Working with a robot in hospital and long-term care homes: staff experience

Although there is a growing literature on the use of telepresence robots in institutional dementia care settings, limited research focused on the perspectives of frontline staff members who deliver dementia care. Our objective was to understand staff perspectives on using telepresence robots to support residents with dementia and their families. Guided by the Consolidated Framework for Implementation Research, we conducted four focus groups and 11 semi-structured interviews across four long-term care (LTC) homes and one hospital in Canada. We included 22 interdisciplinary staff members (e.g., registered nurses, social workers, occupational therapists, recreational therapists) to understand their experiences with telepresence robots. Thematic analysis identified three key themes: 1) Staff Training and Support; 2) Robot Features; 3) Environmental dynamics for Implementation. Our results underscore the imperative of structural support at micro-, meso- and macro-levels for staff in dementia care settings to effectively implement technology. This study contributes to future research and practice by elucidating factors facilitating staff involvement in technology research, integrating staff voices into technology implementation planning, and devising strategies to provide structural support to staff, care teams, and care homes.

The Perspective of Nurses and Healthcare Providers on the use of Television Videos with People with Moderate to Severe Dementia

BACKGROUND

Nurses and healthcare providers need practical tools to deliver person-centred care in hospitals and long-term care homes. Few non-pharmacological interventions are designed to meet the needs of people with moderate to severe dementia. Dementia-friendly television videos (TV videos) offer a familiar stimulation with the potential for meaningful engagement in the relational space of technology. TV videos refer to moving visuals with audio that can be shown on TV and other devices. They can be used for different purposes for people with dementia, such as stimulating memories and facilitating expressions.

PURPOSE

This study aims to understand the perspectives of nurses and healthcare providers on the potential function and practice considerations of using TV videos for people with moderate to severe dementia.

METHODS

We conducted five focus groups with 23 nurses and healthcare providers in a long-term care home and a geriatric hospital unit. Data were analyzed using reflexive thematic analysis and guided by Kitwood's person-centred care model.

RESULTS

Our analysis identified five themes about the use of TV videos: (1) calm the person with dementia who is in emotional distress, (2) form connections with the person with dementia, (3) bring people with dementia together, (4) facilitate the Person's Activities of Daily Living (ADLs), (5) help the person connect with their past.

CONCLUSION

TV videos should be designed to match the person's cognitive abilities, interests, and cultural and linguistic backgrounds. Our findings supplemented Kitwood's model by identifying the person's cultural and language needs.

Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

Imaging in gynecological disease (26): clinical and ultrasound characteristics of benign retroperitoneal pelvic peripheral-nerve-sheath tumors

OBJECTIVE

To describe the clinical and sonographic characteristics of benign, retroperitoneal, pelvic peripheral-nerve-sheath tumors (PNSTs).

METHODS

This was a retrospective study of patients with a benign, retroperitoneal, pelvic PNST who had undergone preoperative ultrasound examination at a single gynecologic oncology center between 1 January 2018 and 31 August 2022. All ultrasound images, videoclips and final histological specimens of benign PNSTs were reviewed side-by-side in order to: describe the ultrasound appearance of the tumors, using the terminology of the International Ovarian Tumor Analysis (IOTA), Morphological Uterus Sonographic Assessment (MUSA) and Vulvar International Tumor Analysis (VITA) groups, following a predefined ultrasound assessment form; describe their origin in relation to nerves and pelvic anatomy; and assess the association between their ultrasound features and histotopography. A review of the literature reporting benign, retroperitoneal, pelvic PNSTs with preoperative ultrasound examination was performed.

RESULTS

Five women (mean age, 53 years) with a benign, retroperitoneal, pelvic PNST were identified, four with a schwannoma and one with a neurofibroma, of which all were sporadic and solitary. All patients had good-quality ultrasound images and videoclips and final biopsy of surgically excised tumors, except one patient managed conservatively who had only a core needle biopsy. In all cases, the findings were incidental. The five PNSTs ranged in maximum diameter from 31 to 50 mm. All five PNSTs were solid, moderately vascular tumors, with non-uniform echogenicity, well-circumscribed by hyperechogenic epineurium and with no acoustic shadowing. Most of the masses were round (n = 4 (80%)), and contained small, irregular, anechoic, cystic areas (n = 3 (60%)) and hyperechogenic foci (n = 5 (100%)). In the woman with a schwannoma in whom surgery was not performed, follow-up over a 3-year period showed minimal growth (1.5 mm/year) of the mass. We also summarize the findings of 47 cases of benign retroperitoneal schwannoma and neurofibroma identified in a literature search.

CONCLUSIONS

On ultrasound examination, no imaging characteristics differentiate reliably between benign schwannomas and neurofibromas. Moreover, benign PNSTs show some similar features to malignant retroperitoneal tumors. They are solid lesions with intralesional blood vessels and show degenerative changes such as cystic areas and hyperechogenic foci. Therefore, ultrasound-guided biopsy may play a pivotal role in their diagnosis. If confirmed to be benign PNSTs, these tumors can be managed conservatively, with ultrasound surveillance. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Telepresence Robots in Long-Term Care Settings in British Columbia During the COVID-19 Pandemic: Analyzing the Experiences of Residents and Family Members

Telepresence robots are being increasingly used in long-term care (LTC) homes for virtual visits between families and residents. This study investigated the impacts and experiences of residents and their families using a telepresence robot (Double 3) for 4 to 12 months during the COVID-19 pandemic. A total of 51 participants were recruited through purposive sampling, including 9 residents, 15 family members, and 27 staff from 4 LTC homes in British Columbia, Canada. Conversational interviews were conducted with residents and family members. Focus groups and one-to-one interviews were held with frontline staff. Thematic analysis was performed, with five themes identified: (1) Stay connected, (2) Regain autonomy, (3) Relieve caregiver burden, (4) Environmental and technical issues, and (5) Scheduling concerns. In conclusion, telepresence robots helped maintain social connections between residents and families, despite the COVID-19 restrictions.

Smoothing tool design and performance during subaperture glass polishing

During subaperture tool grinding and polishing, overlaps of the tool influence function can result in undesirable mid-spatial frequency (MSF) errors in the form of surface ripples, which are often corrected using a smoothing polishing step. In this study, flat multi-layer smoothing polishing tools are designed and tested to simultaneously (1) reduce or remove MSF errors, (2) minimize surface figure degradation, and (3) maximize the material removal rate. A time-dependent convergence model in which spatial material removal varies with a workpiece-tool height mismatch, combined with a finite element mechanical analysis to determine the interface contact pressure distribution, was developed to evaluate various smoothing tool designs as a function of tool material properties, thicknesses, pad textures, and displacements. An improvement in smoothing tool performance is achieved when the gap pressure constant, h¯ (which describes the inverse rate at which the pressure drops with a workpiece-tool height mismatch), is minimized for smaller spatial scale length surface features (namely, MSF errors) and maximized for large spatial scale length features (i.e., surface figure). Five specific smoothing tool designs were experimentally evaluated. A two-layer smoothing tool using a thin, grooved IC1000 polyurethane pad (with a high elastic modulus, E _{p a d} =360M P a), thicker blue foam (with an intermediate modulus, E _{f o a m} =5.3M P a) underlayer, and an optimized displacement (d _t=1m m) provided the best overall performance (namely, high MSF error convergence, minimal surface figure degradation, and high material removal rate).

Exploring experiences of loneliness among Canadian long-term care residents during the COVID-19 pandemic: A qualitative study

BACKGROUND

The COVID-19 pandemic has significant impact on long-term care (LTC) residents' health and well-being.

OBJECTIVES

This study investigated resident experiences of loneliness during the COVID-19 pandemic in Canadian LTC homes to offer lessons learned and implications.

METHODS

15 residents and 16 staff members were recruited from two large urban Canadian LTC homes with large outbreaks and fatalities. We used a telepresence robot to conduct one-on-one semi-structured interviews with participants remotely. We applied the Collaborative Action Research (CAR) methodology and report the early phase of CAR focused on collecting data and reporting findings to inform actions for change. Thematic analysis was performed to identify themes.

RESULTS

Four themes were identified. The first two themes characterise what commonly generated feelings of loneliness amongst residents, including (1) social isolation and missing their family and friends and (2) feeling hopeless and grieving for lives lost. The second two themes describe what helped residents alleviate loneliness, including (3) social support and (4) creating opportunities for recreation and promoting positivity.

CONCLUSIONS

Residents living in LTC experienced significant social isolation and grief during the pandemic that resulted in loneliness and other negative health consequences.

IMPLICATIONS FOR PRACTICE

Promoting meaningful connection, safe recreational activities and a positive atmosphere in LTC homes during the pandemic may help mitigate residents' experiences of loneliness due to social isolation and/or grief and enhance their quality of life.

Understanding the tool influence function during sub-aperture belt-on-wheel glass polishing

The tool influence function (TIF) during sub-aperture belt-on-wheel polishing has been evaluated as a function of various process conditions (belt use/wear, dwell time, displacement, belt velocity, and wheel modulus and diameter) on fused silica glass workpieces using C e O ₂ polishing media. TIF spots are circular or elliptical in shape with a largely flat bottom character. The volumetric removal rate varies significantly with belt use (or wear), stabilizing after ∼15m i n of use. A modified Preston model, where the pressure dependence is adjusted using a different scaling of the wheel modulus (E w0.5), largely predicts the volumetric removal rate over the range of process conditions evaluated. The relatively high volumetric removal rate of 30-60m m ³/h using a fixed C e O ₂-in-resin-host belt offers a rapid, and hence, more economical, initial polish of aspheric and freeform optics.

IMPLEMENTING VISUAL VIDEOS AND IMAGES WITH PEOPLE WITH DEMENTIA IN CARE SETTINGS: A SCOPING REVIEW

There is limited literature on using visual videos and images with people with dementia in care settings. We conducted a scoping review on this topic to fill this literature gap. Our scoping review adopted the Joanna Briggs Institute scoping review methodology. We eventually included eleven papers for the review and conducted the content analysis. We found the facilitators for implementing visual videos and images with people with dementia in care settings: 1. Matching people’s interests 2. Being congruent with people’s cognitive abilities 3. Support from families and staff 4. Using in a group setting. We also found the barriers: 1. Staff is unwilling to support 2. Lack of resources 3. Not congruent with the cognitive or other abilities of the people. We found benefits of using visual videos and images with this population: 1. Encourage expression 2. Facilitate discussions with other people 3. Improve well-being. We also found drawbacks: the potential of arousing negative emotions and memories. We suggest future research should include the voices of people with dementia, staff should be trained to support the people in case negative memories and emotions are aroused, and there should be consideration of using visual videos and images to tackle isolation and loneliness in care settings. With these findings, this scoping review should shed light on implementing visual videos and images in care settings.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

Impact of replacing or adding pregnancy-associated plasma protein-A at 11-13 weeks on screening for preterm pre-eclampsia

OBJECTIVE

To assess whether pregnancy-associated plasma protein-A (PAPP-A) alters or provides equivalent screening performance as placental growth factor (PlGF) when screening for preterm pre-eclampsia (PE) at 11-13 weeks of gestation.

METHODS

This was a secondary analysis of a non-intervention screening study of 6546 singleton pregnancies that were screened prospectively for preterm PE in the first trimester between December 2016 and June 2018. Patient-specific risks for preterm PE were estimated by maternal history, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), PlGF and PAPP-A. A competing-risks model with biomarkers expressed as multiples of the median was used. All women and clinicians were blinded to the risk for preterm PE. The performance of screening for preterm PE using PlGF vs PAPP-A vs both PAPP-A and PlGF was assessed by comparing areas under the receiver-operating-characteristics (AUC) curves. McNemar's test was used to compare detection rate at a fixed false-positive rate (FPR) of 10%.

RESULTS

PlGF and PAPP-A were measured in 6546 women, of whom 37 developed preterm PE. The AUC and detection rate at 10% FPR using PlGF in combination with maternal history, MAP and UtA-PI were 0.854 and 59.46%, respectively. The respective values were 0.813 and 51.35% when replacing PlGF with PAPP-A and 0.855 and 59.46% when using both PAPP-A and PlGF. Statistically non-significant differences were noted in AUC when replacing PlGF with PAPP-A (ΔAUC, 0.04; P = 0.095) and when using both PAPP-A and PlGF (ΔAUC, 0.002; P = 0.423). However, on an individual case basis, screening using PlGF in conjunction with maternal history, MAP and UtA-PI identified three (8.1%) additional pregnancies that developed preterm PE and that were not identified when replacing PlGF with PAPP-A. Screening using PAPP-A in addition to maternal history and other biomarkers did not identify any additional pregnancies.

