER) limits the availability of evidence that could be used to increase CC student success in biology programs. To address this issue, a diverse group of stakeholders convened at the Building Capacity for Biology Education Research at Community Colleges meeting to discuss how to increase the prevalence of CC BER and foster participation of CC faculty as BER collaborators and authors. The group identified characteristics of CCs that make them excellent environments for studying biology teaching and learning, including student diversity and institutional cultures that prioritize teaching, learning, and assessment. The group also identified constraints likely to impede BER at CCs: limited time, resources, support, and incentives, as well as misalignment between doing research and CC faculty identities as teachers. The meeting culminated with proposing strategies for faculty, administrators, journal editors, scientific societies, and funding agencies to better support CC BER.

OBJECTIVE: This article reviews the literature on the use of psychotropic drugs in pregnancy and lactation. METHOD: Medline search yielded more than five hundred titles. Articles were reviewed and ninety-one were selected for reference. RESULTS: Fetal physiology and teratogenicity are discussed and the effects of specific drugs on the fetus and newborn are presented. When possible, recommendations for use or non-use are presented. CONCLUSIONS: Though no controlled studies have ever been done in pregnant women to truly prove their safety, it appears that most, but not all, current psychotropic drugs appear fairly safe for use in pregnancy.

Previous studies suggest that 5 days of prophylactic ginkgo decreases the incidence of acute mountain sickness (AMS) during gradual ascent. This trial was designed to determine if ginkgo is an effective prophylactic agent if begun 1 day prior to rapid ascent. In this double-blind, randomized, placebo-controlled trial, 26 participants residing at sea level received ginkgo (60 mg TID) or placebo starting 24 h before ascending Mauna Kea, Hawaii. Subjects were transported from sea level to the summit (4205 m) over 3 hours, including 1 hour at 2835 m. The Lake Louise Self-report Questionnaire constituted the primary outcome measure at baseline, 2835 m, and after 4 h at 4205 m. AMS was defined as a Lake Louise Self-report Score (LLSR) >/= 3 with headache. Subjects who developed severe AMS were promptly transported to lower altitude for the remainder of the study. The ginkgo (n = 12) and placebo (n = 14) groups were well matched (58% vs. 50% female; median age 28 yr, range 22-53 vs. 33 yr, range 21-53; 58% vs. 57% Caucasian). Two (17%) subjects on ginkgo and nine (64%) on placebo developed severe AMS and required descent for their safety (p = 0.021); all recovered without sequelae. Median LLSR at 4205 m was significantly lower for ginkgo versus placebo (4, range 1-8 vs. 5, range 2-9, p = 0.03). Ginkgo use did not reach statistical significance for lowering incidence of AMS compared with placebo (ginkgo 7/12, 58.3% vs. placebo 13/14, 92.9%, p = 0.07). Twenty-one of 26 (81%) subjects developed AMS overall. This is the first study to demonstrate that 1 day of pretreatment with ginkgo 60 mg TID may significantly reduce the severity of AMS prior to rapid ascent from sea level to 4205 m.

TOPIC: Client decision making in relation to health care. PURPOSE: To develop a conceptual analysis of client decision making regarding health care that represents the current state of the science in order to better understand how clients make decisions. SOURCES: Published literature. CONCLUSIONS: A model of client decision making is presented with implications for nursing. Defining attributes, antecedents, consequences, and empirical referents of decision making are developed and illustrated by case presentations.

Crop evapotranspiration (ET c ) was measured as evaporative heat flux from drip-irrigated coffee ( Coffea arabica L. cv. Yellow Catuai) fields at different stages of canopy development using the Bowen ratio-energy balance technique. Irrigation requirements were determined by comparing the ET c values obtained against reference values (ET 0 ) derived from a modified Penman equation, and expressed as the ET c /ET 0 ratio, or crop coefficient (Kc). In 1991, the average Kc was 0.75 to 0.79 for fields containing 2- to 4-year-old plantings. This ratio was 0.58 for a field containing a 1-year-old planting. Crop coefficient was 30% lower in 1992 due to higher ET 0 values and lower stomatal conductance. Measurements made between July and August and again between September and November 1991 suggested that Kc may vary seasonally. Crop transpiration (T), determined with the stem heat balance technique, comprised from 40% to 95% of ET c as the leaf area index increased from 1.4 to 6.7. Behavior of Kc and T during a 25-day soil drying-reirrigation cycle indicated that the crop was able to maintain relatively high levels of gas-exchange activity during periods of severe water deficit.

