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Translation from German and notes by Wolfram M. Von-Maszewski. Introduction by Theodore Gish. (Denton: German-Texan Heritage Society and University of North Texas Press, c. 2000. Pp. x, 244. $32.50, ISBN [...]

Two alleles in cholesteryl ester transfer protein (CETP) gene polymorphisms have been disputably linked to enhanced cognition and decreased risk of Alzheimer's disease (AD): the V and A alleles of I405V and C-629A. This study investigates whether these polymorphisms affect brain structure in 188 elderly controls and 318 AD or mild cognitive impairment (MCI) subjects from the Alzheimer's Disease Neuroimaging Initiative cohort. Nominally signficant associations were dependent on APOE ε4 carrier status. In APOE ε4 carriers, the V and A alleles, both of which decrease CETP and increase HDL, associated with greater baseline cortical thickness and less 12-month atrophy in the medial temporal lobe. Conversely, in APOE ε4 non-carriers, the I allele, which increases CETP and decreases HDL, associated with greater baseline thickness, less atrophy and lower risk of dementia. These results suggest CETP may contribute to the genetic variability of brain structure and dementia susceptibility in an APOE-dependent manner. [ABSTRACT FROM AUTHOR]

Proliferative responses by human peripheral blood mononuclear cells and rat spleen cells were measured to Pneumocystis carinii in a blastogenic assay using organisms obtained from rat lungs and propagated in (issue culture as the antigen. Responses occurred only in subjects with known prior exposure to P. carinii and the magnitude of the response varied with the number of organisms present in the antigen preparation and days in culture. Healthy human adults showed higher proliferative responses to P. carinii than did patients with Class II (asymptomatic) or Class III (lymphadenopathy) human immunodeficiency virus (HIV) infection. No responses to the preparation were found among Class IV HIV patients with the acquired immunodeficiency syndrome, including those with prior episodes of P. carinii pneumonia or those receiving azidothymidine. Overall, the blastogenic responses obtained with P. carinii were similar to those obtained with tetanus toxoid and phytohemagglutinin, and correlated well with the number of circulating CD4 cells. The data suggest that the blastogenic assay using tissue culture-derived rat P. carinii is specific for the organism and should be helpful in studying the cellular immune responses in pneumocystosis among different human patient populations. [ABSTRACT FROM AUTHOR]

Background: Language preference is a contributing factor for prolonged time from symptom onset to appendectomy within pediatrics, but is poorly characterized in adults. We aimed to investigate associations between language barriers and delays in assessment and treatment for adults with acute appendicitis., Methods: In a multiethnic community, patients aged ≥18 years old who underwent appendectomy were identified between January 2017 and August 2022 at a single institution. Negative binomial regression was used to compare interval wait times to imaging, medication administration, and surgical evaluation between patients with limited English proficiency and those who are English proficient., Results: Of the 1469 patients included, 48% (n = 699) were with limited English proficiency. Average age was higher for patients with limited English proficiency (45 vs 36, P < .001). Most of them were Asian (54%) and without private insurance (65%, P < .001). Symptom duration, incidence of septic shock, and date/time of presentation to the emergency department were similar. Patients with limited English proficiency presented more frequently with gangrenous appendicitis (20% vs 15%, P = .013) but not perforated (23% vs 20%, P = .065). They experienced longer wait times for surgical evaluation (376 vs 348 min, incidence rate ratio [IRR], 1.08; P = .002) but similar times for imaging, and medications administered. After controlling for demographics, triage acuity, and hospital factors, significantly longer wait times for surgical evaluation persisted (IRR adjusted, 1.07; P = .038). There was no significant difference in hospital length-of-stay, postoperative infection, or 30-day readmission rate., Conclusion: Adult patients with limited English proficiency may experience longer wait times for surgical evaluation for acute appendicitis, but this may not result in clinically significant delays in the initiation of treatment., (Published by Elsevier Inc.)

