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The Cryogenic Underground Observatory for Rare Events (CUORE) is the first cryogenic experiment searching for neutrinoless double-beta (0vßß) decay that has been able to reach the one-ton scale. The detector, located at the Laboratori Nazionali del Gran Sasso in Italy, consists of an array of 988 TeO2 crystals arranged in a compact cylindrical structure of 19 towers. Following the completion of the detector construction in August 2016, CUORE began its first physics data run in 2017 at a base temperature of about 10 mK. Following multiple optimization campaigns in 2018, CUORE is currently in stable operating mode. In 2019, CUORE released its 2nd result of the search for 0vßß with a TeO2 exposure of 372.5 kg·yr and a median exclusion sensitivity to a 130Te 0vßß decay half-life of 1.7 · 1025 yr. We find no evidence for 0vßß decay and set a 90% C.I. (credibility interval) Bayesian lower limit of 3.2 · 1025 yr on the 130Te 0vßß decay half-life. In this work, we present the current status of CUORE's search for 0vßß, as well as review the detector performance. Finally, we give an update of the CUORE background model and the measurement of the 130Te two neutrino double-beta (2vßß) decay half-life.

Leaders at Moses H. Cone Memorial Hospital in Greensboro, NC, implemented several interventions that improved the overall care and outcomes for patients with sickle cell disease (SCD).Prior to intervention, patients experienced delays in treatment for pain management, a lack of trust in the staff, and a lack of knowledge about their disease.Interventions for improvement included developing an 8-hour admission protocol for use in the emergency department or observation area and an extended protocol for patients with symptoms requiring inpatient admission.Staff was given additional training on SCD, patient sensitivity issues, and pain management.Patients were provided with educational and diversional resources as well as an ID card with patient-specific information for quick reference upon subsequent encounters.This group of interventions resulted in significant improvements in length of stay, emergency department visits, cost per case, and patient satisfaction. [ABSTRACT FROM AUTHOR]

Like hospitals, skilled nursing facilities (SNFs) face increasing cost and regulatory pressure, but they have also experienced greater turnover rates among staff and bear the brunt of the population growth among the elderly.The researchers examined the relationship between staff turnover and several other variables such as demographics about the DON, facility variables, and staffing patterns.The educational preparation and tenure of the DON, salaries, opportunities for advancement, for/not-for-profit status, and location did not have a significant relationship with turnover rates.The size of the facility showed a nearly significant relationship with turnover, with larger SNFs having higher turnover rates.DONs perceived that pay/benefits, work environment, and teamwork were factors in retention, while poor pay/benefits, schedule conflicts, and relocation were perceived as drivers of turnover.The authors noted DONs and administrators have the ability to control the majority of the perceived factors influencing retention and turnover. [ABSTRACT FROM AUTHOR]

The Asian population in the United States is the fastest growing minority; consequently it behooves psychiatric nurses and other mental health professionals to be aware of symptom presentation of emotional problems that may differ from those of other population groups. Specific syndromes, psychiatric disorders, and symptoms that commonly present as physical disorders are discussed. Recommended adaptations of psychiatric interventions, including medications and other therapies, are offered to enable mental health professionals to provide culturally sensitive care. Mental health care that is culturally competent may improve access to care for Asians residing in the United States. [ABSTRACT FROM AUTHOR]

Excessive time was being spent by the emergency department (ED) staff, head nurse, and unit secretary on a complex 6-week manual self-scheduling system. This issue, plus inevitable errors and staff dissatisfaction, resulted in a manager-lead initiative to automate elements of the scheduling process using Microsoft Excel. The implementation of this initiative included: common coding of all 8-hour and 12-hour shifts, with each 4-hour period represented by a cell; the creation of a 6-week master schedule using the 'count-if' function of Excel based on current staffing guidelines; staff time-off requests then entered by the department secretary; the head nurse, with staff input, then fine-tuned the schedule to provide even unit coverage. Outcomes of these changes included an increase in staff satisfaction, time saved by the head nurse, and staff work time saved because there was less arguing about the schedule. Uultimately, this automated self-scheduling method was expanded to the entire 700-bed hospital. [ABSTRACT FROM AUTHOR]

