Clashing Cultures or Collaborating Networks: A Study of Organization Culture in Breast Cancer Prevention

This study explored organization culture and policy within the community/metaorganization formed by diverse arenas of breast cancer prevention. The subject area of breast cancer was chosen due to its social significance as a major health issue. The phenomenon of organization culture was chosen due to the interest of the researcher, and the implications for collaborative leadership within the cancer prevention community. The community/metaorganization includes formal and informal relationships between organizations that have a role in the prevention of breast cancer. Included were individuals working/volunteering in different arenas across organizations with undefined lines of authority and communication. Four arenas of involvement were determined significant: (a) primary prevention, (b) secondary prevention, (c) tertiary prevention, and (d) advocacy. Qualitative methodology was applied to develop a grounded theory inductively, primarily from interviews and a focus group. The findings of the study suggest nine distinct organization cultures exist within the breast cancer prevention community/metaorganization. The cultures observed related to each other based on their alignment to the three prevention policy arenas: primary, secondary, and tertiary. A dominant culture emerged referred to as conventional wisdom. Emergent was a significant complex interaction of conventional wisdom with the advocacy movement of the early 1990s. This interaction consisted of a clashing that resulted in differentiated culture outcomes for advocacy: radical activism, political activism, and outreacher. The study presents examples of both clashing cultures and collaborating networks, grounded in the data collected from participants. Leadership emerged from the data as a major theme/category expressed in different ways by participants from different organization culture perspectives

Protein adsorption onto Fe3O4 nanoparticles with opposite surface charge and its impact on cell uptake

Nanoparticles (NPs) engineered for biomedical applications are meant to be in contact with protein-rich physiological fluids. These proteins are usually adsorbed onto the NP surface, forming a swaddling layer called protein corona that influences cell internalization. We present a study on protein adsorption onto different magnetic NPs (MNPs) when immersed in cell culture medium, and how these changes affect the cellular uptake. Two colloids with magnetite cores of 25 nm, same hydrodynamic size and opposite surface charge were in situ coated with (a) positive polyethyleneimine (PEI-MNPs) and (b) negative poly(acrylic acid) (PAA-MNPs). After few minutes of incubation in cell culture medium the wrapping of the MNPs by protein adsorption resulted in a 5-fold size increase. After 24 h of incubation large MNP-protein aggregates with hydrodynamic sizes 1500 to 3000 nm (PAA-MNPs and PEI-MNPs respectively) were observed. Each cluster contained an estimated number of magnetic cores between 450 and 1000, indicating the formation of large aggregates with a "plum pudding" structure of MNPs embedded into a protein network of negative surface charge irrespective of the MNP_core charge. We demonstrated that PEI-MNPs are incorporated in much larger amounts than the PAA-MNPs units. Quantitative analysis showed that SH-SY5Y cells can incorporate 100 per cent of the added PEI-MNPs up to about 100 pg per cell, whereas for PAA-MNPs the uptake was less than 50 percent. The final cellular distribution showed also notable differences regarding partial attachment to the cell membrane. These results highlight the need to characterize the final properties of MNPs after protein adsorption in biological media, and demonstrate the impact of these properties on the internalization mechanisms in neural cells.Comment: 32 pages, 10 figure

Prophylaxis of Postoperative Nausea and Vomiting in Adolescent Patients: A Review with Emphasis on Combination of Fixed-Dose Ondansetron and Transdermal Scopolamine

Postoperative nausea and vomiting (PONV) is a relatively common occurrence (20–30%) that delays discharge and, if persistent, can lead to serious complications. The incidence of PONV is a function of patient characteristics, the type and duration of surgery, the type of anesthesia, and the choice of pre-, intra-, and postoperative pharmacotherapy. There are no completely effective antiemetic agents for this condition, but recommendations for treatment strategies are separately available for pediatric and adult patients. Left unclear is whether adolescents should be guided by the pediatric or the adult recommendations. We review the developmental physiology of the relevant physiological factors (absorption, distribution, metabolism, and elimination). We also review the clinical evidence regarding the safety and efficacy of a fixed-dose combination of ondansetron (4 mg, i.v.) and transdermal scopolamine (1.5 mg)

Postoperative pain surveys in Italy from 2006 and 2012. (POPSI and POPSI-2)

OBJECTIVE: Despite established standards, effective treatments, and evidence-based guidelines, postoperative pain control in Italy and other parts of the world remains suboptimal. Pain control has been recognized as a fundamental human right. Effective treatments exist to control postsurgical pain. Inadequate postoperative analgesia may prolong the length of hospital stays and may adversely impact outcomes. MATERIALS AND METHODS: The same multiple-choice survey administered at the SIAARTI National Congress in Perugia in 2006 (n=588) was given at the SIAARTI National Congress in Naples, Italy in 2012 (n=635). The 2012 survey was analysed and compared to the 2006 results. RESULTS: Postoperative pain control in Italy was less than optimal in 2006 and showed no substantial improvements in 2012. Geographical distinctions were evident with certain parts of Italy offering better postoperative pain control than other. Fewer than half of hospitals represented had an active Acute Pain Service (APS) and only about 10% of postsurgical patients were managed according to evidence-based guidelines. For example, elastomeric pumps for continuous IV infusion are commonly used in Italy, although patient-controlled analgesia systems are recommended in the guidelines. The biggest obstacles to optimal postoperative pain control reported by respondents could be categorized as organizational, cultural, and economic. CONCLUSIONS: There is considerable room for improvement in postoperative pain control in Italy, specifically in the areas of clinical education, evidence-based treatments, better equipment, and implementation of active APS departments in more hospitals. Two surveys taken six years apart in Italy reveal, with striking similarity, that there are many unmet needs in postoperative pain control and that Italy still falls below European standards for postoperative pain control

