Changing Healthcare Provider and Parent Behaviors in the Pediatric Post‐Anesthesia‐Care‐Unit to Reduce Child Pain: Nurse and Parent Training in Postoperative Stress (NP‐TIPS)

Background Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain. Methods In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically‐based intervention which was then evaluated by experienced nurses (N = 8) and parents (N = 9) during focus groups. After revising the intervention based on focus group feedback, it was tested in Phase 2 using a pre‐post study design. Nurses (N = 23) who worked in the recovery room were recruited to be part of both pre‐ and post‐intervention data collection periods. Parents were recruited to be part of either the pre‐ (N = 52) or post‐intervention (N = 60) data collection periods. Nurses and parent‐child dyads were recorded in the post anesthesia care unit and videos were coded for the desired (i.e., behaviors that may decrease child pain) and non‐desired (i.e., behaviors that may increase child pain) behaviors. Pain data was collected from the children\u27s medical records to assess pain after surgery. The intervention was given to the nurses and parents in the post‐intervention data collection period. Results Nurses significantly increased their rate of desired behaviors by 231% (p = 0.001; Somer\u27s D = 1) and significantly decreased their rate of non‐desired behaviors by 62% (p = 0.004, Somer\u27s D = ‐0.88, 95% CI [‐1.74, ‐0.03]). Parents significantly increased their rate of desired behaviors by 124% (p = 0.033). Moreover, the intervention significantly decreased child pain in the post anesthesia care unit (b = ‐2.19, SE = 0.63, z = ‐3.46, p = .001, 95%CI [‐3.43, ‐0.95]). Conclusions The intervention was effective in changing nurse and parent behaviors as well as child pain after surgery

CRISPRi-based radiation modifier screen identifies long non-coding RNA therapeutic targets in glioma.

BackgroundLong non-coding RNAs (lncRNAs) exhibit highly cell type-specific expression and function, making this class of transcript attractive for targeted cancer therapy. However, the vast majority of lncRNAs have not been tested as potential therapeutic targets, particularly in the context of currently used cancer treatments. Malignant glioma is rapidly fatal, and ionizing radiation is part of the current standard-of-care used to slow tumor growth in both adult and pediatric patients.ResultsWe use CRISPR interference (CRISPRi) to screen 5689 lncRNA loci in human glioblastoma (GBM) cells, identifying 467 hits that modify cell growth in the presence of clinically relevant doses of fractionated radiation. Thirty-three of these lncRNA hits sensitize cells to radiation, and based on their expression in adult and pediatric gliomas, nine of these hits are prioritized as lncRNA Glioma Radiation Sensitizers (lncGRS). Knockdown of lncGRS-1, a primate-conserved, nuclear-enriched lncRNA, inhibits the growth and proliferation of primary adult and pediatric glioma cells, but not the viability of normal brain cells. Using human brain organoids comprised of mature neural cell types as a three-dimensional tissue substrate to model the invasive growth of glioma, we find that antisense oligonucleotides targeting lncGRS-1 selectively decrease tumor growth and sensitize glioma cells to radiation therapy.ConclusionsThese studies identify lncGRS-1 as a glioma-specific therapeutic target and establish a generalizable approach to rapidly identify novel therapeutic targets in the vast non-coding genome to enhance radiation therapy

The Acceptability of Online Learning Action Cell Session Practice to Tagumpay National High School Teachers

This quantitative study explores the acceptability of Online Learning Action Cell (LAC) practice as a school-based professional development strategy for Tagumpay National High School (TNHS) teachers. The research was motivated by the Department of Education (DepEd) Order No. 35 s. 2016 which prompts public schools to comply with the implementation of LAC sessions because it has a positive impact on teachers’ beliefs and practices resulting in education reforms for learners’ benefit. However, in compliance with DepEd’s policy on maximizing Time-On-Task (DepEd Order No. 9 s. 2005) and the teacher’s conflict of schedule and other ancillary and coordination functions, absences or non-participation in classroom LAC was noted. The viability of offering Online LAC sessions using appropriate media and technologies to provide more options and flexibility for the study is suggested and tested utilizing a conceptual framework drawn from DepEd Order No. 35 s. 2016, Simonson’s Equivalency Theory and Anderson’s Community of Inquiry (COI). A descriptive survey method was used in this study with purposive sampling identifying ten Technology and Livelihood Education (TLE) teachers to pilot the Online LAC based on the memorandum issued by the school head. The subjects went through a week of experience in a LAC session using Facebook (FB) as Learning Management System (LMS) while a researcher-designed survey tool in the form of a Likert-type scale questionnaire was administered via Google forms before and after the online session to measure teacher’s acceptability of Online LAC Session practice. In the analysis, a descriptive statistic shows that pre-post survey results on Online LAC session planning is from ‘moderately acceptable’ to ‘very highly acceptable’; implementation is from ‘acceptable’ to ‘very highly acceptable’, and evaluation is from ‘moderately acceptable’ to ‘very highly acceptable’. TNHS teachers' acceptability of Online LAC session practice increases after their participation in a fully-online learning environment. Limitations, recommendations, future research directions, and conclusions are also included in the study

