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Fulltext Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective

Epping-Jordan JE, van Ommeren M, Ashour HN, Maramis A, Marini A, Mohanraj A, et al.

Int J Ment Health Syst, 2015;9:15.
PMID: 25904981 DOI: 10.1186/s13033-015-0007-9

BACKGROUND: Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development.
CASE DESCRIPTION: Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste.
DISCUSSION AND EVALUATION: These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders.
CONCLUSIONS: Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

Matched MeSH terms: Jordan
Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training

Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al.

Resuscitation, 2014 Jul;85(7):945-51.
PMID: 24607871 DOI: 10.1016/j.resuscitation.2014.02.025

Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e., "Milestones". We developed a simulation-based teaching approach "Rapid Cycle Deliberate Practice" (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e., "first-five minutes" (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to "try again" over lengthy debriefing.
Fulltext Can post-treatment oral cancer patients' concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation?

Aminnudin AN, Doss JG, Ismail SM, Chai MB, Abidin MZ, Basri CSJM, et al.

Ecancermedicalscience, 2020;14:1118.
PMID: 33209109 DOI: 10.3332/ecancer.2020.1118

Background: Oral cancer and its treatment impact patients' post-treatment outcomes, challenging clinicians to manage them optimally. Addressing patients' concerns is central to holistic patient-centred care.
Objectives: This study aimed to determine post-treatment oral cancer patients' concerns and its relationship with patients' clinical characteristics, health-related quality of life (HRQoL), psychological distress and patient satisfaction with the follow-up consultation.
Methods: A total of 85 oral cancer patients were recruited from a three-armed pragmatic RCT study on the patient concerns inventory for head and neck cancer (PCI-H&N), which was conducted at six hospital-based oral maxillofacial specialist clinics throughout Malaysia. Malaysians aged 18 years and above and on follow-ups from 1 month to 5 years or more were eligible. Patients completed the PCI-H&N, functional assessment of cancer therapy -H&N v4.0 and Distress Thermometer at pre-consultation and satisfaction questionnaire at post-consultation. The data were analysed descriptively; multiple linear regression and multivariate logistic regression analyses were used to determine possible predictors of patients' HRQoL and psychological distress.
Results: 'Recurrence or fear of cancer coming back' (31.8%) was most frequently selected. 43.5% of patients selected ≥4 concerns. A significantly high number of concerns were associated with patients of '1-month to 1-year post-treatment' (n = 84%; p = 0.001). A significant association existed between 'time after treatment completed' and patients' concerns of 'chewing/eating', 'mouth opening', 'swelling', 'weight', 'ability to perform', 'cancer treatment' and 'supplement/diet-related'. 'Chewing/eating' was predicted for low HRQoL (p < 0.0001) followed by 'appearance' and 'ability to perform recreation activities' (personal functions domain). Patients with high psychological distress levels were 14 times more likely to select 'ability to perform recreation activities' and seven times more likely to select 'feeling depressed'. No significant association was identified between patients' concerns and patients' satisfaction with the consultation.
Conclusion: Routine follow-up consultations should incorporate the PCI-H&N prompt list to enhance patient-centred care approach as the type and number of patients' concerns are shown to reflect their HRQoL and psychological distress.TRIAL REGISTRATION: NMRR-18-3624-45010 (IIR).
Solubility of ionic surfactants below their Krafft point in mixed micellar solutions: Phase diagrams for methyl ester sulfonates and nonionic cosurfactants

Danov KD, Stanimirova RD, Kralchevsky PA, Slavova TG, Yavrukova VI, Ung YW, et al.

J Colloid Interface Sci, 2021 Nov;601:474-485.
PMID: 34090025 DOI: 10.1016/j.jcis.2021.05.147

