Initiatives to increase colonoscopy capacity - is there an impact on polyp detection? A UK National Endoscopy Database analysis

\ua9 2023 Georg Thieme Verlag. All rights reserved.Background Mismatch between routine endoscopy capacity and demand means centres often implement initiatives to increase capacity, such as weekend working or using locums/agency staff (insourcing). There are concerns about whether increasing workload to meet demand could negatively impact quality. We investigated polyp detection, a key quality metric, in weekend vs weekday and insourced vs standard procedures using data from the UK National Endoscopy Database (NED). Methods We conducted a national retrospective cross-sectional study of diagnostic colonoscopies undertaken 01/01-04/04/2019. The primary outcome was mean number of polyps (MNP) and the secondary, polyp detection rate (PDR). Multi-level mixed-effect regression, fitting endoscopist as a random effect, was used to examine associations between procedure day (weekend/weekday) and type (insourced/standard) and these outcomes, adjusting for patient age, sex and indication. Results 92,879 colonoscopies (weekends: 19,977 (21.5%); insourced: 9,909 (10.7%)) were performed by 2,496 endoscopists. For weekend colonoscopies, patients were more often female and less often having screening-related procedures; for insourced colonoscopies, patients were younger and less often attending for screening-related procedures (all p<0.05). Case-mix adjusted MNP was significantly lower for weekend vs weekday (IRR=0.86, (95%CI 0.83-0.89)) and for insourced vs standard procedures (IRR=0.91, (95%CI 0.87-0.95)). MNP was highest for weekday standard procedures and lowest for weekend insourced procedures, but there was no interaction between procedure day and type. Similar associations were found for PDR. Conclusions Strategies to increase colonoscopy capacity may have adverse effects on polyp detection. Routine quality monitoring should be undertaken following such initiatives. Meantime, reasons for this unwarranted variation require investigation

Methanol diffusion and dynamics in zeolite H-ZSM-5 probed by quasi-elastic neutron scattering and classical molecular dynamics simulations

Zeolite ZSM-5 is a key catalyst in commercially relevant processes including the widely studied methanol to hydrocarbon reaction, and molecular diffusion in zeolite pores is known to be a crucial factor in controlling catalytic reactions. Here, we present critical analyses of recent quasi-elastic neutron scattering (QENS) data and complementary molecular dynamics (MD) simulations. The QENS experiments show that the nature of methanol diffusion dynamics in ZSM-5 pores is dependent both on the Si/Al ratio (11, 25, 36, 40 and 140), which determines the Brønsted acid site density of the zeolite, and that the nature of the type of motion observed may vary qualitatively over a relatively small temperature range. At 373 K, on increasing the ratio from 11 to 140, the observed mobile methanol fraction increases and the nature of methanol dynamics changes from rotational (in ZSM-5 with Si/Al of 11) to translational diffusion. The latter is either confined localized diffusion within a pore in zeolites with ratios up to 40 or non-localized, longer-range diffusion in zeolite samples with the ratio of 140. The complementary MD simulations conducted over long time scales (1 ns), which are longer than those measured in the present study by QENS (≈1-440 ps), at 373 K predict the occurrence of long-range translational diffusion of methanol in ZSM-5, independent of the Si/Al ratios (15, 47, 95, 191 and siliceous MFI). The rate of diffusion increases slightly by increasing the ratio from 15 to 95 and thereafter does not depend on zeolite composition. Discrepancies in the observed mobile methanol fraction between the MD simulations (100% methanol mobility in ZSM-5 pores across all Si/Al ratios) and QENS experiments (for example, ≈80% immobile methanol in ZSM-5 with Si/Al of 11) are attributed to the differences in time resolutions of the techniques. This perspective provides comprehensive information on the effect of acid site density on methanol dynamics in ZSM-5 pores and highlights the complementarity of QENS and MD, and their advantages and limitations. This article is part of the theme issue 'Exploring the length scales, timescales and chemistry of challenging materials (Part 2)'

Hydrogenation of CO on a silica surface: an embedded cluster approach

The sequential addition of H atoms to CO adsorbed on a siliceous edingtonite surface is studied with an embedded cluster approach, using density functional theory for the quantum mechanical (QM) cluster and a molecular force field for the molecular mechanical (MM) cluster. With this setup, calculated QM/MM adsorption energies are in agreement with previous calculations employing periodic boundary conditions. The catalytic effect of the siliceous edingtonite (100) surface on CO hydrogenation is assessed because of its relevance to astrochemistry. While adsorption of CO on a silanol group on the hydroxylated surface did not reduce the activation energy for the reaction with a H atom, a negatively charged defect on the surface is found to reduce the gas phase barriers for the hydrogenation of both CO and H2C = O. The embedded cluster approach is shown to be a useful and flexible tool for studying reactions on (semi-)ionic surfaces and specific defects thereon. The methodology presented here could easily be applied to study reactions on silica surfaces that are of relevance to other scientific areas, such as biotoxicity of silica dust and geochemistry

