Older, vulnerable patient view: a pilot and feasibility study of the patient measure of safety (PMOS) with patients in Australia

Objectives

The UK-developed patient measure of safety (PMOS) is a validated tool which captures patient perceptions of safety in hospitals. We aimed (1) to investigate the extent to which the PMOS is appropriate for use with stroke, acute myocardial infarction (AMI) and hip fracture patients in Australian hospitals and (2) to pilot the PMOS for use in a large-scale, national study 'Deepening our Understanding of Quality in Australia' (DUQuA).

Participants

Stroke, AMI and hip fracture patients (n=34) receiving care in 3 wards in 1 large hospital.

Methods

2 phases were conducted. First, a 'think aloud' study was used to determine the validity of PMOS with this population in an international setting, and to make amendments based on patient feedback. The second phase tested the revised measure to establish the internal consistency reliability of the revised subscales, and piloted the recruitment and administration processes to ensure feasibility of the PMOS for use in DUQuA.

Results

Of the 43 questions in the PMOS, 13 (30%) were amended based on issues patients highlighted for improvement in phase 1. In phase 2, a total of 34 patients were approached and 29 included, with a mean age of 71.3 years (SD=16.39). Internal consistency reliability was established using interitem correlation and Cronbach's α for all but 1 subscale. The most and least favourably rated aspects of safety differed between the 3 wards. A study log was categorised into 10 key feasibility factors, including liaising with wards to understand operational procedures and identify patterns of patient discharge.

Conclusions

Capturing patient perceptions of care is crucial in improving patient safety. The revised PMOS is appropriate for use with vulnerable older adult groups. The findings from this study have informed key decisions made for the deployment of this measure as part of the DUQuA study.

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Does employee participation in workplace health promotion depend on the working environment? A cross-sectional study of Danish workers

Objectives

To investigate if participation in workplace health promotion (WHP) depends on the work environment.

Methods

Questionnaire data on participation in WHP activities (smoking cessation, healthy diet, exercise facilities, weekly exercise classes, contact with health professionals, health screenings) and the work environment (social support, fatiguing work, physical, quantitative and emotional demands, job control and WHP availability setting) were collected cross-sectionally in 2010 in a representative sample (n=10 605) of Danish workers. Binary regression analyses of the association between work environment characteristics and participation in WHP were conducted and adjusted for age, gender and industry.

Results

WHP offered during leisure time was associated with lower participation in all measured activities compared with when offered during working hours. Low social support and fatiguing work were associated with low participation in WHP. No associations with participation in WHPs were observed for physical work or quantitative demands, work pace or job strain. However, high physical demands/low job control and high emotional demands/low job control were associated with low participation.

Conclusions

Lower participation in WHP was associated with programmes during leisure, low social support, very fatiguing work and high physical or emotional demands with low job control. This suggests that to obtain proper effect of health promotion in a workplace setting, a good work environment is essential.

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Consumer concerns about paracetamol: a retrospective analysis of a medicines call centre

Objectives

To identify consumer information needs about paracetamol, the most commonly used analgesic and antipyretic worldwide.

Design

Retrospective analysis of medicines questions from the public.

Setting

Australian consumer medicines call centre.

Participants

Callers to National Prescribing Service Medicines Line between September 2002 and June 2010 (n=123 217).

Main outcome measures

Enquiry profile: demographics, enquiry type and concurrent medicines included in paracetamol calls; question themes derived from subset of call narratives.

Results

Paracetamol comprised part of the enquiry in 5.2% of calls (n=6367). The caller age distribution for paracetamol calls was skewed towards a younger cohort, with 45.2% made by those aged 25–44 vs 37.5% in 'rest of calls'. Significantly more paracetamol-related calls were made for a child (23.7%) compared with 'rest of calls' (12.7%, p<0.001). The most frequent concurrently asked about medicines were codeine (11%, n=1521) and ibuprofen (6.4%, n=884). Questions underpinned by paracetamol risk (interaction, use in pregnancy/lactation or other safety concerns) predominated (55.8%). When individual paracetamol enquiry types were compared with 'rest of calls', efficacy was most frequent (24.9% vs 22.8%); however, interaction (21.5% vs 14.8%), administration (15.5% vs 11%) and pregnancy/lactation (13.8% vs 8.3%) categories were more prevalent for paracetamol calls (all p<0.001). Enquiry type frequency also varied by patient age group, with questions about administration more common in younger groups and efficacy dominating in those over 45. Narrative analysis of over-represented paracetamol enquiry types showed specific concerns relevant to life stages: young children, those of reproductive age and the elderly.

Conclusions

Consumers have many concerns about the use of paracetamol that may be under-recognised by healthcare providers, with the nature of enquiries differing across life stages. These concerns are not adequately addressed by available consumer information. Improving access to targeted information about paracetamol would promote the safe and effective use of this common medicine.

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Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies

Objective

To clarify and quantify the potential association between intake of flavonoids and risk of stroke.

Design

Meta-analysis of prospective cohort studies.

Data source

Studies published before January 2016 identified through electronic searches using PubMed, Embase and the Cochrane Library.

Eligibility criteria for selecting studies

Prospective cohort studies with relative risks and 95% CIs for stroke according to intake of flavonoids (assessed as dietary intake).

Results

The meta-analysis yielded 11 prospective cohort studies involving 356 627 participants and more than 5154 stroke cases. The pooled estimate of the multivariate relative risk of stroke for the highest compared with the lowest dietary flavonoid intake was 0.89 (95% CI 0.82 to 0.97; p=0.006). Dose-response analysis indicated that the summary relative risk of stroke for an increase of 100 mg flavonoids consumed per day was 0.91 (95% CI 0.77 to 1.08) without heterogeneity among studies (I²=0%). Stratifying by follow-up duration, the relative risk of stroke for flavonoid intake was 0.89 (95% CI 0.81 to 0.99) in studies with more than 10 years of follow-up.

Conclusions

Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke.

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Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

Objectives

To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition.

Setting

A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan.

Participants

Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants.

