Bioremediation of aluminium from the waste water of a conventional water treatment plant using the freshwater macroalga Oedogonium

Conventional water treatment processes use aluminium sulphate (alum) as a coagulant in the production of potable water. While alum is an inexpensive and reliable means of treating water, the process generates waste water containing dissolved Al. This waste water is primarily dealt with via on-site retention. In this study we investigate the cultivation of the freshwater macroalga Oedogonium as a means to sequester dissolved Al from waste water from a conventional water treatment plant. Furthermore, we examine the use of CO2 to manipulate the pH of cultivation as a means of enhancing the sequestration of Al by either increasing the productivity of Oedogonium or increasing the bioavailability of Al in the waste water. The relative bioavailability of Al under conditions of CO2 and no-CO2 provision was contrasted by comparing Al uptake by Diffusive Gradients in Thin Films (DGTs). Oedogonium was able to grow rapidly in the waste water (12 g dry weight m−2 day−1) while consistently sequestering Al. The Oedogonium-treated waste water had a sufficiently low Al concentration that it could be used in unrestricted irrigation in the surrounding region. When CO2 was added to the waste water containing concentrations of Al up to 8 mg L−1, there was a slight increase (~10%) in the rate of sequestration of Al by Oedogonium relative to waste water not receiving CO2. This was due to two concurrent processes. The provision of CO2 increased the productivity of Oedogonium by 15% and the bioavailability of Al by up to 200%, as measured by the DGTs. Despite this strong effect of CO2 on Al bioavailability, the increase in Al sequestration by Oedogonium when CO2 was provided was modest (~10%). Al was sequestered by Oedogonium to concentrations below permissible limits for discharge without the need for the addition CO2. The cultivation of Oedogonium in waste water from conventional treatments plants can simultaneously treat waste water for re-use and provide a biomass source for value-added applications

The impacts of the visible differences in appearance caused by burn injuries, and medical tattooing as an appearance-based intervention

Portfolio Abstract Burns injuries can affect both adults and children. They can cause severe and enduring physical and psychological consequences, for both the individual and their family. Changes to appearance are a fundamental part of a burn injury. Medical tattooing (MT) is an intervention designed to address appearance/body dissatisfaction. Systematic Review: a systematic search was completed of five electronic databases (CINAHL, Cochrane Library, MEDLINE, EMBOSE and PsycINFO), reference lists and ‘cited by’ referencing sources to identify and evaluate all published qualitative research literature on the psychological experiences of parents of children who have experienced burn injuries. Seven studies met the selection criteria and four themes were identified: ‘the trauma of witnessing a family member’s burn injury’, ‘the ‘mixed blessing’ of hospitalisation’, ‘attempting to return to ‘normal’ life -adapting to new roles’, and ‘guilt and blame: core issues’. The results suggest parents experience three phases of recovery following a child’s burn, all impacted on by feelings of guilt and blame. Journal Article: Interpretative Phenomenological Analysis (IPA) was applied to eight in-depth interviews with burn survivors with medical tattoos. Three themes were extracted: Management of Hope, The Process and Impacts of MT: ‘Normal-ish is Fantastic’ which were set within a context of ‘Conflict about Legitimacy’. The findings suggest MT may facilitate a regained sense of normality and an improved sense of being acceptable in society. However, a potential paradox was identified between a pressure to conform to certain expectations of appearance and a sense that a desire to meet these expectations is also not viewed as important or acceptable. By understanding these experiences, healthcare professionals can increase awareness of the lived experienced of individuals with burn injuries and of those around them. It also demonstrates that MT is a potentially valuable intervention. Further research needs are highlighted

Mixed-methods evaluation of a novel online STI results service.

OBJECTIVES: Evidence on optimal methods for providing STI test results is lacking. We evaluated an online results service, developed as part of an eSexual Health Clinic (eSHC). METHODS: We evaluated the online results service using a mixed-methods approach within large exploratory studies of the eSHC. Participants were chlamydia- positive and negative users of online postal self-sampling services in six National Chlamydia Screening Programme (NCSP) areas and chlamydia-positive patients from two genitourinary medicine (GUM) clinics between 21 July 2014 and 13 March 2015. Participants received a discreetly worded National Health Service 'NHS no-reply' text message (SMS) informing them that their test results were ready and providing a weblink to a secure website. Participants logged in with their date of birth and mobile telephone or clinic number. Chlamydia-positive patients were offered online management. All interactions with the eSHC system were automatically logged and their timing recorded. Post-treatment, a service evaluation survey (n=152) and qualitative interviews (n=36) were conducted by telephone. Chlamydia-negative patients were offered a short online survey (n=274). Data were integrated. RESULTS: 92% (134/146) of NCSP chlamydia-positive patients, 82% (161/197) of GUM chlamydia-positive patients and 89% (1776/1997) of NCSP chlamydia-negative participants accessed test results within 7 days. 91% of chlamydia-positive patients were happy with the results service; 64% of those who had tested previously found the results service better or much better than previous experiences. 90% of chlamydia-negative survey participants agreed they would be happy to receive results this way in the future. Interviewees described accessing results with ease and appreciated the privacy and control the two-step process gave them. CONCLUSION: A discreet SMS to alert users/patients that results are available, followed by provision of results via a secure website, was highly acceptable, irrespective of test result and testing history. The eSHC results service afforded users privacy and control over when they viewed results without compromising access

Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial

Background Accelerated partner therapy (APT) is a promising partner notification (PN) intervention in specialist sexual health clinic attenders. To address its applicability in primary care, we undertook a pilot randomised controlled trial (RCT) of two APT models in community settings. Methods Three-arm pilot RCT of two adjunct APT interventions: APTHotline (telephone assessment of partner(s) plus standard PN) and APTPharmacy (community pharmacist assessment of partner(s) plus routine PN), versus standard PN alone (patient referral). Index patients were women diagnosed with genital chlamydia in 12 general practices and three community contraception and sexual health (CASH) services in London and south coast of England, randomised between 1 September 2011 and 31 July 2013. Results 199 women described 339 male partners, of whom 313 were reported by the index as contactable. The proportions of contactable partners considered treated within 6 weeks of index diagnosis were APTHotline 39/111 (35%), APTPharmacy 46/100 (46%), standard patient referral 46/102 (45%). Among treated partners, 8/39 (21%) in APTHotline arm were treated via hotline and 14/46 (30%) in APTPharmacy arm were treated via pharmacy. Conclusions The two novel primary care APT models were acceptable, feasible, compliant with regulations and capable of achieving acceptable outcomes within a pilot RCT but intervention uptake was low. Although addition of these interventions to standard PN did not result in a difference between arms, overall PN uptake was higher than previously reported in similar settings, probably as a result of introducing a formal evaluation. Recruitment to an individually randomised trial proved challenging and full evaluation will likely require service-level randomisation

‘Can you recommend any good STI apps?’ A review of content, accuracy and comprehensiveness of current mobile medical applications for STIs and related genital infections

Objective Seeking sexual health information online is common, and provision of mobile medical applications (apps) for STIs is increasing. Young people, inherently at higher risk of STIs, are avid users of technology, and apps could be appealing sources of information. We undertook a comprehensive review of content and accuracy of apps for people seeking information about STIs. Methods Search of Google Play and iTunes stores using general and specific search terms for apps regarding STIs and genital infections (except HIV), testing, diagnosis and management, 10 September 2014 to 16 September 2014. We assessed eligible apps against (1) 19 modified Health on The Net (HON) Foundation principles; and (2) comprehensiveness and accuracy of information on STIs/genital infections, and their diagnosis and management, compared with corresponding National Health Service STI information webpage content. Results 144/6642 apps were eligible. 57 were excluded after downloading. 87 were analysed. Only 29% of apps met ≥6 HON criteria. Content was highly variable: 34/87 (39%) covered one or two infections; 40 (46%) covered multiple STIs; 5 (6%) focused on accessing STI testing. 13 (15%) were fully, 46 (53%) mostly and 28 (32%) partially accurate. 25 (29%) contained ≥1 piece of potentially harmful information. Apps available on both iOS and Android were more accurate than single-platform apps. Only one app provided fully accurate and comprehensive information on chlamydia. Conclusions Marked variation in content, quality and accuracy of available apps combined with the nearly one-third containing potentially harmful information risks undermining potential benefits of an e-Health approach to sexual health and well-being.The Electronic Self-Testing Instruments for Sexually Transmitted Infection (eSTI2) Consortium is funded under the UKCRC Translational Infection Research (TIR) Initiative supported by the Medical Research Council (Grant Number G0901608) with contributions to the Grant from the Biotechnology and Biological Sciences Research Council, the National Institute for Health Research on behalf of the Department of Health, the Chief Scientist Office of the Scottish Government Health Directorates and the Wellcome Trust

Repurposing rapid diagnostic tests to detect falsified vaccines in supply chains

Substandard (including degraded) and falsified (SF) vaccines are a relatively neglected issue with serious global implications for public health. This has been highlighted during the rapid and widespread rollout of COVID-19 vaccines. There has been increasing interest in devices to screen for SF non-vaccine medicines including tablets and capsules to empower inspectors and standardise surveillance. However, there has been very limited published research focussed on repurposing or developing new devices for screening for SF vaccines. To our knowledge, rapid diagnostic tests (RDTs) have not been used for this purpose and have important potential for detecting falsified vaccines. We performed a proof-in-principle study to investigate their diagnostic accuracy using a diverse range of RDT-vaccine/falsified vaccine surrogate pairs. In an initial assessment, we demonstrated the utility of four RDTs in detecting seven vaccines. Subsequently, the four RDTs were evaluated by three blinded assessors with seven vaccines and four falsified vaccines surrogates. The results provide preliminary data that RDTs could be used by multiple international organisations, national medicines regulators and vaccine manufacturers/distributors to screen for falsified vaccines in supply chains, aligned with the WHO global ‘Prevent, Detect and Respond’ strategy

