Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT).

Objective To develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT. Background Measuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used. Methods CEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility. Results CVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28–0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact. Conclusions CEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.

Elucidating the interactions between the adhesive and transcriptioanl functions of beta-catenin in normal and cancerous cells

Wnt signalling is involved in a wide range of physiological and pathological processes. The presence of an extracellular Wnt stimulus induces cytoplasmic stabilisation and nuclear translocation of beta-catenin, a protein that also plays an essential role in cadherin-mediated adhesion. Two main hypotheses have been proposed concerning the balance between beta-catenin's adhesive and transcriptional functions: either beta-catenin's fate is determined by competition between its binding partners, or Wnt induces folding of beta-catenin into a conformation allocated preferentially to transcription. The experimental data supporting each hypotheses remain inconclusive. In this paper we present a new mathematical model of the Wnt pathway that incorporates beta-catenin's dual function. We use this model to carry out a series of in silico experiments and compare the behaviour of systems governed by each hypothesis. Our analytical results and model simulations provide further insight into the current understanding of Wnt signalling and, in particular, reveal differences in the response of the two modes of interaction between adhesion and signalling in certain in silico settings. We also exploit our model to investigate the impact of the mutations most commonly observed in human colorectal cancer. Simulations show that the amount of functional APC required to maintain a normal phenotype increases with increasing strength of the Wnt signal, a result which illustrates that the environment can substantially influence both tumour initiation and phenotype.

Manufactured Nanomaterials: is there a correlation between toxicological effects and the physicochemical properties?

Toxicological information on nanomaterials (NMs) is of major importance for safety assessment, since they are already used in many consumer products and promise cutting-edge applications in the future. While the number of different NMs increases exponentially, new strategies for risk assessment are needed to cope with the safety issues, keeping pace with innovation. However, recent studies have suggested that even subtle differences in the physicochemical properties of NMs that are closely related may define different nano-bio interactions, thereby determining their toxic potential. Further research in this field is necessary to allow straightforward grouping strategies leading time-effective risk assessment to enable the safe use of the emerging NMs. In this presentation the case study of the in vitro toxicity testing of a set of multi-walled carbon nanotubes (MWCNTs) in two human cell lines from the respiratory tract will be described. Those MWCNT have been previously characterized in detail, and differ in thickness, length, aspect ratio and morphology. This comprehensive toxicological investigation undertaken in parallel with physicochemical characterization in the cellular moiety showed that the same NM did not display a consistent effect in different cell types, and that, within the same class of NM, different toxic effects could be observed. The correlation of the cytotoxic and genotoxic effects characterized in the two cell lines with their physicochemical properties will be presented and the relevance of considering the NMs properties in the biological context will be discussed. Overall, this case study suggests that nanotoxicity of closely related MWCNTs depends not only on their primary physicochemical properties, or combinations of these properties, but also on the cellular system, and its context. Challenges posed to toxicologists, risk assessors and regulators when addressing the safety assessment of NMs will be highlighted.

Study of antioxidant, antiproliferative and apoptosis-inducing properties of wild mushrooms from the Northeast of Portugal

Mushrooms are known as a powerful source of bioactive compounds including antioxidants, inhibitors of human tumour cell lines growth, inducers of apoptosis and enhancers of immunity. Indeed, many pre-clinical studies have been conducted in human tumour cell lines and in some cases a number of compounds isolated from mushrooms have followed to clinical trials. The Northeast of Portugal is one of the European regions with higher wild mushrooms diversity. However, to our knowledge, no studies had been conducted so far to verify their bioactivities. The main aim of this work was the evaluation of the bioactive properties (antioxidant properties and growth inhibitory potential on human tumour cell lines) of wild edible mushrooms collected in the Northeast of Portugal. Once properly identified, methanolic, ethanolic and boiling water extracts were prepared from thirty eight wild mushroom species collected in that region. Chemical characterization was obtained by high performance liquid chromatography (HPLC) coupled to a photodiode array detector (DAD) or to a refraction index detector (RI). Antioxidant activity assays were carried out in those extracts, including evaluation of 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals scavenging capacity, reducing power and inhibition of β-carotene bleaching. Extract-induced cell growth inhibition was assessed with the sulforhodamine B assay in four human tumour cell lines (NCI-H460 - lung cancer, MCF-7 -breast cancer, HCT-15 -colon cancer and AGS - gastric cancer). The effects on cell cycle profile and apoptosis were evaluated by flow cytometry and the effect on the expression levels of proteins related to cell cycle and apoptosis was further investigated by Western blotting. Three wild edible mushroom species revealed growth inhibitory activity in the studied human tumour cell lines: Clitocybe alexandri ethanolic extract, Lepista inversa methanolic extract and Suillus collinitus methanolic extract. C. alexandri ethanolic extract induced an S-phase cell cycle arrest and increased the percentage of apoptotic cells, in the NCI-H460 cell line. The analysed mushroom species also provided interesting antioxidant potential, mainly the boiling water extract of L. inversa which showed the highest DPPH radical scavenging activity, reducing power and β-carotene bleaching inhibition. S. collinitus methanolic extract induced a slight increase in the number of cells in G1, with a concomitant decrease in the percentage of cells in the S phase of the cell cycle and an increase in the percentage of apoptotic cells, in the MCF-7 cell line. The combined use of the S. collinitus methanolic extract and etoposide caused a greater decrease in the percentage of cell growth, when compared to either of them used individually, indicating the potential benefit of this combination. The tested extracts were chemically characterized and protocatechuic, p-hydroxybenzoic, p-coumaric and cinnamic acids were the main compounds identified on the phenolic (methanolic and ethanolic) extracts, while mannitol, trehalose and arabinose were the main sugars found in the polysaccharidic (boiling water) extracts after hydrolysis. The individual compounds identified in the extracts were submitted to a screening of tumour cells growth inhibitory activity, but only the phenolic acids and a related compound, cinnamic acid, presented activity. This compound was found to be the most potent one regarding cell growth inhibition in the NCI-H460 cell line. The effect of the individual and combined treatment with the identified compounds was also evaluated. Cinnamic and protochatequic acids caused a statistically significantly reduction in the number of viable cells. In addition, p-hydroxybenzoic acid did not show any significantly reduction in the viable cell number. Nevertheless, it was verified that the concomitant use of the three compounds provided the strongest decrease in the viable cell number, suggesting a possible concomitant effect of those compounds. Overall, the present work has contributed to further understand the bioactive potential of wild edible mushrooms from the Northeast of Portugal. This study allowed to identify some species with antioxidant or tumour cell growth inhibitory potential.

