Comparative Evaluation of Blue Phantom and SCOBY-Based Models for Ultrasound-Guided Intravenous Cannulation Training.

Introduction: Ultrasound-guided intravenous (USIV) cannulation is a common alternative when IV access cannot otherwise be obtained. Many hospitals teach this skill with the commercial CAE Blue Phantom gelatinous training blocks. However, their cost is a barrier.

Improving the suspected cauda equina syndrome pathway at a district general hospital: a quality improvement project.

Cauda equina syndrome (CES) is a surgical emergency caused by acute compression of the lumbosacral nerve roots, requiring urgent surgical decompression. Delays in management can lead to permanent bowel and bladder incontinence, sexual dysfunction, lower limb paralysis and chronic pain.The Getting it Right First Time (GIRFT) National CES Pathway 2023 mandates that patients with red flag symptoms require an 'emergency MRI as soon as possible, certainly within 4 hours of request'.

The cliff-edge of toxicological concern: highlighting the potential issues of an over-reliance on "less-than-lifetime" thresholds.

The Threshold of Toxicological Concern (TTC) is a very well-established concept in applied toxicology, and has become a key tool for the pragmatic human health risk assessment of data-poor chemicals. Within the pharmaceutical sector, regulatory guidance on genotoxins defaults to a TTC of 1.5 μg/day equating to a maximum lifetime cancer risk of 1 in 100,000.

Perceptions of nicotine vaping products among Australians living with HIV.

People living with HIV (PLHIV) are two to three times more likely to smoke tobacco compared to the general community. Evidence from the general population suggests that nicotine vaping products (NVPs) can be acceptable and effective smoking cessation aids, but there is limited evidence on the extent to which this is the case among PLHIV. This manuscript reports findings from the Tobacco Harm Reduction with Vaporised Nicotine (THRiVe) trial, a mixed-methods study investigating the feasibility of NVPs as smoking cessation aids among 29 PLHIV who smoked tobacco.

Tobacco Harm Reduction with Vaporised Nicotine (THRiVe): A Feasibility Trial of Nicotine Vaping Products for Smoking Cessation Among People Living with HIV.

People living with HIV (PLHIV) have high rates of tobacco smoking. Nicotine vaping products (NVPs) may promote tobacco smoking cessation and/or harm reduction. This study aimed to trial the feasibility of NVPs for promoting tobacco smoking cessation among PLHIV.

Views and preferences of people living with HIV about smoking, quitting and use of nicotine products.

Aims And Background: People living with HIV (PLHIV) have a higher rate of smoking and experience a greater burden of tobacco-related disease than the general population. This study aimed to understand the role smoking plays in the lives of PLHIV, participants' views of traditionally available nicotine products (e.g.

Studies pertaining to the monitoring of volatile halogenated anaesthetics in breath by proton transfer reaction mass spectrometry.

Post-operative isoflurane has been observed to be present in the end-tidal breath of patients who have undergone major surgery, for several weeks after the surgical procedures. A major new non-controlled, non-randomized, and open-label approved study will recruit patients undergoing various surgeries under different inhalation anaesthetics, with two key objectives, namely (1) to record the washout characteristics following surgery, and (2) to investigate the influence of a patient's health and the duration and type of surgery on elimination. In preparation for this breath study using proton transfer reaction time-of-flight mass spectrometry (PTR-TOF-MS), it is important to identify first the analytical product ions that need to be monitored and under what operating conditions.

Addressing smoking among people living with HIV: a cross-sectional survey of Australian HIV health practitioners' practices and attitudes.

People living with HIV (PLHIV) have high rates of tobacco smoking, and smoking is a leading cause of premature mortality and morbidity. It is important to understand HIV healthcare providers' practices and attitudes towards addressing smoking with their patients. An online survey that measured: (i) use of the 5A framework for addressing smoking (Ask, Assess, Advise, Assist, Arrange) and (ii) attitudes and barriers to addressing smoking cessation was distributed by relevant professional bodies.

Use of Rapid Reduced Electric Field Switching to Enhance Compound Specificity for Proton Transfer Reaction-Mass Spectrometry.

The high sensitivity of proton transfer reaction-mass spectrometry (PTR-MS) makes it a suitable analytical tool for detecting trace compounds. Its specificity is primarily determined by the accuracy of identifying the m/ z of the product ions specific to a particular compound. However, specificity can be enhanced by changing the product ions (concentrations and types) through modifying the reduced electric field.