CONCLUSION

On an individual case basis, adoption of a screening strategy that uses PAPP-A instead of PlGF results in reduced detection of preterm PE, consistent with previous literature. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

ATRT-17. A phase II study of continuous low dose panobinostat in paediatric patients with malignant rhabdoid tumours and atypical teratoid rhabdoid tumours

BACKGROUND: Panobinostat treatment has been shown to terminally differentiate malignant rhabdoid tumours (MRT) and atypical teratoid rhabdoid tumours (ATRT) in pre-clinical models. We report results of the open label, phase II study of oral panobinostat in patients with newly diagnosed or relapsed MRT/ATRT. AIMS: To assess the anti-tumour activity of low dose, continuous oral panobinostat as well as its associated toxicities. To assess the biological activity of low dose panobinostat by measuring histone H4 acetylation status in peripheral mononuclear cells (PMNC), and differentiation markers. METHODS: Following primary institutional standard of care induction and consolidation chemotherapy and/or radiation treatment, patients were enrolled and commenced on panobinostat as a continuous daily oral dose starting at 10mg/m²/day, with a three-week wash out period between therapies. Real-time acetylation status, measuring acetylated H4 on PMNC, was performed to determine the pharmacodynamics of panobinostat at different dosing levels. Patients were monitored for toxicity; dose reductions were in decrements of 2mg/m²/day. RESULTS: A total of 13 patients with newly diagnosed ATRT/MRT and one patient with relapsed MRT have been enrolled. The average age at enrollment was 3.6 years (range 0.8-6.8 years). The mean treatment duration was 206 days (13-344 days). Currently, six patients (42.9%) remain on study with a mean study duration of 531 days (range 13-895 days). 6/14 patients (42.9%) were removed due to disease progression at a mean study duration of 245 days (44-560 days). 2/14 patients (14.3%) withdrew due to toxicity. 12/14 patients (85.7%) required dose reductions. The main toxicities were thrombocytopaenia and leukopaenia (Grade III-IV). Real-time pharmacodynamic assessment of panobinostat, at a dose as low as 6mg/m²/day resulted in significant acetylation of histone H4 in PMNC. CONCLUSIONS: Treatment with low dose panobinostat is well tolerated in infants and children with MRT/ATRT, with significant acetylation of histone H4 in PMNC.

Exploring the diagnostic utility of genome sequencing for fetal congenital heart defects

OBJECTIVE

The diagnostic yield for congenital heart defects (CHD) with routine genetic testing is around 10-20% when considering the pathogenic CNVs or aneuploidies as positive findings. This is a pilot study to investigate the utility of genome sequencing (GS) for prenatal diagnosis of CHD.

METHODS

Genome sequencing (GS, 30X) was performed on 13 trios with CHD for which karyotyping and/or chromosomal microarray results were non-diagnostic.

RESULTS

Trio GS provided a diagnosis for 4/13 (30.8%) fetuses with complex CHDs and other structural anomalies. Findings included pathogenic or likely pathogenic variants in DNAH5, COL4A1, PTPN11, and KRAS. Of nine cases without a possibly genetic etiology by GS, we had follow-up on eight. For five of them (60%), the parents chose to keep the pregnancy. A balanced translocation [46,XX,t(14;22)(q32.33;q13.31)mat] was detected in a trio with biallelic DNAH5 mutations, which together explained the recurrent fetal situs inversus and dextrocardia that was presumably due to de novo Phelan-McDermid syndrome. A secondary finding of a BRCA2 variant and carrier status of HBB, USH2A, HBA1/HBA2 were detected in the trio.

CONCLUSIONS

GS expands the diagnostic scope of mutation types over conventional testing, revealing the genetic etiology for fetal heart anomalies. Patients without a known genetic abnormality indicated by GS likely opted to keep pregnancy especially if the heart issue could be repaired. We provide evidence to support the application of GS for fetuses with CHD. This article is protected by copyright. All rights reserved.

Understanding and reducing mid-spatial frequency ripples during hemispherical sub-aperture tool glass polishing

During sub-aperture tool polishing of glass optics, mid-spatial surface ripples are generated because of material removal non-uniformities during tool linear translation (resulting in feed ripples) and tool pathway step overlaps (resulting in pitch ripples). A variety of tool influence function (TIF) spots, trenches, and patches were created to understand and minimize such ripples on fused silica workpieces after polishing with cerium oxide slurry using a rotating hemispherical pad-foam tool. The feed ripple amplitude can be decreased by reducing the non-uniformities in the pad texture and/or by minimizing a derived feed ripple metric (r_f=Vmax0.5V_f/R_t) via adjustments in processing parameters. Pitch ripples can be minimized by reducing relative step distance to spot radius ratio (x_s/a_t) and by achieving a flat bottom trench shape cross section or by reducing the material removal per pass. Using the combined methods, an overall ripple error of ∼1.2nm rms has been achieved.

Transperineal ultrasound assessment of fetal head elevation by maneuvers used for managing umbilical cord prolapse

OBJECTIVE

To assess objectively the degree of fetal head elevation achieved by different maneuvers commonly used for managing umbilical cord prolapse.

METHODS

This was a prospective observational study of pregnant women at term before elective Cesarean delivery. A baseline assessment of fetal head station was performed with the woman in the supine position, using transperineal ultrasound for measuring the parasagittal angle of progression (psAOP), head-symphysis distance (HSD) and head-perineum distance (HPD). The ultrasonographic measurements of fetal head station were repeated during different maneuvers, including elevation of the maternal buttocks using a wedge, knee-chest position, Trendelenburg position with a 15° tilt and filling the maternal urinary bladder with 100 mL, 300 mL and 500 mL of normal saline. The measurements obtained during the maneuvers were compared with the baseline measurements.

RESULTS

Twenty pregnant women scheduled for elective Cesarean section at term were included in the study. When compared with baseline (median psAOP, 103.6°), the knee-chest position gave the strongest elevation effect, with the greatest reduction in psAOP (psAOP, 80.7°; P < 0.001), followed by filling the bladder with 500 mL (psAOP, 89.9°; P < 0.001) and 300 mL (psAOP, 94.4°; P < 0.001) of normal saline. Filling the maternal bladder with 100 mL of normal saline (psAOP, 96.1°; P = 0.001), the Trendelenburg position (psAOP, 96.8°; P = 0.014) and elevating the maternal buttocks (psAOP, 98.3°; P = 0.033) gave modest elevation effects. Similar findings were reported for HSD and HPD. The fetal head elevation effects of the knee-chest position, Trendelenburg position and elevation of the maternal buttocks were independent of the initial fetal head station, but that of bladder filling was greater when the initial head station was low.

