Dentontrue7161
This discursive paper provides a call to action from an international collective of Indigenous nurse academics from Australia, Canada, Aotearoa New Zealand and the USA, for nurses to be allies in supporting policies and resources necessary to equitably promote Indigenous health outcomes.
Indigenous Peoples with experiences of colonisation have poorer health compared to other groups, as health systems have failed to address their needs and preferences. Achieving health equity will require leadership from Indigenous nurses to develop and implement new systems of care delivery. However, little is known about how Indigenous nurses influence health systems as levers for change.
A Kaupapa Māori case study design.
Using a Kaupapa Māori case study methodology, coupled with expert Indigenous nursing knowledge, we developed a consensus on key themes. Themes were derived from three questions posed across the four countries. Themes were collated to illustrate how Indigenous nurses have provided nursing leadershipurse leaders around the world is essential for improving models of healthcare delivery and health outcomes for Indigenous Peoples.
To (i) characterise prevalence of distress amongst people diagnosed with cancer, (ii) determine factors associated with increasing distress, (iii) describe reported problems for those with clinically significant distress and (iv) investigate the factors associated with referral to support services.
International studies report a high prevalence of clinically significant distress in people with cancer. Australian studies are notably lacking. Additionally, clinicians still do not fully understand the factors associated with cancer-related distress.
Period prevalence study.
Distress screening data were analysed for 1,071 people accessing the Cancer Council Western Australia information and support line between 01/01/2016-31/12/2018. These data included people's demographics, cancer diagnoses, level of distress, reported problems and the service to which they were referred. Distress and reported problems were measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List. A may be more influential to referral decisions.
Not all factors associated with referral to support services were those associated with increasing levels of distress. This suggests that other factors may be more influential to referral decisions.The aim of the current study was to investigate the performance of integrated RF transmit arrays with high channel count consisting of meander microstrip antennas for body imaging at 7 T and to optimize the position and number of transmit elements. RF simulations using multiring antenna arrays placed behind the bore liner were performed for realistic exposure conditions for body imaging. Simulations were performed for arrays with as few as eight elements and for arrays with high channel counts of up to 48 elements. The B1 + field was evaluated regarding the degrees of freedom for RF shimming in the abdomen. Worst-case specific absorption rate (SARwc ), SAR overestimation in the matrix compression, the number of virtual observation points (VOPs) and SAR efficiency were evaluated. Constrained RF shimming was performed in differently oriented regions of interest in the body, and the deviation from a target B1 + field was evaluated. Results show that integrated multiring arrays are able to generate homogeneous B1 + field distributions for large FOVs, especially for coronal/sagittal slices, and thus enable body imaging at 7 T with a clinical workflow; however, a low duty cycle or a high SAR is required to achieve homogeneous B1 + distributions and to exploit the full potential. In conclusion, integrated arrays allow for high element counts that have high degrees of freedom for the pulse optimization but also produce high SARwc , which reduces the SAR accuracy in the VOP compression for low-SAR protocols, leading to a potential reduction in array performance. Smaller SAR overestimations can increase SAR accuracy, but lead to a high number of VOPs, which increases the computational cost for VOP evaluation and makes online SAR monitoring or pulse optimization challenging. Arrays with interleaved rings showed the best results in the study.Although it is accepted that oncologists should plan for a future beyond full-time oncology, there is little practical guidance for a successful transition into retirement. Previously, we provided strategies for various aspects of retirement planning. However, this became significantly more complicated as we face newer issues such as the COVID-19 pandemic, the move to virtual patient care, greater awareness of burnout, and the increasing burden of regulatory issues such as the electronic medical record. It is evident that more prospective information is needed to guide oncologists in planning their retirement.
Hereditary elliptocytosis (HE) is a heterogeneous red blood cell membrane disorder characterized by the presence of elliptocytes on a peripheral blood smear. Clinical manifestations of HE vary widely from asymptomatic carriers to patients with severe transfusion-dependent anemia. Most patients are asymptomatic or have mild anemia, which hinders diagnosis. The proband in this case had mild anemia and jaundice over a period of 4years, the etiology of which was unclear. Hence, he was admitted to our hospital for further diagnosis.
Peripheral blood smears and routine blood tests were performed and biochemical parameters of the proband, and his family members were determined. To confirm the diagnosis, gene mutations were screened in the proband using next-generation sequencing (NGS) and verified by Sanger sequencing in other family members.
A novel mutation (c.1294delA, p.Ser432fs) in exon 15 of the EPB41 gene was detected in the proband and his family members. This mutation results in a frameshift and a premature stop codon at position 455, encoding a truncated protein. The variant was likely pathogenic according to the criteria of the American College of Medical Genetics and Genomics. SWISS-MODEL protein structure prediction indicated partial loss of the spectrin and actin binding and C-terminal domains.
