Evaluation of a Secure Laptop-Based Testing Program in an Undergraduate Nursing Program: Students' Perspective.

Recently, the many robust learning management systems, and the availability of affordable laptops, have made secure laptop-based testing a reality on many campuses. The undergraduate nursing program at the authors' university began to implement a secure laptop-based testing program in 2009, which allowed students to use their newly purchased laptops to take quizzes and tests securely in classrooms. After nearly 5 years' secure laptop-based testing program implementation, a formative evaluation, using a mixed method that has both descriptive and correlational data elements, was conducted to seek constructive feedback from students to improve the program. Evaluation data show that, overall, students (n = 166) believed the secure laptop-based testing program helps them get hands-on experience of taking examinations on the computer and gets them prepared for their computerized NCLEX-RN. Students, however, had a lot of concerns about laptop glitches and campus wireless network glitches they experienced during testing. At the same time, NCLEX-RN first-time passing rate data were analyzed using the χ2 test, and revealed no significant association between the two testing methods (paper-and-pencil testing and the secure laptop-based testing) and students' first-time NCLEX-RN passing rate. Based on the odds ratio, however, the odds of students passing NCLEX-RN the first time was 1.37 times higher if they were taught with the secure laptop-based testing method than if taught with the traditional paper-and-pencil testing method in nursing school. It was recommended to the institution that better quality of laptops needs to be provided to future students, measures needed to be taken to further stabilize the campus wireless Internet network, and there was a need to reevaluate the Laptop Initiative Program.

Superior Visible Photoelectric Response with Au/Cu2NiSnS4 Core-Shell Nanocrystals.

The incorporation of plasmonic metal nanostructures into semiconducting chalcogenides in the form of core-shell structures provides a promising approach to enhancing the performance of photodetectors. In this study, we combined Au nanoparticles with newly developed copper-based chalcogenides Cu2NiSnS4 (Au/CNTS) to achieve an ultrahigh optoelectronic response in the visible regime. The high-quality Au/CNTS core-shell nanocrystals (NCs) were synthesized by developing a unique colloidal hot-injection method, which allowed for excellent control over sizes, shapes, and elemental compositions. The as-synthesized Au/CNTS hybrid core-shell NCs exhibited enhanced optical absorption, carrier extraction efficiency, and improved photosensing performance owing to the plasmonic-induced resonance energy transfer effect of the Au core. This effect led to a significant increase in the carrier density of the Au/CNTS NCs, resulting in a measured responsivity of 1.2 × 103 AW-1, a specific detectivity of 6.2 × 1011 Jones, and an external quantum efficiency of 3.8 × 105 % at an incident power density of 318.5 µW cm-2. These results enlighten a new era in the development of plasmonic core-shell nanostructure-based visible photodetectors.

The First-Water-Layer Evolution at the Graphene/Water Interface under Different Electro-Modulated Hydrophilic Conditions Observed by Suspended/Supported Field-Effect-Device Architectures.

Interfacial water molecules affect carrier transportation within graphene and related applications. Without proper tools, however, most of the previous works focus on simulation modeling rather than experimental validation. To overcome this obstacle, a series of graphene field-effect transistors (GFETs) with suspended (substrate-free, SF) and supported (oxide-supported, OS) configurations are developed to investigate the graphene-water interface under different hydrophilic conditions. With deionized water environments, in our experiments, the electrical transportation behaviors of the graphene mainly originate from the evolution of the interfacial water-molecule arrangement. Also, these current-voltage behaviors can be used to elucidate the first-water layer at the graphene-water interface. For SF-GFET, our experimental results show positive hysteresis in electrical transportation. These imply highly ordered interfacial water molecules with a separated-ionic distributed structure. For OS-GFET, on the contrary, the negative hysteresis shows the formation of the hydrogen-bond interaction between the interfacial water layer and the SiO2 substrate under the graphene. This interaction further promotes current conduction through the graphene/water interface. In addition, the net current-voltage relationship also indicates the energy required to change the orientation of the first-layer water molecules during electro-potential change. Therefore, our work gives an insight into graphene-water interfacial evolution with field-effect modulation. Furthermore, this experimental architecture also paves the way for investigating 2D solid-liquid interfacial features.

[A study of work stress and professional commitment in outpatient department nurses].