Main outcome measures

For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay.

Results

In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013).

Conclusions

ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective.

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Nerve-insulating cells more diverse than previously thought

Oligodendrocytes, a type of brain cell that plays a crucial role in diseases such as multiple sclerosis, are more diverse than have previously been thought, according to a new study by researchers at Karolinska Institutet in Sweden. The findings, published in the journal Science, will help increase our understanding of diseases in which these cells are affected and possibly provide clues to future treatment strategies. In multiple sclerosis and similar neurological diseases, the electrical signals in the brain propagate more slowly. The reduced speed of information flow contributes to symptoms such as numbness, balance and walking difficulties and blurred vision. Loss of myelin Multiple sclerosis is characterised by the loss of myelin, a protective sheath that insulates nerve cells and allows rapid transmission of electrical signals in the brain. Myelin is produced by a specialized cell type, the oligodendrocyte. While oligodendrocytes have thus far been thought to be a homogenous population, a different view emerges from the current study. The researchers, led by Dr. Gonçalo Castelo-Branco and Dr. Sten Linnarsson, used the recently developed technique of single cell RNA-sequencing. This method allows investigators to get a snapshot of gene activity in individual cells. In this way, they could reveal differences between cells that may not be visible using classical methods. The researchers analysed more than five thousand oligodendrocytes from several regions of the brain and spinal cord in adolescent and adult mice, which allowed them to see the diversity of these cells with unprecedented detail and clarity.  "We uncovered an unexpected diversity within the oligodendrocyte population", says Sten Linnarsson from the Department of Medical Biochemistry and Biophysics. "In this study, we have identified 12 subclasses of oligodendrocytes and a novel cell distinct from oligodendrocytes residing in the blood vessels" Specific regions They found that the initial stages of maturation in oligodendrocyte development were similar across the central nerve system in juvenile mice, whereas different subsets of mature oligodendrocytes were enriched in specific regions in adult brains. "The uncovering of this unexpected oligodendrocyte diversity might bring new insights on mechanisms of degeneration and regeneration of diseases where myelin is lost, such as multiple sclerosis", says Gonçalo Castelo-Branco at the same department. The research has been supported by, among others, the Swedish Research Council, Swedish Brain Foundation (Hjärnfonden), Swedish Society of Medicine (SLS), Åke Wiberg, Clas Groschinsky, Petrus och Augusta Hedlunds foundations and European Union. Publication Oligodendrocyte heterogeneity in the mouse juvenile and adult central nervous system Sueli Marques, Amit Zeisel, Simone Codeluppi, David van Bruggen, Ana Mendanha, Falcão, Lin Xiao, Huiliang Li, Martin Häring, Hannah Hochgerner, Roman A. Romanov, Daniel Gyllborg, Ana Muñoz Manchado, Gioele La Manno, Peter Lönnerberg, Elisa M. Floriddia, Fatemah Rezayee, Patrik Ernfors, Ernest Arenas, Jens Hjerling-Leffler, Tibor Harkany, William D. Richardson, Sten Linnarsson, Gonçalo Castelo-Branco Science, published online 10th of June 2016, doi 10.1126/science.aaf6463.

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The essential function of the Trypanosoma brucei Trl1 homolog in procyclic cells is maturation of the intron-containing tRNATyr [ARTICLE]

Trypanosoma brucei, the etiologic agent of sleeping sickness, encodes a single intron-containing tRNA, tRNA^Tyr, and splicing is essential for its viability. In Archaea and Eukarya, tRNA splicing requires a series of enzymatic steps that begin with intron cleavage by a tRNA-splicing endonuclease and culminates with joining the resulting tRNA exons by a splicing tRNA ligase. Here we explored the function of TbTrl1, the T. brucei homolog of the yeast Trl1 tRNA ligase. We used a combination of RNA interference and molecular biology approaches to show that down-regulation of TbTrl1 expression leads to accumulation of intron-containing tRNA^Tyr and a concomitant growth arrest at the G1 phase. These defects were efficiently rescued by expression of an "intronless" version of tRNA^Tyr in the same RNAi cell line. Taken together, these experiments highlight the crucial importance of the TbTrl1 for tRNA^Tyr maturation and viability, while revealing tRNA splicing as its only essential function.

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Nucleotide specificity of the human terminal nucleotidyltransferase Gld2 (TUT2) [ARTICLE]

The nontemplated addition of single or multiple nucleotides to RNA transcripts is an efficient means to control RNA stability and processing. Cytoplasmic RNA adenylation and the less well-known uridylation are post-transcriptional mechanisms regulating RNA maturation, activity, and degradation. Gld2 is a member of the noncanonical poly(A) polymerases, which include enzymes with varying nucleotide specificity, ranging from strictly ATP to ambiguous to exclusive UTP adding enzymes. Human Gld2 has been associated with transcript stabilizing miRNA monoadenylation and cytoplasmic mRNA polyadenylation. Most recent data have uncovered an unexpected miRNA uridylation activity, which promotes miRNA maturation. These conflicting data raise the question of Gld2 nucleotide specificity. Here, we biochemically characterized human Gld2 and demonstrated that it is a bona fide adenylyltransferase with only weak activity toward other nucleotides. Despite its sequence similarity with uridylyltransferases (TUT4, TUT7), Gld2 displays an 83-fold preference of ATP over UTP. Gld2 is a promiscuous enzyme, with activity toward miRNA, pre-miRNA, and polyadenylated RNA substrates. Apo-Gld2 activity is restricted to adding single nucleotides and processivity likely relies on additional RNA-binding proteins. A phylogeny of the PAP/TUTase superfamily suggests that uridylyltransferases, which are derived from distinct adenylyltransferase ancestors, arose multiple times during evolution via insertion of an active site histidine. A corresponding histidine insertion into the Gld2 active site alters substrate specificity from ATP to UTP.

