A Diagnostic System Using Broad Categories With Clinicaly Relevant Specifiers: Lessons for ICD-10

A diagnostic system for ICD-11 is proposed which commences with broad reorganization and simplification of the current categories and the use of clinically relevant specifiers. Such changes have implications for the positioning of diagnostic groups and lead to a range of possibilities for improving terminology and the juxtaposition of individual conditions. The development of ICD-11 provides the first opportunity in almost two decades to improve the validity and reliability of the international classification system. Widespread change in broad categories and criteria cannot be justified by research that has emerged since the last revision. It would also be disruptive to clinical practice and might devalue past research work. However, the case for reorganization of the categories is stronger and has recently been made by an eminent international group of researchers (Andrews et al., 2009). A simpler, interlinked diagnostic system is proposed here which is likely to have fewer categories than its predecessor. There are major advantages of such a system for clinical practice and research and it could also produce much needed simplification for primary care (Gask et al., 2008) and the developing world (Wig, 1990; Kohn et al., 2004).

CsF and alumina: A mixed homogeneous-heterogeneous catalytic system for the transesterification of sunflower oil with methanol

The activity and nature (i e heterogeneous and/or homogeneous) of catalysts based on CsF supported on alpha-Al2O3 were investigated for the transesterification of vegetable oil with methanol. The effect of the activation temperature, CsF loading and the reusability in a recirculating reactor were first studied CsF/alpha-Al2O3 exhibited the highest activity for a CsF loading of 0 6 mmol/g and when activated at 120 degrees C An important aspect of this study is the effect of CsF leaching into the reaction mixture, which is attributed to the high solubility of CsF in methanol, leading to a complete loss of activity after one run It was Identified that the activity of the catalyst resulted from a synergy between alumina and dissolved CsF, the presence of both compounds being absolutely necessary to observe any conversion The use of an alumina with a higher surface area resulted in a far greater reaction rate, showing that the concentration of surface site on the oxide (probably surface hydroxyl) was rate-limiting in the case of the experiments using the low surface area alpha-Al2O3 This work emphasizes that combined homogeneous-heterogeneous catalytic systems made from the blending of the respective catalysts can be used to obtain high conversion of vegetable oil to biodiesel. Despite the homogeneous/heterogeneous dual character, such a catalytic system may prove valuable in developing a simple and cost-effective continuous catalytic process for biodiesel production (C) 2010 Elsevier B V All rights reserved

Variable temperature, variable-gap Otto prism coupler for use in a vacuum environment

The field of surface polariton physics really took off with the prism coupling techniques developed by Kretschmann and Raether, and by Otto. This article reports on the construction and operation of a rotatable, in vacuo, variable temperature, Otto coupler with a coupling gap that can be varied by remote control. The specific design attributes of the system offer additional advantages to those of standard Otto systems of (i) temperature variation (ambient to 85 K), and (ii) the use of a valuable, additional reference point, namely the gap-independent reflectance at the Brewster angle at any given, fixed temperature. The instrument is placed firmly in a historical context of developments in the field. The efficacy of the coupler is demonstrated by sample attenuated total reflectance results on films of platinum, niobium, and yttrium barium copper oxide and on aluminum/gallium arsenide (Al/GaAs) Schottky diode structures. (C) 2000 American Institute of Physics. [S0034-6748(00)02411-4].

Spatial Allocation of Material Flow Analysis: A Geographic Information System Application of Material Flow Analysis in Ireland

This study concerns the spatial allocation of material flows, with emphasis on construction material in the Irish housing sector. It addresses some of the key issues concerning anthropogenic impact on the environment through spatial temporal visualisation of the flow of materials, wastes and emissions at different spatial levels. This is presented in the form of a spatial model, Spatial Allocation of Material Flow Analysis (SAMFA), which enables the simulation of construction material flows and associated energy use. SAMFA parallels the Island Limits project (EPA funded under 2004-SD-MS-22-M2), which aimed to create a material flow analysis of the Irish economy classified by industrial sector. SAMFA further develops this by attempting to establish the material flows at the subnational geographical scale that could be used in the development of local authority (LA) sustainability strategies and spatial planning frameworks by highlighting the cumulative environmental impacts of the development of the built environment. By drawing on the idea of planning support systems, SAMFA also aims to provide a cross-disciplinary, integrative medium for involving stakeholders in strategies for a sustainable built environment and, as such, would help illustrate the sustainability consequences of alternative The pilot run of the model in Kildare has shown that the model can be successfully calibrated and applied to develop alternative material flows and energy-use scenarios at the ED level. This has been demonstrated through the development of an integrated and a business-as-usual scenario, with the former integrating a range of potential material efficiency and energysaving policy options and the latter replicating conditions that best describe the current trend. Their comparison shows that the former is better than the latter in terms of both material and energy use. This report also identifies a number of potential areas of future research and areas of broader application. This includes improving the accuracy of the SAMFA model (e.g. by establishing actual life expectancy of buildings in the Irish context through field surveys) and the extension of the model to other Irish counties. This would establish SAMFA as a valuable predicting and monitoring tool that is capable of integrating national and local spatial planning objectives with actual environmental impacts. Furthermore, should the model prove successful at this level, it then has the potential to transfer the modelling approach to other areas of the built environment, such as commercial development and other key contributors of greenhouse emissions. The ultimate aim is to develop a meta-model for predicting the consequences of consumption patterns at the local scale. This therefore offers the possibility of creating critical links between socio technical systems with the most important challenge of all the limitations of the biophysical environment.

