Spore Forming Actinobacterial Diversity of Cholistan Desert Pakistan: Polyphasic Taxonomy, Antimicrobial Potential and Chemical Profiling

Background: Actinobacteria are famous for the production of unique secondary metabolites that help in controlling the continuously emerging drug resistance all over the globe. This study aimed at the investigation of an extreme environment the Cholistan desert, located in southern Punjab, Pakistan, for actinobacterial diversity and their activity against methicillin resistant Staphylococcus aureus (MRSA). The Cholistan desert is a sub-tropical and arid ecosystem with harsh environment, limited rainfall and low humidity. The 20 soil and sand samples were collected from different locations in the desert and the actinobacterial strains were selectively isolated. The isolated strains were identified using a polyphasic taxonomic approach including morphological, biochemical, physiological characterization, scanning electron microscopy (SEM) and by 16S rRNA gene sequencing. Results: A total of 110 desert actinobacterial strains were recovered, which were found to be belonging to 3 different families of the order Actinomycetales, including the family Streptomycetaceae, family Pseudonocardiaceae and the family Micrococcaceae. The most frequently isolated genus was Streptomyces along with the genera Pseudonocardia and Arthrobacter. The isolated strains exhibited promising antimicrobial activity against methicillin resistant Staphylococcus aureus (MRSA) with zone of inhibition in the range of 9–32 mm in antimicrobial screening assays. The chemical profiling by thin layer chromatography, HPLC-UV/Vis and LC-MS analysis depicted the presence of different structural classes of antibiotics. Conclusion: The study revealed that Cholistan desert harbors immense actinobacterial diversity and most of the strains produce structurally diverse bioactive secondary metabolites, which are a promising source of novel antimicrobial drug candidates

Light-activated ferroelectric transition in layer dependent Bi2O2Se films

Bi2O2Se has attracted intensive attention due to its potential in electronics, optoelectronics, as well as ferroelectric applications. Despite that, there have only been a handful of experimental studies based on ultrafast spectroscopy to elucidate the carrier dynamics in Bi2O2Se thin films, Different groups have reported various ultrafast timescales and associated mechanisms across films of different thicknesses. A comprehensive understanding in relation to thickness and fluence is still lacking. In this work, we have systematically explored the thickness-dependent Raman spectroscopy and ultrafast carrier dynamics in chemical vapor deposition (CVD)-grown Bi2O2Se thin films on mica substrate with thicknesses varying from 22.44 nm down to 4.62 nm at both low and high pump fluence regions. Combining the thickness dependence and fluence dependence of the slow decay time, we demonstrate a ferroelectric transition in the thinner (< 8 nm) Bi2O2Se films, influenced by substrate-induced compressive strain and non-equilibrium states. Moreover, this transition can be manifested under highly non-equilibrium states. Our results deepen the understanding of the interplay between the ferroelectric phase and semiconducting characteristics of Bi2O2Se thin films, providing a new route to manipulate the ferroelectric transition

Accurate identification of hospital admissions from care homes; development and validation of an automated algorithm

Background: measuring the complex needs of care home residents is crucial for resource allocation. Hospital patient administration systems (PAS) may not accurately identify admissions from care homes. Objective: to develop and validate an accurate, practical method of identifying care home resident hospital admission using routinely collected PAS data. Method: admissions data between 2011 and 2012 (n = 103,105) to an acute Trust were modelled to develop an automated tool which compared the hospital PAS address details with the Care Quality Commission’s (CQC) database, producing a likelihood of care home residency. This tool and the Nuffield method (CQC postcode match only) were validated against a manual check of a random sample of admissions (n = 2,000). A dataset from a separate Trust was analysed to assess generalisability. Results:the hospital PAS was inaccurate; none of the admissions from a care home identified on manual check had a care home source of admission recorded on the PAS. Both methods performed well; the automated tool had a higher positive predictive value than the Nuffield method (100% 95% confidence interval (CI) 98.23–100% versus 87.10% 95%CI 82.28–91.00%), meaning those coded as care home residents were more likely to actually be from a care home. Our automated tool had a high level of agreement 99.2% with the second Trust’s data (Kappa 0.86 P &lt; 0.001). Conclusions: care home status is not routinely or accurately captured. Automated matching offers an accurate, repeatable, scalable method to identify care home residency and could be used as a tool to benchmark how care home residents use acute hospital resources across the National Health Service