HYPOTHESIS: Many ionic surfactants with wide applications in personal-care and house-hold detergency show limited water solubility at lower temperatures (Krafft point). This drawback can be overcome by using mixed solutions, where the ionic surfactant is incorporated in mixed micelles with another surfactant, which is soluble at lower temperatures.
EXPERIMENTS: The solubility and electrolytic conductivity for a binary surfactant mixture of anionic methyl ester sulfonates (MES) with nonionic alkyl polyglucoside and alkyl polyoxyethylene ether at 5 °C during long-term storage were measured. Phase diagrams were established; a general theoretical model for their explanation was developed and checked experimentally.
FINDINGS: The binary and ternary phase diagrams for studied surfactant mixtures include phase domains: mixed micelles; micelles + crystallites; crystallites, and molecular solution. The proposed general methodology, which utilizes the equations of molecular thermodynamics at minimum number of experimental measurements, is convenient for construction of such phase diagrams. The results could increase the range of applicability of MES-surfactants with relatively high Krafft temperature, but with various useful properties such as excellent biodegradability and skin compatibility; stability in hard water; good wetting and cleaning performance.
Complete Genome Sequences of Three Historically Important, Spatiotemporally Distinct, and Genetically Divergent Strains of Zika Virus: MR-766, P6-740, and PRVABC-59

Yun SI, Song BH, Frank JC, Julander JG, Polejaeva IA, Davies CJ, et al.

Genome Announc, 2016;4(4).
PMID: 27540058 DOI: 10.1128/genomeA.00800-16

Here, we report the 10,807-nucleotide-long consensus RNA genome sequences of three spatiotemporally distinct and genetically divergent Zika virus strains, with the functionality of their genomic sequences substantiated by reverse genetics: MR-766 (African lineage, Uganda, 1947), P6-740 (Asian lineage, Malaysia, 1966), and PRVABC-59 (Asian lineage-derived American strain, Puerto Rico, 2015).
The role of competitive counterion adsorption on the electrolyte induced surface ordering in methyl ester sulfonate surfactants at the air-water interface

Xu H, Li P, Ma K, Welbourn RJL, Penfold J, Thomas RK, et al.

J Colloid Interface Sci, 2019 Jan 01;533:154-160.
PMID: 30153592 DOI: 10.1016/j.jcis.2018.08.061

The strong binding of Al3+ trivalent counterions to the anionic surfactants sodium polyethylene glycol monoalkyl ether sulfate and α-methyl ester sulfonate results in surface multilayer formation at the air-water interface. In contrast the divalent and monovalent counterions Ca2+ and Na+ result only in monolayer adsorption. Competitive counterion adsorption has been extensively studied in the context of surfactant precipitation and re-dissolution, but remains an important feature in understanding this surface ordering and how it can be manipulated. The α-methyl ester sulfonate surfactants are a promising class of anionic surfactants which have much potential for improved performance in many applications, greater tolerance to extreme solvent conditions such as water hardness, biocompatibility and sustainable production. Hence in this study we have used neutron reflectivity to extend previous studies on the surface ordering of the α-methyl ester sulfonate surfactant, sodium tetradecanoic 2-sulfo 1-methyl ester, in the presence of electrolyte to investigate the role of binary mixtures of electrolytes, AlCl3/CaCl2, and AlCl3/MgCl2. In the mixed electrolytes the evolution of the surface structure, from monolayer to multilayer with increasing AlCl3 concentration, is observed. It is broadly similar to that reported for the addition of only AlCl3. However with increasing CaCl2 concentration the structural evolution is shifted progressively to higher AlCl3 concentrations. Similar observations occur for the AlCl3/MgCl2 mixtures. However the presence of the MgCl2 results in an additional phenomenon; the partial co-adsorption of a more compact lamellar structure which exists until the highest AlCl3 concentrations. The results demonstrate the importance of the competitive adsorption of different counterions in driving and controlling the formation of surface multilayer structures with anionic surfactants. Furthermore it offers a facile route to the manipulation of these surface structures.
Fulltext Functional Genomics and Immunologic Tools: The Impact of Viral and Host Genetic Variations on the Outcome of Zika Virus Infection

Yun SI, Song BH, Frank JC, Julander JG, Olsen AL, Polejaeva IA, et al.

