3D-printed extraction devices fabricated from silica particles suspended in acrylate resin

In recent years, there has been an increasing worldwide interest in the use of alternative sample preparation methods. Digital light processing (DLP) is a 3D printing technique based on using UV light to form photo-curable resin layer upon layer, which results in a printed shape. This study explores the application of this technique for the development of novel drug extraction devices in analytical chemistry. A composite material consisting of a photocurable resin and C18-modified silica particles was employed as a sorbent device, demonstrating its effectiveness in pharmaceutical analysis. Apart from estimating optimal printing parameters, microscopic examination of the material surface, and sorbent powder to resin ratio, the extraction procedure was also optimised. Optimisation included the type and amount of sample matrix additives, desorption solvent, sorption and desorption times, and proper number of sorbent devices needed in extraction protocol. To demonstrate this method's applicability for sample analysis, the solid-phase extraction followed by gas chromatography coupled with mass spectrometry (SPE-GC-MS) method was validated for its ability to quantify benzodiazepine-type drugs. This evaluation confirmed good linearity in the concentration range of 50-1000 ng/mL, with R2 values being 0.9932 and 0.9952 for medazepam and diazepam, respectively. Validation parameters proved that the presented method is precise (with values ranging in-between 2.98 %-7.40 %), and accurate (88.81 % to 110.80 %). A negative control was also performed to investigate possible sorption properties of the resin itself, proving that the addition of C18-modified silica particles significantly increases the extraction efficiency and repeatability. The cost-effectiveness of this approach makes it particularly advantageous for single-use scenarios, eliminating the need for time-consuming sorbent-cleaning procedures, common in traditional solid-phase extraction techniques. Future optimisation opportunities include refining sorbent size, shape, and geometry to achieve lower limits of quantification. As a result of these findings, 3D-printed extraction devices can serve as a viable alternative to commercially available SPE or solid-phase microextraction (SPME) protocols for studying new sample preparation approaches.

[Breastfeeding Rates and Duration in Germany - A Systematic Review]

Aim: 20 years after establishment of the National Breastfeeding Committee, the present work, based on published data on breastfeeding, is aimed at providing insight into the development of breastfeeding behaviour in Germany. Methods: To identify relevant publications, a comprehensive literature search was conducted in PubMed and Web of Science using the search terms "breast feeding" or "breastfeeding" in combination with "Germany". The publication period was limited to the period 1995-2014. Results: A total of 35 studies with data on breastfeeding for the birth cohorts of 1990-2012 were identified. Most of the data had been collected in regional or local surveys, often retrospectively. About 60% of the studies had been conducted with the primary aim of collecting data on breastfeeding or infant nutrition. Over the past 2 decades, breastfeeding rates were always relatively high at the beginning (72-97%). However, they declined significantly within the first 2 months, and by the age of 6 months, only about 50% of infants were still breastfed. Conclusion: Breastfeeding support and early assistance should be offered to a greater extent in order to achieve sustainable improvement of breastfeeding frequency and duration in Germany. Regarding the quality of data collected on breastfeeding, it seems crucial to implement standardised approaches to monitor breastfeeding in Germany.

VIPP1, a nuclear gene of Arabidopsis thaliana essential for thylakoid membrane formation

The conversion of light to chemical energy by the process of photosynthesis is localized to the thylakoid membrane network in plant chloroplasts. Although several pathways have been described that target proteins into and across the thylakoids, little is known about the origin of this membrane system or how the lipid backbone of the thylakoids is transported and fused with the target membrane. Thylakoid biogenesis and maintenance seem to involve the flow of membrane elements via vesicular transport. Here we show by mutational analysis that deletion of a single gene called VIPP1 (vesicle-inducing protein in plastids 1) is deleterious to thylakoid membrane formation. Although VIPP1 is a hydrophilic protein it is found in both the inner envelope and the thylakoid membranes. In VIPP1 deletion mutants vesicle formation is abolished. We propose that VIPP1 is essential for the maintenance of thylakoids by a transport pathway not previously recognized.

Prognostic value of stress-gated Tc-99m sestamibi SPECT after acute myocardial infarction

Stress-gated technetium-99m (Tc-99 m) sestamibi single-photon emission computed tomography (SPECT) is used to risk stratify patients after acute myocardial infarction (AMI). In clinical practice, results of this test are used primarily to identify patients with myocardial ischemia for intervention. The value of this test to risk stratify patients with AMI not at high ischemic risk has not been addressed. More than 1-year follow-up was undertaken in 124 patients who underwent predischarge gated Tc-99m sestamibi SPECT studies and who did not undergo subsequent revascularization. Clinical variables and test-derived variables were evaluated to predict cardiac death, recurrent AMI, and hospitalization for unstable angina, congestive heart failure, or coronary revascularization. Independent predictors by multivariate analysis for cardiac death or recurrent AMI were a history of prior AMI (relative risk [RR] = 5.32, confidence interval [CI] 2.17 to 12.96), a low exercise capacity (RR = 6.84, CI 1.99 to 23.48), and left ventricular (LV) ejection fraction (EF) <40% (RR = 2.63, CI 1.04 to 6.38). The incidence of cardiac death or recurrent AMI was 29.8% in patients with a low exercise capacity versus 4.5% in those with good exercise capacity, and 38.1% in patients with LVEF <40% versus 9.4% in those with LVEF >40%. Independent predictors of cardiac death, AMI, or hospitalization for unstable angina, congestive heart failure, or revascularization were a history of prior AMI (RR = 2.24, CI 1.11 to 4.50) and LVEF <40% (RR = 3.13, CI 1.64 to 5.95). Among patients followed after AMI without revascularization Tc-99m sestamibi SPECT can identify a high-risk subset. The strongest independent predictors are poor exercise capacity and LVEF < 40%.