BACKGROUND: Nurses working in outpatient departments face tremendous pressure from multiple sources. The effect of nurse professional commitment on continued professional development is an issue worth exploring further. PURPOSE: This study explored relationships among nurses' personal attributes, work stress and professional commitment. METHODS: The Lazarus cognitive appraisal model framed the research plan design. Tools used included stress level and professional commitment scales for healthcare professionals. Of 180 questionnaires sent to outpatient department nurses nurses, 171 (95%) were returned and used in analysis. SPSS 12.0 for windows software was used for statistical analysis. RESULTS: We found a significant negative correlation between work stress and professional commitment and no significant relationship between level of education and either ability to handle work stress or professional commitment. Years of work experience, age and position all correlated positively with ability to handle work stress. Years of work experience correlated positively with professional commitment. IMPLICATIONS FOR PRACTICE: This study suggests that nurses experience the highest work stress levels during their first five years of work. Findings show that providing nurses a clear career development path, in addition to attractive incentives and a reasonable workload, is essential to reducing work stress, bolstering professional commitment and increasing retention.

Differential baseline and response profile to IFN-gamma gene transduction of IL-6/IL-6 receptor-alpha secretion discriminate primary tumors versus bone marrow metastases of nasopharyngeal carcinomas in culture.

BACKGROUND: Understanding of immunobiology of bone marrow metastases (designated BM-NPC) versus primary tumors (P-NPC) of the nasopharynx is far from complete. The aim of this study was to determine if there would be differences between cultured P-NPCs and BM-NPCs with respect to (i) constitutive IL-6 and the IL-6 receptor gp80 subunit (IL-6Ralpha) levels in the spent media of nontransduced cells, and (ii) IL-6 and IL-6Ralpha levels in the spent media of cells transduced with a retroviral vector containing the IFN-gamma gene. METHODS: A panel of NPC cell lines were transduced with the IFN-gamma gene through a retroviral vector. Four clonal sublines were isolated via limiting dilution methods. Cytofluorometric analysis was performed for the detection of cell surface antigens of HLA class I, HLA class II and ICAM-1. ELISA was used to assay for IFN-gamma, IL-6 and IL-6Ralpha in the spent media of cultured cell lines. RESULTS: Our results showed that in day 3 culture supernatants, low levels of soluble IL-6 were detected in 5/5 cultured tumors derived from P-NPCs, while much higher constitutive levels of IL-6 were detected in 3/3 metastasis-derived NPC cell lines including one originated from ascites; the difference was significant (p = 0.025). An inverse relationship was found between IL-6Ralpha and IL-6 in their release levels in cultured P-NPCs and metastasis-derived NPCs. In IFN-gamma-transduced-P-NPCs, IL-6 production increased and yet IL-6Ralpha decreased substantially, as compared to nontransduced counterparts. At variance with P-NPC cells, the respective ongoing IL-6 and IL-6Ralpha release patterns of BM-NPC cells were not impeded as much following IFN-gamma transduction. These observations were confirmed by extended kinetic studies with representative NPC cell lines and clonal sublines. The latter observation with the clonal sublines also indicates that selection for high IL-6 or low IL-6Ralpha producing subpopulations did not occur as a result of IFN-gamma-transduction process. P-NPCs, which secreted constitutively only marginal levels of IFN-gamma (8.4 ~ 10.5 pg/ml), could be enhanced to produce higher levels of IFN-gamma (6.8- to 10.3-fold increase) after IFN-gamma transduction. Unlike P-NPCs, BM-NPCs spontaneously released IFN-gamma at moderate levels (83.8 ~ 100.7 pg/ml), which were enhanced by 1.3- to 2.2-fold in the spent media of their IFN-gamma-transduced counterparts. CONCLUSION: Our results showed that cultured P-NPCs and BM-NPCs could be distinguished from one another on the basis of their differential baseline secretion pattern of IFN-gamma, IL-6 and IL-6Ralpha, and their differential response profiles to IFN-gamma gene transfer of the production of these three soluble molecules. These results suggest that the IL-6 and IFN-gamma pathways in a background of genetic instability be involved in the acquisition of metastatic behaviour in BM-NPCs.

