Research priorities of adult intensive care nurses in 20 European countries: a Delphi study.

Aims: This paper is a report of a three round Delphi study of intensive care nursing research priorities in Europe (October 2006–April 2009).

Background: Internationally, priorities for research in intensive care nursing have received some attention focusing on healthcare interventions and patient needs. Studies as early as the 1980s identified priorities in the United States, United Kingdom, Hong Kong and Australia. Research priorities of intensive care nurses across the European Union are unknown.

Methods: The participants, invited in 2006, included 110 intensive care nurses, managers, educators and researchers from 20 European Critical Care Nursing Associations. Delphi round one was an emailed questionnaire inviting participants to list important areas for research. The list was content analysed and developed into an online questionnaire for rounds two and three. In round two, participants ranked the topics on a scale of 1–6 (not important to extremely important). Mean scores of round two were added to the questionnaire of round three and participants ranked the topics again.

Results: There were 52 research topics in 12 domains. There was a dominance of priorities in five main areas: patient safety; impact of evidence based practice on outcomes; impact of workforce on outcomes; well being of patients and relatives; and impact of end-of-life care on staff and practice.

Conclusions: The results reflect worldwide healthcare concerns and objectives and highlight topics that nurses view as fundamental to the care of critically ill patients. These topics provide a platform for future research efforts to improve clinical practice and care of patients in intensive care.

Mutational hotspot in Exon 20 of PIK3CA in breast cancer among Singapore Chinese

The recent identification of somatic mutations in the catalytic region of PIK3 (PIK3CA) in breast cancer and demonstration of their oncogenic function has implicated PIK3CA in mammary carcinogenesis. To investigate possible ethnic differences in patterns of PIK3CA mutations in Singaporean Chinese breast cancer and to characterize these in a panel of cell lines, we sequenced exons 9 and 20 in 80 primary tumors, 19 breast cancer cell lines and 7 normal human mammary epithelial cells (HMECs). Searching for novel hotspots of mutation, we sequenced additional exons ( 1, 2, 6, 7, 14 and 18) in 20 primary tumors and 6 breast cancer cell lines. We detected 33 point mutations in 31 of 80 (39%) breast cancers, and 11 mutations in 10 of 19 (53%) breast cancer cell lines. No mutations were detected in normal breast tissue adjacent to the tumor, or in the 6 normal HMECs. The exon 20 A3140G (H1047R) substitution was identified most frequently (22/31, 71%) and showed a significant association with patient age ( p = 0.043) and stage of the disease ( p = 0.025), but not with ER/PR status or histological grade of the tumor. The incidence of point mutations in PIK3CA, the A3140G substitution in particular, in Singapore breast cancers are among the most frequent reported to date for any gene in breast cancer. The results suggest that mutation of PIK3CA might contribute to development of early stage breast cancer and could provide a potent target for early diagnosis and therapy.

Peptide IC-20, encoded by skin kininogen-1 of the European yellow-bellied toad, Bombina variegata, antagonizes bradykinin-induced arterial smooth muscle relaxation

The objectives were to determine if the skin secretion of the European yellow-bellied toad (Bombina variegata), in common with other related species, contains a bradykinin inhibitor peptide and to isolate and structurally characterize this peptide. Materials and Methods: Lyophilized skin secretion obtained from this toad was subjected to reverse phase HPLC fractionation with subsequent bioassay of fractions for antagonism of the bradykinin activity using an isolated rat tail artery smooth muscle preparation. Subsequently, the primary structure of the peptide was established by a combination of microsequencing, mass spectroscopy, and molecular cloning, following which a synthetic replicate was chemically synthesised for bioassay. Results: A single peptide of molecular mass 2300.92 Da was resolved in HPLC fractions of skin secretion and its primary structure determined as IYNAIWP-KH-NK-KPGLL-. Database interrogation with this sequence indicated that this peptide was encoded by skin kininogen-1 previously cloned from B. variegata. The blank cycles were occupied by cysteinyl (C) residues and the peptide was located toward the C-terminus of the skin kininogen, and flanked N-terminally by a classical -KR- propeptide convertase processing site. The peptide was named IC-20 in accordance (I = N-terminal isoleucine, C = C-terminal cysteine, 20 = number of residues). Like the natural peptide, its synthetic replicate displayed an antagonism of bradykinin-induced arterial smooth muscle relaxation. Conclusion: IC-20 represents a novel bradykinin antagonizing peptide from amphibian skin secretions and is the third such peptide found to be co-encoded with bradykinins within skin kininogens.