Innovative method for rapid detection of falsified COVID-19 vaccines through unopened vials using handheld Spatially Offset Raman Spectroscopy (SORS)

Preventing, detecting, and responding to substandard and falsified vaccines is of critical importance for ensuring the safety, efficacy, and public trust in vaccines. This is of heightened importance in context of public health crisis, such as the COVID-19 pandemic, in which extreme world-wide shortages of vaccines provided a fertile ground for exploitation by falsifiers. Here, a proof-of-concept study explored the feasibility of using a handheld Spatially Offset Raman Spectroscopy (SORS) device to authenticate COVID-19 vaccines through rapid analysis of unopened vaccine vials. The results show that SORS can verify the chemical identity of dominant excipients non-invasively through vaccine vial walls. The ability of SORS to identify potentially falsified COVID-19 vaccines was demonstrated by measurement of surrogates for falsified vaccines contained in vaccine vials. In all cases studied, the SORS technique was able to differentiate between surrogate samples from the genuine COVISHIELD™ vaccine. The genuine vaccines tested included samples from six batches across two manufacturing sites to account for any potential variations between batches or manufacturing sites. Batch and manufacturing site variations were insignificant. In conjunction with existing security features, for example on labels and packaging, SORS provided an intrinsic molecular fingerprint of the dominant excipients of the vaccines. The technique could be extended to other COVID-19 and non-COVID-19 vaccines, as well as other liquid medicines. As handheld and portable SORS devices are commercially available and widely used for other purposes, such as airport security, they are rapidly deployable non-invasive screening tools for vaccine authentication.</p

Decoding human fetal liver haematopoiesis.

Definitive haematopoiesis in the fetal liver supports self-renewal and differentiation of haematopoietic stem cells and multipotent progenitors (HSC/MPPs) but remains poorly defined in humans. Here, using single-cell transcriptome profiling of approximately 140,000 liver and 74,000 skin, kidney and yolk sac cells, we identify the repertoire of human blood and immune cells during development. We infer differentiation trajectories from HSC/MPPs and evaluate the influence of the tissue microenvironment on blood and immune cell development. We reveal physiological erythropoiesis in fetal skin and the presence of mast cells, natural killer and innate lymphoid cell precursors in the yolk sac. We demonstrate a shift in the haemopoietic composition of fetal liver during gestation away from being predominantly erythroid, accompanied by a parallel change in differentiation potential of HSC/MPPs, which we functionally validate. Our integrated map of fetal liver haematopoiesis provides a blueprint for the study of paediatric blood and immune disorders, and a reference for harnessing the therapeutic potential of HSC/MPPs.We acknowledge funding from the Wellcome Human Cell Atlas Strategic Science Support (WT211276/Z/18/Z); M.H. is funded by Wellcome (WT107931/Z/15/Z), The Lister Institute for Preventive Medicine and NIHR and Newcastle-Biomedical Research Centre; S.A.T. is funded by Wellcome (WT206194), ERC Consolidator and EU MRG-Grammar awards and; S.B. is funded by Wellcome (WT110104/Z/15/Z) and St. Baldrick’s Foundation; E.L. is funded by a Wellcome Sir Henry Dale and Royal Society Fellowships, European Haematology Association, Wellcome and MRC to the Wellcome-MRC Cambridge Stem Cell Institute and BBSRC

“I can't lie to your face”: Minimal face-to-face interaction promotes honesty

Scholars have noted that face-to-face (FTF) interaction promotes honesty because it provides opportunities for conversation in which parties exchange information and build rapport. However, it is unclear whether FTF interaction promotes honesty even in the absence of opportunities for back-and-forth conversation. We hypothesized a minimal interaction effect whereby FTF interaction promotes honesty by increasing potential deceivers' consideration of their own moral-interest. To test this account of how FTF interaction may promote honesty, we used a modified version of the deception game (Gneezy, 2005). We found that people were more honest when communicating FTF as opposed to through an intermediary. While FTF interaction tended to promote honesty irrespective of whether it occurred prior to or during the game, the effect was more pronounced when it occurred during the game. The effect of in-game communication medium was mediated by the activation of potential deceivers' moral-interest. We also ruled out alternate accounts involving interpersonal liking, expected counterpart trust, and retaliation fear as honesty-promoting mechanisms. Furthermore, because these effects were not moderated by whether participants had been visually identified during a pre-game interaction, we suggest that our effects are distinct from theoretical accounts involving anonymity. © 2014

IQuaD dental trial; improving the quality of dentistry : a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care

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