Development and initial validation of a postal survey evaluation of community pharmacists' opinion regarding falsified (counterfeit) medicines in Hampshire (UK)

Context: Falsified-medicines pose a worldwide problem to patients, healthcare professionals, pharmaceutical companies, and governments. Community pharmacists are usually the last points of contact with patients and can protect them by quarantining falsified medicines. Hence, their opinions are valuable in exploring how the profession can combat this. Aims: To explore the opinion of pharmacists with respect to falsified medicines. Methods: A postal survey was developed and distributed to 359 pharmacies via the local pharmaceutical committee in Hampshire, UK. Descriptive statistics and hypothesis testing was conducted. Hypothesis testing (95% CI, α = 0.05) will be conducted to identify any gender differences, differences based on years of experience and differences based on number of working hours per week. Results: A 14% response rate was achieved. Pharmacists surveyed believe that falsified-medicines pose a significant problem to the profession on a five-point Likert scale (4.02 ± 1.078). A pharmacist’s intervention can prevent or disrupt the supply to patients (4.12 ± 0.824) and training courses can improve pharmacist’s knowledge (4.06 ± 0.843). Pharmacists are not confident and capable in identifying falsified-medicines (2.62 ± 1.105). This is surprising and unexpected because pharmacists are medicines-expert. A 10-item scale is validated (72.2% Cronbach alpha). Conclusions: Falsified-medicines pose a small but significant and growing challenge to the profession. There is underutilization of the high street community pharmacist in identifying falsified-medicines. Healthcare professionals should report suspect counterfeits to the MHRA

Telemonitoring in subjects with newly diagnosed heart failure with reduced ejection fraction: From clinical research to everyday practice

© 2018, The Author(s) 2018. Introduction: Heart failure is increasingly common, and characterised by frequent admissions to hospital. To try and reduce the risk of hospitalisation, techniques such as telemonitoring (TM) may have a role. We wanted to determine if TM in patients with newly diagnosed heart failure and ejection fraction < 40% reduces the risk of readmission or death from any cause in a ‘real-world’ setting. Methods: This is a retrospective study of 124 patients (78.2% male; 68.6 ± 12.6 years) who underwent TM and 345 patients (68.5% male; 70.2 ± 10.7 years) who underwent the usual care (UC). The TM group were assessed daily by body weight, blood pressure and heart rate using electronic devices with automatic transfer of data to an online database. Follow-up was 12 months. Results: Death from any cause occurred in 8.1% of the TM group and 19% of the UC group (p = 0.002). There was no difference between the two groups in all-cause hospitalisation, either in the number of subjects hospitalised (p = 0.7) or in the number of admissions per patient (p = 0.6). There was no difference in the number of heart-failure-related readmissions per person between the two groups (p = 0.5), but the number of days in hospital per person was higher in the UC group (p = 0.03). Also, there were a significantly greater number of days alive and out of hospital for the patients in the TM group compared with the UC group (p = 0.0001). Discussion: TM is associated with lower any-cause mortality and also has the potential to reduce the number of days lost to hospitalisation and death

Human Resource Planning: Sector Specific Considerations

The aim of human resource planning (HRP) is to have the right people in the right place at the right time. While the public sector has moved from a civil service to a human resources paradigm, the literature indicates a lack of successful HRP implementation in this sector. This paper explores key issues around HRP in the public sector. Evidence suggests that effective HRP is critical to meeting internal and external organisational challenges, however, relevant processes and practices do not seem to be strategic or integrated in the public sector. If not addressed, the absence of HRP in the public sector can lead to poor organisational performance, increased costs, a lack of continuity and other negative impacts

An integrated circuit for chip-based analysis of enzyme kinetics and metabolite quantification

