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A virtual learning center is the hub for storing enterprise teaching material where the information is immediately accessible and available to staff. Building and maintaining a virtual learning center requires collaboration with information technology staff, creative leaders, and tech-savvy nursing professional development specialists willing to innovate. Outcomes include cost savings, more standardized practice, and improved patient outcomes. [ J Contin Educ Nurs . 2023;54(6):250–252.]

The speed of change in health care dictates that information and education must be rapidly disseminated. One-page tip sheets summarize and highlight the most important information at the point of care and provide links to further resources. The nursing professional development specialist plays a key role in facilitating and enabling rapid organizational change. [ J Contin Educ Nurs. 2023;54(1):11–15.]

Introduction Habitual sleep duration is associated with many aspects of health. Previous studies show that some groups of Hispanic/Latine Americans are somewhat protected from sleep disparities seen in other groups, but also that this may depend on acculturation. This study expanded this finding to nationally-representative data and explored some potential pathways that may link acculturation and sleep in Hispanics/Latinos. Methods Data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) were used (N=309,548 provided complete data). Habitual sleep duration was self-reported in hours and converted to minutes for analysis. Race/ethnicity was self-reported as Non-Hispanic White, Black/African American, Hispanic/Latine, Asian/Pacific-Islander, American Indian/Alaskan Native, and Multiracial/Other. The Hispanic/Latine group was further divided into those who chose to complete the survey in English versus Spanish. Covariates included age, sex, education level, household income, employment status, overall health, and mental health. Linear regression examined sleep duration (minutes) as the outcome, with race/ethnicity as the predictor. Race/ethnicity-by-covariate interactions were explored. Results Compared to non-Hispanic Whites, Blacks/African Americans reported 7.4 minutes less sleep (p< 0.0005), English-speaking Hispanics/Latine reported 4 fewer minutes (p=0.038), Spanish-speaking Hispanic/Latine reported 16.9 more minutes (p< 0.0005), Asians/Pacific Islanders reported 4.7 fewer minutes (p=0.042), no difference was seen for American Indians/Alaskan Natives, and Multiracial/Others reported 9.5 fewer minutes (p< 0.0005). Significant interactions were seen for age, education, income, employment, health, and mental health (all p< 0.05). Sleep duration benefits of speaking Spanish were evident especially in younger groups (under age 50, peaking age 30), those with more education, those with higher income, those in better health, those with fewer mental health problems, and those who were employed or were students. Conclusion Spanish-speaking Hispanics/Latine Americans were the only race/ethnicity group to report more sleep than non-Hispanic White adults and showed markedly different relationships versus when including English-speaking Hispanic/Latine adults. This advantage was differentially experienced, though, and depended on age, socioeconomics, and health status. Also, the BRFSS did not ask about primary household language nor English fluency. Future research is needed to explicitly explore acculturation-related explanations and develop linguistically- and culturally-targeted interventions for sleep health, especially for addressing apparent generational and socioeconomic differences. Support (if any)

Background: Dendritic cells (DCs) play a critical role in anti-tumor immune response. However, tumor-induced immunosuppression promotes DC dysfunction and T cell exhaustion resulting in evasion of tumor immunity. In this study, we aimed to compare two approaches for engaging DCs and inducing an immune response to tumor antigens in the absence of tumor (melanoma) Methods: This is a Phase II open-label, randomized, two-arm study to compare Arm A: Poly-ICLC-matured DC+PolyICLC to Arm B: Montanide ISA-51-VG+Poly-ICLC, as adjuvants for NY-ESO-1 and Melan-A/MART-1 long peptides in patients with melanoma in complete clinical remission but at high risk of disease recurrence (NCT02334735). Each arm also received helper peptide, keyhole limpet hemocyanin (KLH) with the first vaccine and Poly-ICLC on day 2 of each vaccine. 36 patients were consented and randomized. Of these, 31 subjects received treatment, 16 in Arm A and 15 in Arm B. Immunohistochemistry (IHC) was used to determine expression of NY-ESO-1 and Melan-A/MART-1 and to determine the immune infiltrate landscape in the primary tumors. Humoral responses, TCR clonality, and inflammatory pathways were assessed by ELISA, bulk TCR sequencing, and Olink, respectively. Functional T-cell responses were investigated ex-vivo by interferon (IFN)-g enzyme-linked immunospot assay (ELISPOT) and after expansion by intracellular cytokine staining. Results: Arm B induced a stronger humoral response vs Arm A against both Melan-A/MART-1 and NY-ESO-1. A stronger ex vivo IFN-g response as well as expanded CD4+ T cell response against NY-ESO-1 was also induced in Arm B. However, the response to Melan-A/MART-1, as measured by ex vivo ELISPOT and expanded CD4+T cell assay, was comparable in both arms. Interestingly, while similar proportions of patients in each arm displayed a CD8+ T cell response to NYESO-1, more patients in Arm A vs Arm B responded with a CD8+ T cell response to Melan-A/MART-1 (9/16 responders in Arm A vs 4/14 in Arm B). Melan-A expression was observed in 81% of the patients but did not correlate with antigen specific immune response. TCR sequencing, Olink analysis and evaluation of NY-ESO-1 expression and immune infiltrates in the primary tumors is ongoing. Conclusion: This trial reached the primary endpoint of safety and tolerability. Arm B induced a stronger antibody and CD4+ T cell response, especially to NY-ESO-1, whereas the Arm A vaccine appears to be more efficient at eliciting CD8+ T cell responses against MelanA/MART1. The seemingly enhanced CD8 T cell response in Arm A versus Arm B, could be attributed to frequency of specific HLA-I alleles in either arm or pre-existing immune response in select patients. A deeper investigation into correlation between HLA type and cellular immune response to vaccine is ongoing. Citation Format: Mansi Saxena, Ashleih Burke, Anna Pavlick, Ana Blazquez, Gustavo Gimenez, Marcia Meseck, Michael Donovan, Denise Rodriguez, Mireia Castillo-Martin, Tin Htwe Thin, Rachel Sabado, John Mandeli, Sacha Gnjatic, Philip Friedlander, Nina Bhardwaj. Immunogenicity of Poly-ICLC matured dendritic cells as an adjuvant for NY-ESO-1 and Melan-A-MART-1 peptide vaccination compared to Montanide® ISA-51 VG, in study subjects with melanoma in complete clinical remission but at high risk of disease recurrence [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT108.

