The Development, Implementation, and Evaluation of a Geriatric Disaster Nursing Simulation Intervention With Supportive Debriefing.

INTRODUCTION: Geriatric disaster nursing simulation curriculum use scenarios with trauma-based topics that may contribute to lack of psychological safety in learners. This learning condition lowers students' self-efficacy, so supportive debriefing is needed to provide psychological safety for learners. The aims of this study are to develop and apply a geriatric disaster nursing simulation and to evaluate the effectiveness of a supportive debriefing model on psychological safety, learning self-efficacy, and counseling self-efficacy. METHODS: A geriatric nursing simulation scenario, checklists, and a standardized patient were developed based on the Analysis-Design-Development-Implementation-Evaluation model. Nursing students were recruited as participants and randomly assigned to either the experimental group, conventional group, or control group. All 3 groups participated in the same geriatric disaster nursing simulation scenario, after which the experimental group used a supportive debriefing model-the SENSE (share-explore-notice-support-extend) model. The conventional group used a common debriefing model, the GAS (gathering-analyzing-summarizing) model, and the control group received simple comments with no debriefing model. The effects of the debriefing models on psychological safety, learning self-efficacy, and counseling self-efficacy were measured by self-report questionnaires. The aggregate scores of the measures were 222 for counseling self-efficacy, 70 for learning self-efficacy, and 50 for psychological safety. Higher scores within these measures corresponded to heightened capabilities. RESULTS: The mean score of counseling self-efficacy in the SENSE model group was significantly increased after the simulation with the supportive debriefing from 142.80 ± 11.43 to 164.53 ± 15.48 (Z = -3.411, P = 0.001). In addition, the SENSE model group and the GAS model group had significantly higher scores in counseling self-efficacy, learning self-efficacy, and psychological safety than those of the control group. However, the SENSE model group had a significantly higher score in psychological safety than that of the GAS model group. CONCLUSIONS: The SENSE debriefing model is recommended as a supportive debriefing model to foster students' psychological safety in disaster nursing simulations.

Porcine intestinal lymphoid tissues synthesize estradiol.

Estradiol (17ß-estradiol) is synthesized primarily in the gonads of both sexes and regulates the development and function of reproductive organs. Recently, we reported that intestinal lymphocyte homeostasis is regulated by estradiol synthesized de novo in the endothelial cells of the high endothelial venules (HEVs) of mesenteric lymph nodes and Peyer's patches in mice. This observation prompted us to hypothesize that HEVs of intestinal lymphoid tissues are sites of estradiol synthesis across species. In this study, we examined whether estradiol is synthesized in the intestinal lymphoid tissues of adolescent piglets. Comparisons of estradiol levels in blood and tissue showed that estradiol concentrations in mesenteric lymph nodes and Peyer's patches were significantly higher than the level in serum. Reverse transcription polymerase chain reaction showed that porcine intestinal lymphoid tissues express mRNAs for steroidogenic enzymes (StAR, 17ß-Hsd,3ß-Hsd, Cyp17a1, and Cyp19a1), and immunohistochemical results in ilial tissue showed expression of aromatase (CYP19) in Peyer's patch-localized endothelial cells of HEVs. When mesenteric lymph node and Peyer's patch tissues were cultured in vitro, they produced estradiol. Taken together, the results indicate that mesenteric lymph nodes and Peyer's patches are sites of estradiol synthesis in adolescent piglets.

Extra-gonadal sites of estrogen biosynthesis and function.

Estrogens are the key hormones regulating the development and function of reproductive organs in all vertebrates. Recent evidence indicates that estrogens play important roles in the immune system, cancer development, and other critical biological processes related to human well-being. Obviously, the gonads (ovary and testis) are the primary sites of estrogen synthesis, but estrogens synthesized in extra- gonadal sites play an equally important role in controlling biological activities. Understanding non-gonadal sites of estrogen synthesis and function is crucial and will lead to therapeutic interventions targeting estrogen signaling in disease prevention and treatment. Developing a rationale targeting strategy remains challenging because knowledge of extra-gonadal biosynthesis of estrogens, and the mechanism by which estrogen activity is exerted, is very limited. In this review, we will summarize recent discoveries of extra-gonadal sites of estrogen biosynthesis and their local functions and discuss the significance of the most recent novel discovery of intestinal estrogen biosynthesis. [BMB Reports 2016; 49(9): 488-496].

A wafer-level vacuum package using glass-reflowed silicon through-wafer interconnection for nano/micro devices.

We propose a vacuum wafer-level packaging (WLP) process using glass-reflowed silicon via for nano/micro devices (NMDs). A through-wafer interconnection (TWIn) substrate with silicon vias and reflowed glass is introduced to accomplish a vertical feed-through of device. NMDs are fabricated in the single crystal silicon (SCS) layer which is formed on the TWIn substrate by Au eutectic bonding including Cr adhesion layer. The WLPof the devices is achieved with the capping glass wafer anodically bonded to the SCS layer. In order to demonstrate the successful hermetic packaging, we fabricated the micro-Pirani gauge in the SCS layer, and packaged it in the wafer-level. The vacuum level inside the packaging was measured to be 3.1 Torr with +/- 0.12 Torr uncertainty, and the packaging leakage was not detected during 24 hour after the packaging.

MEMS micromirror characterization in space environments.

This paper describes MEMS micromirror characterization in space environments associated with our space applications in earth observation from the International Space Station and earth's orbit satellite. The performance of the micromirror was tested for shock and vibration, stiction, outgassing from depressurization and heating, and electrostatic charging effects. We demonstrated that there is no degradation of the micromirror performance after the space environment tests. A test bed instrument equipped with the micromirrors was delivered and tested in the ISS. The results demonstrate that the proposed micromirrors are suitable for optical space systems.