Advance Care Plans in UK care home residents: a service evaluation using a stepped wedge design

Introduction Advance care planning (ACP) in care homes has high acceptance, increases the proportion of residents dying in place and reduces hospital admissions in research. We investigated whether ACP had similar outcomes when introduced during real-world service implementation. Methods A service undertaking ACP in Lincoln, UK care homes was evaluated using routine data. Outcomes were proportion of care homes and residents participating in ACP; characteristics of residents choosing/declining ACP; and place of death for those with/without ACP. Hospital admissions were analysed using mixed-effects Poisson regression for number of admissions, and a mixed-effects negative binomial model for number of occupied hospital bed days. Results15/24 (63%) eligible homes supported the service, in which 404/508 (79.5%) participants chose ACP. Residents choosing ACP were older, frailer, more cognitively impaired and malnourished. 384/404 (95%) residents choosing ACP recorded their care home as their preferred place of death: 380/404 (94%) declined cardiopulmonary resuscitation. Among deceased residents, 219/248 (88%) and 33/49 (67%) with and without advance care plan respectively died in their care home (relative risk 1.35, 95%CI 1.1-1.6, p<0.001). Hospital admission rates and bed occupancy did not differ after implementation. Discussion 79.5% participants chose ACP. Those doing so were more likely to die at home. Many homes were unwilling or unable to support the service. Further research should consider how to enlist the support of these homes. Hospital admissions were not reduced and may not be an appropriate outcome metric for ACP in care homes

Components, impacts and costs of dementia home support: a research programme including the DESCANT RCT

BackgroundOver half of people with dementia live at home. We know little about what home support could be clinically effective or cost-effective in enabling them to live well.ObjectivesWe aimed to (1) review evidence for components of home support, identify their presence in the literature and in services in England, and develop an appropriate economic model; (2) develop and test a practical memory support package in early-stage dementia, test the clinical effectiveness and cost-effectiveness of routine home support in later-stage dementia and design a toolkit based on this evidence; and (3) elicit the preferences of staff, carers and people with dementia for home support inputs and packages, and evaluate the cost-effectiveness of these approaches in early- and later-stage dementia.DesignWe undertook (1) an evidence synthesis, national surveys on the NHS and social care and an economic review; (2) a multicentre pragmatic randomised trial [Dementia Early Stage Cognitive Aids New Trial (DESCANT)] to estimate the clinical effectiveness and cost-effectiveness of providing memory aids and guidance to people with early-stage dementia (the DESCANT intervention), alongside process evaluation and qualitative analysis, an observational study of existing care packages in later-stage dementia along with qualitative analysis, and toolkit development to summarise this evidence; and (3) consultation with experts, staff and carers to explore the balance between informal and paid home support using case vignettes, discrete choice experiments to explore the preferences of people with dementia and carers between home support packages in early- and later-stage dementia, and cost–utility analysis building on trial and observational study.SettingThe national surveys described Community Mental Health Teams, memory clinics and social care services across England. Recruitment to the trial was through memory services in nine NHS trusts in England and one health board in Wales. Recruitment to the observational study was through social services in 17 local authorities in England. Recruitment for the vignette and preference studies was through memory services, community centres and carers’ organisations.ParticipantsPeople aged > 50 years with dementia within 1 year of first attendance at a memory clinic were eligible for the trial. People aged > 60 years with later-stage dementia within 3 months of a review of care needs were eligible for the observational study. We recruited staff, carers and people with dementia for the vignette and preference studies. All participants had to give written informed consent.Main outcome measuresThe trial and observational study used the Bristol Activities of Daily Living Scale as the primary outcome and also measured quality of life, capability, cognition, general psychological health and carers’ sense of competence.MethodsOwing to the heterogeneity of interventions, methods and outcome measures, our evidence and economic reviews both used narrative synthesis. The main source of economic studies was the NHS Economic Evaluation Database. We analysed the trial and observational study by linear mixed models. We analysed the trial by ‘treatment allocated’ and used propensity scores to minimise confounding in the observational study.ResultsOur reviews and surveys identified several home support approaches of potential benefit. In early-stage dementia, the DESCANT trial had 468 randomised participants (234 intervention participants and 234 control participants), with 347 participants analysed. We found no significant effect at the primary end point of 6 months of the DESCANT intervention on any of several participant outcome measures. The primary outcome was the Bristol Activities of Daily Living Scale, for which scores range from 0 to 60, with higher scores showing greater dependence. After adjustment for differences at baseline, the mean difference was 0.38, slightly but not significantly favouring the comparator group receiving treatment as usual. The 95% confidence interval ran from –0.89 to 1.65 (p = 0.56). There was no evidence that more intensive care packages in later-stage dementia were more effective than basic care. However, formal home care appeared to help keep people at home. Staff recommended informal care that cost 88% of formal care, but for informal carers this ratio was only 62%. People with dementia preferred social and recreational activities, and carers preferred respite care and regular home care. The DESCANT intervention is probably not cost-effective in early-stage dementia, and intensive care packages are probably not cost-effective in later-stage dementia. From the perspective of the third sector, intermediate intensity packages were cheaper but less effective. Certain elements may be driving these results, notably reduced use of carers’ groups.LimitationsOur chosen outcome measures may not reflect subtle outcomes valued by people with dementia.ConclusionsSeveral approaches preferred by people with dementia and their carers have potential. However, memory aids aiming to affect daily living activities in early-stage dementia or intensive packages compared with basic care in later-stage dementia were not clinically effective or cost-effective.Future workFurther work needs to identify what people with dementia and their carers prefer and develop more sensitive outcome measures.Study registrationCurrent Controlled Trials ISRCTN12591717. The evidence synthesis is registered as PROSPERO CRD42014008890.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 6. See the NIHR Journals Library website for further project information