A heterozygous mutation 1294delA in exon 15 of the EPB41 gene was identified using NGS and Sanger sequencing in members of a Chinese family. This identification expands the spectrum of EPB41 mutations and contributes to the genetic diagnosis of families with HE.
A heterozygous mutation 1294delA in exon 15 of the EPB41 gene was identified using NGS and Sanger sequencing in members of a Chinese family. This identification expands the spectrum of EPB41 mutations and contributes to the genetic diagnosis of families with HE.Mixed-type gastric adenocarcinoma (by Lauren Classification) has poor clinical outcomes with few targeted treatment options. The primary objective of this study was to find the prognostic factors, accurate treatment approaches, and effective postoperative adjuvant therapy strategies for patients with mixed-type gastric adenocarcinoma (GA). A microRNA sequencing data set and the corresponding clinical parameters of patients with gastric cancer were obtained from The Cancer Genome Atlas. Differentially expressed microRNAs (DEMs) of diffuse- and intestinal-type GA were, respectively, determined. Kaplan-Meier and log-rank tests were subsequently carried out to evaluate the prognostic relevance of each DEM. To study the common factors between diffuse- and intestinal-type GA, a pathway enrichment analysis was performed on the target genes of identified DEMs using the PANTHER database. After data preprocessing, we analyzed a total of 230 samples from 210 patients with GA. Eighty-six DEMs in diffuse-type GA samples and 59 DEMs in intestinal-type GA samples were, respectively, identified (p 2.0). The Kaplan-Meier survival method further screened out six prognosis-related DEMs for diffuse-type GA and seven prognosis-related DEMs for intestinal-type GA (p less then 0.05). MiR-18a-5p was found to be the only common prognosis-related DEM between diffuse- and intestinal-type GA. The common signaling pathways further revealed that target genes of miR-18a-5p are involved in mixed-type GA progression. this website This study suggests that miR-18a-5p acts as a potential target for treatment, and common signal pathways provide a rich basis to seek reliable and effective molecular targets for the diagnosis, clinical treatment, and postoperative adjuvant therapy strategy of mixed-type GA.
Auditory and non-auditory safety concerns associated with the appreciable sound levels inherent to magnetic resonance imaging (MRI) procedures exist for neonates. However, current gaps in knowledge preclude making an adequate risk assessment.
To measure acoustic exposure (duration, intensity, and frequency) during neonatal brain MRI and compare these values to existing hearing safety limits and data.
Phantom.
Cylindrical doped water phantom.
Neonatal brain protocols acquired at 1-3 T. Scans in the model protocol included a diffusion tensor imaging scan, a gradient echo, a three-dimensional (3D) fast spin echo, 3D fast spin-echo single-shots, a spin echo, a turbo spin echo, a 3D arterial spin labeling scan, and a susceptibility-weighted fast spin-echo scan.
The sound pressure levels (SPLs), frequency profile, and durations of five neonatal brain protocols on five MR scanners (scanner A [3 T, whole-body], scanner B [1.5 T, whole-body], scanner C [1 T, dedicated neonatal], scanner D [1.5 T, whole-body], and scanner E [3 T, whole-body]) located at three different sites were recorded. The SPLs were then compared to the International Electrotechnical Commission (IEC) hearing safety limit and existing data of infant non-auditory responses to loud sounds to assess risk.
Mann-Whitney U test to assess whether the dedicated neonatal scanner was quieter than the other machines.
The average level A-weighted equivalent value (LAEQ) across all five MR scanners and scans was 92.88 dBA and the range of LAEQs across all five MR scanners and scans was 80.8-105.31 dBA. The duration of the recorded neonatal protocols maintained by neonatal scanning facilities (from scanners A, B, and C) ranged from 2733 to 3706 minutes.
Neonatal protocol sound levels straddled existing notions of risk, exceeding sound levels known to cause non-auditory responses in neonates but not exceeding the IEC MRI SPL safety limit.
5 TECHNICAL EFFICACY Stage 5.
5 TECHNICAL EFFICACY Stage 5.
Myocardial infarction (MI) is the most predominant type of cardiovascular diseases with high mortality and morbidity. Stem cell therapy, especially cardiac progenitor cell therapy, has been proposed as a promising approach for cardiac regeneration and MI treatment. Previously, we have successfully generated cardiac progenitor-like cells, induced cardiosphere (iCS), via somatic reprogramming. However, the genome integration characteristic of virus-based reprogramming approach hampered their therapeutic applications due to the risk of tumour formation. In the current study, we aim to establish a safer iCS generation strategy with transgene-free approaches.
Four transgene-free approaches for somatic reprogramming, including episome, minicircle, self-replicative RNA, and sendai virus, were compared, from the perspective of cardiac progenitor marker expression, iCS formation, and cardiac differentiation. The therapeutic effects were assessed in the mouse model of MI, from the perspective of survival rate, cardiac function, and structural alterations.