bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-Dimensional Printed Model and Virtual Reconstruction: An Extra Tool for Pediatric Solid Tumors Surgery
Authors: Sánchez-Sánchez Ángela , Girón-Vallejo Óscar , Ruiz-Pruneda Ramón , Fernandez-Ibieta Maria , García-Calderon Darío , Villamil Vanesa , Giménez-Aleixandre María , Montoya-Rangel Carlos , Hernández Bermejo Juan
Published: October 2018

Introduction Three-dimensional (3D) technology is increasingly applied for planning challenging surgical interventions. We report our experience using 3D printing and virtual reconstruction for surgical planning of complex tumor resections in children.

Methods Data were obtained from preoperative magnetic resonance. imaging analysis and 3D virtual recreations were performed using specialized computer software. 3D real-scale geometry models, including tumor, adjacent organs, and relevant vascularization, were printed in colorimetric scale and different materials for optimal structures discrimination.

Results Four complex cases were selected. The first case was a bilateral Wilms tumor. The volumetric reconstruction proved the presence of enough healthy renal tissue, allowing bilateral nephron-sparing surgery. In the second case, reconstruction contributed to the location of pulmonary metastases. The third case was an abdominal neuroblastoma stage L2. The 3D model was of high value for planning and as a reference during the intervention. The last case is a cervico-thoracic neuroblastoma with an anatomopathological diagnosis of ganglioneuroma, located at the cervico-mediastinal juncture, in close relationship with the cervical vessels.

Conclusions 3D reconstruction and the full-scale printing models are a useful tool in cases of complex tumor resections as they contribute to a better understanding of the relationships between the tumor and adjacent organs, helping to anticipate certain surgical complications. They also provide additional information to conventional imaging tests, being able to influence therapeutic decisions and facilitate the understanding by the family, improving doctor–patient communication.
Seizures and Epilepsy following Subarachnoid Hemorrhage: A Review on Incidence, Risk Factors, Outcome and Treatment
Authors: Ramos Miguel , Teixeira Manoel , Figueiredo Eberval
Published: October 2018

The mortality rates of subarachnoid hemorrhage (SAH) average 51%, and survivors frequently experience acute and long-term neurological conditions, including seizures and epilepsy. The incidence of post SAH-related seizures and epilepsy, its risk factors, outcomes and management are controversial. The present paper aims to discuss these aspects, to provide the pros and cons of different management options of this condition. A review on PubMed was performed encompassing the incidence of seizures and epilepsy following SAH, the risk factors for its occurrence, its related outcomes, and treatment. The incidence of seizures and epilepsy following SAH varies widely in the literature (from 6 to 26%). Some possible risk factors were identified, such as middle cerebral artery (MCA) aneurysm, Hunt and Hess grade III, aneurysm clipping, thick subarachnoid clot, intracerebral hemorrhage, rebleeding, ischemic brain infarction, Fisher grade III or IV, acute hydrocephalus, hypertension history and poor World Federation of Neurosurgical Societies (WFNS) grade. Nevertheless, these relations are frequently uncertain. Also, it appears that the outcome of patients who suffered SAH is worsened by seizures. Given these uncertainties, the need for antiepileptic drug (AED) prophylaxis, the choice of the best drug and dose, as well as the duration of the treatment are controversial topics. However, some recommendations based on low quality evidence are reasonable to be adopted. These include considering AED prophylaxis when a seizure occur after SAH, considering routine long-term AED prophylaxis in specific populations, considering electroencephalogram (EEG) monitoring, and avoiding phenytoin prescription. That is, an individualized approach appears to be the best option, since there is no high-quality evidence.
Chondrosarcoma in the Petrous Apex: Case Report and Review
Authors: Banaz F. , Edem I. , Moldovan I. , Kilty S. , Jansen G. , Alkherayf F.
Published: October 2018

Introduction Surgical treatment of petrous apex chondrosarcoma is challenging due to the location of the tumor. Using an endoscopic technique for tumor resection is favored since it provides a minimally invasive approach.

Case Presentation A 57 years old female was admitted for acute onset of left abducens nerve palsy and occasional headache mainly on the left side of the retro-orbital area with some radiation to the left occiput. Magnetic resonance imaging (MRI) and computed tomography (CT), at the time of admission, were showed lytic lesion on the left petrous apex and left part of the clivus. Results of metastatic workup were negative. The surgical procedure considered was expanded endoscopic endonasal transclival approach to the left of the petrous apex and reconstruction with a pedicled nasoseptal flap with image guidance system. The pathology confirmed chondrosarcoma on myxoid background. The surgical procedure was uncomplicated. The abducens nerve palsy was resolved in few weeks and no new deficits occurred. Postoperative MRI showed complete resection of the tumor.