The widespread presence of the Na-K-2Cl (NKCC) cotransporter protein suggests that chronic administration of inhibitors may result in adverse effects. Inhibition of the NKCC cotransporter by loop diuretics is felt to underlie the diuretic and the pulmonary smooth muscle relaxant effects of this drug class. However, the fundamental regulation of salt and water movement by this cotransporter suggests that it may also mediate cell volume changes occurring during cell cycle progression. Thus we hypothesized that NKCC cotransporter inhibition by loop diuretics would decrease cellular proliferation. Normal human bronchial smooth muscle cells (BSMC) showed a significant concentration-dependent decrease in cell counts after 7 days of exposure to both bumetanide (n=5-10) and furosemide (n=6-16) compared with controls. Proliferation was similarly inhibited in normal human lung fibroblasts (n=5-9). To determine whether this was due to loss of cells, we performed apoptosis assays on BSMC. Both annexin V-propidium iodide staining (n=5-10) and single cell gel electrophoresis assays (n=4) were negative for necrosis and apoptosis in BSMC exposed to 10 microM bumetanide. Subsequent analysis of the cell cycle by flow cytometry showed that bumetanide-exposed BSMC were delayed in G1 phase compared with controls (n=4-8). This is the first evidence for loop diuretic inhibition of airway smooth muscle cell proliferation. NKCC cotransporter inhibition impeded G1-S phase transition without facilitating cell death. Thus although inhibition by loop diuretics relaxes airway smooth muscle, the NKCC cotransporter may have a more important role in cell proliferation regulation.

Cornelia de Lange syndrome (CdLS) is a dominant multisystemic malformation syndrome due to mutations in five genes-NIPBL, SMC1A, HDAC8, SMC3, and RAD21. The characteristic facial dysmorphisms include microcephaly, arched eyebrows, synophrys, short nose with depressed bridge and anteverted nares, long philtrum, thin lips, micrognathia, and hypertrichosis. Most affected individuals have intellectual disability, growth deficiency, and upper limb anomalies. This study looked at individuals from diverse populations with both clinical and molecularly confirmed diagnoses of CdLS by facial analysis technology. Clinical data and images from 246 individuals with CdLS were obtained from 15 countries. This cohort included 49% female patients and ages ranged from infancy to 37 years. Individuals were grouped into ancestry categories of African descent, Asian, Latin American, Middle Eastern, and Caucasian. Across these populations, 14 features showed a statistically significant difference. The most common facial features found in all ancestry groups included synophrys, short nose with anteverted nares, and a long philtrum with thin vermillion of the upper lip. Using facial analysis technology we compared 246 individuals with CdLS to 246 gender/age matched controls and found that sensitivity was equal or greater than 95% for all groups. Specificity was equal or greater than 91%. In conclusion, we present consistent clinical findings from global populations with CdLS while demonstrating how facial analysis technology can be a tool to support accurate diagnoses in the clinical setting. This work, along with prior studies in this arena, will assist in earlier detection, recognition, and treatment of CdLS worldwide.

In online and blended learning environments, students may experience learning barriers that are more pronounced than in the traditional classroom. When designing online instruction, teachers can use digital tools along with instructional strategies to reduce those barriers. Digital tools have various instructional and assistive features, which can provide supports for students with disabilities as well as other learners. This article addresses how teachers can make meaningful use of various digital tools in alignment with the three principles of Universal Design for Learning (UDL) to reduce barriers and support students to meet learning and affective goals. The article describes how various commonly available digital tools coupled with instructional strategies provide supports for representation, action and expression, and engagement for students in online learning environments.

From Kapiolani Hospital and the Department of Obstetrics and Gynecology, University of Hawaii School of Medicine and School of Public Health, Honolulu, Hawaii

Abstract The hindgut of feeding termites that feed on wood and litter contains a diverse population of bacteria and protists that contribute to the carbon, nitrogen, and energy requirements of the termite. For understanding the ecological balance in the termite gut, detailed knowledge about the composition of the microbial gut flora is imperative, i.e., the numbers and relative proportions of the microbial taxa and the variability in the microbial composition among different termite colonies and living conditions of termites should be described. Therefore, we isolated and enumerated eight bacterial morphotypes from the gut of the Formosan subterranean termite, Coptotermes formosanus Shiraki. Five morphotypes (three isolates of lactic acid bacteria, isolates of the family Enterobacteriaceae and isolates belonging to the genus Dysgonomonas) were found frequently in all termite colonies. Three additional morphotypes were found sporadically and were considered to be transient flora. We compared the proportions of the three lactic acid bacteria isolates and the Enterobacteriaceae among three different termite colonies. Furthermore, we investigated the shift in proportions of these four major morphotypes depending on whether bacteria were isolated from freshly collected termites or from termites reared in the laboratory under seminatural conditions (in arenas on wood) or artificial conditions (in petri dishes on filter paper). Differences in the culturable microbial composition were not significant among termite colonies, or between field-collected termites and termites reared under seminatural conditions in the laboratory. However, we found significant shifts in the microbial composition between field-collected termites and termites reared on filter paper.

