Optimization and characterization of chestnut shell pigment extract obtained microwave assisted extraction by response surface methodology

The objective of this study is to find optimum conditions to valorize chestnut shell bioactive compounds with coloring pigments through microwave-assisted extraction. With this aim, response surface methodology with central composite design was used. Microwave power (800 W), extraction time (12 min) and solvent concentration (NaOH: 0.115 mol/L) were determined as the optimum conditions to maximize the responses like color value, total phenolic content and total antioxidant capacity. In the optimized extract (OE), characterization of brown melanin like pigments were assessed by Spectrophotometer, Fourier Transform Infrared Spectrometer and major phenolics were identified as; gallic acid, ellagic acid, protocatechuic acid, catechin, and epicatechin as 0.53, 0.48, 0.46, 0.46, 0.14 mg/g dried weight (dw) by High Performance Liquid Chromatography, respectively. In terms of antibacterial activity, OE inhibited the growth of Staphylococcus aureus. Consequently, chestnut shells were successfully processed into natural coloring agents that were possessing strong brown color properties as well as high bioactive potential.

A109 PATIENTS’ DESCRIPTIONS OF THEIR LAST BOWEL MOVEMENT BEFORE COLONOSCOPY CORRELATES STRONGLY WITH THEIR BOSTON BOWEL PREPARATION SCALE (BBPS) SCORE WHEN ASSESSED USING A STANDARDIZED METHOD

Background

Predicting bowel prep quality prior to colonoscopy may help improve colonoscopy prep quality by instituting adjunct measures before colonoscopy. This will in turn reduce repeat procedures, complications, and costs.

Aims

We determined the utility of a standardized method to obtain information from patients on the characteristics of their last bowel movement before colonoscopy by correlating the obtained information to BBPS. We compared this approach to informal/usual descriptions attained by nurses.

Methods

This is a cross-sectional study with data collected at two tertiary care hospitals. On the day of their colonoscopy, outpatients were asked by an assistant to describe their last bowel movement using a standardized method. The same patients had previously been asked by endoscopy nurses to describe their last bowel movement; the assistant was blind to previous descriptions. Descriptions were assigned a score (Table 1).

Following colonoscopy, total and segmental BBPS scores were recorded by the gastroenterologist performing the procedure; the gastroenterologist was blind to the descriptions.

Bivariate Pearson’s Correlation was used to separately assess the correlation between descriptions and BBPS. Cohen’s Kappa was used to assess agreement between the two descriptions.

Results

121 patients (ages 17–86; 55% Female) with 11% BBPS< 6 were included.

For descriptions attained by the assistant, there was a strong correlation with total BBPS score (r = 0.738; p < 0.001); correlation to segmental BBPS was moderate-to-strong (r=0.70, 0.63 and 0.67 right, transverse and left colon respectively).

For descriptions attained by endoscopy nurses, there was a moderate correlation with total BBPS score (r = 0.525; p < 0.001); correlation to segmental BBPS was weak-to-moderate (r=0.52, 0.49 and 0.44 right, transverse and left colon respectively).

There was weak agreement (K = 0.525) between description attained by assistant and nurses.

Conclusions

When asked using a standardized method, a patient’s description of their last bowel movement correlates strongly with their total and segmental BBPS score; the correlation is weaker for non-standardized descriptions attained by endoscopy nurses. A standardized questionnaire, including assessing consistency, is valuable in assessing the bowel movement before colonoscopy.

Funding Agencies

None

A68 DISTAL MIGRATION OF A PERCUTANEOUS GASTROJEJUNAL DUODOPA INFUSION TUBE DUE TO BEZOAR FORMATION AT THE JEJUNAL TUBE TIP

Background

Continuous intestinal infusion of levodopa/carbidopa intestinal gel (LCIG) for the treatment of advanced Parkinson’s Disease (PD) leads to less variability in plasma drug levels and improved symptom control. Percutaneous Gastrojejunostomy (PEG-J) tube placement has a high placement success rate; however, delayed tube malfunctions occur in approximately 58% of cases within two years. A rare complication is bezoar formation at the jejunal tube tip.

Aims

To present a case of bezoar formation at the jejunal tip of a PEG-J tube that caused distal migration of the tube with gastroduodenal ulceration and required surgical extraction.

Methods

Full chart review was conducted including clinical notes, laboratory results, radiographic imaging, endoscopy reports, and surgical reports. A relevant literature review was conducted.

Results

A 57-year-old male with severe PD underwent endoscopic guided PEG-J tube insertion for continuous infusion of LCIG; intestinal administration was effective for symptom control. Two years later, he noted that the gastric tube had retracted approximately 15 cm into the stoma without external manipulation of the apparatus. Attempts to externally pull the tube back into position were unsuccessful.

The patient underwent Gastroscopy (EGD) with fluoroscopy. Contrast was used to confirm placement of the jejunal tip within the jejunum, but also showed migration of the gastric tip into the duodenum. A gastroscope was used to reposition the gastric tube in the stomach; the jejunal tube was visualized to be under traction. The bumper on the apparatus was re-positioned and external tape was used to further secure the apparatus and prevent migration.

A month later the tube had migrated again; repeat EGD showed the jejunal tube to be under traction with some resultant ulceration of the pyloric channel and duodenal bulb where the tube had been pressing against the mucosa. The jejunal tube could not be pulled back and appeared to be fixed distally. A CT scan was obtained to assess for complications and a coiled tip was seen in the proximal jejunum.

Surgical extraction of the malfunctioning tube was required. At laparotomy, the coiled tip of the feeding tube was successfully removed via enterotomy. The tube tip had coiled around itself and was encased with food materials, creating a large bezoar that was being pulled distally by peristalsis. The patient subsequently underwent insertion of a new GJ tube for ongoing administration of LCIG and has been doing well since.