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Evaluation of microRNA alignment techniques [BIOINFORMATICS]

Genomic alignment of small RNA (smRNA) sequences such as microRNAs poses considerable challenges due to their short length (~21 nucleotides [nt]) as well as the large size and complexity of plant and animal genomes. While several tools have been developed for high-throughput mapping of longer mRNA-seq reads (>30 nt), there are few that are specifically designed for mapping of smRNA reads including microRNAs. The accuracy of these mappers has not been systematically determined in the case of smRNA-seq. In addition, it is unknown whether these aligners accurately map smRNA reads containing sequence errors and polymorphisms. By using simulated read sets, we determine the alignment sensitivity and accuracy of 16 short-read mappers and quantify their robustness to mismatches, indels, and nontemplated nucleotide additions. These were explored in the context of a plant genome (Oryza sativa, ~500 Mbp) and a mammalian genome (Homo sapiens, ~3.1 Gbp). Analysis of simulated and real smRNA-seq data demonstrates that mapper selection impacts differential expression results and interpretation. These results will inform on best practice for smRNA mapping and enable more accurate smRNA detection and quantification of expression and RNA editing.

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Peroxiredoxin-2 nitrosylation facilitates cardiomyogenesis of mouse embryonic stem cells via XBP-1s/PI3K pathway

Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Bowen Wu, Hao Yu, Yifan Wang, Zongfu Pan, Yihan Zhang, Tong Li, Lu Li, Weichen Zhang, Lijun Ge, Ying Chen, Choe Kyong Ho, Danyan Zhu, Xin Huang, Yijia Lou
Protein nitrosylation is a ubiquitous post-translational modification in almost all biological systems. However, its function on stem cell biology is so far incompletely understood. Here, we demonstrated that peroxiredoxin 2 (Prdx-2) nitrosylation was involved in cardiomyocyte differentiation of mouse embryonic stem (ES) cells induced by S-nitrosoglutathione (GSNO). We found that temporary GSNO exposure could promote ES cell-derived cardiomyogenesis. Using a stable isotope labeling by amino acids in cell culture (SILAC)-based proteomics approach, coupled with biotin switch technique, a total of 104 nitrosylated proteins were identified. Specifically, one of the antioxidant enzymes, Prdx-2, was abundantly nitrosylated and temporarily reduced in antioxidant activity, causing transient endogenous hydrogen peroxide (H2O2) accumulation and subsequent X-box binding protein-1s/phosphatidylinositol 3-kinase pathway activation. The present study reveals the mechanism in which GSNO favors cardiomyocyte differentiation. Prdx-2 nitrosylation could be a potent strategy to affect the pluripotent stem cell-derived cardiomyogenesis.

Graphical abstract

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Melatonin prevents secondary intra-abdominal hypertension in rats possibly through inhibition of the p38 MAPK pathway

Publication date: August 2016
Source:Free Radical Biology and Medicine, Volume 97
Author(s): Mingtao Chang, Yang Li, Dong Liu, Lianyang Zhang, Hongguang Zhang, Hao Tang, Huayu Zhang
Exogenous administration of melatonin has been demonstrated to down-regulate inflammatory responses and attenuate organ damage in various models. However, the salutary effect of melatonin against secondary intra-abdominal hypertension (IAH) remains unclear. This study sought to test the influence of melatonin on secondary IAH in a pathophysiological rat model and the underlying mechanisms involved. Before resuscitation, male rats underwent a combination of induced portal hypertension, applying an abdominal restraint device, and hemorrhaging to mean arterial pressure (MAP) of 40mmHg for 2h. After blood reinfusion, the rats were treated with lactated Ringer solution (LR) (30mL/h), melatonin (50mg/kg) +LR, and SB-203580 (10μmol/kg)+LR. LR was continuously infused for 6h. MAP, the inferior vena cava pressure and urine output were monitored. Histopathological examination, immunofluorescence of tight junction proteins, and transmission electron microscopy were administered. Intestinal permeability, myeloperoxidase activity, malondialdehyde, glutathione peroxidase, and levels of TNF-a, IL-2, and IL-6, were assessed. The expression of extracellular signal-regulated kinase, p38, c-Jun NH2-terminal kinase, translocation of nuclear factor kappa B subunit, signal transducers and activators of transcription and tight junction proteins were detected by Western blot. We found that melatonin inhibited the inflammatory responses, decreased expression of p38 MAPK, attenuated intestinal injury, and prevented secondary IAH. Moreover, administration of SB203580 abolished the increase in p38 MAPK and also attenuated intestinal injury. These data indicate that melatonin exerts a protective effect in intestine in secondary IAH primarily by attenuating the inflammatory responses which are in part attributable to p38 MAPK inhibition.



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Design and characterization of novel all-solid-state potentiometric sensor array dedicated to physiological measurements

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Renata Toczyłowska-Mamińska, Monika Kloch, Anna Zawistowska-Deniziak, Agnieszka Bala
A novel construction of all-solid-state potentiometric sensor array designed for physiological measurements has been presented. The planar construction and elimination of liquid phase creates broad opportunities for the modifications in the sensing part of the sensor. The designed construction is based on all-solid-state ion-selective electrodes integrated with the ionic-liquid based reference electrode. Work parameters of the sensor arrays were characterized. It has been shown that presented sensor design indicates high sensitivity (55.2±1mV/dec, 56.3±2mV/dec, 58.4±1mV/dec and 53.5±1mV/pH for sodium-, potassium-, chloride- and pH-selective electrodes, respectively in 10⁻⁵–10^−1.5M range of primary ions), low response time (t95 did not exceed 10s), high potential stability (potential drift in 28-h measurement was ca. ±2mV) and potential repeatability ca. ±1mV. The system was successfully applied to the simultaneous determination of K⁺, Cl⁻, Na⁺ and pH in the model physiological solution and for the ion flux studies in human colon epithelium Caco-2 cell line as well.