Conclusion Expanded endoscopic endonasal transclival approach to petrous apex and reconstruction appears to be safe and feasible technique, capable of achieving total removal of identified lesions near the petrous apex. Nonetheless, future studies with a greater number of patients are crucial to confirm and consolidate this initial impression.
CPA Epidermoid Cyst with Rare Anatomic Variant: Anterior Inferior Cerebellar Artery Embedded in the Subarcuate Fossa: Operative Video and Technical Nuances
Authors: Candanedo Carlos , Spektor Sergey
Published: October 2018

Intracranial epidermoid cysts are considered benign tumors with a good general prognosis; however, their radical removal, including tumor capsule, is associated with significant morbidity, especially when the capsule is attached to neurovascular structures. We show an operative video describing main steps and surgical nuances in the resection of a large right cerebellopontine angle (CPA) epidermoid cyst in a 42-year-old male patient who presented with intractable trigeminal neuralgia. Craniectomy was performed to exposure the transverse-sigmoid sinus junction. A mold for a polymethylmethacrylate (PMMA) bone flap was built before opening the dura to avoid potentially neurotoxic effects on the cerebellum. The video illustrates the management of the rare anatomical variant of the anterior inferior cerebellar artery (AICA). Its loop was embedded in the dura, covering the subarcuate fossa where it gives off the subarcuate artery. Near total removal of the epidermoid cyst was achieved, leaving only a tiny capsule remnant adhering to the abducens nerve. Postoperatively the patient's trigeminal neuralgia was fully relieved and medications were discontinued. The patient's hearing was preserved per audiometry at the preoperative level (Gardner–Robertson II). Postoperative magnetic resonance imaging (MRI) revealed no signs of residual tumor. In this case, it was not possible to obtain optimal surgical exposure of the CPA without handling a rare anatomical anomaly of the AICA in the dura of the subarcuate fossa, which demanded coagulation and transection of the subarcuate artery and transposition of AICA with the dural cuff. This manipulation enabled optimal surgical removal of the epidermoid and didn't cause any neurological deficit.

The link to the video can be found at: https://youtu.be/lLZqBHlu-uA.
Decidual Vasculopathy in Preeclampsia and Spiral Artery Remodeling Revisited: Shallow Invasion versus Failure of Involution
Authors: Zhang Peilin
Published: October 2018

Decidual vasculopathy is commonly associated with preeclampsia and develops in the late pregnancy in the uterine spiral arteries, which were previously remodeled by the extravillous trophoblasts. In normal early pregnancy, trophoblasts invade into the spiral artery, leading to vascular transformation, and this transformation is found to be associated with phenotypic switch of the endovascular trophoblasts to express CD56, a maternal protein likely from the natural killer (NK) cells. These endovascular trophoblasts are diminished at term. The decidual vessels are also returned to near normal at the delivery. Both the uterus and the uterine spiral arteries undergo involution after delivery. In preeclampsia, the endovascular trophoblasts are present within the vessel wall associated with the persistence of switched phenotype similar to those seen in the early implantation. The persistence of the endovascular trophoblasts in decidual vasculopathy indicates a failure to return to normal vessels in preeclampsia, thus suggesting a potential mechanism of pathogenesis. NK cells seem critical not only for early implantation and spiral artery remodeling but also for the development of decidual vasculopathy in preeclampsia. In this short review, some critical aspects of decidual vasculopathy in normal pregnancy and preeclampsia are reexamined and a new hypothesis is proposed.
Invited Article: Molecular biomarkers characterization for human brain glioma grading using visible resonance Raman spectroscopy
Authors: Zhou Yan , Liu Cheng-hui , Wu Binlin , Zhang Chunyuan , Yu Xinguang , Cheng Gangge , Chen Hong , Li Shenglin , Liang Qijun , Zhang Mingqian , Zhu Ke , Shi Lingyan , Alfano Robert R.
Published: October 2018

The accurate identification of the human brain tumor boundary and the complete resection of the tumor are two essential factors for the removal of the glioma tumor in brain surgery. We present a visible resonance Raman (VRR) spectroscopy technique for differentiating the brain tumor margin and glioma grading. Eighty-seven VRR spectra from twenty-one human brain specimens of four types of brain tissues, including the control, glioma grade II, III, and IV tissues, were observed. This study focuses on observing the characteristics of new biomarkers and their changes in the four types of brain tissue. We found that two new RR peaks at 1129 cm−1 and 1338 cm−1 associated with molecular vibrational bonds in four types of brain tissues are significantly different in peak intensities of VRR spectra. These two resonance enhanced peaks may arise from lactic acid/phosphatidic acid and adenosine triphosphate (ATP)/nicotinamide adenine dinucleotide, respectively. We found that lactic acid and ATP concentrations vary with glioma gratings. The higher the grade of malignancy, the more the increase in lactic acid and ATP concentrations. These two RR peaks may be considered as new molecular biomarkers and used to evaluate glioma grades and identify the margin of gliomas from the control tissues. The metabolic process of lactic acid and ATP in glioma cells based on the VRR spectral changes may reveal the Warburg hypothesis.
Ultra-short-term multi-step wind power prediction based on fractal scaling factor transformation
Authors: Yang Mao , Chen Xinxin , Huang Binyang
Published: October 2018