Conditions for efficient and stable ion acceleration by moderate circularly polarized laser pulses at intensities of 10(20) W/cm(2)

Conditions for efficient and stable ion radiation pressure acceleration (RPA) from thin foils by circularly polarized laser pulses at moderate intensities are theoretically and numerically investigated. It is found that the unavoidable decompression of the co-moving electron layer in Light-Sail RPA leads to a change of the local electrostatic field from a

The Roads from Rio: Lessons From 20 Years of Multilateral Environmental Negotiations

A review of international environmental negotiations since the 'Earth Summit' in Rio de Janiero 1992

Decay of Cystalline Order and Equilibration during the Solid-to-Plasma Transition Induced by 20-fs Microfocused 92-eV Free-Electron-Laser Pulses

We have studied a solid-to-plasma transition by irradiating Al foils with the FLASH free electron laser at intensities up to 10(16) W/cm(2). Intense XUV self-emission shows spectral features that are consistent with emission from regions of high density, which go beyond single inner-shell photoionization of solids. Characteristic features of intrashell transitions allowed us to identify Auger heating of the electrons in the conduction band occurring immediately after the absorption of the XUV laser energy as the dominant mechanism. A simple model of a multicharge state inverse Auger effect is proposed to explain the target emission when the conduction band at solid density becomes more atomiclike as energy is transferred from the electrons to the ions. This allows one to determine, independent of plasma simulations, the electron temperature and density just after the decay of crystalline order and to characterize the early time evolution.

Care of the Self, Care of the Earth: A new conversation for Rio+20

What if capitalism, understood as an economic, social and cultural complex, was on the agenda of a world summit on sustainable development? How has the culture of capitalism - its psychic investment in colonizing our attention - compromised our ability to respond meaningfully to the challenges of sustainable development? These are two of the questions behind this exploration of the constraints that appear to limit the scope of economic debate at conferences such as the Rio+20 conference

High-gain x-ray lasing at 11.1 nm in sodiumlike copper driven by a 20-J, 2-ps Nd:glass laser

Evidence of high gain pumped by recombination has been observed in the 5g-4f transition at 11.1 nn in sodiumlike copper ions with use of a 20-J 2-ps Nd:glass laser system. The time- and space-integrated gain coefficient was 8.8 +/- 1.4 cm(-1), indicating a single-transit amplification of similar to 60 times. This experiment has shown that 2 ps is the optimum pulse duration to drive the sodiumlike copper recombination x-ray lasing at 11.1 nm. (C) 1996 Optical Society of America

Measurements of energy transport patterns in solid density laser plasma interactions at intensities of 5x10(20) W cm(-2)

K-alpha x-ray emission, extreme ultraviolet emission, and plasma imaging techniques have been used to diagnose energy transport patterns in copper foils ranging in thickness from 5 to 75 mu m for intensities up to 5x10(20) Wcm(-20). The K-alpha emission and shadowgrams both indicate a larger divergence angle than that reported in the literature at lower intensities [R. Stephens , Phys. Rev. E 69, 066414 (2004)]. Foils 5 mu m thick show triple-humped plasma expansion patterns at the back and front surfaces. Hybrid code modeling shows that this can be attributed to an increase in the mean energy of the fast electrons emitted at large radii, which only have sufficient energy to form a plasma in such thin targets.

Imaging of high harmonic radiation emitted during the interaction of a 20 TW laser with a solid target

We present images of the source of extreme ultraviolet (XUV) harmonic emission at a wavelength of 220 Angstrom from the interaction of a 20 TW, 1.053 mu m Nd:glass laser beam focused to intensities up to 4x10(18) W cm(-2) onto a solid target. From these measurements we determine an upper limit to the source size and brightness of the harmonic emission to show its efficacy as a novel source of short-pulse, coherent XUV radiation. We also demonstrate the empirical scaling of the harmonic generation efficiency with irradiance up to 10(19) W mu m(2) cm(-2), and extrapolate to estimate the possible source brightness at higher irradiances. These source brightnesses are compared to those available from an x-ray laser system. (C) 1997 American Institute of Physics.