A study examines the relationship between middle nurse managers' (MNMs) job satisfaction and how they perceive their chief nurse executive's (CNE) leadership style and adaptability were studied. The study thus examined the interplay between job satisfaction (specifically satisfaction with supervision), leadership style and leadership adaptability. [ABSTRACT FROM AUTHOR]

Asian-Americans are the fastest-growing minority in the United States, and they are a culturally diverse group. Knowledge about this growing minority population is important for the purposes of planning appropriate mental health care. Asian-Americans living in the United States rarely use mental health services. The reasons for this, along with suggestions for developing more culturally sensitive mental health services, are presented. A model for cultural competence can provide a framework for psychiatric nurses and other mental health professionals (MHPs) to become more aware of Asian-American values and beliefs and provide more culturally sensitive care. Awareness tools are included to guide MHPs in determining whether culturally competent care is available locally to meet the needs of this underserved population. [ABSTRACT FROM AUTHOR]

In 1993, 27% of 1,147 surveyed hospitals planned to decrease staff size in the next year. This study surveyed 48 vice presidents of nursing in North Carolina hospitals with an average inpatient census over 100 using a 13-item questionnaire in an effort to discover strategies that were helpful in effective downsizing endeavors. Of the 31 (48%) returned questionnaires, 11 (35%) of the VPs reported downsizing in the past 3 years, most of which required the closing of one or more units. The respondents ranked attrition as the most common strategy, followed by relocation, early retirement, a change in skill mix, and layoffs. The most important components in successful downsizing or reorganization efforts were: two-way communication and sufficient planning, as well as seeking and using input from a broad group of staff (using both individual meetings and group forums/discussions). [ABSTRACT FROM AUTHOR]

The Maoris of New Zealand have an interesting history and culture. In this selected review of literature supplemented with data from limited interviews with Maoris is described their history of settlement, oppresssion, and rebuilding of their cultures. The Maoris make up approximately 12% of New Zealand's population, which is predominantly white. The Maori family has moved from tribal form to extended family to nuclear family, and is currently moving back in the direction of extended family. There is a renewed effort by Maoris to assist their own people to rise from their predominantly lower socioeconomic class and to rebuild their culture. Maori women appear to be playing a major role in these rebuilding efforts. [ABSTRACT FROM AUTHOR]

Due to increasing competetiveness in healthcare, emergency department personnel should focus on patient satisfaction initiatives. [ABSTRACT FROM AUTHOR]

Introduction: A key regulator of collective cell migration is prostaglandin (PG) signaling. However, it remains largely unclear whether PGs act within the migratory cells or their microenvironment to promote migration. Here we use Drosophila border cell migration as a model to uncover the cell-specific roles of two PGs in collective migration. The border cells undergo a collective and invasive migration between the nurse cells; thus, the nurse cells are the substrate and microenvironment for the border cells. Prior work found PG signaling is required for on-time border cell migration and cluster cohesion. Methods: Confocal microscopy and quantitative image analyses of available mutant alleles and RNAi lines were used to define the roles of the PGE 2 and PGF 2α synthases in border cell migration. Results: We find that the PGE 2 synthase cPGES is required in the substrate, while the PGF 2α synthase Akr1B is required in the border cells for on-time migration. Akr1B acts in both the border cells and their substrate to regulate cluster cohesion. One means by which Akr1B may regulate border cell migration and/or cluster cohesion is by promoting integrin-based adhesions. Additionally, Akr1B limits myosin activity, and thereby cellular stiffness, in the border cells, whereas cPGES limits myosin activity in both the border cells and their substrate. Decreasing myosin activity overcomes the migration delays in both akr1B and cPGES mutants, indicating the changes in cellular stiffness contribute to the migration defects. Discussion: Together these data reveal that two PGs, PGE 2 and PGF 2α , produced in different locations, play key roles in promoting border cell migration. These PGs likely have similar migratory versus microenvironment roles in other collective cell migrations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mellentine, Brown, Ramsey, Li and Tootle.)