Most of the existing ultra-short-term wind power prediction methods only involve mathematical models and rarely consider spatial correlation factors. As such, the prediction system remains to be further improved. In this paper, in order to accurately predict the wind power of the large-scale wind farm, the idea of spatial-temporal scale transformation is introduced to establish a spatial up-scaling model of ultra-short-term multi-step wind power prediction based on fractal scaling factor transformation. First, the regional division of the large-scale wind farm is carried out. Then, the affine relationship of the local and whole regions is established by using the theory of stretching transformation of fractal. The process of traditional space up-scaling prediction is improved by fractal transformation. Finally, the deductive process is accomplished by the prediction of local regional to whole regional. To verify the proposed approach, two large-scale wind farms in northeast China were selected to predict its wind power. Compared with the traditional wind power prediction approach of the whole wind farm and the prediction approach of traditional spatial up-scaling, this approach can get better prediction accuracy.
Sample dependence studies of the Kondo Weyl semimetal YbPtBi
Authors: Guo Chunyu , Wu Fan , Smidman Michael , Yuan Huiqiu
Published: October 2018

Materials with non-trivial band topology have attracted enormous attention in recent years due to their unique physical properties and potential applications in quantum computation. After the discovery of topological insulators, many semimetals were also found to possess non-trivial band topology, such as Dirac and Weyl semimetals. To date, most of the discovered topological semimetals are materials with weak electronic correlations, so it is desirable to find topological semimetals with strong electronic correlations. In our previous work, we found that YbPtBi is a promising Kondo Weyl semimetal candidate. At high temperature, electronic structure calculations show that pairs of triply degenerate points can be found, which is supported by angle resolved photonemission spectroscopy (ARPES) measurements. In an external magnetic field, these points are split into pairs of Weyl nodes, and the presence of Weyl fermions is revealed by the angle dependent magnetotransport measurements. However, at low temperatures when the electronic structure are strongly influenced by band hybridization, the results of heat capacity measurements suggest a nodal thermal excitation, which is evidence for the presence of Weyl Kondo semimetal phase in YbPtBi. This is further supported by the observation of a topological Hall effect in Hall resistivity measurements. Here we present a study of the sample dependence of the properties of YbPtBi. The relationship between the carrier density and negative longitudinal magnetoresistance (MR) clearly suggests the presence of the chiral anomaly and can be consistently explained based on the band structure. The analysis of the Hall resistivity reveals a strong signal of an anomalous Hall effect at low temperature, which may arise from the complex Berry curvature in momentum space. These results further suggest that YbPtBi is a potential platform for studying the properties of Weyl fermions in the presence of strong electronic correlations.
Photoluminescence of the integrating sphere walls, its influence on the absolute quantum yield measurements and correction methods
Authors: Valenta Jan
Published: October 2018

Determination of the absolute quantum yield (QY) of photoluminescence (PL) or electroluminescence is commonly performed using an integrating sphere (IS) – versatile device for radiometry applications. The key feature of IS is very high diffused reflectance of its internal surface. Two materials are commonly used: (a) the sintered high-density polytetrafluoroethylene (Spectralon) and (b) materials based on barium sulphate (Spectraflect). Using PL-micro-spectroscopy we show that both materials reveal PL from localized centers excitable by UV, blue and green light emitting broad PL spectrum extending up to the red spectral region. The main effect of PL from IS-walls is introduction of non-constant parasitic background which is mixed with PL from a tested sample during the QY measurements. We develop theoretical description of QY determination which includes effects of PL from IS walls. This allows us to propose and test a reliable and universal correction for the IS-related PL background. Finally, a method of “black sample” is proposed and applied to estimate PL QY of Spectraflect which is shown to decrease from 0.09 to 0.015% for excitation shift from 320 to 440 nm.
Photoluminescence, infrared, and Raman spectra of co-doped Si nanoparticles from first principles
Authors: Somogyi Bálint , Bruyer Emilie , Gali Adam
Published: October 2018

Co-doped silicon nanoparticles (NPs) are promising for the realization of novel biological and optoelectronic applications. Despite the scientific and technological interest, the structure of heavily co-doped Si NPs is still not very well understood. By means of first principles simulations, various spectroscopic quantities can be computed and compared to the corresponding experimental data. In this paper, we demonstrate that the calculated infrared spectra, photoluminescence spectra, and Raman spectra can provide valuable insights into the atomistic structure of co-doped Si NPs.
MdMYBL2 helps regulate cytokinin-induced anthocyanin biosynthesis in red-fleshed apple (Malus sieversii f. niedzwetzkyana) callus
Authors: Wang Yicheng , Sun Jingjing , Wang Nan , Xu Haifeng , Qu Changzhi , Jiang Shenghui , Fang Hongcheng , Su Mengyu , Zhang Zongying , Chen Xuesen
Published: October 2018