Use of a novel micro-fluidic device to create arrays for multiplex analysis of large and small molecular weight compounds by surface plasmon resonance

There is an increasing demand to develop biosensor monitoring devices capable of biomarker profiling for predicting animal adulteration and detecting multiple chemical contaminants or toxins in food produce. Surface plasmon resonance (SPR) biosensors are label free detection systems that monitor the binding of specific biomolecular recognition elements with binding partners. Essential to this technology are the production of biochips where a selected binding partner, antibody, biomarker protein or low molecular weight contaminant, is immobilised. A micro-fluidic immobilisation device allowing the covalent attachment of up to 16 binding partners in a linear array on a single surface has been developed for compatibility with a prototype multiplex SPR analyser.

The immobilisation unit and multiplex SPR analyser were respectively evaluated in their ability to be fit-for-purpose for binding partner attachment and detection of high and low molecular weight molecules. The multiplexing capability of the dual technology was assessed using phycotoxin concentration analysis as a model system. The parent compounds of four toxin groups were immobilised within a single chip format and calibration curves were achieved. The chip design and SPR technology allowed the compartmentalisation of the binding interactions for each toxin group offering the added benefit of being able to distinguish between toxin families and perform concentration analysis. This model is particularly contemporary with the current drive to replace biological methods for phycotoxin screening.

TRARESA: a tissue microarray-based hospital system for biomarker validation and discovery

Formalin fixed and paraffin embedded tissue (FFPE) collections in pathology departments are the largest resource for retrospective biomedical research studies. Based on the literature analysis of FFPE related research, as well as our own technical validation, we present the Translational Research Arrays (TRARESA), a tissue microarray centred, hospital based, translational research conceptual framework for both validation and/or discovery of novel biomarkers. TRARESA incorporates the analysis of protein, DNA and RNA in the same samples, correlating with clinical and pathological parameters from each case, and allowing (a) the confirmation of new biomarkers, disease hypotheses and drug targets, and (b) the postulation of novel hypotheses on disease mechanisms and drug targets based on known biomarkers. While presenting TRARESA, we illustrate the use of such a comprehensive approach. The conceptualisation of the role of FFPE-based studies in translational research allows the utilisation of this commodity, and adds to the hypothesis-generating armamentarium of existing high-throughput technologies.

Advanced educational parallel DSP system based on TMS320C25 processors

This paper describes the design, application, and evaluation of a user friendly, flexible, scalable and inexpensive Advanced Educational Parallel (AdEPar) digital signal processing (DSP) system based on TMS320C25 digital processors to implement DSP algorithms. This system will be used in the DSP laboratory by graduate students to work on advanced topics such as developing parallel DSP algorithms. The graduating senior students who have gained some experience in DSP can also use the system. The DSP laboratory has proved to be a useful tool in the hands of the instructor to teach the mathematically oriented topics of DSP that are often difficult for students to grasp. The DSP laboratory with assigned projects has greatly improved the ability of the students to understand such complex topics as the fast Fourier transform algorithm, linear and circular convolution, the theory and design of infinite impulse response (IIR) and finite impulse response (FIR) filters. The user friendly PC software support of the AdEPar system makes it easy to develop DSP programs for students. This paper gives the architecture of the AdEPar DSP system. The communication between processors and the PC-DSP processor communication are explained. The parallel debugger kernels and the restrictions of the system are described. The programming in the AdEPar is explained, and two benchmarks (parallel FFT and DES) are presented to show the system performance.

