Feeding tube securement in critical illness: Implications for safety

© 2018 MA Healthcare Ltd Over 50% of tape-secured feeding tubes are inadvertently lost. The impact of nasal bridle securement on nasogastric (NG) and nasointestinal (NI) tube loss, outcome and duration of use was determined from 1 October 2014 (NG) and 1 January 2010 respectively to 31 December 2017. From this and published data, the potential impact of nasal bridles on major complications was determined. Use of nasal bridles was independently associated with: an 80% reduction in inadvertent NI tube loss (odds ratio (OR): 95% confidence interval (CI): 0.2: 0.12-0.33,

Hazardous cyanobacteria integrity response to velocity gradient and powdered activated carbon in water treatment plants.

Although some studies have investigated the impact caused by chemicals used on water treatment (coagulants and oxidants) on cyanobacteria integrity, the isolated effect of shear stress during coagulation is still not fully understood. This study evaluated the impact of different velocity gradients, mixing times, and the addition of powdered activated carbon (PAC) on the integrity of Microcystis aeruginosa, Raphidiopsis raciborskii, and Dolichospermum circinale, known producers of toxin and taste and odor (T&O) compounds. No association was found between R. raciborskii cell lysis and velocity gradient, with or without PAC, demonstrating the high resilience of this taxon to shear stress. In contrast, an association was found for M. aeruginosa at the highest velocity gradient evaluated (1000 s-1) and for D. circinale above the lowest velocity gradient studied (600 s-1). After PAC addition, there was a reduction in the chances of finding M. aeruginosa intact cells above velocity gradient 800 s-1 at 45 s, while D. circinale show cell lysis in all the scenarios expect at 600 s-1 and 10 s of agitation. The additional impact of PAC on cell lysis may lead to more release of metabolites and shows the need to adjust the hydraulic conditions in the rapid mixing stage, especially when more “fragile” cyanobacteria are present. Neither cyanobacterial cell size nor morphology was shown to be relevant to shear stress sensitivity, indicating that cell wall composition might have been an important factor in controlling cell lysis

Análise de dados categóricos de integridade celular de cianobactérias.

The techniques used in cyanobacterial cell integrity/viability studies provide two outcomes: intact cells or not. These categorical and dichotomous values often make statistical analysis of the results difficult. In this context, the aim of this paper is to present two methodologies for the analysis of these data, showing a detailed sequence of procedures that allow analyzing, with the necessary statistical accuracy, categorized cell integrity data. For this, 3600-records database was used with the results of cellular integrity of Dc and Rr. Among the results, the traditional approach proved appropriate to identify the association between causes and effect respecting the specific characteristics of each species and the odds ratio (OR) calculation allowed to measure the associations. In this multivariate approach, the estimated OR requires a differentiated interpretation in relation to the traditional approach since the estimates are adjusted for the effect of all other variables of the model

In situ H2O2 treatment of blue-green algae contaminated reservoirs causes significant improvement in drinking water treatability.

The evaluation of water quality improvement brought about by in situ treatment of eutrophic water bodies, especially those used for human supply, is a challenging task since each water system responds differently. To overcome this challenge, we applied exploratory factor analysis (EFA) to understand the effects of using hydrogen peroxide (H2O2) on eutrophic water used as a drinking water supply. This analysis was used to identify the main factors that described the water treatability after exposing blue-green algae (cyanobacteria) contaminated raw water to H2O2 at both 5 and 10 mg L-1. Cyanobacterial chlorophyll-a was undetectable following the application of both concentrations of H2O2 after four days, while not causing relevant changes to green algae and diatoms chlorophyll-a concentrations. EFA demonstrated that the main factors affected by both H2O2 concentrations were turbidity, pH and cyanobacterial chlorophyll-a concentration, which are important variables for a drinking water treatment plant. The H2O2 caused significant improvement in water treatability by decreasing those three variables. Finally, the use of EFA was demonstrated to be a promising tool in identifying which limnological variables are most relevant concerning the efficacy of water treatment, which in turn can make water quality monitoring more efficient and less costly

Synthesis and characterization of the tetranuclear iron(III) complex of a new asymmetric multidentate ligand. A structural model for purple acid phosphatases

