Broad and Potent Neutralizing Antibodies Recognize the Silent Face of the HIV Envelope.

Broadly neutralizing antibodies (bNAbs) against HIV-1 envelope (Env) inform vaccine design and are potential therapeutic agents. We identified SF12 and related bNAbs with up to 62% neutralization breadth from an HIV-infected donor. SF12 recognized a glycan-dominated epitope on Env's silent face and was potent against clade AE viruses, which are poorly covered by V3-glycan bNAbs. A 3.3Å cryo-EM structure of a SF12-Env trimer complex showed additional contacts to Env protein residues by SF12 compared with VRC-PG05, the only other known donor-derived silentface antibody, explaining SF12's increased neutralization breadth, potency, and resistance to Env mutation routes. Asymmetric binding of SF12 was associated with distinct N-glycan conformations across Env protomers, demonstrating intra-Env glycan heterogeneity. Administrating SF12 to HIV-1-infected humanized mice suppressed viremia and selected for viruses lacking the N448gp120 glycan. Effective bNAbs can therefore be raised against HIV-1 Env's silent face, suggesting their potential for HIV-1 prevention, therapy, and vaccine development.

Associations among disability, depression, anxiety, stress, and quality of life between stroke survivors and their family caregivers: An Actor-Partner Interdependence Model.

AIM: To explore the effects of disability, depressive, anxiety and stress symptoms on patients' and their partners' quality of life (QoL) using the actor-partner interdependence model (APIM). DESIGN: A cross-sectional study using actor-partner interdependence model. METHODS: We recruited 183 dyads of stroke survivors and their family caregivers in Indonesia. The World Health Organization Disability Assessment (WHODAS 2.0), Depression, Anxiety and Stress (DASS-42) and Rand Short Form Health Survey (SF-36) were used to measure disability, depressive, anxiety and stress symptoms and QoL of stroke survivors and family caregivers. The actor-partner interdependence model was tested using multilevel modelling. The actor-partner interdependence mediation model (APIMeM) was applied to estimate the direct and indirect effect. RESULTS: Disability had actor effects on stroke survivor's overall QoL and partner effect on family caregiver's overall QoL. More severe disability of stroke survivors was associated with a lower overall QoL of their own and that of family caregiver's overall QoL. Depressive symptoms of stroke survivors had actor effects on stroke survivors' overall QoL and partner effects on family caregivers' overall QoL. Actor and partner effects also exist on family caregiver's depression symptoms to their own overall QoL and stroke survivor's overall QoL. Moreover, higher anxiety symptoms were associated with lower levels of their own and partner's overall QoL in both stroke survivors and family caregivers. Stroke survivor's stress symptoms also negatively associated with their own and family caregiver's overall QoL. However, a family caregiver's stress without a partner effects on stroke survivor's overall QoL. The APIMeM analysis showed that disability of stroke survivors directly decreased their own overall, physical (PCS) and mental QoL (MCS). Also, disability mediated by stroke survivor's depression, anxiety and stress symptoms decreased both stroke survivor's and family caregiver's physical (PCS) and mental QoL (MCS). CONCLUSION: The findings suggest that stroke survivors and family caregivers may influence each other during the caregiving process and social life. The disability of stroke survivors, and the depression, anxiety and stress symptoms of stroke survivors and family caregivers affect their own QoL and their partners' QoL. Disability of stroke survivors directly decreased their own overall, physical (PCS) and mental QoL (MCS). Also, it indirectly via stroke survivor's depression, anxiety and stress symptoms decreased both stroke survivor's and family caregiver's physical (PCS) and mental QoL (MCS). IMPACT: Dyadic actor-partner interdependence models have shown promising potential to predict the QoL among patients and family caregivers. The dyadic effects of disability, depression, anxiety and stress symptoms on the QoL of stroke survivors and family caregivers can be applied to guide the future development of nursing intervention addressed decreasing depression, anxiety and stress symptoms to optimize health outcomes among stroke survivors and their family caregivers.

Nursing and Biobanking.

Nurses are a pivotal component of the translational research movement and apply scientific discoveries to the healthcare and clinical practice fields. Biobanking is also an important factor in furthering translational research by providing biospecimens and related clinical data to the research community. The effectiveness of any biobanking effort necessitates the enrollment of large numbers of diverse participants, which signifies a need for the nursing profession to secure the knowledge necessary to impact biobanking practices and to promote participant advocacy. In addition, biobanks provide the volume, variety, veracity, and velocity of data that can address the challenges of nursing research. Nurse scientists, research nurse coordinators and clinical research and practice nurses must be informed about the various benefits and risks associated with biobanking in addition to ethical issues surrounding informed consent, participant privacy, and the release of research results. Ultimately, nurses need to possess competencies to facilitate biobanking practices both at the research bench and at the point of care.

Novel and emerging strategies for longitudinal data collection.

PURPOSE: To describe novel and emerging strategies practiced globally in research to improve longitudinal data collection. ORGANIZING CONSTRUCT: In research studies, numerous strategies such as telephone interviews, postal mailing, online questionnaires, and electronic mail are traditionally utilized in longitudinal data collection. However, due to technological advances, novel and emerging strategies have been applied to longitudinal data collection, such as two-way short message service, smartphone applications (or "apps"), retrieval capabilities applied to the electronic medical record, and an adapted cloud interface. In this review, traditional longitudinal data collection strategies are briefly described, emerging and novel strategies are detailed and explored, and information regarding the impact of novel methods on participant response rates, the timeliness of participant responses, and cost is provided. We further discuss how these novel and emerging strategies affect longitudinal data collection and advance research, specifically nursing research. CONCLUSIONS: Evidence suggests that the novel and emerging longitudinal data collection strategies discussed in this review are valuable approaches to consider. These strategies facilitate collecting longitudinal research data to better understand a variety of health-related conditions. Future studies, including nursing research, should consider using novel and emerging strategies to advance longitudinal data collection. CLINICAL RELEVANCE: A better understanding of novel and emerging longitudinal data collection strategies will ultimately improve longitudinal data collection as well as foster research efforts. Nurse researchers, along with all researchers, must be aware of and consider implementing novel and emerging strategies to ensure future healthcare research success.

Motor and sensory effects of ipsilesional upper extremity hypothermia and contralesional sensory training for chronic stroke patients.

UNLABELLED: As hypothermia by immersion can reduce the sensory nerve conduction velocity, this study hypothesized that the reduction of sensory input to the ipsilesional upper extremity (UE) using cryotherapy would reduce the inhibitory activity of the contralesional hemisphere in chronic stroke subjects. OBJECTIVE: In this study, hypothermia was applied by immersing the ipsilesional UE in association with sensory training of the contralesional UE of stroke patients to assess the immediate (e.g. sensorimotor function, hemodynamics, and levels of comfort) and long-term (sensory and motor performances of the UEs) effects. METHODS: The sample included 27 stroke patients allocated into group 1 (n = 14), which received conventional physiotherapy for the affected UE, and group 2 (n = 13), which underwent 10 sessions of immersion hypothermia of the ipsilesional wrist and hand. Assessments were performed pre- and post-treatment and at follow-up using esthesiometry, the Fugl-Meyer Assessment (FMA), the Nottingham Sensory Assessment, functional tests, tactile and weight discrimination, motor sequence, level of comfort, and hemodynamic parameters. RESULTS: The immediate effects of hypothermia using immersion of the ipsilesional UE in association with sensory training of the contralesional UE were hemodynamic stability during and after hypothermia, the absence of sensory abnormalities in the contralesional UE, hypoesthesia in the ipsilesional extremity (dermatomes C6 and C8) (P < 0.05), the maintenance of acceptable levels of comfort, and good patient compliance to the technique. The long-term effects included significant increases in scores on tests performed without functional vision, in scores on blindfolded functional tests, and in tactile localization and joint position sense for the contralesional hand in group 2 as well as the maintenance of these gains at long-term follow-up (5 weeks). Improvement was also found in the tactile function of the C6 and C7 dermatomes of the contralesional hand (P < 0.05). CONCLUSIONS: The use of immersion hypothermia on the ipsilesional UE in association with sensory training of the contralesional UE improved motor function and sensitivity in the contralesional UE of individuals with chronic stroke. Immersion hypothermia of the ipsilesional UE in chronic stroke patients is a safe, practical, inexpensive, and easily applied technique.

Using a single screening question for depressive symptoms in patients with acute coronary syndrome.

BACKGROUND: Despite the prevalence of depressive symptoms and increased risk for future cardiovascular events, depressive symptoms frequently go underrecognized in patients hospitalized for acute coronary syndrome (ACS). Identifying an effective approach to depressive symptom screening is imperative in this population. OBJECTIVE: The purpose of this cross-sectional study was to explore the agreement between Beck Depression Inventory-II (BDI-II) scores and a single screening question for depressive symptoms in 1122 patients hospitalized for ACS. METHODS: Independent-samples t tests and χ tests were used to compare the groups with BDI-II scores of 14 or higher and lower than 14. Three separate agreement analyses were conducted using categorized BDI-II scores (≥14, ≥20, and ≥29). Agreement of the BDI-II categories with the responses to the single screening question was assessed with the simple κ statistic. Sensitivity and specificity were calculated using the BDI-II categories as the criterion standards for depressive symptom screening. RESULTS: The agreement analysis revealed a moderate level of agreement (κ coefficient = 0.42) between the BDI-II scores of 14 or higher and the single screening question. Of the participants who reported a BDI-II score of 14 or higher, 61.65% answered yes to the single screening question (sensitivity, 0.62). For those who had BDI-II scores of lower than 14, a total of 82% responded no to the single screening question (specificity, 0.82). When using higher BDI-II scores to define depressive symptoms (≥20 and ≥29), the level of agreement decreased, whereas sensitivity increased to 0.76 and 0.90, with a trade-off in specificity (0.79 and 0.74, respectively). CONCLUSIONS: These results suggest that the single screening question for depressive symptoms correctly identifies depressive symptoms 62% of the time but inappropriately identifies depressive symptoms 18% of the time in patients hospitalized for ACS. This suggests that the single screening question for depressive symptoms may be used with caution to initially screen patients with ACS, who can then undergo a more thorough assessment for clinical depression.

Associations Between the COVID-19 Pandemic and New Nurses' Transition to Practice Outcomes: A Multi-site, Longitudinal Study.

Background: The transition between nursing school and nursing practice has been well studied and recognized as a turbulent time for new nurses. Existing literature suggests that transition to practice (TTP) programs can successfully support new nurses through this challenging period. However, TTP program outcomes have not been studied related to the COVID-19 pandemic, which altered TTP experiences for many new nurses by limiting their access to clinical sites for hands-on patient care experience and shifting delivery of nursing education and TTP programs from in-person to virtual environments. Purpose: The purpose of this study was to analyze the associations between TTP outcomes and the COVID-19 pandemic. Methods: This was a retrospective correlational, longitudinal study using secondary analysis of Vizient /AACN Nurse Residency Program survey data from the Casey-Fink Graduate Nurse Experience Survey and the Nurse Resident Progression Survey. Self-reported data from new nurses in Southeast Texas who participated in a standardized TTP program before the COVID-19 pandemic (2017-2019) were compared with self-reported data from nurses who participated in the TTP program during the pandemic (2020 and 2021). Results: A total of 2,673 nurses participated in this study. When adjusting for demographic composition of the cohorts, statistically significant differences (p < .05) were identified in the advocacy, patient safety, and commitment outcomes with a decline in change scores from baseline to 12 months in the COVID-19 pandemic cohort compared to the pre-COVID-19 pandemic cohort. Conclusion: Our findings provide new information on the impact of the COVID-19 pandemic on new nurses' participating in a standardized TTP program. The results indicate that patient safety and commitment to staying employed in the organization and the nursing profession should be priority improvement areas for employers and TTP program staff as they work to support new nurses' TTP in a pandemic.

In-Person, Remote, or Hybrid Instruction? A Quality Improvement Assessment of a Six Week Interprofessional Education Pathway Program for Undergraduate Pre-Health Students.

There is an emphasis on increasing the diversity of healthcare providers with the goal of reducing health disparities among racial/ethnic minorities. To support this initiative, pathway programs were designed to provide educational and career support to students belonging to racial/ethnic minorities or those who have challenges applying to or entering health professions. As a consequence of the COVID-19 pandemic, pathway programs have assumed various instructional delivery formats (e.g., face to face, virtual, hybrid) with little knowledge on the satisfaction of such methods. The current preliminary study examines whether in person, virtual, or hybrid learning is most effective for underrepresented pre-health undergraduate students who are engaged in a six-week interprofessional health pathway program. Quantitative and qualitative data was collected at one time point towards the end of the program when it was offered in person, virtually, and in hybrid format. Results revealed that the pre-health pathway program received highest satisfaction when presented in a hybrid format and least satisfaction when presented in virtual instruction. Qualitative data suggests that virtual instruction increases feelings of isolation and complicates educational information due to the limitations of virtual streaming. Implications for pathway design are discussed.

Novel role of STAT3 in microglia-dependent neuroinflammation after experimental subarachnoid haemorrhage.

BACKGROUND AND PURPOSE: Signal transducer and activator of transcription 3 (STAT3) may contribute to the proinflammation in the central nervous system diseases by modulating the microglial responses. Thus, this study was intended to investigate the effect of STAT3 on microglia-dependent neuroinflammation and functional outcome after experimental subarachnoid haemorrhage (SAH). METHODS: The SAH model was established by endovascular perforation in the mouse. Real-time PCR (RtPCR) and western blot were used to examine the dynamic STAT3 signalling pathway responses after SAH. To clarify the role of the STAT3 signalling pathway in the microglia-dependent neuroinflammation after SAH, the microglia-specific STAT3 knockout (KO) mice were generated by the Cre-LoxP system. The neurological functions were assessed by Catwalk and Morris water maze tests. Neuronal loss after SAH was determined by immunohistochemistry staining. Microglial polarisation status after STAT3 KO was then examined by RtPCR and immunofluorescence. RESULTS: The STAT3 and Janus kinase-signal transducer 2 activated immediately with the upregulation and phosphorylation after SAH. Downstream factors and related mediators altered dynamically and accordingly. Microglial STAT3 deletion ameliorated the neurological impairment and alleviated the early neuronal loss after SAH. To investigate the underlying mechanism, we examined the microglial reaction after STAT3 KO. STAT3 deletion reversed the increase of microglia after SAH. Loss of STAT3 triggered the early morphological changes of microglia and primed microglia from M1 to M2 polarisation. Functionally, microglial STAT3 deletion suppressed the SAH-induced proinflammation and promoted the anti-inflammation in the early phase. CONCLUSIONS: STAT3 is closely related to the microglial polarisation transition and modulation of microglia-dependent neuroinflammation. Microglial STAT3 deletion improved neurological function and neuronal survival probably through promoting M2 polarisation and anti-inflammatory responses after SAH. STAT3 may serve as a promising therapeutic target to alleviate early brain injury after SAH.

A naturally arising broad and potent CD4-binding site antibody with low somatic mutation.