Non-aqueous silicone elastomer gels as a vaginal microbicide delivery system for the HIV-1 entry inhibitor maraviroc

Aqueous semi-solid polymeric gels, such as those based on hydroxyethylcellulose (HEC) and polyacrylic acid (e.g. Carbopol®), have a long history of use in vaginal drug delivery. However, despite their ubiquity, they often provide sub-optimal clinical performance, due to poor mucosal retention and limited solubility for poorly water-soluble actives. These issues are particularly pertinent for vaginal HIV microbicides, since many lead candidates are poorly water-soluble and where a major goal is the development of a coitally independent, once daily gel product. In this study, we report the use of a non-aqueous silicone elastomer gel for vaginal delivery of the HIV-1 entry inhibitor maraviroc. In vitro rheological, syringeability and retention studies demonstrated enhanced performance for silicone gels compared with a conventional aqueous HEC gel, while testing of the gels in the slug model confirmed a lack of mucosal irritancy. Pharmacokinetic studies following single dose vaginal administration of a maraviroc silicone gel in rhesus macaques showed higher and sustained MVC levels in vaginal fluid, vaginal tissue and plasma compared with a HEC gel containing the same maraviroc loading. The results demonstrate that non-aqueous silicone gels have potential as a formulation platform for coitally independent vaginal HIV microbicides.

Functional and Structural Diversification of the Anguimorpha Lizard Venom System

Venom has only been recently discovered to be a basal trait of the Anguimorpha lizards. Consequently, very little is known about the timings of toxin recruitment events, venom protein molecular evolution, or even the relative physical diversifications of the venom system itself. A multidisciplinary approach was used to examine the evolution across the full taxonomical range of this similar to 130 million-year-old clade. Analysis of cDNA libraries revealed complex venom transcriptomes. Most notably, three new cardioactive peptide toxin types were discovered (celestoxin, cholecystokinin, and YY peptides). The latter two represent additional examples of convergent use of genes in toxic arsenals, both having previously been documented as components of frog skin defensive chemical secretions. Two other novel venom gland-overexpressed modified versions of other protein frameworks were also recovered from the libraries (epididymal secretory protein and ribonuclease). Lectin, hyaluronidase, and veficolin toxin types were sequenced for the first time from lizard venoms and shown to be homologous to the snake venom forms. In contrast, phylogenetic analyses demonstrated that the lizard natriuretic peptide toxins were recruited independently of the form in snake venoms. The de novo evolution of helokinestatin peptide toxin encoding do-mains within the lizard venom natriuretic gene was revealed to be exclusive to the helodermatid/anguid subclade. New isoforms were sequenced for cysteine-rich secretory protein, kallikrein, and phospholipase A 2 toxins. Venom gland morphological analysis revealed extensive evolutionary tinkering. Anguid glands are characterized by thin capsules and mixed glands, serous at the bottom of the lobule and mucous toward the apex. Twice, independently this arrangement was segregated into specialized serous protein-secreting glands with thick capsules with the mucous lobules now distinct (Heloderma and the Lanthanotus/Varanus clade). The results obtained highlight the importance of utilizing evolution-based search strategies for biodiscovery and emphasize the largely untapped drug design and development potential of lizard venoms. Molecular & Cellular Proteomics 9:2369-2390, 2010.

Extent and nature of unlicensed and off-label medicine use in hospitalised children in Palestine

Objective of the study: To determine the extent and nature of unlicensed/off-label prescribing patterns in hospitalised children in Palestine. Setting: Four paediatric wards in two public health system hospitals in Palestine [Caritas children’s hospital (Medical and neonatal intensive care units) and Rafidia general hospital (Medical and surgical units)]. Method: A prospective survey of drugs administered to infants and children <18 years old was carried out over a five-week period in the four paediatric wards. Main outcome measure: Drug-licensing status of all prescriptions was determined according to the Palestinian Registered Product List and the Physician’s Desk Reference. Results: Overall, 917 drug prescriptions were administered to 387 children. Of all drug prescriptions, 528 (57.5%) were licensed for use in children; 65 (7.1%) were unlicensed; and 324 (35.3%) were used off-label. Of all children, 49.6% received off-label prescriptions, 10.1% received unlicensed medications and 8.2% received both. Seventy-two percent of off-label drugs and 66% of unlicensed drugs were prescribed for children <2 years. Multivariate analysis showed that patients who were admitted to the neonatal intensive care unit and infants aged 0–1 years were most likely to receive a greater number of off-label or unlicensed medications (OR 1.80; 95% CI 1.03–3.59 and OR 1.99; 95% CI 0.88–3.73, respectively). Conclusion: The present findings confirmed the elevated prevalence of unlicensed and off-label paediatric drugs use in Palestine and strongly support the need to perform well designed clinical studies in children.

Redispersion Microreactor System for Phase Transfer Catalyzed Esterification

An interdigital mixer - redispersion capillary assembly was applied to prevent the liquid-liquid bubbly flow coalescence in microreactors. The redispersion capillary consisted of 1 mm long and 0.25 mm inner-diameter constrictions placed every 0.50 m along the channel length. The system was tested on the phase transfer catalyzed esterification to produce benzyl benzoate. The application of constrictions to prevent coalescence resulted in a better reproducibility compared to a capillary without the constrictions. By controlling the total flow rate and the aqueous-to-organic ratio the bubbly flow surface-volume ratio could be increased up to 230 700 m(2)m(-3). Compared to the conventional phase transfer catalyzed esterification, the continuous operation in the interdigital-redispersion capillary assembly eliminated the use of solvents and bases, removing an energy intensive step of distillation, while increasing process safety.