This paper responds to a recent critique by Bissett et al. of the fMRI Stop task used in the Adolescent Brain Cognitive Development ℠ Study (ABCD Study®). The critique focuses primarily on a task design feature related to race model assumptions (i.e., that the Go and Stop processes are fully independent). In response, we note that the race model is quite robust against violations of its assumptions. Most importantly, while Bissett raises conceptual concerns with the task we focus here on analyzes of the task data and conclude that the concerns appear to have minimal impact on the neuroimaging data (the validity of which do not rely on race model assumptions) and have far less of an impact on the performance data than the critique suggests. We note that Bissett did not apply any performance-based exclusions to the data they analyzed, a number of the trial coding errors they flagged were already identified and corrected in ABCD annual data releases, a number of their secondary concerns reflect sensible design decisions and, indeed, their own computational modeling of the ABCD Stop task suggests the problems they identify have just a modest impact on the rank ordering of individual differences in subject performance., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: New nurses often struggle with recognizing cues and applying clinical judgment. Nurse educators develop educational simulation scenarios to support students in developing clinical judgment, which includes the foundational step of recognizing cues., Purpose: A scoping review on undergraduate nursing students' cue recognition during simulation was conducted to systematically map the existing research and identify knowledge gaps., Methods: From initial identification of 228 studies published between 2010 and 2020, a total of 17 quantitative or qualitative studies were independently appraised using the Joanna Briggs Institute scoping review process and PRISMA-ScR reporting guidelines., Results: Cues were missed with varying levels of frequency. Participants frequently failed to recognize respiratory rates and physical assessment changes as salient cues to patient deterioration. Verbal cues from simulated patients were often missed or resulted in distancing behaviors., Conclusion: Research is needed to determine the most effective methods for helping learners develop skills in cue recognition and analysis., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Abundant literature supports the value of interprofessional education (IPE) in health profession programs, but few studies focus on undergraduate honors students. The goals of this academic-practice partnership quality improvement project were to increase awareness of IPE, provide experiential opportunities to learn the principles of interprofessional practice, assess perceptions of readiness for practice, and to explore motivations and learning expectations of undergraduate nursing and pre-medical honors students. Average scores on the Readiness for Interprofessional Learning Scale (RIPLS) increased in several areas after the IPE simulation experiences, with small to medium effect sizes (Cohen's d) on individual items and two subscales (Teamwork & Collaboration and Positive Professional Identity). Themes identified in the narrative data were opportunity, fun, self-awareness, situational awareness, and the value of teamwork. These findings add to literature on honor students' expectations and motivations for learning and can be used in designing interprofessional collaborative learning activities for undergraduate health profession students., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The Adolescent Brain Cognitive Development (ABCD) Study ® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development., (© 2021. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Importance: Incidental findings (IFs) are unexpected abnormalities discovered during imaging and can range from normal anatomic variants to findings requiring urgent medical intervention. In the case of brain magnetic resonance imaging (MRI), reliable data about the prevalence and significance of IFs in the general population are limited, making it difficult to anticipate, communicate, and manage these findings., Objectives: To determine the overall prevalence of IFs in brain MRI in the nonclinical pediatric population as well as the rates of specific findings and findings for which clinical referral is recommended., Design, Setting, and Participants: This cohort study was based on the April 2019 release of baseline data from 11 810 children aged 9 to 10 years who were enrolled and completed baseline neuroimaging in the Adolescent Brain Cognitive Development (ABCD) study, the largest US population-based longitudinal observational study of brain development and child health, between September 1, 2016, and November 15, 2018. Participants were enrolled at 21 sites across the US designed to mirror the demographic characteristics of the US population. Baseline structural MRIs were centrally reviewed for IFs by board-certified neuroradiologists and findings were described and categorized (category 1, no abnormal findings; 2, no referral recommended; 3; consider referral; and 4, consider immediate referral). Children were enrolled through a broad school-based recruitment process in which all children of eligible age at selected schools were invited to participate. Exclusion criteria were severe sensory, intellectual, medical, or neurologic disorders that would preclude or interfere with study participation. During the enrollment process, demographic data were monitored to ensure that the study met targets for sex, socioeconomic, ethnic, and racial diversity. Data were analyzed from March 15, 2018, to November 20, 2020., Main Outcomes and Measures: Percentage of children with IFs in each category and prevalence of specific IFs., Results: A total of 11 679 children (52.1% boys, mean [SD] age, 9.9 [0.62] years) had interpretable baseline structural MRI results. Of these, 2464 participants (21.1%) had IFs, including 2013 children (17.2%) assigned to category 2, 431 (3.7%) assigned to category 3, and 20 (0.2%) assigned to category 4. Overall rates of IFs did not differ significantly between singleton and twin gestations or between monozygotic and dizygotic twins, but heritability analysis showed heritability for the presence or absence of IFs (h2 = 0.260; 95% CI, 0.135-0.387)., Conclusions and Relevance: Incidental findings in brain MRI and findings with potential clinical significance are both common in the general pediatric population. By assessing IFs and concurrent developmental and health measures and following these findings over the longitudinal study course, the ABCD study has the potential to determine the significance of many common IFs.