Anthocyanin biosynthesis is induced by cytokinins, and is regulated by MYB transcription factors. However, the underlying molecular mechanisms have not been fully characterised. In the present study, red-fleshed apple callus were induced from the leaves of an R6/R6 homozygous line, which was the hybrid offspring of Malus sieversii f. niedzwetzkyana and ‘Fuji’. We analysed the callus anthocyanin contents in response to different cytokinin concentrations. We observed that cytokinin treatments upregulated the expression of anthocyanin structural genes MdDFR and MdUFGT and transcription factor genes MdMYB10 and MdbHLH3. Additionally, the expression of MdMYBL2, which encodes the bHLH and EAR motifs, was inhibited by cytokinin treatments. The MdMYBL2-overexpressing callus had lower anthocyanin contents than the wild-type controls. We noted that the expression levels of anthocyanin biosynthesis structural genes MdDFR and MdUFGT and transcription factor genes MdMYB10 and MdbHLH3 were strongly suppressed in the transgenic callus. Subsequent yeast two-hybrid, bimolecular fluorescence complementation, and pull-down assays indicated that MdMYBL2 interacts with MdbHLH3, which may influence the expression of anthocyanin biosynthesis-related genes. Our findings may provide new insights into how MYB transcription factors influence the cytokinin-regulated anthocyanin biosynthesis in red-fleshed apples.
Letters, Imagined Communities, and Literate Identities: Perspectives from Rural Ugandan Women
Authors: Kendrick Maureen E. , Hissani Hizzaya
Published: October 2018

Historically, letter reading and writing have been pervasive across human societies, cultures, and communities (Barton & Hall, 2000). Like all literate activities, it derives its meaning and significance from how it is situated within cultural beliefs, values, and practices. Despite its prevalence, however, little is known about the meanings and uses of letter reading and writing in diverse cultural contexts. The purpose of this article is to examine the desire to independently read and write letters as a rationale for rural Ugandan women to join an adult literacy program. Drawing on sociocultural theories, and in particular, the frameworks of a literacy ecology of communities, communities of practice, and imagined communities, the authors use ethnographic techniques to explore the role of letter reading and writing in the lives of 15 women participating in an adult literacy program in 1 rural Ugandan community. The authors argue that letter reading and writing practices, personhood, and identity are intertwined within an imagined community to which these women hope to belong, and these imagined communities may play a critical role in their success in adult literacy programs.
Commodity Prices and Intra‐Household Labor Allocation
Authors: Beck Ulrik , Singhal Saurabh , Tarp Finn
Published: October 2018

Volatility in commodity markets poses a distinct risk to farmers in developing countries who rely on cash crop agriculture. We combine a time series of international coffee prices with a long‐running panel on coffee‐growing households in Vietnam to investigate coping mechanisms employed by farmers in a transitioning economy. We find that households cope with lower coffee prices by increasing wage labor of adults, with children and adolescents substituting for adults on the farm. Heterogeneity analysis indicates a stronger substitution pattern among women, ethnic minorities, and households with fewer assets. A variety of robustness checks corroborate these findings. Account of this finding should be taken in formulating and implementing social protection and inclusive growth policies.
Breaking the myths (or how to have a successful career in science)
Authors: Ovenden Jennifer R
Published: October 2018

The article is a recollection of the ups and downs of my career as a research scientist. It does not chronicle my career in the standard way; there is no timeline of events and only a few details of the type of research that I have devoted my life to. I feel the take-home messages are relevant no matter what type of science you do. The narrative jumps around between periods of my life, uses anecdotes freely and attempts to be informative, forthright, and entertaining. Although science is perceived as a profession, the career pathway can be uneven and forked. In addition to discipline-specific knowledge and experience, successful scientists need a multitude of skills; for instance, human management, logistics, and social media—to name a few. The field often attracts talented introverts for whom working in teams is challenging. The complexity of science is fascinating and powerful. In the fervour for discoveries, care is needed not to become isolated from friends and family by long working hours. For those of you who have gone part or full way down this path, there will be value in comparing your experiences to mine. Mostly I hope that younger scientists who are beginning on this path, or considering whether to enter, will take away some messages that will help them stand on our shoulders.
Do Sequential Mixed-Mode Surveys Decrease Nonresponse Bias, Measurement Error Bias, and Total Bias? An Experimental Study
Authors: Sakshaug Joseph W , Cernat Alexandru , Raghunathan Trivellore E
Published: October 2018

Mixing multiple modes of survey data collection has become standard practice in survey research. Mixed-mode surveys are faced with a slew of design decisions regarding which types of modes to administer and which sequence to administer them in. Such decisions are largely based on administrative objectives, such as minimizing costs and maximizing response rates. However, just as important to these mixed-mode decisions is their impact on nonresponse bias, measurement error bias, and total bias, which are understudied issues in the mixed-mode literature. In this article, we report on a sequential mixed-mode experiment of young adult drivers randomized to one of two mode sequences: an interviewer-administered (telephone) mode with self-administered (mail) follow-up, or the reverse sequence. Using a mix of direct and indirect bias estimation strategies, we find support for the notion that implementing a second mode of data collection can reduce nonresponse and measurement error bias, but the sequence in which the modes are administered makes a difference: the mail-telephone sequence minimizes bias to a greater extent than the telephone-mail sequence, relative to the starting mode and overall. However, a backfiring effect was found: despite reducing both nonresponse and measurement error bias, switching from mail to telephone increased the total bias in a key estimate of traffic accidents. A discussion of these findings and their implications for survey practice are provided in conclusion.
Efficacy of a Surfactant-Based Wound Dressing in the Prevention of Biofilms
Authors: Salisbury Anne-Marie , Percival Steven L.
Published: October 2018

OBJECTIVE:

To assess the biofilm prevention action of two wound dressings, a concentrated surfactant gel preserved with antimicrobials and a concentrated surfactant gel with 1% silver sulfadiazine.

METHODS:

The microorganisms Staphylococcus aureus, methicillin-resistant S aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Enterococcus faecalis were used. Several biofilm models were used whereby the surfaces of each model were coated with either the concentrated surfactant gel preserved with antimicrobials or the concentrated surfactant gel with SSD before biofilm growth.

MAIN RESULTS:

Results showed the concentrated surfactant gel with SSD prevented biofilm growth in the modified minimum biofilm eradication concentration and Centers for Disease Control and Prevention biofilm models. The concentrated surfactant gel preserved with antimicrobials prevented microbial penetration for up to 48 hours, whereas the concentrated surfactant with SSD prevented microbial penetration for at least 72 hours. Using confocal laser scanning microscopy, researchers showed that a surface coated with the concentrated surfactant gel preserved with antimicrobials enhanced microbial sequestration of planktonic microorganisms.

CONCLUSIONS:

These results demonstrated that a concentrated surfactant gel preserved with antimicrobials can sequester and cause the immobilization of planktonic bacteria. Further, the concentrated surfactant gel with SSD can effectively kill planktonic and sessile microorganisms.
Use of the Creighton Tool During a Home Visit Simulation Experience
Authors: Livsey Kae Rivers
Published: October 2018

This article describes implementation of the Creighton Simulation Evaluation Instrument to evaluate student performance during a simulated home visit experience. A total of 48 groups of students participating in the simulation were evaluated by peer evaluators and faculty. Interrater reliability was found to be low to fair. Low agreement between raters may be a result of a number of factors, including enhanced faculty familiarity with the instrument and being able to identify evidence of critical thinking being displayed by the students engaged in the simulation.
The Development of Quantitative Instruments to Evaluate Cognition and Competency of Forensic Nursing Science
Authors: Drake Stacy A. , Langford Rae , Young Anne
Published: October 2018

Few instruments are available to evaluate fundamental forensic nursing science practice. A cognitive exam to assess knowledge and a practical competency rubric to assess skill proficiency were developed and examined for validity and reliability. Content validity of the cognitive exam was investigated using a test blueprint as well as a panel of experts in forensic science and test construction. The same panel inspected the competency rubric. Pilot testing of both instruments was then conducted to assess reliability. Internal consistency of the cognitive exam was low, leading to revision and retesting; interrater reliability of the competency rubric was acceptable.
Sustaining and Improving Study Abroad Experiences Through Comparative Evaluation
Authors: Johanson Linda S.
Published: October 2018

Researchers have related participation in study abroad experiences to many positive outcomes for nursing students; however, educators are faced with the task of not only developing meaningful study abroad opportunities but sustaining and improving them as well. Educators can evaluate repeat study abroad programs by comparing experiences, looking for trends, and conjecturing rationales. To illustrate this process, an example of a study abroad opportunity that has been repeated over 11 years is presented. The first six years have been compared to the most recent five years, revealing three categories of change for evaluation and the resulting course improvements.
Collaborative Design of a Doctoral Nursing Program Online Orientation
Authors: Welch Susan , Cook Jean , West Dianne
Published: October 2018

This article describes the collaborative development of an online orientation for students entering a doctoral nursing education program. Faculty and staff from the school of nursing, university library, and other academic support services worked together to design the orientation course materials, learning activities, and assessments, resulting in a cohesive, active-learning experience for students. As a result, returning adult learners were better prepared to begin their online doctoral studies.
Using a Real Apartment House for Home Visit Simulations: An Eye-Opening Experience
Authors: Gray Kimberly K. , Grist Susan K. , Race Deborah A.
Published: October 2018

The development of a home care visit using a real apartment house is a unique approach to simulated learning experiences. This teaching strategy broadens the traditional simulation center approach by adding realism to the overall experience. The article explains how the use of the apartment house created a unique teaching strategy not otherwise available in traditional simulation center settings and helped junior-level nursing students understand the nuances of home care visits. On the basis of positive learning experiences, additional opportunities are being explored for using the apartment house at all clinical levels.
Student Evaluation of Simulation in a New Hospital-Based Simulation Center
Authors: Myler Linda Anne , Seurynck Kathleen
Published: October 2018

