Reduction of 4-nitrophenol Mediated by Silver Nanoparticles Synthesized using Aqueous Leaf Extract of Peronema canescens

In this study, we developed an alternative of 4-nitrophenol reduction mediated by silver nanoparticles (AgNPs) which was synthesized using aqueous extract of the Peronema canescens leaf through an eco-friendly approach. The reducing 4-nitrophenol to 4-aminophenol mediated by AgNPS in the presence of sodium borohydride as a hydrogen source proceeded rapidly at room temperature without any additional treatments. The AgNPS synthesis was simple and was carried out under mild conditions. Ultraviolet–visible spectroscopy was performed to examine the properties of the obtained AgNPs, which displayed an absorption peak at 431 nm. A transmission electron microscopy analysis revealed that the AgNPs were spherical in shape and had an average particle size of 19 nm as determined by particle size analysis. Copyright © 2021 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0).

Microorganisms on surface culture of injection port of IV sets and its implication to infection control

Nosocomial infection is a disease caused by a pathogenic agent that is acquired during a patient’s hospitalization or treatment inside another health care facility. The said infection can be caused by microorganisms. These microorganisms may already be present in the patient's body or may come from the environment, contaminated hospital equipment; An intravenous (IV) set used during IV therapy is one example of the possible materials containing these microorganisms. The main purpose of this study is to determine the presence of microorganisms on injections ports of IV sets before and after disinfection whenadministering IV medications in the patients admitted to the medicine wards of Hospital X and Y. Presence of microorganisms despite disinfection may pose risk to patients through the entry of bacteria upon injection through the port. Thirty swab samples were obtained from each hospital. Swab samples were then isolated on nutrient agar plates. Hospital Y samples yielded no bacterial isolates whereas all 30 samples in Hospital X showed bacterial isolates. Swab samples underwent gram-staining to distinguish between gram-positive and gram-negative bacteria. Streptococcus species and Staphylococcus species which are classified as grampositive bacteria were among the bacterial species identified before and after disinfection and were found on all the samples obtained from Hospital X. Based on the findings of this study, adherence to infection controlprocedures were not well established to reduce or eliminate microorganisms on injection ports in Hospital X that may cause Nosocomial infections. In line with these, it is highly recommended that proper infection control and maintenance procedures should be strictly enforced to reduce, if not eliminate themicroorganisms on injection port which are possible causes of Nosocomial infections and may threaten thempatients’ healt

Tumour micro-environment elicits innate resistance to RAF inhibitors through HGF secretion.

Drug resistance presents a challenge to the treatment of cancer patients. Many studies have focused on cell-autonomous mechanisms of drug resistance. By contrast, we proposed that the tumour micro-environment confers innate resistance to therapy. Here we developed a co-culture system to systematically assay the ability of 23 stromal cell types to influence the innate resistance of 45 cancer cell lines to 35 anticancer drugs. We found that stroma-mediated resistance is common, particularly to targeted agents. We characterized further the stroma-mediated resistance of BRAF-mutant melanoma to RAF inhibitors because most patients with this type of cancer show some degree of innate resistance. Proteomic analysis showed that stromal cell secretion of hepatocyte growth factor (HGF) resulted in activation of the HGF receptor MET, reactivation of the mitogen-activated protein kinase (MAPK) and phosphatidylinositol-3-OH kinase (PI(3)K)-AKT signalling pathways, and immediate resistance to RAF inhibition. Immunohistochemistry experiments confirmed stromal cell expression of HGF in patients with BRAF-mutant melanoma and showed a significant correlation between HGF expression by stromal cells and innate resistance to RAF inhibitor treatment. Dual inhibition of RAF and either HGF or MET resulted in reversal of drug resistance, suggesting RAF plus HGF or MET inhibitory combination therapy as a potential therapeutic strategy for BRAF-mutant melanoma. A similar resistance mechanism was uncovered in a subset of BRAF-mutant colorectal and glioblastoma cell lines. More generally, this study indicates that the systematic dissection of interactions between tumours and their micro-environment can uncover important mechanisms underlying drug resistance

