Facile two-step encapsulation of small species in a metallic shell

Microencapsulation of small volatile chemicals remains an unsolved challenge for both industry and academia as most capsule walls tend to be permeable to such species. Metal coated capsules are of particular interest as they offer much reduced diffusion coefficient for this same species. A continuous metal shell can provide reduced permeability compared to a standard a polymer shell and can prevent the escape of volatile encapsulated compounds. The permeability of continuous metal films is much lower than that of polymer shells due to their crystalline structure. Additionally, there is potential opportunity to exploit electrical, mechanical, optical and magnetic properties of the metallic shell for additional capsule functionality. Metal encapsulated compounds can have improved shelf life, potentially including those with high sensitivity to water and oxygen. Metallic encapsulation of small species has successfully been demonstrated within our research group1; however the process developed so far has used a solvent evaporation method to form a polymeric capsule on which the metallic film is deposited. This technique tends to start with an oil phase mixture where the oil to be encapsulated is only present up to ~15% and is only suitable for a number of oils and stabilisers due to limiting wetting characteristics. Additionally harmful solvents which require adequate ventilation such as dichloromethane are often used. Other methods exist to produce polymer shells encapsulating an emulsion core, however these also often suffer from initial loss of a small, volatile core via diffusion through the polymer shell during processing. In the method proposed here the metallic film is deposited directly onto a Pickering emulsion droplet stabilised with the catalytic nanoparticles, hence allowing 100% of the active material to be encapsulated. It removes the need for a polymer shell all together. In the method we developed, polymer stabilised platinum nanoparticles act as both the emulsifier by adsorbing to the oil-water interface and the catalyst for the growth of a secondary metallic gold film via electroless deposition. In this presentation we will show the effect of gold salt concentration on the resulting metal film thickness and oil release rates. Please click Additional Files below to see the full abstract

Si-based n-type THz Quantum Cascade Emitter

Employing electronic transitions in the conduction band of semiconductor heterostructures paves a way to integrate a light source into silicon-based technology. To date all electroluminescence demonstrations of Si-based heterostructures have been p-type using hole-hole transitions. In the pathway of realizing an n-type Ge/SiGe terahertz quantum cascade laser, we present electroluminescence measurements of quantum cascade structures with top diffraction gratings. The devices for surface emission have been fabricated out of a 4-well quantum cascade laser design with 30 periods. An optical signal was observed with a maximum between 8-9 meV and full width at half maximum of roughly 4 meV

n-type Ge/SiGe multi quantum-wells for a THz quantum cascade laser

Exploiting intersubband transitions in Ge/SiGe quantum cascade devices provides a way to integrate terahertz light emitters into silicon-based technology. With the view to realizing a Ge/SiGe Quantum Cascade Laser, we present the optical and structural properties of n-type strain-symmetrized Ge/SiGe asymmetric coupled quantum wells grown on Si(001) substrates by means of ultrahigh vacuum chemical vapor deposition. We demonstrate the high material quality of strain-symmetrized structures and heterointerfaces as well as control over the inter-well coupling and electron tunneling. Motivated by the promising results obtained on ACQWs, which are the basic building block of a cascade structure, we investigate, both experimentally and theoretically, a Ge/SiGe THz QCL design, optimized through a non-equilibrium Green's function formalism

Electron-doped SiGe Quantum Well Terahertz Emitters pumped by FEL pulses

We explore saturable absorption and terahertz photoluminescence emission in a set of n-doped Ge/SiGe asymmetric coupled quantum wells, designed as three-level systems (i.e., quantum fountain emitter). We generate a non-equilibrium population by optical pumping at the 1→3 transition energy using picosecond pulses from a free-electron laser and characterize this effect by measuring absorption as a function of the pump intensity. In the emission experiment we observe weak emission peaks in the 14–25 meV range (3–6 THz) corresponding to the two intermediate intersubband transition energies. The results represent a step towards silicon-based integrated terahertz emitters

Clinical impact of genomic testing in patients with suspected monogenic kidney disease

Purpose: To determine the diagnostic yield and clinical impact of exome sequencing (ES) in patients with suspected monogenic kidney disease. Methods: We performed clinically accredited singleton ES in a prospectively ascertained cohort of 204 patients assessed in multidisciplinary renal genetics clinics at four tertiary hospitals in Melbourne, Australia. Results: ES identified a molecular diagnosis in 80 (39%) patients, encompassing 35 distinct genetic disorders. Younger age at presentation was independently associated with an ES diagnosis (p < 0.001). Of those diagnosed, 31/80 (39%) had a change in their clinical diagnosis. ES diagnosis was considered to have contributed to management in 47/80 (59%), including negating the need for diagnostic renal biopsy in 10/80 (13%), changing surveillance in 35/80 (44%), and changing the treatment plan in 16/80 (20%). In cases with no change to management in the proband, the ES result had implications for the management of family members in 26/33 (79%). Cascade testing was subsequently offered to 40/80 families (50%). Conclusion: In this pragmatic pediatric and adult cohort with suspected monogenic kidney disease, ES had high diagnostic and clinical utility. Our findings, including predictors of positive diagnosis, can be used to guide clinical practice and health service design

The Heroic and the Villainous: a qualitative study characterising the role models that shaped senior doctors’ professional identity

The successful development and sustaining of professional identity is critical to being a successful doctor. This study explores the enduring impact of significant early role models on the professional identity formation of senior doctors.Personal Interview Narratives were derived from the stories told by twelve senior doctors as they recalled accounts of people and events from the past that shaped their notions of being a doctor. Narrative inquiry methodology was used to explore and analyse video recording and transcript data from interviews.Role models were frequently characterised as heroic, or villainous depending on whether they were perceived as good or bad influences respectively. The degree of sophistication in participants' characterisations appeared to correspond with the stage of life of the participant at the time of the encounter. Heroes were characterised as attractive, altruistic, caring and clever, often in exaggerated terms. Conversely, villains were typically characterised as direct or covert bullies. Everyday events were surprisingly powerful, emotionally charged and persisted in participants' memories much longer than expected. In particular, unresolved emotions dating from encounters where bullying behaviour had been witnessed or experienced were still apparent decades after the event.The characterisation of role models is an important part of the professional identity and socialisation of senior doctors. The enduring impact of what role models say and do means that all doctors, need to consistently reflect on how their own behaviour impacts the development of appropriate professional behaviours in both students and training doctors. This is especially important where problematic behaviours occur as, if not dealt with, they have the potential for long-lasting undesirable effects. The importance of small acts of caring in building a nurturing and supportive learning atmosphere at all stages of medical education cannot be underestimated

Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission

Funder: Addenbrooke's Charitable Trust, Cambridge University Hospitals; FundRef: http://dx.doi.org/10.13039/501100002927Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme