The RAST-NP Pilot: Preparing New Graduate Nurse Practitioners for Emergent Procedures in Remote Settings Using a Novel Training Program.

With more new graduate primary care nurse practitioners (NPs) practicing in remote locales than ever before, their preparation for performing emergency procedural skills (EPSs) is critical for safe and effective care. Emergency procedural skills are not uniformly taught in primary care academic programs but are easily imparted via additional training and practice. The purpose of this project was to develop and pilot an expert panel-validated training program specifically for NPs bound for remote practice and to evaluate how the participants rated their self-efficacy in performing specific EPSs before and after completing the training, called the Remote Advanced Skills Training for NPs (RAST-NP).

Registered report: RAF inhibitors prime wild-type RAF to activate the MAPK pathway and enhance growth.

The Reproducibility Project: Cancer Biology seeks to address growing concerns about reproducibility in scientific research by conducting replications of selected experiments from a number of high-profile papers in the field of cancer biology. The papers, which were published between 2010 and 2012, were selected on the basis of citations and Altmetric scores (Errington et al., 2014).

Epidemiology of Search and Rescue in Baxter State Park: Dangers of Descent and Fatigue.

Objective: The purpose of this study was to determine the epidemiology of injury in Baxter State Park, Maine, and to better tailor search and rescue (SAR) resources, personnel, and training to acute needs in the park.

Methods: We conducted a retrospective review of all SAR incident reports in Baxter State Park from July 1992 through June 2014. For each event, demographics, location, time, activity before the incident, incident details, and evacuation means were recorded and analyzed.

Revisiting perceptions of quality of hospice care: managing for the ultimate referral.

Hospice services provided in the final months of life are delivered through complex interpersonal relationships between caregivers, patients, and families. Often, service value and quality are defined by these interpersonal interactions. This understanding provides hospice leaders with an enormous opportunity to create processes that provide the optimal level of care during the last months of life.

Discovery of danoprevir (ITMN-191/R7227), a highly selective and potent inhibitor of hepatitis C virus (HCV) NS3/4A protease.

HCV serine protease NS3 represents an attractive drug target because it is not only essential for viral replication but also implicated in the viral evasion of the host immune response pathway through direct cleavage of key proteins in the human innate immune system. Through structure-based drug design and optimization, macrocyclic peptidomimetic molecules bearing both a lipophilic P2 isoindoline carbamate and a P1/P1' acylsulfonamide/acylsulfamide carboxylic acid bioisostere were prepared that possessed subnanomolar potency against the NS3 protease in a subgenomic replicon-based cellular assay (Huh-7). Danoprevir (compound 49) was selected as the clinical development candidate for its favorable potency profile across multiple HCV genotypes and key mutant strains and for its good in vitro ADME profiles and in vivo target tissue (liver) exposures across multiple animal species.

Discharge-driven electric oxygen-iodine laser superlinear enhancement via increasing g0L.

The authors report the development of an electric oxygen-iodine laser with higher output using a larger product of gain and gain length, g0L. A factor of 4.4 increase in laser power output on the 1315 nm atomic iodine transition was achieved with a factor of 3 increase in gain length.

Free-text comments: understanding the value in family member descriptions of hospice caregiver relationships.

Invitations for free-text comments on surveys provide family members of hospice patients an opportunity to "tell" their story of the hospice experience and caregiver relationships during the last months of life. These comments are a rich source of data for understanding the complex interpersonal relationships that influence patient/family perceptions of both quality of care and quality of life. Analysis of 438 free-text comments provided by 243 hospice family members revealed 5 emergent caregiver relationship themes: knowledge, skills, and abilities; empathy and compassion; trust and acceptance; communication experience and time spent with caregiver.

Nurses' perceptions of how rapid response teams affect the nurse, team, and system.

Rapid response teams (RRTs) continue to be implemented in hospitals to prevent unnecessary cardiac arrests and reduce patient mortality. Although studies suggest that RRTs improve patient care, research is lacking on the perspectives of nurses who use them. This focus group study elicited nurses' experiences with RRTs in a community hospital.