Water-soluble substituted chitosan derivatives as technology platform for inhalation delivery of siRNA.

Despite research efforts full potential of siRNA-based therapeutics has not yet been fully realized due to a need for suitable, effective delivery formulations. Here, we examine a potential of a new class of water-soluble chitosans as siRNA platform for pulmonary delivery. The system is based on piperazine-substituted chitosans, a material designed to integrate established, safe application of chitosan for mucosal administration with novel properties: the piperazine-substituted chitosans are freely water-soluble at physiological pH, possess low cytotoxicity (no significant reduction in cell viability up to 0.

Ion Mobility Studies on the Negative Ion-Molecule Chemistry of Isoflurane and Enflurane.

In the present work we present an investigation of the negative ion-molecule chemistry of the anaesthetics isoflurane, ISOF, and enflurane, ENF, in an ion mobility spectrometry/mass spectrometry (IMS/MS), in both air and nitrogen. Hexachloroethane (HCE) was introduced in both air and nitrogen to produce Cl as a reactant ion. This study was undertaken owing to uncertainties in the chemical processes, which lead to the cluster ions reported in other work (Eiceman et al.

Enhancement of Compound Selectivity Using a Radio Frequency Ion-Funnel Proton Transfer Reaction Mass Spectrometer: Improved Specificity for Explosive Compounds.

A key issue with any analytical system based on mass spectrometry with no initial separation of compounds is to have a high level of confidence in chemical assignment. This is particularly true for areas of security, such as airports, and recent terrorist attacks have highlighted the need for reliable analytical instrumentation. Proton transfer reaction mass spectrometry is a useful technology for these purposes because the chances of false positives are small owing to the use of a mass spectrometric analysis.

Insight into the relationship between the cell culture model, cell trafficking and siRNA silencing efficiency.

Despite research efforts, cell uptake processes determining siRNA silencing efficiency remain unclear. Here, we examine the relationship between in vitro cell culture models, cellular trafficking and siRNA silencing efficiency to provide a mechanistic insight on siRNA delivery system design. Model siRNA-polyplexes, based on chitosan as a 'classical' condensing agent, were applied to a panel of lung epithelial cell lines, H1299, A549 and Calu-3 and cell internalization levels, trafficking pathways and gene silencing assessed on exposure to pharmacological inhibitors.

Nasal delivery of fentanyl.

Fentanyl, a potent opioid analgesic, is rapidly and efficiently absorbed from the nasal cavity, giving significant potential for nasally administered fentanyl to be used in pain management. Many reported clinical studies have used nasally administered IV solution, often as drops, which requires high volumes of solution to deliver an effective dose, resulting in insignificant runoff and drip which, in turn, compromises absorption and efficacy. More recently, products have been developed and commercialised with features intended to overcome these drawbacks, notably delivering the dose as a spray in a lower volume of solution and, for one of the products, incorporating an in situ gelling agent with the aim of both reducing runoff/drip and modifying the fentanyl absorption profile.

Development of in vitro models to demonstrate the ability of PecSys®, an in situ nasal gelling technology, to reduce nasal run-off and drip.

Unlabelled: Many of the increasing number of intranasal products available for either local or systemic action can be considered sub-optimal, most notably where nasal drip or run-off give rise to discomfort/tolerability issues or reduced/variable efficacy. PecSys, an in situ gelling technology, contains low methoxy (LM) pectin which gels due to interaction with calcium ions present in nasal fluid. PecSys is designed to spray readily, only forming a gel on contact with the mucosal surface.

The rise and fall of complementary medicine in National Health Service hospitals in England.

Whilst Complementary and Alternative Medicine (CAM) has never been systematically integrated into National Health Service (NHS) provision, there has been some limited evidence of a developing presence of CAM in NHS hospital based nursing and midwifery. This paper reports on a qualitative study that sought to document the nature and extent of such integrative practice in England, and the interpersonal and organisational factors that facilitated or impeded it. The data revealed a history in which attempts to integrate CAM had some initial success underpinned by the enthusiasm of individual practitioners and a relatively permissive organisational context.

Chitosan-based delivery systems for mucosal vaccines.

