Development of Clinical Judgment in Prelicensure Nursing Students Through Simulation: A Longitudinal Study.

Background: There is a lack of longitudinal studies measuring student progression in clinical judgment. Previous studies measured gains in clinical judgment after 1 intervention or over 1 semester.

Purpose: This study evaluated the development and progression of clinical judgment in simulation throughout a prelicensure bachelor of science in nursing (BSN) program using the Lasater Clinical Judgment Rubric (LCJR).

Relaxation as an Educational Strategy for Stress Management and Resiliency.

Background: Prelicensure nursing students experience higher levels of stress, anxiety, and depression than the remainder of the student body.

Purpose: The purpose of this study was to identify whether implementation of Stress Management and Resiliency Training (SMART) and a relaxation room decreased perceived stress levels in prelicensure nursing students.

Methods: This quasi-experimental pre- and posttest interventional study used a within-subjects design.

No such thing as a free lunch: The direct marginal costs of breastfeeding.

Understanding costs associated with breastfeeding is critical to developing maximally effective policy to support breastfeeding by addressing financial barriers. Breastfeeding is not without cost; direct costs include those of equipment, modified nutritional intake, and time (opportunity cost). Breastfeeding need not require more equipment than formula feeding, though maternal equipment use varies by maternal preference.

Long-Term Outcomes of Cardiovascular Operations in Children With Connective Tissue Disorders.

Connective tissue disorders can be associated with significant cardiovascular morbidity needing cardiac surgery during childhood. In this retrospective study, we used the Pediatric Cardiac Care Consortium, a multicenter United States-based registry of pediatric cardiac interventions, to describe the long-term outcomes of patients who underwent their first surgery for connective tissue-related cardiovascular conditions aged <21 years. Between 1982 and 2003, a total of 103 patients were enrolled who underwent cardiac surgery for a connective tissue-related cardiovascular disorder, including 3 severe infantile cases operated on within the first year of life.

Caring for critically ill adults in paediatric intensive care units in England during the COVID-19 pandemic: planning, implementation and lessons for the future.

Objective: To describe the experience of paediatric intensive care units (PICUs) in England that repurposed their units, equipment and staff to care for critically ill adults during the first wave of the COVID-19 pandemic.

Design: Descriptive study.

Setting: Seven PICUs in England.

Discovery of Small-Molecule Selective mTORC1 Inhibitors via Direct Inhibition of Glucose Transporters.

The mechanistic target of rapamycin (mTOR) is a central regulator of cellular metabolic processes. Dysregulation of this kinase complex can result in a variety of human diseases. Rapamycin and its analogs target mTORC1 directly; however, chronic treatment in certain cell types and in vivo results in the inhibition of both mTORC1 and mTORC2.

A small molecule inhibitor of Rheb selectively targets mTORC1 signaling.

The small G-protein Rheb activates the mechanistic target of rapamycin complex 1 (mTORC1) in response to growth factor signals. mTORC1 is a master regulator of cellular growth and metabolism; aberrant mTORC1 signaling is associated with fibrotic, metabolic, and neurodegenerative diseases, cancers, and rare disorders. Point mutations in the Rheb switch II domain impair its ability to activate mTORC1.

A longitudinal study of empathy in pre-clinical and clinical medical students and clinical supervisors.

Background: Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning.

Urban general practice and medical education: Academic outcomes from a unique urban, longitudinal integrated community-based program.

Background: In 2009, Flinders University established an urban, community-based, longitudinal integrated program providing medical students extended placements that offered continuities of patient care, clinical supervision and peer group.

Objective: The aim of this research was to analyse academic outcomes of the new placement program.

Methods: The results of all students undertaking Year 3 exams from 2011 to 2014 were collected and analysed.

How social accountability can be incorporated into an urban community-based medical education program: an Australian initiative.

Background: Medical schools play a role in ensuring that their outcomes ultimately have positive effects on the health status of communities. We describe an initiative that translates this broad intent into meaningful activities that foster positive attitudes to social accountability among medical students in the context of an already full curriculum.

Methods: Faculty members from an urban community-based medical education program undertook broad consultation with its community groups.

Challenges in transformation of the "traditional block rotation" medical student clinical education into a longitudinal integrated clerkship model.

Background: Longitudinal integrated clerkships (LIC) in the first major clinical year in medical student training have been demonstrated to be at least equivalent to and in some areas superior to the "traditional block rotation" (TBR). Flinders University School of Medicine is starting a pilot changing the traditional teaching at the major Academic Medical Centre from TBR to LIC (50% of students in other locations in the medical school already have a partial or full LIC programme).

Methods: This paper summarises the expected challenges presented at the "Rendez-Vous" Conference in October 2012: (a) creating urgency, (b) training to be a clinician rather than imparting knowledge, (c) resistance to change.

