Point-of-care C reactive protein for the diagnosis of lower respiratory tract infection in NHS primary care: a qualitative study of barriers and facilitators to adoption

OBJECTIVES: Point-of-care (POC) C reactive protein (CRP) is incorporated in National Institute of Health and Care Excellence (NICE) guidelines for the diagnosis of pneumonia, reduces antibiotic prescribing and is cost effective. AIM: To determine the barriers and facilitators to adoption of POC CRP testing in National Health Service (NHS) primary care for the diagnosis of lower respiratory tract infection. DESIGN: The study followed a qualitative methodology based on grounded theory. The study was undertaken in 2 stages. Stage 1 consisted of semistructured interviews with 8 clinicians from Europe and the UK who use the test in routine practice, and focused on their subjective experience in the challenges of implementing POC CRP testing. Stage 2 was a multidisciplinary-facilitated workshop with NHS stakeholders to discuss barriers to adoption, impact of adoption and potential adoption scenarios. Emergent theme analysis was undertaken. PARTICIPANTS: Participants included general practitioners (including those with commissioning experience), biochemists, pharmacists, clinical laboratory scientists and industry representatives from the UK and abroad. RESULTS: Barriers to the implementation of POC CRP exist, but successful adoption has been demonstrated abroad. Analysis highlighted 7 themes: reimbursement and incentivisation, quality control and training, laboratory services, practitioner attitudes and experiences, effects on clinic flow and workload, use in pharmacy and gaps in evidence. CONCLUSIONS: Successful adoption models from the UK and abroad demonstrate a distinctive pattern and involve collaboration with central laboratory services. Incorporating antimicrobial stewardship into quality improvement frameworks may incentivise adoption. Further research is needed to develop scaling-up strategies to address the resourcing, clinical governance and economic impact of widespread NHS implementation

Synthesis and characterization of silver nanoarticles from extract of Eucalyptus citriodora

The primary motivation for the study to develop simple eco-friendly green synthesis of silver nanoparticles using leaf extract of Eucalyptus citriodora as reducing and capping agent. The green synthesis process was quite fast and silver nanoparticles were formed within 0.5 h. The synthesis of the particles was observed by UV-visible spectroscopy by noting increase in absorbance. Characterization of the particles was carried out by X-ray diffraction, FTIR and electron microscopy. The developed nanoparticles demonstrated that E. citriodora is good source of reducing agents. UV-visible absorption spectra of the reaction medium containing silver nanoparticles showed maximum absorbance at 460 nm. FTIR analysis confirmed reduction of Ag+ to Ag0 atom in silver nanoparticles. The XRD pattern revealed the crystalline structure of silver nanoparticles. The SEM analysis showed the size and shape of the nanoparticles. The method being green, fast, easy and cost effective can be recommended for large scale production of AgNPs for their use in food, medicine and materials

Mozambique’s peace decades since the end of the conflict: Inclusive or managed democracy?

The article analyses Mozambique’s post-conflict democratisation and argues that Mozambique has become a ‘managed democracy’ in the new period. Mozambique is viewed by the donor community and multilateral  institutions, such as the World Bank and the International Monetary Fund, as a success story of post-war reconstruction and used as a model to be emulated. The article traces the trajectory of democratisation under the auspices of a liberal peace theoretical framework which was agreed upon in the General Peace Agreement ending the conflict in 1992. Secondary quantitative data were made available from leading International Organisations such as the World Bank and the Mo Ibrahim Governance Index. The article found that, despite Mozambique’s commitments to build an inclusive democracy, corruption unmasks Mozambique’s success story. The authors conclude that  democratic consolidation has been accompanied by extractive political and economic institutions leading to a disgruntled citizenry. The country’s peace agreement remains fragile, and faces the reality that political stability has not been accompanied by social justice, equity and deepening democratisation

Explicit Model Checking of Very Large MDP using Partitioning and Secondary Storage