A Phenomenological Study of the Lived Experiences of Tagumpay National High School Teachers Involved in Online Learning Action Cell Session

A qualitative phenomenological approach was used in this study to describe the lived experiences of Tagumpay National High School (TNHS) teachers on Online Learning Action Cell (LAC) session. LAC is a school-based professional development for teachers implemented by the Philippine Department of Education (DepEd). Due to teacher’s lack of participation on classroom LAC, a fully-online mode option is explored by offering TNHS teachers Online LAC session using Facebook as a Learning Management System (LMS). To capture the lived experience of teachers, an in-depth interview with a purposive sample of one TNHS teacher is done in the process. The data gathered went through “Hycner’s Explicitation Process” (1999, in Groenewald, 2004) which includes bracketing, delineating, clustering, summarizing and extracting unique themes. Validity and Credibility were accomplished through an intercoder agreement between researchers, Facebook chat records, bracketing, and member checking. Results identified three themes in relation to teacher’s experience of Online LAC session including usefulness, barriers, and preference. Findings revealed the major role of TNHS teacher’s context on how Online LAC is utilized. Recommendations include administrator and expert teacher working with classroom teachers and the inclusion of teachers’ voices as input in the program design, implementation and evaluation stages of Online LAC to better address curriculum needs and facilitate the delivery of high-quality professional development for teachers’ professional growth

The Relationship between AKI and CKD in Patients with Type 2 Diabetes:An Observational Cohort Study

Background There are few observational studies evaluating the risk of AKI in people with type 2 diabetes, and even fewer simultaneously investigating AKI and CKD in this population. This limits understanding of the interplay between AKI and CKD in people with type 2 diabetes compared with the nondiabetic population. Methods In this retrospective, cohort study of participants with or without type 2 diabetes, we used electronic healthcare records to evaluate rates of AKI and various statistical methods to determine their relationship to CKD status and further renal function decline. Results We followed the cohort of 16,700 participants (9417 with type 2 diabetes and 7283 controls without diabetes) for a median of 8.2 years. Those with diabetes were more likely than controls to develop AKI (48.6% versus 17.2%, respectively) and have preexisting CKD or CKD that developed during follow-up (46.3% versus 17.2%, respectively). In the absence of CKD, the AKI rate among people with diabetes was nearly five times that of controls (121.5 versus 24.6 per 1000 person-years). Among participants with CKD, AKI rate in people with diabetes was more than twice that of controls (384.8 versus 180.0 per 1000 person-years after CKD diagnostic date, and 109.3 versus 47.4 per 1000 person-years before CKD onset in those developing CKD after recruitment). Decline in eGFR slope before AKI episodes was steeper in people with diabetes versus controls. After AKI episodes, decline in eGFR slope became steeper in people without diabetes, but not among those with diabetes and preexisting CKD. Conclusions Patients with diabetes have significantly higher rates of AKI compared with patients without diabetes, and this remains true for individuals with preexisting CKD.on behalf of the BEAt-DKD Consortiu

SUBSEA 2019 Expedition to the Gorda Ridge

The SUBSEA (Systematic Underwater Biogeochemical Science and Exploration Analog) program blends ocean exploration with “ocean worlds” research, along with NASA analog and work studies research, to address science, science operations, and technology knowledge gaps related to the exploration of our solar system. The science group researches venting fluids at isolated seamounts and spreading ridges in the Pacific Ocean as analog environments to putative volcanically hosted hydrothermal systems on other “ocean worlds” (defined as places in the outer solar system that could possess subsurface oceans). The science operations research group studies E/V Nautilus architecture, distributed teams, communication, and lowlatency telerobotics. The technology research group provided Exploration Ground Data Systems (xGDS) software to the shore team to support the integration and visualization of diverse data products during the cruise

A comparative study of extracellular vesicle-associated and cell-free DNA and RNA for HPV detection in oropharyngeal squamous cell carcinoma

