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Background: To increase retention of prelicensure nursing students, several routes are used for admission to nursing programs. Students can be accepted as an early matriculation (EM) student at the point of university admission or they can follow a traditional competitive approach (TR) for admission. Method: A retrospective matched cohort study design was used to explore the differences among selected academic variables in two groups of prelicensure undergraduate students ( n = 136) in the same program. Results: EM students had significantly lower science grade point averages (GPAs), pre-program GPAs, and junior-level GPAs than TR students. However, there were no significant differences between the two groups in scores on the RN Fundamentals ATI examination, an important predictor of future NCLEX-RN success. Conclusion: EM students were as successful as their counterparts on standardized examinations in the first semester of a nursing program. More research is needed to understand program outcomes associated with students entering nursing programs via different routes. [ J Nurs Educ . 2023;62(5):302–306.]

Applicator conspicuity in ultrasound-guided brachytherapy procedures is commonly impaired by imaging artifacts or non-ideal imaging geometry, which can slow down applicator position digitization and increase the geometric uncertainty of the delivered dose distribution.The purpose of this study was to improve the conspicuity of high-dose rate (HDR) brachytherapy needles under B-mode ultrasound imaging by applying an echogenic surface coating. Our hypothesis was that an echogenic coating would reduce artifacts and improve needle visualization within regions of signal degradation.In this study, 17-gauge, 25-cm long titanium HDR brachytherapy needles were coated with acoustically reflective microspheres over a 2.5 cm region starting from the needle tip. Three coating thicknesses (27 μm, 40 μm, 64 μm) were compared against an uncoated control needle. The coated and uncoated needles were imaged using B-mode ultrasound in a tissue-equivalent prostate phantom and in a cadaverous male pelvis using a transrectal probe. Needle conspicuity was assessed under multiple conditions: a single needle implant, an implant with multiple needles between the probe and the needle of interest, and an angled needle implant. All images were assessed qualitatively for needle conspicuity and the presence of artifacts and quantitatively using gray-scale image intensity values.The 64 μm echogenic coating reduced the magnitude of reverberation artifacts by 31 ± 14% and comet tail artifacts by 40-70%. The echogenic coating also improved needle contrast, measured by the relative differences in signal intensity compared with the adjacent environment, when needles were angled up to 30An echogenic surface coating reduced imaging artifacts and improved needle conspicuity under realistic clinical conditions for ultrasound-based prostate or gynecological brachytherapy. The improved conspicuity has the potential to improve the efficiency of needle placement and the accuracy of needle position digitization during brachytherapy procedures. This article is protected by copyright. All rights reserved.

Background Transitioning to practice during the COVID-19 pandemic multiplied the stressors and challenges typically encountered by new graduate nurses (NGNs), yet research exploring mental health variables of this subset of nurses remains sparse. Method This study used an observational design and convenience sampling. NGN alumni ( n = 192) from a pre-licensure nursing program were surveyed during the summer of 2021 regarding their experiences with resilience, anxiety, depression, and stress while transitioning to practice during the COVID-19 pandemic. Results Participants reported moderate to severe levels of stress (76%), anxiety (27.6%), and depression (31.2%) while transitioning to practice. Most (79%) described themselves as resilient. The highest mean scores for stress, anxiety, and depression occurred during the fourth to eighth month of practice. Conclusion Nursing professional development specialists, managers, and other stakeholders need effective strategies to monitor and promote NGNs' well-being and mental health to prevent burnout and turnover throughout the first year of practice. [ J Contin Educ Nurs . 2022;53(12):533–543.]

PDF file - 176K, Supplementary Figure S1: USP22 Specifically Promotes AR Recruitment to Target Loci. Supplementary Figure 2: Depletion of USP22 can be mediated by multiple sequences.Supplementary Figure S3: AR Ubiquitylation Levels are not Altered in Response to USP22 Depletion.

PDF file - 50K, Primer sequences used in manuscript.

Increasing evidence links deregulation of the ubiquitin-specific proteases 22 (USP22) deubitiquitylase to cancer development and progression in a select group of tumor types, but its specificity and underlying mechanisms of action are not well defined. Here we show that USP22 is a critical promoter of lethal tumor phenotypes that acts by modulating nuclear receptor and oncogenic signaling. In multiple xenograft models of human cancer, modeling of tumor-associated USP22 deregulation demonstrated that USP22 controls androgen receptor accumulation and signaling, and that it enhances expression of critical target genes coregulated by androgen receptor and MYC. USP22 not only reprogrammed androgen receptor function, but was sufficient to induce the transition to therapeutic resistance. Notably, in vivo depletion experiments revealed that USP22 is critical to maintain phenotypes associated with end-stage disease. This was a significant finding given clinical evidence that USP22 is highly deregulated in tumors, which have achieved therapeutic resistance. Taken together, our findings define USP22 as a critical effector of tumor progression, which drives lethal phenotypes, rationalizing this enzyme as an appealing therapeutic target to treat advanced disease. Cancer Res; 74(1); 272–86. ©2013 AACR.

