A mixed methods study using case studies prepared by nursing students as a clinical practice evaluation tool

Aim: To identify the presence of variability in the evaluation of case studies prepared by nursing students during their primary care rotations based on the existing evaluation rubric. To explore the difficulties experienced by link lecturers and students in preparing and evaluating case studies. Design: A mixed methods study. Methods: The scores for the rubric items and the final grades for the case studies were collected from a sample of 132 cases. Qualitative information was collected by conducting open-ended interviews with lecturers and a focus group session with students. Results: Statistically significant differences were identified between the lecturers' mean final grades [F(5.136) = 3.984, p = 0.002] and a variety of items in the evaluation rubric (p < 0.05). In addition, effect sizes [η2 (≈0.14)] of considerable magnitude were found. Two themes emerged from the qualitative data: (1). the challenge of preparing the case studies and (2). the variable nature of the evaluations.This study is part of a teaching innovation project entitled ‘Strategies for harmonising clinical practice evaluation standards’, approved by the Autonomous University of Madrid Teaching Innovation Ethical Committee, involving internal and external evaluators, with reference number M_015.18_INN. We would like to thank the students and link lecturers for their collaboration in the study.S

DEA-based deformable cell culture system

We present a deformable cell culture system based on dielectric elastomer actuator (DEA). Understanding how the mechanical environment can affect cells functions could lead to significant advances in diseases diagnosis and drug development. Most available technologies offer low screening throughput, an important limitation considering the statistical nature of cellular studies. We previously reported an array of micro-DEAs for cell stretching application. Our DEA-based solution has the potential to replace current technologies and overcome the high screening throughput limitation. We present a new generation of devices, developed to better address cell biologists requirements. Two different devices were developed to apply periodic (1-5Hz) compressive or tensile strain greater than 10% on a 2mm x 2mm biological sample. Their original designs exploit non-equibiaxial pre-stretch of a silicone membrane and stress induced in passive regions of DEAs. Our technology is now compatible with high resolution optical microscopy for real time monitoring of morphology and chemical activity of the biological sample. This new generation of devices also significantly improves the electric field confinement and provides a fully biocompatible environment

A Resonant Graphene NEMS Vibrometer

Measuring vibrations is essential to ensuring building structural safety and machine stability. Predictive maintenance is a central internet of things (IoT) application within the new industrial revolution, where sustainability and performance increase over time are going to be paramount. To reduce the footprint and cost of vibration sensors while improving their performance, new sensor concepts are needed. Here, double-layer graphene membranes are utilized with a suspended silicon proof demonstrating their operation as resonant vibration sensors that show outstanding performance for a given footprint and proof mass. The unveiled sensing effect is based on resonant transduction and has important implications for experimental studies involving thin nano and micro mechanical resonators that are excited by an external shaker

A multilevel investigation of factors related to achievement in Ireland and Spain using PISA data

The Program for International Assessment (PISA) is a methodology for making comparative judgments about the quality of education systems. Celebrated by proponents as a transparent process that allows policy makers produce data informed judgments about relative quality of their national education system PISA – and through it the OECD – has become a key vehicle for informing and explaining educational policy development. This paper explores the Irish and Spanish outcomes of the 2018 round of PISA. It examines the contextual factors that are associated with performance at student and school level while at the same time developing a multi-level statistical model to explain divergent school performance profiles It finds that issues associated with the socio-economic level of the students, the repetition rate, and student age are common across all domains in both countries. It suggests that the socio-economic status of Spanish students at school level is not significant, that the shortage of teachers in Ireland affects student performance, and that immigrant status does not disadvantage Spanish student performance. It concludes by suggesting that studies involving a wider application of the model be undertaken to assess possible social, economic, and cultural causes that may explain the differences in variable significance in each country

Thin-film dielectric elastomer sensors to measure the contraction force of smooth muscle cells

