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Clinical nurse educators within Queensland, Australia, tend to be selected for the job based on their clinical expertise and consequently may lack knowledge of educational theories and practices. Within the Nursing School in which this project was based, there is interest in developing expertise in Transformative Learning theory. To share this knowledge with clinical educators, a workshop was designed using short films produced by the research team that focused on potentially transformative moments in clinical placement settings that the literature and the researchers' experience had shown to be important. As the project developed iteratively through various stages, action research was chosen as the most suitable methodology to research and document the evaluation of this training workshop, which brought together 20 nursing clinical nurse educators. Interpretive data analysis approaches were employed to understand participants' learning experiences resulting from the workshop, which led to four key themes: 1) first encounters with students need to be engaging and energising; 2) teach students how to bracket personal needs so they can provide professional empathic actions; 3) teach students to value both procedural- and person-centred care; 4) a transformative learning pedagogy is useful for clinical nurse educators to frame and enhance their teaching practice. Learning experiences produced using an action research methodology can stimulate clinical nurse educators to engage with and use relevant educational theory in ways that enable some of the more nuanced and affective dimensions of clinical training.

BackgroundInfant health among newborns with neonatal abstinence syndrome (NAS) has been understudied. We examined infant mortality and hospitalizations among infants diagnosed with NAS after birth.MethodsAll live births in British Columbia (BC), Canada, for fiscal years from 2004–2005 to 2019–2020, were included (N = 696,900). NAS was identified based on International Classification of Diseases, version 10, Canadian modification (ICD-10-CA) codes; the outcomes included infant death and hospitalizations during the first year of life, ascertained from BC linked administrative data. Generalized estimating equation models were used to adjust for maternal factors.ResultsThere were 2,439 infants with NAS (3.50 per 1,000 live births). Unadjusted for other factors, infant mortality was 2.5-fold higher in infants with vs. without NAS (7.79 vs. 3.08 per 1,000 live births, respectively) due to increased post-discharge mortality NAS (5.76 vs. 1.34 per 1,000 surviving infants, respectively). These differences diminished after adjustment: adjusted odds ratio (AOR) for infant death was 0.85 [95% confidence interval (CI): 0.52–1.39]; AOR for post-discharge death was 1.75 (95% CI 1.00–3.06). Overall, 22.3% infants with NAS had at least one hospitalization after post-neonatal discharge, this proportion was 10.7% in those without NAS. During the study period, discharge to foster care declined from 49.5% to 20.3% in infants with NAS.ConclusionUnadjusted for other factors, infants with NAS had increased post-discharge infant mortality and hospitalizations during the first year of life. This association diminished after adjustment for adverse maternal and socio-medical conditions. Infants with NAS had a disproportionately higher rate of placement in foster care after birth, although this proportion declined dramatically between 2004/2005 and 2019/2020. These results highlight the importance of implementing integrated care services to support infants born with NAS and their mothers during the first year of life and beyond, even though NAS itself is not independently associated with increased infant mortality.

IntroductionAmong girls assessed for pubertal precocity, pelvic ultrasound (pUS) may represent a pivotal tool to predict the time expected to elapse between sonographic assessment and the onset of menarche (TUS-M). Accordingly, the present analysis is meant to define the statistical relationship between sonographic parameters and TUS-M, in order to identify the most reliable predictor of the timing of menarche.MethodsRetrospective, multicenter analysis. Girls assessed for sexual precocity and showing sonographic and clinical findings consistent with pubertal onset upon referral were considered eligible. Patients treated with GnRH analogues were excluded and only those who had subsequently achieved complete and spontaneous pubertal attainment and for whom the exact date of menarche was available were included. Overall, we enrolled 184 girls from five tertiary care Italian Centers.ResultsThe time elapsed (months) between baseline endocrine assessment and spontaneous achievement of menarche showed a negative statistically significant correlation (p

Down syndrome (DS) is the most common chromosomal disorder worldwide. Along with intellectual disability, endocrine disorders represent a remarkable share of the morbidities experienced by children, adolescents and young adults with DS. Auxological parameters are plotted on syndrome-specific charts, as growth rates are reduced compared to healthy age- and gender-matched peers. Furthermore, children with DS are at increased risk for thyroid dysfunctions, diabetes mellitus, osteopenia and obesity compared to general population. Additionally, male individuals with DS often show infertility, while women tend to experience menopause at an overall younger age than healthy controls. Given the recent outstanding improvements in the care of severe DS-related comorbidities, infant mortality has dramatically decreased, with a current average life expectancy exceeding 60 years. Accordingly, the awareness of the specificities of DS in this field is pivotal to timely detect endocrine dysfunctions and to undertake a prompt dedicated treatment. Notably, best practices for the screening and monitoring of pediatric endocrine disorders in DS are still controversial. In addition, specific guidelines for the management of metabolic issues along the challenging period of transitioning from pediatric to adult health care are lacking. By performing a review of published literature, we highlighted the issues specifically involving children and adolescent with DS, aiming at providing clinicians with a detailed up-to-date overview of the endocrine, metabolic and auxological disorders in this selected population, with an additional focus on the management of patients in the critical phase of the transitioning from childhood to adult care.