Viruses, 2018 08 11;10(8).
PMID: 30103523 DOI: 10.3390/v10080422

Zika virus (ZIKV) causes no-to-mild symptoms or severe neurological disorders. To investigate the importance of viral and host genetic variations in determining ZIKV infection outcomes, we created three full-length infectious cDNA clones as bacterial artificial chromosomes for each of three spatiotemporally distinct and genetically divergent ZIKVs: MR-766 (Uganda, 1947), P6-740 (Malaysia, 1966), and PRVABC-59 (Puerto Rico, 2015). Using the three molecularly cloned ZIKVs, together with 13 ZIKV region-specific polyclonal antibodies covering nearly the entire viral protein-coding region, we made three conceptual advances: (i) We created a comprehensive genome-wide portrait of ZIKV gene products and their related species, with several previously undescribed gene products identified in the case of all three molecularly cloned ZIKVs. (ii) We found that ZIKV has a broad cell tropism in vitro, being capable of establishing productive infection in 16 of 17 animal cell lines from 12 different species, although its growth kinetics varied depending on both the specific virus strain and host cell line. More importantly, we identified one ZIKV-non-susceptible bovine cell line that has a block in viral entry but fully supports the subsequent post-entry steps. (iii) We showed that in mice, the three molecularly cloned ZIKVs differ in their neuropathogenicity, depending on the particular combination of viral and host genetic backgrounds, as well as in the presence or absence of type I/II interferon signaling. Overall, our findings demonstrate the impact of viral and host genetic variations on the replication kinetics and neuropathogenicity of ZIKV and provide multiple avenues for developing and testing medical countermeasures against ZIKV.
Impact of molecular structure, headgroup and alkyl chain geometry, on the adsorption of the anionic ester sulfonate surfactants at the air-solution interface, in the presence and absence of electrolyte

Wang Z, Li P, Ma K, Chen Y, Campana M, Penfold J, et al.

J Colloid Interface Sci, 2019 May 15;544:293-302.
PMID: 30861434 DOI: 10.1016/j.jcis.2019.03.011

The transition from monolayer to multilayer adsorption at the air-water interface in the presence of multivalent counterions has been demonstrated for a limited range of anionic surfactants which exhibit increased tolerance to precipitation in the presence of multivalent counterions. Understanding the role of molecular structure in determining the transition to surface ordering is an important aspect of the phenomenon. The focus of the paper is on the alkyl ester sulfonate, AES, surfactants; a promising group of anionic surfactants, with the potential for improved performance and biocompatibility. Neutron reflectivity measurements were made in aqueous solution and in the presence of NaCl, CaCl2, MgCl2 and AlCl3, for a range of alkyl ester sulfonate surfactants, in which the headgroup and alkyl chain geometries were manipulated. In the regions of monolayer adsorption changing the AES headgroup and alkyl chain geometries results in an increased saturation adsorption and in a more gradual decrease in the adsorption at low concentrations, consistent with a greater adsorption efficiency. Changing the AES headgroup and alkyl chain geometries also results in changes in the transition from monolayer adsorption to more ordered surface structures with the addition of AlCl3 and mixed multivalent electrolytes. A more limited surface layering is observed for the ethyl ester sulfonate, EES, with a C14 alkyl chain. Replacing the C14 alkyl chain with a C18 isostearic chain results in only monolayer adsorption. The results demonstrate the role and importance of the surfactant molecular structure in determining the nature of the surface adsorption in the presence of different electrolytes, and in the tendency to form extended surface multilayer structures.
Distinct Neural Signatures of Outcome Monitoring After Selection and Execution Errors

Mushtaq F, McDougle SD, Craddock MP, Parvin DE, Brookes J, Schaefer A, et al.

J Cogn Neurosci, 2022 Jan 28.
PMID: 35104323 DOI: 10.1162/jocn_a_01824

Losing a point in tennis could result from poor shot selection or faulty stroke execution. To explore how the brain responds to these different types of errors, we examined feedback-locked EEG activity while participants completed a modified version of a standard three-armed bandit probabilistic reward task. Our task framed unrewarded outcomes as the result of either errors of selection or errors of execution. We examined whether amplitude of a medial frontal negativity (the feedback-related negativity [FRN]) was sensitive to the different forms of error attribution. Consistent with previous reports, selection errors elicited a large FRN relative to rewards, and amplitude of this signal correlated with behavioral adjustment after these errors. A different pattern was observed in response to execution errors. These outcomes produced a larger FRN, a frontocentral attenuation in activity preceding this component, and a subsequent enhanced error positivity in parietal sites. Notably, the only correlations with behavioral adjustment were with the early frontocentral attenuation and amplitude of the parietal signal; FRN differences between execution errors and rewarded trials did not correlate with subsequent changes in behavior. Our findings highlight distinct neural correlates of selection and execution error processing, providing insight into how the brain responds to the different classes of error that determine future action.
Adsorption of Methyl Ester Sulfonate at the Air-Water Interface: Can Limitations in the Application of the Gibbs Equation be Overcome by Computer Purification?

Xu H, Li P, Ma K, Welbourn RJL, Penfold J, Roberts DW, et al.

Langmuir, 2017 09 26;33(38):9944-9953.
PMID: 28871785 DOI: 10.1021/acs.langmuir.7b02725

We describe a new laboratory synthesis of the α-methyl ester sulfonates based on direct sulfonation of the methyl ester by SO3 introduced from the vapor phase. This was used to synthesize a chain deuterated sample of αC14MES, which was then used to measure the surface excess of αC14MES directly at the air/water interface over a wide range of concentration using neutron reflection. The adsorption isotherm could be fitted to an empirical equation close to a Langmuir isotherm and gave a limiting surface excess of (3.4 ± 0.1) × 10-6 mol m-2 in the absence of added electrolyte. The neutron-measured surface excesses were combined with the integrated Gibbs equation to fit the variation in surface tension with concentration (σ-ln C curve). The fit was exact provided that we used a prefactor consistent with the counterion at the surface being an impurity divalent ion, as has previously been found for sodium diethylhexylsulfosuccinate (aerosol OT or AOT) and various perfluorooctanoates. The critical micelle concentration (CMC) was determined from this fit to be 2.4 ± 0.3 mM in the absence of electrolyte. In the presence of 100 mM NaCl, this contamination was suppressed and the σ-ln C curve could be fitted using the integrated Gibbs equation with the expected prefactor of 1. The new data were used to reinterpret measurements by Danov et al. on an unpurified sample of αC14MES for which computer refinement was used to try to eliminate the effects of the impurities.
Biochemical and structural characterization of meningococcal methylenetetrahydrofolate reductase

Pantong W, Pederick JL, Maenpuen S, Tinikul R, Jayapalan JJ, Jovcevski B, et al.

Protein Sci, 2023 Jun;32(6):e4654.
PMID: 37165541 DOI: 10.1002/pro.4654

Methylenetetrahydrofolate reductase (MTHFR) is a key metabolic enzyme in colonization and virulence of Neisseria meningitidis, a causative agent of meningococcal diseases. Here, the biochemical and structural properties of MTHFR from a virulent strain of N. meningitidis serogroup B (NmMTHFR) were characterized. Unlike other orthologs, NmMTHFR functions as a unique homohexamer, composed of three homo-dimerization partners, as shown in our 2.7 Å resolution crystal structure. Six active sites were formed solely within monomers and located away from the oligomerization interfaces. Flavin adenine dinucleotide cofactor formed hydrogen bonds with conserved sidechains, positioning its isoalloxazine ring adjacent to the overlapping binding sites of nicotinamide adenine dinucleotide (NADH) coenzyme and CH2 -H4 folate substrate. NmMTHFR utilized NADH (Km = 44 μM) as an electron donor in the NAD(P)H-CH2 -H4 folate oxidoreductase assay, but not nicotinamide adenine dinucleotide phosphate (NADPH) which is the donor required in human MTHFR. In silico analysis and mutagenesis studies highlighted the significant difference in orientation of helix α7A (Phe215-Thr225) with that in the human enzyme. The extended sidechain of Met221 on helix α7A plays a role in stabilizing the folded structure of NADH in the hydrophobic box. This supports the NADH specificity by restricting the phosphate group of NADPH that causes steric clashes with Glu26. The movement of Met221 sidechain allows the CH2 -H4 folate substrate to bind. The unique topology of its NADH and CH2 -H4 folate binding pockets makes NmMTHFR a promising drug target for the development of new antimicrobial agents that may possess reduced off-target side effects.
Machine learning methods for the modelling and optimisation of biogas production from anaerobic digestion: a review

Ling JYX, Chan YJ, Chen JW, Chong DJS, Tan ALL, Arumugasamy SK, et al.