The development of thin-film dielectric elastomer strain sensors for the characterization of smooth muscle cell (SMC) contraction is presented here. Smooth muscle disorders are an integral part of diseases such as asthma and emphysema. Analytical tools enabling the characterization of SMC function i.e. contractile force and strain, in a low-cost and highly parallelized manner are necessary for toxicology screening and for the development of new and more effective drugs. The main challenge with the design of such tools is the accurate measurement of the extremely low contractile cell forces expected as a result of SMC monolayer contraction (as low as ~ 100 μN). Our approach utilizes ultrathin (~5 μm) and soft elastomer membranes patterned with elastomer-carbon composite electrodes, onto which the SMCs are cultured. The cell contraction induces an in-plane strain in the elastomer membrane, predicted to be in the order 1 %, which can be measured via the change in the membrane capacitance. The cell force can subsequently be deduced knowing the mechanical properties of the elastomer membrane. We discuss the materials and fabrication methods selected for our system and present preliminary results indicating their biocompatibility. We fabricate functional capacitive senor prototypes with good signal stability over the several hours (~ 0.5% variation). We succeed in measuring in-plane strains of 1 % with our fabricated devices with good repeatability and signal to noise ratio

Magnetic nanocrystal modified epoxy photoresist for microfabrication of AFM probes

Nanocomposites based on an organic polymer and inorganic nanocrystals (NCs) represent a class of high impact functional materials able to convey the unique size and shape dependent properties of nano-objects to highly processable resists.[1] In this work, a novel magnetic nanocomposite based on a negative tone epoxy photoresist and magnetic colloidal Fe2O3 NCs has been manufactured for fabricating AFM probes. Epoxy-type photoresist grant superior lithographic performances when patterned by standard near- ultraviolet (UV) optical lithography, providing structures with high aspect-ratio and nearly vertical sidewalls. Such resists are at present employed in optical and micromechanical applications for the fabrication of optical waveguides, microfluidic systems and scanning probes.[2] However, these materials lack of any inherent functionality, e.g. electrical conductivity, luminescence, magnetism, piezoresistivity and dielectricity. Hence, the incorporation of NCs can confer them new properties maintaining the patterning resolutions required for the manufacturing of highly miniaturized devices. These added properties can be interesting for the fabrication of novel micro/nanoelectromechanical systems (MEMS/NEMS)

Robust association between vascular habitats and patient prognosis in glioblastoma: an international retrospective multicenter study