Abstract Background Video-assisted thoracic surgery (VATS) has become the standard for lung cancer diagnosis and treatment. However, this surgical technique requires specific and dedicated training. In the past 20 years, several simulator systems have been developed to promote VATS training. Advances in virtual reality may facilitate its integration into the VATS training curriculum. The present review aims to first provide a comprehensive overview of the simulators for thoracoscopic surgery, focused especially on simulators for lung lobectomy; second, it explores the role and highlights the possible efficacy of these simulators in the surgical trainee curriculum. Methods A literature search was conducted in the PubMed, EMBASE, Science Direct, Scopus and Web of Science databases using the following keywords combined with Boolean operators “AND” and “OR”: virtual reality, VR, augmented reality, virtual simulation, mixed reality, extended reality, thoracic surgery, thoracoscopy, VATS, video-assisted thoracoscopic surgery, simulation, simulator, simulators, training, and education. Reference lists of the identified articles were hand-searched for additional relevant articles to be included in this review. Results Different types of simulators have been used for VATS training: synthetic lung models (dry simulators); live animals or animal tissues (wet simulators); and simulators based on virtual or augmented reality. Their role in surgical training has been generally defined as useful. However, not enough data are available to ascertain which type is the most appropriate. Conclusions Simulator application in the field of medical education could revolutionize the regular surgical training curriculum. Further studies are required to better define their impact on surgeons’ training programs and, finally, on patients’ quality of care.

Abstract The release of DNA to the extracellular milieu is a biological process referred to as etosis, which is involved in both physiological and pathological functions. Although the release of DNA extracellular traps (ETs) was initially attributed to innate immune cells such as neutrophils, eosinophils, and macrophages, recent studies have shown that T cells, as well as non-immune cells, are capable of releasing ETs. These structures were described primarily for their potential to trap and kill pathogens, presenting an important strategy of host defense. Intriguingly, these functions have been associated with intracellular pathogens such as the parasites Leishmania sp. and Trypanosoma cruzi, causative agents of leishmaniasis and Chagas disease, respectively. These are two devastating tropical diseases that lead to thousands of deaths every year. In an apparent contradiction, ETs can also induce and amplify inflammation, which may lead to worsening disease pathology. This has prompted the concept of targeting ETs’ release as a means of controlling tissue destruction to treat human diseases. What is the best approach to prevent disease severity: inducing ETs to kill pathogens or preventing their release? In this Perspective article, we will discuss the importance of understanding ETs released by different cell types and the need to balance their potentially complementary functions. In addition, we will explore other functions of ETs and their translational applications to benefit individuals infected with intracellular parasites and other pathogens. Ultimately, a better understanding of the role of ETs in disease pathogenesis will provide valuable insights into developing novel therapies for human diseases.

IntroductionImpaired testosterone secretion is a frequent sequela following hematopoietic stem cell transplantation (HSCT) in pediatrics, but long-term longitudinal trendlines of clinical and biochemical findings are still scanty.MethodsMonocentric, retrospective analysis. Male patients transplanted

Hospitalisation can be a challenging experience for young people, including higher levels of anxiety, social isolation, and depression. In this paper we identify the possibilities of an applied theatre pilot that aimed to combine co-designed virtual reality (VR) approaches with intermedial work with young people in hospital. Within the pilot study we worked with three participants in individualised bedside workshops over a four-week period. Analysis from the pilot demonstrated the significance of the co-design process leading to greater degrees of agency for young people, and opportunities for the participants to share experiences with medical staff, carers, and siblings.

Dear Editor, we thank Dr. Amore and coworkers for comments and suggestions that allowed us to discuss “The surgical approach of late-onset tracheoesophageal fistula (TEF) in a tracheostomized Covid-19 patient”, published on Monaldi Archives of Chest Disease by our group....

Traiciones Cartoneras es una colección de La Sofia cartonera dedicada a la difusión de traducciones de obras de la literatura extranjera de todas las épocas. Surge con el propósito de estimular la traducción literaria local en sede universitaria y favorecer la recepción de la literatura universal en público variado y amplio y no siempre vinculado con la experiencia literaria. Toma su nombre del célebre adagio italiano Traduttore, traditore que orienta su práctica: traducir y entregar bienes culturales a nuevos sectores sociales. Mediante acciones concretas como los talleres colaborativos de armado y traducción, la colección intenta poner en relación la sofisticada práctica de la traducción literaria con las lógicas colectivas de la edición cartonera y establecer, de este modo, un acercamiento necesario entre los códigos de la cultura letrada y popular para encontrar nuevas vías de circulación del libro.

