Early evolutionary divergence between papillary and anaplastic thyroid cancers.

Background: Papillary thyroid cancer (PTC) is the most common thyroid carcinoma and exhibits an almost uniformly good prognosis, while anaplastic thyroid cancer (ATC) is less frequent and is one of the most aggressive cancers usually resistant to conventional treatment. Current hypothesis posits that ATC derives from PTC through the progressive acquisition of a discrete number of genomic alterations and implies that the mutational landscape of ATC resembles that of PTC. However, the clinical behaviour of ATC and PTC is radically different. We decided to address the disconnection between the clinical behaviour of ATC and PTC and the proposed model of the progressive development of ATC from PTC. Patients and methods: We carried out exome sequencing of DNA from 14 ATC specimens including three cases of concomitant ATC and PTC as well as their corresponding normal DNA from 14 patients. The sequencing results were validated using droplet digital PCR. We carried out immunohistochemistry and immunofluorescence studies of the concomitant ATC and PTC cases. In addition, we integrated our sequencing results with the existing TCGA data. Results: Most of the somatic mutations identified in the ATC component differed from the ones in PTC in the cases of concomitant ATC and PTC. The trunks of the phylogenetic trees representing the somatic mutations were short with long branches. In one case of concomitant PTC and ATC specimens, we observed an infiltration of PTC cells within the ATC component. Moreover, we integrated our results with data obtained from TCGA and observed that the most frequent mutations found in ATC presented high cancer cell fraction values and were significantly different from the PTC ones. Conclusion: ATC diverge from PTC early in tumour development and both tumour types evolve independently. Our work allows the understanding of the relationship between ATC and PTC facilitating the clinical management of these malignancies.

Codependency in nursing students: recognition and modification of behavioral characteristics.

Recent literature estimates that there are approximately 2 1/2 million nurses; of these a significant number may exhibit signs of codependency, a behavior pattern that impedes an individual's ability to relate to others on mature level. Codependency develops in dysfunctional family systems and manifests itself in compulsive behaviors that make life painful and work emotionally difficult. Often, constructive communication is difficult as codependent persons tend to feel low self-esteem and low self-worth. Nursing students may exhibit characteristic codependency traits among fellow students in the classroom, in the clinical setting, and in interactions with faculty. Nurse educators, through their own self-awareness, introspection, and knowledge of the behaviors and characteristics of codependency, can facilitate more effective communication with all nursing students to promote healthier interactions and relationships. Techniques to modify one's method of interacting with others have clear potential for improving professional as well as personal relationships.

A collaborative effort for sex education in rural school settings.

Many students report that sex and sexuality education is, at best, inappropriate and, at worst, nonexistent. Alarming statistics for teen pregnancy and a high incidence of sexually transmitted diseases support the need for education and intervention targeted at a young audience. The traditional approach, to incorporate sex education into health education classes taught by schoolteachers, can be difficult to accomplish in rural school settings where adequate financial resources and community involvement are lacking. Through a partnership funded by the W. K. Kellogg Foundation, a collaborative approach was used in two rural Southeastern communities to deliver a program of sex education to students in fourth through sixth grades. The program united the efforts of community leaders, the school administration, parents, and students and faculty of a university school of nursing.