Increasing Graduate Student Awareness of Cultural Competence Through Bias Exploration Related to Diverse Cultural Families.

Emphasis by the American Nurses Association and the American Association of Colleges of Nursing regarding the importance of cultural competence in nursing education led to the development of a strategy to address personal bias in graduate nursing students. With the updated Essentials and a change to competency-based education, a need to address culturally congruent practices while increasing awareness of professional organization recommendations exists. Since Domain 2 of the Essentials highlights that culturally competent care is essential to person-centered care, a strategy that enhances knowledge by expanding the definition of culture beyond ethnicity and race was developed.

Interfacing CuO, CuBiO, and protective metal oxide layers to boost solar-driven photoelectrochemical hydrogen evolution.

This article reports the development of CuO|CuBiO photocathodes stabilized by protective layers of TiO, MgO, or NiO, with Pt or MoS nanoparticles serving as co-catalysts to facilitate H evolution. Most notably, this work demonstrates the first application of MgO as a protection/passivation layer for photocathodes in a water-splitting cell. All configurations of photocathodes were studied structurally, morphologically, and photoelectrochemically revealing that CuO|CuBiO|MgO|Pt photocathodes achieve the highest stable photocurrent densities of -200 μA cm for over 3 hours with a Faradaic efficiency of ∼90%.

Repeated fuel treatments fall short of fire-adapted regeneration objectives in a Sierra Nevada mixed conifer forest, USA.

Fire exclusion over the last two centuries has driven a significant fire deficit in the forests of western North America, leading to widespread changes in the composition and structure of these historically fire-adapted ecosystems. Fuel treatments have been increasingly applied over the last few decades to mitigate fire hazard, yet it is unclear whether these fuel-focused treatments restore the fire-adapted conditions and species that will allow forests to persist into the future. A vital prerequisite of restoring fire-adaptedness is ongoing establishment of fire-tolerant tree species, and both the type and reoccurrence of fuel treatments are likely to strongly influence stand trajectories.

Understanding and modeling human-AI interaction of artificial intelligence tool in radiation oncology clinic using deep neural network: a feasibility study using three year prospective data.

Artificial intelligence (AI) based treatment planning tools are being implemented in clinic. However, human interactions with such AI tools are rarely analyzed. This study aims to comprehend human planner's interaction with the AI planning tool and incorporate the analysis to improve the existing AI tool.

Mitral Annular Disjunction Associated with Ventricular Dilation in Pediatric Marfan Syndrome: A Cardiovascular Magnetic Resonance Study.

Background: Mitral annular disjunction (MAD) has increasingly been recognized as a marker for adverse cardiovascular events in Marfan syndrome (MFS). As recent adult data links MFS with left ventricular (LV) dilation and reduced ejection fraction (LVEF), we hypothesized that MAD may be associated with LV dilation in pediatric MFS patients.

Methods: A retrospective analysis was performed among MFS patients < 19 years old at initial cardiac MRI (CMR).

IER3IP1 mutations cause neonatal diabetes due to impaired proinsulin trafficking.

Immediate early response 3 interacting-protein 1 (IER3IP1) is an endoplasmic reticulum resident protein, highly expressed in pancreatic cells and the developing brain cortex. Homozygous mutations in IER3IP1 have been found in individuals with microcephaly and neonatal diabetes, yet the underlying mechanism causing beta cell failure remains unclear. Here, we utilized differentiation of genome edited-stem cells into pancreatic islet cells to elucidate the molecular basis of IER3IP1 neonatal diabetes.

Obesity and Left Ventricular Function in American Indian Adolescents: Strong Heart Family Study.

Objectives: Obesity is a known risk factor for developing cardiovascular disease (CVD). American Indian (AI) children have the highest obesity rates of all racial/ethnic groups in the United States (US). However, cardiometabolic health among AI adolescents is understudied.

Removal of the Metaphyseal Screw From Tension Band Constructs After Hemiepiphysiodesis: High Rates of Physeal Tethering and Subsequent Implant Removal.

Background: Removal of the metaphyseal screw from tension band plate constructs after correction of angular deformity in patients treated with hemiepiphysiodesis has been suggested as an alternative to removing the plate and both screws. While this has the potential benefit of easier implant removal and reinsertion in the event of rebound, there is debate in the literature regarding the benefits and risks of leaving the epiphyseal screw and plate in place.

Methods: Patients treated with hemiepiphysiodesis at the distal femur and/or proximal tibia with tension band plates and screws who underwent subsequent removal of the metaphyseal screw after correction were included.

Delphi Recommendations for Diagnosis and Treatment of Sexual Interest in Children in Non-Mandated Community Settings.

This study sought to reach an international expert consensus regarding the diagnosis and treatment of adults with a sexual interest in children in cases where treatment is non-mandated. An expert panel of 27 participants (19 professionals and eight individuals with sexual interest in children) completed at least one of three rounds of an online Delphi survey. In the first round, participants responded to open-ended questions about assessment approaches, treatment goals, treatment approaches, and adapting assessment and treatment for sexual exclusivity.

Social network characteristics and their relationships with physical activity in children with multiple sclerosis.