Hypertension is a chronic condition that disproportionately affects African Americans. Managing high blood pressure (HBP) requires adherence to daily medication. However, many patients with hypertension take their HBP medication inconsistently, putting them at heightened risk of heart disease. Researchers have shown that these health risks are greater for African Americans than for Caucasians. In this article, we examine barriers and facilitators of medication adherence among urban African Americans with hypertension. We interviewed 24 African Americans with hypertension (58.5% women, average age 59.5 years) and conducted a comprehensive thematic analysis. Twenty-two barriers and 32 facilitators to medication adherence emerged. Barriers included side effects and forgetting while facilitators included reminders, routines, and social support. Using this data, we developed a diagram of theme connectedness of factors that affect medication adherence. This diagram can guide multi-level HBP intervention research that targets African Americans to promote medication adherence, prevent heart disease, and reduce ethnic and racial health disparities.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new human disease with few effective treatments

Background Since December 2019, Coronavirus Disease 2019 (COVID-19) has become a global pandemic, causing mass morbidity and mortality. Prior studies in other respiratory infections suggest that convalescent plasma transfusion may offer benefit to some patients. Here, the outcomes of thirty-nine hospitalized patients with severe to life-threatening COVID-19 who received convalescent plasma transfusion were compared against a cohort of retrospectively matched controls. Methods Plasma recipients were selected based on supplemental oxygen needs at the time of enrollment and the time elapsed since the onset of symptoms. Recipients were transfused with convalescent plasma from donors with a SARS-CoV-2 (severe acute respiratory disease coronavirus 2) anti-spike antibody titer of ³1:320 dilution. Matched control patients were retrospectively identified within the electronic health record database. Supplemental oxygen requirements and survival were compared between plasma recipients and controls. Results Convalescent plasma recipients were more likely than control patients to remain the same or have improvements in their supplemental oxygen requirements by post-transfusion day 14, with an odds ratio of 0.86 (95% CI: 0.75∼0.98; p = 0.028). Plasma recipients also demonstrated improved survival, compared to control patients (log-rank test: p = 0.039). In a covariates-adjusted Cox model, convalescent plasma transfusion improved survival for non-intubated patients (hazard ratio 0.19 (95% CI: 0.05 ∼0.72); p = 0.015), but not for intubated patients (1.24 (0.33∼4.67); p = 0.752). Conclusions Convalescent plasma transfusion is a potentially efficacious treatment option for patients hospitalized with COVID-19; however, these data suggest that non-intubated patients may benefit more than those requiring mechanical ventilation.

As police departments across the United States equip officers with body worn cameras (BWCs), research has focused on the technology’s impact on police interactions with citizens, officer misconduct, officer use of force, and false allegations against police. Given the large number of police agencies implementing BWCs across the country (numbering in the thousands), there will be a growing number of opportunities for BWC evaluations and expectations that these programs will be evaluated. Studying the implementation of BWCs presents a number of challenges to both researchers and police agencies, particularly when large police organizations are involved. Drawing on our experiences involving a BWC experiment with the Las Vegas Metropolitan Police Department, this article discusses the programmatic challenges of implementing a BWC program in a large agency (technical, political, and administrative) while simultaneously evaluating the program using a randomized controlled trial design.

This study sought to determine whether deficient Igf1 expression in osteocytes would affect loading-induced osteogenic response. Tibias of osteocyte Igf1 conditional knockout (KO) mice (generated by cross-breeding Igf1 floxed mice with Dmp1- Cre transgenic mice) and wild-type (WT) littermates were subjected to four-point bending for 2 wk. Microcomputed tomography confirmed that the size of tibias of conditional mutants was smaller. Loading with an equivalent loading strain increased periosteal woven bone and endosteal lamellar bone formation in WT mice but not in conditional KO mice. Consistent with the lack of an osteogenic response, the loading failed to upregulate expression of early mechanoresponsive genes ( Igf1, Cox-2, c-fos) or osteogenic genes ( Cbfa-1, and osteocalcin) in conditional KO bones. The lack of osteogenic response was not due to reduced osteocyte density or insufficient loading strain. Deficient osteocyte Igf1 expression reduced the loading-induced upregulation of expression of canonical Wnt signaling genes ( Wnt10b, Lrp5, Dkk1, sFrp2). The loading also reduced (by 40%) Sost expression in WT mice, but the loading not only did not reduce but upregulated (∼1.5-fold) Sost expression in conditional KO mice. Conditional disruption of Igf1 in osteocytes also abolished the loading-induced increase in the bone β-catenin protein level. These findings suggest an impaired response in the loading-induced upregulation of the Wnt signaling in conditional KO mice. In summary, conditional disruption of Igf1 in osteocytes abolished the loading-induced activation of the Wnt signaling and the corresponding osteogenic response. In conclusion, osteocyte-derived IGF-I plays a key determining role in bone mechanosensitivity.