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Graduating senior nursing students (GSNS) are expected to be ready for practice (RFP) upon graduation as they enter the workforce. Skills such as assessment, communication, and clinical reasoning are important because of high patient acuity and longer hospital stays. Therefore, nurse educators must provide teaching-learning strategies that enhance RFP for GSNS. Two authentic experiences which provide opportunities to improve clinical reasoning and promote RFP include senior practicum and complex multipatient simulation. • Readiness for practice (RFP) is critical in today's health care environment. • This quasi-experimental study found senior practicum and simulation enhance RFP. [ABSTRACT FROM AUTHOR]

Abstract Healthcare environments have increased in complexity over the last 30 years. However, educational methods to prepare nurses have remained virtually unchanged. To prepare nurses to practice in today's complex practice environment, there are calls for change and transformation in how nursing education is implemented. This transformation requires nurse educators to shift their epistemic beliefs about teaching and learning by considering theories that promote effective learning. An innovative method being used in nursing education is the Flipped Classroom Method (FCM). The FCM is a teaching strategy that encourages critical thinking and application of knowledge obtained outside of the classroom to real-world situations and problems within the classroom. This paper presents a preliminary framework synthesized from multiple theories including andragogy, constructivism, self-efficacy, and diffusion of innovations. The purpose of this preliminary framework is to support the nurse educator's reflections about the learner, their abilities to implement the FCM and to synthesize theoretical constructs to implement the FCM. Highlights • A conceptual framework for educators considering the innovative teaching strategy called the Flipped Classroom Method. • Advocate the beliefs related to the learner, self-efficacy, and the learning theory behind the FCM. • A process that leads to the identification of best instructional practices when implementing the FCM in nursing programs. [ABSTRACT FROM AUTHOR]

Abstract Online nursing education programs have grown exponentially, including RN to BSN completion program that associate degree nurses may pursue. This study was a qualitative descriptive summary of faculty perceptions and experiences of online teaching. Four themes emerged from the analysis: Technological Proficiency, Time, Relationships with Students, and Faculty Support/Resources. Narrative comments were provided to support these themes, as well as recommendations for further research and implications for nursing education. Highlights • Online nursing education programs have grown exponentially • Understanding faculty perceptions and experiences related to online teaching is imperative to encourage online teaching • The qualitative descriptive summary revealed four themes: Technological Proficiency, Time, Relationships with Students, and Faculty Support/Resources [ABSTRACT FROM AUTHOR]

Carbon-Michael chemistry can be used to produce rigid and viscoelastic foams, as well as flexible elastomers capable of effective function in traditional polyurethane applications. A simple synthetic procedure is provided for converting polyol oligomers and acetoacetate functionalized esters into useful building blocks. In this article detailed procedures for producing foams and elastomers by a carbon-Michael approach, the resulting mechanical properties of these polymeric materials, and structure property relationships for crosslink density are provided. These materials and techniques can potentially be substituted for isocyanate systems, especially in cases where isocyanates may not be advisable due to environmental, health, or safety concerns. [ABSTRACT FROM AUTHOR]

Persons without spinal cord injury (SCI) physiologically acclimate between seven to fourteen consecutive days of exercise in the heat. Decreased resting and exercise core temperature, decreased heart rate, increased plasma volume and increased thermal comfort during exercise are changes consistent with heat acclimation. Autonomic dysfunction after SCI impairs heat dissipation through sweating and vasodilation. The purpose of this study is to determine if seven consecutive days of exercise in the heat would result in physiologic changes consistent with heat acclimation in persons with SCI. Ten persons with SCI divided into two groups: tetraplegia (n=5) and paraplegia (n=5) exercised in 35 °C using an arm ergometer at 50% W peak for 30 min followed by 15 min rest. This protocol was repeated over seven consecutive days. Heart rate (HR), skin temperature, aural temperature (T aur ), rate of perceived exertion (RPE), rate of perceived thermal strain (RPTS), and plasma volume (PV) were measured throughout the protocol. There were no significant differences in resting T aur exercise T aur , mean skin temperature, HR, PV, RPE or RPTS over the 7 days for either the tetraplegic or paraplegic group. Participants with SCI did not demonstrate the ability to dissipate heat more efficiently over 7 days of exercise at 35 °C. The lack of heat acclimation seen in persons with SCI has implications for the athlete and non-athlete alike. For the SCI athlete, inability to acclimate will impair performance and endurance especially in warm environments, compared to the person without SCI. For the SCI non-athlete, there is a greater risk of heat-related illness in warm environments that can negatively affect participation in outdoor activities and thus quality of life. [ABSTRACT FROM AUTHOR]

