Soft and flexible poly(ethylene glycol) nanotubes for local drug delivery

Nanotubes are emerging as promising materials for healthcare applications but the selection of clinically relevant starting materials for their synthesis remains largely unexplored. Here we present, for the first time, the synthesis of poly(ethylene glycol) (PEG) based nanotubes via the photopolymerization of poly(ethylene glycol) diacrylate and other diacrylate derivatives within the pores of anodized aluminum oxide templates. Template-assisted synthesis allowed the manufacture of a diverse set of polymeric nanotubes with tunable physical characteristics including diameter (∼200–400 nm) and stiffness (405–902 kPa). PEG nanotubes were subjected to cytotoxicty assessment in cell lines and primary stem cells and showed excellent cytocompatability (IC50 > 120 μg ml−1). Nanotubes were readily drug loaded but released the majority of the drug over 5 days. Direct administration of drug loaded nanotubes to human orthotopic breast tumors substantially reduced tumor growth and metastasis and outperformed i.v. administration at the equivalent dose. Overall, this nanotube templating platform is emerging as a facile route for the manufacture of poly(ethylene glycol) nanotubes

Multinational consensus antimicrobial stewardship recommendations for children managed in hospital settings

Children are entitled to receive antibiotic therapy that is based on evidence and best practice, but might be overlooked in hospital programmes designed to achieve antimicrobial stewardship [AMS]. This failure to include children could be because children make up small proportion of patients in most hospitals, and are cared for by specialised paediatric staff. We reviewed the evidence and consulted experts in three global regions to develop ten recommendations for good-practice in hospital AMS programmes for children. We performed a review of scientific research, published between Jan 1, 2007, and Oct 17, 2019, concerning AMS, and formed a multinational expert group comprising members from the USA, Canada, the UK, Belgium, Switzerland, Australia, and Aotearoa New Zealand to develop the recommendations. These recommendations aim to help health-care workers who care for children in these regions to deliver best-practice care. We surveyed health-care workers with expertise in antibiotic therapy for children across these regions, and found that the recommendations were considered both very important and generally feasible. These recommendations should be implemented in hospitals to improve antibiotic therapy for children and to stimulate research into future improvements in care

Association of inappropriate outpatient pediatric antibiotic prescriptions with adverse drug events and health care expenditures

Importance: Nonguideline antibiotic prescribing for the treatment of pediatric infections is common, but the consequences of inappropriate antibiotics are not well described. Objective: To evaluate the comparative safety and health care expenditures of inappropriate vs appropriate oral antibiotic prescriptions for common outpatient pediatric infections. Design, Setting, and Participants: This cohort study included children aged 6 months to 17 years diagnosed with a bacterial infection (suppurative otitis media [OM], pharyngitis, sinusitis) or viral infection (influenza, viral upper respiratory infection [URI], bronchiolitis, bronchitis, nonsuppurative OM) as an outpatient from April 1, 2016, to September 30, 2018, in the IBM MarketScan Commercial Database. Data were analyzed from August to November 2021. Exposures: Inappropriate (ie, non-guideline-recommended) vs appropriate (ie, guideline-recommended) oral antibiotic agents dispensed from an outpatient pharmacy on the date of infection. Main Outcomes and Measures: Propensity score-weighted Cox proportional hazards models were used to estimate hazards ratios (HRs) and 95% CIs for the association between inappropriate antibiotic prescriptions and adverse drug events. Two-part models were used to calculate 30-day all-cause attributable health care expenditures by infection type. National-level annual attributable expenditures were calculated by scaling attributable expenditures in the study cohort to the national employer-sponsored insurance population. Results: The cohort included 2 804 245 eligible children (52% male; median [IQR] age, 8 [4-12] years). Overall, 31% to 36% received inappropriate antibiotics for bacterial infections and 4% to 70% for viral infections. Inappropriate antibiotics were associated with increased risk of several adverse drug events, including Clostridioides difficile infection and severe allergic reaction among children treated with a nonrecommended antibiotic agent for a bacterial infection (among patients with suppurative OM, C. difficile infection: HR, 6.23; 95% CI, 2.24-17.32; allergic reaction: HR, 4.14; 95% CI, 2.48-6.92). Thirty-day attributable health care expenditures were generally higher among children who received inappropriate antibiotics, ranging from $21 to$56 for bacterial infections and from -$96 to$97 for viral infections. National annual attributable expenditure estimates were highest for suppurative OM ($25.3 million), pharyngitis ($21.3 million), and viral URI ($19.1 million). Conclusions and Relevance: In this cohort study of children with common infections treated in an outpatient setting, inappropriate antibiotic prescriptions were common and associated with increased risks of adverse drug events and higher attributable health care expenditures. These findings highlight the individual- and national-level consequences of inappropriate antibiotic prescribing and further support implementation of outpatient antibiotic stewardship programs

