Factors influencing intention to plagiarize among nursing students in the Philippines.

Background: Plagiarism is an ethical concern among students but is insufficiently discussed and acknowledged in some educational institutions. Determining what factors influence plagiarism can help the academic community manage its incidence. Objective: This study determined the factors affecting the intention to plagiarize among Filipino nursing students. Methods: Utilizing a cross-sectional research design, data were gathered from 304 nursing students last June 2021 using valid instruments administered online. Regression analysis identified influencing factors of intention to plagiarize. Results: Findings indicated a generally low intention (M = 1.47, SD = 0.74) to plagiarize among nursing students. Internet literacy (B = -0.314, p <0.001), attitude (B = 0.257, p <0.001), moral obligation (B = -0.236, p <0.001), past behavior (B = 0.139, p <0.001), and subjective norm (B = -0.095, p = -0.001) influenced nursing students' plagiarism intention. Conclusion: Several interrelated factors play major roles in nursing students' tendency to plagiarize. Creating an educational environment that does not favor the unethical practice of plagiarism is recommended for nursing schools.

A high-density linkage map and sex-linked markers for the Amazon Tambaqui Colossoma macropomum.

BACKGROUND: Tambaqui (Colossoma macropomum, Cuvier, 1818) is the most economically important native freshwater fish species in Brazil. It can reach a total length of over 1 m and a weight of over 40 kg. The species displays a clear sex dimorphism in growth performance, with females reaching larger sizes at harvest. In aquaculture, the production of monosex populations in selective breeding programmes has been therefore identified as a key priority. RESULTS: In the present study, a genetic linkage map was generated by double digest restriction-site associated DNA (ddRAD) sequencing from 248 individuals sampled from two F1 families. The map was constructed using 14,805 informative SNPs and spanned 27 linkage groups. From this, the tambaqui draft genome was improved, by ordering the scaffolds into chromosomes, and sex-linked markers were identified. A total of 235 markers on linkage group 26 showed a significant association with the phenotypic sex, supporting an XX/XY sex determination system in the species. The four most informative sex-linked markers were validated on another 206 sexed individuals, demonstrating an accuracy in predicting sex ranging from 90.0 to 96.7%. CONCLUSIONS: The genetic mapping and novel sex-linked DNA markers identified and validated offer new tools for rapid progeny sexing, thus supporting the development of monosex female production in the industry while also supporting breeding programmes of the species.

Genome-wide analysis clarifies the population genetic structure of wild gilthead sea bream (Sparus aurata).

Gilthead sea bream is an important target for both recreational and commercial fishing in Europe, where it is also one of the most important cultured fish. Its distribution ranges from the Mediterranean to the African and European coasts of the North-East Atlantic. Until now, the population genetic structure of this species in the wild has largely been studied using microsatellite DNA markers, with minimal genetic differentiation being detected. In this geographically widespread study, 958 wild gilthead sea bream from 23 locations within the Mediterranean Sea and Atlantic Ocean were genotyped at 1159 genome-wide SNP markers by RAD sequencing. Outlier analyses identified 18 loci potentially under selection. Neutral marker analyses identified weak subdivision into three genetic clusters: Atlantic, West, and East Mediterranean. The latter group could be further subdivided into an Ionian/Adriatic and an Aegean group using the outlier markers alone. Seascape analysis suggested that this differentiation was mainly due to difference in salinity, this being also supported by preliminary genomic functional analysis. These results are of fundamental importance for the development of proper management of this species in the wild and are a first step toward the study of the potential genetic impact of the sea bream aquaculture industry.

Genetic diversity and structure in Arapaima gigas populations from Amazon and Araguaia-Tocantins river basins.