The complex and multifactorial etiology of obesity creates challenges for its effective long-term management. Increasingly, the gut microbiome is reported to play a key role in the maintenance of host health and wellbeing, with its dysregulation associated with chronic diseases such as obesity. The gut microbiome is hypothesized to contribute to obesity development and pathogenesis via several pathways involving food digestion, energy harvest and storage, production of metabolites influencing satiety, maintenance of gut barrier integrity, and bile acid metabolism. Moreover, the gut microbiome likely contributes to the metabolic, inflammatory, and satiety benefits and sustained weight-loss effects following bariatric procedures such as sleeve gastrectomy. While the field of gut microbiome research in relation to obesity and sleeve gastrectomy outcomes is largely in its infancy, the gut microbiome nonetheless holds great potential for understanding some of the mechanisms behind sleeve gastrectomy outcomes as well as for optimizing post-surgery benefits. This review will explore the current literature within the field as well as discuss the current limitations, including the small sample size, variability in methodological approaches, and lack of associative data, which need to be addressed in future studies., (© 2023 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

In this study, we considered potential causes of variation in testis size in the livebearing fish Brachyrhaphis rhabdophora . We evaluated variation in testes mass among individual males and among populations that occupy different selective environments. First, we predicted that small males should allocate more to testes mass than large males (i.e., hypoallometric pattern) based on a sperm competition argument. Second, based on life history theory and associated differences in mortality rates between populations that coexist with many fish predators and those with few predators, we predicted that males in high-predation environments should allocate more to testes mass than males in habitats with few predators. Our results showed that small males allocated proportionally more to testes mass than larger males (slope of testes mass to body mass was hypoallometric). However, there was no effect of predator environment on testes mass independent of body size differences. In this system, size-specific patterns of reproductive allocation in males (hypoallometry) differ from that seen in females (hyperallometry). Allocation to testes mass may respond to differences in mortality rate through selection on body size.

The spin precession frequency of muons stored in the (g-2) storage ring has been analyzed for evidence of Lorentz and CPT violation. Two Lorentz and CPT violation signatures were searched for a nonzero delta omega a(=omega a mu+ - omega a mu-) and a sidereal variation of omega a mu+/-). No significant effect is found, and the following limits on the standard-model extension parameters are obtained: bZ = -(1.0+/-1.1) x 10(-23) GeV; (m mu dZ0 + HXY)=(1.8+/-6.0) x 10(-23) GeV; and the 95% confidence level limits b perpendicular mu+ <1.4 x 10(-24) GeV and b perpendicular mu- <2.6 x 10(-24) GeV.

Three known non-synonymous polymorphisms (Ala394Thr, Ser471Leu and Pro690Ala) in the largest circadian gene, Neuronal PAS domain protein 2 (NPAS2), were genotyped in a breast cancer case-control study conducted in Connecticut, USA (431 cases and 476 controls). We found that women with the heterozygous Ala394Thr genotype were significantly associated with breast cancer risk compared to those with the common homozygous Ala394Ala (OR = 0.61, 0.46-0.81, P = 0.001). This is the first evidence demonstrating a role of the circadian gene NPAS2 in human breast cancer, suggesting that genetic variations in circadian genes might be a novel panel of biomarkers for breast cancer risk.

Circadian disruption is theorized to cause immune dysregulation, which is the only established risk factor for non-Hodgkin's lymphoma (NHL). Genes responsible for circadian rhythm are also involved in cancer-related biological pathways as potential tumor suppressors. However, no previous studies have examined associations between circadian genes and NHL risk. In this population-based case control study (n = 455 cases; 527 controls), we examined the only identified nonsynonymous polymorphism (Ala394Thr; rs2305160) in the largest circadian gene, neuronal PAS domain protein 2 (NPAS2), in order to examine its impact on NHL risk. Our results demonstrate a robust association of the variant Thr genotypes (Ala/Thr and Thr/Thr) with reduced risk of NHL (OR = 0.66, 95% CI: 0.51-0.85, p = 0.001), especially B-cell lymphoma (OR = 0.61, 95% CI: 0.47-0.80, p

College Bound Sisters (CBS) is a program that helps younger sisters of teenage mothers change their life trajectory by accomplishing three objectives: avoidance of pregnancy, completion of high school, and enrollment in college. Data related to religious activities and accomplishment of the three objectives for 129 members were analyzed using chi square. CBS defines health as the accomplishment of the three program objectives using Norbeck's theoretical model of social support. The adolescents were divided into three groups: those who became pregnant, dropped out of school, or completed high school. The three groups were compared with regard to the frequency of participating in religious activities. The majority of the CBS adolescents reported participating in weekly religious activities. No significant difference was found among the three groups, with regard to religious activities. However, CBS program participants were more likely than nonparticipants to graduate high school and enroll in college. Implications for incorporating religious activities in teenage pregnancy prevention programs are discussed.

