A Microfluidic Device for Nucleic Acid-Based Analysis of Helicobacter pylori and Antibiotic Susceptibility Testing

© 2020, Springer Nature Singapore Pte Ltd. Rapid diagnosis of bacterial infections enables earlier implementation of appropriate and effective treatment regimens, therefore improving patient outcomes. We have previously demonstrated a microfluidic device for nucleic acid-based analysis of Helicobacter pylori, which can cause peptic ulcers and increase the risk of stomach cancer. One of the major challenges to overcome has been the use of challenging real-world samples, e.g. stool, and urine allowing use at the point-of-care. Here we present results for bacterial identification as well as initial studies on the use of screen-printed electrodes (SPE) for miniaturised electrochemical detection for determining antibiotic susceptibility of pathogenic Escherichia coli. Resazurin was used as an indicator of bacterial viability, with reduction of resazurin demonstrating continued cell growth. Differential pulse voltammetry was used to measure potential reduction and showed measurement at −0.58 V or −0.38 V to be the most discriminatory. A fixed voltage of −0.58 V was then used to monitor current changes as a function of increasing gentamycin (antibiotic) concentration, with the results showing a significant reduction in current with increasing amounts of gentamycin (ANOVA, p < 0.001), within 90 min. The ability to integrate diagnosis with antibiotic susceptibility testing would allow administration of timely and specific treatment to patients with serious infections in low-resource settings

An evaluation of the anti-proliferative and pro-apoptotic properties of Nigella Sativa

Background: Nigella sativa is a traditional herb used since ancient Egyptian and Greek civilizations. It is also known as black seed, black cumin, and as the blessed seed, after its reported extraordinary curing ability. Nigella sativa has a broad range of therapeutic properties including anti-cancer, anti-oxidant, anti-inflammatory, anti-microbial, anti-helminthic, and anti-fungal activities. Objective: The aim of this study was to evaluate the anti-cancer properties of Nigella sativa oil on the Jurkat E6.1 cell line. Method: Investigation of the anti-cancer properties of Nigella sativa oil in the human T lymphoblastic Jurkat E6.1 cell line was undertaken evaluating 4 different concentrations (undiluted, diluted 1:10,1:50 and 1:100) at three time points (24, 48 and 72 hours). Cell viability was assessed using the vital dye, trypan blue. Apoptosis was detected using the Human Annexin V assay by flow cytometry. Wilcoxon Signed–Rank test was used for statistical analysis. A p-value ≼ 0.05 was considered statistically significant. Results: Cells treated with undiluted oil could not be assessed by trypan blue due to the hydrophobicity of oil and bubble formation when mixed with culture media. The 1:10 dilution had the highest percentage of non-viable cells with 92.78% followed by 90.53% and 67.62% for the 1:50 and 1:100 dilutions, respectively, after 72 hours. Cells treated with undiluted oil had 58.18% apoptotic cells followed by 44.3%, 33.89% and 26.81% for the 1:10, 1:50 and 1:100 dilutions respectively. Conclusion: Nigella sativa seed oil induced apoptosis and inhibited cell proliferation in the Jurkat E6.1 cell line in vitro in a time- and dosage-dependant manner. Further research is required to determine whether Nigella sativa demonstrates similar efficacy in other leukaemic cell lines, and other cancer types, and also to determine which bioactive constituent(s) present is(are) responsible

Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine.

OBJECTIVE: Circulatory shock is a life-threatening syndrome resulting in multiorgan failure and a high mortality rate. The aim of this consensus is to provide support to the bedside clinician regarding the diagnosis, management and monitoring of shock. METHODS: The European Society of Intensive Care Medicine invited 12 experts to form a Task Force to update a previous consensus (Antonelli et al.: Intensive Care Med 33:575-590, 2007). The same five questions addressed in the earlier consensus were used as the outline for the literature search and review, with the aim of the Task Force to produce statements based on the available literature and evidence. These questions were: (1) What are the epidemiologic and pathophysiologic features of shock in the intensive care unit ? (2) Should we monitor preload and fluid responsiveness in shock ? (3) How and when should we monitor stroke volume or cardiac output in shock ? (4) What markers of the regional and microcirculation can be monitored, and how can cellular function be assessed in shock ? (5) What is the evidence for using hemodynamic monitoring to direct therapy in shock ? Four types of statements were used: definition, recommendation, best practice and statement of fact. RESULTS: Forty-four statements were made. The main new statements include: (1) statements on individualizing blood pressure targets; (2) statements on the assessment and prediction of fluid responsiveness; (3) statements on the use of echocardiography and hemodynamic monitoring. CONCLUSIONS: This consensus provides 44 statements that can be used at the bedside to diagnose, treat and monitor patients with shock

A description of physical therapists' knowledge in managing musculoskeletal conditions

BACKGROUND: Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions. METHODS: This study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties. RESULTS: Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues. CONCLUSION: The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions

Nowa Konstytucja Państwa Litewskiego

Digitalizacja i deponowanie archiwalnych zeszytów RPEiS sfinansowane przez MNiSW w ramach realizacji umowy nr 541/P-DUN/201

The Feasibility and Impact of Delivering a Mind-Body Intervention in a Virtual World

Introduction: Mind-body medical approaches may ameliorate chronic disease. Stress reduction is particularly helpful, but face-to-face delivery systems cannot reach all those who might benefit. An online, 3-dimensional virtual world may be able to support the rich interpersonal interactions required of this approach. In this pilot study, we explore the feasibility of translating a face-to-face stress reduction program into an online virtual setting and estimate the effect size of the intervention. Methods and Findings: Domain experts in virtual world technology joined with mind body practitioners to translate an existing 8 week relaxation response-based resiliency program into an 8-week virtual world-based program in Second Life™ (SL). Twenty-four healthy volunteers with at least one month's experience in SL completed the program. Each subject filled out the Perceived Stress Scale (PSS) and the Symptom Checklist 90- Revised (SCL-90-R) before and after taking part. Participants took part in one of 3 groups of about 10 subjects. The participants found the program to be helpful and enjoyable. Many reported that the virtual environment was an excellent substitute for the preferred face-to-face approach. On quantitative measures, there was a general trend toward decreased perceived stress, (15.7 to 15.0), symptoms of depression, (57.6 to 57.0) and anxiety (56.8 to 54.8). There was a significant decrease of 2.8 points on the SCL-90-R Global Severity Index (p<0.05). Conclusions: This pilot project showed that it is feasible to deliver a typical mind-body medical intervention through a virtual environment and that it is well received. Moreover, the small reduction in psychological distress suggests further research is warranted. Based on the data collected for this project, a randomized trial with less than 50 subjects would be appropriately powered if perceived stress is the primary outcome

Economic Evaluations of Occupational Health Interventions from a Company’s Perspective: A Systematic Review of Methods to Estimate the Cost of Health-Related Productivity Loss

Objectives: To investigate the methods used to estimate the indirect costs of health-related productivity in economic evaluations from a company’s perspective. Methods: The primary literature search was conducted in Medline and Embase. Supplemental searches were conducted in the Cochrane NHS Economic Evaluation Database, the National Institute for Occupational Safety and Health database, the Ryerson International Labour, Occupational Safety and Health Index database, scans of reference lists and researcher’s own literature database. Article selection was conducted independently by two researchers based on title, keywords, and abstract, and if needed, full text. Differences were resolved by a consensus procedure. Articles were selected based on seven criteria addressing study population, type of intervention, comparative intervention, outcome, costs, language and perspective, respectively. Characteristics of the measurement and valuation of health-related productivity were extracted and analyzed descriptively. Results: A total of 34 studies were included. Costs of health-related productivity were estimated using (a combination of) data related to sick leave, compensated sick leave, light or modified duty or work presenteeism. Data were collected from different sources (e.g. administrative databases, worker self-report, supervisors) and by different methods (e.g. questionnaires, interviews). Valuation varied in terms of reported time units, composition and source of the corresponding price weights, and whether additional elements, such as replacement costs, were included. Conclusions: Methods for measuring and valuing health-related productivity vary widely, hindering comparability of results and decision-making. We provide suggestions for improvement

Inter-domain Communication Mechanisms in an ABC Importer: A Molecular Dynamics Study of the MalFGK2E Complex

ATP-Binding Cassette transporters are ubiquitous membrane proteins that convert the energy from ATP-binding and hydrolysis into conformational changes of the transmembrane region to allow the translocation of substrates against their concentration gradient. Despite the large amount of structural and biochemical data available for this family, it is still not clear how the energy obtained from ATP hydrolysis in the ATPase domains is “transmitted” to the transmembrane domains. In this work, we focus our attention on the consequences of hydrolysis and inorganic phosphate exit in the maltose uptake system (MalFGK2E) from Escherichia coli. The prime goal is to identify and map the structural changes occurring during an ATP-hydrolytic cycle. For that, we use extensive molecular dynamics simulations to study three potential intermediate states (with 10 replicates each): an ATP-bound, an ADP plus inorganic phosphate-bound and an ADP-bound state. Our results show that the residues presenting major rearrangements are located in the A-loop, in the helical sub-domain, and in the “EAA motif” (especially in the “coupling helices” region). Additionally, in one of the simulations with ADP we were able to observe the opening of the NBD dimer accompanied by the dissociation of ADP from the ABC signature motif, but not from its corresponding P-loop motif. This work, together with several other MD studies, suggests a common communication mechanism both for importers and exporters, in which ATP-hydrolysis induces conformational changes in the helical sub-domain region, in turn transferred to the transmembrane domains via the “coupling helices”