Effects of synthetic conditions on the structural, stability and ion conducting properties of Li0.30(La0.50Ln0.50)0.567TiO3 (Ln= La, Pr, Nd) solid electrolytes for rechargeable lithium batteries

The structure, thermal stability, morphology and ion conductivity of titanium perovskites with the general formula Li3xLn2/3−xTiO3 (Ln = rare earth element; 3x= 0.30) are studied in the context of their possible use as solid electrolyte materials for lithium ion batteries. Materials are prepared by a glycine-nitrate method using different sintering treatments, with a cation-disorder-induced structural transition from tetragonal to cubic symmetry, detected as quenching temperature increases. SEM images show that the average grain size increases with increasing sintering temperature and time. Slightly higher bulk conductivity values have been observed for quenched samples sintered at high temperature. Bulk conductivity decreases with the lanthanide ion size. A slight conductivity enhancement, always limited by grain boundaries, is observed for longer sintering times. TDX measurements of the electrolyte/cathode mixtures also show a good stability of the electrolytes in the temperature range of 30-1100ºC.

Phenolic profile of Cynara scolymus L. and Silybum marianum(L.) Gaertn and related antimicrobial properties

Cynara scolymus L. (artichoke) and Silybum marianum (L.) Gaertn (milk thistle), belonging to the Asteraceae family, are medicinal plants vo.ith well-reported antioxidant and hepatoprotective effects. Widely consumed as infusions, these plants can also be found in several formulations to allow an easier consumption. The bioactivity of infusions, pills, and syrups based on artichoke and milk thistle was previously reported by our research group [1 ,2] and among the various phytochemicals present in these dietary supplements, phenolic compounds are pointed out as the most responsible for their beneficial properties. With the aim of studying the antimicrobial activity and possible relation vo.ith the phenolic composition, two different formulations of each plant were assessed (pills and syrups). The phenolic profiles were obtained by HPLC-DAD-ESIIMS, and the antimicrobial activity was performed with clinical isolates from hospitalized patients, namely Escherichia coli, Escherichia coli spectrum extended producer of P-lactarnases (ESBL), Proteus mirabilis, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus (MRSA). Vanillic acid (5.58 J.tg/g) and luteolin-7-0-glucoside (2.2 J.tg/g) were the most abundant compounds in artichoke syrup, that did not reveal antimicrobial activity against the studied strains, which could be due to their low concentrations. On the other hand, artichoke pills presented a prevalence of 5-0-caffeoylquinic (28.2 J.tg/g), 1,3-dicaffeoylquinic (24 J.tg/g), and 4-0-Caffeoylquinic acids (13.3 J.tg/g); revealing the capacity to inhibit MRSA vo.ith a MIC value of 1.9 mg!g. Regarding milk thistle, isorhamnetin-0-deoxyhexoside-0-hexoside, isorhamnetin-3-0-rutinoside, and isorhamnetin-0-deoxyhexoside-0-dihexoside were the major compounds detected in the syrup, in concentrations of 7.26, 5. 75, and 3.64 J.tg/g, respectively. This formulation proved to be able to inhibit the growth of E. coli, ESBL, MRSA and P. aeruginosa, with MIC values ranging from 0.2 to 1.3 mg!mL. Hydroxylated silibinin (1.565 J.!g/g) was the major flavonoid found in the pills, that revealed antimicrobial activity against ESBL, with a MIC value of 15 mg!mL, but did not inhibit the growth of the remaining bacteria None of the studied samples was able to inhibit P. mirabilis at the studied concentrations (1000 and 26.4 mg!mL for the syrups of artichoke and milk thistle, respectively; 150 mg/mL for both pills). Overall, the studied syrups and pills of artichoke and milk thistle revealed to be a good source of phenolic compounds, with some of these formulations revealing antimicrobial activity.