Tailoring Gold Nanoparticle Characteristics and the Impact on Aqueous-Phase Oxidation of Glycerol

Poly(vinyl alcohol) (PVA)-stabilized Au nanoparticles (NPs) were synthesized by colloidal methods in which temperature variations (−75 to 75 °C) and mixed H2O/EtOH solvent ratios (0, 50, and 100 vol/vol) were used. The resulting Au NPs were immobilized on TiO2 (P25), and their catalytic performance was investigated for the liquid phase oxidation of glycerol. For each unique solvent system, there was a systematic increase in the average Au particle diameter as the temperature of the colloidal preparation increased. Generation of the Au NPs in H2O at 1 °C resulted in a high observed activity compared with current Au/TiO2 catalysts (turnover frequency = 915 h–1). Interestingly, Au catalysts with similar average particle sizes but prepared under different conditions had contrasting catalytic performance. For the most active catalyst, aberration-corrected high angle annular dark field scanning transmission electron microscopy analysis identified the presence of isolated Au clusters (from 1 to 5 atoms) for the first time using a modified colloidal method, which was supported by experimental and computational CO adsorption studies. It is proposed that the variations in the populations of these species, in combination with other solvent/PVA effects, is responsible for the contrasting catalytic properties

Controlling structural transitions in AuAg nanoparticles through precise compositional design

We present a study of the transitional pathways between highsymmetry structural motifs for AgAu nanoparticles, with a specific focus on controlling the energetic barriers through chemical design. We show that the barriers can be altered by careful control of the elemental composition and chemical arrangement, with core@shell and vertex-decorated arrangements being specifically influential on the barrier heights. We also highlight the complexity of the potential and free energy landscapes for systems where there are low-symmetry geometric motifs that are energetically competitive to the high-symmetry arrangements. In particular, we highlight that some core@shell arrangements preferentially transition through multistep restructuring of lowsymmetry truncated octahedra and rosette-icosahedra, instead of via the more straightforward square-diamond transformations, due to lower energy barriers and competitive energetic minima. Our results have promising implications for the continuing efforts in bespoke nanoparticle design for catalytic and plasmonic applications

Lattice Relaxation and Charge-Transfer Optical Transitions Due to Self-Trapped Holes in Non-Stoichiometric LaMnO3_3 Crystal

We use the Mott-Littleton approach to evaluate polarisation energies in LaMnO$_3$ lattice associated with holes localized on both Mn$^{3+}$ cation and O$^{2-}$ anion. The full (electronic and ionic) lattice relaxation energy for a hole localized at the O-site is estimated as 2.4 eV which is appreciably greater than that of 0.8 eV for a hole localized at the Mn-site, indicating on the strong electron-phonon interaction in the former case. Using a Born-Haber cycle we examine thermal and optical energies of the hole formation associated with electron ionization from Mn$^{3+}$, O$^{2-}$ and La$^{3+}$ ions in LaMnO$_3$ lattice. For these calculations we derive a phenomenological value for the second electron affinity of oxygen in LaMnO$_3$ lattice by matching the optical energies of La$^{4+}$ and O$^-$ hole formation with maxima of binding energies in the experimental photoemission spectra. The calculated thermal energies predict that the electronic hole is marginally more stable in the Mn$^{4+}$ state in LaMnO$_3$ host lattice, but the energy of a hole in the O$^-$ state is only higher by a small amount, 0.75 eV, rather suggesting that both possibilities should be treated seriously. We examine the energies of a number of fundamental optical transitions, as well as those involving self-trapped holes of Mn$^{4+}$ and O$^-$ in LaMnO$_3$ lattice. The reasonable agreement with experiment of our predicted energies, linewidths and oscillator strengths leads us to plausible assignments of the optical bands observed. We deduce that the optical band near 5 eV is associated with O(2p) - Mn(3d) transition of charge-transfer character, whereas the band near 2.3 eV is rather associated with the presence of Mn$^{4+}$ and/or O$^-$ self-trapped holes in non-stoichiometric LaMnO$_3$ compound.Comment: 18 pages, 6 figures, it was presented partially at SCES-2001 conference in Ann Arbor, Michiga

Algorithmic Food Justice: Co-Designing More-than-Human Blockchain Futures for the Food Commons

The relationships that constitute the global industrial food system tend towards two dominant values that are creating unsustainable social and environmental inequalities. The first is a human-centered perspective on food that privileges humans over all other species. The second is a view of food as a commodity to be traded for maximum economic value, rewarding a small number of shareholders. We present work that explores the unique algorithmic affordances of blockchain to create new types of value exchange and governance in the food system. We describe a project that used roleplay with urban agricultural communities to co-design blockchain-based food futures and explore the conditions for creating a thriving multispecies food commons. We discuss how the project helped rethink algorithmic food justice by reconfiguring more-than-human values and reconfiguring food as more-than-human commons. We also discuss some of the challenges and tensions arising from these explorations