CONCLUSIONS

To elevate the fetal presenting part, the knee-chest position provides the best effect, followed by filling the maternal urinary bladder with 500 mL then 300 mL of fluid, respectively. Filling the bladder with 100 mL of fluid, the Trendelenburg position and elevation of the maternal buttocks have modest effects. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Creating Dementia-Friendly Communities for Social Inclusion: A Scoping Review

Aims: This scoping review explores key strategies of creating inclusive dementia-friendly communities that support people with dementia and their informal caregiver. Background: Social exclusion is commonly reported by people with dementia. Dementia-friendly community has emerged as an idea with potential to contribute to cultivating social inclusion. Methods: This scoping review follows the Joanna Briggs Institute scoping review methodology and took place between April and September 2020. The review included a three-step search strategy: (1) identifying keywords from CINAHL and AgeLine; (2) conducting a second search using all identified keywords and index terms across selected databases (CINAHL, AgeLine, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google); and (3) hand-searching the reference lists of all included articles and reports for additional studies. Results: Twenty-nine papers were included in the review. Content analysis identified strategies for creating dementia-friendly communities: (a) active involvement of people with dementia and caregivers (b) inclusive environmental design; (c) public education to reduce stigma and raise awareness; and (d) customized strategies informed by theory. Conclusion: This scoping review provides an overview of current evidence on strategies supporting dementia-friendly communities for social inclusion. Future efforts should apply implementation science theories to inform strategies for education, practice, policy and future research.

152 Evaluating the Incidence and Predictors of Readmission in Patients Awaiting Cholecystectomy for Previously Diagnosed Acute Gallstone Disease

Introduction

The prevalence of gallstones up to 15%.20-40% will develop symptomatic gallstones and occupy most of the surgical waiting list. The timing of a cholecystectomy remains controversial.

Method

Retrospective data analysis over 2 years, including: diagnosis, commodities, ASA class, investigations, readmissions numbers and causes, time to surgery, operative details, and rate of conversion to open procedures. Chi-square test was used for analysis.

Results

532 cholecystectomies were performed.44% of the patients had commodities. Presentations were; Acute cholecystitis (41.7%), biliary colic (23.1%), acute pancreatitis (15.9), obstructive jaundice (9.2%). USS was performed in 97.3%, CT scan in 17.8% and MRCP in 45.8%. 14% had ERCP. Re admission rate was 56.4%, between 1-6 times, secondary to; cholecystitis (12.5%), biliary colic (26.7), gallstone pancreatitis (8.2%), obstructive jaundice (8.0%), other complications (0.5-1.5%). Emergency cholecystectomy was performed in 14.9% with conversion rate 1.4%.major complication rate was 2.7. The median time on waiting list was 12 (0-123) weeks. This prolonged to 25 (0-400) weeks, when calculated at time of diagnosis. Complicated gallstones disease (p-value 0.0001) was predictors of recurrent symptoms and readmissions.

Conclusions

Management plan is due to optimize the timing of cholecystectomy to decrease the negative impact on readmission and complication rates plus the hospitals’ bed capacity and costs.

Abstract P108: Impact of the Covid-19 Pandemic on Hyperacute Stroke Treatment: Experience From a Comprehensive Stroke Centre in Singapore

Background: The Coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving and affecting healthcare systems across the world. Singapore has escalated its alert level to Disease Outbreak Response System Condition (DORSCON) Orange, signifying severe disease with community spread.

Objectives: We aimed to study the overall volume of AIS cases and the delivery of hyperacute stroke services during DORSCON Orange.

Methods: This was a single-centre, observational cohort study performed at a comprehensive stroke centre responsible for AIS cases in the western region of Singapore, as well as providing care for COVID-19 patients. All AIS patients reviewed as an acute stroke activation in the Emergency Department (ED) from November 2019 to April 2020 were included. System processes timings, treatment and clinical outcome variables were collected.

Results: We studied 350 AIS activation patients admitted through the ED, 206 (58.9%) pre- and 144 during DORSCON Orange. Across the study period, number of stroke activations showed significant decline (p =0.004, 95% CI 6.513 - -2.287), as the number of COVID-19 cases increased exponentially, whilst proportion of activations receiving acute recanalization therapy remained stable ( p = 0.519, 95% CI -1.605 - 2.702). Amongst AIS patients that received acute recanalization therapy, early neurological outcomes in terms of change in median NIHSS at 24 hours (-4 versus -4, p = 0.685) were largely similar between the pre- and during DORSCON orange periods.

Conclusions: The number of stroke activations decreased while the proportion receiving acute recanalization therapy remained stable in the current COVID-19 pandemic in Singapore.

Effect of workpiece curvature on the tool influence function during hemispherical sub-aperture tool glass polishing

The influence of workpiece curvature on the tool influence function spot during polishing of fused silica glass with cerium oxide slurry, while using a rotating hemispherical pad-foam tool for a wide variety of process conditions (tool displacement, inclination angle, and rotation rate), has been investigated. (Workpiece curvature ranged from 500 mm radius concave to 43 mm radius convex.) The TIF spot decreases in diameter and increases in the peak removal rate on more convex workpieces. In contrast, the TIF spot increases both in diameter and peak removal rate on more concave workpieces. For the range of workpiece curvatures investigated, both the spot size and the peak removal rate changed significantly, as much as 2 times. An elastic sphere-sphere contact mechanics model, which utilizes both a modified displacement (that leads to a change in the applied load) as well as a mismatch factor (that influences the pressure distribution shape), has been developed. The model was validated using both offline load-displacement measurements and finite-element analysis simulations. The model quantitatively describes the measured change in the relative contact diameter and relative pressure distribution, as well as semiquantitively describes the change in the relative volumetric removal rate on a large variety of TIF spots. The change in the volumetric removal rate for convex workpieces is a result of the balance between a decreasing spot size (reducing removal) and an increasing peak pressure (increasing removal), which usually results in relatively small changes in volumetric removal. In the case of concave workpieces, the volumetric removal rate change is also governed by a similar balance, but the spot size increase contribution dominates, resulting in a significant increase in volumetric removal rate. Understanding these trends can enable methods to add greater determinism during the fabrication of freeform optics by adjusting polishing parameters (such as dwell time) while the tool translates along a workpiece surface with different local curvatures.

