MODEL ENTREPRENURSE: TINJAUAN INTEGRATIF

Abstract   The unemployment rate of nurses is increasing and there are still many who adhere to the traditional perspective of the nursing profession as employees. This global competitive era, as well as this pandemic, requires out-of-the-box nurses who dare to open nursing practices as entrepreneurs in overcoming the rising of unemployment.  The study attempted to investigate entrepreneurial nurse model with Whittemore and Knafl's integrative review design, analyzing the quality of the articles with the Alberta Heritage Foundation's QualSyst tool. The search strategy is with the keywords "perawat wirausaha" and "nurse entrepreneur", written in English and Indonesian, with articles published in the last 10 years. The results of an integrative review of five eligible articles resulted in an entreprenurse model. The entreprenurse model shows that the factors that influence entrepreneurship or entrepreneurial tendencies were starting from the student level (course period - urgency to get a job) and creativity. Then, departing from that, the identification of opportunities is carried out to become entreprenurse, however, there are also perceived barriers felt by the entreprenurses. Recommendations to the Faculty of Nursing to invest by providing opportunities for students to practice entrepreneurship in college and for nurse entrepreneurs to share their lived experiences that can provide insight into the identification of opportunities and how to overcome obstacles in entrepreneurship in the field of nursing.   Keywords: entreprenurse, model Abstrak   Angka pengangguran perawat semakin meningkat dan masih banyak yang menganut perspektif tradisional dari profesi keperawatan sebagai pegawai. Era kompetitif global dan juga pandemik ini, memerlukan perawat out-of-the-box yang berani membuka praktik keperawatan sebagai wirausahawan dalam mengatasi bertambahnya angka pengangguran.  Studi ini mencoba menginvestigasi tren perawat wirausaha dengan desain tinjauan integratif Whittemore dan Knafl, menganalisis kualitas artikel dengan QualSyst tool dari Alberta Heritage Foundation. Strategi pencarian adalah dengan kata kunci “nurse entrepreneur” dan “perawat wirausaha”, berbahasa Inggris dan Indonesia, dengan artikel yang dipublikasi 10 tahun terakhir. Hasil tinjauan integratif dari lima artikel eligible menghasilkan model entreprenurse. Model entreprenurse menunjukkan bahwa faktor yang mempengaruhi kecenderungan wirausaha atau kewirausahaan yaitu dimulai dengan tingkat mahasiswa (course period - urgensi mencari pekerjaan) dan kreativitas. Kemudian, berangkat dari itu, ada identifikasi peluang dilakukan untuk menjadi entreprenurse, tapi ada juga persepsi hambatan yang dirasakan oleh entreprenurse. Rekomendasi pada Fakultas keperawatan untuk dapat berinvestasi dengan memberikan kesempatan kepada mahasiswa untuk praktek entrepreneurship di bangku kuliah dan kepada perawat wirausahawan untuk dapat berbagi pengalaman yang dapat memberikan wawasan mengenai identifikasi peluang dan cara mengatasi hambatan dalam kewirausahaan dalam bidang keperawatan.   Kata Kunci: entreprenurse, mode

