Interparticle Forces of a Native and Encapsulated Metal-Organic Framework and Their Effects on Colloidal Dispersion

The colloidal properties of suspended metal-organic frameworks (MOFs) are critical for device fabrication and application. Herein, van der Waals attractive, electric double layer repulsive, and steric repulsive forces of a native and encapsulated MOF are quantified for the first time. The van der Waals attractive forces were investigated by conducting environmental ellipsometric porosimetry (EEP) and spectroscopic ellipsometry (SE) on submicron, optical-quality nanoparticle films. The repulsive forces were determined from colloid and material characterization measurements. These data were used to predict suspension properties via extended Derjaguin, Landau, Verwey, and Overbeek theory. The state of dispersion was quantified for comparison with theoretical predictions for nine solvents. The MOF encapsulated with a surface-selective modification showed superior suspension in hydrophobic solvents. These findings should expedite the formulation of MOF colloidal suspensions for future works.

Water residence time (age) and flow path exert synchronous effects on annual characteristics of dissolved organic carbon in terrestrial runoff

Catchment hydro-physical controls on the interannual variability of dissolved organic carbon (DOC) in terrestrial watershed runoff, important for water quality, ecosystem structure, and foodweb dynamics, are not well understood. To address this, we simulated water residence time ("age") and flow path of terrestrial runoff and analyzed their mediating effect on relationships between annual runoff volume, DOC concentration, and DOC age. We applied this analysis to a snow-influenced watershed in California's Sierra Nevada (USA) across a range of soil types, elevations (90-4210 m), and years (1950-1999). Simulated increases in annual runoff volume were accompanied by younger ages (r² = 0.53-0.63) of DOC in quickflow, comprised of surface runoff and lateral flow through soil. Increases in annual runoff volume were also accompanied by gentler relationships between intra-annual (weekly) values of DOC concentration and runoff volume, regression-slopes of which followed a power-law relationship to annual runoff (r² = 0.12-0.92) for approximately 70% of the watershed. Simulations including dynamics of water age and soil temperature produced annual ages of quickflow DOC ranging from 1 to 70 days over all soil types and water years. Similarity of this range to an observed, 1-69 day range in half-lives of relatively labile DOC in previous studies suggests substantial interannual and spatial variability in the biodegradability of DOC in terrestrial runoff. Simulations excluding dynamics of water age and soil temperature predicted order-of-magnitude less interannual variability in age of quickflow DOC, demonstrating the important effect of interannual variability in soil-water interaction times. These findings suggest that the distribution of DOC bioprocessing along transitions between terrestrial and aquatic systems may be strongly influenced by year-to-year variability in age of water.

A descriptive systematic review of salivary therapeutic drug monitoring in neonates and infants

AIMS

Saliva, as a matrix, offers many benefits over blood in therapeutic drug monitoring (TDM), in particular for infantile TDM. However, the accuracy of salivary TDM in infants remains an area of debate. This review explored the accuracy, applicability and advantages of using saliva TDM in infants and neonates.

METHODS

Databases were searched up to and including September 2016. Studies were included based on PICO as follows: P: infants and neonates being treated with any medication, I: salivary TDM vs. C: traditional methods and O: accuracy, advantages/disadvantages and applicability to practice. Compounds were assessed by their physicochemical and pharmacokinetic properties, as well as published quantitative saliva monitoring data.

RESULTS

Twenty-four studies and their respective 13 compounds were investigated. Four neutral and two acidic compounds, oxcarbazepine, primidone, fluconazole, busulfan, theophylline and phenytoin displayed excellent/very good correlation between blood plasma and saliva. Lamotrigine was the only basic compound to show excellent correlation with morphine exhibiting no correlation between saliva and blood plasma. Any compound with an acid dissociation constant (pKa) within physiological range (pH 6-8) gave a more varied response.

CONCLUSION

There is significant potential for infantile saliva testing and in particular for neutral and weakly acidic compounds. Of the properties investigated, pKa was the most influential with both logP and protein binding having little effect on this correlation. To conclude, any compound with a pKa within physiological range (pH 6-8) should be considered with extra care, with the extraction and analysis method examined and optimized on a case-by-case basis.

A Biochemical Study of the Blood and Urine in Mental Disorders

This work has been undertaken with the object of disclosing metabolic deviations which might aid in the ætiologyor diagnosis of the psychoses, especially in cases of dementia præcox, epilepsy, melancholia and secondary dementia.

Spawning in a cold bath: reproduction of polar and deep-sea fish family Psychrolutidae

This study describes the spawning of the fatheads Psychrolutes marmoratus and Cottunculus granulosus, two psychrolutid species that inhabit the shelf edge and continental slope of the south-west Atlantic. Females lay large eggs of c. 2·5 mm (P. marmoratus) and 4·5-5·0 mm (C. granulosus); fecundity is from the hundreds (C. granulosus) to a few thousand eggs (P. marmoratus). Egg maturation is synchronous in P. marmoratus with an autumn-winter peak of spawning and group-synchronous in C. granulosus, which reproduces all year round. In the fishery, females predominate among adult fish in both species, possibly indicating male nest guarding on hard grounds inaccessible to fishing vessels. The reproductive strategy of representatives of the Psychrolutidae is similar to that of other sculpins of the superfamily Cottoidea.

