Identification of rare missense variants in the BSN gene co-segregating with chronic otitis media in a consanguineous Pakistani family.

BACKGROUND: Otitis media (OM) is the most frequent and complex middle ear condition with multifactorial etiology including genetic predisposition. OM depicts a variable clinical spectrum, leading to speech, developmental delay, and hearing loss. Here, we report the clinical and genetic findings of chronic suppurative otitis media (CSOM) segregating in a six-generation consanguineous Pakistani family PKOM08. METHODS: Clinical evaluations, including audio and tympanometry, were conducted to assess OM manifestation and their impact on hearing function. Exome sequencing was performed to identify potential genetic variants underlying CSOM in the study participants. RESULTS: Clinical evaluation of participating individuals revealed varying degrees of disease severity, with mild to moderate hearing loss. All the affected individuals had CSOM with no other apparent comorbidity. Whole exome followed by Sanger sequencing revealed two rare heterozygous variants [c.1867C>T, p.(Pro623Ser) and c.11015G>A, p.(Arg3672Gln)] of BSN gene in most of the affected individuals of family PKOM08. BSN encodes a scaffold bassoon protein involved in synaptic vesicle trafficking. The identified variants replaced evolutionary conserved amino acid residues in the encoded protein and are predicted to impact the ionic interactions in the secondary structure. CONCLUSION: A deep intronic variant of BSN has been previously implicated in the etiology of childhood ear infections. Our study further supports a link between BSN-impaired function and ear infection and CSOM in children.

The growth and development of a novel distance accelerated bachelor of science in nursing program.

Severe nursing shortages threaten the sustainability of US health systems. Rural and underserved communities are disproportionately affected by staffing crises and associated facility closures, as well as health disparities. A major factor contributing to geographic gaps in care is the absence of nursing schools, nursing faculty, and locations for clinical rotations in many rural and underserved areas. Emory School of Nursing is helping to solve for these issues through the Distance Accelerated Bachelor of Science in Nursing (DABSN) program. The DABSN is establishing accelerated pipelines of nursing students into practice in locations where nursing education has historically been difficult or impossible to access. This innovative nursing education model allows students to enroll in a top-ranked nursing school while remaining in their home communities. Students complete synchronous didactic coursework with peers in every US time zone while performing clinical rotations in local healthcare facilities. This paper details the growth and development of the DABSN. It describes the challenges and opportunities we have navigated in implementing the program, along with information about its pedagogy, clinical placement practices, and student/faculty characteristics. We share program outcomes and conclude with recommendations for the future.

Innovating to meet AACN essentials in a bachelor of science in nursing program.

Our large, two campus (one urban and one suburban) and two track (RN-BSN and Entry-level BSN) program has revised our BSN curriculum to reflect the new Level One American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Nursing Education (AACN, 2021). This article describes the work to revise the curriculum to meet the demands of contemporary nursing education with increased elective choices for Generation Z learners, professional role courses on wellness and resiliency, a course on palliative care and symptom management, increased clinical hours to include virtual simulation and more community and public health experiences, and increased innovative student experiences with our clinical partners. A revised clinical evaluation tool (CET) was also developed to evaluate students in competency-based education and to reflect our new program outcomes.

Barriers to and facilitators of accelerated BSN students' success: a scoping review with possible strategies for success.

OBJECTIVES: This scoping review aims to map the evidence on barriers and facilitators of success with accelerated BSN (ABSN) students with the inclusion of faculty perspectives. METHODS: We followed the scoping review methodology of the Joanna Briggs Institute for this review. The databases of CINAHL, PubMed, ProQuest, and Google Scholar were searched. RESULTS: The search resulted in 39 studies. The identified barriers were: Academic factors, non-academic factors, challenges faced by non-native English-speaking and ethnically diverse students, socialization struggles, and faculty perceptions. The facilitators identified were: Supportive environment and practices, benefits of ABSN program completion, students' background and life experiences, innovative learning strategies and school resources, and faculty perceptions. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Given the global nature of the ABSN program now, findings from this scoping review and the strategies for success addressed in discussion will inform ABSN faculty and program managers about helpful strategies to support students' needs.