The use of simulation is gaining momentum in nursing as a safe, controlled pedagogical method to imitate clinical situations. This article describes the development of a partnership between a hospital-based center and a university to launch a new simulation program. One hundred sixty junior and senior nursing students completed the Simulation Effectiveness Tool. Most students agreed with statements about the importance of simulation related to critical thinking, decision-making, and the value of debriefing. This study adds to the existing literature on the positive effects of simulation while applying it to a unique setting and partnership.
Faculty Descriptions of Simulation Debriefing in Traditional Baccalaureate Nursing Programs
Authors: Waznonis Annette R.
Published: October 2018

AIM

A study was conducted to describe simulation debriefing practices of faculty in accredited, traditional, baccalaureate nursing programs in the United States.

BACKGROUND

Best debriefing practices include debriefing by a competent facilitator in a safe environment using a structured framework. Yet, structured frameworks and evaluation of debriefing are lacking in nursing education.

METHOD

This article reports the interview findings from the qualitative component of a large-scale mixed-methods study.

RESULTS

Twenty-three full-time faculty members with an average of 6 years of simulation debriefing experience participated in interviews. Three themes emerged with subthemes: a) having the student’s best interest at heart, b) getting over the emotional hurdle, and c) intentional debriefing evolves into learning. Gaps were found in faculty development, use of a structured framework, and evaluation.

CONCLUSION

Research is warranted on use of video, postdebriefing assignments, cofacilitation, and debriefing effectiveness.
Video-Enhanced Simulation in Pediatric End-of-Life Care
Authors: Gotwals Beth A. , Scholtz Susan
Published: October 2018

Pediatric end-of-life care is a challenge for nursing education. Until recently, there was little evidence of pedagogical approaches to meet the educational needs of nursing students. Based on End-of-Life Nursing Education Consortium guidelines and recent literature, a clinical simulation was developed using the documentary “A Lion in the House.” Learning objectives were developed along with presimulation student learning activities. Reflection and dialogue were guided postsimulation. This simulation provided a novel approach to student-centered learning and a context for resolving the problem of providing clinical learning experiences to educate nursing students to care for the child and family experiencing the end of life.
Interprofessional Research Guidelines for Health Care Students
Authors: Poling Deborah B. , Wilson Meg , Finke Linda K. , Bokhart Gordon , Buchanan Jeb
Published: October 2018

Although there has been a substantial increase in published research about interprofessional education for future health care providers in recent years, little has been published about students conducting interprofessional research using an interprofessional model. To help address this gap, a community research consortium developed a set of interprofessional research guidelines to enhance both the learning experiences of health care providers and students and provide a strong research foundation for future interprofessional projects. The guidelines were adapted from the Interprofessional Education Collaborative Core Competencies.
Using the Evidence-Based Practice Knowledge Assessment in Nursing Instrument to Evaluate Exposure Effects in Baccalaureate Nursing Students
Authors: Wonder Amy Hagedorn , Spurlock Darrell R. , Ironside Pamela M.
Published: October 2018

To prepare nursing students for evidence-based practice (EBP), it is essential to evaluate the exposure effects of courses and pedagogy on EBP knowledge development. Secondary analysis of cross-sectional, descriptive, correlational study data focused on identifying relationships between completion of undergraduate research and statistics courses and EBP knowledge of baccalaureate nursing students. There were statistically significant differences in EBP knowledge scores when comparing subjects recently exposed versus unexposed to statistical coursework. Research course exposure effects were nonsignificant. Further study of exposure effects is needed to clarify the role of research and statistical coursework in developing EBP knowledge.
Rising from the Rubble: A Capstone Simulation Integrating Leadership and Clinical Skills
Authors: Wiles Lynn L. , Isibel Denise
Published: October 2018

This novel simulation approach incorporates assessment, prioritization, patient care, and clinical reasoning with leadership and ethical principles when teaching disaster preparedness content in a prelicensure BSN curriculum. Using a combination of live actors and simulation equipment, 10 patients arrive in the skills lab seeking help for a variety of illnesses and injuries in the aftermath of a severe storm. The patients’ ages and conditions represent each of the clinical courses in the nursing curriculum. Students are assigned to assume the role of nurse, triage nurse, or incident commander and plan, prioritize, and provide patient care.
Meeting a Growing Need: An Online Approach to Cultural Competence Education for Health Professionals
Authors: Utley-Smith Queen E.
Published: October 2018

Prelicensure education may inadvertently lead to a belief that learning about different cultures is an end point, whereas cultural competency is an ongoing process. An online cultural competency education module incorporating organizational cultural assessment was developed for graduate nursing education. After completion, nurses have reported intent to continue career-long cultural competence learning and expressed determination to promote cultural competence in organizations where they work and lead.
Evaluating the Need for Organ Donation and Transplant-Related Education in Nursing Curricula
Authors: Cerrato Annette , Ea Emerson , Flom Peter
Published: October 2018