BACKGROUND: Arapaima gigas (Schinz, 1822) is the largest freshwater scaled fish in the world, and an emerging species for tropical aquaculture development. Conservation of the species, and the expansion of aquaculture requires the development of genetic tools to study polymorphism, differentiation, and stock structure. This study aimed to investigate genomic polymorphism through ddRAD sequencing, in order to identify a panel of single nucleotide polymorphisms (SNPs) and to simultaneously assess genetic diversity and structure in wild (from rivers Amazon, Solimões, Tocantins and Araguaia) and captive populations. RESULTS: Compared to many other teleosts, the degree of polymorphism in A. gigas was low with only 2.3% of identified RAD-tags (135 bases long) containing SNPs. A panel of 393 informative SNPs was identified and screened across the five populations. Higher genetic diversity indices (number of polymorphic loci and private alleles, Shannon's Index and HO) were found in populations from the Amazon and Solimões, intermediate levels in Tocantins and Captive, and very low levels in the Araguaia population. These results likely reflect larger population sizes from less urbanized environments in the Amazon basin compared to Araguaia. Populations were significantly differentiated with pairwise FST values ranging from 0.086 (Amazon × Solimões) to 0.556 (Amazon × Araguaia). Mean pairwise relatedness among individuals was significant in all populations (P < 0.01), reflecting a degree of inbreeding possibly due to severe depletion of natural stocks, the species sedentary behaviour and possible sampling biases. Although Mantel test was not significant (P = 0.104; R2 = 0.65), Bayesian analysis in STRUCTURE and discriminant analysis of principal components (DAPC) showed populations of Amazon and Solimões to be genetically differentiated from Araguaia, with Tocantins comprising individuals from both identified stocks. CONCLUSIONS: This relatively rapid genotyping by sequencing approach proved to be successful in delineating arapaima stocks. The approach and / or SNP panels identified should prove valuable for more detailed genetic studies of arapaima populations, including the elucidation of the genetic status of described discrete morphotypes and aid in delivery of conservation programs to maintain genetic diversity in reservoirs across the Amazon region.

Electronic nicotine delivery systems ("e-cigarettes"): review of safety and smoking cessation efficacy.

BACKGROUND AND OBJECTIVES: Cigarette smoking is common among cancer patients and is associated with negative outcomes. Electronic nicotine delivery systems ("e-cigarettes") are rapidly growing in popularity and use, but there is limited information on their safety or effectiveness in helping individuals quit smoking. DATA SOURCES: The authors searched PubMed, Web of Science, and additional sources for published empirical data on safety and use of electronic cigarettes as an aid to quit smoking. REVIEW METHODS: We conducted a structured search of the current literature up to and including November 2013. RESULTS: E-cigarettes currently vary widely in their contents and are sometimes inconsistent with labeling. Compared to tobacco cigarettes, available evidence suggests that e-cigarettes are often substantially lower in toxic content, cytotoxicity, associated adverse effects, and secondhand toxicity exposure. Data on the use of e-cigarettes for quitting smoking are suggestive but ultimately inconclusive. CONCLUSIONS: Clinicians are advised to be aware that the use of e-cigarettes, especially among cigarette smokers, is growing rapidly. These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking. IMPLICATIONS FOR PRACTICE: In the absence of further data or regulation, oncologists are advised to discuss the known and unknown safety and efficacy information on e-cigarettes with interested patients and to encourage patients to first try FDA-approved pharmacotherapies for smoking cessation.

Human junctophilin-2 undergoes a structural rearrangement upon binding PtdIns(3,4,5)P3 and the S101R mutation identified in hypertrophic cardiomyopathy obviates this response.

JP2 (junctophilin-2) is believed to hold the transverse tubular and jSR (junctional sarcoplasmic reticulum) membranes in a precise geometry that facilitates excitation-contraction coupling in cardiomyocytes. We have expressed and purified human JP2 and shown using electron microscopy that the protein forms elongated structures ~15 nm long and 2 nm wide. Employing lipid-binding assays and quartz crystal microbalance with dissipation we have determined that JP2 is selective for PS (phosphatidylserine), with a Kd value of ~0.5 µM, with the N-terminal domain mediating this interaction. JP2 also binds PtdIns(3,4,5)P3 at a different site than PS, resulting in the protein adopting a more flexible conformation; this interaction is modulated by both Ca(2+) and Mg(2+) ions. We show that the S101R mutation identified in patients with hypertrophic cardiomyopathy leads to modification of the protein secondary structure, forming a more flexible molecule with an increased affinity for PS, but does not undergo a structural transition in response to binding PtdIns(3,4,5)P3. In conclusion, the present study provides new insights into the structural and lipid-binding properties of JP2 and how the S101R mutation may have an effect upon the stability of the dyad organization with the potential to alter JP2-protein interactions regulating Ca(2+) cycling.

