The Novel Platinum Analog Dicycloplatin Provides Reliable Growth Inhibition of Urothelial Carcinoma Cells In Vitro.

BACKGROUND/AIM: Platinum-based chemotherapies are a component of standard-of-care regimens for urothelial carcinoma (UC). These nephrotoxic drugs are often dose-limiting, with cisplatin and carboplatin being the most commonly used. Dicycloplatin (DCP) has better solubility and stability, with comparable efficacy and better tolerability. Some suggest the use of DCP as primary treatment for non-muscle-invasive bladder cancer. We exposed UC cell lines to DCP in vitro to assess its efficacy. MATERIALS AND METHODS: A high grade (IV) in vitro UC cell line (TCCSUP) was exposed to varying concentrations of cisplatin (0-600 µg/ml), carboplatin (0-600 µg/ml), oxaliplatin (0-4.0 µg/ml), and DCP (0-350 µg/ml). Grade II-IV cells were exposed to varying concentrations of DCP (0-350 µg/ml) to assess time- and concentration-dependent growth inhibition, and simulate intravesical treatment. Growth inhibition was determined following 24, 48, and 72 h of exposure, using a tetrazolium dye to assess mitochondrial dehydrogenase activity. RESULTS: DCP, cisplatin, and carboplatin effectively achieved >90% cell kill at 72 h. Concentrations of 325 µg/ml DCP, 50 µg/ml cisplatin, and 600 µg/ml carboplatin were sufficient for >90% cell-kill, with cisplatin demonstrating the highest efficacy at the lowest concentration/time intervals. Dose- and time-dependent cell kill were demonstrated at varying concentrations of DCP in grade II-IV cell lines, including cells exposed intravesically. CONCLUSION: In vitro, DCP demonstrates cell-killing efficacy in a time- and concentration-dependent manner in grade II-IV UC cell lines, showing promise for its intravenous, oral, and intravesical use for bladder UC in both primary and adjuvant/neoadjuvant settings.

Adult Age Differences in Sensitivity to Semantic Satiation.

OBJECTIVE: In this study, we investigated age differences in sensitivity to semantic satiation.Semantic satiation was conceptualized as occurring within a semantic activation framework. METHOD: A prime or to-be-satiated word (e.g., ANIMAL) was presented repeatedly for an average of 2.5, 12.5, or 22.5 times. Afterward, a word triad comprised of two related words (e.g., PURPLE, YELLOW) and one unrelated word (e.g., DOG) was presented. The two related words were designated as nontargets or context words in the display and the unrelated word was the target. Participants were instructed to indicate as quickly and as accurately as possible which of the words in the triad was the unrelated word by pressing a key which was spatially compatible to the position of the stimulus on the CRt. RESULTS: For young but not older adults, there was an attenuation of priming effects in the response latency data as repetition of the prime increased. CONCLUSION: These results were interpreted as evidence that older adults are less sensitive to the semantic satiation phenomenon than young adults.

The Influence of Maternal Cognitions Upon Motor Development in Infants Born Preterm: A Scoping Review.

PURPOSE: This scoping review summarizes the extent, nature, and type of evidence linking broadly defined maternal cognitions to motor outcomes in infants born preterm. Maternal cognitions are beliefs, perceptions, or psychosocial attributes that inform parenting practices. METHODS: Arksey and O'Malley's 5-step method was applied. Thirteen articles between 1980 and November 2019 met inclusion criteria. RESULTS: Two key themes emerged with infants born preterm: (1) quality of the social and physical caregiving environment influence developmental outcomes with implications for motor development; and (2) complex interactions between environmental factors, prematurity-related biomedical risks, and maternal cognitions contribute to eventual motor outcomes. CONCLUSION: Further research is needed to understand how maternal cognitions either scaffold or constrain early motor opportunities for infants born preterm and at risk for motor delays. WHAT THIS ADDS TO THE EVIDENCE: This review summarizes studies that explore potential links between maternal cognitions and motor development in infants born preterm.

The Educare intervention: Outcomes at age 3.

The effectiveness of Educare, a center-based early education program, in improving child outcomes at age 3 was evaluated in a randomized clinical trial. Educare programs serve children from birth to age 5 and are designed to reduce the achievement gap between children from low-income families and their more advantaged peers. This study began following 239 children from low-income families who were randomly assigned as infants (<19 months) to Educare or a business-as-usual control group. At age 3, assessments of the skills of 202 children remaining in the study revealed significant differences in favor of children in the treatment group on auditory language skills, early math skills, and parent-reported problem behaviors. Effect sizes were in the modest range, although not as strong as the previously reported age 2 findings. No effects were found for observations of parent-child interactions, observer-rated child behaviors, or parent-rated social competence. For English-language skills, children who were dual language learners (DLLs) benefitted more from treatment than non-DLLs. Analyses of outcomes by child care type, regardless of treatment group assignment, showed that children in Educare had better language, math, and behavioral scores than children in less formal care, whereas children in other center-based care only had higher language scores than children in less formal care. Differences in outcomes between Educare and other center-based care were not significant.

Game On: Evaluating the Impact of Gamification in Nursing Orientation on Motivation and Knowledge Retention.

The purpose of this descriptive correlational study was to determine if implementing gamification teaching methodologies in nondigital format into nursing orientation has a positive effect on orientees' motivation and knowledge retention. The study included a convenience sample of 152 registered nurses who attended the nursing orientation class at a Midwestern acute care facility. This study found that gamification had a positive effect on the orientees' motivation and knowledge retention.

Sitting Matters! Differences Between Sitters and Nonsitters at 6 Months' Adjusted Age in Infants At-Risk and Born Preterm.

PURPOSE: Sitting delays in infants born preterm compound cognitive and language deficits. This retrospective study examines differences in prematurity-related risk and compares developmental outcomes between sitters and nonsitters at 6 months' adjusted age. METHODS: A total of 105 graduates of the neonatal intensive care unit met inclusion criteria. Infant demographic and medical risk profiles and 6-month Bayley Scales of Infant Development-3rd edition (BSID-III) cognitive and language scores were retrieved. Infants who sat with hands free greater than 60 seconds were classified as "sitters." RESULTS: Sixty-nine percent of the sample were nonsitters and were born earlier, had lower birth weights, were chronologically older at follow-up, and spent more days with respiratory support. BSID-III scores were significantly higher in sitters but did not differ by gender, multiple birth, head ultrasound results, payment type, or race/ethnicity. CONCLUSION: Sitting abilities at 6 months' adjusted age are associated with prematurity risk factors. Cognitive and language scores differ significantly between sitters and nonsitters.

Effect of chronic stress on running wheel activity in mice.

Acute and chronic stress have been reported to have differing effects on physical activity in rodents, but no study has examined a chronic stress protocol that incorporates stressors often experienced by rodents throughout a day. To examine this, the effects of the Unpredictable Chronic Mild Stress (UCMS) protocol on voluntary running wheel activity at multiple time points, and/or in response to acute removal of chronic stress was determined. Twenty male Balb/c mice were given access and accustomed to running wheels for 4 weeks, after which they were randomized into 2 groups; exercise (EX, n = 10) and exercise with chronic stress using a modified UCMS protocol for 7 hours/day (8:00 a.m.-3:00p.m.), 5 days/week for 8 weeks (EXS, n = 10). All mice were given access to running wheels from approximately 3:30 p.m. to 7:30 a.m. during the weekday, however during weekends mice had full-time access to running wheels (a time period of no stress for the EXS group). Daily wheel running distance and time were recorded. The average running distance, running time, and work each weekday was significantly lower in EXS compared to EX mice, however, the largest effect was seen during week one. Voluntary wheel running deceased in all mice with increasing age; the pattern of decline appeared to be similar between groups. During the weekend (when no stress was applied), EXS maintained higher distance compared to EX, as well as higher daily distance, time, and work compared to their weekday values. These results indicate that mild chronic stress reduces total spontaneous wheel running in mice during the first week of the daily stress induction and maintains this reduced level for up to 8 consecutive weeks. However, following five days of UCMS, voluntary running wheel activity rebounds within 2-3 days.

