Effects of web-based electrocardiography simulation on strategies and learning styles

Objective: To identify the association between the use of web simulation electrocardiography and the learning approaches, strategies and styles of nursing degree students. Method: A descriptive and correlational design with a one-group pretest– posttest measurement was used. The study sample included 246 students in a Basic and Advanced Cardiac Life Support nursing class of nursing degree. Results: No significant differences between genders were found in any dimension of learning styles and approaches to learning. After the introduction of web simulation electrocardiography, significant differences were found in some item scores of learning styles: theorist (p < 0.040), pragmatic (p < 0.010) and approaches to learning. Conclusion: The use of a web electrocardiogram (ECG) simulation is associated with the development of active and reflexive learning styles, improving motivation and a deep approach in nursing students

Health-related quality of life of patients following selected types of lumbar spinal surgery: A pilot study

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Targeting cells with single vectors using multiple-feature Boolean logic

Precisely defining the roles of specific cell types is an intriguing frontier in the study of intact biological systems and has stimulated the rapid development of genetically encoded tools for observation and control. However, targeting these tools with adequate specificity remains challenging: most cell types are best defined by the intersection of two or more features such as active promoter elements, location and connectivity. Here we have combined engineered introns with specific recombinases to achieve expression of genetically encoded tools that is conditional upon multiple cell-type features, using Boolean logical operations all governed by a single versatile vector. We used this approach to target intersectionally specified populations of inhibitory interneurons in mammalian hippocampus and neurons of the ventral tegmental area defined by both genetic and wiring properties. This flexible and modular approach may expand the application of genetically encoded interventional and observational tools for intact-systems biology

Pretransplantation Erythropoiesis-Stimulating Agent Hyporesponsiveness Is Associated with Increased Kidney Allograft Failure and Mortality

BACKGROUND: Poor response to erythropoiesis stimulating agents (ESA) is associated with morbidity and mortality among dialysis patients. It is unclear whether the risk associated with poor ESA response during dialysis extends beyond kidney transplantation. We examined pretransplant ESA response and its effect on allograft failure and mortality. METHODS: The cohort included all adult Medicare recipients from the United States Renal Data System who had received a kidney transplant during years 2000–2007 and had at least 6 months of hemodialysis immediately prior to transplant. ESA hyporesponsiveness was primarily defined as a monthly ESA dose ≥75,000 units and hematocrit ≤33% for at least 3 consecutive months in the pretransplant period. Crude and adjusted Cox-proportional hazards models and Kaplan-Meier methods were used to estimate the effect of ESA hyporesponsiveness on allograft failure and all-cause mortality. RESULTS: The study group consisted of 36,450 patients; 1,004 exhibited hyporesponsiveness. The adjusted hazard ratios for allograft failure and mortality post-transplant were 1.23 (95%CI 1.10, 1.42) and 1.61 (1.43, 1.81), respectively, supporting that poor ESA response during hemodialysis is associated with adverse post-transplant outcomes. CONCLUSIONS: ESA hyporesponsiveness may be useful in identifying potential allograft recipients who are at high-risk for subsequent morbidity and mortality, and may benefit from more intensive pre- and post-transplant follow-up