Causes of death after radical prostatectomy at a large tertiary center.

PURPOSE: Most men treated with radical prostatectomy do not die of prostate cancer. We evaluated the cause of death in a large series of patients who underwent radical prostatectomy and compared the rate of death to that of the general American population. MATERIALS AND METHODS: The study population consisted of 18,209 men who underwent radical prostatectomy at our institution between 1975 and 2009. Close patient followup and a national database were used to identify which patients died and classify the cause of death. These data were compared with general American population data from the National Vital Statistics System. RESULTS: Median age at radical prostatectomy was 59 years (IQR 54.0-63.0). At a median followup of 7.4 years (IQR 3.7-11.9) 1,419 patients had died (7.8%), including 379 of prostate cancer. Actuarial 10 and 20-year overall survival rates after radical prostatectomy were 92.6% and 69.2%, respectively. The overall death rate was lower in men treated with radical prostatectomy than in the general American population (standardized mortality ratio 0.47, 95% CI 0.44-0.49). Differences were particularly pronounced for heart disease, chronic respiratory conditions, diabetes and infection. Of men who died of a nonprostate cancer cause 44.0% died of a secondary malignancy. CONCLUSIONS: Overall survival after radical prostatectomy is excellent. Men who undergo radical prostatectomy usually die of a nonprostate cancer cause. Almost half of patients who survive prostate cancer die of a secondary malignancy, likely due to the selection of surgical candidates at low cardiopulmonary risk.

Plasma Plasmodium falciparum histidine-rich protein-2 concentrations are associated with malaria severity and mortality in Tanzanian children.

Plasma Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) concentrations, a measure of parasite biomass, have been correlated with malaria severity in adults, but not yet in children. We measured plasma PfHRP-2 in Tanzanian children with uncomplicated (n = 61) and cerebral malaria (n = 45; 7 deaths). Median plasma PfHRP-2 concentrations were higher in cerebral malaria (1008 [IQR 342-2572] ng/mL) than in uncomplicated malaria (465 [IQR 36-1426] ng/mL; p = 0.017). In cerebral malaria, natural log plasma PfHRP-2 was associated with coma depth (r = -0.42; p = 0.006) and mortality (OR: 3.0 [95% CI 1.03-8.76]; p = 0.04). In this relatively small cohort study in a mesoendemic transmission area of Africa, plasma PfHRP-2 was associated with pediatric malaria severity and mortality. Further studies among children in areas of Africa with higher malaria transmission and among children with different clinical manifestations of severe malaria will help determine the wider utility of quantitative PfHRP-2 as a measure of parasite biomass and prognosis in sub-Saharan Africa.

Eurythmy Therapy in anxiety.

Anxiety is a highly frequent condition; many patients seek complementary treatment. One of these is anthroposophic medicine (AM) using therapeutic approaches that are based on a distinct concept of the human organism, illness, and healing. AM is applied in anxiety; however, little is known about underlying therapeutic concepts, the effectiveness, and the modalities of clinical reasoning and judgment. Presented is a 21-year-old woman who had suffered from severe and increasing anxiety for 6 months, which had led to social isolation and complete sick leave from work. She had attended an AM health care center and counseling at a psychiatric hospital but had not improved significantly after 6 months. Eurythmy therapy (EYT) was then applied for 8 weeks. Within the AM pathophysiological context, the patient was diagnosed as having stress-induced anxiety based on a juvenile disturbance of the rhythmical system. Associated symptoms were specific anomalies in the patient's eurythmy movement pattern, a "breathed-in-upwards syndrome." In the EYT sessions, clear interconnections between EYT-exercises and symptom-relief were observable, paralleled by a substantial relief of the patient's anxiety. EYT might have some impact on anxiety syndrome and should be investigated in more detail.

Mean arterial pressure and systolic blood pressure for detection of hypotension during hemapheresis: implications for patients with baseline hypertension.