Graphical abstract

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An improved matrix separation method for characterization of ultrapure germanium (8N)

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): M.A. Reddy, R. Shekhar, Sunil Jai Kumar
An improved matrix separation method has been described to characterize ultrapure germanium of 8N (99.999999%) purity. In this method, temperature of the reaction vessel in which in-situ generated chlorine gas reacts with germanium solid material directly is optimized to quantitatively remove Ge matrix from all its impurities. Optimized reaction temperature has been found to be 230±5°C. Recovery studies on more than 60 elements have been carried out at the optimized temperature. Recoveries of all the analytes except As, Se, Sn, Hg, Tl are found to be quantitative. The method has been examined for various amounts of Ge material and found to be suitable even for 10g of Ge sample and provides low parts per billion and trillion levels of process blanks. Determination of concentrations of impurities has been done by inductively coupled plasma quadrupole mass spectrometer (ICP-QMS) and high resolution continuum source graphite furnace atomic absorption spectrometer (HR-CS-GFAAS). In the absence of certified reference materials for ultrapure germanium, accuracy of the proposed method is established by spike recovery tests. Precision of this method is found to vary from 7% to 50% for concentrations between 4 and 0.004ngg⁻¹. Limits of detection (LOD) for the target analytes are found to be between 6 and 0.011ngmL⁻¹ or 1.8–0.003ngg⁻¹ for the proposed procedure. The method has been successfully applied for that characterization of ultrapure germanium material of 8N purity.

Graphical abstract

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Selective adsorption of hemoglobin with polyoxometalate-derived hybrid by solidification of super-lacunary phosphotungstate polyoxoanions

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Dan-Dan Zhang, Lin-Lin Hu, Qing Chen, Xu-Wei Chen, Jian-Hua Wang
A novel polyoxometalate (POM)-based hybrid P8W48-APTS is prepared by the solidification of super-lacunary P8W48O184^40- polyoxoanions with APTS in an acidic medium. The oxygen (O⁻) atoms in P8W48O184^40- are bound to silicon atoms in APTS by the formation of Si-O linkage through dehydration condensation. The solidification is confirmed by characterizations with XRD, FT-IR, TGA, SEM and EDXS. Selective isolation of proteins of interest, hemoglobin (Hb) in this case, from complex sample matrices is achieved by using P8W48-APTS hybrid as adsorbent under controlled conditions. 5.0mg of P8W48-APTS hybrid results in an adsorption efficiency of 93% for 100mgL⁻¹ hemoglobin in 1.0mL sample solution at pH 7. The adsorption behavior of Hb onto P8W48-APTS hybrid fits Langmuir adsorption model, corresponding to an adsorption capacity of 355.0mgg⁻¹. The retained Hb could be readily recovered with either a SDS solution (0.1molL⁻¹) or a Na3PO4 (0.1molL⁻¹) solution as stripping reagent, providing recoveries of 94.6% or 83.9%, respectively. The biological activity of Hb remains 96.7% after an adsorption/desorption process (with elution by SDS), which illustrates virtually no change on the conformation of hemoglobin. The P8W48-APTS hybrid has been applied for the selective adsorption of Hb from human whole blood, and the results are demonstrated by SDS-PAGE assay.

Graphical abstract

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Understanding microwave vessel contamination by chloride species

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Sandro Recchia, Davide Spanu, Davide Bianchi, Carlo Dossi, Andrea Pozzi, Damiano Monticelli
Microwaves are widely used to assist digestion, general sample treatment and synthesis. The use of aqua regia is extensively adopted for the closed vessel mineralization of samples prior to trace element detection, leading to the contamination of microwave vessels by chlorine containing species. The latter are entrapped in the polymeric matrix of the vessels, leading to memory effects that are difficult to remove, among which the risk of silver incomplete recoveries by removal of the sparingly soluble chloride is the predominant one. In the present paper, we determined by mass spectrometry that hydrogen chloride is the species entrapped in the polymeric matrix and responsible for vessel contamination. Moreover, several decontamination treatments were considered to assess their efficiency, demonstrating that several cleaning cycles with water, nitric acid or silver nitrate in nitric acid were inefficient in removing chloride contamination (contamination reduction around 90%). Better results (≈95% decrease) were achieved by a single decontamination step in alkaline environment (sodium hydroxide or ammonia). Finally, a thermal treatment in a common laboratory oven (i.e. without vacuum and ventilation) was tested: a one hour heating at 150°C leads to a 98.5% decontamination, a figure higher than the ones obtained by wet treatments which requires comparable time. The latter treatment is a major advancement with respect to existing treatments as it avoids the need of a vacuum oven for at least 17h as presently proposed in the literature.

Graphical abstract

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The use of graphene nanoribbons as efficient electrochemical sensing material for nitrite determination

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Eda Mehmeti, Dalibor M. Stanković, Ahmet Hajrizi, Kurt Kalcher
In this work new designed, highly sensitive electrochemical method is developed for the determination of nitrites in tap water using glassy carbon electrode modified with graphene nanoribbons (GNs/GCE). Graphene nanoribbons (GNs) have been newly synthetized and aligned to the surface of glassy carbon electrode (GCE) and exhibited excellent electrocatalytic activity for nitrite oxidation with a very high peak currents. Studies about electrochemical behavior and optimization of the most important experimental conditions were done using cyclic voltammetry (CV), while quantitative studies were done with amperometric detection. Nitrite provides a well-defined, oxidation peak at +0.9V (vs. Ag/AgCl, 3.0M KCl) in Britton-Robinson buffer solution (BRBS) at pH 3. The influence of most possible interferent ions has been examined and was found to be negligible. Under optimized experimental conditions in BRBS at pH 3 linear calibration curves were obtained in the range from 0.5 to 105µM with the detection limit of 0.22µM. Reproducibility of ten replicate measurements of 1µM of nitrite was estimated to be 1.9%. Proposed method and constructed sensor is successfully applied for the determination of nitrite present in tap water samples without any pretreatment. This developed method represents inexpensive analytical alternative approach compared to other analytical methods.