The applicability of model checking is hindered by the state space explosion problem in combination with limited amounts of main memory. To extend its reach, the large available capacities of secondary storage such as hard disks can be exploited. Due to the specific performance characteristics of secondary storage technologies, specialised algorithms are required. In this paper, we present a technique to use secondary storage for probabilistic model checking of Markov decision processes. It combines state space exploration based on partitioning with a block-iterative variant of value iteration over the same partitions for the analysis of probabilistic reachability and expected-reward properties. A sparse matrix-like representation is used to store partitions on secondary storage in a compact format. All file accesses are sequential, and compression can be used without affecting runtime. The technique has been implemented within the Modest Toolset. We evaluate its performance on several benchmark models of up to 3.5 billion states. In the analysis of time-bounded properties on real-time models, our method neutralises the state space explosion induced by the time bound in its entirety.Comment: The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-319-24953-7_1

Effect of lead and cadmium on germination and seedling growth of Leucaena leucocephala

A study was conducted to determine the effect of different concentrations of lead and cadmium on seed germination and seedling growth of Leucaena leucocephala. Seed were grown under laboratory conditions at 25, 50, 75 and 100 ppm of metal ions of lead and cadmium. Both lead and cadmium treatments showed toxic effectson various growth indices of L. leucocephala. Increasing the concentration of lead to 75 ppm, significantly (

Moving horizon estimation for networked systems with quantized measurements and packet dropouts

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Solubility and Permeability Studies of Aceclofenac in Different Oils

Purpose: To measure the extent of solubility of the lipophilic drug,   aceclofenac, in 13 oils as well as its in vitro permeability from these oils in order to develop optimized topical microemulsion and  microemulsion-based gel for improved bioavailability.Methods: UV spectrophotometeric method was used at the wavelength of 276 nm to measure the dissolved quantity of aceclofenac in each of the oils (almond oil, oleic acid, castor oil, paraffin oil, cinnamon oil, clove oil, canola oil, sesame oil, isopropyl myristate (ipm), sunflower oil, corn oil, coconuts oil and eucalyptus oil) at 25 °C. The in-vitro permeability of aceclofenac in each of these oils was determined at 32 ± 0.5 °C using Franz diffusion cell with phosphate buffer (pH 7.4) as medium with 0.45ì cellulose acetate membrane. The solubility and permeability of aceclofenac were compared with the hydroalcoholic solution of aceclofenac.Results: The highest solubility values of 9.153 and 8.560 mg/ml for  aceclofenac were obtained with almond oil and oleic acid, respectively (p < 0.05). However the solubility and permeability of aceclofenac in hydro-alcoholic solution were 150.65 mg/ml and 14.91± 0.05 ìg/cm2/h,  respectively. Aceclofenac also showed higher permeability values (1.45± 0.04 and 1.21 ± 0.06) in almond oil and oleic acid, respectively, than in the other oils (p < 0.05).Conclusion: These findings show that almond oil and oleic acid are  promising vehicles for aceclofenac as its enhanced solubility and  permeability in these vehicles are suggestive of improved bioavailability.Keywords: Aceclofenac, Almond oil, Solubility; Permeability, Oleic acid, Bioavailability

Quantum gravitational sensor for space debris

Matter-wave interferometers have fundamental applications for gravity experiments such as testing the equivalence principle and the quantum nature of gravity. In addition, matter-wave interferometers can be used as quantum sensors to measure the local gravitational acceleration caused by external massive moving objects, thus lending itself for technological applications. In this paper, we will establish a three-dimensional model to describe the gravity gradient signal from an external moving object, and theoretically investigate the achievable sensitivities using the matter-wave interferometer based on the Stern-Gerlach setup. As an application we will consider the mesoscopic interference for metric and curvature and gravitational-wave detection scheme [R. J. Marshman, Mesoscopic interference for metric and curvature (MIMAC) & gravitational wave detection, New J. Phys. 22, 083012 (2020)NJOPFM1367-263010.1088/1367-2630/ab9f6c] and quantify its sensitivity to gravity gradients using frequency-space analysis. We will consider objects near Earth-based experiments and space debris in proximity of satellites and estimate the minimum detectable mass of the object as a function of their distance, velocity, and orientation