Due to increasing competitiveness in healthcare, emergency department personnel should focus on patient satisfaction initiatives.

Circadian disruption has been indicated as a risk factor for breast cancer in recent epidemiologic studies. A novel finding in circadian biology is that genes responsible for circadian rhythm also regulate many other biological pathways, including cell proliferation, cell cycle regulation, and apoptosis. Therefore, mutations in circadian genes could conceivably result in deregulation of these processes and contribute to tumor development, and be markers for susceptibility to human cancer. In this study, we investigated the association between an exonic length variation in a circadian gene, Period3 (Per3), and breast cancer risk using blood samples collected from a recently completed breast cancer case-control study in Connecticut. There were 389 Caucasian cases and 432 Caucasian controls included in our analysis. We found that the variant Per3 genotype (heterozygous + homozygous 5-repeat alleles) was associated with an increased risk of breast cancer among premenopausal women (odds ratio, 1.7; 95% confidence interval, 1.0-3.0). Our finding suggests that the circadian genes might be a novel panel of potential biomarkers for breast cancer and worth further investigation.

Introduction: MBD2, the gene encoding methyl-CpG-binding domain (MBD)2, is a major methylation related gene and functions as a transcriptional repressor that can specifically bind to the methylated regions of other genes. MBD2 may also mediate gene activation because of its potential DNA demethylase activity. The present case-control study investigated associations between two single nucleotide polymorphisms (SNPs) in the MBD2 gene and breast cancer risk., Methods: DNA samples from 393 Caucasian patients with breast cancer (cases) and 436 matched control individuals, collected in a recently completed breast cancer case-control study conducted in Connecticut, were included in the study. Because no coding SNPs were found in the MBD2 gene, one SNP in the noncoding exon (rs1259938) and another in the intron 3 (rs609791) were genotyped. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to estimate cancer risk associated with the variant genotypes and the reconstructed haplotypes., Results: The variant genotypes at both SNP loci were significantly associated with reduced risk among premenopausal women (OR = 0.41 for rs1259938; OR = 0.54 for rs609791). Further haplotype analyses showed that the two rare haplotypes (A-C and A-G) were significantly associated with reduced breast cancer risk (OR = 0.40, 95% CI = 0.20-0.83 for A-C; OR = 0.47, 95% CI = 0.26-0.84 for A-G) in premenopausal women. No significant associations were detected in the postmenopausal women and the whole population., Conclusion: Our results demonstrate a role for the MBD2 gene in breast carcinogenesis in premenopausal women. These findings suggest that genetic variations in methylation related genes may potentially serve as a biomarker in risk estimates for breast cancer.

The anomalous magnetic moment of the negative muon has been measured to a precision of 0.7 ppm (ppm) at the Brookhaven Alternating Gradient Synchrotron. This result is based on data collected in 2001, and is over an order of magnitude more precise than the previous measurement for the negative muon. The result a(mu(-))=11 659 214(8)(3) x 10(-10) (0.7 ppm), where the first uncertainty is statistical and the second is systematic, is consistent with previous measurements of the anomaly for the positive and the negative muon. The average of the measurements of the muon anomaly is a(mu)(exp)=11 659 208(6) x 10(-10) (0.5 ppm).

A higher precision measurement of the anomalous g value, a(mu)=(g-2)/2, for the positive muon has been made at the Brookhaven Alternating Gradient Synchrotron, based on data collected in the year 2000. The result a(mu(+))=11 659 204(7)(5)x10(-10) (0.7 ppm) is in good agreement with previous measurements and has an error about one-half that of the combined previous data. The present world average experimental value is a(mu)(expt)=11 659 203(8)x10(-10) (0.7 ppm).