A quality improvement collaborative aiming for Proactive HEAlthcare of Older People in Care Homes (PEACH): a realist evaluation protocol

Introduction: This protocol describes a study of a Quality Improvement Collaborative (QIC) to support implementation and delivery of Comprehensive Geriatric Assessment (CGA) in UK care homes. The QIC will be formed of health and social care professionals working in and with care homes and will be supported by clinical, quality improvement, and research specialists. QIC participants will receive quality improvement training using the Model for Improvement. An appreciative approach to working with care homes will be encouraged through facilitated shared learning events, quality improvement coaching, and assistance with project evaluation. Methods and analysis: The QIC will be delivered across a range of partnering organisations which plan, deliver and evaluate health services for care home residents in 4 local areas of one geographical region. A realist evaluation framework will be used to develop a programme theory informing how QICs are thought to work, for whom, and in what ways when used to implement and deliver CGA in care homes. Data collection will involve participant observations of the QIC over 18 months, and interviews/focus groups with QIC participants to iteratively define, refine, test, or refute the programme theory. Two researchers will analyse field notes, and interview/focus group transcripts, coding data using inductive and deductive analysis. The key findings and linked programme theory will be summarised as context-mechanism-outcome configurations (CMOs) describing what needs to be in place to use QICs to implement service improvements in care homes. Ethics and dissemination: The study protocol was reviewed by the NHS Health Research Authority (London Bromley research ethics committee reference: 205840) and the University of Nottingham ethics committee (reference: LT07092016). Both determined that the PEACH study was as a service and quality improvement initiative. Findings will be shared nationally and internationally through conference presentations, publication in peer-reviewed journals, a graphic illustration, and a dissemination video

Current Progress in 2D Metal–Organic Frameworks for Electrocatalysis

The 2D nanosheets of metal–organic frameworks (MOFs) have recently emerged as a promising material that makes them valuable in widespread electrocatalytic fields due to their atomic‐level thickness, abundant active sites, and large surface area. Efficient electrocatalysts for hydrogen evolution reaction (HER), oxygen evolution reaction (OER), and overall water splitting are highly desired with low overpotentials to promote the industrial applications of energy conversion and devices. 2D MOF nanostructures provide long‐term stability and high electrical conductivity to enhance catalyst activity and durability. This review briefly summarizes the synthesis and electrocatalytic applications of 2D MOF for HER/OER/water splitting. More attention is focused on the synthetic strategies of 2D MOF and their derivatives. The catalytic performance and superior properties of these materials are highlighted. The outperformance of these materials originates from the rational design, myriad of abundant active sites, and atomic‐level thickness. The current and future challenges in this field and the scientific perspectives to overcome these challenges are highlighted. It is suggested that the construction of 2D MOF nanostructures can develop a state‐of‐the‐art electrocatalyst in energy and environmental division

Spore forming Actinobacterial diversity of Cholistan Desert Pakistan: Polyphasic taxonomy, antimicrobial potential and chemical profiling