Association of self-efficacy and faculty support on students' readiness for practice.

BACKGROUND: The nursing shortage is apparent again after nearly five decades of having a stable workforce. One novel development is that new Registered Nurses (RNs) are exiting their careers too early. Many of them leave the profession for multiple reasons such as burnout and family obligations, yet one reason has emerged - lack of readiness for practice, that also drives the RNs to leave the profession. PURPOSE: The purpose of this study was twofold - (1) to investigate the relationship between students' characteristics, their Generalized Self-Efficacy (GSE), Perceived Faculty Support (PFS), the Assessment Technologies, Inc. (ATI) Comprehensive Predictor RN Exam scores and their self-report of readiness for practice and (2) to examine which variables best explains the students' readiness for practice. METHODS: A cross-sectional descriptive correlational research design with convenience sampling was utilized. Descriptive statistics were obtained to investigate the students' socio-demographic data. The Pearson r and multiple regression were used to analyze the relationships and influence between dependent variables Casey-Fink Readiness for Practice scale (CFRPS) and independent variables, students' characteristics, GSE, PFS, and ATI scores. RESULTS: One hundred forty-three (143) out of 416 students in five baccalaureate schools from the western region of the United States participated in the survey. Findings showed GSE and PFS had significant positive correlations with students' readiness for practice. Further, factors of CFRPS in learning strategies, problem-solving, resourcefulness, and team player are best explained by GSE and PFS, accounting for 91 % of the variance. CONCLUSION: Students' GSE and PFS can contribute to their readiness for practice. Nurse educators must employ strategies that will bolster students' preparedness by improving their sense of self-efficacy and showing them the utmost faculty support.

Bilateral adrenal neuroblastoma: peculiar pattern of a rare pediatric presentation.

BACKGROUND: Bilateral suprarenal neuroblastoma (BSN) is a rare presentation. Few previously published literature showed BSN patients to have favorable pattern and prognosis. This study aim was to evaluate clinical and biological features in relation to outcome of Egyptian patients with BSN. METHODS: Included patients were diagnosed from 2007 to 2017, retrospectively. Tissue biopsy, imaging and bone marrow were evaluated at presentation. Clinical, demographic, biological variables and risk group were determined and analyzed in relation to overall (OS) and event-free-survival (EFS). RESULTS: BSN patients (n = 33) represented 2% of hospital patients with neuroblastoma during the 10-year study period, 17 were males and 16 were females. Twenty-four patients (72.7%) were infants, and 9 patients (27.3%) were above 1 year of age (range: 1 month to 3 years). Metachronous disease was present in only one patient. Amplified MYCN was found in 10 patients. Initially, most patients (n = 25) had distant metastasis, 6 had stage 3 versus 2 stage 2. Fifteen were high risk (HR), 15 intermediate (IR), 1 low risk (LR) and 2 were undetermined due to inadequate tissue biopsy. Three-year OS for HR and IR patients were 40.5% and 83.9% versus 23.2% and 56.6% EFS; respectively. CONCLUSION: BSN treatment is similar to unilateral disease. A more conservative surgical approach with adrenal tissue preservation on less extensive side should be considered. Biological variables and extent of disease are amongst the most important prognostic determinants. Future studies are warranted to further address the biologic profiling of BSN and highlight prognostic significance of size difference between both adrenal sides.

Barriers and motivating factors for licensed practical nurses to pursue a bachelor's degree in nursing.