Transplant education has been historically unstructured and inconsistent. The purpose of this study was to measure nursing students’ knowledge and attitudes toward organ donation, allocation, and preparation for practice using a modified version of the Organ Donation Attitude Questionnaire II-Student Version. Scores were low, particularly regarding brain death and organ allocation. Preparedness for practice was related to knowledge of brain death (z = 2.05, p = .04); knowledge (t = 2.24, p = .03) and attitude (t = 7.55, p < .0001) were related to signing a driver’s license. Results support including organ donation and transplant education in nursing curricula.
Technology Use and Technological Self-Efficacy Among Undergraduate Nursing Faculty
Authors: Roney Linda N. , Westrick Susan J. , Acri Mary C. , Aronson Barbara S. , Rebeschi Lisa M.
Published: October 2018

AIM

This study explored faculty responses to a survey about using technology to teach undergraduate nursing students.

BACKGROUND

Little is known regarding faculty confidence, technology use, or supports for integrating technology into nursing education.

METHOD

A descriptive correlational design was utilized to explore the relationship between technology use and technological self-efficacy in faculty (N = 272) who teach at Commission on Collegiate Nursing Education–accredited nursing programs. Instruments used were a sociodemographic questionnaire, the Roney Technology Use Scale, and the Technology Self-Efficacy Scale.

RESULTS

Participants who taught didactic content had moderate technology use as compared to those teaching didactic and clinical/laboratory who reported high levels of technology use. A weak relationship between age and technological self-efficacy (ρ = .127, p < .05) was also found.

CONLUSION

This research was an initial step in understanding levels of technology use and responses to this challenge by undergraduate nursing faculty.
Reflective Responses Following a Role-play Simulation of Nurse Bullying
Authors: Ulrich Deborah L. , Gillespie Gordon Lee , Boesch Maura C. , Bateman Kyle M. , Grubb Paula L.
Published: October 2018

A qualitative exploratory design was used for this study to evaluate role-play simulation as an active learning strategy. The context for the role-play was bullying in nursing practice. Following a simulation, 333 students from five college campuses of three universities completed a reflection worksheet. Qualitative thematic findings were personal responses, nonverbal communications exhibited, actions taken by participants, and the perceived impact of bullying during the simulation. Role-play simulation was a highly effective pedagogy, eliciting learning at both the cognitive and affective domains.
Long-term outcomes of adolescents with juvenile-onset fibromyalgia into adulthood and impact of depressive symptoms on functioning over time
Authors: Kashikar-Zuck Susmita , Cunningham Natoshia , Peugh James , Black William R. , Nelson Sarah , Lynch-Jordan Anne M. , Pfeiffer Megan , Tran Susan T. , Ting Tracy V. , Arnold Lesley M. , Carle Adam , Noll Jennie , Powers Scott W. , Lovell Daniel J.
Published: October 2018

Juvenile-onset fibromyalgia (JFM) is typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment. The long-term impact of JFM into adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (∼8-year follow-up), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study in which pain symptoms, and physical and psychosocial functioning were assessed at 4 time points over approximately 8 years. At the time 4 follow-up (Mage = 24.2 years), the majority continued to suffer from pain and impairment in physical, social, and psychological domains. However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analysis using growth mixture modeling revealed 2 pain trajectories (Steady Improvement and Rapid Rebounding Improvement), whereas depressive symptoms followed 3 distinct trajectories (Low-Stable, Improving, and Worsening). Membership in the Worsening Depressive symptoms group was associated with poorer physical functioning over time (P < 0.001) compared with the Low-Stable and Improving groups. This study offers evidence that although JFM symptoms persist for most individuals, pain severity tends to decrease over time. However, depressive symptoms follow distinct trajectories that indicate subgroups of JFM. In particular, JFM patients with worsening depressive symptoms showed decreasing physical functioning and may require more intensive and consistent intervention to prevent long-term disability.
Increased pain sensitivity and decreased opioid analgesia in T-cell-deficient mice and implications for sex differences
Authors: Rosen Sarah F. , Ham Boram , Haichin Michael , Walters Ilana C. , Tohyama Sarasa , Sotocinal Susana G. , Mogil Jeffrey S.
Published: October 2018

