Nursing Educators' Knowledge, Skills in Evidence-Based Practice and their Critical Thinking Skills: Self Report Study

Background: With increasing emphasis on EBNP, nursing educators need to have a strong body of knowledge and skills in EBP that help them to gain critical thinking skills related to inquiry and understand the importance of EBNP. Aims: To assess the nursing educators' report of their knowledge and skills in EBP, determine their critical thinking skills and investigate the relationship between their knowledge and skills in EBP and their critical thinking skills. Method: Two questionnaires were filled by 144 of nursing educators at nine academic nursing departments at the Faculty of Nursing, Alexandria University. Findings: The mean score percentage of the nursing educator's report of their knowledge and skills in EBP were 67.7±15.8 and 68.9±14.3 respectively. Furthermore, the highest mean score percentage of nursing educators' skills in critical thinking was found in their inquisitiveness skills (75.0±7.7). On the other hand, the lowest mean score percentage was found in truth seeking (55.5±11.6) and maturity skills (56.6±2.7). Highly significant positive correlations were found between the overall mean score percentages of nursing educators’ report of their knowledge and skills in EBP from one side and their critical thinking skills (r= 0.408, p .000, r=0.321, p .000). Conclusions: Understanding nursing educators' knowledge and skills in EBP is a critical step to successfully transforming the school's culture to an EB framework for teaching nursing practice, integrating of EBP content into curricula, and ensuring student mastery and appreciation of EBP. Keywords: evidence-based practice, knowledge, skills, critical thinking, nursing educator

Enhancing Corrosion Resistance of Stainless Steel 304 Using Laser Surface Treatment

Stainless steel AISI 304 was laser treated to enhance corrosion resistance and improve surface properties. This alloy has many applications in auto industry (car body) as well as oil and gas industry. Different conditions were applied in the laser surface treatment, namely: laser power density, scan speed, distance between paths, medium gas (air, argon and nitrogen). After laser treatment, the samples microstructures were investigated using optical microscope to examine microstructural changes due to laser irradiation. Specimen surfaces were investigated using XRD, SEM and EDAX before and after laser treatment to examine the surface composition changes brought by laser irradiation. Results showed that laser irradiation enhances the corrosion resistance of AISI 304 Stainless steel to a large extent. Corrosion rates as low as 0.011 mpy for laser treated samples were obtained in comparison to 0.952 mpy obtained for the untreated samples. Superior pitting corrosion resistance was obtained under specific treatment conditions. The enhancement of corrosion resistance depends on the laser irradiation conditions. The corrosion protection afforded by laser treatment is attributed mainly to the grain refinement of the top surface layer. This layer is found to consist of nano-scale grains

The influence of the preparation methods on the inclusion of model drugs in a β-cyclodextrin cavity

NOTICE: this is the author’s version of a work that was accepted for publication in European Journal of Pharmaceutics and Biopharmaceutics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Eur J Pharm Biopharm. 2009 Feb;71(2):377-386. Epub 2008 Oct 17.The work aims to prove the complexation of two model drugs (ibuprofen, IB and indomethacin, IN) by bcyclodextrin (bCD), and the effect of water in such a process, and makes a comparison of their complexation yields. Two methods were considered: kneading of a binary mixture of the drug, bCD, and inclusion of either IB or IN in aqueous solutions of bCD. In the latter method water was removed by air stream, spray-drying and freeze-drying. To prove the formation of complexes in final products, optical microscopy, UV spectroscopy, IR spectroscopy, DSC, X-ray and NMR were considered. Each powder was added to an acidic solution (pH = 2) to quantify the concentration of the drug inside bCD cavity. Other media (pH = 5 and 7) were used to prove the existence of drug not complexed in each powder, as the drugs solubility increases with the pH. It was observed that complexation occurred in all powders, and that the fraction of drug inside the bCD did not depend neither on the method of complexation nor on the processes of drying considered

Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial

Background: The STICH trial showed superiority of coronary artery bypass plus medical treatment (CABG) over medical treatment alone (MED) in patients with left ventricular ejection fraction (LVEF) ≤35%. In previous publications, percutaneous coronary intervention (PCI) prior to CABG was associated with worse prognosis. Objectives: The main purpose of this study was to analyse if prior PCI influenced outcomes in STICH. Methods and results: Patients in the STICH trial (n = 1212), followed for a median time of 9.8 years, were included in the present analyses. In the total population, 156 had a prior PCI (74 and 82, respectively, in the MED and CABG groups). In those with vs. without prior PCI, the adjusted hazard-ratios (aHRs) were 0.92 (95% CI = 0.74–1.15) for all-cause mortality, 0.85 (95% CI = 0.64–1.11) for CV mortality, and 1.43 (95% CI = 1.15–1.77) for CV hospitalization. In the group randomized to CABG without prior PCI, the aHRs were 0.82 (95% CI = 0.70–0.95) for all-cause mortality, 0.75 (95% CI = 0.62–0.90) for CV mortality and 0.67 (95% CI = 0.56–0.80) for CV hospitalization. In the group randomized to CABG with prior PCI, the aHRs were 0.76 (95% CI = 0.50–1.15) for all-cause mortality, 0.81 (95% CI = 0.49–1.36) for CV mortality and 0.61 (95% CI = 0.41–0.90) for CV hospitalization. There was no evidence of interaction between randomized treatment and prior PCI for any endpoint (all adjusted p > 0.05). Conclusion: In the STICH trial, prior PCI did not affect the outcomes of patients whether they were treated medically or surgically, and the superiority of CABG over MED remained unchanged regardless of prior PCI. Clinical trial registration: Clinicaltrials.gov; Identifier: NCT0002359

Genome-wide association study for systemic lupus erythematosus in an egyptian population

Systemic lupus erythematosus (SLE) susceptibility has a strong genetic component. Genome-wide association studies (GWAS) across trans-ancestral populations show both common and distinct genetic variants of susceptibility across European and Asian ancestries, while many other ethnic populations remain underexplored. We conducted the first SLE GWAS on Egyptians–an admixed North African/Middle Eastern population–using 537 patients and 883 controls. To identify novel susceptibility loci and replicate previously known loci, we performed imputation-based association analysis with 6,382,276 SNPs while accounting for individual admixture. We validated the association analysis using adaptive permutation tests (n = 109). We identified a novel genome-wide significant locus near IRS1/miR-5702 (Pcorrected = 1.98 × 10−8) and eight novel suggestive loci (Pcorrected 0.8) with lead SNPs from four suggestive loci (ARMC9, DIAPH3, IFLDT1, and ENTPD3) were associated with differential gene expression (3.5 × 10−95 < p < 1.0 × 10−2) across diverse tissues. These loci are involved in cellular proliferation and invasion—pathways prominent in lupus and nephritis. Our study highlights the utility of GWAS in an admixed Egyptian population for delineating new genetic associations and for understanding SLE pathogenesis

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Споживча цінність послуг, залучення споживачів та лояльність бренду оздоровчих центрів Єгипту