Graphical abstract

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New evidences on efficacy of boronic acid-based derivatization method to identify sugars in plant material by gas chromatography–mass spectrometry

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Marianna Faraco, Daniela Fico, Antonio Pennetta, Giuseppe E. De Benedetto
This work presents an analytical procedure based on gas chromatography–mass spectrometry which allows the determination of aldoses (glucose, mannose, galactose, arabinose, xylose, fucose, rhamnose) and chetoses (fructose) in plant material.One peak for each target carbohydrate was obtained by using an efficient derivatization employing methylboronic acid and acetic anhydride sequentially, whereas the baseline separation of the analytes was accomplished using an ionic liquid capillary column. First, the proposed method was optimized and validated. Successively, it was applied to identify the carbohydrates present in plant material. Finally, the procedure was successfully applied to samples from a XVII century painting, thus highlighting the occurrence of starch glue and fruit tree gum as polysaccharide materials.

Graphical abstract

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Aptamer and PNIPAAm co-conjugated nanoparticles regulate activity of enzyme with different temperature

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Jiemiao Yu, Liangrong Yang, Xiangfeng Liang, Tingting Dong, Hongnan Qu, Meng Rong, Huizhou Liu
In this paper, we described a temperature responsive nano-system that can regulate activity of enzyme with different temperature. Temperature responsive polymer poly(N-isopropylacrylamide) (PNIPAAm), with low critical solution temperature of 32°C, was synthesized with thiol modification. PNIPAAm and thrombin aptamer were co-functionalized on the surface of gold nanoparticles for effective regulation of thrombin activity with different temperature. On the one hand, we studied the thermal responsive properties of this inhibitor via UV–visible spectroscopy. On the other hand, we investigated the regulation of thrombin activity by this platform with different temperature. The PNIPAAm chains could extend and shrink with different temperature, which suggested that PNIPAAm on the surface of gold nanoparticles could regulate interaction between thrombin and aptamer according to temperature changing. At 25°C, PNIPAAm was hydrophilic extended state, which blocked the interaction between thrombin and aptamer on the surface of gold nanoparticles, therefore thrombin activity had no change. On the contrary, at 37°C, PNIPAAm transformed from hydrophilic extended state to hydrophobic shrank state, allowing the aptamer to capture thrombin, inhibiting the activity of thrombin. More interestingly, this regulation was reverse to normal condition, where 37°C was always the optimum reaction temperature for most of human enzymes. This system we prepared was opposite, which was capable of inhibiting the thrombin activity at 37°C. Furthermore, this was the first report of regulation of thrombin activity using this temperature responsive platform.

Graphical abstract

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Simultaneous determination of radiocesium (135Cs, 137Cs) and plutonium (239Pu, 240Pu) isotopes in river suspended particles by ICP-MS/MS and SF-ICP-MS

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Liguo Cao, Jian Zheng, Hirofumi Tsukada, Shaoming Pan, Zhongtang Wang, Keiko Tagami, Shigeo Uchida
Due to radioisotope releases in the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident, long-term monitoring of radiocesium (¹³⁵Cs and ¹³⁷Cs) and Pu isotopes (²³⁹Pu and ²⁴⁰Pu) in river suspended particles is necessary to study the transport and fate of these long-lived radioisotopes in the land-ocean system. However, it is expensive and technically difficult to collect samples of suspended particles from river and ocean. Thus, simultaneous determination of multi-radionuclides remains as a challenging topic. In this study, for the first time, we report an analytical method for simultaneous determination of radiocesium and Pu isotopes in suspended particles with small sample size (1–2g). Radiocesium and Pu were sequentially pre-concentrated using ammonium molybdophosphate and ferric hydroxide co-precipitation, respectively. After the two-stage ion-exchange chromatography separation from the matrix elements, radiocesium and Pu isotopes were finally determined by ICP-MS/MS and SF-ICP-MS, respectively. The interfering elements of U (²³⁸U¹H⁺ and ²³⁸U²H⁺ for ²³⁹Pu and ²⁴⁰Pu, respectively) and Ba (¹³⁵Ba⁺ and ¹³⁷Ba⁺ for ¹³⁵Cs and ¹³⁷Cs, respectively) were sufficiently removed with the decontamination factors of 1–8×10⁶ and 1×10⁴, respectively, with the developed method. Soil reference materials were utilized for method validation, and the obtained ¹³⁵Cs/¹³⁷Cs and ²⁴⁰Pu/²³⁹Pu atom ratios, and ^239+240Pu activities showed a good agreement with the certified/information values. In addition, the developed method was applied to analyze radiocesium and Pu in the suspended particles of land water samples collected from Fukushima Prefecture after the FDNPP accident. The ¹³⁵Cs/¹³⁷Cs atom ratios (0.329-0.391) and ¹³⁷Cs activities (23.4–152Bq/g) suggested radiocesium contamination of the suspended particles mainly originated from the accident-released radioactive contaminates, while similar Pu contamination of suspended particles caused by the accident could be neglected as the ²⁴⁰Pu/²³⁹Pu atom ratios (0.182–0.208) were within the range of global fallout.

Graphical abstract

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Purification of quantum dot-based bioprobes via high-performance size exclusion chromatography

Publication date: 1 October 2016
Source:Talanta, Volume 159
Author(s): Jia-Kai Wu, Zhi-Quan Tian, Zhi-Ling Zhang, An-An Liu, Bo Tang, Li-Juan Zhang, Zhi-Liang Chen, Dai-Wen Pang
Due to excellent optical properties, quantum dots (QDs) have been widely applied to sensing, labeling, and imaging. For the fabrication of QD-based bioprobes, purification is usually the crucial step. Hydrophilic octylamine grafted polyacrylic acid modified QDs (OPA-QDs) were prepared, and purified by high-performance size exclusion chromatography (HPSEC) to remove excess OPA and aggregated QDs. The percentage of suspended agglomerates of OPA-QDs in the unpurified OPA-QDs increases from 4% to 31% through a year, but the purified OPA-QDs of the same batch possess excellent colloidal stability for at least one year. Subsequently, QD-based bioprobes were fabricated by the conjugation between QDs and streptavidin (SA) or antibody (IgG), generating QD-SA and QD-IgG, respectively, which were purified via HPSEC. Finally, the resulting QD-SA and QD-IgG were adopted to detect tumour markers on slices and showed specific positive signals without nonspecific adsorption, which was contrary to the unpurified QD-IgG. Thus, the HPSEC-coupled system proposed in the current work is potent and universal for the generation of purified and monodisperse QD-based bioprobes, which is promising in the nanobiodetection field.