Future of Leadership in Healthcare: Enabling Complexity Dynamics Across Levels

Healthcare is one of the world\u27s fastest-growing industries with over $10 trillion in projected spending by 2022 (Deloitte, 2019). Despite this growth, the industry faces several challenges including rising costs, care delivery outside urban areas and to marginalized populations, digital transformation, and regulatory compliance. To navigate these challenges and capitalize on growth opportunities, leaders must build and manage complex dynamics occurring in the space between the organization and a wide range of internal and external stakeholders. In this symposium, we address this issue by assembling a group of scholars trained in healthcare management, strategy, leadership, and organizational theory to discuss the role of leaders in the future of healthcare. Through a series of presentations, we will illustrate how leaders in healthcare enable complexity dynamics across organizational levels to drive desired outcomes. In doing so, we bring to the forefront the multilevel and complex nature of healthcare leadership and invite innovative thinking about leadership for the future of healthcare. Building Extra-Organizational Adaptive Networks: Complexity Leadership in Healthcare Presenter: Erin Bass; U. of Nebraska, Omaha Presenter: Ivana Milosevic; College of Charleston Physician CEOs & Patient Safety Presenter: Geoffrey Silvera; Auburn U. Presenter: Timothy J. Vogus; Vanderbilt U. Presenter: Jonathan Clark; U. of Texas At San Antonio Management Practices of Under-Resourced Nursing Homes Presenter: Justin Lord; Louisiana State U. Shreveport Stitching Ties: Team Performance in the Connected Organization Presenter: John Hollingsworth; U. of Michigan Presenter: Jason Owen-Smith; U. of Michigan, Ann Arbor Presenter: Dennie Kim; U. of Virginia Darden School of Business Presenter: Marlon DeMarcie Twyman; U. of Southern California, Annenberg School for Communication and Journalism Identifying Healthcare\u27s Future Leaders: Development of a Leadership Potential Model for Healthcare Presenter: Kevin S. Groves; Pepperdine U. Presenter: Ann E. Feyerherm; Pepperdine Graziadio Business Schoo

Tumor microenvironment induces innate RAF-inhibitor resistance through HGF secretion

Drug resistance remains a vexing problem in the treatment of cancer patients. While many studies have focused on cell autonomous mechanisms of drug resistance, we hypothesized that the tumor microenvironment may confer innate resistance to therapy. Here we developed a co-culture system to systematically assay the ability of 23 stromal cell types to influence the innate resistance of 45 cancer cell lines to 35 anti-cancer drugs. We found that stroma-mediated resistance is surprisingly common – particularly to targeted agents. We further characterized the stroma-mediated resistance of BRAF-mutant melanoma to RAF inhibition because most of these patients exhibit some degree of innate resistance1-4. Proteomic analysis showed that stromal secretion of the growth factor hepatocyte growth factor (HGF) resulted in activation of the HGF receptor MET, reactivation of the MAPK and PI3K/AKT pathways, and immediate resistance to RAF inhibition. Immunohistochemistry confirmed stromal HGF expression in patients with BRAF-mutant melanoma and a statistically significant correlation between stromal HGF expression and innate resistance to treatment. Dual inhibition of RAF and MET resulted in reversal of drug resistance, suggesting RAF/MET combination therapy as a potential therapeutic strategy for BRAF-mutant melanoma. A similar resistance mechanism was uncovered in a subset of BRAF-mutant colorectal and glioblastoma cell lines. More generally, these studies indicate that the systematic dissection of tumor-microenvironment interactions may reveal important mechanisms underlying drug resistance

Beyond chance? The persistence of performance in online poker

A major issue in the widespread controversy about the legality of poker and the appropriate taxation of winnings is whether poker should be considered a game of skill or a game of chance. To inform this debate we present an analysis into the role of skill in the performance of online poker players, using a large database with hundreds of millions of player-hand observations from real money ring games at three different stakes levels. We find that players whose earlier profitability was in the top (bottom) deciles perform better (worse) and are substantially more likely to end up in the top (bottom) performance deciles of the following time period. Regression analyses of performance on historical performance and other skill-related proxies provide further evidence for persistence and predictability. Simulations point out that skill dominates chance when performance is measured over 1,500 or more hands of play

Disease-specific survival for limited-stage small-cell lung cancer affected by statistical method of assessment

BACKGROUND: In general, prognosis and impact of prognostic/predictive factors are assessed with Kaplan-Meier plots and/or the Cox proportional hazard model. There might be substantive differences from the results using these models for the same patients, if different statistical methods were used, for example, Boag log-normal (cure-rate model), or log-normal survival analysis. METHODS: Cohort of 244 limited-stage small-cell lung cancer patients, were accrued between 1981 and 1998, and followed to the end of 2005. The endpoint was death with or from lung cancer, for disease-specific survival (DSS). DSS at 1-, 3- and 5-years, with 95% confidence limits, are reported for all patients using the Boag, Kaplan-Meier, Cox, and log-normal survival analysis methods. Factors with significant effects on DSS were identified with step-wise forward multivariate Cox and log-normal survival analyses. Then, DSS was ascertained for patients with specific characteristics defined by these factors. RESULTS: The median follow-up of those alive was 9.5 years. The lack of events after 1966 days precluded comparison after 5 years. DSS assessed by the four methods in the full cohort differed by 0–2% at 1 year, 0–12% at 3 years, and 0–1% at 5 years. Log-normal survival analysis indicated DSS of 38% at 3 years, 10–12% higher than with other methods; univariate 95% confidence limits were non-overlapping. Surgical resection, hemoglobin level, lymph node involvement, and superior vena cava (SVC) obstruction significantly impacted DSS. DSS assessed by the Cox and log-normal survival analysis methods for four clinical risk groups differed by 1–6% at 1 year, 15–26% at 3 years, and 0–12% at 5 years; multivariate 95% confidence limits were overlapping in all instances. CONCLUSION: Surgical resection, hemoglobin level, lymph node involvement, and superior vena cava (SVC) obstruction all significantly impacted DSS. Apparent DSS for patients was influenced by the statistical methods of assessment. This would be clinically relevant in the development or improvement of clinical management strategies