Antioxidant and free radical scavenging activities of essential oils.

Introduction: Reactive oxygen and nitrogen free radicals are produced during immune activity, and are triggered by several environmental factors such as pollution, smoke, and sunlight. Harmful effects of these reactive species include cellular damage to RNA, DNA, proteins and lipids. In humans several diseases including those connected with the heart, lung, and the eye are associated with the accumulation of reactive oxygen and nitrogen species (ROS/RNS).

Enhancement of electric oxygen-iodine laser performance using larger mode volume resonators.

Herein the authors report on the demonstration of an 87% enhancement in cw laser power on the 1315 nm transition of atomic iodine via a 100% increase in the resonator mode volume. O(2)(a1Delta) is produced by a single rf-excited electric discharge sustained in an O(2)-He-NO gas mixture flowing through a rectangular geometry, and I(P2(1/2)) is then pumped using energy transferred from O(2)(a1Delta). A total laser output power of 102.

Three-dimensional quantitative structure activity relationships of quorum-sensing and biofilm inhibitors in gram-negative bacteria.

Thirty N-acyl homoserine lactone (AHL) analogs with variable antibacterial activity and displaying inhibition of biofilm formation were selected to develop models for establishing three-dimensional quantitative structure-activity relationships (3D-QSAR). Comparative molecular field analysis (CoMFA) and comparative similarity indices analysis (CoMSIA) were carried out to determine the optimum structural requirements for selectivity and potency of quorum-sensing and bacterial biofilm inhibition. The best CoMFA model predicted a q2 value of 0.

Chemical, microbial and physical evaluation of commercial bottled waters in greater Houston area of Texas.

Due to the increased demand and consumption of bottled water in the United States, there has been a growing concern about the quality of this product. Retail outlets sell local as well as imported bottled water to consumers. Three bottles for each of 35 different brands of bottled water were randomly collected from local grocery stores in the greater Houston area.

Oxygen discharge and post-discharge kinetics experiments and modeling for the electric oxygen-iodine laser system.

Laser oscillation at 1315 nm on the I(2P1/2)-->I(2P3/2) transition of atomic iodine has been obtained by a near resonant energy transfer from O2(a1Delta) produced using a low-pressure oxygen/helium/nitric oxide discharge. In the electric discharge oxygen-iodine laser (ElectricOIL) the discharge production of atomic oxygen, ozone, and other excited species adds levels of complexity to the singlet oxygen generator (SOG) kinetics which are not encountered in a classic purely chemical O2(a1Delta) generation system. The advanced model BLAZE-IV has been introduced to study the energy-transfer laser system dynamics and kinetics.

3D-QSAR of fungal quorum-sensing inhibiting analogs of farnesol.

Thirty-four analogs with variable antifungal activity were selected to develop models for establishing three-dimensional quantitative structure-activity relationships (3D-QSAR). Comparative molecular field analysis (CoMFA) and comparative similarity indices analyses (CoMSIA) were conducted on the group of analogs to determine the structural requirements for selectivity and potency in inhibiting biofilm formation and fungal growth. The best CoMFA model predicted a q(2) = 0.

Probing the mechanism of the hamster mitochondrial folate transporter by mutagenesis and homology modeling.

The mitochondrial folate transporter (MFT) was previously identified in human and hamster cells. Sequence homology of this protein with the inner mitochondrial membrane transporters suggested a domain structure in which the N- and C-termini of the protein are located on the mitochondrial intermembrane-facing surface, with six membrane-spanning regions interspersed by two intermembrane loops and three matrix-facing loops. We now report the functional significance of insertion of the c-myc epitope into the intermembrane loops and of a series of site-directed mutations at hamster MFT residues highly conserved in orthologues.

Using SERVQUAL to evaluate quality disconfirmation of nursing service in Taiwan.