Introduction: Mucosal vaccine development faces several challenges and opportunities. Critical issues for effective mucosal vaccination include the antigen-retention period that enables interaction with the lymphatic system, choice of adjuvant that is nontoxic and induces the required immune response and possibly an ability to mimic mucosal pathogens. Chitosan-based delivery systems are reviewed here as they address these issues and hence represent the most promising candidates for the delivery of mucosal vaccines.

Proton transfer reaction mass spectrometry and the unambiguous real-time detection of 2,4,6 trinitrotoluene.

Fears of terrorist attacks have led to the development of various technologies for the real-time detection of explosives, but all suffer from potential ambiguities in the assignment of threat agents. Using proton transfer reaction mass spectrometry (PTR-MS), an unusual bias dependence in the detection sensitivity of 2,4,6 trinitrotoluene (TNT) on the reduced electric field (E/N) has been observed. For protonated TNT, rather than decreasing signal intensity with increasing E/N, which is the more usual sensitivity pattern observed in PTR-MS studies, an anomalous behavior is first observed, whereby the signal intensity initially rises with increasing E/N.

Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.

This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice.

Re-formulating drugs and vaccines for intranasal delivery: maximum benefits for minimum risks?

The challenges being faced by the pharmaceutical industry in terms of patent expiries and a sparse pipeline of new products are well documented, as are the risks and costs associated with developing new molecular entities. Major pharmaceutical companies are increasingly looking to augment their traditional core expertise in the discovery of small molecules with the development of biologicals (e.g.

Real-time trace detection and identification of chemical warfare agent simulants using recent advances in proton transfer reaction time-of-flight mass spectrometry.

This work demonstrates for the first time the potential of using recent developments in proton transfer reaction mass spectrometry for the rapid detection and identification of chemical warfare agents (CWAs) in real-time. A high-resolution (m/Deltam up to 8000) and high-sensitivity (approximately 50 cps/ppbv) proton transfer reaction time-of-flight mass spectrometer (PTR-TOF 8000 from Ionicon Analytik GmBH) has been successfully used to detect a number of CWA simulants at room temperature; namely dimethyl methylphosphonate, diethyl methylphosphonate, diisopropyl methylphosphonate, dipropylene glycol monomethyl ether and 2-chloroethyl ethyl sulfide. Importantly, we demonstrate in this paper the potential to identify CWAs with a high level of confidence in complex chemical environments, where multiple threat agents and interferents could also be present in trace amounts, thereby reducing the risk of false positives.

PecSys: in situ gelling system for optimised nasal drug delivery.

PecSys (PS) is a proprietary pectin-based drug delivery system designed to gel when applied to mucosal surfaces and with potential areas of application for drugs used in local and systemic disease therapy. The current area of focus is intranasal drug delivery where PS is being used to optimise absorption of lipophilic drugs into the systemic circulation. Pectin is described as GRAS (generally regarded as safe) with an excellent regulatory position through its long history of pharmaceutical and food usage.

The development of industry-specific odor impact criteria for feedlots using models.

Emissions from feedlot operations are known to vary by environmental conditions and few if any techniques or models exist to predict the variability of odor emission rates from feedlots. The purpose of this paper is to outline and summarize unpublished reports that are the result of a collective effort to develop industry-specific odor impact criteria for Australian feedlots. This effort used over 250 olfactometry samples collected with a wind tunnel and past research to develop emission models for pads, sediment basins, holding ponds, and manure storage areas over a range of environmental conditions and tested using dynamic olfactometry.

TARGIT technology: coated starch capsules for site-specific drug delivery into the lower gastrointestinal tract.

TARGIT technology (West Pharmaceutical Services) is designed for site-specific delivery of drugs in the gastrointestinal (GI) tract and, in particular, targeted release into the colonic region. A key area of application is the delivery of therapeutic agents for local treatment of lower GI diseases. The technology is based on the application of pH-sensitive coatings onto injection-moulded starch capsules.

The impact of high risk human papillomavirus testing in an inner London colposcopy clinic.

This is an audit of a new technique to improve the colposcopy service. Samples were tested for high risk HPV DNA using Digene Hybrid Capture II. Sixty-four percent of the sampled women under 30 had detectable high risk HPV DNA, decreasing to 44% in 30--39 year olds and to 27% in women over 40.