Environ Sci Pollut Res Int, 2024 Feb 20.
PMID: 38376778 DOI: 10.1007/s11356-024-32435-6

Biogas plant operators often face huge challenges in the monitoring, controlling and optimisation of the anaerobic digestion (AD) process, as it is very sensitive to surrounding changes, which often leads to process failure and adversely affects biogas production. Conventional implemented methods and mechanistic models are impractical and find it difficult to model the nonlinear and intricate interactions of the AD process. Thus, the development of machine learning (ML) algorithms has attracted considerable interest in the areas of process optimization, real-time monitoring, perturbation detection and parameter prediction. This paper provides a comprehensive and up-to-date overview of different machine learning algorithms, including artificial neural network (ANN), fuzzy logic (FL), adaptive network-based fuzzy inference system (ANFIS), support vector machine (SVM), genetic algorithm (GA) and particle swarm optimization (PSO) in terms of working mechanism, structure, advantages and disadvantages, as well as their prediction performances in modelling the biogas production. A few recent case studies of their applications and limitations are also critically reviewed and compared, providing useful information and recommendation in the selection and application of different ML algorithms. This review shows that the prediction efficiency of different ML algorithms is greatly impacted by variations in the reactor configurations, operating conditions, influent characteristics, selection of input parameters and network architectures. It is recommended to incorporate mixed liquor volatile suspended solids (MLVSS) concentration of the anaerobic digester (ranging from 16,500 to 46,700 mg/L) as one of the input parameters to improve the prediction efficiency of ML modelling. This review also shows that the combination of different ML algorithms (i.e. hybrid GA-ANN model) could yield better accuracy with higher R2 (0.9986) than conventional algorithms and could improve the optimization model of AD. Besides, future works could be focused on the incorporation of an integrated digital twin system coupled with ML techniques into the existing Supervisory Control and Data Acquisition (SCADA) system of any biogas plant to detect any operational abnormalities and prevent digester upsets.
Enhanced solubility of methyl ester sulfonates below their Krafft points in mixed micellar solutions

Yavrukova VI, Danov KD, Slavova TG, Stanimirova RD, Wei Ung Y, Tong Kim Suan A, et al.

J Colloid Interface Sci, 2024 Jan 22;660:896-906.
PMID: 38280282 DOI: 10.1016/j.jcis.2024.01.127

HYPOTHESIS: Methyl ester sulfonates (MES) show limited water solubility at lower temperatures (Krafft point). One way to increase their solubility below their Krafft points is to incorporate them in anionic surfactant micelles. The electrostatic interactions between the ionic surfactant molecules and charged micelles play an important role for the degree of MES solubility.
EXPERIMENTS: The solubility and electrolytic conductivity for binary and ternary surfactant mixtures of MES with anionic sodium alpha olefin sulfonate (AOS) and sodium lauryl ether sulfate with two ethylene oxide groups (SLES-2EO) at 5 °C during long-term storage were measured. Phase diagrams were established; a general phase separation theoretical model for their explanation was developed and checked experimentally.
FINDINGS: The binary and ternary phase diagrams for studied surfactant mixtures include phase domains: mixed micelles; micelles + crystallites; crystallites, and molecular solution. The proposed general phase separation model for ionic surfactant mixtures is convenient for construction of such complex phase diagrams and provides information on the concentrations of all components of the complex solution and on the micellar electrostatic potential. The obtained maximal MES mole fraction of transparent micellar solutions could be of interest to increase the range of applicability of MES-surfactants.
The burden of HIV-associated neurocognitive disorder (HAND) in the Asia-Pacific region and recommendations for screening

Ian E, Gwen CL, Soo CT, Melissa C, Chun-Kai H, Eosu K, et al.

Asian J Psychiatr, 2016 Aug;22:182-9.
PMID: 26617385 DOI: 10.1016/j.ajp.2015.10.009

HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment.
Context and priorities for health systems strengthening for pain and disability in low- and middle-income countries: a secondary qualitative study and content analysis of health policies

Briggs AM, Jordan JE, Sharma S, Young JJ, Chua J, Foster HE, et al.

