Hand hygiene compliance monitoring in anaesthetics: Feasibility and validity

Background: Hand hygiene compliance scores in the anaesthetic department of an acute NHS hospital were persistently low. Aims: To determine the feasibility and validity of regular accurate measurement of HHC in anaesthetics and understand the context of care delivery, barriers and opportunities to improve compliance. Methods: The hand hygiene compliance of one anaesthetist was observed and noted by a senior infection control practitioner (ICP). This was compared to the World Health Organization five moments of hand hygiene and the organisation hand hygiene tool. Findings: In one sequence of 55 min, there were approximately 58 hand hygiene opportunities. The hand hygiene compliance rate was 16%. The frequency and speed of actions in certain periods of care delivery made compliance measurement difficult and potentially unreliable. During several activities, taking time to apply alcohol gel or wash hands would have put the patients at significant risk. Discussion: We concluded that hand hygiene compliance monitoring by direct observation was invalid and unreliable in this specialty. It is important that hand hygiene compliance is optimal in anaesthetics particularly before patient contact. Interventions which reduce environmental and patient contamination, such as cleaning the patient and environment, could ensure anaesthetists encounter fewer micro-organisms in this specialty

Translational Cancer Research: Balancing Prevention and Treatment to Combat Cancer Globally

Cancer research is drawing on the human genome project to develop new molecular-targeted treatments. This is an exciting but insufficient response to the growing, global burden of cancer, particularly as the projected increase in new cases in the coming decades is increasingly falling on developing countries. The world is not able to treat its way out of the cancer problem. However, the mechanistic insights from basic science can be harnessed to better understand cancer causes and prevention, thus underpinning a complementary public health approach to cancer control. This manuscript focuses on how new knowledge about the molecular and cellular basis of cancer, and the associated high-throughput laboratory technologies for studying those pathways, can be applied to population-based epidemiological studies, particularly in the context of large prospective cohorts with associated biobanks to provide an evidence base for cancer prevention. This integrated approach should allow a more rapid and informed translation of the research into educational and policy interventions aimed at risk reduction across a population

Factors associated with disease progression in early-diagnosed pulmonary arterial hypertension associated with systemic sclerosis: longitudinal data from the DETECT cohort

OBJECTIVE: Pulmonary arterial hypertension (PAH) is a severe complication of systemic sclerosis (SSc). In this longitudinal study, we aimed to identify factors associated with an unfavourable outcome in patients with SSc with early PAH (SSc-PAH) from the DETECT cohort. METHODS: Patients with SSc-PAH enrolled in DETECT were observed for up to 3 years. Associations between cross-sectional variables and disease progression (defined as the occurrence of any of the following events: WHO Functional Class worsening, combination therapy for PAH, hospitalisation or death) were analysed by univariable logistic regression. RESULTS: Of 57 patients with PAH (median observation time 12.6 months), 25 (43.9%) had disease progression. The following factors (OR (95% CI)) were associated with disease progression: male gender (4.1 (1.2 to 14.1)), high forced vital capacity % predicted/carbon monoxide lung diffusion capacity (DLCO)% predicted ratio (3.6 (1.2 to 10.7)), high Borg Dyspnoea Index (1.7 (1.1 to 2.6)) and low DLCO% predicted (non-linear relationship). CONCLUSION: More than 40% of early-diagnosed patients with SSc-PAH had disease progression during a short follow-up time, with male gender, functional capacity and pulmonary function tests at PAH diagnosis being associated with progression. This suggests that even mild PAH should be considered a high-risk complication of SSc

Nel positively regulates the genesis of retinal ganglion cells by promoting their differentiation and survival during development

Peer reviewedPublisher PD

Utilization of galactomannan from Gleditsia triacanthos in polysaccharide-based films : effects of interactions between film constituents on film properties

The objective of this work was to evaluate the effect of the concentrations of Gleditsia triacanthos galactomannan and glycerol and the presence of corn oil in the physical properties of edible films. The influence of interactions between those constituents on films' permeability to gases (water vapour, CO2 and O2), solubility in water, mechanical properties and colour was evaluated. The effects of those variables were analysed according to a 23 factorial design; regression coefficients were used to understand the influence of each variable (factor) on the studied properties, and a multifactor model was developed. Results show that galactomannan concentration is the most significant factor affecting the studied properties; moreover, the increase of plasticizer concentration and the presence of oil showed to be the most influent in the particular cases of solubility and transport properties (water vapour permeability and O2 permeability), respectively. These results show that galactomannan films' properties can be tailored to allow their use as alternative to non-biodegradable, non-edible packaging materials.The author M. A. Cerqueira is recipient of a fellowship from Fundacao para a Ciencia e Tecnologia (FCT, SFRH/BPD/72753/2010) and B. W. S. Souza is a recipient of a fellowship from the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Brazil (Capes, Brazil)

