-
Lindsay Lindahl posted an update 3 days, 15 hours ago
Glucose metabolism (Warburg effect) was also altered and stem-like traits were suppressed by ATL-1. In addition, ATL-1 effectively acted as an inhibitor or AKT/mTOR by downregulating the phosphorylation of proteins related to the AKT/mTOR pathway. In vivo studies showed that tumor weight and volume were reduced by ATL-1 and that aerobic glycolysis, stemness maintenance, and AKT/mTOR activation were impaired by ATL-1 in colorectal tumors. CONCLUSIONS ATL-1 acts as an effective agent to suppress colorectal tumor progression, mainly by inhibiting CRC cell proliferation through altering apoptosis, glucose metabolism, and stem-like behavior. These processes were mediated by the AKT/mTOR signaling pathway both in vitro and in vivo. ATL-1 may be a potential agent to be used in molecular-targeted strategies for cancer treatment. BACKGROUND Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses’ competences to provide person-centred nursing care. PURPOSE To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. METHOD Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. RESULTS The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p less then 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. buy VPS34-IN1 The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p less then 0.001)]. CONCLUSIONS The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses. OBJECTIVES Simulation can serve as an effective educational method to provide experience and opportunities to learn about the nursing management of clinical cases in a secure environment. Numerous debriefing methods have been used in simulation in nurse education to improve clinical competencies and learning outcomes. However, there is insufficient evidence to identify the debriefing methods that are most effective in improving learning outcomes. In this systematic review and meta-analysis, the focus is on debriefing methods and learning outcomes in simulation in nurse education. DESIGN This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. DATA SOURCES Studies published from January 1995 to December 2016 were identified from PubMed, Embase, MEDLINE, PsycINFO, Web of Science, CINAHL, the Cochrane Library, and Korean databases. REVIEW METHODS Experimental studies that used debriefing methods in simulation in nurse education were included as review studies. Studies that used identical validated measurement tools were included in the meta-analysis. We applied a random-effects model with subgroups. Effect sizes for learning outcomes according to debriefing methods were calculated using standardized mean differences. RESULTS A total of 18 studies were selected through systematic review and 7 studies were included in the meta-analysis using four types of scales measuring learning outcomes after debriefing. The overall effect size of the learning outcomes, according to the type of debriefing method, was 0.31. The results regarding debriefing methods were statistically non-significant in the learning outcomes (95% CI [-0.33-0.96], Z = 0.95, p = 0.34). A symmetric shape indicated a lack of publication bias. CONCLUSIONS The study findings indicated that structured debriefing helped to improve learning. Future studies are needed to provide effective debriefing strategies with larger sample sizes. OBJECTIVE Isolated rapid eye movement sleep behavior disorder (iRBD) patients are at risk of cognitive impairments, however the underlying mechanism is still unclear. This study aimed to evaluate thalamo-cortical functional connectivity (FC) using resting-state functional magnetic resonance imaging (fMRI) and its correlation with cognitive dysfunction in patients with iRBD. METHODS A total 37 polysomnographies (PSGs) confirmed iRBD patients and 15 age-sex matched controls underwent resting-state fMRI and comprehensive neuropsychological assessment. Thalamo-cortical FC was evaluated by using seed-to voxel analysis and was compared between the iRBD and controls. Correlation between the average value of significant clusters and cognitive function scores in iRBD were calculated. RESULTS Compared to the control subjects, patients with iRBD patients showed cognitive decline in word list recognition (p = 0.016), and constructional recall (p = 0.044). The FC analysis showed increased FC between the left thalamus and occipital regions including the right cuneal cortex, left fusiform gyrus and lingual gyrus (cluster level p less then 0.05, corrected for false discovery rate). The averaged thalamo-fusiform FC value positively correlated with word list recognition after adjusting for age and sex (adjusted r = 0.347, p = 0.041). CONCLUSION Thalamic resting state FC is altered in iRBD patients and is associated with the cognitive function. Enhancement of the thalamo-occipital FC may reflect a compensatory mechanism for cognitive impairment in iRBD.