Transcriptional analysis of natural killer T cell development

Type 1 NKT cells are an innate-like population of T cells that rapidly respond to both cytokine and TCR stimulation by the production of pro-inflammatory and immunoregulatory cytokines. Different from conventional αβT cells, which express a diverse repertoire of TCR sequences that are generated by random rearrangement and are positively selected by thymic epithelium expressing MHC Class I and Class II products, type 1 NKT cells express a highly restricted TCR (Vα14-Jα18 in mice, and the homologous Vα24-Jα18 chain in humans, paired with a restricted range of β chains) and are positively selected by ligating β2 Microglobulin (β2M)/CD1d and SLAM family members expressed on CD4⁺CD8⁺ (double positive – DP) cortical thymocytes. In the periphery of mice, type 1 NKT cells express a 'memory' or 'activated' like surface phenotype (CD62L⁻CD69⁺CD44hi) and the great majority is either CD4⁺CD8⁻ (single positive; SP) or CD4⁻CD8⁻ (double negative; DN). Studies on NKT cell development indicated that they are originated from the same progenitor as conventional T cells, and branched off from the mainstream lineage at DP stage. NKT cells' development is thymus dependent, they develop in fetal thymic organ culture; neonatal thymectomy on the third day of life selectively depletes them. NKT cells are not found in the peripheral tissues of mice until 1-2 weeks after birth. Many efforts have been made to understand the molecular mechanisms that govern their commitment and homeostasis. However, the very low numbers of developing NKT cells, especially DP NKT cells at Stage 0, makes it difficult to analyse transcriptional programs controlling NKT cell development. To further dissect the events surrounding NKT cell lineage commitment and to examine transcriptional factors controlling early NKT cell ontogeny, a mouse model with increased numbers of immature type 1 NKT cells was generated on the SLAM-deficient, NOD background. These mice were found to have greatly increased numbers of CD24⁺NK1.1⁻ DP NKT cells with the characteristics of pre-selection and Stage 0 NKT cells. This provides an opportunity to compare the transcriptional profiles of these very immature CD24⁺NK1.1⁻ DP NKT cells with those of conventional T cells (CD24⁺NK1.1⁻ DP T cells), and those of more mature NKT cell subsets, including CD24⁺NK1.1⁻ CD4⁺ NKT cells and CD24⁺NK1.1⁻ DN NKT cells. Expression levels of a total of 35,556 transcripts of each biological samples of above four different cell populations were obtained by microarray analysis. Principal component analysis indicated that the four populations clearly separated, in order, across principal component 1 from CD24⁺NK1.1⁻ DP T cells, to CD24⁺NK1.1⁻ DP NKT cells, to CD24⁺NK1.1⁻ CD4⁺ NKT cells, and finally to CD24⁺NK1.1⁻ DN NKT cells. Comparison of gene expression between these populations has provided an overall transcriptional profile during TCR validation, positive selection and lineage commitment of NKT cells. These findings have further confirmed phenotypic changes during NKT cell development observed by previous studies and suggest that immature DP NKT cells are pre-selection progenitors of NKT cells. Our transcriptional regulatory network approach mapped TCR validation to the transition from DP T to DP NKT cells, while positive selection and lineage commitment were associated with the transition from DP NKT to CD4 NKT cells. This is the first time that the effects of positive and negative selection have been examined on their actual population – the immature DP NKT cells. We confirm by in vivo experimentation that both positive and negative selection occur at the latter transition, separating for the first time in any T cell population the events associated with TCR validation from those associated with positive selection. NOD.Vα14Tg mice provide a model to study the earliest identifiable stages of NKT cell commitment and differentiation, and to help dissect factors controlling the numbers and function of this important immunoregulatory population

Efficacy and Toxicity of Folfoxiri for Patients with Metastatic Colorectal Cancer

BACKGROUND: In recent times, scientists have found new treatments for colorectal cancer patients. AIM: The study is to evaluate the efficacy and toxicity of triplet combination chemotherapy of 5-fluorouracil/leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) for patients with metastatic colorectal cancer in stage IV. METHODS: Uncontrolled clinical trial carried on 39 stage IV colorectal cancer patients. RESULTS: The overall response rate of the treatment was 79.4%. The average progression-free survival was 13.4 ± 9 months. The overall survival rate at 12th month and 24th month were 90% and 76%, respectively. The proportion of granulocytopenia was 48.9%, no grade 3 or 4. Side effect beyond hematology was most seen in hepatic toxicity with 52.5%, mainly at grade 1. Vomiting was 18.3%, all at grade 1. Other adverse event was very low at percentage. CONCLUSIONS: The triplet combination FOLFOXIRI chemotherapy improves the outcome of patients with metastatic colorectal cancer regarding rate of response, overall survival rate and progression-free survival, and the level of toxicity was acceptable

ELECTRODEPOSITION OF HYDROXYAPATITE/FUNCTIONALIZED CARBON NANOTUBES (HAp/fCNTs) COATINGS ON THE SURFACE OF 316L STAINLESS STEEL

The coatings of hydroxyapatite/functionalized carbon nanotubes (HAp/fCNTs) were successfully synthesized on the surface of 316L stainless steel (316L SS) by electrodeposition. To improve the dispersion of CNTs into the electrolyte, CNTs were functionalized in the mixture of 67 % HNO3 and 98 % H2SO4 before electrodeposition coatings to form fCNTs. Different amounts of fCNTs were  incorporated into the apatite coatings by adding fCNTs into the  electrolyte solution. In this study, Fourier Transform Infrared Spectroscopy (FT-IR), X-Ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Thermal Gravimetric Analysis (TGA) and mechanical techniques were used to analyze characteristic of fCNTs and the HAp/fCNTs coatings. The FTIR spectra of CNTs before and after acid treated process show that CNTs are functionalized by chemically method with carboxylic acid groups (–COOH) on their surface. The SEM images confirm that the functionalized process by the acid mixture does not change the morphology of CNTs. The nanocomposite coatings contain single phase of HAp and CNTs with the coating thickness of 6.9 µm and the amount of fCNTs in the coatings is 7.25 %. With 0.5 g/L of fCNTs in the electrolyte solution, the solubility of the coating decreases in comparision with pure HAp coatings

The Predictors of Students’ Satisfaction and Academic Achievements in Online Learning Environment in Higher Education

Student satisfaction is crucial in remote education course evaluation because it is linked to the quality of online programs and student academic performance. Meanwhile, self-regulated learning is crucial in both traditional and online learning environments since it involves the ability to organize, manage, and control their learning process. In this study, the authors tested the correlations between student satisfaction and academic achievement involving student characteristics, self-regulated learning, and Internet self-efficacy. Data were collected from 750 undergraduate students responding to an online survey questionnaire. To examine the correlation between factors in this research, a correlation analysis approach in SPSS 25 was utilized. Qualitative data were coded using MAXQDA in order to figure out other factors affecting student satisfaction. The results of the research showed Internet self-efficacy, self-regulated learning, student satisfaction, and academic achievement were significantly correlated with each other whereas gender and students’ prior experience online were perceived to highly correlate with those constructs as well. Qualitative results indicated factors impacting students’ satisfaction in online learning and supported most part of the quantitative results. Pedagogical implications and limitations of the study are also discussed

Expanding workplace HIV/AIDS prevention activities for a highly mobile population: Construction workers in Ho Chi Minh City

In Ho Chi Minh City, the locus of the HIV epidemic in Vietnam, efforts have been under way for several years to implement prevention efforts for migrant worker populations. The main activity has been volunteer health communicators (HCs) visiting workplaces and conducting HIV education activities. These efforts have reached only a small number of the intended audience, and the impact is unclear. Local authorities want to scale up their efforts but need information on the most effective and least costly activities, and their potential for scale up. The Horizons Program, the Population Council/Vietnam, and partners compared two programs for highly mobile construction workers: the existing HC workplace program, where social work students deliver HIV-prevention education, and a new peer-education program. Concerns exist about the turnover of health communicators in the HC program and whether social work students, about half of whom are female, are the most effective HIV-prevention educators for a largely male construction worker population. The new program uses construction worker peer educators to promote HIV risk reduction. Findings noted in this report indicate that the peer-educator program reached a higher proportion of workers than the health-communicator program

Experiência de aprendizagem de estudantes de enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IACS) em países asiáticos: um estudo qualitativo exploratório

Background: Healthcare-associated infection prevention and control (HAI-PC) education programs in Asian countries seem limited and require improvement and support. Objective: This study explored students’ learning experiences with HAI-PC education programs in Asian countries (two Vietnamese and two Cambodian universities) to support a pedagogical model in HAI-PC. Method: A qualitative exploratory study design was employed, and inductive content analysis was conducted. Students were selected to participate in the focus group to investigate their experiences with HAI-PC using five structured questions. There were 48 nursing students in total from four universities, 28 from 2 universities in Cambodia, and 20 from two universities in Vietnam. Results: The summary results gained from the four universities were synthesized by grouping them into sub-categories and four primary categories, which were students’ HAI-PC competence, students’ current learning methods in HAI-PC Education, the HAI-PC teaching and learning environment, students’ capacity, and entrepreneurial skills in HAI-PC development. Conclusion: This study revealed evidence to improve nursing education in HAI-PC in Asian countries. The new learning method of the simulation scenario and the model fascinated the students; they were happy and more confident about their future careers in practicing HAI-PC skills in their clinical practicum and hospital practice. The current HAI-PC education faces issues related to education and healthcare systems in Asian countries, highlighting the need for improvement.Enquadramento: Os programas de educação em prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IAS) em países asiáticos parecem ser limitados e necessitam de melhorias e apoio. Objetivo: Este estudo explorou as experiências de aprendizagem dos estudantes com programas de educação em PC-IAS em países asiáticos (duas universidades vietnamitas e duas universidades cambojanas) para apoiar um modelo pedagógico em PC-IAS. Método: Foi utilizado um desenho de estudo exploratório qualitativo, e foi realizada uma análise de conteúdo indutiva. Os estudantes foram selecionados para participar no grupo focal para investigar as suas experiências com PC-IAS usando cinco perguntas estruturadas. No total, participaram 48 estudantes de enfermagem de quatro universidades, sendo 28 de duas universidades no Camboja e 20 de duas universidades no Vietname. Resultados: Os resultados resumidos das quatro universidades foram sintetizados agrupando-os em subcategorias e quatro categorias principais, que eram competência dos estudantes em PC-IAS, métodos de aprendizagem atuais dos estudantes em Educação em PC-IAS, ambiente de ensino e aprendizagem em PC-IAS, capacidade dos estudantes e habilidades empreendedoras no desenvolvimento de PC-IAS. Conclusão: Este estudo revelou evidências para melhorar a educação em enfermagem em PC-IAS em países asiáticos. O novo método de aprendizagem do cenário de simulação e o modelo cativaram os estudantes; eles ficaram felizes e mais confiantes em relação às suas futuras carreiras na prática de habilidades em PC-IAS no estágio clínico e na prática hospitalar. A educação atual em PC-IAS enfrenta questões relacionadas aos sistemas de educação e saúde em países asiáticos, destacando a necessidade de melhorias

Simulação como método de ensino na formação em enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde em países asiáticos: um estudo qualitativo

Background: Applying simulation for nursing education, especially in healthcare-associated infection prevention and control (HAI-PC) in developing countries has limited evidence. The study was conducted to explore educators’ perceptions of simulation as a teaching method for nursing education in HAI-PC in two Vietnamese and two Cambodian universities. Methods: An exploratory qualitative design was applied. A focus group of 37 educators from four universities was conducted for data collection. Inductive and deductive qualitative content analysis was applied in analysing the data. Results: The core category was constructed to reflect educators’ perception of scenario-based simulation (SBS) as a teaching method for nursing education in HAI prevention and control. This main category included three subcategories: (i) enhancing nursing competence; (ii) preparing students for simulation; and [1] promoting simulation pedagogy competence. Conclusions: The findings identified the importance and benefits of applying simulation as a teaching method in nursing education. Additionally, it emphasized the necessity of enhancing knowledge associated with HAIs and providing additional training on simulation for educators to improve the quality of conducting simulations.Enquadramento: A aplicação da simulação no ensino de enfermagem, especialmente na prevenção e controlo de infeções associadas aos cuidados de saúde (IACS), em países em desenvolvimento, tem evidências limitadas. O estudo foi conduzido para explorar as perceções dos educadores sobre a simulação como método de ensino para a formação em enfermagem na prevenção e controlo de IACS em duas universidades vietnamitas e duas universidades cambojanas. Métodos: Foi aplicado um desenho qualitativo exploratório. Um grupo de discussão com 37 educadores de quatro universidades foi conduzido para a recolha de dados. A análise qualitativa de conteúdo indutiva e dedutiva foi aplicada na análise dos dados. Resultados: A categoria central foi construída para refletir a perceção dos educadores sobre a simulação baseada em cenários (SBC) como método de ensino para a formação em enfermagem na prevenção e controlo de IACS. Esta categoria principal incluiu três subcategorias: (i) aprimoramento da competência em enfermagem; (ii) preparação dos estudantes para a simulação; e [1] promoção da competência em pedagogia de simulação. Conclusões: Os resultados identificaram a importância e benefícios da aplicação da simulação como método de ensino na formação em enfermagem. Além disso, enfatizou a necessidade de aprimorar o conhecimento associado às ICACS e fornecer treinamento adicional sobre simulação para educadores, visando melhorar a qualidade da condução das simulações

Experiências do estudante de enfermagem na aprendizagem da prevenção e controlo de IACS em países asiáticos através do uso de simulação baseada em cenários: um estudo qualitativo exploratório

Background: Healthcare-associated infections (HAIs) have posed a major threat to both patients and to the safety healthcare personnel worldwide. According to the World Health Organization, 10% of hospitalized patients are affected by HAIs worldwide. Objective: The objective of this study was to explore the experiences of nursing students in learning HAIs prevention and control by the application of the scenario-based simulation pedagogy now in use in two Vietnamese and two Cambodian universities. Methods: A qualitative study was conducted among 160 nursing students from 2 Cambodian universities and 2 Vietnamese universities, and by using the purposive-sampling method. The data were collected through a focus group discussion and analyzed by the Graneheim and Lundman method (Graneheim & Lundman, 2004). Results: Two themes and six categories were generated. 1) First theme: factors for enhancing student learning on the prevention and control of HAIs by use of scenario-based simulation; and 2) Second theme: factors hindering students learning on HAI prevention and control by use of scenario-based simulation. Conclusion: The findings showed that SBS is an effective learning method for nursing students that can be applied to enhance the quality of nursing education in the Asian countries as SBS not only improves the clinical skills, but also the soft skills of nursing students. However, the effective outcomes and impacts can only be achieved in the context with the appropriate learning materials and equipment, simulation facilities and the instructors with pedagogical skills.Enquadramento: As infeções associadas a cuidados de saúde (IACS) têm representado uma grande ameaça tanto para os pacientes quanto para a segurança dos profissionais de saúde em todo o mundo. De acordo com a Organização Mundial da Saúde, 10% dos pacientes hospitalizados são afetados por IACS em todo o mundo. Objetivo: O objetivo deste estudo foi explorar as experiências dos estudantes de enfermagem na aprendizagem da prevenção e controlo de IACS através da aplicação da pedagogia de simulação baseada em cenários, atualmente em uso em duas universidades vietnamitas e duas universidades cambojanas. Métodos: Um estudo qualitativo foi conduzido entre 160 estudantes de enfermagem de duas universidades cambojanas e duas universidades vietnamitas, utilizando o método de amostragem propositada. Os dados foram recolhidos através de uma discussão em grupo focal e analisados pelo método de Graneheim e Lundman (Graneheim & Lundman, 2004). Resultados: Dois temas e seis categorias foram gerados. 1) Primeiro tema: fatores que contribuem para a aprendizagem dos estudantes na prevenção e controlo de IACS pelo uso de simulação baseada em cenários; e 2) Segundo tema: fatores que impedem a aprendizagem dos estudantes na prevenção e controlo de IACS pelo uso de simulação baseada em cenários (SBC). Conclusão: Os resultados demonstraram que a SBC é um método de aprendizagem eficaz para estudantes de enfermagem que pode ser aplicado para melhorar a qualidade da educação em enfermagem nos países asiáticos, uma vez que a SBC não só melhora as habilidades clínicas, mas também as habilidades interpessoais dos estudantes de enfermagem. No entanto, os resultados e impactos efetivos só podem ser alcançados no contexto com os materiais e equipamentos de aprendizagem apropriados, instalações de simulação e instrutores com habilidades pedagógicas

SIMULATION AS A TEACHING METHOD FOR NURSING EDUCATION IN HEALTHCARE-ASSOCIATED INFECTION PREVENTION AND CONTROL IN ASIAN COUNTRIES: A QUALITATIVE STUDY

BACKGROUND: Applying simulation for nursing education, especially in healthcare-associated infection prevention and control (HAI-PC) in developing countries has limited evidence. The study was conducted to explore educators’ perceptions of simulation as a teaching method for nursing education in HAI-PC in two Vietnamese and two Cambodian universities. METHODS: An exploratory qualitative design was applied. A focus group of 37 educators from four universities was conducted for data collection. Inductive and deductive qualitative content analysis was applied in analysing the data. RESULTS: The core category was constructed to reflect educators’ perception of scenario-based simulation (SBS) as a teaching method for nursing education in HAI prevention and control. This main category included three subcategories: (i) enhancing nursing competence; (ii) preparing students for simulation; and [1] promoting simulation pedagogy competence. CONCLUSIONS: The findings identified the importance and benefits of applying simulation as a teaching method in nursing education. Additionally, it emphasized the necessity of enhancing knowledge associated with HAIs and providing additional training on simulation for educators to improve the quality of conducting simulations

EXPERIENCES OF THE NURSING STUDENT IN LEARNING HAI PREVENTION AND CONTROL IN ASIAN COUNTRIES THROUGH THE USE OF SCENARIO-BASED SIMULATION: AN EXPLORATIVE QUALITATIVE STUDY

BACKGROUND: Healthcare-associated infections (HAIs) have posed a major threat to both patients and to the safety healthcare personnel worldwide. According to the World Health Organization, 10% of hospitalized patients are affected by HAIs worldwide. OBJECTIVE: The objective of this study was to explore the experiences of nursing students in learning HAIs prevention and control by the application of the scenario-based simulation pedagogy now in use in two Vietnamese and two Cambodian universities. METHODS: A qualitative study was conducted among 160 nursing students from 2 Cambodian universities and 2 Vietnamese universities, and by using the purposive-sampling method. The data were collected through a focus group discussion and analyzed by the Graneheim and Lundman method (Graneheim & Lundman, 2004). RESULTS: Two themes and six categories were generated. 1) First theme: factors for enhancing student learning on the prevention and control of HAIs by use of scenario-based simulation; and 2) Second theme: factors hindering students learning on HAI prevention and control by use of scenario-based simulation. CONCLUSION: The findings showed that SBS is an effective learning method for nursing students that can be applied to enhance the quality of nursing education in the Asian countries as SBS not only improves the clinical skills, but also the soft skills of nursing students. However, the effective outcomes and impacts can only be achieved in the context with the appropriate learning materials and equipment, simulation facilities and the instructors with pedagogical skills