Plane wave (PW) transmission has enabled multiple new applications such as shear wave elastography, ultrafast Doppler imaging, and functional ultrasound imaging. Plane Wave Compounding (PWC), which coherently sums the echo signals from multiple PW transmits with different angles, is widely used to improve B-mode image quality. When the motion between two speckle images is estimated, PWC suffers from an inherent displacement estimation error. This is derived theoretically and experimentally demonstrated in this work. We show that the phase difference between the acquired data with PW emissions with different angles is related to this error. When the absolute value of the phase difference is larger than π/2, the displacement estimation error occurs. A new scheme, named Initial-Phase-Compensated PWC (IPCPWC) is proposed, which compensates the phase of echo signals from each PW transmit and maintains the absolute value of the phase difference smaller than π/2. The increased signal-to-noise ratio and reduced jitter of IPCPWC in motion data are demonstrated using tissue mimicking phantoms compared to PWC.

Although incivility in nursing education is linked with negative physical and psychological effects on students, it is unclear how resilience and stress interact and relate to student incivility. The purpose was to understand the role of resilience and stress with peer incivility in a sample of prelicensure nursing students during coronavirus disease 2019. The study design was cross-sectional and correlational. Data were from an online survey administered to undergraduate nursing students of one college of nursing in a southwestern US state during September-October 2020. In a sample of 490 students, ordinal regression model results supported that including a stress and resilience interaction term resulted in a nonsignificant effect of stress and resilience, as the main effect correlates on low-level uncivil student behavior. More research is needed to understand the prevalence of stress and resilience at different points in prelicensure nursing education so that targeted interventions can be developed and deployed to assist students.

Autonomous through-thickness scratch repair (healing) in coatings requires scratch closure and interfacial molecular sealing. Although qualitative aspects of the first stage of self-healing have been addressed, quantitative description enabling the control over the healing process need further understanding. In this work the polymer-architecture-dependent stored entropic energy during deformation is quantified using the rubber elasticity theory and correlated to the scratch closure degree experimentally observed in microscopic measurements. Using well-defined thermoplastic healing polyurethanes with variable soft phase fraction contents these studies show that pressure-free damage closure of scratches maintaining mechanical integrity during healing is governed by the capability of the polymer to store entropic energy during damage. The storage (and release) of energy is controlled by varying the damage and healing temperatures in relation to the specific viscoelastic length transition (TVLT) and the glass transition temperature (Tg). Damage closure increases linearly with the entropy release and is controlled by two parameters of the network, the junction density and damping factor. If mechanical damage does not lead to storage of mechanical energy healing does not occur.

Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being.The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students.A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress.More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being.Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

Shear wave elastography (SWE) is a method of evaluating mechanical properties of soft tissues. Most current implementations of SWE report the group velocity for shear wave velocity, which assumes an elastic, isotropic, homogenous and incompressible tissue. Local Phase Velocity Imaging (LPVI) is a novel method of phase velocity reconstruction that allows for accurate evaluation of shear wave velocity at specified frequencies. This method’s robustness was evaluated in 11 elastic and 8 viscoelastic phantoms using linear and curvilinear arrays. We acquired data with acoustic radiation force push beams with different focal depths and F-numbers and reconstructed phase velocity images over a wide range of frequencies. Regardless of phantom, push beam focal depth, and reconstruction frequency, using an F-number around 3.0 was found to produce the largest usable area in the phase velocity reconstructions. For elastic phantoms scanned with a linear array, the optimal focal depth, frequency range, and maximum region-of interest (ROI) were 20–30 mm, 100–400 Hz, and 2.70 cm(2), respectively. For viscoelastic phantoms scanned with a linear array, the optimal focal depth, frequency, and maximum ROI were 20–30 mm, 100–300 Hz, 1.54 cm(2), respectively. For the curvilinear array in the same phantoms; optimal focal depth, frequency range, and maximum ROIs were 45–60 mm, 100–400 Hz and 100–300 Hz, and 1.54 cm(2), respectively. Further work will be done to evaluate LPVI reconstructions from inclusion phantoms to simulate nonhomogeneous tissues. Additionally, LPVI will be evaluated in larger volume phantoms to account for wave reflection from the containers when using the curvilinear array.