The induction of broadly neutralizing antibodies (bNAbs) is a potential strategy for a vaccine against HIV-1. However, most bNAbs exhibit features such as unusually high somatic hypermutation, including insertions and deletions, which make their induction challenging. VRC01-class bNAbs not only exhibit extraordinary breadth and potency but also rank among the most highly somatically mutated bNAbs. Here, we describe a VRC01-class antibody isolated from a viremic controller, BG24, that is much less mutated than most relatives of its class while achieving comparable breadth and potency. A 3.8-Å x-ray crystal structure of a BG24-BG505 Env trimer complex revealed conserved contacts at the gp120 interface characteristic of the VRC01-class Abs, despite lacking common CDR3 sequence motifs. The existence of moderately mutated CD4-binding site (CD4bs) bNAbs such as BG24 provides a simpler blueprint for CD4bs antibody induction by a vaccine, raising the prospect that such an induction might be feasible with a germline-targeting approach.

The Dynamics of Microglial Polarization Reveal the Resident Neuroinflammatory Responses After Subarachnoid Hemorrhage.

Neuroinflammation plays a critical role in the pathogenesis of subarachnoid hemorrhage (SAH). Microglia, as the resident immune cells, orchestrate neuroinflammation distinctly in neurological diseases with different polarization statuses. However, microglial polarizations in the neuroinflammatory responses after SAH are not fully understood. In this study, we investigated the dynamics of microglial reaction in an endovascular perforated SAH model. By using the Cx3cr1GFP/GFP Ccr2RFP/RFP transgenic mice, we found that the reactive immune cells were largely from resident microglia pool rather than infiltrating macrophages. Immunostaining and real-time PCR were employed to analyze the temporal microglial polarization and the resulting inflammatory responses. Our results showed that microglia accumulated immediately after SAH with a centrifugal spreading through the Cortex Adjacent to the Perforated Site (CAPS) to the remote motor cortex. Microglia polarized dynamically from M1 to M2 phenotype along with the morphological transformation from ramified to amoeboid shapes. The ramified microglia demonstrated the M1 property, which suggested the function-related microglial polarization occurred prior to morphological transformation after SAH. Bipolar-shaped microglia appeared as the intermediate and transitional status with the capacity of bidirectional polarization. The microglial polarization status is distinct in molecular inflammatory responses; M1-related pro-inflammation was predominant in the early phase and subsequently transited to the M2-related anti-inflammation. The systematic characterization of the dynamics of microglial polarization in this study contributes to the understanding of the origin of neuroinflammatory responses after SAH and provides key foundation for further investigations to develop target treatment.

Integrating Diverse Disciplines to Enhance Interprofessional Competency in Healthcare Delivery.

Interprofessional education (IPE) typically involves clinical simulation exercises with students from medical and nursing schools. Yet, healthcare requires patient-centered teams that include diverse disciplines. Students from public health and informatics are rarely incorporated into IPE, signaling a gap in current educational practices. In this study, we integrated students from administrative and non-clinical disciplines into traditional clinical simulations and measured the effect on communication and teamwork. From July 2017-July 2018, 408 students from five schools (medicine, nursing, dentistry, public health, and informatics) participated in one of eight three-hour IPE clinical simulations with Standardized Patients and electronic health record technologies. Data were gathered using a pre-test-post-test interventional Interprofessional Collaborative Competency Attainment Survey (ICCAS) and through qualitative evaluations from Standardized Patients. Of the total 408 students, 386 (94.6%) had matched pre- and post-test results from the surveys. There was a 15.9% improvement in collaboration overall between the pre- and post-tests. ICCAS competencies showed improvements in teamwork, communication, collaboration, and conflict management, with an average change from 5.26 to 6.10 (t = 35.16; p < 0.001). We found by creating new clinical simulations with additional roles for non-clinical professionals, student learners were able to observe and learn interprofessional teamwork from each other and from faculty role models.

Effects of Gender-Specific Differences, Inflammatory Response, and Genetic Variation on the Associations Among Depressive Symptoms and the Risk of Major Adverse Coronary Events in Patients With Acute Coronary Syndrome.