BACKGROUND: Connecticut License Practical Nurses (LPNs) face unique challenges in pursuing higher education. Understanding these challenges is essential for addressing the current nursing shortage and enhancing the nursing workforce's educational level. PURPOSE: This project aimed to identify the barriers preventing Connecticut LPNs from pursuing higher education and the factors motivating them to obtain a Bachelor of Science degree in Nursing (BSN) and Registered Nurse (RN) licensure. METHOD: A survey was administered to 13,684 LPNs in Connecticut after Institutional Review Board (IRB) approval. Of these, 1791 LPNs consented to participate, with 1424 completing at least one survey question. The survey was designed to identify the top three motivators and barriers influencing LPNs' decisions to pursue further education. RESULTS: The primary motivators identified were the desire for college credits for completed LPN coursework (96.7 %), a simplified BSN enrollment procedure (93.8 %), and potential salary increases (93.7 %). Conversely, the top barriers were current financial position (76.4 %), personal responsibilities (71.1 %), and the requirement to repeat previously taken courses (65.9 %). An unexpected finding was that 63 participants expressed readiness to immediately pursue a BSN degree, indicating a strong latent demand for advanced nursing education. CONCLUSION: The study highlights the eagerness of LPNs to advance their education, contingent on receiving credit for previous coursework, financial aid, tuition reimbursement, and flexible schooling options. These findings suggest the need for tailored educational programs and support systems to facilitate LPNs' transition to higher educational levels, addressing both the motivators and barriers identified.

Expression of BSN314 lysozyme genes in Escherichia coli BL21: a study to demonstrate microbicidal and disintegarting potential of the cloned lysozyme.

This study is an extension of our previous studies in which the lysozyme was isolated and purified from Bacillus subtilis BSN314 (Naveed et al., 2022; Naveed et al., 2023). In this study, the lysozyme genes were cloned into the E. coli BL21. For the expression of lysozyme in E. coli BL21, two target genes, Lyz-1 and Lyz-2, were ligated into the modified vector pET28a to generate pET28a-Lyz1 and pET28a-Lyz2, respectively. To increase the production rate of the enzyme, 0.5-mM concentration of IPTG was added to the culture media and incubated at 37 °C and 220 rpm for 24 h. Lyz1 was identified as N-acetylmuramoyl-L-alanine amidase and Lyz2 as D-alanyl-D-alanine carboxypeptidase. They were purified by multi-step methodology (ammonium sulfate, precipitation, dialysis, and ultrafiltration), and antimicrobial activity was determined. For Lyz1, the lowest MIC/MBC (0.25 µg/mL; with highest ZOI = 22 mm) were recorded against Micrococcus luteus, whereas the highest MIC/MBC with lowest ZOI were measured against Salmonella typhimurium (2.50 µg /mL; with ZOI = 10 mm). As compared with Aspergillus oryzae (MIC/MFC; 3.00 µg/mL), a higher concentration of lysozyme was required to control the growth of Saccharomyces cerevisiae (MIC/MFC; 50 µg/mL). Atomic force microscopy (AFM) was used to analyze the disintegrating effect of Lyz1 on the cells of selected Gram-positive bacteria, Gram-negative bacteria, and yeast. The AFM results showed that, as compared to Gram-negative bacteria, a lower concentration of lysozyme (Lyz1) was required to disintegrate the cell of Gram-positive bacteria.

An ultrasensitive unlabeled electrochemical immunosensor for the detection of cardiac troponin I based on Pt/Au-B,S,N-rGO as the signal amplification platform.

In this study, an ultrasensitive unlabeled electrochemical immunosensor for the detection of cardiac troponin I (cTnI) was developed based on Pt/Au modified B,S,N co-doped reduced graphene oxide (Pt/Au-B,S,N-rGO) as a signal amplification platform. First-principles calculations were employed to analyze the electron density of states of Pt/Au-B,S,N-rGO, revealing an increase in the electron density of the graphene oxide (GO) states. Furthermore, scanning electron microscopy (SEM), X-ray photoelectron diffraction spectroscopy (XPS), and electrochemical detection were used to successfully construct and analyze Pt/Au-B,S,N-rGO. The results showed that B,S,N-rGO exhibited good electrochemical activity, and the Au/Pt NPs demonstrated excellent catalytic properties, which provided a strong foundation for achieving high-sensitivity detection. Moreover, the constructed unlabeled electrochemical immunosensor had an ideal linear range (0.1 pg/mL∼50 ng/mL) and detection limit (0.082 pg/mL). In human serum detection, the results of this immunosensor were essentially similar to the ELISA results for the same samples, which suggested that the immunosensor had a promising clinical application prospect for the detection of cTnI.