Titanium and implantology: a review in dentistry

Implant dentistry has become a popular restorative option in clinical practice. Titanium and titanium alloys (TTA) are the gold standard for endo-osseus dental implants production, thanks to their biocompatibility, resistance to corrosion and mechanical properties. The characteristics of the TTA implant surface seem to be particularly relevant in the early phase of osseointegration. Furthermore, the microstructure of implant surface can largely influence the bone remodelling at the level of the bone-implant surface. Recently, research has stated on the long-term of both survival and success rates of osseointegrated implants and mainly on biomechanical aspects, such as load distribution and biochemical and histological processes at the bone-implant interface. This short review reports recent knowledge on chemical and mechanical properties, biological aspects, innovations in preventing peri-implantitis, describing clinical applications and recent improvements of TTA dental implants. In addition, it highlights current knowledge about a new implant coating that has been demonstrated to reduce the number of initially adhering bacteria and peri-implantitis.

Implementing Silent Disco Headphones in a Hospital Unit: A Qualitative Study of Feasibility, Acceptance, and Experience Among Patients and Staff

INTRODUCTION

Music is so widely available and inexpensive in the modern world; it is a common option for stress reduction, comfort and enjoyment. Silent disco headphones are used among young people; however, no study has yet investigated whether it is feasible to use these headphones to support mental health and well-being among older people with dementia in hospital settings.

OBJECTIVE

The study's main objective is to explore whether music delivered by silent disco headphones was feasible and acceptable to a sample of inpatients staying in an older adult mental health unit of a large urban hospital.

METHODS

We employed a video-ethnographic design in data collection, including conversational interviews and observations with video recording among ten patient participants in a hospital unit. A focus group was conducted with ten hospital staff on the unit.

RESULTS

Our analysis identified three themes that represented experiences of patients and staff: (1) perceived usefulness, (2) perceived ease of use, and (3) attitude. Patient participants reported the music delivered by the headphones brought positive benefits. Witnessing the positive effects on patients influenced the staff's view of how music could be used in the clinical setting to support patients' well-being.

CONCLUSIONS

The music delivered by the silent disco headphones in an older adult mental health unit was found to be an acceptable and feasible intervention for patients. Leadership support is identified as an enabling factor in supporting technology adoption in the clinical setting. The findings can be used to inform practice development and future research.

Mechanisms influencing and prediction of tool influence function spots during hemispherical sub-aperture tool polishing on fused silica

Sub-aperture tool polishing of precision optics requires a detailed understanding of the local material removal [tool influence function (TIF)] at the contact spot between the workpiece and tool to achieve high removal determinism and hence precision of the optic relative to the desired/design surface figure. In this study, the mechanisms influencing and the quantitative prediction of the removal rate and shape of TIF spots during polishing of fused silica glass with cerium oxide slurry using a rotating hemispherical pad-foam tool for a wide variety of process conditions (including tool properties, kinematics, and applied displacements) are investigated. The TIF volumetric removal rate can be estimated utilizing the average relative velocity and contact area using a simple analytical model. In addition, stability of the volumetric removal rate for fixed process conditions is shown to be greatly dependent on the pad preparation and amount of tool use (affecting both pad topography and slurry buildup), whose general behavior shows an increase in removal rate followed by stabilization with polishing time. The determination of the TIF removal shape is more complex. An extended version of the Preston removal model is developed to explain a comprehensive set of measured TIF removal shapes to within ∼22%. This model incorporates a number of phenomena impacting the TIF removal shape including: (a) temporal and spatial dependent relative velocity between the workpiece and tool; (b) an elastic mechanics based, as well as hydrodynamic, pressure distribution; (c) a spatially dependent friction coefficient possibly caused by both reduced slurry replenishment in low velocity regions and pad slurry islands (100 µm scale) and porosity (millimeter scale); and (d) a shear-based removal mechanism on the periphery of the contact spot.

ATRT-08. A PHASE II STUDY OF CONTINUOUS LOW DOSE PANOBINOSTAT IN PAEDIATRIC PATIENTS WITH MALIGNANT RHABDOID TUMORS/ATYPICAL TERATOID RHABDOID TUMORS

BACKGROUND

Panobinostat treatment has been shown to terminally differentiate malignant rhabdoid tumor (MRT)/atypical teratoid rhabdoid tumors (ATRT) in pre-clinical models. This is an open label, phase II study of panobinostat in patients with newly diagnosed or relapsed MRT/ATRT. AIMS: To assess the anti-tumor activity of low dose, continuous panobinostat, its associated toxicities, the biological activity of low dose panobinostat by measuring histone acetylation status in peripheral mononuclear cells (PMNC), and markers of differentiation in fresh tumor tissue specimens.

METHODS

Following cycles of induction and consolidation chemotherapy and/or radiation treatment, patients were enrolled and commenced on panobinostat as a continuous daily oral dose starting at 10mg/m² following a three-week wash out period between therapies. Real-time acetylation status, measuring acetylated H4 on PMNC, was performed to determine the pharmacodynamics of panobinostat. Patients were monitored for drug toxicities with the possibility of dose reductions in decrements of 2mg/m².

RESULTS

Six patients with newly diagnosed ATRT/MRT and one patient with relapsed MRT have been enrolled to date. The average age at enrollment was 2.5 years. Currently, six patients (85.7%) remain on study with a mean treatment duration of 170 days (range 44–327 days). One patient was removed from study at day 44 due to disease progression. The main dose-limiting toxicity observed to date has been myelosuppression. Panobinostat, at a dose of 10mg/m², caused significant acetylation of H4 in PMNC.

CONCLUSIONS

Treatment with panobinostat appears to be well tolerated in infants with MRT/ATRT, with successful real-time pharmacodynamic assessment of H4 acetylation.

People with Type Diabetes Mellitus (T1DM) self-reported views on their own condition management reveal links to potentially improved outcomes and potential areas for service improvement

BACKGROUND

The self-management of type 1 diabetes (T1DM) has moved forward in many areas over the last 40 years. Our study asked people with T1DM what is their experience of blood glucose (BG) monitoring day to day and how this influences decisions about insulin dosing.

METHODS

An on-line self-reported questionnaire containing 44 questions prepared after consultation with clinicians and patients was circulated to people with T1DM 116 responders provided completed responses. Fixed responses were allocated specific values (e.g. not confident = 0 fairly confident = 1). Multivariate regression analysis was carried out. Only those 5 factors with p-value <0.05 were retained.