Characterized by pain, cartilage degradation, and inflammation, osteoarthritis is often treated with anti-inflammatory therapies that provide short-term relief but can have adverse side effects; intra-articular drug delivery systems with controlled release of anti-inflammatory peptides using degradable poly( N -isopropylacrylamide) (pNIPAM) nanoparticles could prolong relief and minimize these side effects. Nanoparticles provide a biocompatible drug carrier that can protect encapsulated therapeutics from enzymatic degradation and increase payload delivery upon encountering a degradation stimulus. Here we demonstrate passive targeting of inflamed cartilage ex vivo by uptake of PEGylated pNIPAM nanoparticles with degradable disulfide crosslinks (abbreviated as NGPEGSS) into chondrocytes and subsequent intracellular release of an anti-inflammatory peptide KAFAKLAARLYRKALARQLGVAA (KAFAK). The KAFAK-loaded NGPEGSS treatment reduced ex vivo inflammation to a greater extent compared to its non-degradable counterparts. This study highlights a nanoparticle system that delivers therapeutics intracellularly with improved efficacy by triggered degradation and suppresses inflammation in multiple cell types within an inflamed joint. [ABSTRACT FROM AUTHOR]

A large carbon-14 dataset for groundwater in Indian Wells Valley, California, is used to identify groundwater recharged during the pluvial climate of the previous glacial period, more than 12,000 years before present. Additional data collected in 2019, including measurements of 13C and 14C in the recharge areas and dissolved organic carbon isotopes, substantiated the unusually heavy-isotope-enriched 13C and relatively low 14C compositions in the Sierra Nevada canyons on the northwestern margin of the basin. The carbon isotopic characteristics in this area may be due to aeolian deposits of sodium carbonate minerals from dried lake beds along the ancient Owens River, or dissolution of metasediments within the Sierra Nevada batholith, or geothermally sourced CO 2 gas, or a combination of these. Recognizing these isotope characteristics is essential for correcting apparent 14C groundwater ages. Additional complications arise from sulfate reduction and related conversion of 14C-dead sedimentary organic material to dissolved inorganic carbon with a light 13C composition. The lacustrine deposits of pluvial China Lake and organic-rich spring deposits along the Sierra Nevada range front offer reducing environments across much of the valley. A similarly large 2H dataset provides an independent marker for recharge in a previous climate, facilitated by exhaustive regional studies of 2H content of precipitation, springs, and groundwater (Smith et al., 2002). The 14C data support an association of δ2H values less than −100‰ with pluvial-climate groundwater and δ2H values greater than −96‰ with groundwater recharged under current climatic conditions. Groundwaters with δ2H between these values cannot be assigned with certainty to either group. Evaporation is also evident for a small set of groundwater samples, rendering 2H unreliable as a climate indicator for them. Using 14C and 2H in combination, much of Indian Wells Valley is found to contain groundwater consistent with recharge during current climatic conditions, with ages generally less than 6000 years. Groundwater with pluvial characteristics occurs primarily in the far end of the flow system, in the eastern part of the valley near the evapotranspiration discharge area. The footprint of this older water is more extensive in the deeper parts of the flow system and the vertical distribution of ages indicates it moves upward from the deeper parts of the flow system to the shallow zone to discharge. Estimates of groundwater travel time from a numerical flow model of the basin are generally consistent with the isotopic interpretations. • Most groundwater in Indian Wells Valley is isotopically consistent with current recharge. • Older groundwater with pluvial isotopic character occurs in downgradient part of valley. • Unusually heavy carbon-13 occurs in part of the recharge area, impacting age calculations. • Radiocarbon groundwater ages must be corrected for sulfate reduction and carbonate reactions. • Travel time from a groundwater flow model is consistent with isotopic interpretations. [ABSTRACT FROM AUTHOR]

Regulation of inwardly rectifying potassium channels by intracellular ligands couples cell membrane excitability to important signaling cascades and metabolic pathways. We investigated the molecular mechanisms that link ligand binding to the channel gate in ATP-sensitive Kir6.2 channels. In these channels, the "slide helix" forms an interface between the cytoplasmic (ligand-binding) domain and the transmembrane pore, and many slide helix mutations cause loss of function. Using a novel approach to rescue electrically silent channels, we decomposed the contribution of each interface residue to ATP-dependent gating. We demonstrate that effective inhibition by ATP relies on an essential aspartate at residue 58. Characterization of the functional importance of this conserved aspartate, relative to other residues in the slide helix, has been impossible because of loss-of-function of Asp-58 mutant channels. The Asp-58 position exhibits an extremely stringent requirement for aspartate because even a highly conservative mutation to glutamate is insufficient to restore normal channel function. These findings reveal unrecognized slide helix elements that are required for functional channel expression and control of Kir6.2 gating by intracellular ATP. [ABSTRACT FROM AUTHOR]

