Hyposplenism in gastro-intestinal disease

The hazards of living without a spleen were recognised by the paediatricians in the early 1960’s when they focussed attention on the syndrome of fulminant sepsis, often due to pneumococcal infection, occurring in young children within the first two years of splenectomy. The danger of post-splenectomy sepsis (PSS) extends into adult life and splenectomised patients remain at risk 10, 20 and even 30 years after the operation. Problems following splenectomy may just be the tip of the iceberg. It is clear that many other diseases are associated with impaired splenic function in the presence of intact spleens.peer-reviewe

Cobalt(II) complexes with azole-pyridine type ligands for non-aqueous redox-flow batteries:tunable electrochemistry via structural modification

Abstract A single species redox flow battery employing a new class of cobalt(II) complexes with ‘tunable’ tridentate azole-pyridine type ligands is reported. Four structures were synthesised and their electrochemical, physical and battery characteristics were investigated as a function of successive substitution of the ligand terminal pyridyl donors. The Co(II/I) and Co(III/II) couples are stable and quasi-reversible on gold and glassy carbon electrodes, however redox potentials are tunable allowing the cobalt potential difference to be preferentially increased from 1.07 to 1.91 V via pyridine substitution with weaker σ-donating/π-accepting 3,5-dimethylpyrazole groups. The charge-discharge properties of the system were evaluated using an H-type glass cell and graphite rod electrodes. The complexes delivered high Coulombic efficiencies of 89.7–99.8% and very good voltaic efficiencies of 70.3–81.0%. Consequently, energy efficiencies are high at 63.1–80.8%, marking an improvement on other similar non-aqueous systems. Modification of the ligands also improved solubility from 0.18 M to 0.50 M via pyridyl substitution with 3,5-dimethylpyrazole, though the low solubility of the complexes limits the overall energy capacity to between 2.58 and 12.80 W h L−1. Preliminary flow cell studies in a prototype flow cell are also demonstrated

Non-Enzymatic Sensing of Creatinine for Early Detection of Chronic Kidney Disease

Chronic kidney disease (CKD) affects a 8-16 % of the global population. Creatinine is a useful biomarker for screening and detecting CKD. Creatinine concentrations in urine outside the normal clinical range (4.4-13.3 mM) gives an indication of kidney conditions including CKD, and requires further evaluation by the nephrologists in secondary care clinical settings. The fact that CKD is asymptomatic, it is critical to detect it at earlier stages and prevent its rogression with medicines. Currently Jaffe reaction method of creatinine detection is the most widely used technique. Although, this significantly suffers from low specificity and high interferences from molecules including ascorbic acid. Enzymatic methods, although are highly specific, but have problems with high cost and low stability due to use of enzymes. Therefore, there is an urgent need to develop low cost and simple non-invasive creatinine detection methods, which is the focus of this PhD project.We have developed a novel simple sensing mechanism based on bare glassy carbon electrode (GCE) which can detect creatinine electrochemically (LOD 60 µM and sensitivity 1.50 µA/mM) and colorimetrically (LOD 6.63 µM). An application for a patent has been made for this work. Additionally, nickel-based systems have also been studied to detect creatinine, although there is high interference to urea and requires further optimisation. SPE based creatinine sensing methods designed (LOD 60 µM) as part of a preliminary study in this project including surface modifications, aims to use creatinine sensing for POCT applications in future. Market testing of the concepts used in this project has informed us to evaluate albumin sensing

Dithiolene Complexes of First Row Transition Metals for Symmetric Non-Aqueous Redox Flow Batteries

Five metal complexes of the dithiolene ligand maleonitriledithiolate (mnt2−) with M=V, Fe, Co, Ni, Cu were studied as redox‐active materials for nonaqueous redox flow batteries (RFBs). All five complexes exhibit at least two redox processes, making them applicable to symmetric RFBs as single‐species electrolytes, that is, as both negolyte and posolyte. Charge–discharge cycling in a small‐scale RFB gave modest performances for [(tea)2Vmnt], [(tea)2Comnt], and [(tea)2Cumnt] whereas [(tea)Femnt] and [(tea)2Nimnt] (tea=tetraethylammonium) failed to hold any significant capacity, indicating poor stability. Independent negolyte‐ and posolyte‐only battery cycling of a single redox couple, as well as UV/Vis spectroscopy, showed that for [(tea)2Vmnt] the negolyte is stable whereas the posolyte is unstable over multiple charge–discharge cycles; for [(tea)2Comnt], [(tea)2Nimnt], and [(tea)2Cumnt], the negolyte suffers rapid capacity fading although the posolyte is more robust. Identifying a means to stabilize Vmnt3−/2− as a negolyte, and Comnt2−/1−, Nimnt2−/1−, and Cumnt2−/1− as posolytes could lead to their use in asymmetric RFBs

Non-enzymatic Electrochemical Determination of Glucose Concentration

There are a variety of applications for electrochemistry (including synthetic, physical and analytical chemistry), and here we present an experimental protocol for the non-enzymatic electrochemical quantitation of glucose in liquids that can be used in teaching laboratories. This offers an interesting experiential learning experience that is contextualized through a real world application where comparable technology the students employ touches the lives of humans across the world on a daily basis

Stability of molecular radicals in organic non-aqueous redox flow batteries:A mini review

The application of novel organic redox materials is a plausible pathway towards techno-economic energy storage targets due to their low cost and sustainable design. Their operation in non-aqueous redox flow batteries affords researchers the opportunity to innovate, design and optimise these new chemistries towards practical energy densities. Despite this, the identification of high capacity organics which also display long-term stability is inherently challenging due to the high reactivity of molecular radicals

Aging, Bone Marrow and Next-Generation Sequencing (NGS): Recent Advances and Future Perspectives

The aging of bone marrow (BM) remains a very imperative and alluring subject, with an ever-increasing interest among fellow scientists. A considerable amount of progress has been made in this field with the established ‘hallmarks of aging’ and continued efforts to investigate the age-related changes observed within the BM. Inflammaging is considered as a low-grade state of inflammation associated with aging, and whilst the possible mechanisms by which aging occurs are now largely understood, the processes leading to the underlying changes within aged BM remain elusive. The ability to identify these changes and detect such alterations at the genetic level are key to broadening the knowledgebase of aging BM. Next-generation sequencing (NGS) is an important molecular-level application presenting the ability to not only determine genomic base changes but provide transcriptional profiling (RNA-seq), as well as a high-throughput analysis of DNA–protein interactions (ChIP-seq). Utilising NGS to explore the genetic alterations occurring over the aging process within alterative cell types facilitates the comprehension of the molecular and cellular changes influencing the dynamics of aging BM. Thus, this review prospects the current landscape of BM aging and explores how NGS technology is currently being applied within this ever-expanding field of research

The electrochemical determination of formaldehyde in aqueous media using nickel modified electrodes

Abstract Glassy carbon (GC) electrodes were modified with nickel metal via a simple deposition procedure, followed by enrichment of the nickel in a potassium hydroxide solution to deliver the catalytic nickel hydroxide species (Ni(OH)2). In solutions of 1 M KOH, the nickel modified GC electrode (Ni-GC) contained a reproducible detection limit of the order of 1.1 × 10−5 M for formaldehyde additions. This is comparable and, in many cases, surpasses, platinum group metal modified electrodes. The potentiometric analytical method also allowed for the accurate determination of “unknown” formaldehyde concentrations, over a linear range of 1 × 10−5–1 × 10−3 M and a sensitivity of 22.7± 3.8 μA/mM. Furthermore, the Ni-GC electrode showed negligible response to formate and methanol, even when they were present in concentrations 10 times greater than the formaldehyde. The electrochemical performance was compared to a simple colorimetric approach to formaldehyde determination, wherein a detection limit of 6 × 10−6 M was obtained

Fast synthesis of platinum nanopetals and nanospheres for highly-sensitive non-enzymatic detection of glucose and selective sensing of ions

Novel methods to obtain Pt nanostructured electrodes have raised particular interest due to their high performance in electrochemistry. Several nanostructuration methods proposed in the literature use costly and bulky equipment or are time-consuming due to the numerous steps they involve. Here, Pt nanostructures were produced for the first time by one-step template-free electrodeposition on Pt bare electrodes. The change in size and shape of the nanostructures is proven to be dependent on the deposition parameters and on the ratio between sulphuric acid and chloride-complexes (i.e., hexachloroplatinate or tetrachloroplatinate). To further improve the electrochemical properties of electrodes, depositions of Pt nanostructures on previously synthesised Pt nanostructures are also performed. The electroactive surface areas exhibit a two order of magnitude improvement when Pt nanostructures with the smallest size are used. All the biosensors based on Pt nanostructures and immobilised glucose oxidase display higher sensitivity as compared to bare Pt electrodes. Pt nanostructures retained an excellent electrocatalytic activity towards the direct oxidation of glucose. Finally, the nanodeposits were proven to be an excellent solid contact for ion measurements, significantly improving the time-stability of the potential. The use of these new nanostructured coatings in electrochemical sensors opens new perspectives for multipanel monitoring of human metabolism

Support and Assessment for Fall Emergency Referrals (SAFER) 2: a cluster randomised trial and systematic review of clinical effectiveness and cost-effectiveness of new protocols for emergency ambulance paramedics to assess older people following a fall with referral to community-based care when appropriate.

BACKGROUND: Emergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services. OBJECTIVES: To compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use. DESIGN: Cluster randomised controlled trial. PARTICIPANTS: Participating paramedics at three ambulance services in England and Wales were based at stations randomised to intervention or control arms. Participants were aged 65 years and over, attended by a study paramedic for a fall-related emergency service call, and resident in the trial catchment areas. INTERVENTIONS: Intervention paramedics received a clinical protocol with referral pathway, training and support to change practice. Control paramedics continued practice as normal. OUTCOMES: The primary outcome comprised subsequent emergency health-care contacts (emergency admissions, emergency department attendances, emergency service calls) or death at 1 month and 6 months. Secondary outcomes included pathway of care, ambulance service operational indicators, self-reported outcomes and costs of care. Those assessing outcomes remained blinded to group allocation. RESULTS: Across sites, 3073 eligible patients attended by 105 paramedics from 14 ambulance stations were randomly allocated to the intervention group, and 2841 eligible patients attended by 110 paramedics from 11 stations were randomly allocated to the control group. After excluding dissenting and unmatched patients, 2391 intervention group patients and 2264 control group patients were included in primary outcome analyses. We did not find an effect on our overall primary outcome at 1 month or 6 months. However, further emergency service calls were reduced at both 1 month and 6 months; a smaller proportion of patients had made further emergency service calls at 1 month (18.5% vs. 21.8%) and the rate per patient-day at risk at 6 months was lower in the intervention group (0.013 vs. 0.017). Rate of conveyance to emergency department at index incident was similar between groups. Eight per cent of trial eligible patients in the intervention arm were referred to falls services by attending paramedics, compared with 1% in the control arm. The proportion of patients left at scene without further care was lower in the intervention group than in the control group (22.6% vs. 30.3%). We found no differences in duration of episode of care or job cycle. No adverse events were reported. Mean cost of the intervention was £17.30 per patient. There were no significant differences in mean resource utilisation, utilities at 1 month or 6 months or quality-adjusted life-years. In total, 58 patients, 25 paramedics and 31 stakeholders participated in focus groups or interviews. Patients were very satisfied with assessments carried out by paramedics. Paramedics reported that the intervention had increased their confidence to leave patients at home, but barriers to referral included patients' social situations and autonomy. CONCLUSIONS: Findings indicate that this new pathway may be introduced by ambulance services at modest cost, without risk of harm and with some reductions in further emergency calls. However, we did not find evidence of improved health outcomes or reductions in overall NHS emergency workload. Further research is necessary to understand issues in implementation, the costs and benefits of e-trials and the performance of the modified Falls Efficacy Scale. TRIAL REGISTRATION: Current Controlled Trials ISRCTN60481756 and PROSPERO CRD42013006418. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 13. See the NIHR Journals Library website for further project information