A qualitative study of attitudes to and perceptions of betel quid consumption and its oral health implications in Taiwan.

OBJECTIVES: Betel quid (BQ) chewing is extremely prominent in South and Southeast Asia because it considered by users to be of social, cultural and religious importance. BQ chewing has been recognized as a risk factor for oral premalignant lesions and oral cancer. Because BQ chewing has become a severe health risk in Taiwan, the development of prevention and cessation programmes is essential. The purpose of this study was to explore the attitudes and perceptions associated with BQ consumption and its oral health implications in an attempt to inform the development of health promotion initiatives and BQ cessation efforts in Taiwan, where the dental profession could have a pivotal role in preventing and controlling BQ use among persons at risk. METHODS: This qualitative study used data gathered from focus groups and individual interviews. A convenience sample of 41 adults from Jhushan and Lugu Townships (Nantou County) and Taichung City, Taiwan, participated in this study (27 men, 14 women; 31 Han, 10 aboriginals from the Paiwan tribe; mean age 40.3, SD 9.2 years). RESULTS: Among the seven themes that emerged from the original study, five (Initiation, Health Risk Perception, Health Consequences, Withdrawal Symptoms and Help from Healthcare Providers) had oral/dental implications. CONCLUSIONS: Our study highlights research areas relevant to further investigation, such as incorporating brief BQ prevention and cessation counselling when early oral and dental signs associated with BQ consumption are detected. Undertaking behavioural interventions in dental settings might help to reduce the prevalence of BQ chewing in Taiwan.

Increase Trichomonas vaginalis detection based on urine routine analysis through a machine learning approach.

Trichomonas vaginalis (T. vaginalis) detection remains an unsolved problem in using of automated instruments for urinalysis. The study proposes a machine learning (ML)-based strategy to increase the detection rate of T. vaginalis in urine. On the basis of urinalysis data from a teaching hospital during 2009-2013, individuals underwent at least one urinalysis test were included. Logistic regression, support vector machine, and random forest, were used to select specimens with a high risk of T. vaginalis infection for confirmation through microscopic examinations. A total of 410,952 and 428,203 specimens from men and women were tested, of which 91 (0.02%) and 517 (0.12%) T. vaginalis-positive specimens were reported, respectively. The prediction models of T. vaginalis infection attained an area under the receiver operating characteristic curve of more than 0.87 for women and 0.83 for men. The Lift values of the top 5% risky specimens were above eight. While the most risky vigintile was picked out by the models and confirmed by microscopic examination, the incremental cost-effectiveness ratios for T. vaginalis detection in men and women were USD$170.1 and USD$29.7, respectively. On the basis of urinalysis, the proposed strategy can significantly increase the detection rate of T. vaginalis in a cost-effective manner.

Effects of manufacturing conditions on the adsorption capacity of heavy metal ions by Makino bamboo charcoal.

The objective of this study was to investigate the effects of manufacturing conditions on the adsorption capacity of heavy metal ions by Makino bamboo charcoal. Results show that the specific surface area and iodine number of bamboo charcoal activated at 900 degrees C were larger than those of bamboo charcoal activated at 800 degrees C. The specific surface area of bamboo charcoal activated at 800 degrees C by carbon dioxide was larger than that of charcoal activated by steam. However, a contrary result was observed when the activation temperature was 900 degrees C. The total volume and proportion of micropores in bamboo charcoal activated by carbon dioxide were greater than those in the other sample groups. However, the total volume and bulk volume of meso- and macropores, and average pore diameter for bamboo charcoal activated by steam were greater than those in the other sample groups. Using 5g bamboo charcoal (10-30 mesh) with a soaking time of 24h, a better adsorption effect on Pb2+ (100%), Cu2+ (100%), and Cr3+ (88-98%) was found. However, medium frequencies were observed for the adsorption of Cd2+ (40-80%) and Ni2+ (20-60%). Very limited adsorption of As5+ was detected in this study. For the same charcoal grain sizes, the adsorption capacity of 0.5g of charcoal was better than that of 0.1g. The improved adsorption effect of the sample group activated by steam was compared with the sample group activated by carbon dioxide.

Value of computed tomography-based tumor volume as a predictor of outcomes in hypopharyngeal cancer after treatment with definitive radiotherapy.

OBJECTIVES: To investigate the value of pretreatment computed tomography (CT) volumetric analysis for the prediction of treatment outcome in patients with hypopharyngeal cancer (HPC) treated by definitive radiotherapy (RT). METHODS: From January 2000 through February 2004, 63 patients with HPC were enrolled for a retrospective analysis. The pyriform sinus was the principle site of involvement in 62 cases. All patients received with 1.8 Gy daily to a total dose of 68.4 to 73.8 Gy (median, 70.2 Gy). Contrast-enhanced CT images were transferred to a planning system. Tumor volume measurement was derived from summation of the primary and metastatic nodal tumor. RESULTS: With a median follow-up of 38 (range, 24-68) months, the 5 year local relapse-free survival (LRFS) was 83% for patients with T1 to T2 disease, 46% for those with T3 disease, and 40% for those with T4 disease (P = .01). The 5 year LRFS was 75% for those with tumors less than 40 mL and 26% when volumes were 40 mL of larger (P = .0001). For patients with T3 to T4 disease, the 5 year LRFS was 70% for those with tumors less than 40 mL and 24% when volumes were 40 mL or larger (P = .0005). Multivariate analyses of local relapse-free survival revealed two prognostic factors: tumor volume more than 40 mL and the involvement of the larynx. CONCLUSIONS: CT-based tumor volumes are a strong predictor of outcomes for HPC treated using definitive RT. A selected group of patients, mainly those with tumor volumes less than 40 mL, should be considered for laryngeal preservation.

The Contribution of Matrix Metalloproteinase-1 Genotype to Oral Cancer Susceptibility in Taiwan.

AIM: Metalloproteinases (MMPs) are a family of multifunctional proteins which have been shown to be up-regulated in various types of cancer. However, the contribution of MMP1 genotype to oral cancer has not been elucidated. This study aimed to evaluate the contribution of MMP1 promoter 1607 genotype to the risk of oral cancer. MATERIALS AND METHODS: In this case-control study, MMP1 genotype and its interaction with consumption of areca, cigarettes, and alcohol in determining oral cancer risk were investigated in 788 patients with oral cancer and 956 gender-matched healthy controls. RESULTS: The distribution of 2G/2G, 1G/2G and 1G/1G for MMP1 promoter 1607 genotype was 36.8%, 40.2% and 23.0% in the oral cancer group and 34.3%, 44.9% and 20.8% in the non-cancer control group, respectively (p for trend=0.1454). We also analyzed the allelic frequency distributions and found that the variant 1G allele of MMP1 promoter 1607 conferred similar oral cancer susceptibility as the wild-type 2G allele (odds ratio=0.99, 95% confidence interval=0.87-1.14, p=0.9199). As for the gene-lifestyle interaction, there was an obvious protective effect of MMP1 promoter 1607 1G/2G genotype on the risk of oral cancer among smokers (odds ratio=0.71, 95% confidence interval=0.55-0.91, p=0.0076), but not non-smokers. There was no interaction between MMP1 promoter 1607 genotype and areca chewing or alcohol drinking habits. CONCLUSION: The 1G/2G genotype of MMP1 promoter 1607 may have a protective effect on oral cancer risk for smokers. The detailed mechanisms involved in this require further investigation.

The inhibitory effect of ellagic Acid on cell growth of ovarian carcinoma cells.

Ellagic acid (EA) is able to inhibit the growth of several cancer cells; however, its effect on human ovarian carcinoma cells has not yet been investigated. Ovarian carcinoma ES-2 and PA-1 cells were treated with EA (10~100 µ M) and assessed for viability, cell cycle, apoptosis, anoikis, autophagy, and chemosensitivity to doxorubicin and their molecular mechanisms. EA inhibited cell proliferation in a dose- and time-dependent manner by arresting both cell lines at the G1 phase of the cell cycle, which were from elevating p53 and Cip1/p21 and decreasing cyclin D1 and E levels. EA also induced caspase-3-mediated apoptosis by increasing the Bax : Bcl-2 ratio and restored anoikis in both cell lines. The enhancement of apoptosis and/or inhibition of autophagy in these cells by EA assisted the chemotherapy efficacy. The results indicated that EA is a potential novel chemoprevention and treatment assistant agent for human ovarian carcinoma.