Population pharmacokinetics of ciprofloxacin in neonates and young infants less than three months of age.

Ciprofloxacin is used in neonates with suspected or documented Gram-negative serious infections. Currently, its use is off-label partly because of lack of pharmacokinetic studies. Within the FP7 EU project TINN (Treat Infection in NeoNates), our aim was to evaluate the population pharmacokinetics of ciprofloxacin in neonates and young infants <3 months of age and define the appropriate dose in order to optimize ciprofloxacin treatment in this vulnerable population.

A review of longitudinal community and hospital placements in medical education: BEME Guide No. 26.

Background: Traditionally, clinical learning for medical students consists of short-term and opportunistic encounters with primarily acute-care patients, supervised by an array of clinician preceptors. In response to educational concerns, some medical schools have developed longitudinal placements rather than short-term rotations. Many of these longitudinal placements are also integrated across the core clinical disciplines, are commonly termed longitudinal integrated clerkships (LICs) and often situated in rural locations.

Compensation of the AKT signaling by ERK signaling in transgenic mice hearts overexpressing TRIM72.

The AKT and ERK signaling pathways are known to be involved in cell hypertrophy, proliferation, survival and differentiation. Although there is evidence for crosstalk between these two signaling pathways in cellulo, there is less evidence for cross talk in vivo. Here, we show that crosstalk between AKT and ERK signaling in the hearts of TRIM72-overexpressing transgenic mice (TRIM72-Tg) with alpha-MHC promoter regulates and maintains their heart size.

Urban community based medical education - general practice at the core of a new approach to teaching medical students.

Background: The benefits of community based medical education for both students and teachers are becoming increasingly clear. Rural programs offering year-long general practice based clinical training for medical students are well established and highly successful. Urban general practice teaching is currently more likely to be based on short term placements.

Genome-wide DNA methylation studies suggest distinct DNA methylation patterns in pediatric embryonal and alveolar rhabdomyosarcomas.

Rhabdomyosarcoma is the most common soft-tissue sarcoma in children. While cytogenetic abnormalities have been well characterized in this disease, aberrant epigenetic events such as DNA hypermethylation have not been described in genome-wide studies. We have analyzed the methylation status of 25,500 promoters in normal skeletal muscle, and in cell lines and tumor samples of embryonal and alveolar rhabdomyosarcoma from pediatric patients.

Down-regulation of CMTM8 induces epithelial-to-mesenchymal transition-like changes via c-MET/extracellular signal-regulated kinase (ERK) signaling.

The acquisition of an invasive phenotype is a critical turning point for malignant tumor cells. CMTM8, a potential tumor suppressor, is frequently down-regulated in solid tumors, and its overexpression induces tumor cell apoptosis. Here, we identify a new role for CMTM8 in regulating tumor cell migration.

Glucose addiction of TSC null cells is caused by failed mTORC1-dependent balancing of metabolic demand with supply.

The mTORC1-signaling pathway integrates environmental conditions into distinct signals for cell growth by balancing anabolic and catabolic processes. Accordingly, energetic stress inhibits mTORC1 signaling predominantly through AMPK-dependent activation of TSC1/2. Thus, TSC1/2-/- cells are hypersensitive to glucose deprivation, and this has been linked to increased p53 translation and activation of apoptosis.

DNA methylation of developmental genes in pediatric medulloblastomas identified by denaturation analysis of methylation differences.

DNA methylation might have a significant role in preventing normal differentiation in pediatric cancers. We used a genomewide method for detecting regions of CpG methylation on the basis of the increased melting temperature of methylated DNA, termed denaturation analysis of methylation differences (DAMD). Using the DAMD assay, we find common regions of cancer-specific methylation changes in primary medulloblastomas in critical developmental regulatory pathways, including Sonic hedgehog (Shh), Wingless (Wnt), retinoic acid receptor (RAR), and bone morphogenetic protein (BMP).

A novel role for Gtb1p in glucose trimming of N-linked glycans.

Glucosidase II (GluII) is a glycan-trimming enzyme active on nascent glycoproteins in the endoplasmic reticulum (ER). It trims the middle and innermost glucose residues (Glc2 and Glc1) from N-linked glycans. The monoglucosylated glycan produced by the first GluII trimming reaction is recognized by calnexin/calreticulin and serves as the signal for entry into this folding pathway.

Cell signaling in protein synthesis ribosome biogenesis and translation initiation and elongation.

Protein synthesis is a highly energy-consuming process that must be tightly regulated. Signal transduction cascades respond to extracellular and intracellular cues to phosphorylate proteins involved in ribosomal biogenesis and translation initiation and elongation. These phosphorylation events regulate the timing and rate of translation of both specific and total mRNAs.