Graphical abstract

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Scaling of GFR and SUV for body size: the curious conflict of whole body metric preferences

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Three-Dimensional Environment Sustains Morphological Heterogeneity and Promotes Phenotypic Progression During Astrocyte Development

Tissue Engineering Part A Jun 2016, Vol. 22, No. 11-12: 885-898.


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Purinergic Signaling Regulates the Transforming Growth Factor-β3-Induced Chondrogenic Response of Mesenchymal Stem Cells to Hydrostatic Pressure

Tissue Engineering Part A Jun 2016, Vol. 22, No. 11-12: 831-839.


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Expandable Scaffold Improves Integration of Tissue-Engineered Cartilage: An In Vivo Study in a Rabbit Model

Tissue Engineering Part A Jun 2016, Vol. 22, No. 11-12: 873-884.


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Effects of Composition and Mechanical Property of Injectable Collagen I/II Composite Hydrogels on Chondrocyte Behaviors

Tissue Engineering Part A Jun 2016, Vol. 22, No. 11-12: 899-906.


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Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

High Altitude Medicine & Biology Jun 2016, Vol. 17, No. 2: 93-100.


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Fatigue and Exhaustion in Hypoxia: The Role of Cerebral Oxygenation

High Altitude Medicine & Biology Jun 2016, Vol. 17, No. 2: 72-84.


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High Altitude Medicine & Biology Jun 2016, Vol. 17, No. 2: 57-60.

High Altitude Medicine & Biology Jun 2016, Vol. 17, No. 2: 57-60.


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Muscarinic Receptor Activation Affects Pulmonary Artery Contractility in Sheep: The Impact of Maturation and Chronic Hypoxia on Endothelium-Dependent and Endothelium-Independent Function

High Altitude Medicine & Biology Jun 2016, Vol. 17, No. 2: 122-132.


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Significance of power average of sinusoidal and non-sinusoidal periodic excitations in nonlinear non-autonomous system

Abstract

Additional sinusoidal and different non-sinusoidal periodic perturbations applied to the periodically forced nonlinear oscillators decide the maintainance or inhibitance of chaos. It is observed that the weak amplitude of the sinusoidal force without phase is sufficient to inhibit chaos rather than the other non-sinusoidal forces and sinusoidal force with phase. Apart from sinusoidal force without phase, i.e., from various non-sinusoidal forces and sinusoidal force with phase, square force seems to be an effective weak perturbation to suppress chaos. The effectiveness of weak perturbation for suppressing chaos is understood with the total power average of the external forces applied to the system. In any chaotic system, the total power average of the external forces is constant and is different for different nonlinear systems. This total power average decides the nature of the force to suppress chaos in the sense of weak perturbation. This has been a universal phenomenon for all the chaotic non-autonomous systems. The results are confirmed by Melnikov method and numerical analysis. With the help of the total power average technique, one can say whether the chaos in that nonlinear system is to be supppressed or not.

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Origins of sp3C peaks in C1s X-ray Photoelectron Spectra of Carbon Materials

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b01327

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(Almost) Stationary Isotachophoretic Concentration Boundary in a Nanofluidic Channel Using Charge Inversion

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b01701

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Qualitative Study of Foster Caregivers' Views on Adherence to Pediatric Appointments

The current study is a qualitative investigation of how foster caregivers, primarily Latinos, view adherence to pediatric appointments. Our purpose was to identify how the child welfare system, pediatric clinics, and pediatric health providers serving foster children might promote appointment attendance. Participants in the study had a return appointment at an outpatient pediatric clinic that served only children in the child welfare system. Twenty-eight caregivers (13 related and 15 unrelated) participated in telephone interviews after the date of their scheduled pediatric appointment; 32% missed their return appointment.

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Effectiveness of Bilateral Transforaminal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis Patients with Neurogenic Claudication: A Case Series

As our population ages, neurogenic claudication from central canal stenosis of the lumbar spine is an increasingly common condition. Studies have been done to assess the efficacy of caudal, interlaminar, or unilateral transforaminal epidural injections, but bilateral transforaminal epidural injections have not been evaluated to date.

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Unusual Hypersensitivity Reaction to Iohexol during Epidural Steroid Injection Resulting in Lipoma Development-A Case Report

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The “Near-Peer” Approach to Teaching Musculoskeletal Physical Examination Skills Benefits Residents and Medical Students

The musculoskeletal physical examination (MSK PE) is an essential part of medical student training, and it is best taught in a hands-on, longitudinal fashion. A barrier to this approach is faculty instructor availability. "Near-peer" teaching refers to physicians-in-training teaching their junior colleagues. It is unknown whether near-peer teaching is effective in teaching this important physical examination skill.

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Alleviating thoracotomy pain with intercostal liposomal bupivacaine: a case report

Thoracotomy pain is common after chest surgery and may result from injury to the lung pleura, intercostal muscles, costovertebral joint, or intercostal nerves. Inappropriately controlled post-operative pain can hinder recovery and increase the risk of complications such as infection, atelectasis, blood clots, and development of post-thoracotomy pain syndrome. A number of acute pain treatment options are available, most requiring systemic medications or indwelling catheters that may be contraindicated in patients on anticoagulants.

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Zika virus, the new kid on the block

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Longitudinal follow-up of Zika virus RNA in semen of a traveller returning from Barbados to the Netherlands with Zika virus disease, March 2016

We report the longitudinal follow-up of Zika virus (ZIKV) RNA in semen of a traveller who developed ZIKV disease after return to the Netherlands from Barbados, March 2016. Persistence of ZIKV RNA in blood, urine, saliva and semen was followed until the loads reached undetectable levels. RNA levels were higher in semen than in other sample types and declined to undetectable level at day 62 post onset of symptoms.