The purpose of this study was to determine the extent of disconfirmation of the perceived quality of nursing services, and its relationship to patient's satisfaction, intent to return, and intent to recommend to others. The service dimensions were tangibles, reliability, responsiveness, assurance, and empathy, which were adopted from the Gap model of Parasuraman, Zeithaml and Berry (1985). A total of 186 subjects was tested by a modified SERVQUAL (service quality) instrument.

Strategic group stability: evidence from the health care industry.

To better understand strategic group stability and the associated mobility barriers concept, we surveyed health care administrators on their reasons for remaining in their current strategic group. We offer administrators' responses to the strategic group stability (mobility barrier) question. Decision-makers may be unaware of these cognitive biases (e.

Structure of two azide salts of a copper(II) macrocycle and magnetic properties of Cu(14ane)Cu(N3)4.

Synthesis of azide complexes with the copper(II) macrocycle complex Cu(14ane)(2+) (where 14ane = 1,4,8,11-tetraazacyclothetradecane) has yielded two compounds. Cu(14ane)Cu(N(3))(4) contains micro(1,3)-azido bridged chains of Cu(14ane)(2+) cations and Cu(N(3))(4)(2)(-) anions. Magnetic studies reveal the presence of ferromagnetic interactions within the chains with J/k = 0.

2,2-Disubstituted analogues of the natural hormone 1 alpha,25-dihydroxyvitamin D(3): chemistry and biology.

Six new 2,2-disubstituted analogues of the natural hormone calcitriol have been prepared. Chemical novelty includes (1) the first example of an inverse-electron-demand Diels-Alder cycloaddition using a pyrone diene and a difluorinated vinyl ether dienophile, leading to difluorinated analogues 7 and (2) a conceptually streamlined approach to dimethylated 19-nor analogues. Analogues 7a and are similar to calcitriol in terms of in vitro antiproliferative activity, but they are different from calcitriol in terms of transcriptional activity: difluorinated analogue 7a is 2-3 times more active transcriptionally than calcitriol, whereas dimethylated analogue is 7.

Transformation of an academic medical center: lessons learned from restructuring and downsizing.

This article reviews management literature on health care transformation and describes the processes, including restructuring, job redesign, and downsizing, involved in one academic medical center's experience. The article concludes with lessons learned at each of the stages of the transformation process: planning, implementation, and process continuation. Managerial implications for similar transformation efforts in other health care organizations are suggested.

Effects of the sulforaphane analog compound 30, indole-3-carbinol, D-limonene or relafen on glutathione S-transferases and glutathione peroxidase of the rat digestive tract.

Several dietary compounds have been demonstrated to reduce gastrointestinal cancer rates in both humans and animals. We showed that high human gastrointestinal tissue levels of glutathione S-transferase (GST), a family of detoxification enzymes consisting of class Alpha, Mu, Pi and Theta isoforms, were inversely correlated with cancer risk. We now investigated whether the sulforaphane analog compound 30, indole-3-carbinol, D-limonene or relafen, supplemented in the diet for two weeks at 1450, 250, 10,000, and 200 ppm, respectively, influenced (i) GST activity, (ii) GST isoenzyme levels, (iii) GSH levels, or (iv) glutathione peroxidase (GPx) activity in the gastrointestinal tract of male Wistar rats.

Differential use of transcription activation function 2 domain of the vitamin D receptor by 1,25-dihydroxyvitamin D3 and its A ring-modified analogs.

Analogs of 1,25-dihydroxyvitamin D3 (1,25D3) can be used to elucidate details of vitamin D receptor (VDR) activation. The A ring-modified analog, (TN-2) has 15-fold less affinity for VDR, but its transcriptional activity is diminished 1000-fold. Likewise, the ability of TN-2 to induce a protease-resistant conformation in VDR is 1/1000 that of 1,25D3.

Organizational power and conflict regarding the hospital-physician relationship: symbolic or substantive?

The purpose of this paper is to provide a critical review of organizational power and conflict regarding the hospital-physician relationship. The issue of power being symbolic and/or substantive is discussed. The classification (Mintzberg Model) of organizations as simple structures, machine bureaucracies, professional bureaucracies, divisionalized forms and adhocracies are reviewed.