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The New Diagnostic Team, Mark L. Graber, Diana Rusz, Melissa L. Jones

Articles

The National Academy of Medicine (NAM) in the recently issued report Improving Diagnosis in Health Care outlined eight major recommendations to improve the quality and safety of diagnosis. The #1 recommendation was to improve teamwork in the diagnostic process. This is a major departure from the classical approach, where the physician is solely responsible for diagnosis. In the new, patient-centric vision, the core team encompasses the patient, the physician and the associated nursing staff, with each playing an active role in the process. The expanded diagnostic team includes pathologists, radiologists, allied health professionals, medical librarians, and others. We review the …

Efficacy And Mechanistic Insigh Endocrine Disruptor Degradation Using Atmospheric Air Plasma, Chaitanya Sarangapani, Martin Danaher, Brijesh Tiwari, Peng Lu, Paula Bourke, Patrick Cullen

Articles

Endocrine disruptors are a class of contaminants found in water and process effluents at low concentrations. They are of concern due to their high estrogenic potency. Their presence in the environment has led to the search for effective techniques for their removal in wastewater. For this purpose, an atmospheric air plasma reactor was employed for the study of the degradation of three endocrine disruptor chemicals (EDC) namely; bisphenol A (BPA), estrone (E1) and 17β- 27 estradiol (E2) within a model dairy effluent. Identification of the plasma induced active species both in the gas and liquid phases were performed. Also studied …

A Mathematical Analysis Of Drug Dissolution In The Usp Flow Through Apparatus, David Mcdonnell, Deirdre M. D'Arcy, Lawrence J. Crane, Brendan Redmond

Articles

This paper applies boundary layer theory to the process of drug dissolution in the USP (United States Pharmacopeia) Flow Through Apparatus. The mass transfer rate from the vertical planar surface of a compact within the device is examined. The theoretical results obtained are then compared with those of experiment. The paper also examines the effect on the dissolution process caused by the interaction between natural and forced convection within the apparatus and the introduction of additional boundaries.

Vitamin D Supplementation To Prevent Asthma Exacerbations: A Systematic Review And Meta-Analysis Of Individual Participant Data, David Jolliffe, Lauren Greenberg, Richard Hooper, Christopher Griffiths, Carlos Camargo Jr., Mitsuyoshi Urashima, Conor Kerley, Megan Jensen, David Mauger, Iwona Stelmach, Adrian Martineau

Articles

No abstract provided.

Plasmonic Gold Nanoparticle For Detection Of Fungi And Human Cutaneous Fungal Infections, Tobiloba Sojinrin, Kangze Liu, Joao Conde, Hugh Byrne, James Curtin, Daxiang Cui, Furong Tian

Articles

Fungi, which are common in the environment, can cause a multitude of diseases. Warm, humid conditions allow fungi to grow and infect humans via the respiratory, digestive and reproductive tracts, genital area and other bodily interfaces. Fungi can be detected directly by microscopy, using the potassium hydroxide (KOH) test, which is the gold standard and most popular method for fungal screening. However, this test requires trained personnel operating specialist equipment, including a fluorescent microscope and culture facilities. As most acutely infected patients seek medical attention within the first few days of symptoms, the optimal diagnostic test would be rapid and …

Lack Of Effect Of Vitamin D3 Supplementation In Autism: A 20-Week, Placebo-Controlled Rct, Conor Kerley, Clare Power, Louise Gallagher, David Coghlan

Articles

No abstract provided.

Extraoral Maxillofacial Prosthesis Implant Retention Systems: A Critical Review., Hugh Byrne, Marina L. Pimentel

Articles

Objectives: The purpose of this literature review is to provide information on the different available techniques for implant-supported prosthetic retention, which are bar-clip, o-ring or magnets. Through presenting the practitioner preferences reported in literature, although limited from strict comparison due to the heterogeneity of methodologies and studied individuals, this review aims to identify the choices for maxillofacial prosthesis implant retention systems, regarding patient comfort and good aesthetic outcome, as an aid to surgical and prosthetic planning for implant-supported extraoral maxillofacial prosthetics. With proper knowledge of each implant retention system, a practitioner can design a treatment plan which allows for a …

Ultra-Filtration Of Human Serum For Improved Quantitative Analysis Of Low Molecular Weight Biomarkers Using Atr-Ir Spectroscopy, Franck Bonnier, Luis Felipe Cs. Carvalho, Matthew J. Baker, Hugh Byrne, Igor Chourpa