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Job vacancy at the European Centre for Disease Prevention and Control

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Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016

The current Zika virus outbreak and its potential severe health consequences, especially congenital fetal syndrome, have led to increased concern about sexual transmission, especially in pregnant women and women of reproductive age. Here we report a case of Zika virus sexual transmission, likely male-to-female, in a totally asymptomatic couple.

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Outbreak of diarrhoeal illness in participants in an obstacle adventure race, Alpes-Maritimes, France, June 2015

An acute gastroenteritis (AG) outbreak occurred among participants in an obstacle race in France in the summer of 2015. An investigation in two phases was conducted to identify the source of infection and document the extent of the outbreak. First, a message on a social media website asked racers to report any symptoms by email to the Regional Health Agency of Provence-Alpes-Côte d'Azur. Second, a retrospective cross-sectional study was conducted through an interactive questionnaire for all participants, followed by an analytical study of potential risks factors. Of 8,229 persons registered, 1,264 adults reported AG resolved within 48 hours. Of adults who reported AG, 866 met the case definition. Age group, departure time and ingestion of mud were associated with AG. Twenty stool specimens tested negative for bacteria. All four stool samples tested for viruses were positive for norovirus genogroup I and genotype 2. No indicator bacteria for faecal contamination were found in drinking water but muddy water of ponds tested positive. The outbreak was possibly caused by human-to-human transmission of a norovirus introduced by one or more persons and transmitted through contaminated mud. Risks related to similar races should be assessed and recommendations be proposed to raise awareness among health authorities and organisers.

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Assessment of edema volume in skin upon injury in a mouse ear model with optical coherence tomography

Abstract

Accurate measurement of edema volume is essential for the investigation of tissue response and recovery following a traumatic injury. The measurements must be noninvasive and repetitive over time so as to monitor tissue response throughout the healing process. Such techniques are particularly necessary for the evaluation of therapeutics that are currently in development to suppress or prevent edema formation. In this study, we propose to use optical coherence tomography (OCT) technique to image and quantify edema in a mouse ear model where the injury is induced by a superficial-thickness burn. Extraction of edema volume is achieved by an attenuation compensation algorithm performed on the three-dimensional OCT images, followed by two segmentation procedures. In addition to edema volume, the segmentation method also enables accurate thickness mapping of edematous tissue, which is an important characteristic of the external symptoms of edema. To the best of our knowledge, this is the first method for noninvasively measuring absolute edema volume.

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Proteomic analysis of changes in mitochondrial protein expression during peach fruit ripening and senescence

Publication date: Available online 8 June 2016
Source:Journal of Proteomics
Author(s): Xiaoqin Wu, Li Jiang, Mingliang Yu, Xiujuan An, Ruijuan Ma, Zhifang Yu
Ripening and senescence define the last step of fruit development, which directly affects its commercial value, and mitochondria play a crucial role in these processes. To better understand mitochondrial roles in maintaining and regulating metabolism in storage tissues, highly purified mitochondria were isolated from peach tissues (Prunus persica. cv. Xiahui-8) stored at 4°C and 25°C, respectively, and their proteome was conducted using the method of 2-DE and MALDI-TOF/TOF. Twenty-four (24) differentially expressed proteins (2-fold, p≤0.01) were identified out of more than 300 spots and were divided into six categories by PIR and Uniprot, including oxidative stress (34%), carbon metabolism (29%), respiratory chain (17%), amino acid metabolism and protein biosynthesis (8%), heat shock protein (4%), ion channels (4%). Proteins involved in antioxidative systems, gluconeogenesis, glycolysis, ethanol fermentation were changed significantly in response to high temperature. Storage at 4°C dramatically delayed ripening and senescence processes by postponing the climacteric peak, slowing down carbon metabolism and degradation of cell structure. Besides, low temperature induced the expression of formate dehydrogenase and some amino acid metabolism proteins. Proteins classified in respiratory chain, ion channels showed high coherence with climacteric respiratory burst, and the antioxidative enzymes showed relatively important symptoms on ROS scavenging through orderly expressions.SignificanceWith the advent of proteomics and mass spectrometry (MS), it becomes possible to identify the specific functions of differentially abundant proteins in peach mitochondria. In the present study, a procedure to isolate mitochondria from peach fruits was established, and the mitochondrial proteome was systematically analyzed by 2-D gel electrophoresis procedures in combination with protein identification by mass spectrometry. Differentially expressed proteins in peach mitochondria during different stages of peach fruit ripening and senescence were characterized. Our data provide a great deal of information likely to enhance the understanding of the mitochondrial function in peach ripening and senescent process during storage.



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Trading off accountability against professional survival? Or the consequences of Pareto's principle…

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Quantitative analysis of treatment process time and throughput capacity for spot scanning proton therapy

Purpose:

To determine the patient throughput and the overall efficiency of the spot scanning system by analyzing treatment time, equipment availability, and maximum daily capacity for the current spot scanning port at Proton Therapy Center Houston and to assess the daily throughput capacity for a hypothetical spot scanning proton therapy center.

Methods:

At their proton therapy center, the authors have been recording in an electronic medical record system all treatment data, including disease site, number of fields, number of fractions, delivered dose, energy, range, number of spots, and number of layers for every treatment field. The authors analyzed delivery system downtimes that had been recorded for every equipment failure and associated incidents. These data were used to evaluate the patient census, patient distribution as a function of the number of fields and total target volume, and equipment clinical availability. The duration of each treatment session from patient walk-in to patient walk-out of the spot scanning treatment room was measured for 64 patients with head and neck, central nervous system, thoracic, and genitourinary cancers. The authors retrieved data for total target volume and the numbers of layers and spots for all fields from treatment plans for a total of 271 patients (including the above 64 patients). A sensitivity analysis of daily throughput capacity was performed by varying seven parameters in a throughput capacity model.