Depressive symptoms independently contribute to major adverse coronary events (MACEs), with the biological immune response to depression being a likely mediator of this relationship. To determine whether genetic- and/or gender-specific phenotypic differences contribute to associations among depressive symptoms, inflammatory response, and risk of MACE in patients with acute coronary syndrome (ACS), we conducted a prospective study of 1,117 ACS patients to test a gender-specific model in which depressive symptoms (Beck Depression Inventory-II [BDI-II]) are associated with risk of MACE. Cox proportional hazards models were used to model time to incident MACE and determine whether single-nucleotide polymorphisms (SNPs) in specific inflammatory protein-coding genes and depressive symptoms interact to influence levels of inflammatory proteins or risk of MACE. Females had significantly higher high-sensitivity C-reactive protein and monocyte chemoattractant protein-1 levels. Depression status differed by gender (29.9% of females and 21.1% of males had BDI-II scores indicative of depression [ p = .0014]). Depressive symptoms were associated with MACE; however, the interaction between these symptoms and gender was not significant. SNPs and depressive symptoms did not interact to influence inflammation or MACE. More females than males had BDI-II scores indicative of depression, yet the association between positive depressive symptom status and MACE did not vary by gender. Nor did the SNPs interact with depressive symptoms to influence inflammation or MACE. It remains of interest to identify a high-risk subgroup of ACS patients with genetic polymorphisms that result in immunoinflammatory dysregulation in the presence of depressive symptoms.

Sensory deficits in ipsilesional upper-extremity in chronic stroke patients.

Objective To investigate somatosensory deficits in the ipsilesional wrist and hand in chronic stroke patients and correlate these deficits with contralesional sensorimotor dysfunctions, functional testing, laterality and handedness.Methods Fifty subjects (twenty-two healthy volunteers and twenty-eight stroke patients) underwent evaluation with Semmes-Weinstein monofilaments, the sensory and motor Fugl-Meyer Assessment, the Nottingham Sensory Assessment in both wrists and hands and functional tests.Results Twenty-five patients had sensory changes in the wrist and hand contralateral to the stroke, and eighteen patients (64%) had sensory deficits in the ipsilesional wrist and hand. The most significant ipsilesional sensory loss was observed in the left-handed patients. We found that the patients with brain damage in the right hemisphere had better scores for ipsilesional tactile sensation.Conclusions A reduction in ipsilesional conscious proprioception, tactile or thermal sensation was found in stroke subjects. Right hemisphere damage and right-handed subjects had better scores in ipsilesional tactile sensation.

When decision heuristics and science collide.

The ongoing discussion among scientists about null-hypothesis significance testing and Bayesian data analysis has led to speculation about the practices and consequences of "researcher degrees of freedom." This article advances this debate by asking the broader questions that we, as scientists, should be asking: How do scientists make decisions in the course of doing research, and what is the impact of these decisions on scientific conclusions? We asked practicing scientists to collect data in a simulated research environment, and our findings show that some scientists use data collection heuristics that deviate from prescribed methodology. Monte Carlo simulations show that data collection heuristics based on p values lead to biases in estimated effect sizes and Bayes factors and to increases in both false-positive and false-negative rates, depending on the specific heuristic. We also show that using Bayesian data collection methods does not eliminate these biases. Thus, our study highlights the little appreciated fact that the process of doing science is a behavioral endeavor that can bias statistical description and inference in a manner that transcends adherence to any particular statistical framework.

The bidirectional relationship between myocardial infarction and depressive disorders: a follow-up study.