Articles

Infrared spectroscopy is a reliable, rapid and cost effective characterisation technique, delivering a molecular finger print of the sample. It is expected that its sensitivity would enable detection of small chemical variations in biological samples associated with disease. ATR-IR is particularly suitable for liquid sample analysis and, although air drying is commonly performed before data collection, just a drop of human serum is enough for screening and early diagnosis. However, the dynamic range of constituent biochemical concentrations in the serum composition remains a limiting factor to the reliability of the technique. Using glucose as a model spike in human serum, …

Copd Management And Role Of The Nurse Coach: Increasing Referrals And Participation In Pulmonary Rehabilitation, Carol Upcraft, C. Hoover, Joy Plamann, Jessica Oman

Articles

Chronic obstructive pulmonary disease (COPD) remains a significant cause for hospitalization and with complex management issues upon discharge a significant portion are being re-admitted within 30-days of first hospitalization. The beneficial effects of pulmonary rehabilitation (PR) in the management of COPD is well documented but continues to be underutilized as an important management strategy to reduce hospital readmissions. Transitional care programs which include nurse coaches, have immerged to empower patients to manage their disease and facilitate transitions through multiple care environments. Little is known about the efficacy of such programs on referral and participation in PR and subsequent reductions in …

Competency-Based Assessment Of Refractive Error Measurement In A Mozambique Optometry School, Kajal Shah, Kovin Naidoo, Luigi Bilotto, James Loughman

Articles

Background: The aims of this study were to develop a process for assessing refractive error management competence among the first two cohorts of students in a new optometry program at Unilúrio in Mozambique and to understand the effectiveness of implementing the process in the context of a low resource environment. Methods: The assessment methods were developed using information from a literature review and a focus group discussion and implemented on 15 students. Results: The exams consisted of direct observation of two patients, short-answer questions and a structured oral examination. Conclusion: The use of existing checklists and rating skills helped to …

Open-Label Phase I Clinical Study To Assess The Safety And Efficacy Of Cilostazol In Patients Undergoing Internal Carotid Artery Stent Placement, A E. Hassan, H Zacharatos, M Grigoryan, Muhammed Suri, Adnan Qureshi

Articles

BACKGROUND:

One-month dual antiplatelet treatment, with aspirin and clopidogrel, following internal carotid artery stent placement is the current standard of care to prevent in-stent thrombosis. Cilostazol, an antiplatelet drug, has been demonstrated to have a safety profile comparable to aspirin and clopidogrel.

OBJECTIVE:

To evaluate the safety and clinical efficacy of cilostazol and aspirin therapy following internal carotid artery stent placement up to 1 month postprocedure.

METHODS:

A phase I open-label, nonrandomized two-center prospective study was conducted. All subjects received aspirin (325 mg/day) and cilostazol (200 mg/day) 3 days before extracranial stent placement. Two antiplatelet agents were continued for 1 …

Pilot Evaluation Of An Online Weight Management Programme, Shona Cawley, Stephen Farrell, Declan G. Byrne, Michael Turner, B. Clune, Daniel Mccartney

Articles

This intervention examined the efficacy of a six-week online weight loss programme. Students and staff of a third level institution (n=183) were recruited to the programme which provided individualised dietary advice for weight loss. Eighty-five participants (mean age 29.7 years, mean BMI 28.9kg/m2, 33% male) met the minimum inclusion criterion of logging on to the study website at least twice. All participants who completed the full six-week programme lost weight (n=31), with significant reductions in mean weight (2.8kg), BMI (0.9kg/m2) and waist circumference (4.1cm) observed between the start and end of the programme (all P5% of their bodyweight, with reductions …

Differentiating Responses Of Lung Cancer Cell Lines To Doxorubicin Exposure: In Vitro Raman Micro Spectroscopy, Oxidative Stress And Bcl-2 Protein Expression, Zeineb Farhane, Franck Bonnier, Marcus A. Maher, Jane Bryant, Alan Casey, Hugh Byrne

Articles

The potential of Raman micro spectroscopy as an in vitro, non-invasive tool for clinical applications has been demonstrated in recent years, specifically for cancer research. To further illustrate its potential as a high content and label free technique, it is important to show its capability to elucidate drug mechanisms of action and cellular resistances. In this study, cytotoxicity assays were employed to establish the toxicity profiles for 24 hr exposure of lung cancer cell lines, A549 and Calu-1, to the commercially available drug, doxorubicin (DOX). Raman spectroscopy, coupled with Confocal Laser Scanning Microscopy and Flow Cytometry, was used to track …

In Vitro Comparative Cytotoxicity Study Of Aminated Polystyrene, Zinc Oxide And Silver Nanoparticles On A Cervical Cancer Cell Line, Akash Sharma, Brian Gorey, Alan Casey

Articles

Nanoparticles use in nano-biotechnology applications have increased significantly with Aminated polystyrene amine (AmPs NP), Zinc oxide (ZnO NP), and Silver (Ag NP) nanoparticles utilized in wide variety of consumer products. This has presented a number of concerns due to their increased exposure risks and associated toxicity on living systems. Changes in the structural and physicochemical properties of nanoparticles can lead to changes in biological activities. This study investigates, compares, and contrasts the potential toxicity of AmPs, ZnO and Ag NPs on an in vitro model (HeLa cells) and assesses the associated mechanism for their corresponding cytotoxicity relative to the surface …

How Adverse Outcome Pathways Can Aid The Development And Use Of Computational Prediction Models For Regulatory Toxicology, Clemens Wittwehr, Hristo Aladjov, Gerald Ankley, Hugh Byrne, Joop Deknecht

Articles

Efforts are underway to transform regulatory toxicology and chemical safety assessment from a largely empirical science based on direct observation of apical toxicity outcomes in whole organism toxicity tests to a predictive one in which outcomes and risk are inferred from accumulated mechanistic understanding. The adverse outcome pathway (AOP) framework provides a systematic approach for organizing knowledge that may support such inference. Likewise, computational models of biological systems at various scales provide another means and platform to integrate current biological understanding to facilitate inference and extrapolation. We argue that the systematic organization of knowledge into AOP frameworks can inform and …

Graphene Toxicity As A Double-Edged Sword Of Risks And Exploitable Opportunities: A Critical Analysis Of The Most Recent Trends And Developments, Yuri Volkov, Jennifer Mcintyre, Adriele Prina-Mello

Articles

Increased production volumes and a broadening application spectrum of graphene have raised concerns about its potential adverse effects on human health. Numerous reports demonstrate that graphene irrespective of its particular form exerts its effects on a widest range of living organisms, including prokaryotic bacteria and viruses, plants, micro-and macro-invertebrates, mammalian and human cells and whole animals in vivo. However, the available experimental data is frequently a matter of significant divergence and even controversy. Therefore, we provide here a critical analysis of the most recent (2015-2016) reports accumulated in the graphene-related materials biocompatibility and toxicology field in order to elucidate the …

Retention Systems For Extraoral Maxillofacial Prosthetic Implants: A Critical Review, M.V. Cobein, N.P. Coto, O. Crivello Junior, J.B.D. Lemos, L.M. Vieira, M.L. Pimentel, Hugh Byrne, R.B. Dias

Articles

We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001–13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after …

3d Printing Aids Acetabular Reconstruction In Complex Revision Hip Arthroplasty, Andrew J. Hughes, Cathal Debuitleir, Philip Soden, Brian O'Donnchada, Anthony Tansey, Ali Abdulkarim, Colm Mcmahon, Conor J. Hurson

Articles

Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D) representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise …

Reduction Of Surgical Site Infections After Cesarean, Melissa Erickson Msn Ed, Bsn, Rnc-Mnn, Phn, Patricia Dumonceaux Msn, Phn, Cic

Articles

To decrease cesarean surgical site infection (SSI) rates to less than the National Healthcare Safety Network (NHSN) mean. By decreasing SSI rates, secondary goals included improving the patient experience, decreasing readmissions, and promoting bonding between the mother and newborn.

Ambulatory Hemodynamic Monitoring Reduces Heart Failure Hospitalizations In "Real-World" Clinical Practice, Akshay S. Desai, Arvind Bhimaraj, Rita Jermyn, Jamie M. Pelzel

Articles

BACKGROUND:

In the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in New York Heart Association [NYHA] Functional Class III Heart Failure Patients) trial, heart failure hospitalization (HFH) rates were lower in patients managed with guidance from an implantable pulmonary artery pressure sensor compared with usual care.

OBJECTIVES:

This study examined the effectiveness of ambulatory hemodynamic monitoring in reducing HFH outside of the clinical trial setting.

METHODS:

We conducted a retrospective cohort study using U.S. Medicare claims data from patients undergoing pulmonary artery pressure sensor implantation between June 1, 2014, and December 31, 2015. Rates of HFH …

Epidemiological, Clinical And Genetic Aspects Of Adult Onset Isolated Focal Dystonia In Ireland, L. Williams, E. Mcgovern, O. Kimmich, A. Molloy, I. Beiser, John Butler, F. Molloy, P. Logan, D.G. Healy, T. Lynch, R. Walsh, L. Cassidy, P. Moriarty, H. Moore, T. Mcswiney, C. Walsh, S. O'Riordan, M. Hutchinson

Articles

Background: Adult onset idiopathic isolated focal dystonia presents with a number of phenotypes. Reported prevalence rates vary considerably; well-characterized cohorts are important to our understanding of this disorder.

Aim: To perform a nationwide epidemiological study of adult onset idiopathic isolated focal dystonia in the Republic of Ireland.

Methods: Patients with adult onset idiopathic isolated focal dystonia were recruited from multiple sources. Diagnosis was based on assessment by a neurologist with an expertise in movement disorders. When consent was obtained, a number of clinical features including family history were assessed.

Results: On the prevalence date there were 592 individuals in Ireland …

A Six Stage Operational Framework For Individualising Injury Risk Management In Sport, Mark Roe, Shane Malone, Catherine Blake, Kieran Collins, Conor Gissane, Fionn Buttner, John C. Murphy, Eamonn Delahunt

Articles

Managing injury risk is important for maximising athlete availability and performance. Although athletes are inherently predisposed to musculoskeletal injuries by participating in sports, etiology models have illustrated how susceptibility is influenced by repeat interactions between the athlete (i.e. intrinsic factors) and environmental stimuli (i.e. extrinsic factors). Such models also reveal that the likelihood of an injury emerging across time is related to the interconnectedness of multiple factors cumulating in a pattern of either positive (i.e. increased fitness) or negative adaptation (i.e. injury).

Co-Colonisation With Aspergillus Fumigatus And Pseudomonas Aeruginosa Is Associated With Poorer Health In Cystic Fibrosis Patients: An Irish Registry Analysis, Emma Reece, Ricardo Segurado, Abaigeal Jackson, Siobhan Mcclean, Julie Renwick, Peter Greally

Articles

Pulmonary infection is the main cause of death in cystic fibrosis (CF). Aspergillus fumigatus (AF) and Pseudomonas aeruginosa (PA) are the most prevalent fungal and bacterial pathogens isolated from the CF airway, respectively. Our aim was to determine the effect of different colonisation profiles of AF and PA on the clinical status of patients with CF.

Hypoxia Reduces The Pathogenicity Of Pseudomonas Aeruginosa By Decreasing The Expression Of Multiple Virulence Factors, Bettina Schaible, Javier Rodriguez, Amaya Garcia, Alexander Von Kriegsheim, Siobhan Mcclean, Caitríona Hickey, Ciara E. Keogh, Eric Brown, Kirsten Schaffer, Alexis Broquet, Cormac T. Taylor

Articles

Our understanding of how the course of opportunistic bacterial infection is influenced by the microenvironment is limited. We demonstrate that the pathogenicity of Pseudomonas aeruginosa strains derived from acute clinical infections is higher than that of strains derived from chronic infections, where tissues are hypoxic. Exposure to hypoxia attenuated the pathogenicity of strains from acute (but not chronic) infections, implicating a role for hypoxia in regulating bacterial virulence. Mass spectrometric analysis of the secretome of P. aeruginosa derived from an acute infection revealed hypoxia-induced repression of multiple virulence factors independent of altered bacterial growth. Pseudomonas aeruginosa lacking the Pseudomonas prolyl-hydroxylase …

Effects Of Carbohydrate Mouth Rinse And Caffeine On High-Intensity Interval Running In A Fed State, Simon Devenney, Shane Mangan, Marcus Shortall, Kieran Collins