This is the peer reviewed version of the following article: del Mar Álvarez-Torres, M., Juan-Albarracín, J., Fuster-Garcia, E., Bellvís-Bataller, F., Lorente, D., Reynés, G., Font de Mora, J., Aparici-Robles, F., Botella, C., Muñoz-Langa, J., Faubel, R., Asensio-Cuesta, S., García-Ferrando, G.A., Chelebian, E., Auger, C., Pineda, J., Rovira, A., Oleaga, L., Mollà-Olmos, E., Revert, A.J., Tshibanda, L., Crisi, G., Emblem, K.E., Martin, D., Due-Tønnessen, P., Meling, T.R., Filice, S., Sáez, C. and García-Gómez, J.M. (2020), Robust association between vascular habitats and patient prognosis in glioblastoma: An international multicenter study. J Magn Reson Imaging, 51: 1478-1486, which has been published in final form at https://doi.org/10.1002/jmri.26958. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.[EN] Background Glioblastoma (GBM) is the most aggressive primary brain tumor, characterized by a heterogeneous and abnormal vascularity. Subtypes of vascular habitats within the tumor and edema can be distinguished: high angiogenic tumor (HAT), low angiogenic tumor (LAT), infiltrated peripheral edema (IPE), and vasogenic peripheral edema (VPE). Purpose To validate the association between hemodynamic markers from vascular habitats and overall survival (OS) in glioblastoma patients, considering the intercenter variability of acquisition protocols. Study Type Multicenter retrospective study. Population In all, 184 glioblastoma patients from seven European centers participating in the NCT03439332 clinical study. Field Strength/Sequence 1.5T (for 54 patients) or 3.0T (for 130 patients). Pregadolinium and postgadolinium-based contrast agent-enhanced T-1-weighted MRI, T-2- and FLAIR T-2-weighted, and dynamic susceptibility contrast (DSC) T-2* perfusion. Assessment We analyzed preoperative MRIs to establish the association between the maximum relative cerebral blood volume (rCBV(max)) at each habitat with OS. Moreover, the stratification capabilities of the markers to divide patients into "vascular" groups were tested. The variability in the markers between individual centers was also assessed. Statistical Tests Uniparametric Cox regression; Kaplan-Meier test; Mann-Whitney test. Results The rCBV(max) derived from the HAT, LAT, and IPE habitats were significantly associated with patient OS (P < 0.05; hazard ratio [HR]: 1.05, 1.11, 1.28, respectively). Moreover, these markers can stratify patients into "moderate-" and "high-vascular" groups (P < 0.05). The Mann-Whitney test did not find significant differences among most of the centers in markers (HAT: P = 0.02-0.685; LAT: P = 0.010-0.769; IPE: P = 0.093-0.939; VPE: P = 0.016-1.000). Data Conclusion The rCBV(max) calculated in HAT, LAT, and IPE habitats have been validated as clinically relevant prognostic biomarkers for glioblastoma patients in the pretreatment stage. This study demonstrates the robustness of the hemodynamic tissue signature (HTS) habitats to assess the GBM vascular heterogeneity and their association with patient prognosis independently of intercenter variability. Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019.This work was partially supported by: MTS4up project (National Plan for Scientific and Technical Research and Innovation 2013-2016, No. DPI2016-80054-R) (to J.M.G.G.); H2020-SC1-2016-CNECT Project (No. 727560) (to J.M.G.G.) and H2020-SC1-BHC-2018-2020 (No. 825750) (to J.M.G.G.); M.A.T was supported by DPI2016-80054-R (Programa Estatal de Promocion del Talento y su Empleabilidad en I + D + i). The data acquisition and curation of the Oslo University Hospital was supported by: the European Research Council (ERC) under the European Union's Horizon 2020 (Grant Agreement No. 758657), the South-Eastern Norway Regional Health Authority Grants 2017073 and 2013069, and the Research Council of Norway Grants 261984 (to K.E.E.). We gratefully acknowledge the support of NVIDIA Corporation with the donation of the Titan V GPU used for this research. E.F.G. was supported by the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No. 844646. Figure 1 was designed by the Science Artist Elena Poritskaya.Álvarez-Torres, MDM.; Juan-Albarracín, J.; Fuster García, E.; Bellvís-Bataller, F.; Lorente, D.; Reynés, G.; Font De Mora, J.... (2020). Robust association between vascular habitats and patient prognosis in glioblastoma: an international retrospective multicenter study. Journal of Magnetic Resonance Imaging. 51(5):1478-1486. https://doi.org/10.1002/jmri.2695814781486515Louis, D. N., Perry, A., Reifenberger, G., von Deimling, A., Figarella-Branger, D., Cavenee, W. K., … Ellison, D. W. (2016). The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathologica, 131(6), 803-820. doi:10.1007/s00401-016-1545-1Gately, L., McLachlan, S., Dowling, A., & Philip, J. (2017). 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Type 2 Diabetes Variants Disrupt Function of SLC16A11 through Two Distinct Mechanisms

Type 2 diabetes (T2D) affects Latinos at twice the rate seen in populations of European descent. We recently identified a risk haplotype spanning SLC16A11 that explains ∼20% of the increased T2D prevalence in Mexico. Here, through genetic fine-mapping, we define a set of tightly linked variants likely to contain the causal allele(s). We show that variants on the T2D-associated haplotype have two distinct effects: (1) decreasing SLC16A11 expression in liver and (2) disrupting a key interaction with basigin, thereby reducing cell-surface localization. Both independent mechanisms reduce SLC16A11 function and suggest SLC16A11 is the causal gene at this locus. To gain insight into how SLC16A11 disruption impacts T2D risk, we demonstrate that SLC16A11 is a proton-coupled monocarboxylate transporter and that genetic perturbation of SLC16A11 induces changes in fatty acid and lipid metabolism that are associated with increased T2D risk. Our findings suggest that increasing SLC16A11 function could be therapeutically beneficial for T2D. Video Abstract [Figure presented] Keywords: type 2 diabetes (T2D); genetics; disease mechanism; SLC16A11; MCT11; solute carrier (SLC); monocarboxylates; fatty acid metabolism; lipid metabolism; precision medicin

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms