Health policy engagement among graduate nursing students in the United States

Aim The aim was to understand how health policy education is currently being delivered in the United States’ graduate nursing programs. Methods This exploratory cross‐sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions. Results Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% ( n = 131) of the sample responded that a health policy course was required and an equal distribution among master’s and doctoral students. There was no significant difference between type of graduate degree sought and the requirement to take a health policy course ( P = 0.37). For students involved in health policy, there was a greater proportion of master’s students involved at the state level, than doctorate of nursing practice (DNP) or PhD students ( P = 0.04). Conclusions Health policy and advocacy education are important aspects of graduate nursing curriculum and have been integrated into curricula. Graduate nursing students at all levels reported that health policy AACN Essential competencies are being included in their program, either as stand‐alone health policy courses or integrated health policy learning activities during matriculation

A look at the anatomy educator job market: anatomists remain in short supply

In 2002, a widely publicized report projected an anatomy educator shortage based on department chairpersons' perceptions. Now, 17 years later, the question lingers: “Does an anatomy educator shortage persist and, if so, how severe is the shortage?” Trends in the number, type, and fill rate of anatomy educator job openings were explored by analyzing job posting in the United States over the past two years. A survey was distributed to leaders of anatomy‐related departments in the United States, Canada, and European Union. Most departmental leaders who responded (65% or more) from the United States/Canada (n = 81) and the European Union (n = 52) anticipate they will have “moderate” to “great” difficulty hiring anatomy educators in gross anatomy, histology, and embryology over the next five years. Within the United States, the number of anatomy educator job postings at medical schools more than doubled from at least 21 postings in 2017 to 52 postings in 2018. Twenty‐one percent of postings between 2017 and 2018 were never filled. While the number of anatomy educator openings within the United States/Canada is perceived to remain in a steady state for the next five years, the European Union estimates a five‐fold increase in the number of openings. Departmental leaders prioritize anatomy educator applicants who have teaching experience (mean ± SD = 4.64 ± 0.84 on five‐point Likert scale), versatility in teaching multiple anatomy disciplines (3.93 ± 1.07), and flexibility in implementing various teaching pedagogies (3.69 ± 1.17). Collectively, these data suggest the shortage of anatomy educators continues in the United States/Canada and the European Union

Making America A Better Place for All: Sustainable Development Recommendations for the Biden Administration

In 2015, the United Nations Member States, including the United States, unanimously approved 17 Sustainable Development Goals (SDGs) to be achieved by 2030. The SDGs are nonbinding; each nation is to implement them based on its own priorities and circumstances. This Article argues that the SDGs are a critical normative framework the United States should use to improve human quality of life, freedom, and opportunity by integrating economic and social development with environmental protection. It collects the recommendations of 22 experts on steps that the Biden-Harris Administration should take now to advance each of the SDGs. It is part of a book project that will recommend not only federal actions, but also actions by state and local governments, the private sector, and civil society. In the face of multiple challenges and opportunities, this Article is intended to contribute to a robust public discussion about how to accelerate the transition to a sustainable society and make America a better place for all

Making America a Better Place for All: Sustainable Development Recommendations for the Biden Administration

In 2015, the United Nations Member States, including the United States, unanimously approved 17 Sustainable Development Goals (SDGs) to be achieved by 2030. The SDGs are nonbinding; each nation is to implement them based on its own priorities and circumstances. This Article argues that the SDGs are a critical normative framework the United States should use to improve human quality of life, freedom, and opportunity by integrating economic and social development with environmental protection. It collects the recommendations of 22 experts on steps that the Biden-Harris Administration should take now to advance each of the SDGs. It is part of a book project that will recommend not only federal actions, but also actions by state and local governments, the private sector, and civil society. In the face of multiple challenges and opportunities, this Article is intended to contribute to a robust public discussion about how to accelerate the transition to a sustainable society and make America a better place for all

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Transcriptomic analysis of lignocellulosic biomass degradation by the anaerobic fungal isolate Orpinomyces sp. strain C1A

Background: Anaerobic fungi reside in the rumen and alimentary tract of herbivores where they play an important role in the digestion of ingested plant biomass. The anaerobic fungal isolate Orpinomyces sp. strain C1A is an efficient biomass degrader, capable of simultaneous saccharification and fermentation of the cellulosic and hemicellulosic fractions in multiple types of lignocellulosic biomass. To understand the mechanistic and regulatory basis of biomass deconstruction in anaerobic fungi, we analyzed the transcriptomic profiles of C1A when grown on four different types of lignocellulosic biomass (alfalfa, energy cane, corn stover, and sorghum) versus a soluble sugar monomer (glucose).Results: A total of 468.2 million reads (70.2 Gb) were generated and assembled into 27,506 distinct transcripts. CAZyme transcripts identified included 385, 246, and 44 transcripts belonging to 44, 13, and 8 different glycoside hydrolases (GH), carbohydrate esterases, and polysaccharide lyases families, respectively. Examination of CAZyme transcriptional patterns indicates that strain C1A constitutively transcribes a high baseline level of CAZyme transcripts on glucose. Although growth on lignocellulosic biomass substrates was associated with a significant increase in transcriptional levels in few GH families, including the highly transcribed GH1 B-glucosidase, GH6 cellobiohydrolase, and GH9 endoglucanase, the transcriptional levels of the majority of CAZyme families and transcripts were not significantly altered in glucose-grown versus lignocellulosic biomass-grown cultures. Further, strain C1A co-transcribes multiple functionally redundant enzymes for cellulose and hemicellulose saccharification that are mechanistically and structurally distinct. Analysis of fungal dockerin domain-containing transcripts strongly suggests that anaerobic fungal cellulosomes represent distinct catalytic units capable of independently attacking and converting intact plant fibers to sugar monomers.Conclusions: Collectively, these results demonstrate that strain C1A achieves fast, effective biomass degradation by the simultaneous employment of a wide array of constitutively-transcribed cellulosome-bound and free enzymes with considerable functional overlap. We argue that the utilization of this indiscriminate strategy could be justified by the evolutionary history of anaerobic fungi, as well as their functional role within their natural habitat in the herbivorous gut.Peer reviewedMicrobiology and Molecular Genetic

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

The Effects of Ethanol on Cone Photoreceptor Function in Zebrafish Larvae

Everyone experiences vision on a spectrum depending on the health and functioning of structures within the visual system. The process of vision is mediated by a cascade that begins by light entering the eye and being interpreted by cells that send signals to neighboring cells. These electrical signals lead to the movement of ions and neurotransmitters that form a signal that the brain can ultimately interpret as vision. One of the key structures in the visual transduction cascade are cells that receive the first light stimulus, known as photoreceptor cells. There are two types of photoreceptor cells: rod cells are responsible for vision in dim lighting and cone cells are responsible for color vision and visual acuity. The ubiquitin-proteasome system (UPS) is important in the health of photoreceptor cells and functions to degrade proteins that the cell no longer needs by tagging it with a molecule, ubiquitin, marking it for destruction. Dysfunction of these cells or systems can lead to visual impairments and sometimes blindness. This experiment was designed to test the effects of ethanol on the function of photoreceptor cells. The data will be added to a larger study being performed to examine UPS disturbances in relation to vision loss associated with ethanol.Zebrafish larvae approximately five to eleven days post fertilization (dpf) were used as the animal model to test the functioning of cone photoreceptor cells. At this stage of development, the larvae have visual functioning but only working cone photoreceptor cells are present. The larvae were exposed to 1% ethanol for 72 hours, then given a three-day recovery period. The visual performance of the ethanol-treated and control larvae were examined through a behavioral test known as the optomotor response (OMR). Moving stripes ran perpendicular to a narrow tank in which the larvae were placed. If the larvae’s vision was intact, their innate response would be to swim towards the destination end for the stripes (OMR +). To measure the functioning of the cone photoreceptor cells, a burst of light was directed onto the eye of the zebrafish and the sum electrical response of the retina was recorded graphically on a computer. The compilation of graphs between both groups allowed us to compare ethanol’s effect on the cone cells.Photoreceptor cell function is measured by the electrical response elicited upon light stimulation. When looking at the graph, the large upward deflection is termed the b-wave and represents the signal that is sent from the photoreceptor cells to the next structure in the cascade; the ON bipolar cells. Therefore, dysfunctions in the photoreceptor cells can be inferred by calculating b-wave amplitude variations. The b-wave amplitudes from both groups at varying light intensities were also gathered and graphed on a dose-response curve. After completing the experiment, it was discovered that ethanol produced detrimental effects on the visual system. During the OMR test, most of the ethanol- treated larvae failed to swim towards the stripes (OMR -) indicating visual dysfunction. They also had significantly lower b-wave amplitudes at every light intensity. This led to the conclusion that ethanol produced partial loss of function of the cone photoreceptor cells measured by decrease in bipolar cell activation. This study along with other preliminary data supports the working hypothesis that ethanol exposure leads to UPS disturbances causing visual deficits

Characterization of corneal deposition keratopathy in the setting of blood cell dyscrasia and a minimally invasive technique to clear the cornea in a single case

Purpose: To report 3 cases of corneal protein deposition occurring in association with systemic disease, with one case demonstrating a novel technique for clearing corneal deposits. Observations: Three patients presented with corneal deposits associated with systemic disease. Corneal involvement was noted prior to diagnosis of systemic disease in two patients, leading to subsequent diagnosis of multiple myeloma or monoclonal gammopathy of undetermined significance. OCT revealed protein deposition at various corneal levels, including at different stromal depths in the two cases of multiple myeloma. A novel technique of posterior endothelial scraping was performed in one case with deep stromal deposits, leading to significant corneal clearing. Conclusions and Importance: This case series demonstrates that recognition of corneal deposits may precede the diagnosis of systemic disease. It incorporates the use of anterior segment OCT to characterize corneal deposits, and demonstrates a novel surgical technique for clearing certain types corneal deposits. Keywords: Crystalline keratopathy, Deposition keratopathy, Paraproteinemia, Corneal pathology, Anterior segment optical coherence tomography, Multiple myelom