Results:

The mean monthly equipment clinical availability for the spot scanning port in April 2012–March 2015 was 98.5%. Approximately 1500 patients had received spot scanning proton therapy as of March 2015. The major disease sites treated in September 2012–August 2014 were the genitourinary system (34%), head and neck (30%), central nervous system (21%), and thorax (14%), with other sites accounting for the remaining 1%. Spot scanning beam delivery time increased with total target volume and accounted for approximately 30%–40% of total treatment time for the total target volumes exceeding 200 cm³, which was the case for more than 80% of the patients in this study. When total treatment time was modeled as a function of the number of fields and total target volume, the model overestimated total treatment time by 12% on average, with a standard deviation of 32%. A sensitivity analysis of throughput capacity for a hypothetical four-room spot scanning proton therapy center identified several priority items for improvements in throughput capacity, including operation time, beam delivery time, and patient immobilization and setup time.

Conclusions:

The spot scanning port at our proton therapy center has operated at a high performance level and has been used to treat a large number of complex cases. Further improvements in efficiency may be feasible in the areas of facility operation, beam delivery, patient immobilization and setup, and optimization of treatment scheduling.

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Generation of Microtumors Using 3D Human Biogel Culture System and Patient-derived Glioblastoma Cells for Kinomic Profiling and Drug Response Testing

Patient-derived xenografts of glioblastoma multiforme can be miniaturized into living microtumors using 3D human biogel culture system. This in vivo-like 3D tumor assay is suitable for drug response testing and molecular profiling, including kinomic analysis.

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Frequency Mixing Magnetic Detection Scanner for Imaging Magnetic Particles in Planar Samples

A scanner for imaging magnetic particles in planar samples was developed using the planar frequency mixing magnetic detection technique. The magnetic intermodulation product response from the nonlinear nonhysteretic magnetization of the particles is recorded upon a two-frequency excitation. It can be used to take 2D images of thin biological samples.

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Emission Spectroscopic Boundary Layer Investigation during Ablative Material Testing in Plasmatron

Development of new ablative materials and their numerical modeling requires extensive experimental investigation. This protocol describes procedures for material response characterization in plasma flows with the core techniques being non-intrusive methods to track the material recession along with the chemistry in the reactive boundary layer by emission spectroscopy.

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GT405 5MP USB Borescope Camera

The GT405 5MP Digital Video Borescope Camera is a special purpose digital video camera combined with a universal coupler that streams live, TRUE 5.0 megapixel video to a computer. Providing unprecedented viewing convenience with popular rigid and flexible borescopes, this powerful tool is designed for all types of industrial applications including inspection and quality assurance. Unlike older borsecope cameras, the GT405 delivers these breakthrough capabilities, along with image and video capture, at a highly economical cost.

For Technical Specifications Click Here

[See image gallery at fireflyglobal.com]

Features

• TRUE 5.0 Megapixel resolution
• Easily captures microscopic pictures and videos
• Observes and records in real time
• Built-in snapshot button
• Rugged industrialized construction

Uses

• Quality Assurance
• Instrument Inspection
• Research

What's Included

• 5MP Digital Video Borescope Camera
• Universal Coupler
• FireflyPro Software CD
• USB Cable
• Carrying Bag
• User Manual on CD

Technical Details
Resolution	True 5.0 Megapixels (2592 x 1944)
Video	Format: MJPG Frame rate: 15-30 FPS
Video/Image Properties	Color: Hue, Saturation Exposure: Brightness, Contrast Image: Sharpness, Gamma
Video, Image Files	BMP, JPG, AVI
Power Source	USB Powered
Dimensions	11.5cm x 5.5cm x 5.5cm
Interface	USB 2.0
Software	Scalable Window, Zoom, Freeze, Resolution, Rotate, Flip Region of Interest (ROI) Automatic/Manual white balance
Operating Systems	Windows 10, 8, 7 and Mac OS 10.4 or higher
Warranty	1 Year Limited Hardware Warranty

For more information contact sales@fireflyglobal.com

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Sensors, Vol. 16, Pages 846: Physical Layer Security Using Two-Path Successive Relaying

Relaying is one of the useful techniques to enhance wireless physical-layer security. Existing literature shows that employing full-duplex relay instead of conventional half-duplex relay improves secrecy capacity and secrecy outage probability, but this is at the price of sophisticated implementation. As an alternative, two-path successive relaying has been proposed to emulate operation of full-duplex relay by scheduling a pair of half-duplex relays to assist the source transmission alternately. However, the performance of two-path successive relaying in secrecy communication remains unexplored. This paper proposes a secrecy two-path successive relaying protocol for a scenario with one source, one destination and two half-duplex relays. The relays operate alternately in a time division mode to forward messages continuously from source to destination in the presence of an eavesdropper. Analytical results reveal that the use of two half-duplex relays in the proposed scheme contributes towards a quadratically lower probability of interception compared to full-duplex relaying. Numerical simulations show that the proposed protocol achieves the ergodic achievable secrecy rate of full-duplex relaying while delivering the lowest probability of interception and secrecy outage probability compared to the existing half duplex relaying, full duplex relaying and full duplex jamming schemes.

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Pediatric Fracture Complications, Specific Injury - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing injuries involving the growth plates in children - complications.

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Regional Influences on Chinese Medicine Education: Comparing Australia and Hong Kong

High quality education programs are essential for preparing the next generation of Chinese medicine (CM) practitioners. Currently, training in CM occurs within differing health and education policy contexts. There has been little analysis of the factors influencing the form and status of CM education in different regions. Such a task is important for understanding how CM is evolving internationally and predicting future workforce characteristics. This paper compares the status of CM education in Australia and Hong Kong across a range of dimensions: historical and current positions in the national higher education system, regulatory context and relationship to the health system, and public and professional legitimacy. The analysis highlights the different ways in which CM education is developing in these settings, with Hong Kong providing somewhat greater access to clinical training opportunities for CM students. However, common trends and challenges shape CM education in both regions, including marginalisation from mainstream health professions, a small but established presence in universities, and an emphasis on biomedical research. Three factors stand out as significant for the evolution of CM education in Australia and Hong Kong and may have international implications: continuing biomedical dominance, increased competition between universities, and strengthened links with mainland China.

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