Background: Physical activity has been found to associate with improved health outcomes in children with multiple sclerosis (MS). Social networks may facilitate physical activity in children with MS.

Objectives: To estimate associations between social network characteristics and physical activity in children with MS compared to children with monophasic acquired demyelinating syndrome (mono-ADS).

Enhancing the Classification of Congenital Heart Defects for Outcome Association Studies in Birth Defects Registries.

Introduction: Traditional strategies for grouping congenital heart defects (CHDs) using birth defect registry data do not adequately address differences in expected clinical consequences between different combinations of CHDs. We report a lesion-specific classification system for birth defect registry-based outcome studies.

Methods: For Core Cardiac Lesion Outcome Classifications (C-CLOC) groups, common CHDs expected to have reasonable clinical homogeneity were defined.

The NR4A2/VGF pathway fuels inflammation-induced neurodegeneration via promoting neuronal glycolysis.

A disturbed balance between excitation and inhibition (E/I balance) is increasingly recognized as a key driver of neurodegeneration in multiple sclerosis (MS), a chronic inflammatory disease of the central nervous system. To understand how chronic hyperexcitability contributes to neuronal loss in MS, we transcriptionally profiled neurons from mice lacking inhibitory metabotropic glutamate signaling with shifted E/I balance and increased vulnerability to inflammation-induced neurodegeneration. This revealed a prominent induction of the nuclear receptor NR4A2 in neurons.

Analysis of beta-cell maturity and mitochondrial morphology in juvenile non-human primates exposed to maternal Western-style diet during development.

Introduction: Using a non-human primate (NHP) model of maternal Western-style diet (mWSD) feeding during pregnancy and lactation, we previously reported altered offspring beta:alpha cell ratio and insulin hyper-secretion Mitochondria are known to maintain beta-cell function by producing ATP for insulin secretion. In response to nutrient stress, the mitochondrial network within beta cells undergoes morphological changes to maintain respiration and metabolic adaptability. Given that mitochondrial dynamics have also been associated with cellular fate transitions, we assessed whether mWSD exposure was associated with changes in markers of beta-cell maturity and/or mitochondrial morphology that might explain the offspring islet phenotype.

Congenital Heart Defects and Concurrent Diagnoses in Influenza Hospitalization in the Pediatric Health Information System Study, 2004-2019.

Influenza is associated with adverse outcomes in children, although modification by additional medical conditions is not well-documented. We aimed to compare outcomes in children with versus without congenital heart defects (CHDs) who were hospitalized for influenza. We retrospectively evaluated patients 1-18y hospitalized for influenza in the Pediatric Health Information (PHIS) database from 2004 to 2019.

Sexual Exploitation of Children in Travel and Tourism Perpetration: An Expansion of the Ecosystem Model.

The sexual exploitation of children in travel and tourism (SECTT), also referred to as child sex tourism, involves engaging in sexual activity with someone under the age of 18 in the context of travel and/or tourism. Research on the perpetration of SECTT is vastly underdeveloped. The present review considers the operationalization of SECTT, its prevalence, and existing theoretical models.

Wood ducks and hooded mergansers as interspecific brood parasites: An evaluation of parasitic egg survival.

Conspecific and interspecific brood parasitism are alternate reproductive strategies more pervasive in waterfowl than in any other group of birds. While previous research has measured costs incurred by nest hosts incubating parasitized clutches, few studies have focused on the relative success of parasites. Here, we evaluated the success of wood duck () and hooded merganser () eggs laid parasitically in Louisiana and Mississippi.

Temporal Trends in End-Tidal Capnography and Outcomes in Out-of-Hospital Cardiac Arrest: A Secondary Analysis of a Randomized Clinical Trial.

Importance: While widely measured, the time-varying association between exhaled end-tidal carbon dioxide (EtCO2) and out-of-hospital cardiac arrest (OHCA) outcomes is unclear.

Objective: To evaluate temporal associations between EtCO2 and return of spontaneous circulation (ROSC) in the Pragmatic Airway Resuscitation Trial (PART).

Design, Setting, And Participants: This study was a secondary analysis of a cluster randomized trial performed at multicenter emergency medical services agencies from the Resuscitation Outcomes Consortium.

Interactive Media-Based Approach for an Exception From Informed Consent Trial Involving Patients With Trauma.

Importance: Exception From Informed Consent (EFIC) research requires community consultation (CC) and public disclosure (PD). Traditional methods of conducting CC and PD are slow, expensive, and labor intensive.

Objective: To describe the feasibility and reach of a novel interactive, media-based approach to CC and PD and to identify the similarities and differences between trial sites in website views, survey responses, online community forum attendance, and opt-out requests.

A metabolic redox relay supports ER proinsulin export in pancreatic islet β cells.

ER stress and proinsulin misfolding are heralded as contributing factors to β cell dysfunction in type 2 diabetes, yet how ER function becomes compromised is not well understood. Recent data identify altered ER redox homeostasis as a critical mechanism that contributes to insulin granule loss in diabetes. Hyperoxidation of the ER delays proinsulin export and limits the proinsulin supply available for insulin granule formation.