Abstract: We have discovered a series of N-bromosuccinimide-promoted 1,4-bromocyclization reactions for conjugated 1,3-enynes. Various nitrogen nucleophiles could be added to conjugated enynes to generate bromoallenyl substituted nitrogen heterocycles. These processes led to simultaneous formation of a highly functionalized axially chiral allene and a stereogenic center under mild conditions. [Copyright &y& Elsevier]

Purpose: The aim of this project was to gain a better understanding of cardiovascular disease (CVD) as a women''s health issue among Alabama women in a rural county. Research Questions: [1.] What are the risks and perceptions of CVD of Alabama women in a rural county? [2.] What demographic and study variables predict CVD? Methods: One hundred twelve women participated in this descriptive, prospective study. Findings: Thirty percent identified CVD as the greatest health problem facing women and the leading cause of death in women. Ninety percent believed that they had a 41% or greater chance of developing CVD. The variables in the study explained 60% of the participant''s coronary heart disease risk prediction scores. Conclusions: The understanding gained in this study will be used to find ways to increase the awareness of CVD and to design interventions that improve the cardiovascular health of women in a rural area of Alabama. [Copyright &y& Elsevier]

Abstract: This study sought to determine the effect of an advanced-practice-nurse (APN)-led telephone intervention on hospital readmissions, quality of life, and self-care behaviors (SCBs) of patients with heart failure (HF). Twenty participants were randomly assigned to either an experimental group that received the APN-led telephone intervention (ALTI) or a control group that received usual care in this pretest–posttest experimental study. The results of this study support the idea that an ALTI positively impacts outcomes of patient with HF, particularly by improving SCBs and decreasing hospital readmissions. An ALTI warrants consideration to improve outcomes of patients with HF. [Copyright &y& Elsevier]

Abstract: An intramolecular hydroamination of conjugated enyne was developed using commercially available n-BuLi as a precatalyst. This hydroamination reaction led to products with allene and pyrrolidine functional groups. One of the enyne hydroamination products was successfully converted to natural products irniine and irnidine in three steps. The scope and mechanism of the enyne hydroamination are also discussed. [Copyright &y& Elsevier]

Auburn University School of Nursing (AUSON) has been in a partnership with the Auburn Housing Authority (AHA), a low-income public housing provider, for several years by providing a weekly nursing care clinic. AUSON was convinced expansion of the clinics would be beneficial to all. This article describes the process and lessons learned in expanding the scope and depth of the partnership and how this service learning experience was integrated throughout the nursing curriculum. Journaling by students revealed that interactions with a different culture over time changed their perceptions. Residents have been empowered to take control of their health. A community partnership takes persistence, perseverance, and consistency. This partnership has been beneficial to residents, students, and faculty. The university’s land-grant mission of service and access is demonstrated through a partnership that offers opportunities for students and faculty to address the community’s needs. [Copyright &y& Elsevier]

Purpose: The purposes of this study were to (1) describe the characteristics of the population with congestive heart failure (CHF) who were admitted to a large, southeastern, acute-care hospital and (2) determine which patients are at risk for readmissions within 6 months. Methods: A descriptive correlational design, using variables maintained in a computerized data bank on patients with CHF (N = 557, 39% were black) who were admitted between October 2000 and March 2002, was used to describe the adult population with CHF and identify variables associated with a likelihood of readmission. Results: In the 6 months after the index admission, 224 (40%) of the patients were readmitted to the hospital for CHF. Variables significantly associated with readmission included lack of cardiology consult during admission, living status, point of entry of index admission, receiving Medicare, and having pulmonary hypertension. Four models, composed of subsets of variable from the data bank were developed and tested with logistic regression. The model composed of discharge variables was the only model that predicted readmission at a significant level. Conclusions: There is a need to develop comprehensive data banks to describe patterns of care and their outcomes. Such data should inform plans to manage this vulnerable population. [Copyright &y& Elsevier]

: ObjectiveTo establish whether the concentration of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), and transforming growth factor-beta (TGF-β) is influenced by the presence or absence of adhesions, and whether the concentration of these mediators vary throughout the menstrual cycle.: DesignProspective case-control study.: SettingWomen undergoing laparoscopy in a university hospital in the United Kingdom.: Patient(s)Women undergoing laparoscopy for benign gynecological conditions.: Intervention(s)Samples of peritoneal fluid were collected at diagnostic laparoscopy in one group, and at laparoscopy and serially during the first 48 hours after laparoscopic adhesiolysis in a second group. We correlated the concentrations of mediators in serially sampled peritoneal fluid during the 48 hours following laparoscopic adhesiolysis to the adhesion formation and reformation found during second-look laparoscopy.: Main outcome measure(s)The concentrations of MMP-9, TIMP-1, and TGF-β in peritoneal fluid.: Result(s)MMP-9 concentration was lower in the follicular phase than the luteal phase of the menstrual cycle. MMP-9 concentration was significantly lower in women with pelvic adhesions than in women with a normal pelvis. The MMP-9/TIMP-1 ratio is significantly higher in women with significant adhesions at second-look laparoscopy compared to women with minimal or no adhesions.: Conclusion(s)The components of extracellular matrix remodeling may play an important part in the adhesion formation/reformation process. [Copyright &y& Elsevier]