The ligand, 2-((2-hydroxy-5-methyl-3-((pyridin-2-ylmethylamino)methyl)benzyl)(2-hydroxybenzyl)amino)acetic acid (H(3)HPBA), which contains a donor atom set that mimics that of the active site of purple acid phosphatase is described. Reaction of H(3)HPBA with iron(III) or iron(II) salts results in formation of the tetranuclear complex, [Fe-4(HPBA)(2)(OAc)(2)(mu-O)(mu-OH)(OH2)(2)]ClO4 center dot 5H(2)O. X-Ray structural analysis reveals the cation consists of four iron(III) ions, two HPBA(3-) ligands, two bridging acetate ligands, a bridging oxide ion and a bridging hydroxide ion. Each binucleating HPBA(3-) ligand coordinates two structurally distinct hexacoordinate iron(III) ions. The two metal ions coordinated to a HPBA(3-) ligand are linked to the two iron(III) metal ions of a second, similar binuclear unit by intramolecular oxide and hydroxide bridging moieties to form a tetramer. The complex has been further characterised by elemental analysis, mass spectrometry, UV-vis and MCD spectroscopy, X- ray crystallography, magnetic susceptibility measurements and variable-temperature Mossbauer spectroscopy

Exploring digital biomarkers of illness activity in mood episodes:Hypotheses generating and model development study

Background: Depressive and manic episodes within bipolar disorder (BD) and major depressive disorder (MDD) involve altered mood, sleep, and activity, alongside physiological alterations wearables can capture. Objective: Firstly, we explored whether physiological wearable data could predict (aim 1) the severity of an acute affective episode at the intra-individual level and (aim 2) the polarity of an acute affective episode and euthymia among different individuals. Secondarily, we explored which physiological data were related to prior predictions, generalization across patients, and associations between affective symptoms and physiological data.Methods: We conducted a prospective exploratory observational study including patients with BD and MDD on acute affective episodes (manic, depressed, and mixed) whose physiological data were recorded using a research-grade wearable (Empatica E4) across 3 consecutive time points (acute, response, and remission of episode). Euthymic patients and healthy controls were recorded during a single session (approximately 48 h). Manic and depressive symptoms were assessed using standardized psychometric scales. Physiological wearable data included the following channels: acceleration (ACC), skin temperature, blood volume pulse, heart rate (HR), and electrodermal activity (EDA). Invalid physiological data were removed using a rule-based filter, and channels were time aligned at 1-second time units and segmented at window lengths of 32 seconds, as best-performing parameters. We developed deep learning predictive models, assessed the channels’ individual contribution using permutation feature importance analysis, and computed physiological data to psychometric scales’ items normalized mutual information (NMI). We present a novel, fully automated method for the preprocessing and analysis of physiological data from a research-grade wearable device, including a viable supervised learning pipeline for time-series analyses.Results: Overall, 35 sessions (1512 hours) from 12 patients (manic, depressed, mixed, and euthymic) and 7 healthy controls (mean age 39.7, SD 12.6 years; 6/19, 32% female) were analyzed. The severity of mood episodes was predicted with moderate (62%-85%) accuracies (aim 1), and their polarity with moderate (70%) accuracy (aim 2). The most relevant features for the former tasks were ACC, EDA, and HR. There was a fair agreement in feature importance across classification tasks (Kendall W=0.383). Generalization of the former models on unseen patients was of overall low accuracy, except for the intra-individual models. ACC was associated with “increased motor activity” (NMI>0.55), “insomnia” (NMI=0.6), and “motor inhibition” (NMI=0.75). EDA was associated with “aggressive behavior” (NMI=1.0) and “psychic anxiety” (NMI=0.52).Conclusions: Physiological data from wearables show potential to identify mood episodes and specific symptoms of mania and depression quantitatively, both in BD and MDD. Motor activity and stress-related physiological data (EDA and HR) stand out as potential digital biomarkers for predicting mania and depression, respectively. These findings represent a promising pathway toward personalized psychiatry, in which physiological wearable data could allow the early identification and intervention of mood episodes

Giving an Account of One’s Pain in the Anthropological Interview

In this paper, I analyze the illness stories narrated by a mother and her 13-year-old son as part of an ethnographic study of child chronic pain sufferers and their families. In examining some of the moral, relational and communicative challenges of giving an account of one’s pain, I focus on what is left out of some accounts of illness and suffering and explore some possible reasons for these elisions. Drawing on recent work by Judith Butler (Giving an Account of Oneself, 2005), I investigate how the pragmatic context of interviews can introduce a form of symbolic violence to narrative accounts. Specifically, I use the term “genre of complaint” to highlight how anthropological research interviews in biomedical settings invoke certain typified forms of suffering that call for the rectification of perceived injustices. Interview narratives articulated in the genre of complaint privilege specific types of pain and suffering and cast others into the background. Giving an account of one’s pain is thus a strategic and selective process, creating interruptions and silences as much as moments of clarity. Therefore, I argue that medical anthropologists ought to attend more closely to the institutional structures and relations that shape the production of illness narratives in interview encounters

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements