Using a monitored sip test to assess risk of aspiration in perioperative patients.

• PULMONARY ASPIRATION is associated with high morbidity and mortality rates. Older adult patients have been shown to be particularly at risk for aspiration.

• A RANDOMIZED CONTROLLED TRIAL was conducted to investigate the efficacy of a simple, noninvasive screening test—the monitored sip test—in identifying patients at risk for aspiration, including “silent aspirators.”

• BASED ON CLINICAL JUDGMENT using the study's outcome measures, incidence of aspiration-related lung injury was high (ie, 37.5%); however, no identification of patients at risk for aspiration occurred after either the use of the monitored sip test or routine cautious introduction of fluids during the data collection phase of the study.

A systematic review of the quality of liver biopsy specimens

Characteristics for an optimal liver biopsy specimen were recently defined as 20 to 25 mm long and/or containing more than 11 complete portal tracts (CPTs). A systematic review of percutaneous liver biopsy (PLB) and transjugular liver biopsy (TJLB) series yielded only 32 PLB studies in which these characteristics were evaluated: mean ± SD length, 17.7 ± 5.8 mm and number of CPTs, 7.5 ± 3.4; and 15 TJLB studies: mean ± SD length, 13.5 ± 4.5 mm and number of CPTs, 6.8 ± 2.3. Studies of sampling heterogeneity and intraobserver and interobserver variability also used inadequate specimens by present standards. Only 11 (5.3%) of 207 therapeutic studies for chronic hepatitis B and C documented length and/or number of CPTs. Of the current 12 studies evaluating noninvasive fibrosis tests, only 8 documented length or number of CPTs, and only 1 documented length and number of CPTs. New studies are needed based on adequate liver biopsy samples to provide reliable estimation of grading and staging in chronic liver disease.

Epithelial cell folate is an accurate marker when compared with whole tissue biopsy folate for examining the role of folate status in colorectal cancer

Background – Epidemiological studies have shown low folate status is associated with colorectal cancer. Colonic tissue folate levels at different stages of cancer development should give important information, but different methodologies to extract the colonic tissue folates have been used. This has hampered progress in defining the relationship between systemic and tissue folate levels.
Objective – To evaluate two methods of colonic tissue preparation for estimation of total folate content.
Design – Whole tissue punch biopsy samples were obtained from the descending colon of 31individuals following a normal colonoscopy. Blood samples were obtained for the determination of plasma homocysteine (Hcy), red cell folate (RCF), methylenetetrahydrofolate reductase 677C>T genotype, and serum vitamin B12 and folate. Colonic tissue folate was measured both in washed whole tissue biopsies and in epithelial cells isolated from tissue biopsies.
Outcomes - Whole biopsy and epithelial cell folate concentrations were significantly correlated (R=.375; P=.038). Hcy was inversely correlated with both measures (R=-.365; P=.043 and R=-.364; P=.044 respectively). RCF was significantly correlated with isolated epithelial cell folate (R=.477; P=.007) but not with whole tissue biopsy folate (R=.264; P=.151). There were no significant associations between serum and colonic folate in this study.
Conclusion - Both methods are useful for comparing systemic and localised tissue folate status but epithelial cells may provide more reliable data.

Mobility, aspiration, voice : a new structure of feeling for student equity in higher education

There is a changed ‘structure of feeling’ emerging in higher education systems, particularly in OECD nations, in response to changed social, cultural and economic arrangements. Taking a student equity perspective, the paper names this change in terms of ‘mobility’, ‘aspiration’ and ‘voice’. It argues that (1) new kinds and degrees of mobility are now a significant factor in sustaining unequal access to and experience of higher education for different student groups, (2) despite government and institutional aspirations to expand higher education, students' desires for university are not a given among new target populations and (3) while universities are seeking to enroll different students in greater numbers, the challenge now is how to give greater voice to this difference. Drawing on these themes of mobility, aspiration and voice and taking recent changes to higher education policy in Australia as the case, the paper presents a new conceptual framework for thinking about student equity in HE. The framework extends from established approaches that focus on barriers to accessing higher education in order to focus on people's capacities in relation to higher education participation.

Programs to raise tertiary education aspiration, 2011-2012 data

Data is a collation of local and global programs that address tertiary education attainment. It is in the form of a Microsoft Office Excel spreadsheet and is purely text.

The need to examine metastatic tissue at the time of progression of breast cancer : is re-biopsy a necessity or a luxury?

Knowledge of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2) status is necessary for determining the optimal treatment of breast cancer patients. At the same time, the discordance between marker profiles (ER/PR and HER2) of primary and metastatic breast cancer is well documented. Whether discordant cases are secondary to “clonal selection” in the face of targeted anti-estrogen or anti-HER2 therapy or whether they are a laboratory artifact is still debated; both scenarios are likely. This article outlines current modalities for ER, PR, and HER2 testing in primary breast carcinoma and its metastases and reviews prospective and retrospective studies that have addressed these issues, as well as recent advances in the field.

Calculating student aspiration: Bourdieu, spatiality and the politics of recognition

This paper reports on a recent study of aspirations for higher education by secondary school students from disadvantaged backgrounds in regional Australia. At the same time, it goes in search of explanations that transcend a Bourdieuian account of aspirations as produced by and reproductive of cultural histories and dominance, given the apparent inadequacy of these accounts in redressing disadvantage. To this end the authors distinguish between historicising and spatialising aspirations, taking up Appadurai’s notion of navigational capacity as a way of advancing greater agency for disadvantaged groups. Data from the research inform the analysis, including the mediation of students’ desired futures by their perception of what is possible given their differentiated locations and access to resources. It is concluded that while this spatial turn in theorising aspiration has potential for changing the terms of recognition internal to disadvantaged communities, there remain structural limits on change ‘from below’.

Democracy and its aspiration in Hong Kong

This chapter addresses aspirations for more direct, representative democratic process in Hong, manifested in the street protests and occupations of 2014.

Effect of creatine ingestion on glucose tolerance and insulin sensitivity in men

Purpose: This study investigated whether acute (5 d) and/or short-term (28 d) creatine (Cr) ingestion altered glucose tolerance or insulin action in healthy, untrained men (aged 26.9 ± 5.7 yr; SD). Methods : Subjects were randomly allocated to either a Cr (N = 8) or placebo group (N = 9) and were tested in the control condition (presupplementation), and after 5 and a further 28 d of supplementation. The Cr group ingested 20 g and 3 g·d-1 of Cr for the first 5 and following 28 d, respectively. The placebo group ingested similar amounts of glucose over the same time period. During each testing period, subjects underwent an oral glucose tolerance test (OGTT) to determine insulin sensitivity, and six subjects from each group underwent a muscle biopsy before each OGTT. Results : Cr supplementation resulted in an increased (P < 0.05) muscle TCr content after both the acute and short-term loading phase compared with placebo. Neither acute nor short-term Cr supplementation influenced skeletal muscle glycogen content, glucose tolerance, or measures of insulin sensitivity. Conclusions: These findings demonstrated that acute Cr supplementation (20 g·d-1 for 5 d) followed by short-term Cr supplementation (3 g·d-1 for 28 d) did not alter insulin action in healthy, active untrained men.

Detection of pyrrolizidine alkaloids using flow analysis with both acidic potassium permanganate and tris(2,2’-bipyridyl)ruthenium(II) chemiluminescence

For the first time, analytically useful chemiluminescence was elicited from the reactions of the pyrrolizidine alkaloids. Heliotrine, retronecine, supinine, monocrotaline and echinatine N-oxide yielded chemiluminescence upon reaction with tris(2,2′-bipyridyl)ruthenium(II) whilst lasiocarpine, its N-oxide and supinine elicited light upon reaction with acidic potassium permanganate. Detection limits for heliotrine were 1.25 × 10⁻⁷ M and 9 × 10⁻⁹ M for tris(2,2′-bipyridyl)ruthenium(III) perchlorate with flow injection analysis (FIA) and the silica-immobilised reagent (4-[4-(dichloromethylsilanyl)-butyl]-4′-methyl-2,2′-bipyridine)bis(2,2′-bipyridyl)ruthenium(II) with sequential injection analysis (SIA), respectively. Lasiocarpine was detectable at 1.4 × 10⁻⁷ M using acidic potassium permanganate with FIA. Additionally, the silica-immobilised reagent was optimised with respect to the oxidant (ammonium ceric nitrate) concentration and the aspiration times which afforded a detection limit for codeine of 5 × 10⁻¹⁰ M using SIA.

Identification of novel genes expressed during rhabdomyosarcoma differentiation using cDNA microarrays

Rhabdomyosarcomas (RMS) are highly aggressive tumors that are thought to arise as a consequence of the regulatory disruption of the growth and differentiation of skeletal muscle progenitor cells. Normal myogenesis is characterized by the expression of the myogenic regulatory factor gene family but, despite their expression in RMS, these tumor cells fail to complete the latter stages of myogenesis. The RMS cell line RD-A was treated with 12-O-tetradecanoylphorbol-13-acetate to induce differentiation and cultured for 10 days. RNA was extracted on days 1, 3, 6, 8 and 10. A human skeletal muscle cDNA microarray was developed and used to analyze the global gene expression of RMS tumors over the time-course of differentiation. As a comparison, the genes identified were subsequently examined during the differentiated primary human skeletal muscle cultures. Prothymosin alpha (PTMA), and translocase of inner mitochondrial membrane 10 (Tim10), two genes not previously implicated in RMS, showed reduced expression during differentiation. Marked differences in the expression of PTMA and Tim10 were observed during the differentiation of human primary skeletal muscle cells. These results identify several new genes with potential roles in the myogenic arrest present in rhabdomyosarcoma. PTMA expression in RMS biopsy samples might prove to be an effective diagnostic marker for this disease.