Factor structure and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a sample of mentally disordered offenders

Investigations of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) have produced conflicting results. The current study assessed the factor structure of the AUDIT for a group of Mentally Disordered Offenders (MDOs) and examined the pattern of scoring in specific subgroups. The sample comprised 2005 MDOs who completed a battery of tests including the AUDIT. Confirmatory factor analyses revealed that a two-factor solution – alcohol consumption and alcohol-related consequences – provided the best data fit for AUDIT scores. A three-factor solution provided an equally good fit, but the second and third factors were highly correlated and a measure of parsimony also favoured the two-factor solution. This study provides useful information on the factor structure of the AUDIT amongst a large MDO population, while also highlighting the difficulties associated with the presence of people with mental health problems in the criminal justice system.

Acid-catalyzed hydrolysis of cellulose and cellulosic waste using a microwave reactor system

A microwave reactor system was investigated as a potential technique to maximize sugar yield for the hydrolysis of municipal solid waste for ethanol production. Specifically, dilute acid hydrolysis of a-cellulose and waste cellulosic biomass (grass clippings) with phosphoric acid was undertaken within the microwave reactor system. The experimental data and reaction kinetic analysis indicate that the use of a microwave reactor system can successfully facilitate dilute acid hydrolysis of cellulose and waste cellulosic biomass, producing high yields of total sugars in short reaction times. The maximum yield of reducing sugars was obtained at 7.5% (w/v) phosphoric acid and 160 degrees C, corresponding to 60% of the theoretical total sugars, with a reaction time of 5 min. When using a very low acid concentration (0.4% w/v) for the hydrolysis in the microwave reactor, it was found that 10 g of total sugars/100 g dry mass was produced, which is significant considering the low acid concentration. When hydrolyzing grass clippings using the microwave reactor, the optimum conditions were an acid concentration of 2.5% (w/v), 175 degrees C with a 15 min reaction time, giving 18 g/100 g dry mass of total sugars, with xylose being the sugar with the highest yield. It was observed that pentose sugars were more easily formed but also more easily degraded, these being significantly affected by increases in acid concentration and temperature. Kinetic modeling of the data indicated that the use of microwave heating may account for an increase in reaction rate constant, k(1), found in this study in comparison with conventional systems described in the literature.

An Investigation into the Optimum Thickness of Titanium Dioxide Thin Films Synthesized by Using Atmospheric Pressure Chemical Vapour Deposition for Use in Photocatalytic Water Oxidation

Twenty eight films of titanium dioxide of varying thickness were synthesised by using atmospheric pressure chemical vapour deposition (CVD) of titanium(IV) chloride and ethyl acetate onto glass and titanium substrates. Fixed reaction conditions at a substrate temperature of 660 degrees C were used for all depositions, with varying deposition times of 5-60 seconds used to control the thickness of the samples. A sacrificial electron acceptor system composed of alkaline sodium persulfate was used to determine the rate at which these films could photo-oxidise water in the presence of 365 nm light. The results of this work showed that the optimum thickness for CVD films on titanium substrates for the purposes of water oxidation was approximate to 200 nm, and that a platinum coating on the reverse of such samples leads to a five-fold increase in the observed rate of water oxidation.

Photobleaching of methylene blue sensitised by TiO2: an ambiguous system?

The photobleaching of methylene blue MB, sensitised by TiO2, in an aqueous solution is studied in the absence and presence of oxygen, in the absence of oxygen and in the presence of a sacrificial electron acceptor (SED), MB is photoreduced to its colourless leuco form, LMB, by the TiO2 photocatalyst. This same photoreduction process is observed even if an SED is not present, indicating that MB itself can act as an SED. The oxidation of LMB by oxygen to regenerate MB is significantly slower if the aqueous solution is acidified (0.01 mol dm(-3) HClO4) and, at low partial pressures, the rate of reaction depends directly upon the concentration of dissolved oxygen. The TiO2-sensitised photobleaching of MB is irreversible in an oxygen-saturated aqueous solution, as expected, since the bleaching was due to an oxidative process. However, in an acidified solution (0.01 mol dm(-3) HClO4), the photobleaching process, in an oxygen-saturated solution, generates LMB initially. The latter situation arises because, under acidic conditions, LMB reacts only very slowly with oxygen to form MB. The significance of these findings with respect to the popular use of photobleaching of MB as a demonstration of semiconductor photomineralisation is discussed. (C) 1999 Elsevier Science S.A. All rights reserved.