RESULTS

59% of respondents were >50 years old and 66% had diabetes for >20 years, with 63% of patients reporting HbA1c results ≤8% or 64 mmol/mol. Findings included; 75% used only 1 m; 56% had used the same meter for ≥3 years; 10% had tried flash monitors; 47% were concerned about current BG level; 85% were concerned about long-term impact of higher BG. 72% of respondents keep BG level high to avoid hypoglycaemia; 25% used ≥7 mmol/L as pre-meal BG target to calculate dose; 65% were concerned they might be over/under-dosing; 83% did not discuss accuracy when choosing meter. However 85% were confident in their meter's performance. The factors that linked to LOWER HbA1c included LESS units of basal insulin (p < 0.001), HIGHER number of daily BG tests (p = 0.008), LOWER bedtime blood glucose (p = 0.009), HIGHER patient's concern over long-term impact of high BG (BG) (p < 0.009 but LOWER patient's concern over current BG values (p = 0.009). The final statistical model could explain 41% of the observed variation in HbA1c.

CONCLUSION

Many people still run their BG high to avoid hypoglycaemia. Concern about the longer-term consequences of suboptimal glycaemic control was associated with a lower HbA1c and is an area to explore in the future when considering how to help people with T1DM.

Abstract PO-051: Genetic counseling for high-risk public hospital patients: A randomized and preference-based trial compares delivery in person, by phone, and video

In public health settings, where availability of genetic counseling (GC) and testing for hereditary breast and ovarian cancer is limited, telehealth could expand access to academic centers where these services are concentrated. However, little is known about the effectiveness of remote modes for ethnically diverse and low health literacy patients. Methods. From 2017-20 UCSF researchers partnered with 3 public hospitals to conduct a partially randomized preference noninferiority trial with English-, Spanish-, and Cantonese-speaking patients with strong personal and/or family history of cancer. Participants received GC in person, by phone, or via video. Pre- and post-GC telephone surveys measured study outcomes: knowledge, cancer- specific distress, decisional conflict, risk perception, and satisfaction. A subset of 23 participants was recruited for case studies (CS) to elucidate quantitative findings. CS integrated patient and counselor in-depth interviews, GC session transcripts, and survey and tracking data for a multi-dimensional understanding of each individual’s GC experience. Results. Among 23,633 family history forms collected, 1,574 patients were eligible; 1404 were reached and 708 consented. Of 394 randomized, 322 attended GC and 312 completed the final survey. After GC, mean knowledge scores increased, and cancer-specific distress and decisional conflict decreased overall.

Counseling attendance varied significantly by assigned mode (75% via video at a clinic, 77% in person, and 92% by phone), but the modes yielded noninferior outcomes. Respondents overwhelmingly rated all modes as “very convenient” and satisfaction with counseling as “very high.” Compared with baseline, knowledge increased significantly regardless of mode. However, this increase was significantly less for African Americans and for those with less education (with each adjusted for the other) across all modes. Completion of genetic testing (GT) was the inverse of counseling attendance: 94% in person, 93% video, and 65% by phone. Case studies (CS) revealed the complexities of counseling public hospital patients. Phone patients valued the access despite connection issues, but phone appointments tended to be briefer, and qualitative interviews suggested that communication was less effective by phone. While many phone patients said they would not be able to access GC any other way, several felt they would get more out it in person. Importantly, GT was offered on the spot to in-person patients while some counseled by phone had second thoughts and other barriers. CS of video counseling found benefits similar to in-person GC such as use of visual cues and formation of meaningful connections. Conclusion. Our findings indicate that GC can be delivered to high-risk public hospital patients remotely by phone, video, or in-person in order to fill a gap in access to critical genetic services. Further research is needed to achieve optimal outcomes for all patients and to increase the rate of testing for those counseled by phone.

Citation Format: Rena J Pasick, Susan L. Stewart, Robin Lee, Claudia Guerra, Celia Kaplan, Galen Joseph, Selina Flores, Janice Tsoh, Niharika Dixit, Miya Frick, Heather Cedermaz, Lily Wong, Amal Khoury, Brittany Campbell. Genetic counseling for high-risk public hospital patients: A randomized and preference-based trial compares delivery in person, by phone, and video [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-051.

Efficacy and safety of expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis

STUDY QUESTION

Is expectant management (EM) of tubal ectopic pregnancy (EP) an effective and safe treatment strategy when compared to alternative interventions?

SUMMARY ANSWER

There is insufficient evidence to conclude EM yields a difference in the resolution of tubal EP, the avoidance of surgery or time to resolution of tubal EP when compared to intramuscular methotrexate in stable patients with β-hCG <1500 IU/l.

WHAT IS ALREADY KNOWN

The utilisation of medical and surgical management for EP is well established. EM aims to allow spontaneous resolution of the EP without intervention.

STUDY DESIGN SIZE AND DURATION

We performed a systematic review and meta-analysis, searching Ovid MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, OpenGrey.eu, Google Scholar, cross-referencing citations and trial registries to 15 December 2019. There were no limitations placed on language or publication date. Search terms included tubal EP and EM as well as variations of these terms.

PARTICIPANTS/MATERIALS SETTING AND METHOD

We considered studies that included patients with tubal EP, EM as a comparator, and that were randomised controlled trials (RCTs). The primary outcome was resolution of tubal EP. Secondary outcomes included avoidance of surgery and the time to resolution of EP. Two reviewers independently selected the studies, assessed bias and extracted data. Relative risk (RR) and mean difference with 95% CI were assessed using a random effects model. The certainty of evidence was scored according to Grading of Recommendations Assessment, Development and Evaluation guidelines.

MAIN RESULTS AND THE ROLE OF CHANCE

In total, 920 studies were screened. Five studies were eligible for inclusion in the systematic review. Two RCTs comparing methotrexate to EM were identified as being eligible for inclusion in meta-analysis. No RCTs comparing surgery to EM were identified. Compared with EM, there was insufficient evidence that methotrexate yields a difference on resolution of tubal EP (RR 1.04, 95% CI 0.88-1.23, P = 0.67; two RCTs, moderate-certainty evidence), avoiding surgery (RR 1.10, 95% CI 0.94-1.29, P = 0.25; two RCTs, low-certainty evidence) or the time to resolution of tubal EP (-2.56 days (favouring EM), 95% CI -7.93-2.80, P = 0.35; two RCTs, low-certainty evidence).