Articles

The current study aims to identify if mouth rinsing with a 6% carbohydrate mouth-rinse (CMR) solution and mouth rinsing and ingestion of caffeine (CMR+CAFF) can affect exercise performance during steady-state (SS) running and high-intensity intervals (HIIT) in comparison with a 0% control solution (PLA) when in a fed state. Eight recreationally trained males completed 3 trials (CMR, CMR+CAFF, and PLA) of 45 min SS running and an HIIT protocol (90% peak treadmill velocity) until fatigue in a double blinded, repeated-measures study. Participants ingested a capsule of either CAFF or PLA before and after SS. Participants received a 25-mL bolus of …

Sequential Burkholderia Cenocepacia Isolates From Siblings With Cystic Fibrosis Show Increased Lung Cell Attachment, Louise Cullen, Andrew O'Connor, Pavel Drevinek, Kirsten Schaffer, Siobhan Mcclean

Articles

No abstract available

Isolation And Spectroscopic Characterization Of Zn(Ii), Cu(Ii), And Pd(Ii) Complexes Of 1,3,4-Thiadiazole-Derived Ligand, Dariusz Karcz, Arkadiusz Matwijczuk, Bozena Boron, Bernadette Creaven, Leszek Fiedor, Andrzej Niewiadomy, Mariusz Gagos

Articles

A series of complexes incorporating Zn(II), Cu(II), and Pd(II) ions, and 4-(5-heptyl-1,3,4-thiadiazol-2-yl)benzene-1,3-diol (L1) as model ligand, was synthesized in order to examine the nature of potential interactions between biologically active ligands, 1,3,4-thiadiazoles and metal ions with proven biological relevance. The structures of the compounds isolated were characterized using a number of spectroscopic methods including IR, Uv–vis, AAS, steady state and time-resolved fluorescence (TRF). The results obtained suggest that the L1-Zn(II) and L1-Pd(II) complexes consist of one molecule of L1 and one acetate ion acting as ligands, while the L1-Cu(II) complex adapts a 2:1 (L1: metal) stoichiometry. The coordination of L1 …

Validation Of A Membrane Touch Biosensor For The Qualitative Detection Of Igg Class Antibodies To Herpes Simplex Virus Type 2, Tony Loughman, Baljit Singh, Brian Seddon, Philip Noone, Padmanabhan Santhosh

Articles

A novel type of biosensor was assessed for application to the qualitative determination of circulating antibodies to herpes simplex virus type 2 (HSV-2). The device utilises a high activity HSV-2 type specific gG2 antigen for antibody capture and commercially available ELISA reagents. The study compares the diagnostic performance of a prototype HSV-2 biochip to well-established in vitro tests routinely applied in clinical procedures. A panel of human serum samples (n = 60) previously characterised for HSV-2 serological status using the DiaSorin LIAISON® HSV-2 chemiluminescent immunoassay were assayed on the HSV-2 biochip and the Focus Diagnostics HerpeSelect® 2 ELISA IgG kit …

Effect Of Game Design, Goal Type, And Player Numbers On The Physiological And Physical Demands Of Hurling-Specific Small-Sided Games, Shane Malone, Kieran Collins

Articles

The current study examined the effect that game design modification, goal type, and player numbers on the running performance and physiological demands of small-sided hurling games (SSG). Forty-eight hurling players (age, 25.5 ± 3.2 years; height, 178.9 ± 3.2 cm; body mass, 78.5 ± 4.5 kg) performed 4 types of SSG (possession [P], normal play [NP], regular goals [RG] and small goals [SG]) in 4-a-side, 5-a-side, and 6-a-side formats. Heart rate (Polar Electro Oy) and global positioning system technology (VX Sport, 4-Hz, Lower Hutt) were used to analyze the physical and physiological differences between SSG. Total distance (m), high-speed running …

Are Small-Sided Games An Effective Training Methodology For Improving Fitness In Hurling Players? A Comparative Study Of Training Methodologies, Shane Malone, Brian Hughes, Kieran Collins

Articles

The current investigation compared the effects of specific small-sided games training versus generic continuous aerobic training on team sport related exercise performances. Forty-eight hurling players (age: 25 ± 6.4 years; height: 180.2 ± 20.4 cm; mass: 80.5 ± 3.2 kg; V·O2max" role="presentation" style="display: inline; line-height: normal; word-spacing: normal; overflow-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; position: relative;">V⋅O2maxV·O2max: 58.78 ± 3.05 ml·kg·min⁻¹) completed either traditional continuous aerobic training (n = 24) or team sport-specific small-sided game training (n = 24), consisting …