Development of Irinotecan Liposome Armed with Dual-Target Anti-Epidermal Growth Factor Receptor and Anti-Fibroblast Activation Protein-Specific Antibody for Pancreatic Cancer Treatment.

Pancreatic cancer is one of the most common causes of death in Taiwan. Previous studies have shown that more than 90% of pancreatic cancer cells presented epidermal growth factor receptor (EGFR) cell marker, and this marker is thought to be important as it is related to activation of cancer cell proliferation, angiogenesis, and cancer progression. Moreover, tumor-associated fibroblasts were involved in tumor proliferation and progression. In this study, we fabricated an anti-EGFR and anti-fibroblast activation protein bispecific antibody-targeted liposomal irinotecan (BS-LipoIRI), which could specifically bind to pancreatic cancer cells and tumor-associated fibroblasts. The drug encapsulation efficiency of BS-LipoIRI was 80.95%, and the drug loading was 8.41%. We proved that both pancreatic cancer cells and fibroblasts could be targeted by BS-LipoIRI, which showed better cellular uptake efficacy compared to LipoIRI. Furthermore, an in vivo mouse tumor test indicated that BS-LipoIRI could inhibit pancreatic cancer growth up to 46.2% compared to phosphate-buffered saline control, suggesting that BS-LipoIRI could be useful in clinical cancer treatment.

Factors associated with gender differences in medication adherence: a longitudinal study.

AIMS: To examine gender differences in the medication adherence of patients with hypertension by applying a longitudinal follow-up. BACKGROUND: Patient views of illness affect their adherence to therapeutic regimens. However, few studies have explored these issues by using a longitudinal design or from a gender perspective. DESIGN: This study used a longitudinal, correlational design. METHODS: A purposive sampling of 118 patients were recruited from cardiovascular clinics of a teaching hospital in Central Taiwan in 2007-2009. Data were collected using the Chinese Illness Perception Questionnaire-Revised and the Medication Adherence Inventory at three time points: at the first clinic visit, 6 and 12 months after the initial survey. Generalized estimating equations were calculated using the STATA software for data analysis. RESULTS: The findings revealed that male patients adhere more effectively to medications than female patients do. The interaction between systolic blood pressure and gender emerged as a significant predictor of adherence. Factors associated with adherence in male patients included less causal attribution to culture, more attribution to risk factors, fewer symptoms and uncertain symptoms related to high blood pressure, lower scores for timeline-cyclical and higher scores for illness consequences and coherence. Medication adherence for female patients was significantly related to more causal attribution to balance and risk factors, less personal control and enhanced illness coherence. CONCLUSION: Factors associated with adherence to antihypertensive medication were relatively gender-specific. Awareness of the differences is crucial for health professionals to provide appropriate advice for patients to cope effectively with their health threat.

[The development and current status of high-fidelity patient simulation teaching].

High-fidelity patient simulation teaching represents one of the most important innovations in healthcare education in the past two decades. In Taiwan, many medical centers and medical colleges now have clinical skill centers equipped with a high-fidelity patient simulator. Practicing clinical scenarios in this simulated environment can help strengthen students' professional essentials and competencies outside of classroom and clinical teaching settings. High-fidelity simulation teaching is an integrated teaching strategy that is continuing to receive greater attention. This article describes the historical development of high-fidelity patient simulation teaching, its current status, and applications in nursing education as a reference for nursing educators.

The longitudinal effect of concept map teaching on critical thinking of nursing students.

Concept map is a useful cognitive tool for enhancing a student's critical thinking by encouraging students to process information deeply for understanding. However, there is limited understanding of longitudinal effects of concept map teaching on students' critical thinking. The purpose of the study was to investigate the growth and the other factors influencing the development of critical thinking in response to concept map as an interventional strategy for nursing students in a two-year registered nurse baccalaureate program. The study was a quasi-experimental and longitudinal follow-up design. A convenience sample was drawn from a university in central Taiwan. Data were collected at different time points at the beginning of each semester using structured questionnaires including Critical Thinking Scale and Approaches to Learning and Studying. The intervention of concept map teaching was given at the second semester in the Medical-Surgical Nursing course. The results of the findings revealed student started with a mean critical thinking score of 41.32 and decreased at a rate of 0.42 over time, although not significant. After controlling for individual characteristics, the final model revealed that the experimental group gained a higher critical thinking score across time than the control group. The best predictive variables of initial status in critical thinking were without clinical experience and a higher pre-test score. The growth in critical thinking was predicted best by a lower pre-test score, and lower scores on surface approach and organized study. Our study suggested that concept map is a useful teaching strategy to enhance student critical thinking.

Effects of concept map teaching on students' critical thinking and approach to learning and studying.

The purpose of this study was to explore the effects of concept mapping in developing critical thinking ability and approach to learning and studying. A quasi-experimental study design with a purposive sample was drawn from a group of nursing students enrolled in a medical-surgical nursing course in central Taiwan. Students in the experimental group were taught to use concept mapping in their learning. Students in the control group were taught by means of traditional lectures. After the intervention, the experimental group had better overall critical thinking scores than did the control group, although the difference was not statistically significant. After controlling for the effects of age and the pretest score on critical thinking using analysis of covariance, the experimental group had significantly higher adjusted mean scores on inference and overall critical thinking compared with the control group. Concept mapping is an effective tool for improving students' ability to think critically.