Purpose: This study compares the detection sensitivity of two separate liquid biopsy sources, cell-free (cf) DNA/RNA and extracellular vesicle (EV)-associated DNA/RNA (EV-DNA/RNA), to identify circulating Human Papilloma Virus (HPV) DNA/RNA in plasma obtained from patients with oropharyngeal squamous cell carcinoma (OPCSCC). We also report on the longitudinal changes observed in HPV-DNA levels in response to treatment. Experimental design: A prospective study was conducted that included 22 patients with locally advanced disease and six patients with metastatic OPCSCC. Twenty-three patients had HPV-related OPCSCC defined by p16 immunohistochemistry. Levels of circulating HPV-DNA and HPV-RNA from plasma-derived cf-DNA/RNA and EV-DNA/RNA were quantified using digital droplet PCR. Results: Circulating HPV-DNA was detected with higher sensitivity in cf-DNA compared to EV-DNA at 91% vs. 42% (p = \u3c 0.001). Similarly, circulating tumoral HPV-RNA was detected at a higher sensitivity in cf-RNA compared to EV-RNA, at 83% vs. 50% (p = 0.0019). In the locally advanced cohort, 100% (n = 16) of HPV-OPCSCC patients demonstrated a reduction in circulating HPV-DNA levels in cf-DNA following curative treatment, with 81% of patients demonstrating complete clearance to undetectable levels. However, in metastatic HPV-OPCSCC patients (n = 4), HPV-DNA levels did not correlate with treatment response. Conclusion: Our study demonstrates that although HPV-DNA/RNA can be detected in EV associated DNA/RNA, cf-DNA/RNA is the more sensitive liquid biopsy medium. As circulating HPV-DNA levels were found to only correlate with treatment response in the locally advanced but not metastatic setting in our small cohort of patients, the use of HPV-DNA as a dynamic biomarker to monitor treatment response requires further evaluation. © 2020, The Author(s)

A comparative study of extracellular vesicle-associated and cell-free DNA and RNA for HPV detection in oropharyngeal squamous cell carcinoma

Purpose: This study compares the detection sensitivity of two separate liquid biopsy sources, cell-free (cf) DNA/RNA and extracellular vesicle (EV)-associated DNA/RNA (EV-DNA/RNA), to identify circulating Human Papilloma Virus (HPV) DNA/RNA in plasma obtained from patients with oropharyngeal squamous cell carcinoma (OPCSCC). We also report on the longitudinal changes observed in HPV-DNA levels in response to treatment. Experimental design: A prospective study was conducted that included 22 patients with locally advanced disease and six patients with metastatic OPCSCC. Twenty-three patients had HPV-related OPCSCC defined by p16 immunohistochemistry. Levels of circulating HPV-DNA and HPV-RNA from plasma-derived cf-DNA/RNA and EV-DNA/RNA were quantified using digital droplet PCR. Results: Circulating HPV-DNA was detected with higher sensitivity in cf-DNA compared to EV-DNA at 91% vs. 42% (p = \u3c 0.001). Similarly, circulating tumoral HPV-RNA was detected at a higher sensitivity in cf-RNA compared to EV-RNA, at 83% vs. 50% (p = 0.0019). In the locally advanced cohort, 100% (n = 16) of HPV-OPCSCC patients demonstrated a reduction in circulating HPV-DNA levels in cf-DNA following curative treatment, with 81% of patients demonstrating complete clearance to undetectable levels. However, in metastatic HPV-OPCSCC patients (n = 4), HPV-DNA levels did not correlate with treatment response. Conclusion: Our study demonstrates that although HPV-DNA/RNA can be detected in EV associated DNA/RNA, cf-DNA/RNA is the more sensitive liquid biopsy medium. As circulating HPV-DNA levels were found to only correlate with treatment response in the locally advanced but not metastatic setting in our small cohort of patients, the use of HPV-DNA as a dynamic biomarker to monitor treatment response requires further evaluation. © 2020, The Author(s)

Driver mutations in Janus kinases in a mouse model of B-cell leukemia induced by deletion of PU.1 and Spi-B

Precursor B-cell acute lymphoblastic leukemia (B-ALL) is associated with recurrent mutations that occur in cancer-initiating cells. There is a need to understand how driver mutations influence clonal evolution of leukemia. The E26-Transformation-specific (ETS) transcription factors PU.1 and Spi-B (encoded by Spi1 and Spib) execute a critical role in B-cell development and serve as complementary tumor suppressors. Here, we used a mouse model to conditionally delete Spi1 and Spib genes in developing B cells. These mice developed B-ALL with a median time to euthanasia of 18 weeks. We performed RNA and whole-exome sequencing (WES) on leukemias isolated from Mb1-CreDPB mice and identified single nucleotide variants (SNVs) in Jak1, Jak3, and Ikzf3 genes, resulting in amino acid sequence changes. Jak3 mutations resulted in amino acid substitutions located in the pseudo-kinase (R653H, V670A) and in the kinase (T844M) domains. Introduction of Jak3 T844M into Spi1/Spib-deficient precursor B cells was sufficient to promote proliferation in response to low IL-7 concentrations in culture, and to promote proliferation and leukemia-like disease in transplanted mice. We conclude that mutations in Janus kinases represent secondary drivers of leukemogenesis that cooperate with Spi1/Spib deletion. This mouse model represents a useful tool to study clonal evolution in B-ALL