Commentary: Essential Programs and Services Model

To further discussion about the Essential Programs and Services (EPS) model for funding public education in Maine, Maine Policy Review asked eight superintendents—representing districts across the state— to provide their views. We also asked each to discuss the needs of his district and whether additional state policy options were necessary to tackle the most pressing issues. The districts represented by these superintendents are a cross section of urban and rural high-receivers and low-receivers. Still, several commonalities emerge: the need for a state commitment that does not wax and wane with the business cycle; the urgency of professional development for new and experienced teachers; and, the importance of linking student outcomes with student assessment measures and student funding. In short, EPS is not seen as a solution to the state’s ongoing debate over public-education funding, but is recognized as a necessary first step

Structural Characterization of Plasma Metabolites Detected via LC-Electrochemical Coulometric Array Using LC-UV Fractionation, MS, and NMR

Liquid chromatography (LC) separation combined with electrochemical coulometric array detection (EC) is a sensitive, reproducible, and robust technique that can detect hundreds of redox-active metabolites down to the level of femtograms on column, making it ideal for metabolomics profiling. EC detection cannot, however, structurally characterize unknown metabolites that comprise these profiles. Several aspects of LC-EC methods prevent a direct transfer to other structurally informative analytical methods, such as LC-MS and NMR. These include system limits of detection, buffer requirements, and detection mechanisms. To address these limitations, we developed a workflow based on the concentration of plasma, metabolite extraction, and offline LC-UV fractionation. Pooled human plasma was used to provide sufficient material necessary for multiple sample concentrations and platform analyses. Offline parallel LC-EC and LC-MS methods were established that correlated standard metabolites between the LC-EC profiling method and the mass spectrometer. Peak retention times (RT) from the LC-MS and LC-EC system were linearly related (<i>r</i>² = 0.99); thus, LC-MS RTs could be directly predicted from the LC-EC signals. Subsequent offline microcoil-NMR analysis of these collected fractions was used to confirm LC-MS characterizations by providing complementary, structural data. This work provides a validated workflow that is transferrable across multiple platforms and provides the unambiguous structural identifications necessary to move primary mathematically driven LC-EC biomarker discovery into biological and clinical utility

Characterization of hepatic and cardiac iron deposition during standard treatment of anaemia in haemodialysis

Background: Parenteral iron is integral in the treatment of anaemia of chronic kidney disease patients on haemodialysis (HD). However, increased liver iron concentration (LIC) can result from such treatment, and this correlates poorly with serum ferritin or transferrin saturation values. It is unclear whether increased cardiac iron concentration also occurs in this setting. We aimed to evaluate the relationship of intravenous iron supplementation to hepatic and cardiac iron deposition in chronic HD subjects. Methods: A cohort of 10 patients on chronic HD for at least 1 year underwent MRI-based quantitation of hepatic and cardiac iron content to evaluate the relationship between intravenous iron supplements and hepatic and cardiac iron deposition. The results were compared against the cumulative parenteral iron dose and serum iron markers. Results: The median age was 61 years (95% confidence interval (CI) 50–71), HD time 2.5 years (95%CI 2.0–5.3) and cumulative iron dose 4300 mg (95%CI 2110–9045). Hepatic iron concentration was elevated in eight of 10 subjects (median 46 mmol/kg, range 31–76). Cardiac iron levels were within the reference range in all subjects. There was poor correlation between conventional haematinic values and either LIC or cardiac iron levels. None of the study subjects exhibited elevated cardiac iron concentration. Conclusion: Whilst HD patients receiving standard parenteral iron therapy have elevated LICs, this is not associated with cardiac iron deposition. Transferrin saturation and serum ferritin levels are poor markers of either liver or cardiac iron deposition in HD subjects