Trace element distribution and arsenic speciation in toenails as affected by external contamination and evaluation of a cleaning protocol

Open Access via the ACS agreement This research was performed on the XFM beamline at the Australian Synchrotron, part of ANSTO. Special thanks to Prof Dr Rajiv Chowdhury (University of Florida, Miami, USA) for the financial and academic support as scientific manager of the BRAVE study while at the University of Cambridge (Cambridge, UK). We gratefully acknowledge the contributions of all BRAVE study participants, the scientific staff of the collaborating centre icddr,b and the recruitment centre NICVD in Bangladesh. Epidemiological fieldwork in BRAVE has been supported by grants to the coordination centre for BRAVE at the British Heart Foundation (BHF) Cardiovascular Epidemiology Unit (CEU) at the University of Cambridge. The CEU is underpinned by programme grants from the: BHF (RG/13/13/30194; RG/18/13/33946), UK Medical Research Council (MR/L003120/1) and NIHR Cambridge Biomedical Research Centre (BRC-1215-20014; NIHR203312) [*]. *The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.Peer reviewe

Many Hands Lighter Work? Deciphering the Relationship between Adverse Working Conditions and Organization Citizenship Behaviours in Small and Medium-sized Enterprises during a Severe Economic Crisis

What is the relationship between adverse working conditions and employees’ organizational citizenship behaviour (OCB) in small and medium-sized enterprises (SMEs) operating under a severe economic crisis? To address this question, a survey of 312 front-line workers was undertaken in 62 Greek SMEs − an instrumental setting where the current deterioration of working conditions is acute. Our contribution is twofold. First, we develop and test a scale for measuring adverse working conditions. Second, we decipher the extent to which such conditions relate to organizational and individual aspects of OCB, considering job satisfaction's mediating role. Through this research we extend the OCB literature within the context of SMEs operating under severe economic crisis and highlight the implications for managing human resources in SMEs, a sector conspicuous for its socio-economic significance and its vulnerability during economic downturns

Investigating the effects of smart technology on customer dynamics and customer experience

Increased use of smart technologies by customers is leading to recognition of their influence on the shopping experiences of customers by practitioners. However, the academic literature fails to acknowledge the influence of smart technology usage, combined with behavioural intention of the customer, on the dynamics and experience of customers. This research utilises explanatory research at the preliminary stage to examine this phenomenon in a retail setting. A conceptual framework was created, based on the scholarly knowledge available in extant literature, and was tested using a survey of a convenience sample of 330 consumers shopping in a high-end retail store in London, United Kingdom. Structural Equation Modelling (SEM) via AMOS was employed to test the proposed model. This study contributes to technology adoption based consumer behaviour literature, by explaining the ability of learning commitment to drive the participation of an individual, but its inability to influence their behavioural intention. Findings of this research also reflect on the role of customer dynamics and customer experience in embracing innovative application of smart technologies in a retail setting. The results and implications included in our study also contribute to the understanding of the determinants that affect customer dynamics and customer experience when making use of smart technologies

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Trace Element Distribution and Arsenic Speciation in Toenails as Affected by External Contamination and Evaluation of a Cleaning Protocol.

Publication status: PublishedTrace element concentrations in toenail clippings have increasingly been used to measure trace element exposure in epidemeological research. Conventional methods such as inductively coupled plasma mass spectrometry (ICP-MS) and high-performance liquid chromatography ICP-MS (HPLC-ICP-MS) are commonly used to measure trace elements and their speciation in toenails. However, the impact of the removal of external contamination on trace element quantification has not been thoroughly studied. In this work, the microdistribution of trace elements (As, Ca, Co, Cu, Fe, K, Mn, Ni, Rb, S, Sr, Ti, and Zn) in dirty and washed toenails and the speciation of As in situ in toenails were investigated using synchrotron X-ray fluorescence microscopy (XFM) and laterally resolved X-ray absorption near edge spectroscopy (XANES). XFM showed different distribution patterns for each trace element, consistent with their binding properties and nail structure. External (terrestrial) contamination was identified and distinguished from the endogenous accumulation of trace elements in toenails─contaminated areas were characterized by the co-occurrence of Co, Fe, and Mn with elements such as Ti and Rb (i.e., indicators of terrestrial contamination). The XANES spectra showed the presence of one As species in washed toenails, corresponding to As bound to sulfhydryl groups. In dirty specimens, a mixed speciation was found in localized areas, containing AsIII-S species and AsV species. ArsenicV is thought to be associated with surface contamination and exogenous As. These findings provide new insights into the speciation of arsenic in toenails, the microdistribution of trace elements, and the effectiveness of a cleaning protocol in removing external contamination

Nurses’ Role in Implementing and Sustaining Acute Telemedicine:A Mixed-Methods, Pre-Post Design Using an Extended Technology Acceptance Model

PURPOSE: Technology-based systems like telemedicine are frequently being implemented into healthcare settings, impacting clinician practices. Little is known about factors influencing acute telemedicine uptake, if factors differ across time, or between nurses and non-nurses. DESIGN: A mixed-methods, pre-post design with implementation of a new acute stroke telemedicine service. METHODS: A survey based on an extended Technology Acceptance Model (TAM) was administered to clinicians involved in acute stroke care at 16 regional hospitals (2014-2017). Open-ended questions postimplementation (at 6 months) included strengths of the program and areas to improve. Subsequently, a secondary analysis of nurses' semistructured interviews at the first telemedicine site (2010-2011) was completed to provide greater explanatory detail. FINDINGS: Surveys were completed by nurses (preimplementation n = 77, postimplementation n = 92) and non-nurses (pre n = 90, post n = 44). Preimplementation, perceived usefulness was the only significant predictor of intending to use telemedicine for nurses, while perceived ease of use and social influence were significant for non-nurses. Postimplementation, perceived usefulness was significant for both groups, as was facilitating conditions for nurses. Specific examples aligned to TAM categories from our detailed interviews (n = 11 nurses) included perceived usefulness (improved clinical support and patient care), perceived ease of use (technical, clinical aspects), facilitating conditions (setting, education, confidence), and social influence (working relationships). CONCLUSIONS: Important factors for acute stroke telemedicine varied between nurses and non-nurses, and changed after implementation. The benefits of telemedicine should be emphasized to nurses. Preimplementation, more non-nurses wanted systems to be easy. Support in clinical, technical, and relationship aspects of telemedicine consultations is required. CLINICAL RELEVANCE: Nurses are influential in implementing acute telemedicine, which is complex, with clinical and technical aspects entwined. Evidence-based implementation strategies must be tailored over time, and between nurses and non-nurses, to ensure initial uptake and ongoing use