Linking epileptic phenotypes and neural extracellular matrix remodeling signatures in mouse models of epilepsy.

Epilepsies are multifaceted neurological disorders characterized by abnormal brain activity, e.g. caused by imbalanced synaptic excitation and inhibition. The neural extracellular matrix (ECM) is dynamically modulated by physiological and pathophysiological activity and critically involved in controlling the brain's excitability. We used different epilepsy models, i.e. mice lacking the presynaptic scaffolding protein Bassoon at excitatory, inhibitory or all synapse types as genetic models for rapidly generalizing early-onset epilepsy, and intra-hippocampal kainate injection, a model for acquired temporal lobe epilepsy, to study the relationship between epileptic seizures and ECM composition. Electroencephalogram recordings revealed Bassoon deletion at excitatory or inhibitory synapses having diverse effects on epilepsy-related phenotypes. While constitutive Bsn mutants and to a lesser extent GABAergic neuron-specific knockouts (BsnDlx5/6cKO) displayed severe epilepsy with more and stronger seizures than kainate-injected animals, mutants lacking Bassoon solely in excitatory forebrain neurons (BsnEmx1cKO) showed only mild impairments. By semiquantitative immunoblotting and immunohistochemistry we show model-specific patterns of neural ECM remodeling, and we also demonstrate significant upregulation of the ECM receptor CD44 in null and BsnDlx5/6cKO mutants. ECM-associated WFA-binding chondroitin sulfates were strongly augmented in seizure models. Strikingly, Brevican, Neurocan, Aggrecan and link proteins Hapln1 and Hapln4 levels reliably predicted seizure properties across models, suggesting a link between ECM state and epileptic phenotype.

Concurrent enrollment pathway: A model for ADN-BSN programs.

INTRODUCTION: The purpose of this article is to share the collaborative planning and execution of these two public universities and one community college in developing an innovative program to increase BSN-prepared nurses. The aim of the collaboration is to offer a high quality, affordable, and time-saving pre-licensure, concurrent enrollment program (CEP) which allows community college ADN students direct access to BSN study, while maintaining excellent program outcomes, and increasing diverse baccalaureate-prepared nurses in practice. METHODS: Key stakeholders in two public educational systems met to discuss the development of a regional collaboration between two state universities and one local community college. The group designed university-specific, concurrent curricular roadmaps for each university. Students admitted in ADN program chose if they want to attend a concurrent enrollment or a traditional plan of study. RESULTS: In Fall 2019, the CEP program was launched admitting 40 ADN students concurrently enrolled in one university. Subsequently, another cohort started in Spring 2020 with 39 students dually enrolled at the other state university. All students in both cohorts resided in the region. Over 75 % of the total CEP enrollees came from diverse backgrounds, 49 % Hispanics, 16 %, Asians, and 8 % African Americans and 4 % native Hawaiians. Forty-four percent were first generation college students. The average age was 25 with a range of 21-39. Twenty percent of the students were male which is above the national average of 12 %. After four semesters, students completed their ADN degree, passed the licensure exam, and transitioned to earn their BSN degree in the university for another two semesters. CONCLUSION: The literature reveals that BSN-prepared nurses contribute to safe patient care. The current number of cost-effective and accessible nursing programs are not sufficient to reach the IOM 80/20 goal, which contributes to the ongoing shortage of BSN-prepared nurses in the nation, including California. Creativity and open collaboration of nurse leaders, faculty, and staff across different levels of education was instrumental in the success of the students and the program.

Comprehensive Analysis of lncRNA and mRNA Expression Profile of Macrophage RAW264.7 Stimulated by Antimicrobial Peptide BSN-37.

