Midwifery and Nursing Students' Communication Skills and Life Orientation: Correlation with Stress Coping Approaches

Background: Methods learnt by nursing and midwifery students’ such as communication skills, optimisim and coping with stress would be used in their profeesional life. It is very important to promote their positive thinking and communication skills to raise coping with stress. Objectives: This cross sectional study was performed to examine the nursing and midwifery students’ communication skills and optimistic life orientation and its correlation with coping strategies with stress. Materials and Methods: The study population included 2572 students who were studying in departments of nursing and midwifery in Istanbul. The sample was included 1419 students. Three questionnaires including Communication Skills Test, Life Orientation Test and Ways of Coping Inventory were used for data collection. The data were evaluated by calculating frequency, percentage, arithmetic mean, standard deviation and Pearson correlation coefficient. Results: Students’ total mean score from the Communication Skills Scale was 165.27 ± 15.39 and for the Life Orientation Test was 18.51 ± 4.54. There was a positive correlation between their Life Orientation scores and the scores for self confidence (r = 0.34, P < 0.001), optimistic approach (r = 0.42, P < 0.001), and seeking social help (r = 0.17, P < 0.001). Also there was a significant positive correlation between Communication skill scores and self confidence (r = 0.46, P < 0.001), optimistic (r = 0.37, P < 0.001) and seeking social help approaches (r = 0.29, P < 0.001), but there was a significant negative correlation between communication skill scores and scores for helpless (r = -0.29, P < 0.001) and submissive approaches (r = -0.36, P < 0.001). Conclusions: As scores of students in optimistic life orientation and communication skills increased self confidence approach, optimistic, and social support seeking scores increased, whereas helpless, and submissive scores decreased

Business Value from Closed-loop Supply Chains

This study provides a complete framework to define and classify the value that firms can attain by their closed-loop supply chains (CLSC) and analyzes the role of information systems (IS) in this process. We present a novel typology to identify the four value types a firm can generate in CLSCs, namely sourcing, environmental, customer, and informational value. Particularly the last two types have not been recognized in literature. We adopt a case methodology and analyze 8 cases to illustrate the generation of each value type through CLSCs and highlight the role that IS play in this value generation. We ground our analysis on the integrative model of IT business value in [30] which considers the role of external business partners, which is essential to CLSCs. We find 3 key results: (1) IS is an essential enabler for all value types, (2) while sourcing value and to some extent environmental value, can be created with IS internal to the firm, the novel value types (customer and informational) can only be created with extraorganizational IS, (3) the value created by extraorganizational systems can only be created if the appropriate intraorganizational systems are in place. Our findings show that substantial value can be gained from implementing IS in CLSCs but stakeholder collaboration is necessary to reap the full value. This is an important managerial insight for the firms who still consider CLSC activities as costly and do not notice all the benefits that they can obtain from CLSCs

Targeting p110gamma in gastrointestinal cancers: attack on multiple fronts

Phosphoinositide 3-kinases (PI3Ks) regulate several cellular functions that are critical for cancer progression and development, including cell survival, proliferation and migration. Three classes of PI3Ks exist with the class I PI3K encompassing four isoforms of the catalytic subunit known as p110α, p110β, p110γ, and p110δ. Although for many years attention has been mainly focused on p110α recent evidence supports the conclusion that p110β, p110γ, and p110δ can also have a role in cancer. Amongst these, accumulating evidence now indicates that p110γ is involved in several cellular processes associated with cancer and indeed this specific isoform has emerged as a novel important player in cancer progression. Studies from our laboratory have identified a specific overexpression of p110γ in human pancreatic ductal adenocarcinoma (PDAC) and in hepatocellular carcinoma (HCC) tissues compared to their normal counterparts.Our data have further established that selective inhibition of p110γ is able to block PDAC and HCC cell proliferation, strongly suggesting that pharmacological inhibition of this enzyme can directly affect growth of these tumors. Furthermore, increasing evidence suggests that p110γ plays also a key role in the interactions between cancer cells and tumor microenvironment and in particular in tumor-associated immune response. It has also been reported that p110γ can regulate invasion of myeloid cells into tumors and tumor angiogenesis. Finally p110γ has also been directly involved in regulation of cancer cell migration. Taken together these data indicate that p110γ plays multiple roles in regulation of several processes that are critical for tumor progression and metastasis. This review will discuss the role of p110γ in gastrointestinal tumor development and progression and how targeting this enzyme might represent a way to target very aggressive tumors such as pancreatic and liver cancer on multiple fronts