ENTREPRENURSING IN THE EYES OF NURSING STUDENTS: SEBUAH STUDI FENOMENOLOGI HERMENEUTIKA

Current and predicted economic perplexities, high unemployment rate, and difficulties of obtaining and extending of licensure should open the eyes of nursing students not to sojourn in the stereotype nurses’ mindset as employees of health care institutions only, but also to look at the option of entreprenursing. This study aims to investigate how nursing students see entreprenursing concept and give meaning to it. The research design used was hermeneutic phenomenology with Heidegger's philosophical underpinning, Van Manen's thematic analysis technique and the trustworthiness of the data ascertained. The results of the thematic analysis of hermeneutics witness the results of data saturation on the response of 9 participants. Two meanings of entreprenursing emerged from nursing students’ perspective. Independent entreprenurses are "nurses who work privately (separated from conventional health institutions) in business relation as a supporting agency to meet the health needs in the community." Secondly, the sideline entreprenurses are "nurses who work as employees of health care institutions but also having sideline jobs that support the fulfillment of the health needs in the community. However, in addition to this, there are also those who stated of not knowing anything regarding this entreprenurse concept. Then, participants also mentioned entreprenurse activities such as providing complementary therapies (juices, healthy foods and massages), opening clinics, homecare, medical device stores and training. It seems that the participants have only understood the entreprenursing concept on what the practitioners are doing and have not yet on the overall concept. Recommendations to nursing teachers to provide entreprenursing experience through on-the-job-training and also the introduction of general business terminology related to entrepreneurship.   Keywords: entreprenursing, nursing students Abstrak   Kesulitan ekonomi yang terjadi sekarang dan diprediksi akan semakin memburuk, tingginya pengangguran, dan susahnya mendapat dan memperpanjang STR harus membuka mata para mahasiswa keperawatan untuk tidak tinggal pada stereotipe perawat sebagai pegawai institusi layanan kesehatan tetapi juga melirik opsi entreprenursing. Studi ini bertujuan untuk menginvestigasi bagaimana mahasiswa perawat melihat entreprenursing dan mengartikannya. Desain penelitian yang digunakan adalah fenomenologi hermeneutika dengan filosofi Heidegger, teknik analisa tematik Van Manen dan keabsahan data dipastikan. Hasil analisis tematik hermeneutika diambil peneliti dari hasil saturasi data pada jawaban 9 partisipan. Ditemukan dua arti entreprenursing menurut mahasiswa keperawatan. Entreprenurse Mandiri adalah “perawat-perawat yang bekerja secara pribadi (terpisah institusi kesehatan konvensional) dalam kaitan bisnis sebagai supporting agency untuk pemenuhan kebutuhan kesehatan di masyarakat.” Kemudian, yang entreprenurse sampingan yaitu “perawat yang bekerja sebagai pegawai institusi layanan kesehatan namun juga memiliki pekerjaan bisnis sampingan yang menjadi pendukung pemenuhan kebutuhan kesehatan masyarakat. Namun, selain itu ada juga yang mengatakan bahwa dia belum ada bayangan mengenai entreprenurse ini. Kemudian, partisipan juga menyebutkan kegiatan-kegiatan entreprenurse seperti pemberian terapi komplementer (jus, makanan sehat dan massage), pembukaan klinik mandiri, homecare, toko alat kesehatan dan training. Tampaknya para partisipan baru mengerti entreprenursing dari apa yang dilakukan oleh praktisinya dan belum konsep keseluruhannya. Rekomendasi kepada pengajar keperawatan untuk dapat memberikan pengalaman entreprenursing melalui on-the-job-training dan juga pengenalan terminologi bisnis umum yang berkaitan dengan kewirausahaan.   Kata Kunci: entreprenursing, mahasiswa keperawata

Genes adapt to outsmart gene-targeting strategies in mutant mouse strains by skipping exons to reinitiate transcription and translation.

BACKGROUND: Gene disruption in mouse embryonic stem cells or zygotes is a conventional genetics approach to identify gene function in vivo. However, because different gene disruption strategies use different mechanisms to disrupt genes, the strategies can result in diverse phenotypes in the resulting mouse model. To determine whether different gene disruption strategies affect the phenotype of resulting mutant mice, we characterized Rhbdf1 mouse mutant strains generated by three commonly used strategies-definitive-null, targeted knockout (KO)-first, and CRISPR/Cas9. RESULTS: We find that Rhbdf1 responds differently to distinct KO strategies, for example, by skipping exons and reinitiating translation to potentially yield gain-of-function alleles rather than the expected null or severe hypomorphic alleles. Our analysis also revealed that at least 4% of mice generated using the KO-first strategy show conflicting phenotypes. CONCLUSIONS: Exon skipping is a widespread phenomenon occurring across the genome. These findings have significant implications for the application of genome editing in both basic research and clinical practice

ISA-TAB-Nano: A Specification for Sharing Nanomaterial Research Data in Spreadsheet-based Format

BACKGROUND AND MOTIVATION: The high-throughput genomics communities have been successfully using standardized spreadsheet-based formats to capture and share data within labs and among public repositories. The nanomedicine community has yet to adopt similar standards to share the diverse and multi-dimensional types of data (including metadata) pertaining to the description and characterization of nanomaterials. Owing to the lack of standardization in representing and sharing nanomaterial data, most of the data currently shared via publications and data resources are incomplete, poorly-integrated, and not suitable for meaningful interpretation and re-use of the data. Specifically, in its current state, data cannot be effectively utilized for the development of predictive models that will inform the rational design of nanomaterials. RESULTS: We have developed a specification called ISA-TAB-Nano, which comprises four spreadsheet-based file formats for representing and integrating various types of nanomaterial data. Three file formats (Investigation, Study, and Assay files) have been adapted from the established ISA-TAB specification; while the Material file format was developed de novo to more readily describe the complexity of nanomaterials and associated small molecules. In this paper, we have discussed the main features of each file format and how to use them for sharing nanomaterial descriptions and assay metadata. CONCLUSION: The ISA-TAB-Nano file formats provide a general and flexible framework to record and integrate nanomaterial descriptions, assay data (metadata and endpoint measurements) and protocol information. Like ISA-TAB, ISA-TAB-Nano supports the use of ontology terms to promote standardized descriptions and to facilitate search and integration of the data. The ISA-TAB-Nano specification has been submitted as an ASTM work item to obtain community feedback and to provide a nanotechnology data-sharing standard for public development and adoption

Enhancing the efficacy of glycolytic blockade in cancer cells via RAD51 inhibition.

Targeting the early steps of the glycolysis pathway in cancers is a well-established therapeutic strategy; however, the doses required to elicit a therapeutic effect on the cancer can be toxic to the patient. Consequently, numerous preclinical and clinical studies have combined glycolytic blockade with other therapies. However, most of these other therapies do not specifically target cancer cells, and thus adversely affect normal tissue. Here we first show that a diverse number of cancer models - spontaneous, patient-derived xenografted tumor samples, and xenografted human cancer cells - can be efficiently targeted by 2-deoxy-D-Glucose (2DG), a well-known glycolytic inhibitor. Next, we tested the cancer-cell specificity of a therapeutic compound using the MEC1 cell line, a chronic lymphocytic leukemia (CLL) cell line that expresses activation induced cytidine deaminase (AID). We show that MEC1 cells, are susceptible to 4,4\u27-Diisothiocyano-2,2\u27-stilbenedisulfonic acid (DIDS), a specific RAD51 inhibitor. We then combine 2DG and DIDS, each at a lower dose and demonstrate that this combination is more efficacious than fludarabine, the current standard- of- care treatment for CLL. This suggests that the therapeutic blockade of glycolysis together with the therapeutic inhibition of RAD51-dependent homologous recombination can be a potentially beneficial combination for targeting AID positive cancer cells with minimal adverse effects on normal tissue. IMPLICATIONS: Combination therapy targeting glycolysis and specific RAD51 function shows increased efficacy as compared to standard of care treatments in leukemias

Genomic data analysis workflows for tumors from patient-derived xenografts (PDXs): challenges and guidelines.

BACKGROUND: Patient-derived xenograft (PDX) models are in vivo models of human cancer that have been used for translational cancer research and therapy selection for individual patients. The Jackson Laboratory (JAX) PDX resource comprises 455 models originating from 34 different primary sites (as of 05/08/2019). The models undergo rigorous quality control and are genomically characterized to identify somatic mutations, copy number alterations, and transcriptional profiles. Bioinformatics workflows for analyzing genomic data obtained from human tumors engrafted in a mouse host (i.e., Patient-Derived Xenografts; PDXs) must address challenges such as discriminating between mouse and human sequence reads and accurately identifying somatic mutations and copy number alterations when paired non-tumor DNA from the patient is not available for comparison. RESULTS: We report here data analysis workflows and guidelines that address these challenges and achieve reliable identification of somatic mutations, copy number alterations, and transcriptomic profiles of tumors from PDX models that lack genomic data from paired non-tumor tissue for comparison. Our workflows incorporate commonly used software and public databases but are tailored to address the specific challenges of PDX genomics data analysis through parameter tuning and customized data filters and result in improved accuracy for the detection of somatic alterations in PDX models. We also report a gene expression-based classifier that can identify EBV-transformed tumors. We validated our analytical approaches using data simulations and demonstrated the overall concordance of the genomic properties of xenograft tumors with data from primary human tumors in The Cancer Genome Atlas (TCGA). CONCLUSIONS: The analysis workflows that we have developed to accurately predict somatic profiles of tumors from PDX models that lack normal tissue for comparison enable the identification of the key oncogenic genomic and expression signatures to support model selection and/or biomarker development in therapeutic studies. A reference implementation of our analysis recommendations is available at https://github.com/TheJacksonLaboratory/PDX-Analysis-Workflows

Home medicines reviews following acute coronary syndrome: study protocol for a randomized controlled trial

Background: Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service.Methods/Design: We will be conducting a randomized controlled trial to compare the directed home medicines review service to usual care following acute coronary syndromes. All patients aged 18 to 80 years and with a working diagnosis of acute coronary syndrome, who are admitted to two public, acute care hospitals, will be screened for enrolment into the trial. Exclusion criteria will include: not being discharged home, documented cognitive decline, non-Medicare eligibility, and presence of a terminal malignancy. Randomization concealment and sequence generation will occur through a centrally-monitored computer program. Patients randomized to the control group will receive usual post-discharge care. Patients randomized to receive the intervention will be offered usual post-discharge care and a directed home medicines review at two months post-discharge. The study endpoints will be six and twelve months post-discharge. The primary outcome will be the proportion of patients who are adherent to a complete, guideline-based medication regimen. Secondary outcomes will include hospital readmission rates, length of hospital stays, changes in quality of life, smoking cessation rates, cardiac rehabilitation completion rates, and mortality.Discussion: As the trial is closely based on an existing service, any improvements observed should be highly translatable into regular practice. Possible limitations to the success of the trial intervention include general practitioner approval of the intervention, general practitioner acceptance of pharmacists' recommendations, and pharmacists' ability to make appropriate recommendations. A detailed monitoring process will detect any barriers to the success of the trial. Given that poor medication persistence following acute coronary syndrome is a worldwide problem, the findings of our study may have international implications for the care of this patient group.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000452998. © 2012 Bernal et al; licensee BioMed Central Ltd

ISA-TAB-Nano: A Specification for Sharing Nanomaterial Research Data in Spreadsheet-based Format

Background and motivation: The high-throughput genomics communities have been successfully using standardized spreadsheet-based formats to capture and share data within labs and among public repositories. The nanomedicine community has yet to adopt similar standards to share the diverse and multi-dimensional types of data (including metadata) pertaining to the description and characterization of nanomaterials. Owing to the lack of standardization in representing and sharing nanomaterial data, most of the data currently shared via publications and data resources are incomplete, poorly-integrated, and not suitable for meaningful interpretation and re-use of the data. Specifically, in its current state, data cannot be effectively utilized for the development of predictive models that will inform the rational design of nanomaterials. Results: We have developed a specification called ISA-TAB-Nano, which comprises four spreadsheet-based file formats for representing and integrating various types of nanomaterial data. Three file formats (Investigation, Study, and Assay files) have been adapted from the established ISA-TAB specification; while the Material file format was developed de novo to more readily describe the complexity of nanomaterials and associated small molecules. In this paper, we have discussed the main features of each file format and how to use them for sharing nanomaterial descriptions and assay metadata. Conclusion: The ISA-TAB-Nano file formats provide a general and flexible framework to record and integrate nanomaterial descriptions, assay data (metadata and endpoint measurements) and protocol information. Like ISA-TAB, ISA-TAB-Nano supports the use of ontology terms to promote standardized descriptions and to facilitate search and integration of the data. The ISA-TAB-Nano specification has been submitted as an ASTM work item to obtain community feedback and to provide a nanotechnology data-sharing standard for public development and adoption