In breast radiology, ultrasound detection of biopsy markers or clips for localization purposes is often challenging, especially in the axilla. The purpose of this research was to test the hypothesis that the surface roughness of biopsy clips would elicit a twinkling signature on color Doppler, making them more readily identifiable by ultrasound. Ultrasound color Doppler imaging of 12 biopsy markers was performed and consensus scoring of the degree of twinkling (0 [no twinkling] to 4 [exuberant twinkling]) was obtained for each of the markers. The surface roughness characteristics of the markers were measured using 3-D coherence scanning interferometry. The 3 markers scoring at least 3 for twinkling in vitro were cork, Q and Vision. Of these 3 markers, only the cork marker scored a 4 ex vivo and in cadaveric tissue. Surface roughness metrics demonstrated a positive estimated correlation with the twinkling scores (rho = 0.33, 95% CI = [–0.48 to 0.84]). Of the 12 markers tested, the markers that twinkled corresponded to surface roughness measured with non-contact 3-D optical imaging. Qualitatively, lower color scales and color frequencies optimized twinkling, but the most specific qualitative predictor of confidence in twinkling was insensitivity to changes in color scale and color frequency values.

PURPOSE: To evaluate the short-term safety of a nonmetallic twinkle marker and compare its conspicuity at color Doppler US with that of standard breast biopsy clips and radioactive seeds by using B-mode US in axillary lymph nodes. MATERIALS AND METHODS: This prospective study (November 2020–July 2021) of participants with node-positive breast cancer who completed chemotherapy involved placing a twinkle marker at the time of preoperative radioactive seed localization. A five-point scoring system (1 = easiest, 5 = most difficult) was used to rate the ease of identifying the clip, seed, and twinkle marker on postlocalization sonograms, mammograms, specimen radiographs, and gross pathologic specimens. Descriptive statistics were used. RESULTS: Eight women (mean age, 57 years ± 16 [SD]) were enrolled. The median scores for US conspicuity of each device were 3.9 (range, 3.7–5.0) for the radioactive seed, 2.4 (range, 1.0–5.0) for the clip, and 2.0 (range, 1.0–4.3) for the twinkle marker. In six of eight participants, the twinkle marker was the most identifiable at US. The seeds, clips, and twinkle markers were scored “very easy” to identify on seven of eight postlocalization mammograms. The surgeon retrieved all eight twinkle markers 1–3 days after localization. In all 16 interpretations, the seeds, clips, and twinkle markers were rated as very easy to identify on specimen radiographs. The clip was the most difficult device to identify at pathologic examination in all participants, and the twinkle marker was the easiest to identify in seven of eight participants. CONCLUSION: This pilot study demonstrates that the safety and ease of US detection of a twinkling tissue marker may be comparable to a biopsy clip. Keywords: Ultrasonography, US-Doppler, Breast, Localization, Surgery Clinical trial registration no. NCT04674852 © RSNA, 2022

Ultrasound is a key imaging tool for the evaluation of the kidney. Over the last two decades, methods to measure the mechanical properties of soft tissues have been developed and used in clinical practice, though the use in the kidney has not been as widespread as for other applications. The mechanical properties of the kidney are determined by the structure and composition of the renal parenchyma as well as the perfusion characteristics. As pathological processes change these factors, the mechanical properties change and can be used for diagnostic purposes as well as monitoring treatment or disease progression. Ultrasound-based elastography methods for evaluating the mechanical properties of the kidney use focused ultrasound beams to perturb the kidney and then high frame rate ultrasound methods are used to measure the resulting motion. The motion is analyzed to estimate the mechanical properties. This review will describe the principles of these methods and discuss several seminal studies related to characterizing the kidney. Additionally, an overview of the clinical use of elastography methods in native and kidney allografts will be provided. Perspectives on future developments and uses of elastography technology along with other complementary ultrasound imaging modalities will be provided.

Shear wave elastography (SWE) is an ultrasonic technique able to quantitatively assess the mechanical properties of tissues, combining acoustic radiation force and ultrafast imaging. While utilizing coherent plane wave compounding enhances echo and shear wave motion signal-to-noise ratio (SNR), it also reduces the effective pulse repetition frequency (PRF(e)), affecting the accuracy of the measurements of the motion and, consequently, of the material properties. It is important to maintain both high motion SNR and PRF(e), particularly for the characterization of (material and/or geometrical) dispersive tissues such as arteries. This work proposes a method for SWE measurements with high SNR, while maintaining a high PRF(e), using conventional clinical ultrasound scanners. A time alignment process is applied, after acquiring data from plane wave transmissions at different angles. The time alignment uses interpolation to obtain data points at higher frame rates, and the time-aligned data is compounded to increase the SNR. The method is used for SWE in tissue-mimicking phantoms of various stiffness and is compared to traditional plane wave compounding. An increase of 58% and of 36% in spatial and temporal bandwidth compared to conventional plane wave compounding, respectively, can be achieved for SWE measurements of representative arterial stiffness values. Improvements on phase velocity accuracy and bandwidth in an arterial phantom are also presented, to emphasize the beneficial advantage in dispersive cases.