Conclusions

Bezoar formation at the jejunal tip of LCIG PEG-J tubes is a rare complication and can lead to distal migration and traction related gastroduodenal ulceration. Surgical removal may be required.

Funding Agencies

None

International study on nurses' views and experiences of compassion

BACKGROUND

Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics.

AIM

The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses.

METHODS

An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire.

RESULTS

The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion.

CONCLUSION

Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers.

LIMITATIONS

Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses.

IMPLICATIONS FOR NURSING POLICY

Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

Dynamics of gene regulatory networks with stochastic propensities

Gene regulatory networks (GRNs) control the production of proteins in cells. It is well-known that this process is not deterministic. Numerous studies employed a non-deterministic transition structure to model these networks. However, it is not realistic to expect state-to-state transition probabilities to remain constant throughout an organism’s lifetime. In this work, we focus on modeling GRN state transition (edge) variability using an ever-changing set of propensities. We suspect that the source of this variation is due to internal noise at the molecular level and can be modeled by introducing additional stochasticity into GRN models. We employ a beta distribution, whose parameters are estimated to capture the pattern inherent in edge behavior with minimum error. Additionally, we develop a method for obtaining propensities from a pre-determined network.

Does metoprolol inhibit the cortical spreading depression? Acute effects of systematic metropol on CSD in rats

Cortical spreading depression (CSD) is supposed to be the underlying biological basis of the migraine aura. Metoprolol was proven to be effective in migraine prophylaxis in clinical trials, but its mechanism of action has not been clarified yet. We studied direct effects of metoprolol on a continuous CSD induction model in rats. Six adult Wistar rats were anaesthetized with intraperitoneal thiopental (50 mg/kg). CSD was induced with application of 1 m KCL through a burr hole into the left frontal dura-mater, and recorded by an Ag/AgCl DC electrode on the left parietal dura-mater. After a basal recording of CSD induction during the first 40-min period, metoprolol (5 mg/kg) was infused within 4 min. Then DC recordings were maintained for a further 120 min. Any significant differences in total number and duration of CSDs before and after metoprolol administration were not detected. This study suggests that the mode of action of metoprolol in prophylaxis is not via direct CSD inhibition.

Characterisation of congenital nystagmus waveforms in terms of periodic orbits

Because the oscillatory eye movements of congenital nystagmus vary from cycle to cycle, there is no clear relationship between the waveform produced and the underlying abnormality of the ocular motor system. We consider the durations of successive cycles of nystagmus which could be (1) completely determined by the lengths of the previous cycles, (2) completely independent of the lengths of the previous cycles or (3) a mixture of the two. The behaviour of a deterministic system can be characterised in terms of a collection of (unstable) oscillations, referred to as periodic orbits, which make up the system. By using a recently developed technique for identifying periodic orbits in noisy data, we find evidence for periodic orbits in nystagmus waveforms, eliminating the possibility that each cycle is independent of the previous cycles. The technique also enables us to identify the waveforms which correspond to the deterministic behaviour of the ocular motor system. These waveforms pose a challenge to our understanding of the ocular motor system because none of the current extensions to models of the normal behaviour of the ocular motor system can explain the range of identified waveforms.

Interaction of extracellular matrix and activin-A in the initiation of follicle growth in the mouse ovary

The precise mechanism for the initiation of follicle growth and progression through the earliest stages of follicle development remains largely unknown. Activins play a role during early follicle development, and evidence suggests that the extracellular matrix plays a role during later stages of follicular growth. We investigated the role of activin-A and extracellular matrix in follicle growth initiation and early follicular development in the mouse ovary. Ovaries were collected from 5-day-old mice and cultured for 10 days on polylysine, collagen, or laminin in the presence or absence of recombinant human activin-A. Follicle density, indices of follicle growth initiation (primary:primordial follicle [PY:PD] and primary:total follicle [PY:TF] ratios), ratios of multilayer follicle:total follicle (ML:TF), and follicle growth rates were compared between groups. Follicle densities were significantly higher in the extracellular matrix treatment group compared with the polylysine group (P < 0.01). Also, compared with polylysine, both collagen and laminin significantly increased indices of follicle growth initiation (PY:PD ratio: P < 0.001, odds ratio of 3.3; PY:TF ratio: P < 0.001, odds ratio of 2.5), and these were not altered by activin treatment. In the absence of activin-A, exposure to neither collagen nor laminin had an effect on multilayer follicle development. When activin-A was added, collagen and laminin had opposing effects on multilayer follicle development. Activin-A stimulated multilayer follicle development in the presence of laminin (ML:TF ratio: P = 0.01, odds ratio of 10.8), whereas it suppressed follicle growth in collagen (P = 0.01). Activin-A did not affect the ML:TF ratio in the polylysine-treated groups. These results strongly suggest that extracellular matrix components and activin-A interact with each other, and that they regulate follicle growth initiation and multilayer follicle development.

Detection of BCR/ABL gene rearrangement and the elimination of rearranged clone in chronic myelocytic leukemia patients

Cytogenetic and molecular studies were performed on 20 interferon-alpha receiving Turkish chronic myelocytic leukemia patients. Four different restriction endonucleases and bcr-G probe were used for southern blot analysis to detect rearrangements of the bcr gene. The RT-PCR method was also applied to detect chimeric bcr/abl mRNA. Seventeen patients showed a chromosomal break within the 5.8 kb M-bcr region by southern blot analysis while three cases out of 20 have not shown any rearrangement. These three cases were further analysed by RT-PCR and they were also found to be carrying the Philadelphia translocation (Ph). However, in four years of follow-up this RT-PCR positivity has disappeared, which suggests an elimination of Ph clone with prolonged interferon-alpha treatment.