Achieving continuity of care and carer

The aims of a new service need to be clarified and agreed to avoid disappointment both for midwives and the women they are caring for. Midwives have different views, expectations and priorities, which may be determined by their previous experience. Providing continuity of care to mixed caseloads is complicated to organise, as women with complications need more time and different skills. The success of any service that aims to provide women with care from a small group of midwives depends on adequate staffing and resourcing.

General practitioners' views on the implementation of community-led maternity care in south Camden, London

New recommendations suggesting that maternity care should be increasingly community-based have generated concern regarding the interprofessional cooperation between general practitioners and midwives. In Camden, London, this service was expanded in 1993. Although existing joint antenatal care arrangements between GPs and midwives were not expected to alter significantly, the shift of care from hospital to community midwives, and the expansion of community-led care to women with complications, was expected to have implications for the GPs. A questionnaire-based study asked GPs who provide antenatal care about their role and liaison with other professionals. Most were satisfied with the current arrangements; only a minority felt that their workload, clinical practice, or communication with obstetric teams had altered.

Is community-led maternity care a feasible option for women assessed at low risk and those with complicated pregnancies? Results of a population based study in south Camden, London

OBJECTIVE

to assess the feasibility of obstetric offering community-led maternity care to most women, both those assessed to be at low obstetric risk and those with complicated pregnancies at 'booking'. Community-led care is defined as appropriate care by community midwives and general practitioners during pregnancy, birth and the puerperium, with routine hospital care kept to a minimum.

DESIGN

observational study.

SETTING

South Camden, London, UK: University College Obstetric Hospital and community.

PARTICIPANTS

453 women, resident in South Camden, including those 'booked' for home births, who were 'booked' for maternity care at University College Hospital between October 1993 and April 1994.

MEASUREMENTS AND FINDINGS

this paper assesses the extent to which community midwives and general practitioners were able to give local women community-led care and describes the amount of care provided to women by their 'named' community midwives and team. Most local women were eligible for community-led care and 85% planned to have it. The majority of care was given by the community midwives, but the amount of hospital input varied. Women who remained at low obstetric risk generally had their antenatal care in the community, only attending hospital for two or three routine assessments and occasional extra referrals. Women attending hospital more frequently usually had a complicated pregnancy. Care given by a woman's 'named' midwives was generally provided antenatally, but care from familiar midwives was less common in labour and postnatally.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

community-led maternity care can be provided to the majority of women, even those with a complicated pregnancy, as long as specialist opinion and facilities are accessible and women are referred as necessary. Although the majority of women had access to local antenatal care from staff they got to know, the 'named' community midwives and teams found it difficult to provide comprehensive care, particularly to the women who developed complications, so priorities need to be established. Further research is needed to compare alternative models of care and their costs.

Spontaneous perinephric urinoma in pregnancy

A rare case is presented of spontaneous urinary extravasation (urinary ascites) with left pleural effusion occurring during pregnancy. The clinical course, pathogenesis and treatment are described.

Postnatal care: teamwork in the community

To offer continuity of care as recommended by Changing Childbirth, close communication between midwives and health visitors is important. Selective postnatal visiting allows continuation of visits after the tenth day and encourages communication between the midwife and health visitor. Good communication between a midwife and health visitor can ensure that a framework of care is provided to support mothers as they develop self-confidence and independence. To ensure continuity of care, midwives should involve health visitors during the antenatal period wherever possible. Formal and informal lines of communication between midwives and health visitors should be encouraged.

Fibrolamellar carcinoma of the liver in pregnancy. A case report

Fibrolamellar carcinoma of the liver is a rare tumor that has not been previously reported to occur during pregnancy. A 22-year-old, pregnant Arab woman with documented fibrolamellar carcinoma of the liver was followed at our high-risk pregnancy unit. Despite the severity of the disease, the pregnancy and delivery were uneventful.

Energy expenditure in normal labor

The energy expenditure in 23 healthy parturient women during spontaneous labor was assessed by continuous measurement of their O2 consumption and CO2 production. Due to the intermittent character of uterine contractions, normal labor and delivery did not impose high energy demands on the parturient, whereas a prolonged labor and delivery in which energy input was high led to maternal metabolic disturbances.

Puerperal hypertension, stroke, and seizures after suppression of lactation with bromocriptine

The "absolute safety" of bromocriptine as a drug of choice in suppression of lactation is questioned. Two cases of cerebrovascular events after the use of bromocriptine for lactation suppression are presented, and the available, pertinent literature is reviewed.