A precise measurement of the anomalous g value, a(mu) = (g-2)/2, for the positive muon has been made at the Brookhaven Alternating Gradient Synchrotron. The result a(mu+) = 11 659 202(14) (6) x 10(-10) (1.3 ppm) is in good agreement with previous measurements and has an error one third that of the combined previous data. The current theoretical value from the standard model is a(mu)(SM) = 11 659 159.6(6.7) x 10(-10) (0.57 ppm) and a(mu)(exp) - a(mu)(SM) = 43(16) x 10(-10) in which a(mu)(exp) is the world average experimental value.

A pilot study in which faculty from nursing and English departments at two universities in different states shared a common evaluation tool and collaborated through e-mail to evaluate the evidence of critical thinking in writing portfolios of baccalaureate and masters' nursing students. Loxley's (1997) four processes--assessment, building, managing the process, and evaluating--are used as a framework for describing collaboration among the disciplines in the two universities. Social exchange theory was used to explain the collaboration between participants. All six professors learned a great deal from studying and scoring the writings, but they learned most from each other through their e-mail dialogue.

The Dollar-A-Day program in Greensboro, North Carolina, was established in 1990 to prevent subsequent pregnancies in girls under 16 years of age who had already given birth to one child. Conceptualized by nursing professors and using principles from theories of adolescent development and social exchange, the program was planned and implemented in collaboration with nurses from the local health department. Weekly meetings featured food, an informal program focused on needs identified by members, setting of short-term goals, and an award of a dollar for each day they remained nonpregnant. After five years of operation with a series of small grants, only 15% of the 65 girls who had been enrolled in the program experienced subsequent pregnancies. The success of the program convinced health department officials to incorporate Dollar-A-Day into their budget as a permanent service to the population of adolescents they serve. It remains as a model program for others to emulate.

Hospitals must establish patients' expectations of care and their satisfaction with the care delivered. This telephone survey tool measures patient satisfaction based on empathy, communication, competence and continuity of care, and amenities.

This article discusses an interdisciplinary research project in which faculty from nursing and english collaborated in the assessment of students' critical thinking skills as reflected in writing portfolios. Faculty reviewed students' writing portfolios and then corresponded on email from two different universities about evidence of critical thinking in the portfolios. Findings suggest that writing portfolios can provide important evidence of critical thinking outcomes. To do this, however, faculty need to design writing assignments to foster critical thinking skills, helping students to think not only about learning to write, but also about using writing to learn.

Nurse educators from a university setting and staff from the county health department collaborated to establish an innovative program to prevent repeated pregnancy in adolescents. Called Dollar-A-Day and patterned after the original in Denver, CO, the program was operated jointly for 5 years and today continues to operate under the auspices of the health department. Success of the venture is attributed to use of skills in assessment, building, managing, and evaluating, as described by Loxley (1997). These elements were used to construct a context for collaboration.

Case management is a strategy for restructuring the health care delivery system. The system requires critical planning and implementation steps to achieve quality care at reduced cost.

Objective: To develop a game-based review instrument for use by newborn caregivers in preparing for emergency situations., Design: One hundred and one test questions covering pathophysiology, resuscitation, and medications were developed. The questions then underwent expert and peer review, psychometric testing for content validity and test-retest reliability, and a game trial., Analysis: The needs of adult learners are different from those of other learners. The gaming format uses knowledge gained through experience and provides an avenue for validating knowledge and sharing experiences. This format has been found effective for review and reinforcement of facts. Twelve nurses participated in a trial game and completed a written evaluation using a Likert scale., Conclusion: The Neonatal Emergency Trivia Game is an effective tool for reviewing material related to neonatal emergency care decisions. Additional testing with a larger group would strengthen validity and reliability data.

We developed a 21-item questionnaire to evaluate the effectiveness of nursing care provided in an outpatient surgery center. The four constructs of the instrument for measuring patient satisfaction are caring, continuity of care, competence of nurses, and education of patients and family members. Content validity and test-retest reliability have been established. Using this tool to analyze patients' responses to nursing care can help perioperative nurses improve patient care and patient satisfaction.

The committee had a strong sense of accomplishment when they submitted the names to the Provost. Both the process and the screening tool worked well for the search process.

The clinical journal offers a valuable medium through which faculty can teach critical thinking. Both analysis and evaluation of the interactions and relationships between clinical practice, theory, and research can be greatly enhanced through careful structuring of clinical journal assignments. The authors discuss ideas about structuring clinical and journal assignments and strategies for giving feedback.