Background: Vaccine-preventable diseases significantly influence the health and academic success of college students. Despite the known negative impact of these diseases, vaccination rates routinely fall short of national goals and recommendations. Although vaccination decisions are complex, a recommendation from a health care provider is one of the key motivators for individuals receiving a vaccine. Motivational interviewing (MI), a counseling approach primarily used to address substance abuse, can be applied to other health-related behaviors., Local Problem: Despite previous quality improvement efforts aimed at increasing vaccine rates for influenza, human papillomavirus (HPV), and meningitis B (MenB), vaccinations at large university health centers have been well below benchmarks set by Healthy People 2020., Methods: This study was guided by the Theory of Planned Behavior and included MI training and regular reinforcement for health care providers to address vaccine hesitancy with college students., Results: Influenza vaccination rates improved, but HPV vaccine rates remained stable and MenB vaccine rates decreased compared with the previous year. Clinicians demonstrated a significant increase in knowledge of MI techniques after a targeted educational intervention. Repeat measures indicate the potential for sustained improvement when ongoing reinforcement is provided., Conclusion: MI can be an effective part of a strategy to increase vaccination rates., Competing Interests: Competing interests: The authors report no conflicts of interest., (Copyright © 2019 American Association of Nurse Practitioners.)

Aim: This qualitative study sought to describe motivators and outcomes of academic nurse education certification., Background: Several studies have explored perceptions of the value of nurse educator certification (CNE). However, there is a gap in understanding motivators and outcomes of certification as a nurse educator., Method: As part of a larger, web-based, mixed-method study, a national sample of certified and noncertified nursing educator administrators and faculty responded to nine open-ended questions. The inductive content analysis approach was used to identify constructs and themes., Results: From an overall sample of 721 participants, three constructs and associated themes emerged., Conclusion: Motivators for pursing CNE align with previously reported intrinsic values. Participants seek extrinsic rewards as well. Educator outcomes include enhanced teaching and expanded roles. Student outcomes were less clear. Further study of outcomes of CNE is recommended to promote recognition of academic nursing education as an advanced nursing specialty.

Posttraumatic stress disorder (PTSD) is known to persist, eliciting early medical co-morbidity, and accelerated aging. Although PTSD diagnosis has been found to be associated with smaller volume in multiple brain regions, posttraumatic stress (PTS) symptoms and their associations with brain morphometry are rarely assessed over long periods of time. We predicted that persistent PTS symptoms across ~24 years would be inversely associated with hippocampal, amygdala, anterior cingulate volumes, and hippocampal occupancy (HOC = hippocampal volume/[hippocampal volume + inferior lateral ventricle volume]) in late middle age. Exploratory analyses examined prefrontal regions. We assessed PTS symptoms in 247 men at average ages 38 (time 1) and 62 (time 2). All were trauma-exposed prior to time 1. Brain volumes were assessed at time 2 using 3 T structural magnetic resonance imaging. Symptoms were correlated over time (r = 0.46 p < .0001). Higher PTS symptoms averaged over time and symptoms at time 1 were both associated with lower hippocampal, amygdala, rostral middle frontal gyrus (MFG), and medial orbitofrontal cortex (OFC) volumes, and a lower HOC ratio at time 2. Increased PTS symptomatology from time 1 to time 2 was associated with smaller hippocampal volume. Results for hippocampal, rostral MFG and medial OFC remained significant after omitting individuals above the threshold for PTSD diagnosis. Even at sub-diagnostic threshold levels, PTS symptoms were present decades after trauma exposure in parallel with highly correlated structural deficits in brain regions regulating stress responsivity and adaptation.

Background and Purpose: Educators, employers, and regulatory agencies face substantive challenges in evaluating nursing competency. Evidence on what competency is and how to measure it can mitigate the challenges., Methods: Participants ( N = 67) completed three high-fidelity simulation tests. Each video-recorded test was scored by three raters using a 41-item instrument. Exploratory factor analysis was used to define the latent structure of the instrument., Results: A five-factor solution accounted for 56% of the variance, minimized negative loadings, and minimized the number of cross-loadings. The factors were minimally correlated (each r < .30)., Conclusions: The factors, Vigilant Action, Role Nuances, Precision, Procedural Skills , and Risk Reduction , represent integrated dimensions of competency that can be linked to specific tasks underlying safe practice., (© Copyright 2020 Springer Publishing Company, LLC.)

In 2011, a task force sponsored by an organization that has Accreditation Board for Specialty Nurse Certification-accredited programs published a definition of continuing competence. Eight years later, the organization sponsored the work of another task force to revisit that definition, with the 2018-2019 task force broadening its focus beyond the U.S. borders and beyond nursing. After an extensive literature review, task force members collated their findings into four categories: Identifying Competencies, Validating Competencies, The International Perspective on Competency Assessment, and Competency in Disciplines Other Than Nursing. The task force identified perspectives on continuing competency and found that although licensing and credentialing organizations addressed the topic thoroughly, little attention was devoted to the perspectives of the public, individual clinicians, and recipients of clinicians' services. This article identifies that little consensus exists on definitions of competence and competency, international perspectives have much to offer, and theoretical frameworks for research on competence and competency are lacking. [J Contin Educ Nurs. 2020;51(1):15-24.]., (Copyright 2020, SLACK Incorporated.)

Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Background: Although Doppler echocardiography is routinely used to assess left ventricle cardiac output, there are limited data about the feasibility of Doppler echocardiography for right ventricular (RV) cardiac output assessment in patients with left-to-right shunt. The purpose of the study was to determine the correlation between Doppler-derived and Fick-derived RV cardiac index (CI), and the interobserver correlation in Doppler-derived RV CI assessment., Methods: Retrospective study of patients (age ≥18 years) with unrepaired atrial septal defect who underwent cardiac catheterization and echocardiography (within 3 days), 2004-2017. RV CI was calculated using the hydraulic orifice formula: [.785 × (right ventricle outflow tract diameter) 2  × right ventricular outflow tract (RVOT) time velocity integral × heart rate]/body surface area., Results: A total of 128 patients (age 52 ± 17 years; female 88 [69%]) met the inclusion criteria. There was a modest correlation between Doppler-derived and Fick-derived RV CI (r = .57, P < .001), and the mean difference between Doppler-derived and Fick-derived RV CI was -.3 (95% confidence interval of agreement, -.8 to +.9) L/min/m 2 . There was also a modest correlation between Doppler-derived RV CI from observer #1 and observer #2 (r = .62, P < .001), and the mean difference between Doppler-derived RV CI from observer #1 and observer #2 was -.2 (95% confidence interval of agreement, -.9 to +.6)., Conclusions: The current study demonstrated a modest correlation between Doppler-derived and Fick-derived RV cardiac output, and a modest interobserver correlation in Doppler-derived RV cardiac output assessment. Further studies are required to validate these results and to explore other potential applications such as in patients with chronic pulmonary regurgitation., (© 2019 Wiley Periodicals, Inc.)

Background: Certification is one option for validating the professional competence of academic nurse educators. The relative value associated with such certification has not yet been established., Method: Psychometric analysis of a new Perceived Value of Certification Tool for Academic Nurse Educators (PVCT-ANE) was conducted. Certified nurse educators (CNE) and noncertified nurse educators and nursing program administrators responded to an online survey using the PVCT-ANE., Results: A sample of 718 nurse faculty members and administrators from 48 states in the United States participated. Academic nurse educator certification was valued by nurse educators and administrators as representing specialized knowledge, attainment of a professional standard, educator competence, and professional credibility. Value statements associated with satisfaction and professional accomplishments were rated higher than statements associated with professional recognition and marketing., Conclusion: The PVCT-ANE is useful for assessing how different groups perceive the value associated with academic nurse educator certification. [J Nurs Educ. 2019;58(9):502-509.]., (Copyright 2019, SLACK Incorporated.)

The promotion of competency of nurses and other health-care professionals is a goal shared by many stakeholders. In nursing, observation-based assessments are often better suited than paper-and-pencil tests for assessing many clinical abilities. Unfortunately, few instruments for simulation-based assessment of competency have been published that have undergone stringent reliability and validity evaluation. Reliability analyses typically involve some measure of rater agreement, but other sources of measurement error that affect reliability should also be considered. The purpose of this study is three-fold. First, using extant data collected from 18 nurses evaluated on 3 Scenarios by 3 Raters, we utilize generalizability (G) theory to examine the psychometric characteristics of the Nursing Performance Profile, a simulation-based instrument for assessing nursing competency. Results corroborated findings of previous studies of simulation-based assessments showing that obtaining desired score reliability requires substantially greater numbers of scenarios and/or raters. Second, we provide an illustrative exemplar of how G theory can be used to understand the relative magnitudes of sources of error variance-such as scenarios, raters, and items-and their interactions. Finally, we offer general recommendations for the design and psychometric study of simulation-based assessments in health-care contexts.

Executive functions are a diverse and critical suite of cognitive abilities that are often disrupted in individuals with psychiatric disorders. Despite their moderate to high heritability, little is known about the molecular genetic factors that contribute to variability in executive functions and how these factors may be related to those that predispose to psychiatric disorders. We examined the relationship between polygenic risk scores built from large genome-wide association studies of psychiatric disorders and executive functioning in typically developing children. In our discovery sample (N = 417), consistent with previous reports on general cognitive abilities, polygenic risk for autism spectrum disorder was associated with better performance on the Dimensional Change Card Sort test from the NIH Cognition Toolbox, with the largest effect in the youngest children. Polygenic risk for major depressive disorder was associated with poorer performance on the Flanker test in the same sample. This second association replicated for performance on the Penn Conditional Exclusion Test in an independent cohort (N = 3681). Our results suggest that the molecular genetic factors contributing to variability in executive function during typical development are at least partially overlapping with those associated with psychiatric disorders, although larger studies and further replication are needed., (© 2018 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.)