The Limits to Moral Erosion in Markets: Social Norms and the Replacement Excuse

This paper studies the impact of a key feature of competitive markets on moral behavior: the possibility that a competitor will step in and conclude the deal if a conscientious market actor forgoes a profitable business opportunity for ethical reasons. We study experimentally whether people employ the argument "if I don’t do it, someone else will" to justify taking a narrowly self-interested action. Our data reveal a clear pattern. Subjects do not employ the "replacement excuse" if a social norm exists that classifies the selfish action as immoral. But if no social norm exists, subjects are more inclined to take a selfish action in situations where another subject can otherwise take it. By demonstrating the importance of social norms of moral behavior for limiting the power of the replacement excuse, our paper informs the long-standing debate on the effect of markets on morals

Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE)

Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center. Conclusion: The proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities. © 202

Variability in cytochrome P450 2D6 and 1A2 activities during treatment with selective serotonin reuptake inhibitor antidepressants, relevance for antipsychotic pharmacokinetics and side effects

grantor: University of Toronto'Background'. The selective serotonin reuptake inhibitor (SSRI) antidepressants paroxetine, sertialine and fluvoxamine inhibit CYP2D6 and CYP1A2 isozymes in vitro. CYP2D6 and CYP1A2 contribute to disposition of 30 or more frequently used medications including antipsychotics. The studies presented in this thesis tested the effect of paroxetine on CYP2D6 activity in vivo and its clinical importance in relation to perphenazine (a CYP2D6 substrate) pharmacokinetics and side effects. The effects of different SSRIs on CYP2D6 and CYP1A2 activities were also compared in vivo. 'Methods. Study 1': Eight healthy volunteers with an extensive metabolizer (EM) phenotype for CYP2D6 were administered a single oral dose of perphenazine (0.11 mg/kg) or placebo in a randomized double blind manner. Perphenazine plasma concentration and side effects were assessed for eight hours after drug administration. Subsequently, subjects were administered paroxetine (20 mg/day) for 10 days and test sessions with perphenazine and placebo were repeated. 'Study 2': Patients and healthy volunteers were treated with paroxetine (17.7 mg/day ± 4.4) (mean ± SD), sertraline (93.5 mg/day ± 26.4) or fluvoxamine (83.3 mg/day ± 25.0) for 5 to 74 days. AD subjects had an EM phenotype for CYP2D6 and received a single oral dose of dextromethorphan (30 mg) and caffeine (100 mg) before and after SSRI treatment. The log 'O'-demethylation ratio (ODMR) of dextromethorphan and the caffeine metabolic ratio in overnight urine were used as in vivo indices of the CYP2D6 and CYP1A2 isozyme activities, respectively. 'Results. Study 1': Perphenazine peak plasma concentration increased 2- to 13-fold after paroxetine treatment (p 0.05). The baseline caffeine metabolic ratio (5.1 ± 1.3) decreased only after fluvoxamine (2.8 ± 1.1) treatment (p < 0.05). The extent of inhibition of CYP2D6 and CYP1A2 by paroxetine and fluvoxamine, respectively, correlated with baseline enzyme activity (p < 0.05). 'Conclusion'. Paroxetine and fluvoxamine cause a significant inhibition of CYP2D6 and CYP1A2, respectively, in vivo. The inhibition of CYP2D6 by paroxetine results in an increase in perphenazine plasma concentration and side effects. A reduction of perphenazine dose is recommended during concurrent treatment with paroxetine. These results have potential ramifications for inter-individual variability in the risk for drug-drug interactions mediated by CYP2D6 and CYP1A2.Ph.D

Attack Dynamics: An Automatic Attack Graph Generation Framework Based on System Topology, CAPEC, CWE, and CVE Databases

Through a built-in security analysis feature based on metadata, this article provides a novel framework that starts with a scenario input and produces a collection of visualizations based on Common Attack Pattern Enumeration and Classification (CAPEC) and Common Weakness Enumeration (CWE) Standards. It immediately links enterprise mitigations from MITRE ATT&CK framework to the security flaws it discovered. It's also integrated with a third-party optimization tool targeted at cutting security costs for businesses, which it can perform in real-time or later using JSON output in the preferred format, depending on the execution mode. All of these stages are conducted without human intervention. Adaptive metadata with a variety of rules for capturing different sorts of known or prospective attack types allows for the production of attack graphs. It can be used as a quick and practical what-if analysis tool to detect potential intrusions for a variety of network configuration setups and assigned access privileges. As a threat modeler, it is suitable for both novice and expert users. Due to the easy input scheme and human-readable outputs, it can also be utilized as an educational tool