Effects of interactions between the constituents of chitosan-edible films on their physical properties

The main objective of this work was to evaluate the effect of chitosan and plasticizer concentrations and oil presence on the physical and mechanical properties of edible films. The effect of the film constituents and their in-between interactions were studied through the evaluation of permeability, opacity and mechanical properties. The effects of the studied variables (concentrations of chitosan, plasticizer and oil) were analysed according to a 2 3 factorial design. Pareto charts were used to identify the most significant factors in the studied properties (water vapour, oxygen and carbon dioxide permeability; opacity; tensile strength; elongation at break and Young's modulus). When addressing the influence of the interactions between the films' constituents on the properties above, results show that chitosan and plasticizer concentrations are the most significant factors affecting most of the studied properties, while oil incorporation has shown to be of a great importance in the particular case of transport properties (gas permeability), essentially due to its hydrophobicity. Water vapour permeability values (ranging from 1. 62 × 10 -11 to 4. 24 × 10 -11 g m -1 s -1 Pa -1) were half of those reported for cellophane films. Also the mechanical properties (tensile strength values from 0. 43 to 13. 72 MPa and elongation-at-break values from 58. 62% to 166. 70%) were in the range of those reported for LDPE and HDPE. Based on these results, we recommend the use of 1. 5% (w/w) chitosan concentration to produce films, where the oil and plasticizer proportions will have to be adjusted in a case-by-case basis according to the use intended for the material. This work provides a useful guide to the formulation of chitosan-based film-forming solutions for food packaging applications.The author MA Cerqueira is a recipient of a fellowship from Fundacao para a Ciencia e Tecnologia (FCT, SFRH/BD/23897/2005) and BWS Souza is a recipient of a fellowship from the Coordenacao Aperfeicoamento de Pessoal de Nivel Superior, Brazil (Capes, Brazil)

Modelling the Effect of Temperature on Respiration Rate of Fresh Cut Papaya (Carica papaya L.) Fruits.

A respiration rate (RR) model based on Peleg’s equation was developed for predicting RRs of fresh cut papaya. Respiration data for fresh cut papaya at 3/4 maturity were generated at temperatures 5, 10, 15, 20, 25 and 30°C using a closed system. RRs was found to be significantly influenced by storage temperature and increased from 0.021 to 0.289 mL[O2]/kg·h and 0.063 to 0.393 mL[CO2]/kg·h as a function of O2 and CO2 gas concentrations, respectively. Peleg’s constant K 1 and K 2 were obtained from linear regression analysis using GraphPad Prism 5.0 software and regression coefficients have good fit with values close to unity. The model was verified to assess the capability of its predictability of the RRs over the temperatures. There was good agreement with the experimentally estimated RRs. Information derived from the model can contribute in the design of successful modified atmospheric systems for storage of fresh cut papaya

Stress-Induced Reinstatement of Drug Seeking: 20 Years of Progress

In human addicts, drug relapse and craving are often provoked by stress. Since 1995, this clinical scenario has been studied using a rat model of stress-induced reinstatement of drug seeking. Here, we first discuss the generality of stress-induced reinstatement to different drugs of abuse, different stressors, and different behavioral procedures. We also discuss neuropharmacological mechanisms, and brain areas and circuits controlling stress-induced reinstatement of drug seeking. We conclude by discussing results from translational human laboratory studies and clinical trials that were inspired by results from rat studies on stress-induced reinstatement. Our main conclusions are (1) The phenomenon of stress-induced reinstatement, first shown with an intermittent footshock stressor in rats trained to self-administer heroin, generalizes to other abused drugs, including cocaine, methamphetamine, nicotine, and alcohol, and is also observed in the conditioned place preference model in rats and mice. This phenomenon, however, is stressor specific and not all stressors induce reinstatement of drug seeking. (2) Neuropharmacological studies indicate the involvement of corticotropin-releasing factor (CRF), noradrenaline, dopamine, glutamate, kappa/dynorphin, and several other peptide and neurotransmitter systems in stress-induced reinstatement. Neuropharmacology and circuitry studies indicate the involvement of CRF and noradrenaline transmission in bed nucleus of stria terminalis and central amygdala, and dopamine, CRF, kappa/dynorphin, and glutamate transmission in other components of the mesocorticolimbic dopamine system (ventral tegmental area, medial prefrontal cortex, orbitofrontal cortex, and nucleus accumbens). (3) Translational human laboratory studies and a recent clinical trial study show the efficacy of alpha-2 adrenoceptor agonists in decreasing stress-induced drug craving and stress-induced initial heroin lapse

Investigating hydrodynamic cavitation as an efficient means for removal of per- and polyfluoroalkyl substances from solution

With nearly five decades of per- and polyfluoroalkyl substances (PFASs) being associated with firefighting and industrial activities, these compounds inevitably accumulate in both ground and surface water. PFAS contamination in water has emerged as a significant environmental and public health concern, particularly perfluorooctanesulfonic acid (PFOS), which is often found in higher concentrations compared to other PFAS and has more pronounced adverse health effects. Addressing PFAS contamination requires treating large volumes of water, making technologies that rapidly separate and concentrate PFASs highly favoured. The strong surface activity of PFAS, such as PFOS, enables them to generate colloidal gas aphrons (CGAs) during high shear mixing of their aqueous solutions, where PFASs can be separated and collected as foam. This study aims to evaluate the effectiveness of high shear mixing in separating PFOS from solution, leveraging its accumulation at air–water interfaces. High shear-assisted PFOS separation was tested by varying parameters like rotational speed (4000 to 10,000 rpm), mixing time (30 s to 30 min), and the effect of electrolytes. Results showed greater PFOS separation in the presence of electrolytes, particularly monovalent cations like Na+, compared to divalent cations such as Ca2+, due to the creation of more stable CGAs with smaller sizes. At a mixing rate of 6000 rpm, 85 % of PFOS was removed in 30 s from a highly contaminated PFOS solution (10 mg/L), with over 95 % separation after 5 mixing cycles. While high-shear mixing was efficient in PFOS separation from highly contaminated solutions it was less efficient for low-level contaminated solutions (less than 1 mg/L). These results suggest that hydrodynamic cavitation induced by high-shear mixing seems promising for enhancing the separation of PFOS from heavily contaminated solutions. This technique could serve as a standalone method or be integrated with other PFAS removal technologies to enhance the overall efficiency of PFAS removal from polluted water sources.fals

Chronic Metformin Associated Cardioprotection Against Infarction: Not Just a Glucose Lowering Phenomenon

Purpose: Clinical and experimental investigations demonstrated that metformin, a widely used anti-diabetic drug, exhibits cardioprotective properties against myocardial infarction. Interestingly, metformin was previously shown to increase the expression of PGC-1α a key controller of energy metabolism in skeletal muscle, which is down-regulated in diabetic conditions. We hypothesized that chronic treatment with metformin could protect the aged, diabetic heart against ischemia-reperfusion injury (IRI) by up-regulating PGC-1α and improving the impaired functionality of diabetic mitochondria. / Methods: Following 4 weeks of metformin (300 mg/kg) administered in the drinking water, 12 month-old diabetic Goto Kakizaki and non-diabetic Wistar rat hearts were assigned for infarct measurement following 35 min ischemia and 60 min reperfusion or for electron microscopy (EM) and Western blotting (WB) investigations. / Results: Metformin elicited a cardioprotective effect in both non-diabetic and diabetic hearts. In contrast with the diabetic non-treated hearts, the diabetic hearts treated with metformin showed more organized and elongated mitochondria and demonstrated a significant increase in phosphorylated AMPK and in PGC-1α expression. / Conclusions: In summary these results show for the first time that chronic metformin treatment augments myocardial resistance to ischemia-reperfusion injury, by an alternative mechanism in addition to the lowering of blood glucose. This consisted of a positive effect on mitochondrial structure possibly via a pathway involving AMPK activation and PGC-1α. Thus, metformin prescribed chronically to patients may lead to a basal state of cardioprotection thereby potentially limiting the occurrence of myocardial damage by cardiovascular events