Abstract Background Actinobacteria are famous for the production of unique secondary metabolites that help in controlling the continuously emerging drug resistance all over the globe. This study aimed at the investigation of an extreme environment the Cholistan desert, located in southern Punjab, Pakistan, for actinobacterial diversity and their activity against methicillin resistant Staphylococcus aureus (MRSA). The Cholistan desert is a sub-tropical and arid ecosystem with harsh environment, limited rainfall and low humidity. The 20 soil and sand samples were collected from different locations in the desert and the actinobacterial strains were selectively isolated. The isolated strains were identified using a polyphasic taxonomic approach including morphological, biochemical, physiological characterization, scanning electron microscopy (SEM) and by 16S rRNA gene sequencing. Results A total of 110 desert actinobacterial strains were recovered, which were found to be belonging to 3 different families of the order Actinomycetales, including the family Streptomycetaceae, family Pseudonocardiaceae and the family Micrococcaceae. The most frequently isolated genus was Streptomyces along with the genera Pseudonocardia and Arthrobacter. The isolated strains exhibited promising antimicrobial activity against methicillin resistant Staphylococcus aureus (MRSA) with zone of inhibition in the range of 9–32 mm in antimicrobial screening assays. The chemical profiling by thin layer chromatography, HPLC-UV/Vis and LC-MS analysis depicted the presence of different structural classes of antibiotics. Conclusion The study revealed that Cholistan desert harbors immense actinobacterial diversity and most of the strains produce structurally diverse bioactive secondary metabolites, which are a promising source of novel antimicrobial drug candidates

Designing four naphthalene di-imide based small organic solar cells with 5,6-difluoro-3-oxo-2,3-dihydro-indene non-fullerene acceptors

Four new molecules namely bis (5,6-difluoro-3-oxo-2,3-dihydro-1H-indene-2,1-diylidene) di-malononitrile (NDM-1), 3-fluorothiophen-2-yl) methylene)-5, 6-difluoro-3-oxo-2, 3-dihydro-1H-inden-1-ylidene) acetate (NDM-2), 5, 6-difluoro-3-oxo-2, 3-dihydro-1H-inden-1-ylidene)-3-methyl-2-thioxothiazolidin-4-ylidene) malononitrile (NDM-3) and bis (1-methyl-2, 6-dioxo-1, 2, 5, 6-tetrahydropyridine-3-carbonitrile) (NDM-4) contains central Naphthalene Di-Imide unit with different end cap acceptors have been designed for enhance the photovoltaic efficiencies. Absorption values of designed molecules lies between 400 and 490 nm, re-organization energy values varies from 0.41 to 0.67 eV for electron and 0.49 eV to 1.25 eV for hole transfer, open circuit voltages range from 4.39 to 4.73 V which indicates their better photovoltaic properties as compared to the R (3-methyl-4-oxo-2-thioxothiazolidin-5-ylidene) methyl). Designed molecules proposed large number of electronic excitations and less charge loss at donor/acceptor interfaces due to small binding energy than reference molecule. Graphic abstract Charge transfer mechanism for adiabatic and vertical exchange

Structural and Magnetic Response in Bimetallic Core/Shell Magnetic Nanoparticles

Bimagnetic monodisperse CoFe2O4/Fe3O4 core/shell nanoparticles have been prepared by solution evaporation route. To demonstrate preferential coating of iron oxide onto the surface of ferrite nanoparticles X-ray diffraction (XRD), High resolution transmission electron microscope (HR-TEM) and Raman spectroscopy have been performed. XRD analysis using Rietveld refinement technique confirms single phase nanoparticles with average seed size of about 18 nm and thickness of shell is 3 nm, which corroborates with transmission electron microscopy (TEM) analysis. Low temperature magnetic hysteresis loops showed interesting behavior. We have observed large coercivity 15.8 kOe at T = 5 K, whereas maximum saturation magnetization (125 emu/g) is attained at T = 100 K for CoFe2O4/Fe3O4 core/shell nanoparticles. Saturation magnetization decreases due to structural distortions at the surface of shell below 100 K. Zero field cooled (ZFC) and Field cooled (FC) plots show that synthesized nanoparticles are ferromagnetic till room temperature and it has been noticed that core/shell sample possess high blocking temperature than Cobalt Ferrite. Results indicate that presence of iron oxide shell significantly increases magnetic parameters as compared to the simple cobalt ferrite