Assessment of Home Safety in Children From Kentuckiana.

PURPOSE: To evaluate home safety of children in the Ohio Valley Region. DESIGN AND METHODS: Using a cross-sectional design, data were collected by baccalaureate nursing students enrolled in a pediatric nursing course. A standardized Home Safety Assessment Survey and a Rural or Urban Safety Assessment were used with 95 families. Participants included 15 families who lived in rural areas and 80 families who lived in urban areas. The surveys were conducted in the homes of families that nursing students selected. RESULTS: Families with children under the age of 1 year had lower safe practices, while those with older and more than one child demonstrated higher safe practices. PRACTICE IMPLICATIONS: Based on these findings, interventions could be developed that focus on child injury prevention within home settings. Families presenting with the greatest risk of unintentional injuries can be identified and given extra attention and education.

Effect of community size on eligibility for early intervention for infants with a neonatal intensive care experience.

PURPOSE: To determine if population density (rural vs urban) in a child's home community influenced the decision of eligibility for early intervention (EI) services. METHODS: The sample included 356 infants with a gestational age of <31 weeks referred from a statewide child find program for an evaluation for EI services. A binary logistic regression analysis was completed to determine which variables predicted acceptance into EI services. FINDINGS: Infants less than 31 weeks gestation residing in rural areas were more likely to be eligible for EI services than premature infants (ie, <31 weeks gestation) with similar birth characteristics from urban areas. A binary logistic regression analysis revealed an odds ratio for eligibility for EI services among children living in rural areas compared to those living in urban areas was 3.007 (95% CI, 1.497 to 6.040). Additionally, the odds ratio for eligibility for males as compared to females was 1.908 (95% CI, 1.017 to 3.578). Participants who lived in a rural area and were male were more likely to be eligible for EI services than those who lived in urban locations and were female. CONCLUSIONS: Factors such as community support, experience with high-risk populations, and differences in interpreting eligibility criteria may influence the differences found between the rural and urban populations. Analysis of intervention cost versus effectiveness will be needed to determine whether the system as adopted in the rural versus urban environment is more appropriate for the provision of EI services.

Integrating genetics and genomics into nursing curricula: you can do it too!

Rapid advances in knowledge and technology related to genomics cross health care disciplines and touch almost every aspect of patient care. The ability to sequence a genome holds the promise that health care can be personalized. Health care professionals are faced with a gap in the ability to use the rapidly expanding technology and knowledge related to genomics in practice. Yet, nurses are key to bridging the gap between genomic discoveries and the human experience of illness. This article presents a case study documenting the experience of five nursing schools/colleges of nursing as they work to integrate genetics and genomics into their curricula.

Developmental outcomes of children with congenital diaphragmatic hernia: a multicenter prospective study.

PURPOSE: To determine developmental outcomes and associated factors in patients with congenital diaphragmatic hernia (CDH) at 2 years of age. METHODS: This is a multicenter prospective study of a CDH birth cohort. Clinical and socioeconomic data were collected. Bayley Scales of Infant Development (BSID-III) and Vineland Adaptive Behavior Scales (VABS-II) were performed at 2 years of age. RESULTS: BSID-III and VABS-II assessments were completed on 48 and 49 children, respectively. The BSID-III mean cognitive, language, and motor scores were significantly below the norm mean with average scores of 93 ± 15, 95 ± 16, and 95 ± 11. Ten percent (5/47) scored more than 2 standard deviations below the norm on one or more domains. VABS-II scores were similar to BSID-III scores with mean communication, daily living skills, social, motor, adaptive behavior scores of 97 ± 14, 94 ± 16, 93 ± 13, 97 ± 10, and 94 ± 14. For the BSID-III, supplemental oxygen at 28 days, a prenatal diagnosis, need for extracorporeal membrane oxygenation (ECMO) and exclusive tube feeds at time of discharge were associated with lower scores. At 2 years of age, history of hospital readmission and need for tube feeds were associated with lower scores. Lower socioeconomic status correlated with lower developmental scores when adjusted for significant health factors. CONCLUSION: CDH patients on average have lower developmental scores at 2 years of age compared to the norm. A need for ECMO, oxygen at 28 days of life, ongoing health issues and lower socioeconomic status are factors associated with developmental delays.