Abstract Background The aim of this study is to compare the 2021–2022 bronchiolitis season to the four previous years (2017–2018, 2018–2019, 2019–2020, 2020–2021) to see if there was an anticipation of the peak, an overall increase of cases, and an increased need of intensive care. Methods A retrospective single-centre study in the San Gerardo Hospital Fondazione MBBM, Monza, Italy was performed. Emergency Departments (ED) visits of patients aged

Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas. Methods We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns. Results Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033-1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054-1.344, respectively). These results were confirmed after the propensity score matching analysis. Conclusions pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors., Author(s): Pietro Bertoglio [sup.1], Vittorio Aprile [sup.2], Luigi Ventura [sup.3] [sup.4], Maria Cattoni [sup.5], Dania Nachira [sup.6], Filippo Lococo [sup.6], Maria Rodriguez Perez [sup.7], Francesco Guerrera [sup.8], Fabrizio Minervini [sup.9], [...]

A five classes (A-E) aggregate risk score predicting 90-day mortality after video-assisted thoracoscopic lobectomy for lung cancer, including as independent factors male sex (3 points), DLCO 150 minutes (1 point), has been recently published. This study aims to assess the effectiveness and reliability of this risk model in a large, independent cohort of patients, to confirm its generalizability. From the Italian VATS Group Database, we selected 2,209 patients [60% males; median age 69 years (IQR:63-74)] who underwent video-assisted thoracoscopic lobectomy for non-small cell lung cancer. We calculated the aggregate risk score and the corresponding class of 90-day mortality risk for each patient. The correlation between risk classes and mortality rates was tested by Spearman’s r-test. Model calibration was evaluated by Hosmer-Lemeshow goodness-of-fit test. Class A-E 90-day mortality rates were 0.33%, 0.51%, 1.39%, 1.31% and 2.56%, respectively. A strong uphill correlation was identified between risk classes and 90-day mortality (r=0.90; p=0.037), showing a positive correlation between increased mortality rate and class A to E. Hosmer-Lemeshow chi-squared value was 67.47 (p

O presente artigo propõe um debate acerca do papel constitucional da Defensoria Pública sob uma perspectiva teórico-crítica própria à instituição. Nesse sentido, analisa-se a evolução de seus paradigmas normativos, que, se antes permitiam fosse confundida com uma espécie de assistência judiciária constitucionalizada, hoje legitimam a Defensoria Pública como instituição da soberania popular, vital ao Estado Democrático de Direito brasileiro. Sustenta-se, assim, uma Defensoria Pública que se apresente como verdadeira Defensoria do Povo, cuja principal função é a manutenção da tensão entre expectativas normativas igualitárias e universalizáveis e um sistema que sempre investe para colonizá-las. Nesse contexto, a ideia de Defensoria Pública conecta-a a um povo ativo no exercício de sua autodeterminação democrática, que se vale do Direito para afirmar sua cidadania.

Surface Plasmon Polaritons (SPPs) in Au thin films are nowadays intensively exploited for sensing applications that leverage the strong optical field confinement at the metal/dielectric interface and the easy functionalization of the Au surface. Moreover, Au thin films represent one of the common starting points for the top-down nanofabrication of plasmonic nanostructures supporting localized resonances. In this framework, strategies for the growth of high-quality Au films on transparent substrates are crucial and not yet fully established. In this study, we exploit MgO(001) substrates for the growth of thin (about 45 nm) Au films, also including an additional buffer layer of Fe. We successfully demonstrate Au samples with reduced roughness and presenting Low-Energy Electron Diffraction (LEED) features, indicating a high degree of crystalline ordering. This is supported by the experimental evidence of an increased (by almost a factor of 3) propagation length compared to a reference Au sample grown on standard glass slides, which is however still significantly lower than the one expected from first principles.

Abstract Cell-free biosensors are promising tools for medical diagnostics, yet their performance can be affected by matrix effects arising from the sample itself or from external components. Here we systematically evaluate the performance and robustness of cell-free systems in serum, plasma, urine, and saliva using two reporter systems, sfGFP and luciferase. In all cases, clinical samples have a strong inhibitory effect. Of the different inhibitors, only RNase inhibitor mitigated matrix effects. However, we found that the recovery potential of RNase inhibitor was partially muted by interference from glycerol contained in the commercial buffer. We solved this issue by designing a strain producing an RNase inhibitor protein requiring no additional step in extract preparation. Furthermore, our new extract yielded higher reporter levels than previous conditions and tempered interpatient variability associated with matrix effects. This systematic evaluation and improvements of cell-free system robustness unified across many types of clinical samples is a significant step towards developing cell-free diagnostics for a wide range of conditions.