Implementation issues and barriers for assessing oral health in dependent patients after stroke:A qualitative study

Objectives: To explore implementation issues and potential barriers for assessing oral health in dependent post-stroke patients. Methods: Semi-structured interviews were conducted with a purposively identified sample of healthcare service providers who work in two National Health Service (NHS) Trusts in the north of England. Interviews were conducted until data saturation was achieved (n = 30). Data were analysed using the constant comparative method. Results: Six themes were drawn out in this study, which described potential barriers to assessing oral health in post-stroke patients, aspects of oral health that need assessment, streamlining the oral health assessment, input methods for oral health assessment, characteristics of assessors, and how oral care should be planned. Conclusions: Assessment of oral health for post-stroke patients has been viewed as a complex task because of several identified barriers. Several suggestions have been proposed to overcome these barriers, aiming to enable more feasible and effective oral health assessments for post-stroke patients. Clinical Significance: The findings from this study have the potential to contribute to developing oral health measurement instruments that might be more successfully implemented and guide oral care planning for dependent patients after stroke.</p

Generation of a bloodstream form Trypanosoma brucei double glycosyltransferase null mutant competent in receptor-mediated endocytosis of transferrin

The bloodstream form of Trypanosoma brucei expresses large poly-N-acetyllactosamine (pNAL) chains on complex N-glycans of a subset of glycoproteins. It has been hypothesised that pNAL may be required for receptor-mediated endocytosis. African trypanosomes contain a unique family of glycosyltransferases, the GT67 family. Two of these, TbGT10 and TbGT8, have been shown to be involved in pNAL biosynthesis in bloodstream form Trypanosoma brucei, raising the possibility that deleting both enzymes simultaneously might abolish pNAL biosynthesis and provide clues to pNAL function and/or essentiality. In this paper, we describe the creation of a TbGT10 null mutant containing a single TbGT8 allele that can be excised upon the addition of rapamycin and, from that, a TbGT10 and TbGT8 double null mutant. These mutants were analysed by lectin blotting, glycopeptide methylation linkage analysis and flow cytometry. The data show that the mutants are defective, but not abrogated, in pNAL synthesis, suggesting that other GT67 family members can compensate to some degree for loss of TbGT10 and TbGT8. Despite there being residual pNAL synthesis in these mutants, certain glycoproteins appear to be particularly affected. These include the lysosomal CBP1B serine carboxypeptidase, cell surface ESAG2 and the ESAG6 subunit of the essential parasite transferrin receptor (TfR). The pNAL deficient TfR in the mutants continued to function normally with respect to protein stability, transferrin binding, receptor mediated endocytosis of transferrin and subcellular localisation. Further the pNAL deficient mutants were as viable as wild type parasites in vitro and in in vivo mouse infection experiments. Although we were able to reproduce the inhibition of transferrin uptake with high concentrations of pNAL structural analogues (N-acetylchito-oligosaccharides), this effect disappeared at lower concentrations that still inhibited tomato lectin uptake, i.e., at concentrations able to outcompete lectin-pNAL binding. Based on these findings, we recommend revision of the pNAL-dependent receptor mediated endocytosis hypothesis.</p

Tensile Behavior of Small Screw Anchors under Cyclic Crack Openings

Small-sized anchors (typically 6 mm [0.24 in.]) are commonly used for nonstructural applications. There has been increasing demand for seismic performance of fastenings for nonstructural applications; however, there have been no 6 mm (0.24 in.) size screw anchors with seismic prequalification for large crack width. This study investigated the feasibility of small-sized screw anchors to perform under tension loading in crack widths of up to 0.8 mm (0.03 in.). Tension tests were conducted in cracked concrete with varying crack widths (0.3, 0.5, and 0.8 mm [0.01, 0.02, and 0.03 in.]) under monotonic, pulsating, and varying crack width load protocol. Based on the findings of this study, 6 mm (0.24 in.) screw anchors exhibited load drop and slip behavior in large crack width during the residual capacity test, even for anchors with a deeper embedment. Finite element analysis was conducted to investigate the feasibility of a larger-sized thread width to perform in 0.8 mm (0.03 in.) crack width.</p