We have created a novel chip-based diagnostic tools based upon quantification of metabolites using enzymes specific for their chemical conversion. Using this device we show for the first time that a solid-state circuit can be used to measure enzyme kinetics and calculate the Michaelis-Menten constant. Substrate concentration dependency of enzyme reaction rates is central to this aim. Ion-sensitive field effect transistors (ISFET) are excellent transducers for biosensing applications that are reliant upon enzyme assays, especially since they can be fabricated using mainstream microelectronics technology to ensure low unit cost, mass-manufacture, scaling to make many sensors and straightforward miniaturisation for use in point-of-care devices. Here, we describe an integrated ISFET array comprising 216 sensors. The device was fabricated with a complementary metal oxide semiconductor (CMOS) process. Unlike traditional CMOS ISFET sensors that use the Si3N4 passivation of the foundry for ion detection, the device reported here was processed with a layer of Ta2O5 that increased the detection sensitivity to 45 mV/pH unit at the sensor readout. The drift was reduced to 0.8 mV/hour with a linear pH response between pH 2 – 12. A high-speed instrumentation system capable of acquiring nearly 500 fps was developed to stream out the data. The device was then used to measure glucose concentration through the activity of hexokinase in the range of 0.05 mM – 231 mM, encompassing glucose’s physiological range in blood. Localised and temporal enzyme kinetics of hexokinase was studied in detail. These results present a roadmap towards a viable personal metabolome machine

A colorimetric CMOS-based platform for rapid total serum cholesterol quantification

Elevated cholesterol levels are associated with a greater risk of developing cardiovascular disease and other illnesses, making it a prime candidate for detection on a disposable biosensor for rapid point of care diagnostics. One of the methods to quantify cholesterol levels in human blood serum uses an optically mediated enzyme assay and a bench top spectrophotometer. The bulkiness and power hungry nature of the equipment limits its usage to laboratories. Here, we present a new disposable sensing platform that is based on a complementary metal oxide semiconductor process for total cholesterol quantification in pure blood serum. The platform that we implemented comprises readily mass-manufacturable components that exploit colorimetric changes of cholesterol oxidase and cholesterol esterase reactions. We have shown that our quantification results are comparable to that obtained by a bench top spectrophotometer. Using the implemented device, we have measured cholesterol concentration in human blood serum as low as 29 μM with a limit of detection at 13 μM, which is approximately 400 times lower than average physiological range, implying that our device also has the potential to be used for applications that require greater sensitivity

Phylogenetics and Mitogenome Organisation in Black Corals (Anthozoa: Hexacorallia: Antipatharia): An Order-Wide Survey Inferred From Complete Mitochondrial Genomes

Black corals (Anthozoa: Antipatharia) are an ecologically and culturally important group of deep-sea cnidarians. However, as the majority of species inhabit depths >50 m, they are relatively understudied. The inaccessibility of well-preserved tissue for species of interest has limited the scope of molecular analysis, and as a result only a small number of antipatharian mitochondrial genomes have been published. Using next generation sequencing, 18 complete and five partial antipatharian mitochondrial genomes were assembled, increasing the number of complete mitochondrial genomes to 22. This includes species from six antipatharian families, four of which were previously unrepresented, enabling the first family-level, full mitochondrial gene analysis over the whole order. The circular mitogenomes ranged in size from 17,681 to 21,669 bp with the large range in size due to the addition of an intron in COX1 in some species and size variation of intergenic regions. All mitogenomes contained the genes standard to all hexacoral mitogenomes (13 protein coding genes, two rRNAs and two tRNAs). The only difference in gene content is the presence of the COX1 intron in five families. The most variable mitochondrial gene is ND4 which may have implications for future barcoding studies. Phylogenetic analysis confirms that Leiopathidae is sister to all other families. Families Antipathidae, Cladopathidae and Schizopathidae are polyphyletic, supporting previous studies that call for a taxonomic revision

Connexin 43 is overexpressed in human fetal membrane defects after fetoscopic surgery

This project was funded by the RoseTrees Trust (M400, TTC), the QMUL Life Sciences Initiative, Institutional Strategic Support Fund from the Wellcome Trust (105626/Z/14/Z, TTC) and supported by researchers at the National Institute for Health Research, University College London Hospitals Biomedical Research Centre (ALD)

Mermin-Ho vortex in ferromagnetic spinor Bose-Einstein condensates

The Mermin-Ho and Anderson-Toulouse coreless non-singular vortices are demonstrated to be thermodynamically stable in ferromagnetic spinor Bose-Einstein condensates with the hyperfine state F=1. The phase diagram is established in a plane of the rotation drive vs the total magnetization by comparing the energies for other competing non-axis-symmetric or singular vortices. Their stability is also checked by evaluating collective modes.Comment: 4 pages, 4 figure