Impact of donor left ventricular hypertrophy on survival after heart transplant

Left ventricular hypertrophy (LVH) of the donor heart is believed to increase the risk of allograft failure after transplant. However this effect is not well quantified, with variable findings from single-center studies. The United Network for Organ Sharing database was used to analyze the effect of donor LVH on recipient survival. Three cohorts, selected in accordance with the American Society of Echocardiography guidelines, were examined: recipients of allografts without LVH (<1.1 cm), with mild LVH (1.1-1.3 cm) and with moderate-severe LVH (≥ 1.4 cm). The study group included 2626 patients with follow-up of up to 3.3 years. Mild LVH was present in 38% and moderate-severe LVH in 5.6% of allografts. Predictors of mortality included a number of donor and recipient characteristics, but not LVH. However, a subgroup analysis showed an increased risk of death in recipients of allografts with LVH and donor age >55 years, and in recipients of allografts with LVH and ischemic time ≥ 4 h. In the contemporary era, close to half of all transplanted allografts demonstrate LVH, and survival of these recipients is similar to those without LVH. However, the use of allografts with LVH in association with other high-risk characteristics may result in increased mortality.

A feminist exploration of Traveller women's experiences of maternity care in the Republic of Ireland

OBJECTIVE

to explore Traveller women's experiences of maternity care so that their needs might be identified and perceptions of helpful responses elicited.

DESIGN

feminist research methodology using unstructured non-directive interviews.

SETTING

community setting in the Republic of Ireland.

PARTICIPANTS

snowball sample of 13 Traveller women aged 19-42 years. Each had experienced between two and eight pregnancies.

FINDINGS

a fluid concept of culture affected Traveller women's expectations and negotiation of maternity care. The essential nature of familism, socialisation and religious beliefs, and the particular emphasis placed upon peer support, reflected cohesive and supportive aspects of culture. The concept of 'possessive individualism' was portrayed as conflicting with contraceptive use, the uptake of preventive care and women's reporting of mental-health problems. Majority norm expectations of breast feeding, husband participation and 'rooming in' were culturally unacceptable. Political and structural factors, such as the direct discriminatory barriers created by general practitioner services, indirect discrimination arising from dysfunctional communication and control of information, poor housing and lack of public transport were the basic causes of inequity of access to care.

IMPLICATIONS FOR PRACTICE

midwives are challenged to respond sensitively to cultural preferences, meet informational needs and act as political advocates in efforts to improve maternity care experiences for Traveller women.

Vestibular Rehabilitation in Individuals with Inner-Ear Dysfunction: A Pilot Study

A randomised control prospective study was carried out examining patient outcomes after performing a 10-week vestibular home exercise programme. Thirty-two adults with vestibular dysfunction who reported vestibular symptoms negatively affecting daily life were enrolled. Test subjects were provided with an individualised vestibular rehabilitation programme designed by a physiotherapist. Control subjects received a set of strength and endurance exercises only. All subjects performed their exercises 3 times a day for 10 weeks. Subjective and objective patient measures were collected at 0, 6, 10 and 26 weeks. Results showed that both groups improved after beginning exercise, and that test subjects significantly benefited compared to the controls. These benefits were long term and measurable 6 months later. This study provides evidence that individualised vestibular exercises promote better outcomes for patients with vestibular dysfunction.

Fatal autochthonous eosinophilic meningitis in a Jamaican child caused by Angiostrongylus cantonensis

A fatal case of infection with Angiostrongylus cantonensis is reported in a 14-month-old Jamaican boy. Although infection with Angiostrongylus was not considered initially, sections of multiple worms were observed in the brain and lungs at autopsy and confirmed the infection. This is the first reported fatality due to this infection in the Western Hemisphere, and follows shortly after an outbreak of eosinophilic meningitis among a group of travelers to Jamaica. The source of infection in this case could not be determined.

Oomycete plant pathogens use electric fields to target roots

Plant roots generate electrical currents and associated electrical fields as a consequence of electrogenic ion transport at the root surface. Here we demonstrate that the attraction of swimming zoospores of oomycete plant pathogens to plant roots is mediated in part by electrotaxis in natural root-generated electric fields. The zones of accumulation of anode- or cathode-seeking zoospores adjacent to intact and wounded root surfaces correlated with their in vitro electrotactic behavior. Manipulation of the root electrical field was reflected in changes in the pattern of zoospore accumulation and imposed focal electrical fields were capable of overriding endogenous signals at the root surface. The overall pattern of zoospore accumulation around roots was not affected by the presence of amino acids at concentrations expected within the rhizosphere, although higher concentrations induced encystment and reduced root targeting. The data suggest that electrical signals can augment or override chemical ones in mediating short-range tactic responses of oomycete zoospores at root surfaces.

Suspected child abuse: communicating with a child and her mother

The purpose of this article is to explore and examine how the value judgments of the health professionals involved affected the interaction between themselves and a mother with her injured child who presented at an accident and emergency department. The interaction is depicted by means of a classroom role-play in which the "actors" are nurses. Analysis of the interaction demonstrates clearly how the perspectives of health professionals may be enshrouded by a miasma of suspicion. Indeed, by focusing on the actions of the mother rather than the needs of the child, suspicion gained momentum and finally entered the public domain. Encouraging health professionals to listen to what the child has to say goes some way to challenging the suspicion of abuse. Nonetheless, in the role-play analyzed, the mounting suspicion so antagonized the mother that an angry confrontation with the doctor ensued, the doctor being forced to make an embarrassing apology. Yet the interaction is so irredeemably prejudiced that it remains impossible either to confirm or reject the suspicion of abuse. Analysis of the interaction attempted to unravel some of the knots in which we, as health professionals, unfailingly tie ourselves when communicating with patients-knots of suspicion, labeling, conflict, embarrassment, and power that fail to anchor the humanity of "self" or others.

Clinical analysis of families with heart, midline, and laterality defects

Disturbances of the normal asymmetric placement of organs, such as polysplenia or situs inversus, have been defined traditionally as laterality defects. However, there is compelling evidence from vertebrate models and human birth defects to hypothesize that defects of the midline, isolated congenital heart defects, and laterality defects are etiologically related. We present the clinical characteristics of three families that exhibit a variety of midline defects and isolated heart defects in addition to laterality defects. These observations suggest that the phenotypic consequences of mutations causing laterality defects include defects of the midline as well as isolated heart defects. To further explore the relationship between midline, heart, and laterality defects, it is imperative that detailed phenotyping of individuals and families with laterality defects be done and a classification system created to facilitate identification of genes causing human laterality disorders.

Nurse consultants. Room at the top

The role of nurse consultant needs to be embedded in trust culture if it is to achieve its potential. The process of defining key competencies can enhance the organisation's ownership. The post needs to be evaluated at local level.

Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues

With the increasing recognition and application of casemix for managing and financing healthcare resources, the evaluation of alternative versions of systems such as diagnosis-related groups (DRGs) has been afforded high priority by governments and researchers in many countries. Outside the United States, an important issue has been the perceived need to produce local versions, and to establish whether or not these perform more effectively than the US-based classifications. A discussion of casemix evaluation criteria highlights the large number of measures that may be used, the rationale and assumptions underlying each measure, and the problems in interpreting the results. A review of recent evaluation studies from a number of countries indicates that considerable emphasis has been placed on the predictive validity criterion, as measured by the R2 statistic. However, the interpretation of the findings has been affected greatly by the methods used, especially the treatment and definition of outlier cases. Furthermore, the extent to which other evaluation criteria have been addressed has varied widely. In the absence of minimum evaluation standards, it is not possible to draw clear-cut conclusions about the superiority of one version of a casemix system over another, the need for a local adaptation, or the further development of an existing version. Without the evidence provided by properly designed studies, policy-makers and managers may place undue reliance on subjective judgments and the views of the most influential, but not necessarily best informed, healthcare interest groups.

Under-coding in Australia limits the performance of DRG groupers

The Diagnosis Related Group (DRG) system is now used extensively in Australia to classify acute inpatients for many applications, including payments to hospitals. The quality of the inpatient separation data affects the performance of the DRG version, especially its predictive validity. Data from the State of Maryland, in the United States, contain more secondary diagnosis and procedure codes than Australian data. A comparison of the performance of DRG versions using data from Australia and Maryland allowed us to answer the following research question: What impact did these additional codes have on the performance of the DRGs? The best performance in predictive validity (R2) was obtained using the Maryland data no matter which DRG version was used. Casemix-adjusted code counts showed that more diagnoses were coded in Maryland. The most plausible reason for this was that conditions were not being recorded comprehensively by doctors in the medical record in Australia.

The performance of Australian DRGs

This paper reports the results of an evaluation study of the Australian National Diagnosis Related Groups (AN-DRGs). The evaluation was based on statistical rather than clinical criteria with the principal goal being to provide information for the future development of the classification system. As well as comparing versions 1.0 to 3.0 of AN-DRGs, the project included a comparison of these systems with the most recent versions of the DRG systems from the United States. Taking all the evaluation criteria together, Version 3.0 of AN-DRGs performed best of all the systems except for the All Patient Refined (APR)-DRGs with its much larger number of groups. However, the differences between all the classifications were slight. Data of higher quality are needed if further refinements of the AN-DRGs are to produce substantial improvements in performance.