BACKGROUND: BSN-37, a novel antimicrobial peptide (AMP) containing 37 amino acid residues isolated from the bovine spleen, has not only antibacterial activity but also immunomodulatory activity. Recent evidence shows that long non-coding RNAs (lncRNAs) play an important role in regulating the activation and function of immune cells. The purpose of this experiment was to investigate the lncRNA and mRNA expression profile of mouse macrophages RAW264.7 stimulated by bovine antimicrobial peptide BSN-37. METHODS: The whole gene expression microarray was used to detect the differentially expressed lncRNA and mRNA between antimicrobial peptide BSN-37 activated RAW264.7 cells and normal RAW264.7 cells. KEGG pathway analysis and GO function annotation analysis of differentially expressed lncRNAs and mRNA were carried out. Eight kinds of lncRNAs and nine kinds of mRNA with large differences were selected for qRT-PCR verification, respectively. RESULTS: In the current study, we found that 1294 lncRNAs and 260 mRNAs were differentially expressed between antibacterial peptide BSN-37 treatment and control groups. Among them, Bcl2l12, Rab44, C1s, Cd101 and other genes were associated with immune responses and were all significantly up-regulated. Mest and Prkcz are related to cell growth, and other genes are related to glucose metabolism and lipid metabolism. In addition, some immune-related terms were also found in the GO and KEGG analyses. At the same time, real-time quantitative PCR was used to verify selected lncRNA and mRNA with differential expression. The results of qRT-PCR verification were consistent with the sequencing results, indicating that our data were reliable. CONCLUSION: This study provides the lncRNA and mRNA expression profiles of RAW264.7 macrophages stimulated by antimicrobial peptide BSN-37 and helps to provide a reference value for subsequent studies on lncRNA regulation of antimicrobial peptide BSN-37 immune function.

Soluble Expression of Antimicrobial Peptide BSN-37 from Escherichia coli by SUMO Fusion Technology.

Antimicrobial peptides (AMPs) are a kind of small molecular peptide that an organism produces to resist the invasion of foreign microorganisms. AMP BSN-37 is a bovine AMP that exhibits high antibacterial activity. In this paper, the optimized gene AMP BSN-37 was cloned into pCold-SUMO for fusion expression by recombinant DNA technology. The gene sequence of AMP BSN-37 was obtained by codons reverse translation, and the codons were optimized according to the codons preference of Escherichia coli (E. coli). The recombinant plasmid was constructed and identified by PCR, enzyme digestion and sequencing. Then the recombinant plasmid was transformed into BL21 E. coli to induce expression, and the IPTG concentration and time were optimized. The expressed soluble fusion protein SUMO-BSN-37 was purified by chromatography and then cleaved by SUMO proteases to release BSN-37. SDS-PAGE electrophoresis and Western blotting were used for identification. The recombinant plasmid pCold-SUMO-BSN-37 was obtained, and the fusion AMP BSN-37 was preliminarily expressed in BL21. After optimization, the optimal expression condition was 37 ℃ with 0.4 µM IPTG and 6 h incubation. Under optimal conditions, a large amount of fusion AMP BSN-37 was obtained by purification. Western blotting showed that the fusion peptide was successfully expressed and had good activity. The expressed BSN-37 showed antimicrobial activity similar to that of synthesized BSN-37. In this study, soluble expression products of AMP BSN-37 were obtained, and the problem regarding the limited source of AMP BSN-37 could be effectively solved, laying a foundation for further research on AMP BSN-37.

RN-to-BSN student reports of work experiences, academic performance, and program progression during the COVID-19 pandemic.

BACKGROUND: Individuals who were RN to BSN students during the COVID-19 pandemic had the unique experience of being both undergraduate students and nurses during a time of exceptional stress for the healthcare system. PURPOSE: The aim of this study was to explore student perceptions of their work experiences during the COVID-19 pandemic and how working as a nurse during this time affected their academic performance and progression through their RN to BSN program. METHODS: This qualitative study was conducted using Braun and Clark's six-step thematic analysis process. CONCLUSION: Students reported experiencing both challenges and adaptability in their RN to BSN program performance and progression during the pandemic. DISCUSSION: Nurse educators and nurse managers can help RN to BSN nursing students during times marked by heavy workloads and increased stress by ascertaining their needs, being flexible, and providing self-care support.

Engaging patients as teachers in a baccaulaureate nursing reproductive health care course: A qualitative study.

BACKGROUND: Teaching nursing students about the principles and practical application of person-centered care is an essential yet challenging component of nursing education. Integrating patients as teachers to share their personal stories of maternity care can elicit positive outcomes toward students achieving course objectives. OBJECTIVES: To determine how the educational experience of having patients as teachers in the classroom could influence students' awareness of patients' perceptions of their maternity care, delivering person-centered care and the roles of nursing in their future practice. DESIGN: Retrospective qualitative study of student reflections. SETTINGS: Reproductive health course within a BSN program. PARTICIPANTS: Ninety-nine second semester BSN student reflections. METHODS: Two course faculty and a qualitative nurse researcher conducted a thematic content analysis of written student reflections. RESULTS: Three primary themes emerged from the students' reflections of hearing patient and family advisors describe their maternity experiences: 1) awareness of the impact of nursing practice on patient and family well-being, 2) awareness of personal biases and emotions about difficulties in maternity care, and 3) appreciation to hear from patients directly as part of didactic coursework. CONCLUSIONS: Including patients as teachers is an enhanced method to aid nursing students in understanding the humanistic and impactful roles of nursing in the clinical setting.

A crosswalk of foundational BSN population health documents and the AACN essentials.

To guide the development of entry-level nursing education, the American Association of Colleges of Nursing (AACN) published the Essentials document in 2021 with a broadened scope of competencies. Community, population, and public health (CPPH) nurse educators use a number of foundational documents to crosswalk for gaps in the AACN principles, highlighting the need of including these contemporary documents within the baccalaureate CPPH nursing curriculum. In this crosswalk, the authors highlight important capabilities and knowledge exclusive to these fundamental documents and tools, as well as the relevance of these competencies and knowledge to CPPH baccalaureate nursing education.

Practical Implications of Online Learning with Nurses During Coronavirus Disease 2019.

This study explores how teaching practices were impacted by coronavirus disease 2019 (COVID-19) in a fully online nursing program. In-depth interviews were conducted of faculty in an online nursing program. The findings of the study suggest that the COVID-19 pandemic was challenging for the faculty members, but still they considered it an opportunity for personal and professional growth; they used this disruption to humanize their teaching practices by focusing on self-care to support their students in the challenging times of a global pandemic. The members also mentioned institutional support was crucial for their perseverance, growth, and job satisfaction.

Purification, Characterization and Bactericidal Action of Lysozyme, Isolated from Bacillus subtillis BSN314: A Disintegrating Effect of Lysozyme on Gram-Positive and Gram-Negative Bacteria.

In the present study, lysozyme was purified by the following multi-step methodology: salt (ammonium sulfate) precipitation, dialysis, and ultrafiltration. The lysozyme potential was measured by enzymatic activity after each purification step. However, after ultrafiltration, the resulting material was considered extra purified. It was concentrated in an ultrafiltration centrifuge tube, and the resulting protein/lysozyme was used to determine its bactericidal potential against five bacterial strains, including three gram-positive (Bacillus subtilis 168, Micrococcus luteus, and Bacillus cereus) and two gram-negative (Salmonella typhimurium and Pseudomonas aeruginosa) strains. The results of ZOI and MIC/MBC showed that lysozyme had a higher antimicrobial activity against gram-positive than gram-negative bacterial strains. The results of the antibacterial activity of lysozyme were compared with those of ciprofloxacin (antibiotic). For this purpose, two indices were applied in the present study: antimicrobial index (AMI) and percent activity index (PAI). It was found that the purified lysozyme had a higher antibacterial activity against Bacillus cereus (AMI/PAI; 1.01/101) and Bacillus subtilis 168 (AMI/PAI; 1.03/103), compared to the antibiotic (ciprofloxacin) used in this study. Atomic force microscopy (AFM) was used to determine the bactericidal action of the lysozyme on the bacterial cell. The purified protein was further processed by gel column chromatography and the eluate was collected, its enzymatic activity was 21.93 U/mL, while the eluate was processed by native-PAGE. By this analysis, the un-denatured protein with enzymatic activity of 40.9 U/mL was obtained. This step shows that the protein (lysozyme) has an even higher enzymatic potential. To determine the specific peptides (in lysozyme) that may cause the bactericidal potential and cell lytic/enzymatic activity, the isolated protein (lysozyme) was further processed by the SDS-PAGE technique. SDS-PAGE analysis revealed different bands with sizes of 34 kDa, 24 kDa, and 10 kDa, respectively. To determine the chemical composition of the peptides, the bands (from SDS-PAGE) were cut, enzymatically digested, desalted, and analyzed by LC-MS (liquid chromatography-mass spectrometry). LC-MS analysis showed that the purified lysozyme had the following composition: the number of proteins in the sample was 56, the number of peptides was 124, and the number of PSMs (peptide spectrum matches) was 309. Among them, two peptides related to lysozyme and bactericidal activities were identified as: A0A1Q9G213 (N-acetylmuramoyl-L-alanine amidase) and A0A1Q9FRD3 (D-alanyl-D-alanine carboxypeptidase). The corresponding protein sequence and nucleic acid sequence were determined by comparison with the database.