In vitro regulation of cell growth and angiogenesis by inositol hexaphosphate in bladder cancer.

BACKGROUND: Inositol Hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate that is found in food sources high in fiber content. We hypothesized that IP6 would inhibit the cell growth rate of bladder cancer in vitro. METHODS: T24 and TCCSUP bladder cancer cell lines were treated with titrating doses of IP6 (0.3, 0.6 and 0.9 mM/well). Cell viability and vascular endothelial growth factor levels were measured. RESULTS: Significant reductions (p < 0.001) in cellular growth were noted in both cell lines at all doses and time points tested, with the exception of 0.3 mM IP6 at 24 hours in the T24 cell line. The percent inhibition of vascular endothelial growth factor was significantly higher than that observed in the TCCSUP cell line at 48 and 72 hours with 0.3 mM IP6 (p < 0.001). The T24 cells exhibited the same level of inhibition at 24 and 48 hours with 0.6 mM dose of IP6 and at 72 hours with the 0.3 mM dose (p < 0.001). CONCLUSIONS: In vitro treatment of bladder cancer with the common dietary polyphosphorylated carbohydrate IP6 significantly decreased cellular growth by anti-angiogenic mechanisms. We feel that this data warrants further investigation and consideration for initiation of clinical trials to evaluate the safety and clinical utility of this agent.

Sacral nerve stimulation for neuromodulation of the lower urinary tract.

Sacral neuromodulation (SNM) has become a standard treatment option for patients suffering from urinary urge incontinence, urgency-frequency, and/or nonobstructive urinary retention refractory to conservative and pharmacologic treatment. Since its initial development, the manufacturer of InterStim therapy (Medtronic, Inc., Minneapolis, MN, USA), has introduced technical modifications, while surgeons and researchers have adapted and published various innovations and alterations of the implantation technique. In this article, we feature our SNM technique including patient selection, comprehensive dialogue/evaluation, procedure details, and appropriate follow up. Although there is often great variability in patients with lower urinary tract dysfunction, we maintain that great success can be achieved with a systematic and methodical approach to SNM.

Possible prevention and treatment of prostate cancer by exercise.

Exercise and physical activity have been linked to the prevention of certain types of cancer such as colon and breast. As prostate cancer is the most common malignancy diagnosed in the male population, there is obvious interest in determining a possible effect of exercise on disease prevention and improvement of disease-related outcomes. Thus far, data has been conflicting and there has been no clear determination of prostate cancer prevention through exercise. However, as prostate cancer treatment carries many side effects which may be bothersome and health-threatening, researchers have examined the effects of exercise training on reducing treatment-related complications and improving outcomes and quality of life (QOL). In this review, we discuss the impact of exercise on reducing side effects of prostate cancer treatment and improving cancer-specific and overall survival outcomes, as well as improving QOL in prostate cancer patients.

Long-term neurodevelopmental outcomes in children born with gastroschisis: the tiebreaker.

PURPOSE: We evaluated 2-year neurodevelopmental outcomes in children with gastroschisis. METHODS: We reviewed the records of children with gastroschisis treated between August 2001 and July 2008. Children discharged from the neonatal intensive care unit were referred to the state-sponsored Developmental Tracking Infant Progress Statewide (TIPS) program. We reviewed TIPS assessments performed before age 2 years. School districts evaluated children referred by TIPS and determined their eligibility for early intervention services. Poor outcomes were defined as scores of "failure" or "moderate/high risk" on the screening assessment or enrollment in early intervention services by 2 years. Children with gastroschisis were compared with case-matched nonsurgical, nonsyndromic children of similar gestational age and birth weight. RESULTS: One hundred five children were born with gastroschisis, and 46 were followed up with TIPS. There was no statistically significant difference in performance on screening assessments or in the rate of enrollment in early intervention services between the gastroschisis children and controls. CONCLUSIONS: Children born with gastroschisis have similar 2-year neurodevelopmental outcomes as nonsurgical, nonsyndromic neonatal intensive care unit children of similar gestational age and birth weight. Both groups of children have a higher rate of enrollment in early intervention than their healthy peers. These data suggest that neurodevelopmental outcomes in gastroschisis children are delayed secondary to prematurity rather than the presence of the surgical disease.

