Multifunctional microelectronic fibers enable wireless modulation of gut and brain neural circuits.

Progress in understanding brain-viscera interoceptive signaling is hindered by a dearth of implantable devices suitable for probing both brain and peripheral organ neurophysiology during behavior. Here we describe multifunctional neural interfaces that combine the scalability and mechanical versatility of thermally drawn polymer-based fibers with the sophistication of microelectronic chips for organs as diverse as the brain and the gut. Our approach uses meters-long continuous fibers that can integrate light sources, electrodes, thermal sensors and microfluidic channels in a miniature footprint. Paired with custom-fabricated control modules, the fibers wirelessly deliver light for optogenetics and transfer data for physiological recording. We validate this technology by modulating the mesolimbic reward pathway in the mouse brain. We then apply the fibers in the anatomically challenging intestinal lumen and demonstrate wireless control of sensory epithelial cells that guide feeding behaviors. Finally, we show that optogenetic stimulation of vagal afferents from the intestinal lumen is sufficient to evoke a reward phenotype in untethered mice.

Magnetoelectric Nanodiscs Enable Wireless Transgene-Free Neuromodulation.

Deep-brain stimulation (DBS) with implanted electrodes revolutionized treatment of movement disorders and empowered neuroscience studies. Identifying less invasive alternatives to DBS may further extend its clinical and research applications. Nanomaterial-mediated transduction of magnetic fields into electric potentials offers an alternative to invasive DBS. Here, we synthesize magnetoelectric nanodiscs (MENDs) with a core-double shell Fe3O4-CoFe2O4-BaTiO3 architecture with efficient magnetoelectric coupling. We find robust responses to magnetic field stimulation in neurons decorated with MENDs at a density of 1 µg/mm2 despite individual-particle potentials below the neuronal excitation threshold. We propose a model for repetitive subthreshold depolarization, which combined with cable theory, corroborates our findings in vitro and informs magnetoelectric stimulation in vivo. MENDs injected into the ventral tegmental area of genetically intact mice at concentrations of 1 mg/mL enable remote control of reward behavior, setting the stage for mechanistic optimization of magnetoelectric neuromodulation and inspiring its future applications in fundamental and translational neuroscience.

Deletion of BDNF in Pax2 Lineage-Derived Interneuron Precursors in the Hindbrain Hampers the Proportion of Excitation/Inhibition, Learning, and Behavior.

Numerous studies indicate that deficits in the proper integration or migration of specific GABAergic precursor cells from the subpallium to the cortex can lead to severe cognitive dysfunctions and neurodevelopmental pathogenesis linked to intellectual disabilities. A different set of GABAergic precursors cells that express Pax2 migrate to hindbrain regions, targeting, for example auditory or somatosensory brainstem regions. We demonstrate that the absence of BDNF in Pax2-lineage descendants of Bdnf Pax2 KOs causes severe cognitive disabilities. In Bdnf Pax2 KOs, a normal number of parvalbumin-positive interneurons (PV-INs) was found in the auditory cortex (AC) and hippocampal regions, which went hand in hand with reduced PV-labeling in neuropil domains and elevated activity-regulated cytoskeleton-associated protein (Arc/Arg3.1; here: Arc) levels in pyramidal neurons in these same regions. This immaturity in the inhibitory/excitatory balance of the AC and hippocampus was accompanied by elevated LTP, reduced (sound-induced) LTP/LTD adjustment, impaired learning, elevated anxiety, and deficits in social behavior, overall representing an autistic-like phenotype. Reduced tonic inhibitory strength and elevated spontaneous firing rates in dorsal cochlear nucleus (DCN) brainstem neurons in otherwise nearly normal hearing Bdnf Pax2 KOs suggests that diminished fine-grained auditory-specific brainstem activity has hampered activity-driven integration of inhibitory networks of the AC in functional (hippocampal) circuits. This leads to an inability to scale hippocampal post-synapses during LTP/LTD plasticity. BDNF in Pax2-lineage descendants in lower brain regions should thus be considered as a novel candidate for contributing to the development of brain disorders, including autism.

