Micro RNA expression profiles as adjunctive data to assess the risk of hepatocellular carcinoma recurrence after liver transplantation.

Donor livers are precious resources and it is, therefore, ethically imperative that we employ optimally sensitive and specific transplant selection criteria. Current selection criteria, the Milan criteria, for liver transplant candidates with hepatocellular carcinoma (HCC) are primarily based on radiographic characteristics of the tumor. Although the Milan criteria result in reasonably high survival and low-recurrence rates, they do not assess an individual patient's tumor biology and recurrence risk. Consequently, it is difficult to predict on an individual basis the risk for recurrent disease. To address this, we employed microarray profiling of microRNA (miRNA) expression from formalin fixed paraffin embedded tissues to define a biomarker that distinguishes between patients with and without HCC recurrence after liver transplant. In our cohort of 64 patients, this biomarker outperforms the Milan criteria in that it identifies patients outside of Milan who did not have recurrent disease and patients within Milan who had recurrence. We also describe a method to account for multifocal tumors in biomarker signature discovery.

Psychopathic traits and conduct problems in community and clinic-referred samples of children: further development of the psychopathy screening device.

This study examined the structure of psychopathic traits in 2 samples of children. The nonreferred community sample included 1,136 children recruited from elementary schools in 2 school districts in the southeastern United States. The clinic sample included 160 children referred to an outpatient mental health clinic serving the same geographic region. In both samples, parent and teacher ratings of psychopathic traits were subjected to a principal-axis factor analysis, and the congruence of the factor structure across samples was examined using confirmatory factor analysis. In both samples, 1 dimension that consisted of the callous and unemotional traits that have been hallmarks of most clinical descriptions of psychopathy was isolated. Two other dimensions consisting of narcissistic traits and impulsivity emerged in the community sample. Both the narcissism and impulsivity dimensions were highly related to symptoms of oppositional defiant disorder, conduct disorder, and attention deficit hyperactivity disorder. However, the callous and unemotional traits were only weakly associated with these symptoms after controlling for the other dimensions of psychopathy.

Profiles of nurses professionally involved in public policy.

A widely acclaimed goal of the nursing profession is to increase the number of nurses involved in shaping U.S. health policy. This study describes 33 nurses holding positions in regulatory agencies, state legislatures, and congressional offices.

Information systems technology: barriers and challenges to implementation.

Nurses, like other professionals, manage massive amounts of information. Without adequate means to process that data, neither the profession, the industry, nor the public will achieve all the benefits of contemporary health care. The authors highlight barriers to and strategies for increasing the use and effectiveness of health care information systems.