The processing of pain in the central nervous system is now known to have an important immune component, including T cells of the adaptive immune system. T cells have been shown to release endogenous opioids, and although it is well known that opioids have effects on T-cell populations, very little attention has been given to the converse: how T cells may affect opioid regulation. We find here that, in addition to displaying significantly increased baseline pain sensitivity across various pain modalities, T-cell-deficient mice (CD-1 nude, Rag1 null mutant, and Cd4 null mutant) exhibit pronounced deficiencies in morphine inhibition of thermal or inflammatory pain. Nude mice are also deficient in endogenous opioid-mediated analgesia, exhibiting no stress-induced analgesia from restraint. The relevant T-cell subpopulation seems to be CD4+ T cells because adoptive transfer of them but not CD8+ cells into nude mice rescues both the pain and morphine analgesia phenotypes. As previously reported, we also observe a sex difference in CD-1 mice, with females requiring 2- to 3-fold more morphine than males to produce equal analgesia. Nude mice display no sex differences in morphine analgesia, and the sex difference is restored in nude mice of either sex receiving CD4+ T cells from CD-1 donor male or female mice. These results suggest that CD4+ T cells play an as yet unappreciated role in opioid analgesia and may be a driver of sex differences therein.
Fanconi Anemia and Ataxia Telangiectasia in Siblings who Inherited Unique Combinations of Novel FANCA and ATM Null Mutations
Authors: Balta Gunay , Patiroglu Turkan , Gumruk Fatma
Published: October 2018

A unique consanguineous family with 2 genomic instability disorders, Fanconi anemia and ataxia telangiectasia, revealed exceptional combinations of null mutations in the FANCA and ATM genes. Two siblings with Fanconi anemia had novel homozygous consecutive microdeletions (c.1361-1370delCCTCCTTTGG, c.1374delC) adjoined to upstream 65 nucleotide direct tandem repeats and deletion hotspot motifs in the FANCA gene. The sibling with ataxia telangiectasia revealed a homozygous p.Arg2993Stop (c.8977C>T) null mutation in the ATM gene. All patients were also heterozygous for the opposite mutations without any additional clinical or laboratory manifestations. Double heterozygote parents did not present any clinical symptoms suggestive of the 2 disorders.
Outcome Measures in Interventions That Enhance Breastfeeding Initiation, Duration, and Exclusivity
Authors: Wood Natsuko K. , Woods Nancy F.
Published: October 2018

Objective:

The purpose of this review was to examine outcome measures used in interventions focusing on enhancement of breastfeeding initiation, duration, and exclusivity.

Methods:

A literature search guided by search terms on outcome measures of breastfeeding interventions was conducted using PubMed, CINAHL Plus, & PsycINFO databases on publications between 2006 and 2017.

Results:

Nine studies were included in this review, using PRISMA guidelines. Rates of breastfeeding initiation, duration, and exclusivity were measured during specific points in time. Data collection methods involve interviews, self-report, observations, and/or feeding logs. Although breastfeeding types (exclusive breastfeeding, predominant breastfeeding, and complementary breastfeeding) were measured, methods of infant feeding (breastfeeding and bottle feeding) were rarely assessed, ignoring significant mediators or moderators of breastfeeding.

Conclusions:

There were methodological limitations to the reviewed studies: (1) a 24-hour recall bias, (2) misclassification of breastfeeding categories, (3) lack of consistency in breastfeeding definitions, and (4) few reports of the reason for breastfeeding discontinuation. Future studies should focus on the modifiable cause of the problem: outcome measures attributed to the targets of the intervention, followed by breastfeeding initiation, duration, and/or exclusivity.
Pediatric Major Vascular Injuries
Authors: Perea Lindsey L. , Hazelton Joshua P. , Fox Nicole , Gaughan John P. , Porter John , Goldenberg Anna
Published: October 2018

Objectives

Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center.

Methods

A retrospective review (January 2000 to May 2016) was conducted of all pediatric (<18 years old) trauma patients who presented with a vascular injury. A total of 177 patients were identified, with 60 (34%) having an MVI, defined as injury in the neck, torso, or proximal extremity. Patients were then further analyzed based on location of injury, mechanism, age, and race. P ≤ 0.05 was deemed significant.

Results

Of the 60 patients with MVI, the mean age was 14.3 years (range, 4–17 years). Mean intensive care unit length of stay (LOS) was 5.4 days, and mean hospital LOS was 12.5 days. Blunt mechanism was more common in patients 14 years or younger; penetrating trauma was more common amongst patients older than 14 years. Overall, blunt injuries had a longer intensive care unit LOS compared with penetrating trauma (7.8 vs 3.1 days; P = 0.016). A total of 33% (n = 20) of MVIs occurred in the torso, with 50% (n = 10) of these from blunt trauma. Location of injury did correlate with mortality; 45% (n = 9) of torso MVIs resulted in death (penetrating n = 7, blunt n = 2). Overall mortality from an MVI was 15.3% (n = 9); all were torso MVIs. Higher Injury Severity Score and Glasgow Coma Scale score were found to be independently associated with mortality.

Conclusions

Our experience demonstrates that MVIs are associated with a significant mortality (15.3%), with a majority of those resulting from gunshot wounds, more than 9-fold greater than the overall mortality of pediatric trauma patients at our institution (1.6%). Further research should be aimed at improving management strategies specific for MVIs in the pediatric trauma patient as gun violence continues to afflict youth in the United States.