BACKGROUND: Data from multiple studies have shown the relationship between myocardial infarction (MI) and depressive disorders; however, most of these studies have focused only on one direction in evaluating the effect of depressive disorders on MI outcomes. This study analyzed data compiled from a large-scale dataset, the National Health Insurance Research Database, to determine whether a bidirectional relationship exists between MI and depressive disorders. METHODS: A total of 3482 patients diagnosed with MI between 2002 and 2004 were included in analyzing the effects of MI on depressive disorders. A total of 26,418 patients diagnosed with depressive disorders between 2002 and 2004 were included in studying the effect of depressive disorders on MI. The comparison groups of both analyses were 4-fold larger than the case group. The Cox proportional hazard regression model was used to analyze the results. RESULTS: The risk of MI patients developing depressive disorders was significantly higher (P<.001) than that of the comparison group, even after the data were adjusted for the variables of age, gender, income, region, and the Charlson Comorbidity Index. Conversely, the risk of patients with depressive disorders developing MI was not significantly higher than that of the comparison group after we controlled for covariates. CONCLUSION: The patients with MI exhibited a significantly higher risk of developing depressive disorders compared with the patients without MI. The results suggest that health providers should carefully manage the treatment offered for mental conditions and sensitively detect the psychological reactions of patients with MI.

Reply to Rouder (2014): good frequentist properties raise confidence.

Established psychological results have been called into question by demonstrations that statistical significance is easy to achieve, even in the absence of an effect. One often-warned-against practice, choosing when to stop the experiment on the basis of the results, is guaranteed to produce significant results. In response to these demonstrations, Bayes factors have been proposed as an antidote to this practice, because they are invariant with respect to how an experiment was stopped. Should researchers only care about the resulting Bayes factor, without concern for how it was produced? Yu, Sprenger, Thomas, and Dougherty (2014) and Sanborn and Hills (2014) demonstrated that Bayes factors are sometimes strongly influenced by the stopping rules used. However, Rouder (2014) has provided a compelling demonstration that despite this influence, the evidence supplied by Bayes factors remains correct. Here we address why the ability to influence Bayes factors should still matter to researchers, despite the correctness of the evidence. We argue that good frequentist properties mean that results will more often agree with researchers' statistical intuitions, and good frequentist properties control the number of studies that will later be refuted. Both help raise confidence in psychological results.

Nursing and genetic biobanks.

Biobanks function as vital components in genetic research, which often requires large disease-based or population-based biospecimens and clinical data to study complex or rare diseases. Genetic biobanks aim to provide resources for translational research focusing on rapidly moving scientific findings from the laboratory into health care practice. The nursing profession must evolve as genetic biobanking practices advance. Nursing involvement in genetic biobanking practices comes with a distinct set of educational, ethical, and practice competencies. In response to these growing competency standards, nursing science developed a conceptual framework and continues to study ethical considerations to guide genetic biobanking initiatives.

The influence of initial beliefs on judgments of probability.

This study aims to investigate whether experimentally induced prior beliefs affect processing of evidence including the updating of beliefs under uncertainty about the unknown probabilities of outcomes and the structural, outcome-generating nature of the environment. Participants played a gambling task in the form of computer-simulated slot machines and were given information about the slot machines' possible outcomes without their associated probabilities. One group was induced with a prior belief about the outcome space that matched the space of actual outcomes to be sampled; the other group was induced with a skewed prior belief that included the actual outcomes and also fictional higher outcomes. In reality, however, all participants sampled evidence from the same underlying outcome distribution, regardless of priors given. Before and during sampling, participants expressed their beliefs about the outcome distribution (values and probabilities). Evaluation of those subjective probability distributions suggests that all participants' judgments converged toward the observed outcome distribution. However, despite observing no supporting evidence for fictional outcomes, a significant proportion of participants in the skewed priors condition expected them in the future. A probe of the participants' understanding of the underlying outcome-generating processes indicated that participants' judgments were based on the information given in the induced priors and consequently, a significant proportion of participants in the skewed condition believed the slot machines were not games of chance while participants in the control condition believed the machines generated outcomes at random. Beyond Bayesian or heuristic belief updating, priors not only contribute to belief revision but also affect one's deeper understanding of the environment.