The Role of Students\u27 Professional Experience in Online Learning: Analysis of Asynchronous Participation

This paper reports on a causal-comparative study that investigated potential differences in students\u27 participation in asynchronous online learning environments according to their professional experience. In the study, 893 messages from 77 students in an online master\u27s program in human resource development (HRD) at a large U.S. university were analyzed. The research shed light on an important component of online education by illuminating ways in which novices and experienced students tend to relate to each other, the instructor, and the content of specific topics. Findings show evidence of both novices and experienced students using this medium in a very similar way when dealing with asynchronous tools. Discussion and recommendations are presented

Management of oxygen saturation monitoring in preterm newborns in the NICU: the Italian picture

Background: Although many studies emphasize the importance of using oxygen saturation (SpO2) targets in the NICUs, there is a wide variability in used saturation ranges among centers. Primary aim was to draw a representative picture on how the management of oxygen monitoring is performed in the Italian NICUs. Second aim was to identify healthcare-professionals related factors associated with oxygen targeting in the preterm population. Methods: Cross-sectional study with data collection via an electronic survey form. A questionnaire containing pre-piloted and open questions on monitoring and management of the SpO2 was administered to neonatologists across the network of the Italian Society of Neonatology. The questions focused on: the infrastructure, specific training, healthcare professionals and patients-related factors. The results of the survey were anonymously collected, summarized and analyzed. Results: Out of 378 questionnaires, 93 were correctly filled. Thirty-six different SpO2 ranges were observed. Centers using written standard operating procedures on oxygen management and SpO2 monitoring maintained a correct average range of SpO2 90–95%, avoided hyperoxia and reconsidered saturation targets in relation to comorbidities. 39.8% of responders disabled alarms during neonatal care. One center used biomarkers for complete monitoring of neonatal oxygenation status. Conclusions: There is considerable variation in SpO2 targets for preterm infants in the Italian NICUs. Standard operating procedures and specific training for health care personnel are the main factors playing a role for the correct maintenance of the recommended oxygen targets in preterms

EROS 2.0 study: evaluation of two interventional radiotherapy (brachytherapy) schedules for endometrial cancer: a comparison of late vaginal toxicity rates

Background To compare the late toxicity rates after two different high dose rate (HDR) adjuvant intravaginal interventional radiotherapy (IRT-brachytherapy) dose schedules in stage I-II endometrial cancer. Methods Stage I-II patients with endometrial cancer treated with surgery (with or without lymphadenectomy) and adjuvant HDR-IRT between 2014 and 2020 were included in this analysis. Patients were treated with two schedules. In the first cohort (C1), 21 Gy were delivered in three weekly fractions (7 Gy) prescribed 0.5 cm from the applicator surface. In the second cohort (C2), 24 Gy were delivered in four weekly fractions (6 Gy). The clinical target volume was the upper third of the vagina for C1 and the upper 3 cm for C2. HDR-IRT technique and point prescription (5 mm depth from the applicator surface) were the same for all patients. Vaginal toxicity was scored according to the CTCAE 5.0 scale in terms of the presence versus absence of any toxicity grade. The correlation among toxicity and clinical covariates (age, lymphadenectomy, fractionation, stage) was tested by Pearson correlation test (univariate) and by logistic regression (multivariable). Results 114 stage I and three stage II patients, median age 62 (range: 32-85) years, were included in this analysis. The mean follow-up was 56.3 months in C1 (40-76) and 20 months in C2 (8-42). Vaginal late toxicity was recorded in 40 and 15 patients in C1 and 2, respectively. Age, lymphadenectomy, and fractionation were significantly correlated with toxicity at univariate analysis (p value = 0.029, 0.006, and 0.002, respectively), while stepwise logistic regression confirmed only age and fractionation as significantly correlated parameters (p value = 0.02 and 0.001, respectively). Three-year local relapse-free, distant metastasis-free and cause-specific survival rates were 96.6%, 94.8%, and 99.1%, respectively. Conclusions This analysis showed lower vaginal late toxicity rate in C2 compared to C1

Patient Perceptions and Knowledge of Ionizing Radiation from Medical Imaging

Importance: Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite technological advancements and campaigns calling for better awareness and minimization of unnecessary exposures. Objective: To assess patients' knowledge about medical radiation and related risks. Design, Setting, and Participants: A survey study of hospitals in Italy was conducted; all patients in waiting rooms for medical imaging procedures before undergoing imaging examinations at 16 teaching and nonteaching hospitals were approached to take the survey. The survey was performed from June 1, 2019, to May 31, 2020. Main Outcomes and Measures: Survey respondents' basic knowledge of ionizing radiation levels and health risks, earlier imaging tests performed, and information and communication about radiation protection issues. Results: Among 3039 patients invited to participate, the response rate was 94.3% (n = 2866). Participants included 1531 women (53.4%); mean (SD) age was 44.9 (17.3) years. Of the 2866 participants, 1529 (53.3%) were aware of the existence of natural sources of ionizing radiation. Mammography (1101 [38.4%]) and magnetic resonance imaging (1231 [43.0%]) were categorized as radiation-based imaging modalities. More than half of the 2866 patients (1579 [55.1%]; P =.03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P =.004). A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff. A better knowledge of radiation issues was associated with receiving information from health care professionals (odds ratio [OR], 1.71; 95% CI, 1.43-2.03; P <.001) and having a higher educational level (intermediate vs low: OR, 1.48; 95% CI, 1.17-1.88; P <.001; high vs low: OR, 2.68; 95% CI, 2.09-3.43; P <.001). Conclusions and Relevance: The results of this survey suggest that patients undergoing medical imaging procedures have overall limited knowledge about medical radiation. Intervention to achieve better patient awareness of radiation risks related to medical exposures may be beneficial

Inhibition of IL-10 Production by Maternal Antibodies against Group B Streptococcus GAPDH Confers Immunity to Offspring by Favoring Neutrophil Recruitment

Group B Streptococcus (GBS) is the leading cause of neonatal pneumonia, septicemia, and meningitis. We have previously shown that in adult mice GBS glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is an extracellular virulence factor that induces production of the immunosuppressive cytokine interleukin-10 (IL-10) by the host early upon bacterial infection. Here, we investigate whether immunity to neonatal GBS infection could be achieved through maternal vaccination against bacterial GAPDH. Female BALB/c mice were immunized with rGAPDH and the progeny was infected with a lethal inoculum of GBS strains. Neonatal mice born from mothers immunized with rGAPDH were protected against infection with GBS strains, including the ST-17 highly virulent clone. A similar protective effect was observed in newborns passively immunized with anti-rGAPDH IgG antibodies, or F(ab')2 fragments, indicating that protection achieved with rGAPDH vaccination is independent of opsonophagocytic killing of bacteria. Protection against lethal GBS infection through rGAPDH maternal vaccination was due to neutralization of IL-10 production soon after infection. Consequently, IL-10 deficient (IL-10−/−) mice pups were as resistant to GBS infection as pups born from vaccinated mothers. We observed that protection was correlated with increased neutrophil trafficking to infected organs. Thus, anti-rGAPDH or anti-IL-10R treatment of mice pups before GBS infection resulted in increased neutrophil numbers and lower bacterial load in infected organs, as compared to newborn mice treated with the respective control antibodies. We showed that mothers immunized with rGAPDH produce neutralizing antibodies that are sufficient to decrease IL-10 production and induce neutrophil recruitment into infected tissues in newborn mice. These results uncover a novel mechanism for GBS virulence in a neonatal host that could be neutralized by vaccination or immunotherapy. As GBS GAPDH is a structurally conserved enzyme that is metabolically essential for bacterial growth in media containing glucose as the sole carbon source (i.e., the blood), this protein constitutes a powerful candidate for the development of a human vaccine against this pathogen

The Role of Students\u27 Professional Experience in Online Learning: Analysis of Asynchronous Participation

This paper reports on a causal-comparative study that investigated potential differences in students\u27 participation in asynchronous online learning environments according to their professional experience. In the study, 893 messages from 77 students in an online master\u27s program in human resource development (HRD) at a large U.S. university were analyzed. The research shed light on an important component of online education by illuminating ways in which novices and experienced students tend to relate to each other, the instructor, and the content of specific topics. Findings show evidence of both novices and experienced students using this medium in a very similar way when dealing with asynchronous tools. Discussion and recommendations are presented

A rapid Candida albicans hyphal\u2010form growth inhibition assay: determination of myelomonocytic\u2010mediated antifungal activity: Schnellverfahren zur Messung der Wachstumshemmung von Candida albicans durch Myelomonozyten\u2010vermittelte antifungale Aktivit\ue4t

Summary. An in vitro microassay for the measurement of Candida albicans hyphal\u2010form growth inhibition by myelomonocytic cells is described. The assay is rapid, easy\u2010to\u2010perform and objective. A Candida strain capable of in vitro dimorphic transition from yeast to hyphal form has been employed. The assay is based on the incorporation of 3H\u2010glu\u2010cose by the fungus, the effect being dependent upon the time of pulse, size of the inoculum and concentration of radiolabelled metabolite. In particular, C. albicans hyphal form, obtained by a 3 h incubation in vitro in the presence of 10% fetal calf serum, is co\u2010incubated with the effector cells. A pulse with 3H\u2010glucose in water is then performed and the radioactivity incorporated by the residual Candida is taken as an indication of hyphal growth. We found that polymorphonuclear cells, peritoneal macrophages and the cloned GG2EE macrophage cell line significantly inhibited hyphal growth, the effects being time and effector\u2010to\u2010target cell ratio dependent. Zusammenfassung. Es wird ein Mikroverfahren in vitro zur Messung der Wachstumshemmung von Candida albicans in der Myzelphase durch Mye\u2010lomonozyten beschrieben. Der Ansatz ist schnell, leicht in der Ausf\ufchrung und liefert objektive Re\u2010sultate. Hierzu wurde ein Candida\u2010Stamm verwen\u2010det mit der F\ue4higkeit, in vitro den dimorphen Pha\u2010senwechsel von der Hefe\u2010 zur Myzelphase zu durch\u2010laufen. Der Ansatz basiert auf dem 3H\u2010Glucose\u2010Ein\u2010bau durch den Pilz. Dieser Einbau ist abh\ue4ngig von der Expositionszeit, der Inoculum\u2010Gr\uf6 fe und der Konzentration des radioaktiv markierten Metabo\u2010liten. Hierzu wird die C. albicans\u2010Myzelphase, er\u2010halten nach 3 h Bebr\ufctung in vitro in der Gegen\u2010wart von 10%igem f\uf6talem K\ue4lberserum, mit den Effektorzellen ko\u2010inkubiert. Dann werden die Hefen der 3H\u2010Glucose in Wasser ausgesetzt, und die ein\u2010gebaute Radioaktivit\ue4t in den Candida\u2010Zellen wird als Indikator des Hyphenwachstums angesehen. Unsere Ergebnisse zeigen, da f polymorphonukle\ue4re Zellen, Peritonealmakrophagen und die geklonte GG2EE\u2010Makrophagen\u2010Zellinie das Hyphenwachs\u2010tum in Abh\ue4ngigkeit von der Expositionszeit und dem Effektor/Zielzell\u2010Verh\ue4ltnis signifikant hem\u2010men. Copyright \ua9 1991, Wiley Blackwell. All rights reserve

Safety profile assessment of risperidone and olanzapine in long-term care patients with dementia.

OBJECTIVE: To assess the adverse events associated with the appropriate use of oral risperidone and oral olanzapine in long-term care patients with behavioral and psychotic disturbances associated with dementia. DESIGN: Observational analysis. SETTING: Analysis was performed at five consulting pharmacist sites across the United States. Participants were recruited at 89 skilled nursing facilities by consultant pharmacists who provided services at each site. PATIENTS: A total of 730 men and women with dementia who had been residents of a skilled nursing facility for at least 90 days were included in the study. Alzheimer\u27s disease was the primary diagnosis in 47% of patients. INTERVENTION: Patients were treated with risperidone \u3c or =2 mg/day or olanzapine \u3c or =10 mg/day for at least 90 days. MEASUREMENTS: Targets for antipsychotic use included nonaggressive symptoms of psychosis and verbally and physically aggressive behaviors. The effects of risperidone and olanzapine were determined from progress notes, psychotropic monitoring forms, and physicians\u27 order forms after 91 days of treatment. Adverse events of particular significance in the elderly population, including agitation/anxiety, laxative use, dry eyes, and falls, were collected from audited medical records. The evaluation period extended from 3 months before to 3 months after initiation of treatment with risperidone or olanzapine. RESULTS: There were 474 patients in the risperidone group and 256 patients in the olanzapine group. Mean dosages of risperidone at Days 1 and 91 (0.7 +/- 0.3 mg/day and 1.0 +/- 0.5 mg/day, respectively) and olanzapine (3.3 +/- 1.4 mg/day and 4.7 +/- 2.1 mg/day, respectively) were at least 50% lower than the maximum dosages recommended by the Center for Medicare and Medicaid Services for elderly patients with psychosis or behavioral symptoms of dementia. The need for eye lubrication was minimal in both groups and did not differ significantly between them. Anxiolytic use decreased in the risperidone group and remained constant in the olanzapine group, with no significant difference between groups. In the olanzapine and risperidone groups, the number of patients with orders for laxatives increased 10.2% and 1.8%, respectively (P = 0.003), the mean number of days of laxative administration increased 19.1% and 4.3%, respectively (P \u3c 0.001), and the mean number of doses of laxative administered increased 14.2% and 4.1%, respectively (P = 0.001). Among patients qualifying for analysis, falls were recorded for 17.9% of patients receiving olanzapine and 6.9% receiving risperidone (P = 0.001). CONCLUSION: Among long-term care residents with dementia who received low doses of risperidone or olanzapine, the incidence of adverse events was low. When considering adverse events of particular concern in the elderly, specifically falls and laxative use, risperidone may be preferred over olanzapine in this population