Age-Dependent Auditory Processing Deficits after Cochlear Synaptopathy Depend on Auditory Nerve Latency and the Ability of the Brain to Recruit LTP/BDNF.

Age-related decoupling of auditory nerve fibers from hair cells (cochlear synaptopathy) has been linked to temporal processing deficits and impaired speech recognition performance. The link between both is elusive. We have previously demonstrated that cochlear synaptopathy, if centrally compensated through enhanced input/output function (neural gain), can prevent age-dependent temporal discrimination loss. It was also found that central neural gain after acoustic trauma was linked to hippocampal long-term potentiation (LTP) and upregulation of brain-derived neurotrophic factor (BDNF). Using middle-aged and old BDNF-live-exon-visualization (BLEV) reporter mice we analyzed the specific recruitment of LTP and the activity-dependent usage of Bdnf exon-IV and -VI promoters relative to cochlear synaptopathy and central (temporal) processing. For both groups, specimens with higher or lower ability to centrally compensate diminished auditory nerve activity were found. Strikingly, low compensating mouse groups differed from high compensators by prolonged auditory nerve latency. Moreover, low compensators exhibited attenuated responses to amplitude-modulated tones, and a reduction of hippocampal LTP and Bdnf transcript levels in comparison to high compensators. These results suggest that latency of auditory nerve processing, recruitment of hippocampal LTP, and Bdnf transcription, are key factors for age-dependent auditory processing deficits, rather than cochlear synaptopathy or aging per se.

A History of Systemic Racism at the University of Minnesota School of Nursing.

A history of discrimination against racial and religious minorities at the University of Minnesota, maintained by powerful administrators who were subsequently honored with named buildings, was reflected in acts and patterns of racism in admissions and housing, within the School of Nursing. This article recounts well-documented examples of racial bias, particularly the story of Frances Mchie Rains, the first nurse of color to graduate from the University of Minnesota School of Nursing and a pioneer in overcoming racial barriers.

Lesbian, Gay, Bisexual, and Transgender People, and the Nursing Imperative.

This essay speaks to the legacy value of nurses' caring for all people, no matter how they feel about the person's values or lifestyle, including the current issues around gender identity and sexual orientation. This legacy is deeply imbedded in the moral ethics of nursing and supports the proposition that if there isn't caring, it isn't nursing.

Substance Use Disorders and the American Nurses Association Code of Ethics for Nurses.

Substance use disorder is a serious problem in nursing that is often invisible and not well understood or well handled. It tears at the social contract between nursing and society and disrupts the trust so essential to that contract. The American Nurses Association Code of Ethics contains clear language about a nurse's duty to take action to protect patients and to ensure the impaired nurse gets assistance. Specific interpretive statements provide useful guidance in dealing with this problem.

From the Archive-A Brief Compendium of Curious and Peculiar Aspects of Nursing Resource Management.

The compendium of extraordinary operational skills required, the lack of recognition about the exact nature of nursing work, and deeply imbedded negative mind-sets result in staff nurses experiencing guilt and anger rather than the satisfaction of knowing they made a difference in someone's life because of the nursing care they gave. A change of mind-set from entitlement thinking to entrepreneurial thinking, with an emphasis on maximizing available resources, will empower nurses to understand that they have the right and the responsibility to decide what to do and what not to do when there is more work to do than time available.

BDNF-Live-Exon-Visualization (BLEV) Allows Differential Detection of BDNF Transcripts in vitro and in vivo.

Bdnf exon-IV and exon-VI transcripts are driven by neuronal activity and are involved in pathologies related to sleep, fear or memory disorders. However, how their differential transcription translates activity changes into long-lasting network changes is elusive. Aiming to trace specifically the network controlled by exon-IV and -VI derived BDNF during activity-dependent plasticity changes, we generated a transgenic reporter mouse for B DNF- l ive- e xon- v isualization (BLEV), in which expression of Bdnf exon-IV and -VI can be visualized by co-expression of CFP and YFP. CFP and YFP expression was differentially activated and targeted in cell lines, primary cultures and BLEV reporter mice without interfering with BDNF protein synthesis. CFP and YFP expression, moreover, overlapped with BDNF protein expression in defined hippocampal neuronal, glial and vascular locations in vivo. So far, activity-dependent BDNF cannot be explicitly monitored independent of basal BDNF levels. The BLEV reporter mouse therefore provides a new model, which can be used to test whether stimulus-induced activity-dependent changes in BDNF expression are instrumental for long-lasting plasticity modifications.

Visualizing BDNF Transcript Usage During Sound-Induced Memory Linked Plasticity.

Activity-dependent BDNF (brain-derived neurotrophic factor) expression is hypothesized to be a cue for the context-specificity of memory formation. So far, activity-dependent BDNF cannot be explicitly monitored independently of basal BDNF levels. We used the BLEV ( B DNF- live-exon- visualization) reporter mouse to specifically detect activity-dependent usage of Bdnf exon-IV and -VI promoters through bi-cistronic co-expression of CFP and YFP, respectively. Enriching acoustic stimuli led to improved peripheral and central auditory brainstem responses, increased Schaffer collateral LTP, and enhanced performance in the Morris water maze. Within the brainstem, neuronal activity was increased and accompanied by a trend for higher expression levels of Bdnf exon-IV-CFP and exon-VI-YFP transcripts. In the hippocampus BDNF transcripts were clearly increased parallel to changes in parvalbumin expression and were localized to specific neurons and capillaries. Severe acoustic trauma, in contrast, elevated neither Bdnf transcript levels, nor auditory responses, parvalbumin or LTP. Together, this suggests that critical sensory input is essential for recruitment of activity-dependent auditory-specific BDNF expression that may shape network adaptation.

A Brief Compendium of Curious and Peculiar Aspects of Nursing Resource Management.

The compendium of extraordinary operational skills required, the lack of recognition about the exact nature of nursing work, and deeply imbedded negative mind-sets result in staff nurses experiencing guilt and anger rather than the satisfaction of knowing they made a difference in someone's life because of the nursing care they gave. A change of mind-set from entitlement thinking to entrepreneurial thinking, with an emphasis on maximizing available resources, will empower nurses to understand that they have the right and the responsibility to decide what to do and what not to do when there is more work to do than time available.

The glucocorticoid antagonist mifepristone attenuates sound-induced long-term deficits in auditory nerve response and central auditory processing in female rats.

Systemic corticosteroids have been the mainstay of treatment for various hearing disorders for more than 30 yr. Accordingly, numerous studies have described glucocorticoids (GCs) and stressors to be protective in the auditory organ against damage associated with a variety of health conditions, including noise exposure. Conversely, stressors are also predictive risk factors for hearing disorders. How both of these contrasting stress actions are linked has remained elusive. Here, we demonstrate that higher corticosterone levels during acoustic trauma in female rats is highly correlated with a decline of auditory fiber responses in high-frequency cochlear regions, and that hearing thresholds and the outer hair cell functions (distortion products of otoacoustic emissions) are left unaffected. Moreover, when GC receptor (GR) or mineralocorticoid receptor (MR) activation was antagonized by mifepristone or spironolactone, respectively, GR, but not MR, inhibition significantly and permanently attenuated trauma-induced effects on auditory fiber responses, including inner hair cell ribbon loss and related reductions of early and late auditory brainstem responses. These findings strongly imply that higher corticosterone stress levels profoundly impair auditory nerve processing, which may influence central auditory acuity. These changes are likely GR mediated as they are prevented by mifepristone.-Singer, W., Kasini, K., Manthey, M., Eckert, P., Armbruster, P., Vogt, M. A., Jaumann, M., Dotta, M., Yamahara, K., Harasztosi, C., Zimmermann, U., Knipper, M., Rüttiger, L. The glucocorticoid antagonist mifepristone attenuates sound-induced long-term deficits in auditory nerve response and central auditory processing in female rats.