PANIC DISORDER, ANXIETY, AND CARDIOVASCULAR DISEASES

Different data indicate that psychological and/or emotional disorders may play an important role in the natural history of heart diseases. Although the major evidence is that related to depression, epidemiological data would indicate that anxiety and panic disorders are highly represented in cardiac patient, thus influencing mortality and morbidity. The diagnosis of panic disorder in patients with chest pain is crucial to a correct therapeutic approach, as well as to reduce the risks and costs of inappropriate treatments. Anxiety and panic may accelerate different direct and indirect processes involved in the pathogenesis of cardiovascular diseases: lifestyle risk factors, arterial hypertension, myocardial perfusion, autonomic nervous system or hypothalamus-pituitary-adrenal axis, platelet activation, and inflammation processes. Panic disorder seems to correlate particularly with sudden death: this suggests that it may be considered one of the main inducers of life-threatening arrhythmias, rather than to be linked to the development and progression of coronary atherosclerosis. Beyond hard outcomes, panic disorders produce negative effects on both global adjustment and life quality that may impair the course of the cardiac diseases. Interestingly, specific antipanic and anxiolytic agents seem to be particularly effective upon life quality. In any case, adequate controlled clinical trials are necessary in order to confirm the possibility of cardiovascular risk reduction by means of anxiety and panic disorder treatment

Growth factor choice is critical for successful functionalization of nanoparticles

Nanoparticles (NPs) show new characteristics compared to the corresponding bulk material. These nanoscale properties make them interesting for various applications in biomedicine and life sciences. One field of application is the use of magnetic NPs to support regeneration in the nervous system. Drug delivery requires a functionalization of NPs with bio-functional molecules. In our study, we functionalized self-made PEI-coated iron oxide NPs with nerve growth factor (NGF) and glial cell-line derived neurotrophic factor (GDNF). Next, we tested the bio-functionality of NGF in a rat pheochromocytoma cell line (PC12) and the bio-functionality of GDNF in an organotypic spinal cord culture. Covalent binding of NGF to PEI-NPs impaired bio-functionality of NGF, but non-covalent approach differentiated PC12 cells reliably. Non-covalent binding of GDNF showed a satisfying bio-functionality of GDNF:PEI-NPs, but turned out to be unstable in conjugation to the PEI-NPs. Taken together, our study showed the importance of assessing bio-functionality and binding stability of functionalized growth factors using proper biological models. It also shows that successful functionalization of magnetic NPs with growth factors is dependent on the used binding chemistry and that it is hardly predictable. For use as therapeutics, functionalization strategies have to be reproducible and future studies are needed

Atlas-Based Evaluation of Hemodynamic in Ascending Thoracic Aortic Aneurysms

Atlas-based analyses of patients with cardiovascular diseases have recently been explored to understand the mechanistic link between shape and pathophysiology. The construction of probabilistic atlases is based on statistical shape modeling (SSM) to assess key anatomic features for a given patient population. Such an approach is relevant to study the complex nature of the ascending thoracic aortic aneurysm (ATAA) as characterized by different patterns of aortic shapes and valve phenotypes. This study was carried out to develop an SSM of the dilated aorta with both bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV), and then assess the computational hemodynamic of virtual models obtained by the deformation of the mean template for specific shape boundaries (i.e., ±1.5 standard deviation, σ). Simulations demonstrated remarkable changes in the velocity streamlines, blood pressure, and fluid shear stress with the principal shape modes such as the aortic size (Mode 1), vessel tortuosity (Mode 2), and aortic valve morphologies (Mode 3). The atlas-based disease assessment can represent a powerful tool to reveal important insights on ATAA-derived hemodynamic, especially for aneurysms which are considered to have borderline anatomies, and thus challenging decision-making. The utilization of SSMs for creating probabilistic patient cohorts can facilitate the understanding of the heterogenous nature of the dilated ascending aorta

BNNT- Mediated Irreversible Electroporation: It\u27s Potential on Cancer Cells

Irreversible lethal electroporation (IRE) is a new non-thermal ablation modality that uses short pulses of high amplitude static electric fields (up 1000V/cm) to create irreversible pores in the cell membrane, thus, causing cell death. Recently, IRE has emerged as a promising clinical modality for cancer disease treatment. Here, we investigated the responses of tumour human He La cells when subjected to IRE in the presence of BNNTs. These consist of tiny tubes of B and N atoms (arranged in hexagons) with diameters ranging from a 1 to 3 nanometres and lengths \u3c2 μm. BNNTs have attracted wide attention because of their unique electrical properties. We speculate that BNNTs, when interacting with cells exposed to static electrical fields, amplify locally the electric field, leading to cell death. In this work, electroporation assays were performed with a commercial electroporator using the cell-specific protocol suggested by the supplier (exponential decay wave, time constant 20ms) with the specific aim to compare IRE in absence and in presence of BNNTs. We observed that BNNTs have the capacity to decrease substantially the voltage required for IRE. When cells were pulsed at 800V/cm, we observed a 2,2-fold reduction in cell survival in the presence of BNNTs compared to controls. We conclude that the death of the tumour cells exposed to IRE is strongly enhanced in the presence of BNNTs, indicating their potential therapeutic application