Bayley Scales of Infant Development Screening Test-Gross Motor Subtest: efficacy in determining need for services.

PURPOSE: To identify the efficacy of the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), Screening Test-Gross Motor Subtest (GMS) in identifying infants who are accepted for early intervention services. METHODS: This retrospective study included 93 infants with a neonatal intensive care experience who participated in a 6-month developmental assessment follow-up visit. All infants were examined using the BSID-III Screening Test-GMS and the Alberta Infant Motor Scale. A binary logical regression analysis was used to determine the best predictors of acceptance status in this sample. RESULTS: The BSID-III Screening Test-GMS accounted for a significant portion of the variance in acceptance status. CONCLUSION: The results suggest that the BSID-III Screening Test-GMS has great applicability for transdisciplinary/interdisciplinary teams as it effectively identified children who were eligible for early intervention.

Genetic analysis in the Collaborative Cross breeding population.

Genetic reference populations in model organisms are critical resources for systems genetic analysis of disease related phenotypes. The breeding history of these inbred panels may influence detectable allelic and phenotypic diversity. The existing panel of common inbred strains reflects historical selection biases, and existing recombinant inbred panels have low allelic diversity. All such populations may be subject to consequences of inbreeding depression. The Collaborative Cross (CC) is a mouse reference population with high allelic diversity that is being constructed using a randomized breeding design that systematically outcrosses eight founder strains, followed by inbreeding to obtain new recombinant inbred strains. Five of the eight founders are common laboratory strains, and three are wild-derived. Since its inception, the partially inbred CC has been characterized for physiological, morphological, and behavioral traits. The construction of this population provided a unique opportunity to observe phenotypic variation as new allelic combinations arose through intercrossing and inbreeding to create new stable genetic combinations. Processes including inbreeding depression and its impact on allelic and phenotypic diversity were assessed. Phenotypic variation in the CC breeding population exceeds that of existing mouse genetic reference populations due to both high founder genetic diversity and novel epistatic combinations. However, some focal evidence of allele purging was detected including a suggestive QTL for litter size in a location of changing allele frequency. Despite these inescapable pressures, high diversity and precision for genetic mapping remain. These results demonstrate the potential of the CC population once completed and highlight implications for development of related populations.

Comparison of arm and calf automatic noninvasive blood pressures in pediatric intensive care patients.

The purpose of this study was to compare upper arm and calf automatic blood pressures (BPs) in a convenience sample of 221 children, ages 1 to 8 years, admitted to a pediatric intensive care unit of a 180-bed teaching hospital in the Mid-Atlantic region of the United States. Subjects were positioned in bed, with the head of bed elevated 30° and extremities resting on the bed. BP cuff size was based on arm and calf circumferences. BPs were measured simultaneously using bedside and portable Spacelabs monitors. Calf BPs were greater than arm BPs in approximately 73% of the sample. Paired t tests show statistically significant differences for systolic BPs and mean arterial pressures. Influence of demographics, agitation levels, medical diagnoses, and current medications was explored. Calf and arm BPs were not interchangeable in acutely ill children, ages 1 to 8 years.

Ischemic gastropathy: an unusual cause of abdominal pain and gastric ulcers.

Chronic mesenteric ischemia classically presents as "intestinal angina" with generalized postprandial abdominal pain lasting up to 3 hours. Over time, these episodes can become much more intense and ultimately lead to sitophobia with significant weight loss. Symptoms are not specific and often mistakenly attributed to other gastrointestinal etiologies such as peptic ulcer disease. Gastric ulcerations as a direct result of mesenteric ischemia have been reported but are relatively rare because of the rich collateral blood supply to the stomach. Therefore, a diagnosis of ischemic gastropathy is seldom entertained in patients presenting with abdominal pain and gastric ulcers.