LIMITATIONS REASONS FOR CAUTION

Only two RCTs with a total of 103 patients were eligible for inclusion in this meta-analysis. Further RCTs comparing EM to medical and surgical management are needed and these should also report adverse events. Patient preference should also be evaluated.

WIDER IMPLICATIONS OF THE FINDINGS

We found insufficient evidence of differences in terms of resolution, avoidance of surgery and time to resolution between expectant and medical management. Given the imprecision in the effect estimates as demonstrated by the wide CIs, resulting in the downgrading of certainty of evidence for all outcomes in this meta-analysis, larger RCTs comparing interventions for tubal EP are needed. Caution should be exercised when trying to decide between EM and methotrexate to treat tubal EP.

STUDY FUNDING/COMPETING INTERESTS

There was no funding for this study. NICM receives funding from various sources; none specifically supported this research. M.L. reports grants from Australian Women and Children's Research Foundation, outside the submitted work. M.A.: As a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies and industry. Sponsors and donors provide untied and tied funding for work to advance the vision and mission of the Institute. This systematic review was not specifically supported by donor or sponsor funding to NICM. M.A. reports a partnership grant with Metagenetics outside the submitted work. G.C. reports grants from Australian Women and Children's Research Foundation, personal fees from Roche and GE Healthcare, outside the submitted work. The remaining authors report no conflicts of interest.

PROSPERO REGISTRATION NUMBER

CRD42020142736.

Phosphatidylinositol 4-kinase IIIβ mediates contraction-induced GLUT4 translocation and shows its anti-diabetic action in cardiomyocytes

In the diabetic heart, long-chain fatty acid (LCFA) uptake is increased at the expense of glucose uptake. This metabolic shift ultimately leads to insulin resistance and a reduced cardiac function. Therefore, signaling kinases that mediate glucose uptake without simultaneously stimulating LCFA uptake could be considered attractive anti-diabetic targets. Phosphatidylinositol-4-kinase-IIIβ (PI4KIIIβ) is a lipid kinase downstream of protein kinase D1 (PKD1) that mediates Golgi-to-plasma membrane vesicular trafficking in HeLa-cells. In this study, we evaluated whether PI4KIIIβ is involved in myocellular GLUT4 translocation induced by contraction or oligomycin (an F₁F₀-ATP synthase inhibitor that activates contraction-like signaling). Pharmacological targeting, with compound MI14, or genetic silencing of PI4KIIIβ inhibited contraction/oligomycin-stimulated GLUT4 translocation and glucose uptake in cardiomyocytes but did not affect CD36 translocation nor LCFA uptake. Addition of the PI4KIIIβ enzymatic reaction product phosphatidylinositol-4-phosphate restored oligomycin-stimulated glucose uptake in the presence of MI14. PI4KIIIβ activation by PKD1 involves Ser294 phosphorylation and altered its localization with unchanged enzymatic activity. Adenoviral PI4KIIIβ overexpression stimulated glucose uptake, but did not activate hypertrophic signaling, indicating that unlike PKD1, PI4KIIIβ is selectively involved in GLUT4 translocation. Finally, PI4KIIIβ overexpression prevented insulin resistance and contractile dysfunction in lipid-overexposed cardiomyocytes. Together, our studies identify PI4KIIIβ as positive and selective regulator of GLUT4 translocation in response to contraction-like signaling, suggesting PI4KIIIβ as a promising target to rescue defective glucose uptake in diabetics.

Performance on the Robotics On-Board Trainer (ROBoT-r) Spaceflight Simulation During Acute Sleep Deprivation

Exploration of deep space poses many challenges. Mission support personnel will not be immediately available to assist crewmembers performing complex operations on future long-duration exploration operations. Consequently, it is imperative that crewmembers have objective, reliable, and non-invasive metrics available to aid them in determining their fitness for duty prior to engaging in potentially dangerous tasks. The Robotics On-Board Trainer (ROBoT) task is NASA's platform for training astronauts to perform docking and grappling maneuvers. It is regularly used by crewmembers during spaceflight for refresher training. The operational ROBoT system, however, does not record data. Thus, a research version of ROBoT, called ROBoT-r, was developed so that operationally relevant data could be mined to provide feedback to crewmembers. We investigated whether ROBoT-r metrics would change according to sleep loss and circadian phase in a 28-h laboratory-based sleep deprivation study. Overall, participants showed improvement over time despite sleep loss, indicating continued learning. Performance on the psychomotor vigilance task (PVT) followed an expected profile, with reduced performance across the night. These findings suggest that individuals may be able to temporarily compensate for sleep loss to maintain performance on complex, novel tasks. It is possible that some ROBoT-r metrics may be sensitive to sleep loss after longer bouts of wakefulness or after individuals have habituated to the task. Studies with additional participants and extended pre-training on the ROBoT-r task should be conducted to disentangle how brain activity may change as individuals learn and habituate to complex tasks during sleep loss.

Transport and concentration of wealth: Modeling an amenities-based-theory

We derive a reaction-advection-diffusion equation based framework for analyzing the movement of wealth in urban environments. Gentrification is a core issue that affects many urban areas, and the dynamics of such are not fully understood. To understand the process using a few physically relevant variables, we develop an approach to model the interplay between local amenities and wealth from existing analyses of factors influencing gentrification. We conduct a linear stability analysis on model parameters that results in spatially homogeneous solutions and determine directions for parameter changes to induce instabilities. From these parameters, we determine quantities that lead to the formation of areas of wealth and amenity concentration in the long term on bounded and unbounded domains. We present a global bifurcation result in two dimensions, leading to the existence and stability of non-constant equilibrium solutions, which represents solutions with wealth and amenity hotspots. Finally, we present a theory for discerning the one-dimensional pattern formation in the transition between stability and instability and verify numerically through a weakly nonlinear analysis. The analysis provides a promising framework for further verification using publicly available geospatial data on the relevant variables.