The impact of primary nursing care pattern: Results from a before-after study.

AIMS AND OBJECTIVES: To explore the effect of "Primary Nursing" on nursing-sensitive patient outcomes, staff-related outcomes and organisation-related outcomes. BACKGROUND: Primary nursing is one example of a care pattern that has recently been implemented in many countries. DESIGN: Before-after study. METHODS: This study was conducted in an Italian hospital. We observed patient-related outcomes (pressure ulcers, falls, urinary tract infection and venous catheter infection) in 2,857 inpatients before the implementation of primary nursing and in 3,169 inpatients after its implementation. Staff-related outcomes (nursing competence and diagnostic thinking) and organisation-related outcomes (empowerment and team climate) were collected from 369 nurses. From a subgroup of inpatients, we collected data regarding their satisfaction with the care provided. RESULTS: After the implementation of primary nursing, some nursing competencies and diagnostic thinking were improved, so were organisation-related outcomes. Our data showed that the number of inpatients with urinary catheter infections (5.5% vs. 4.3%) and venous catheter infections (peripheral: 2.2% vs. 1%; central: 5.6% vs. 1%) was significantly decreased; also, the numbers of falls (2.4% vs. 1.9%) and pressure ulcers (4.8% vs. 4%) decreased, although these decreases were not statistically significant. Overall, the implementation of primary nursing increased patient satisfaction with nursing care (193.57 vs. 210.21). CONCLUSIONS: Primary nursing improved staff-related outcomes, nursing-sensitive patient outcomes and organisation outcomes. RELEVANCE TO CLINICAL PRACTICE: Our results show that primary nursing has the potential to positively impact on inpatients, nurses and organisations. Moreover, the implementation of this care pattern is feasible.

Bridging the Policy/Clinical Practice Divide: A Conversation With Parmeeth M. S. Atwal, JD, MSN, RN, MPH, FNP.

Marie Manthey, founder of Creative Health Care Management, interviews Parmeeth "Par" Atwal, whose first career included representing the National Association of Community Health Centers as an attorney, editor of a major health policy journal, and a senior position in the Office of the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. He then became an active participant in the health care system, earning a bachelor of science in nursing, working in cardiac critical care, and now becoming a family nurse practitioner. He shares his perspective on the divide between health care policy and regulation, and the delivery of direct patient care.

Distress Calls of a Fast-Flying Bat (Molossus molossus) Provoke Inspection Flights but Not Cooperative Mobbing.

Many birds and mammals produce distress calls when captured. Bats often approach speakers playing conspecific distress calls, which has led to the hypothesis that bat distress calls promote cooperative mobbing. An alternative explanation is that approaching bats are selfishly assessing predation risk. Previous playback studies on bat distress calls involved species with highly maneuverable flight, capable of making close passes and tight circles around speakers, which can look like mobbing. We broadcast distress calls recorded from the velvety free-tailed bat, Molossus molossus, a fast-flying aerial-hawker with relatively poor maneuverability. Based on their flight behavior, we predicted that, in response to distress call playbacks, M. molossus would make individual passing inspection flights but would not approach in groups or approach within a meter of the distress call source. By recording responses via ultrasonic recording and infrared video, we found that M. molossus, and to a lesser extent Saccopteryx bilineata, made more flight passes during distress call playbacks compared to noise. However, only the more maneuverable S. bilineata made close approaches to the speaker, and we found no evidence of mobbing in groups. Instead, our findings are consistent with the hypothesis that single bats approached distress calls simply to investigate the situation. These results suggest that approaches by bats to distress calls should not suffice as clear evidence for mobbing.

Foundations of interprofessional communication and collaboration.

Communication and collaboration skills are important now among health professionals and are likely to become absolutely vital in the future. Health care team efficiency will be the hallmark of clinical and financial success as care delivery systems continue to evolve. Teaching these skills to beginning health professions students, with reinforcement throughout their education, is an exciting development in academia.