Densities, viscosities and derived thermophysical properties of water-saturated imidazolium-based ionic liquids

In order to evaluate the impact of the alkyl side chain length and symmetry of the cation on the thermophysical properties of water-saturated ionic liquids (ILs), densities and viscosities as a function of temperature were measured at atmospheric pressure and in the (298.15 to 363.15) K temperature range, for systems containing two series of bis(trifluoromethylsulfonyl)imide-based compounds: the symmetric [C n C n im][NTf2] (with n = 1-8 and 10) and asymmetric [C n C1im][NTf2] (with n = 2-5, 7, 9 and 11) ILs. For water-saturated ILs, the density decreases with the increase of the alkyl side chain length while the viscosity increases with the size of the aliphatic tails. The saturation water solubility in each IL was further estimated with a reasonable agreement based on the densities of water-saturated ILs, further confirming that for the ILs investigated the volumetric mixing properties of ILs and water follow a near ideal behaviour. The water-saturated symmetric ILs generally present lower densities and viscosities than their asymmetric counterparts. From the experimental data, the isobaric thermal expansion coefficient and energy barrier were also estimated. A close correlation between the difference in the energy barrier values between the water-saturated and pure ILs and the water content in each IL was found, supporting that the decrease in the viscosity of ILs in presence of water is directly related with the decrease of the energy barrier.

Synthesis and proton conduction properties of lanthanide amino-sulfophosphonates

Crystalline acid-functionalized metal phosphonates are potential candidates as proton conducting electrolytes. Their frameworks can be chemically modified to contain proton carriers such as acidic groups (P-OH; -SO3H, -COOH,…) and guest molecules (H2O, NH3,…) that generates hydrogen bond networks stable in a wide range of temperature [1,2]. In this work, focus is laid on properties derived from the combination of lanthanide ions with the amino-sulfophosphonate ligand (H2O3PCH2)2-N-(CH2)2-SO3H. Hightrough-put screening was followed to reach the optimal synthesis conditions under solvothermal conditions at 140 ºC. Isolated polycrystalline solids, Ln[(O3PCH2)2-NH-(CH2)2-SO3H].2H2O (Ln= La, Pr and Sm), crystallize in the monoclinic (La) and orthorhombic (Pr and Sm) systems with unit cell volume of ~2548 Å3. Preliminary proton conductivity measurements for Sm derivative have been carried out between 25º and 80 ºC at relative humidity (RH) values of 70 % and 95 %. The sample exhibits enhanced conductivity at high RH and T (Figure 1) and constant activation energies of 0.4 eV, typical of a Grothuss mechanism of proton.

Antimicrobial and bond strength properties of a dental adhesive containing zinc oxide nanoparticles

Aim: To assess the effect of adding zinc oxide nanoparticles to dental adhesives on their anti-microbial and bond strength properties. Methods: 45 human premolars were cut at the cement enamel junction (CEJ) and the crowns were sliced into buccal and lingual halves. The specimens were classified into three groups, etched with 37% phosphoric acid for 15 s and rinsed for 30 s. Single Bond, Single Bond+5% zinc oxide and Single Bond+10% zinc oxide were used in the first, second and third groups. A cylinder of Z250 composite was bonded and cured for 40 s. For anti-bacterial testing, 10 samples of each group were assessed by direct contact test; 10 μL of bacterial suspension was transferred into tubes containing adhesives and incubated for one hour; 300 μL of brain heart infusion (BHI) broth was added to each tube and after 12 h, 50 μL of bacteria and broth were spread on blood agar plates and incubated for 24 h. Results: The colony count decreased significantly in the second and third groups compared to the first. Conclusions: Incorporation of zinc oxide nanoparticles into dental adhesives increases their anti-microbial properties without affecting their bond strength.

Unpolarized transverse momentum dependent parton distribution and fragmentation functions at next-to-next-to-leading order

The transverse momentum dependent parton distribution/fragmentation functions (TMDs) are essential in the factorization of a number of processes like Drell-Yan scattering, vector boson production, semi-inclusive deep inelastic scattering, etc. We provide a comprehensive study of unpolarized TMDs at next-to-next-to-leading order, which includes an explicit calculation of these TMDs and an extraction of their matching coefficients onto their integrated analogues, for all flavor combinations. The obtained matching coefficients are important for any kind of phenomenology involving TMDs. In the present study each individual TMD is calculated without any reference to a specific process. We recover the known results for parton distribution functions and provide new results for the fragmentation functions. The results for the gluon transverse momentum dependent fragmentation functions are presented for the first time at one and two loops. We also discuss the structure of singularities of TMD operators and TMD matrix elements, crossing relations between TMD parton distribution functions and TMD fragmentation functions, and renormalization group equations. In addition, we consider the behavior of the matching coefficients at threshold and make a conjecture on their structure to all orders in perturbation theory.