High predictive accuracy of an unbiased proteomic profile for sustained virologic response in chronic hepatitis C patients.

UNLABELLED: Chronic hepatitis C (CHC) infection is a leading cause of endstage liver disease. Current standard-of-care (SOC) interferon-based therapy results in sustained virological response (SVR) in only one-half of patients, and is associated with significant side effects. Accurate host predictors of virologic response are needed to individualize treatment regimens. We applied a label-free liquid chromatography mass spectrometry (LC-MS)-based proteomics discovery platform to pretreatment sera from a well-characterized and matched training cohort of 55 CHC patients, and an independent validation set of 41 CHC genotype 1 patients with characterized IL28B genotype. Accurate mass and retention time methods aligned samples to generate quantitative peptide data, with predictive modeling using Bayesian sparse latent factor regression. We identified 105 proteins of interest with two or more peptides, and a total of 3,768 peptides. Regression modeling selected three identified metaproteins, vitamin D binding protein, alpha 2 HS glycoprotein, and Complement C5, with a high predictive area under the receiver operator characteristic curve (AUROC) of 0.90 for SVR in the training cohort. A model averaging approach for identified peptides resulted in an AUROC of 0.86 in the validation cohort, and correctly identified virologic response in 71% of patients without the favorable IL28B "responder" genotype. CONCLUSION: Our preliminary data indicate that a serum-based protein signature can accurately predict treatment response to current SOC in most CHC patients.

Creating a racial justice plan in a school of nursing: A journey of discovery and learning.

While there are many individuals and instances which illustrate the injustices experienced by people of color at the hands of police in the United States, the video which documented the murder of George Floyd by a law enforcement officer graphically illustrated our long and sad history of racial injustices. This and other events in 2020 forced our society to look at racism and systemic injustices that are embedded so deeply within our policies and practices that differentially advantage or disadvantage certain faculty, students and staff within higher education. This paper will describe the infrastructure and processes used to examine and address individual and systemic racism and white supremacy-based practices and policies at a School of Nursing. We describe the initial phases of racial justice work and infrastructure used to engage and support the efforts of committed faculty, staff and students aspiring to achieve racial equity. We share our challenges as well as immediate outcomes with the hope of stimulating thinking and dialogue in other schools around eliminating racial injustices in nursing education programs so the profession can achieve its' vision of preparing a diverse nursing workforce for the future who will work to improve the health of all.

The Power of Two:: One Academic-Practice Partnership's Response to Coronavirus Disease 2019 (COVID-19).

Academic-practice partnerships are necessary for strengthening nursing practice, robust and relevant academic programs, and advancing health care. The purpose of this paper is to describe how a strong academic-practice partnership shaped our response to the coronavirus disease 2019 (COVID-19) pandemic. During this unprecedented time, existing relationships between the health system and school of nursing were quickly leveraged to provide mutually beneficial relief, opportunities, and support. Initiatives described in this paper demonstrate how powerful a concentrated academic-practice partnership can be in transforming the nursing profession. Moving forward, it will be crucial for schools to build partnerships with appropriate organizations that have a vested interest in preparing nurses for the future.

An innovative DNP post-doctorate program to improve quality improvement and implementation science skills.

BACKGROUND: Doctor of Nursing Practice programs prepare nurse leaders for unique roles to address healthcare needs across the quality spectrum. However, additional mentoring and training in implementation science and analytical skills is needed to effectively lead system-wide quality initiatives. PURPOSE: The purpose of this article is to describe the planning, implementation, and evaluation of an innovative post-doctoral DNP Quality Implementation Scholars Program developed through an academic-practice partnership to address this need. PROJECT METHOD: Throughout the one year post-doctoral program, we evaluated student experiences qualitatively using focus groups and quantitatively using standardized course and instructor surveys to assess overall programmatic goals. Program outcomes were evaluated from the perspective of the academic-practice partnership planning committee through a Qualtrics© survey. FINDINGS: Strengths of the program included the in-depth mentoring by faculty and relationships built across the larger health system. Both scholars and the planning team noted that the system-wide project implemented by the scholars was relevant, timely, and quality-focused. CONCLUSIONS: This innovative DNP post-doctoral program leveraged the skill-sets of DNP-prepared nurse leaders to lead system-wide quality improvement initiatives tailored specifically to healthcare organizations.

A Leadership Framework for Implementation of an Organization's Strategic Plan.

Many schools of nursing have employed strategic planning as resources have become limited and demands for organizational efficiency have increased. Although the process of developing a strategic plan has been described in the literature, there is little information about how to implement and evaluate a plan. In this paper, we provide an overview of one nursing school's strategic plan development and the implementation and evaluation processes. Our paper provides a detailed description of the leadership framework used to shape, implement and evaluate the plan and makes recommendations for their application to other schools engaging in strategic planning.

A Plan for Academic Biobank Solvency-Leveraging Resources and Applying Business Processes to Improve Sustainability.

Researcher-initiated biobanks based at academic institutions contribute valuable biomarker and translational research advances to medicine. With many legacy banks once supported by federal funding, reductions in fiscal support threaten the future of existing and new biobanks. When the Brain Bank at Duke University's Bryan Alzheimer's Disease Center (ADRC) faced a funding crisis, a collaborative, multidisciplinary team embarked on a 2-year biobank sustainability project utilizing a comprehensive business strategy, dedicated project management, and a systems approach involving many Duke University entities. By synthesizing and applying existing knowledge, Duke Translational Medicine Institute created and launched a business model that can be adjusted and applied to legacy and start-up academic biobanks. This model provides a path to identify new funding mechanisms, while also emphasizing improved communication, business development, and a focus on collaborating with industry to improve access to biospecimens. Benchmarks for short-term Brain Bank stabilization have been successfully attained, and the evaluation of long-term sustainability metrics is ongoing.

The use of complementary and alternative medicine by patients with chronic hepatitis C.

BACKGROUND: The use of complementary and alternative medicine (CAM) is expanding globally. However, prevalence of its use by patients with chronic hepatitis C (CHC) remains unclear. METHODS: An exploratory, descriptive study was conducted using a questionnaire and interview to describe the use of CAM by patients with CHC attending a liver clinic in the United States. RESULTS: Eighty percent (n = 120) had used CAM in the last 12 months, most often prayer for health reasons (63%), multivitamins (56%) and herbal medicine (25%). A higher level of education (p < 0.005), poorer health status (p < 0.002) and prior use of anti-viral therapy (p < 0.02) were predictors of CAM use. Participants used CAM to promote general health, but herbal medicine was used to treat CHC symptoms and prevent liver disease. CONCLUSION: Use of CAM is common among patients with CHC. Failure to acknowledge the use of CAM as a management strategy may restrict the health provider's ability to provide optimal care.