Readiness for practice (RFP) is essential as new nurses will practice in a nursing shortage climate, with high acuity patients and complex technology. Nurse educators are challenged to foster readiness for practice. The aim of this integrative review was to explore the impact of simulation and senior practicum on graduating senior nursing students' readiness for practice. Readiness for practice has been a point of concern for healthcare for quite some time. This has led to a need for better understanding for what RFP means including their perceptions of various stakeholders. Further, it is important to address what teaching and learning strategies can be implemented to assist in ensuring the graduating senior nursing student is ready for practice on graduation and for their first professional practice. Readiness for practice is defined as the ability to safely and competently care for patients by synthesizing theory, skills, attitudes and values in applying clinical reasoning in practice settings. An integrative review identified 48 published papers on simulation and senior practicum that met the inclusion criteria. Themes identified from the senior practicum/preceptor literature included clinical reasoning, skills, barriers to the senior practicum and transition. Themes identified regarding simulation as a strategy included preparation, competence development, clinical reasoning and the number of human patient simulators used. Although the evidence is not conclusive, simulation and senior practicums have the promise of preparing graduating nursing students for their first professional practice. However, nurse educators must ensure simulations are well-organized with clear objectives and that preceptors are supported in teaching and assessing students. [ABSTRACT FROM AUTHOR]

Summary: We present a case of traumatic vertical atlantoaxial dislocation of 16 millimetres with a fatal outcome. We hypothesize that this extremely rare traumatic vertical atlantoaxial dislocation results from insufficiency of the C1/C2 facet capsules after rupture of the tectorial membrane and the alar ligaments. [Copyright &y& Elsevier]

Hydrogen isotope selectivity of palladium membranes has long been known and studied, but the emergence of vanadium-based membranes as a low-cost alternative naturally inspires curiosity as to whether these membranes exhibit similar properties. Accordingly, experiments to calculate the permeability of hydrogen and deuterium through a palladium-coated vanadium membrane at 300 °C were undertaken, and they revealed that hydrogen permeates at a rate 1.5 × faster than deuterium. With hydrogen absorption experiments at the same temperature showing very little difference in the amount of each isotope absorbed over a wide pressure range, it can be concluded that atomic hydrogen diffuses through vanadium 1.5 × faster than atomic deuterium. In practice, this gives rise to a significant separation factor, with deuterium being depleted in the permeate stream, but enriched in the retentate stream. Creating a cascading series of membranes, with successive retentate streams combined, will allow the deuterium concentration to be enriched far beyond the natural value of 0.015%. This work suggests that further work is warranted to explore whether this separation factor can be enhanced ( e.g. , through alloying), and to demonstrate a cascading membrane system to deliver high purity deuterium from a natural hydrogen source. [ABSTRACT FROM AUTHOR]

Introduction: Surgery for pharmacoresistant epilepsy is well accepted as an efficient treatment for children suffering the debilitating consequences of repetitive seizures. The goal of this study was to analyse seizure control and complications after epilepsy surgery in our center. Methods: Data were retrospectively reviewed from 73 patients aged from 5 months to 16years old who underwent epilepsy surgery at the Geneva University Hospital and Lausanne University Hospital between 1997 and 2011. Epilepsy surgery included temporal surgery (29 cases), extra-temporal surgery (32 cases) and hemispherotomies (12 cases). Three aged groups were identified: under 3years old (18 cases), between 4 and 12years old (35 cases) and between 13 and 17years old (20 cases). Mean follow-up was 27.25months (range 4–96months). Results: The overall seizure-free rate at the time of follow up was 65.7% (48 out of 73 cases). Interestingly in children under 3years old, the seizure free rate after surgery was 83.3% (15 out of 18 cases). Also, the seizure free outcome was significantly better for temporal epilepsy (79.3%) compared to extra-temporal epilepsy (56.2%) (p =0.028, < 0.05). At least 50.6% of patients (37 out of 73 cases) had a reduction in their post-operative antiepileptic medication. Complications included five transient hemiparesis, two wound infections, one cerebral oedema after hemispherotomy, one extradural hematoma, one subdural hematoma after insertion of subdural grids and one intraventricular hematoma after hemispherotomy. Conclusions: These data highlight the good outcome and significant seizure free rate of epilepsy surgery at a very young age (children under 3y/o). Efforts to promote epilepsy surgery in children are crucial since it significantly impacts on the cognitive development of these children. A better understanding of extra-temporal epilepsy is needed to help improving seizure free outcome in this large group of patients. [ABSTRACT FROM AUTHOR]