Effects of COVID-19 on Anxiety and Virtual Group Work Among Graduate Students: A Mixed-Methods Pilot Study

Date Presented 04/01/2022

The purpose of this study is to examine the anxiety levels of graduate students related to virtual group work. Results showed a slight negative correlation between satisfaction with group work and anxiety. Educators can use this research to focus on adapting teaching methods to facilitate learning.

Primary Author and Speaker: Ashley Van Ells

Additional Authors and Speakers: Yesenia Lopez, Christopher Harrell, Barbra Katerberg

Prediction equation to estimate dead space to tidal volume fraction correlates with mortality in critically ill patients

OBJECTIVE

The measurement of dead space to tidal volume fraction (Vd/Vt) using various methodologies has been shown to be a reliable predictor of mortality in critically ill patients. In this study, we evaluated the correlation of a validated equation using clinically available information to predict calculation of Vd/Vt with clinically relevant outcome parameters in patients requiring mechanical ventilation.

METHODS

Calculations of Vd/Vt were obtained based upon a previously published prediction equation for dead space ventilation fraction: Vd/Vt = 0.320 + 0.0106 (Paco2--end-tidal carbon dioxide measurement) + 0.003 (respiratory rate per minute) + 0.0015 (age in years) on study days 1, 3 to 4, 6 to 9, and 14 after initiation of mechanical ventilation in adult patients who satisfied 1 of the 3 study defined diseases: (1) acute bacterial pneumonia, (2) acute respiratory distress syndrome, or (3) cystic fibrosis.

RESULTS

Using the final/last available time point calculation of Vd/Vt, a significant difference was observed between survivors and nonsurvivors both in relation to mean and median values (56.5% vs 71.2% and 56.0% vs 65.0%, respectively). In addition, sequential analyses of Vd/Vt calculations over time also demonstrated a statistically significant difference between survivors and nonsurvivors for days 6 to 9.

CONCLUSION

In this study-specific population of critically ill patients, the prediction equation of Vd/Vt using clinically available parameters correlates with mortality. In addition, we provide a simple method to estimate Vd/Vt that can be potentially applicable to all critically ill intensive care unit patients.

Abstract P6-04-10: Components of cap-independent translation as novel targets in breast cancer

Background: The majority of cellular mRNAs are translated in a cap-dependent manner, involving ribosome assembly at 5’ 7-methylguanylate cap structures followed by scanning and initiation at a favorable AUG codon. Alternatively, mRNA structural elements termed internal ribosome entry sites (IRESs) facilitate translation in a cap-independent manner, and have been identified in mRNAs encoding many canonical cellular oncogenes, including c-MYC, c-SRC, XIAP, Aurora-A kinase, and IGF1R. IRES trans-activating factors (ITAFs) are accessory proteins that augment or inhibit translation mediated by specific IRES sequences, via binding to IRES structures and/ or other translational machinery. In addition, conversion of ribosomal RNA (rRNA) uracil bases to pseudouracil enhances IRES-mediated translation.

Methods: Analysis of publically available microarray datasets of breast cancer and normal breast tissue clinical specimens revealed that expression of several ITAFs is upregulated at the mRNA level in malignant tissues compared to normal controls. mRNAs encoding the ITAFs polypyrimidine tract binding protein 1 (PTBP1), splicing factor proline/ glutamine rich (SFPQ), poly-RC binding protein 2 (PCBP2), and interleukin enhancer binding factor 2 (ILF2, also NF45) were significantly upregulated (p < 0.05), as well as mRNA encoding the dyskeratosis congenita 1 (DKC1) rRNA-modifying enzyme. Independent analysis of an 855 human breast tumor dataset revealed that high mRNA expression of DKC1 and ILF2 are enriched in basal-like breast tumors compared to other intrinsic subtypes (t-test, p<0.01). Kaplan-Meier analyses revealed that high expression of DKC1 or ILF2 mRNAs were both significantly associated with decreased relapse-free survival duration (p = 0.0007 and p = 0.002, respectively).

To investigate the biological impact of ITAF and DKC1 silencing, PTBP1, PCBP2, SFPQ, and DKC1 knockdown was accomplished using pGIPZ and pTRIPZ lentiviral shRNA vectors. Silencing of these genes and concomitant reduction in protein levels (measured by western blot) led to significant proliferation impairment in MDA-MB-231, MDA-MB-436, and MCF7 breast cancer cells in culture, using Alamar Blue assay. In addition, 4T1 mouse mammary carcinoma cells express DKC1, PTBP1 and SFPQ, and may serve as a useful model in immunocompetent mice.

Conclusions and future directions: Future experiments will include investigation of protein-level expression in archival human specimens using immunohistochemistry, as well as investigation of the effects of ITAF/ DKC1 silencing in human xenografts using NOD/ SCID mice. Based on their increased expression in malignant breast tissues and activity in translation of oncoproteins, cellular ITAF genes and DKC1 gene may represent novel therapeutic targets for intervention. In particular, the increased expression of DKC1 enzyme and ILF2 in basal-like breast cancers implies a possible therapeutic opportunity in triple-negative breast cancers.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-04-10.

Severe hypercapnia in critically ill adult cystic fibrosis patients

Background

Cystic fibrosis (CF) is a monogenetic autosomal recessive multi-organ disease affecting approximately 50,000 patients worldwide. Overall median survival is continually increasing but pulmonary disease remains the most common cause of death. Guidelines have been published in relation to the outpatient maintenance of lung health for CF patients and treatment of acute lung exacerbations but little information exists about the management of the critically ill CF patient. Invasive mechanical ventilation in CF patients with acute respiratory failure is associated with poor outcome and high mortality.

Methods

Retrospective analysis of adult patients with CF who required endotracheal intubation and invasive mechanical ventilation in the Medical Intensive Care Unit (MICU).

Results

Between the years 2003 - 2009, 14 adult patients with CF required endotracheal intubation and invasive mechanical ventilation in the Medical Intensive Care Unit (MICU) of the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA. Eleven patients died in the MICU because of progressive respiratory failure and inability to liberate from mechanical ventilation. Seven individuals consistently manifested arterial partial pressures of carbon dioxide (PaCO₂) greater than 20.00 kPa despite high levels of conventional modes of mechanical ventilation.

Conclusion

Intubated CF patients with respiratory failure have a high mortality rate. Based on our experience, multiple factors contribute to severe hypercapnia and the effectiveness of conventional modes of mechanical ventilation in many of these patients is limited.

Keywords

Cystic fibrosis; Mechanical ventilation; Critical care; Hypercapnia; Respiratory failure

The effect of gabapentin on neuropathic pain

OBJECTIVE

To evaluate the effects of gabapentin on pain scores and opiate use.

DESIGN

Retrospective review of patients charts who received gabapentin for at least 30 days. Data were collected concerning patients' diagnosis, current drug use, concurrent drug use, gabapentin dose, pain scores, and patient-reported side effects. Patients were divided into three groups based on their pain diagnosis; low back, neuropathic, and myofascial pain. The neuropathic group was subdivided into postherpetic neuralgia, diabetic neuropathy, sympathetically maintained pain, and phantom pain.

SETTING

Two tertiary referral teaching hospitals in southeastern Michigan.

RESULTS

A total of 122 charts were reviewed and included in this study. A significant decrease in pain scores with gabapentin was seen in the neuropathic pain group (paired t-test, p < .0001) but not in the low back pain group. Of the neuropathic pain group, patients with postherpetic neuralgia had the greatest decrease in pain scores. Ten patients showed a > 75% decrease in pain scores, of these: nine had a direct nerve injury, and one had postherpetic neuralgia. Opiate use was unchanged in all groups. Patients who were taking opiates had significantly less benefit with gabapentin use in terms of pain score. Patient-reported side effects were similar to those reported in a nonchronic pain population.

CONCLUSION

Gabapentin may be a useful adjunct for treating neuropathic pain with a minimum of side effects. Particular advantage may be gained with the use of this drug for postherpetic neuralgia and direct peripheral nerve injuries.

On being a mentor to nurse practitioner students: the preceptor-student relationship

This article explores the identity of NPs as clinical practice preceptors and mentors for NP students, including the inherent conflict created for preceptors by these overlapping role expectations. Also examined is the nurse practitioner-student relationship with phases of the relationship between student and preceptor/mentor presented. Issues related to student and preceptor role development and personal characteristics of both impacting on the relationship are identified. Implications for client health outcomes, educational programs, students, preceptors and nursing researchers are discussed.

A simple process for controlling operating room specialized inventory

As with any new system, success would not exist without team efforts. Cooperation from the materiel service department played an important role in its success. Prompt purchase orders and a prompt delivery system are a must when PAR levels are kept at a minimum. The new manual inventory system became an efficient and effective alternative to controlling products within the surgery department at Tampa General Hospital. And now for automation!