Mean arterial pressure (MAP) has been characterized as a more sensitive and physiologically appropriate hemodynamic parameter in the detection of hemapheresis-related hypotension, resulting in a much closer correlation with the presence of symptomatic hypotension. Patients were enrolled over a 12-month period and data collected on any previous diagnosis of hypertension, antihypertensive therapy used, indication for apheresis, age decile, and gender. Baseline vital signs, any hypotensive signs or symptoms observed, and the patient's vital signs at the time of any hypotensive episode were recorded. Patients were assigned to a subgroup, sensitivity and specificity analysis performed, positive likelihood ratios calculated, receiver operating characteristic curves constructed, and ideal cutoff values identified. The incidence of hypotension among our study population was found to be 6.8%. Over all procedures, systolic blood pressure (SBP) was determined to be a "poor" test for detecting hypotension, while MAP demonstrated a "fair" capacity. A downward normalization was evident in the ideal cutoff value based upon a patient's hypertensive history. The currently accepted SBP less than 80 mmHg cutoff failed to detect hypotensive episodes among baseline hypertensive patients, raising questions about its sensitivity. Based upon physiologic principles and study findings, a MAP-based criterion is preferable in the diagnosis of hypotension during hemapheresis.

The departmental advisor's effect on medical students' confidence when the advisor evaluates or recruits for their own program during the match.

BACKGROUND: Departmental advisors who also serve on residency selection committees at their institutions have a dual role as advisor and evaluator of residency applicants. PURPOSE: This study explores this dual role and its effect on medical students' confidence in the advising relationship. METHODS: A secure, anonymous questionnaire was made available online to 1,362 graduating medical students from ten U.S. medical schools who participated in the 2001 match. RESULTS: Of the 740 respondents (54.3% response rate), 349 (47.2%) met with a departmental advisor at their medical school. Most (212 or 60.7%) had departmental advisors who also served on a residency selection committee. These applicants reported feeling significantly less comfortable with their advisors and were significantly more likely to make misleading statements during the match. CONCLUSIONS: Applicants whose departmental advisors serve on a residency selection committee have less confidence in the advising relationship. These interactions may have adverse effects on the clinical and professional development of medical students.

Febrile nonhemolytic transfusion reactions. Management by premedication and cost implications in adult patients.

CONTEXT: Febrile nonhemolytic transfusion reactions (FNHTRs) cause unwelcome interruptions during the course of blood product transfusions and necessitate measures to verify the nature of the reaction and to exclude certain dangerous reactions, such as hemolytic and septic phenomena. OBJECTIVE: To examine transfusion medicine data to determine the clinical implications of the routine administration of antipyretic medication to adult patients before transfusion for the prevention of FNHTRs. DESIGN: A retrospective review was conducted of FNHTR data during 5 years (1998-2002), and a determination was made of the cost of a transfusion complicated by an FNHTR. In addition, a comparative cost analysis was performed using our data and published data on the incidence of FNHTRs. The clinical implications of medication with respect to possible drug-induced adverse effects were assessed, as well as the potential interference with diagnosing other forms of transfusion reactions and the mitigation of the clinical effect of an FNHTR. RESULTS: For nearly 120,000 U of transfused blood components, approximately 80% of which were preceded by antipyretic medication during the study period, the overall incidence of FNHTR was found to be 0.09%. Furthermore, there was no evidence of antipyretic-associated complications, nor any evidence that antipyretics prevented the recognition of other more dangerous complications of transfusions. CONCLUSION: Our findings indicate that this practice provides significant advantages to the recipient of a transfusion, but does not appear to yield significant cost benefits for the health care provider.

A new HLA-A1 mutation: a novel, null variant allele.

From an unusually informative family of 8 with near identical parental haplotypes (a and c), which differed by a single nucleotide substitution, we identified a new HLA-A1 null variant. While serologic antigen typing initially showed a "blank" allele in maternal haplotype "c" and 2 male offspring, more sophisticated DNA molecular HLA typing subsequently revealed the presence of a novel HLA-A0101 allele. Sequence-based typing showed a point mutation consisting of a nucleotide substitution of a cytosine for a guanine at nucleotide 215 yielding an amino acid change of arginine to proline at codon 48 in exon 2 (R48P). The impact on the HLA and immunogenetics laboratory is the need to not assume that all blanks are homozygous, as well as the need for the availability of high-resolution DNA molecular typing to clarify new alleles and to detect HLA-A null variants.

Communication between programs and applicants during residency selection: effects of the match on medical students' professional development.

PURPOSE: Communication between programs and applicants during the Match has raised concern among medical educators. This study explores the patterns of such communication and its effect on the ethical and professional development of medical students. METHOD: In March and April 2001, the authors made a secure, anonymous questionnaire available online to 1,362 medical students who were graduating from ten U.S. medical schools and who participated in the 2001 Match. Data analysis included chi square, ANOVA, and correlation tests as appropriate. RESULTS: A total of 740 students (54.3%) completed the questionnaire. Patterns of communication between programs and applicants varied significantly by medical school and specialty. Communication initiated by applicants came predominantly from those from less highly ranked medical schools (p =.000), and those applying to specialties with lower fill rates (p =.000). Programs initiated significantly more communication with applicants from more highly ranked schools (p =.006), and with those applying to specialties with higher fill rates (p =.000). The amount of pressure felt by applicants was related to the level of communication, whether initiated by applicants (p =.028) or programs (p =.000). Applicants who felt more pressure were significantly more likely to make misleading statements to programs (p =.000). CONCLUSIONS: Communication between applicants and programs during the Match varies and may have adverse effects on the ethical and professional development of medical students. This study provides support for proposals to limit communication between programs and applicants during the residency selection process.

Comprehensive graphic-based display of clinical pathology laboratory data.

In this age of ever-increasing demands for and uses of patient data, technologic advancements in the form of electronic patient records permit improved data access and prompt retrieval of higher quality patient care data, with more versatility in display, facilitating the integration of information concerning patients over time and between settings of care, which is in turn more accessible for use by practitioners and provides more efficient and effective decision support in areas of patient care. The graphic display of laboratory data is central to the evolving computerized patient record and needs to be taken into careful consideration along with clinician perception and ease of data interpretation in redesigning the graphic reporting of numeric clinical pathology laboratory data. An ideal system should generate user-friendly, graphic-based comprehensive reports highlighting abnormalities with trends for diagnosis, clinical management, and risk-factor detection.

Mean arterial pressure (MAP): an alternative and preferable measurement to systolic blood pressure (SBP) in patients for hypotension detection during hemapheresis.

Current protocols utilize systolic blood pressure (SBP) of less than 80 mmHg as objective evidence of hypotension during hemapheresis. However, tissue hypoperfusion is the pathophysiologic endpoint of low blood pressure, and mean arterial pressure (MAP), rather than SBP, is the physiologic driving force behind blood flow to organs and tissues. It is thus hypothesized that MAP is more appropriate than SBP in the assessment of hypotension and that a threshold MAP can be utilized as a sensitive indicator of hypotension during hemapheresis. Thirty-one patients who experienced hypotension during hemapheresis over a 4.5 year period reflecting forty-four hypotensive episodes were selected. The initial phase of each hemapheresis procedure provided baseline MAP and blood pressure (BP) measurements as control values. BP and MAP were then determined at the onset of subjective hypotension and compared to one another by using regression and sensitivity analyses. Correlation coefficients between SBP and MAP were found to be 0.8097 in baseline normotensive patients and 0.7725 in hypotensive patients. Sensitivity in the detection of hypotension was 0.09% for SBP equal to 80 mmHg and 56.81% for MAP equal to 70 mmHg. An SBP of 80 mmHg or less was therefore concluded to be a less sensitive and physiologically less appropriate measurement of hypotension than MAP. As a single value less than 70 mmHg or a series of successive measurements trending downward toward 70 mmHg, MAP provides an objective assessment of hypotension that may precede hemodynamic decompensation.

Trimethoprim-induced aseptic meningitis in an adolescent male.

Drug-induced aseptic meningitis attributable to trimethoprim alone has only rarely been documented in the literature. A previously healthy adolescent male presented to our hospital with recurrent headaches, photophobia, and meningismus after serially starting and stopping trimethoprim. Cerebrospinal fluid studies revealed elevated white blood cell counts with a polymorphonuclear predominance. This case is the second documented report of trimethoprim-induced aseptic meningitis in a pediatric patient.