Метою даної статті є аналіз концепції споживчої цінності, описаної вченими Сенгіз та Кіркбір (2007), з точки зору восьми ключових оціночних індикаторів впливу на залучення споживачів та рівень їх лояльності. Автори зазначають, що кожен з восьми індикаторів споживчої цінності послуг розглядався окремо у попередніх дослідженнях. Тому у цій статті представлено результати врахування сили дії усіх індикаторів споживчої цінності послуг на зростання кількості залучених клієнтів та рівня їх лояльності на прикладі оздоровчих центрів Єгипту. Об’єкт дослідження було обрано виходячи з тенденції стрімкого зростання обсягу ринку оздоровчих послуг в Єгипті. Імпульсом зростання зазначеного ринку було залучення клієнтів до процесу формування асортименту та плану надання послуг: місячні програми з фітнесу, позитивні/негативні рекомендації конкретного оздоровчого центру своїм друзям, родичам та іншим випадковим користувачам у соціальних мережах, а також отримання відчуття приналежності до конкретного оздоровчого центру. Окрім цього, у багатьох оздоровчих центрах також було створено активний механізм отримання скарг та залучення клієнтів до процесу вирішення виявлених проблем. Запроваджені зміни в системі надання оздоровчих послуг призвело до активізації позитивних поведінкових намірів клієнтів. Емпіричні результати роботи ґрунтуються на анкетуванні через особисті інтерв'ю з респондентами у різних оздоровчих центрах. Дослідженням охоплено 400 користувачів оздоровчих центрів з цільовою групою – підлітки, молодь та доросле населення. Крім того, було розглянуто вплив бренду оздоровчого центру на взаємозв’язок між задоволенням і рівнем залучення клієнтів. Визначено вплив віку цільової аудиторії на взаємозв'язок між якістю послуг і рівнем залучення клієнтів. Авторами перевірено вплив рівня залучення клієнтів на взаємозв'язок між контролем та лояльністю споживачів.This study focused on examining the effect of Cengiz & Kirkbir (2007)’s eight dimensions of perceived value on customer engagement and customer loyalty. Each of the eight dimensions of perceived service value has been studied separately in previous studies. Therefore, this research provides an integrative framework to examine the role all the dimensions of perceived service value in increasing customer engagement and loyalty in health care centres in Egypt. Healthcare centres were chosen because the degree of engagement in the service delivery process has started to increase in the past few years such as engaging the customers in the service delivery plan (e.g. Fitness Monthly Programs), the mechanism of positive/negative recommendation of specific healthcare centres to their friends and family, also to other random users on online social networks, and acquiring a high sense of belonging to their healthcare centre. This has resulted in a great degree of positive behavioural intentions. Also, the active mechanism of receiving complaints and involving the customers in its solving process has been applied in many health care centres. The study focused on the adolescents, youths and adults since they represent the majority of the healthcare centres users according to the context understudy (based on the exploratory research conducted). This research targeted 400 healthcare centres users. In addition, the moderation effect of the brand name of health care centre on the relationship between Hedonics and Customer Engagement was examined. Also, the moderating effect of age on the relationship between service quality and customer engagement was tested. Finally, the mediating effect of customer engagement mediates the relationship between control and customer loyalty was examined

Competitive exclusion of Yersinia enterocolitica biotype 4, serotype O:3 by Yersinia enterocolitica biotype 1A, serotype O:6, 30 in tissue culture and in pigs

AIMS: To study the adhesion properties of a biotype 4, serotype O:3 (human pathogenic) strain of Yersinia enterocolitica and to determine if adhesion in vitro and colonisation in vivo can be prevented by competition with a biotype 1A, serotype O:6,30 (non-pathogenic) strain. To study interaction between Y. enterocolitica biotype 4, serotype O:3 and cultured epithelial cells using the synthetic tripeptide arginine-glycine-aspartic acid (RGD). METHODS: The human intestinal epithelial (HEp-2) cell line was used for in vitro studies. Inocula of Y. enterocolitica biotype 4, serotype O:3 radiolabelled using tritium were incubated with HEp-2 cells and RGD tripeptide, or with Y. enterocolitica biotype 1A, serotype O:6,30 sequentially or concurrently, then washed and lysed, and radioactivity measured to determine the effect of RGD on adhesion, and competitive exclusion of pathogenic by non-pathogenic bacteria. For in vivo studies, two groups of 5-week-old piglets (n=5/group) were sequentially inoculated orally with 5x109 colony forming units (cfu) of either a non-pathogenic biotype 1A, serotype O:6,30 strain of Y. enterocolitica followed by a pathogenic biotype 4, serotype O:3 strain, or vice versa. Pigs were monitored for carriage of strains using bacterial culture and a multiplex polymerase chain reaction (PCR). RESULTS: The RGD tripeptide significantly inhibited adherence of the pathogenic Y. enterocolitica strain to cultured epithelial cells, suggesting that adhesion involved the RGD tripeptide sequence. The non-pathogenic biotype 1A, serotype O:6,30 strain of Y. enterocolitica prevented adhesion of the pathogenic strain to cells in vitro when allowed to adhere first. Pathogenic Y. enterocolitica was consistently isolated from rectal swabs from 80–100% of pigs on all sampling occasions but not from oral swabs after 14 days in pigs first inoculated with the non-pathogenic strain or at 26 days in pigs first inoculated with the pathogenic strain. CONCLUSIONS: A non-pathogenic strain of Y. enterocolitica reduced adhesion of a human pathogenic strain in vitro but not in vivo