Let $A$ be an $n \times n$ matrix whose elements are independent random variables with standard normal distributions. As $n \to \infty$, the expected number of real eigenvalues is asymptotic to $\sqrt {2n/\pi }$. We obtain a closed form expression for the expected number of real eigenvalues for finite $n$, and a formula for the density of a real eigenvalue for finite $n$. Asymptotically, a real normalized eigenvalue $\lambda /\sqrt n$ of such a random matrix is uniformly distributed on the interval [-1, 1]. Analogous, but strikingly different, results are presented for the real generalized eigenvalues. We report on numerical experiments confirming these results and suggesting that the assumption of normality is not important for the asymptotic results.

This pilot study evaluated the effectiveness of a nurse-delivered home-visiting program during the postpartum period that included a low-intensity smoking relapse-prevention intervention. A prospective two-group design was used. Participants were women who had quit smoking during their pregnancy. They were invited to participate during postpartum hospitalization on a university hospital postpartum ward. A brief intervention during postpartum hospitalization, a home visit, and two follow-up phone calls over a 1- to 2-month period were compared with a routine home visit without any prescribed focus on tobacco use. The main outcome was biochemically verified smoking abstinence at 3 and 6 months postenrollment. Abstinence was defined as a salivary cotinine level of 14 ng/ml or less. At 3 months postenrollment, 26.4% of the intervention group were classified as abstinent, compared with 12.4% of the comparison group (OR = 2.4, 95% CI = 1.16-4.98). At 6 months, the proportion of the intervention group categorized as abstinent was 21.5%, compared with 10.2% of comparison group participants (OR = 2.5, 95% CI = 1.13-5.71). Greater than three times as many in the intervention group remained abstinent at both times (18.2%), compared with the comparison group (5.2%; OR = 2.4, 95% CI = 1.16-4.93). The effectiveness of this brief, low-cost, and potentially replicable intervention in improving the rate of persistent postpartum smoke-free status for women who quit smoking during pregnancy is encouraging. A randomized trial of the approach is warranted.

This study looks at the relationship between second language learners' notes taken while listening to audiotaped lectures and the learners9 success on two different types of comprehension measures. A review of hi and hi literature on the effects of taking notes and retaining notes on students' recall of lecture information reveals several factors as important contributors to successful recall, such as quality of notes, and training in note-taking. In this study, the effect on comprehension tests of the availability of notes taken, and the quality of hi learners' notes, was studied. Both multiple-choice and cloze listening comprehension measures were employed. Results indicate no favorable role for retaining or not retaining notes on short-term recall success, but complex relationships appeared between measures of lecture note quality and successful recall.

Abstract The authors consider the current need for faculty leadership, the motivation to lead, and the challenges and problems faculty encounter in their leadership roles and provide a sampling of leadership development initiatives across the nation.

This article bridges the fields of instructional design and teacher education, presenting and modernizing the media influence debate and synthesizing it with the technological pedagogical and content knowledge (TPACK) framework. Five modern technologies are presented as media comparison studies, analyzed from both the medium-as-variable and medium-and-method-as-variable perspectives, and highlighted in an example teaching and learning scenario analyzed for TPACK. The media debate is newly synthesized with TPACK, acknowledging the teacher as a critical variable in instructional success, and implications for research and teacher education and professional development are presented.

Rubinstein-Taybi syndrome (RSTS) is an autosomal dominant disorder, caused by loss-of-function variants in CREBBP or EP300. Affected individuals present with distinctive craniofacial features, broad thumbs and/or halluces, and intellectual disability. RSTS phenotype has been well characterized in individuals of European descent but not in other populations. In this study, individuals from diverse populations with RSTS were assessed by clinical examination and facial analysis technology. Clinical data of 38 individuals from 14 different countries were analyzed. The median age was 7 years (age range: 7 months to 47 years), and 63% were females. The most common phenotypic features in all population groups included broad thumbs and/or halluces in 97%, convex nasal ridge in 94%, and arched eyebrows in 92%. Face images of 87 individuals with RSTS (age range: 2 months to 47 years) were collected for evaluation using facial analysis technology. We compared images from 82 individuals with RSTS against 82 age- and sex-matched controls and obtained an area under the receiver operating characteristic curve (AUC) of 0.99 (p < .001), demonstrating excellent discrimination efficacy. The discrimination was, however, poor in the African group (AUC: 0.79; p = .145). Individuals with EP300 variants were more effectively discriminated (AUC: 0.95) compared with those with CREBBP variants (AUC: 0.93). This study shows that clinical examination combined with facial analysis technology may enable earlier and improved diagnosis of RSTS in diverse populations.

Abstract A partnership has been developed linking the United States Military Academy and Special People in the Northeast, a non‐profit agency for the mentally and physically handicapped children and adults based in Philadelphia. The present work documents a student design team's design and construction of a ticket‐tearing device for a young man in the advanced stages of cerebral palsy and concludes with an evaluation of the entire process.