Students' perceptions of the value of electronic feedback : does disciplinary background really matter?

Feedback on student work is a key mechanism for improving learning in Higher Education (HE) and can be provided in a variety of forms. Recently, many institutions have moved to the provision of electronic feedback, although evidence for the effectiveness of this is mixed. While many studies evaluating the students’ perception of feedback are now available, there is little evidence of contrasting perceptions of its value according to different disciplines. This work aims to evaluate the relationship between students’ expectations and perception of feedback, especially electronic, and the disciplinary area of study in HE. Students (n=1017) across different courses from a post-1992 university in the UK were surveyed and categorized into five disciplinary clusters: Science, Technology, Engineering and Mathematics; Business and Accounting; Art and Design; Media and Languages; and Psychology and Social Care. Perceived relevance as well as the most pertinent features and expectations of the quality of electronic feedback for students varies according to disciplinary cluster and thus closely aligns with a specific cluster’s learning and teaching practices. The findings of this study may help institutions to reflect on the role of electronic feedback as part of their ongoing assessment practice and how teaching in the different disciplines may result in different understandings of the value of electronic feedback

Police, public, and offender perceptions of body-worn video: a single jurisdictional multiple-perspective analysis

Objectives. Police, public, and offender survey responses from a single jurisdiction give a multiple-perspective insight into the use of body-worn video (BWV) cameras by police. Methods. Police attitudinal data was collected from before (n = 190), during (n = 139), and at the conclusion (n = 221) of a BWV implementation trial. Public attitudes were collected at the conclusion of the BWV implementation trial via online survey (n = 995 respondents) and intercept survey (n = 428 respondents). Offender attitudes (n = 302) were collected in police custody over a 6-month period immediately preceding the BWV trial. Results. The extent to which police felt BWV influenced their behavior tempered during the trial. All three perspectives were supportive of the use of BWV. The public who had encountered BWV-wearing officers and the offender sample indicated limited belief that BWV would reduce bad behavior. There was also clear contention about the policy and practice decisions around recording. Conclusions. These findings have significance for BWV trials, commenting on the importance of (a) collecting police attitudes at multiple points, (b) separating the attitudes of public who did encounter police wearing BWV, and (c) data collection and policy for evaluation outcomes

Estimation of mechanistic parameters in the gas-phase reactions of ozone with alkenes for use in automated mechanism construction

Reaction with ozone is an important atmospheric removal process for alkenes. The ozonolysis reaction produces carbonyls and carbonyl oxides (Criegee intermediates, CI), which can rapidly decompose to yield a range of closed shell and radical products, including OH radicals. Consequently, it is essential to accurately represent the complex chemistry of Criegee intermediates in atmospheric models in order to fully understand the impact of alkene ozonolysis on atmospheric composition. A mechanism construction protocol is presented which is suitable for use in automatic mechanism generation. The protocol defines the critical parameters for describing the chemistry following the initial reaction, namely the primary carbonyl/CI yields from the primary ozonide fragmentation, the amount of stabilisation of the excited CI, the unimolecular decomposition pathways, rates and products of the CI, and the bimolecular rates and products of atmospherically important reactions of the stabilised CI (SCI). This analysis implicitly predicts the yield of OH from the alkene–ozone reaction. A comprehensive database of experimental OH, SCI and carbonyl yields has been collated using reported values in the literature and used to assess the reliability of the protocol. The protocol provides estimates of OH, SCI and carbonyl yields with root mean square errors of 0.13 and 0.12 and 0.14, respectively. Areas where new experimental and theoretical data would improve the protocol and its assessment are identified and discussed