Seamless and early gap healing of osteochondral defects by autologous mosaicplasty combined with bioactive supramolecular nanofiber-enabled gelatin methacryloyl (BSN-GelMA) hydrogel.

Autologous mosaicplasty is a common approach used to treat osteochondral defects in clinical practice. Gap integration between host and transplanted plugs requires bone tissue reservation and hyaline cartilage regeneration without uneven surface, graft necrosis and sclerosis. However, poor gap integration is a serious concern, which eventually leads to deterioration of joint function. To deal with such complications, this study has developed a strategy to effectively enhance integration of the gap region following mosaicplasty by applying injectable bioactive supramolecular nanofiber-enabled gelatin methacryloyl (GelMA) hydrogel (BSN-GelMA). A rabbit osteochondral defect model demonstrated that BSN-GelMA achieved seamless osteochondral healing in the gap region between plugs of osteochondral defects following mosaicplasty, as early as six weeks. Moreover, the International Cartilage Repair Society score, histology score, glycosaminoglycan content, subchondral bone volume, and collagen II expression were observed to be the highest in the gap region of BSN-GelMA treated group. This improved outcome was due to bio-interactive materials, which acted as tissue fillers to bridge the gap, prevent cartilage degeneration, and promote graft survival and migration of bone marrow mesenchymal stem cells by releasing bioactive supramolecular nanofibers from the GelMA hydrogel. This study provides a powerful and applicable approach to improve gap integration after autologous mosaicplasty. It is also a promising off-the-shelf bioactive material for cell-free in situ tissue regeneration.

Student Learning Outcomes of Dedicated Education Units (DEU): A Systematic Review.

The purpose of this systematic review was to evaluate research conducted on the DEU to identify and synthesize student learning outcomes. A systematic literature review was conducted through Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. After extracting data from seven (N = 7) published studies, eight (N = 8) valid and reliable instruments were identified to objectively evaluate student learning outcomes. Statistically significant objective learning outcomes of these studies included self-reported increased confidence and critical thinking, decreased anxiety, enhanced leadership skills and implementation of EBP, and feeling more supported by experienced nurses during training and transition to practice. With the exception of ATI assessments, HESI exam scores, and NCLEX pass rates, the instruments identified in this review measured personal perceptions of students' experiences. The majority of the instruments involved student nurses' self-reports, the lowest level of evaluation. From an academic standpoint, it is imperative to evaluate this model's impact on higher levels of learning and measurable behavioral changes after training. The collaborative model of DEU requires both academic and practice partners to collaborate to objectively measure the impact of the DEU model on student outcomes, new graduate nurses' transition to practice, and patient outcomes. While the results are promising, this systematic review suggests that more objective evidence is needed to determine measurable student learning outcomes of DEUs.