Sapphire advanced mitigation process: wet etch to expose sub-surface damage and increase laser damage resistance and mechanical strength

A novel, to the best of our knowledge, method of wet chemical etching of sapphire workpieces (such as optics, wafers, windows, and cones), called the sapphire advanced mitigation process (or sapphire AMP), has been developed that exposes sub-surface mechanical damage created during the optical fabrication process and significantly enhances the surface laser damage resistance ($ \gt {2{\times}}$>2×) and mechanical strength (up to $\sim{2.6{\times}}$∼2.6×). Sapphire AMP involves first treating the workpiece with a mixture of sulfuric and phosphoric acid $([{\rm H_{2}{\rm SO_{4}}}]:[{\rm H_{3}{\rm PO_{4}}}]=1:3)$([H₂SO₄]:[H₃PO₄]=1:3) at 220°C, followed with phosphoric acid at 160°C, then with sodium hydroxide base (NaOH) and surfactant at 40°C, and finally with a high-pressure deionized water spray rinse. Sapphire AMP has been demonstrated on both A- and C-plane sapphire workpieces. The mechanism of this etch process involves the reaction of the sapphire $({\rm Al_{2}}{\rm O_{3}})$(Al₂O₃) surface with sulfuric acid $({\rm H_{2}}{\rm SO_{4}})$(H₂SO₄) forming aluminum sulfate $[{{\rm Al}_2}{({{\rm SO}_4})_3}]$[Al₂(SO₄)₃], which has low solubility. The high phosphoric acid content in the first and second steps of sapphire AMP results in the efficient conversion of ${{\rm Al}_2}{({{\rm SO}_4})_3}$Al₂(SO₄)₃ to aluminum phosphate $({\rm AlPO_{4}})$(AlPO₄), which is very soluble, greatly reducing reaction product redeposition on the workpiece surface. Sapphire AMP is shown to expose sub-surface mechanical damage on the sapphire surface created during the grinding and polishing processes, whose etched morphology has either isotropic or anisotropic evolution depending on the nature of the initial surface damage. Sapphire AMP was also designed to remove the key known surface, laser absorbing precursors (namely, foreign chemical impurities, the fracture surface layer of preexisting sub-surface damage, and reaction product or foreign species redeposition or precipitation). Static and sliding indention induced surface microfractures on sapphire are shown after sapphire AMP to have a significant decrease in the fast photoluminescence intensity (a known metric for measuring the degree of laser damaging absorbing precursors). In addition, the onset of laser damage (at 351 nm 3 ns) on sapphire AMP treated workpieces was shown to increase in fluence from $\sim{4}$∼4 to $ \gt {9}.{5}\;{{\rm J/cm}^2}$>9.5J/cm². Finally, biaxial ball-on-ring mechanical tests on sapphire disks showed an increase in the failure stress from 340 MPa (with pre-existing 28 µm flaws) to $\sim{900}\;{\rm MPa}$∼900MPa after sapphire AMP, which is attributed to the blunting of the surface microfractures.

Liquid Chromatographic Method for the Determination of Nine Phenolic Antioxidants in Butter Oil: Collaborative Study

Ten laboratories collaboratively studied a liquid chromatographic (LC) method for the determination of propyl, octyl, and dodecyl gallate (PG, OG, and DG, respectively), 2,4,5-trihydroxybutyrophenone (THBP), ferf-butylhydroquinone (TBHQ), nordihydroguaiaretic acid (NDGA), 2- and 3-tert-butyl-4- hydroxyanisole (BHA), 2,6-di-ferf-butyl-4-hydroxymethylphenol (lonox-100), and 3,5-di-terf-butyl-4- hydroxytoluene (BHT) in butter oil. The 10 samples analyzed were spiked in matched pairs at about 100,50, and 10 μg/g. In the method studied, antioxidants are extracted as in AOAC LC method 983.15, but different LC eluants are used to separate the 9 antioxidants. Results from 1 laboratory were rejected as not valid and were not included in any calculations. For the remaining 9 laboratories, the overall mean recoveries for PG, THBP, TBHQ, NDGA, BHA, OG, lonox, BHT, and DG were 100.9, 97.8,103.4,95.4, 97.4,93.6,95.5,79.0, and 96.2%, respectively. The overall reproducibility relative standard deviations were 8.55,17.4,25.6,14.5,6.60, 9.64,10.8,11.4, and 7.35%, respectively. The method was adopted first action by AOAC International as a modification of AOAC method 983.15.

Evaluation of Applied Biosystems MicroSEQ® Real-Time PCR System for Detection of Salmonella spp. in Food

Real-time PCR methods for detecting foodborne pathogens offer the advantages of simplicity and quick time-to-results compared to traditional culture methods. In this study, the MicroSEQ® real-time PCR system was evaluated for detection of Salmonella spp. in 10 different food matrixes following the AOAC Research Institute's Performance Tested MethodSM validation program. In addition, the performance of the MicroSEQ system was evaluated for the detection of Salmonella in peanut butter as a part of the Emergency Response Validation Program sponsored by the AOAC Research Institute. The system was compared to the ISO 6579 reference method using a paired-study design for detecting Salmonella spp. in raw ground beef, raw chicken, raw shrimp, Brie cheese, shell eggs, cantaloupe, chocolate, black pepper, dry infant formula, and dry pet food. For the peanut butter study, the system was compared to the U.S. Food and Drug Administration's Bacteriological Analytical Manual procedures using an unpaired-study design. No significant difference in performance was observed between the MicroSEQ Salmonella spp. detection system and the corresponding reference methods for all 11 food matrixes. The MicroSEQ system detected all Salmonella strains tested, while showing good discrimination against detection of an exclusivity panel of 30 strains, with high accuracy.

Determination of Low-Level Glucose and Fructose in Raw and Refined Crystalline Sugar by High-Performance Anion-Exchange Chromatography: Collaborative Study

A method was developed and a collaborative study was performed under the auspices of the International Commission of Uniform Methods for Sugar Analysis. The collaborators used high-performance anion-exchange chromatography (HPAEC) to determine trace amounts of glucose and fructose in 3 raw and 3 refined sugar samples provided as blind duplicates. Fourteen laboratories participated in the study. Although difficulties were experienced by a few analysts, 10 laboratories reported positive results. Average repeatabilities and reproducibilities for glucose and fructose in raw sugar were slightly above 5 and 10%, respectively, and the average Horwitz ratios were well under 2. Average repeatabilities and reproducibilities for glucose and fructose in refined sugar were 10 and 22%, respectively; although the Horwitz ratios were &gt;2, they were marginal (2.8). The HPAEC results agreed with results obtained by gas chromatography in an independent laboratory. Because the method was collaboratively studied according to the protocol of the International Union of Pure and Applied Chemistry for collaborative studies, and the results meet its criteria, it is recommended that the method be adopted Official First Action by AOAC INTERNATIONAL.