Health Policy Plan, 2023 Feb 13;38(2):129-149.
PMID: 35876078 DOI: 10.1093/heapol/czac061

Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and opportunities, for improving population-level prevention and management of MSK health in LMICs using secondary qualitative data from a previous study exploring HSS priorities for MSK health globally and (2) to contextualize these findings through a primary analysis of health policies for integrated management of non-communicable diseases (NCDs) in select LMICs. Part 1: 12 transcripts of interviews with LMIC-based key informants (KIs) were inductively analysed. Part 2: systematic content analysis of health policies for integrated care of NCDs where KIs were resident (Argentina, Bangladesh, Brazil, Ethiopia, India, Kenya, Malaysia, Philippines and South Africa). A thematic framework of LMIC-relevant challenges and opportunities was empirically derived and organized around five meta-themes: (1) MSK health is a low priority; (2) social determinants adversely affect MSK health; (3) healthcare system issues de-prioritize MSK health; (4) economic constraints restrict system capacity to direct and mobilize resources to MSK health; and (5) build research capacity. Twelve policy documents were included, describing explicit foci on cardiovascular disease (100%), diabetes (100%), respiratory conditions (100%) and cancer (89%); none explicitly focused on MSK health. Policy strategies were coded into three categories: (1) general principles for people-centred NCD care, (2) service delivery and (3) system strengthening. Four policies described strategies to address MSK health in some way, mostly related to injury care. Priorities and opportunities for HSS for MSK health identified by KIs aligned with broader strategies targeting NCDs identified in the policies. MSK health is not currently prioritized in NCD health policies among selected LMICs. However, opportunities to address the MSK-attributed disability burden exist through integrating MSK-specific HSS initiatives with initiatives targeting NCDs generally and injury and trauma care.
Advocacy in Action: International Patient Group Improves Hereditary Angioedema Diagnosis and Care Across the Asia-Pacific

Wong JCY, Tsui CCW, Lao KCW, Abong J, Ali A, Bhattarai D, et al.

Clin Exp Allergy, 2025 Jan 12.
PMID: 39800561 DOI: 10.1111/cea.14623

This study demonstrates that patient advocacy groups significantly enhance medication availability and improve diagnosis of hereditary angioedema (HAE), particularly in emerging economies within the Asia-Pacific region. This study supports integrating patient advocacy group involvement into management guidelines, emphasising their role in improving access to diagnostics and treatment for HAE.
A novel approach to life support training using "action-linked phrases"

Hunt EA, Cruz-Eng H, Bradshaw JH, Hodge M, Bortner T, Mulvey CL, et al.

Resuscitation, 2015 Jan;86:1-5.
PMID: 25457379 DOI: 10.1016/j.resuscitation.2014.10.007

Observations of cardiopulmonary arrests (CPAs) reveal concerning patterns when clinicians identify a problem, (e.g. loss of pulse) but do not immediately initiate appropriate therapy (e.g. compressions) resulting in delays in life saving therapy.
Fulltext Methods and matrices: approaches to identifying miRNAs for nasopharyngeal carcinoma

Plieskatt JL, Rinaldi G, Feng Y, Levine PH, Easley S, Martinez E, et al.

J Transl Med, 2014;12:3.
PMID: 24393330 DOI: 10.1186/1479-5876-12-3

Nasopharyngeal carcinoma (NPC) is a solid tumor of the head and neck. Multimodal therapy is highly effective when NPC is detected early. However, due to the location of the tumor and the absence of clinical signs, early detection is difficult, making a biomarker for the early detection of NPC a priority. The dysregulation of small non-coding RNAs (miRNAs) during carcinogenesis is the focus of much current biomarker research. Herein, we examine several miRNA discovery methods using two sample matrices to identify circulating miRNAs (c-miRNAs) associated with NPC.
Fulltext Use of bevacizumab as a single agent or in adjunct with traditional chemotherapy regimens in children with unresectable or progressive low-grade glioma

Zhukova N, Rajagopal R, Lam A, Coleman L, Shipman P, Walwyn T, et al.

Cancer Med, 2019 01;8(1):40-50.
PMID: 30569607 DOI: 10.1002/cam4.1799

In pediatric low-grade gliomas not amenable to complete resection, various chemotherapy regimens are the mainstream of treatment. An excellent overall survival of these patients makes justification of the intensification of chemotherapy difficult and calls for the development of new strategies. Bevacizumab, a humanized monoclonal antibody directed against Vascular endothelial growth factor (VEGF), has been successfully used in combination with irinotecan in a number of adult and pediatric studies and reports. Fifteen patients at median age of 7 years old (range 3 months to 15 years) were treated with bevacizumab in combination with conventional low-toxicity chemotherapy. The majority had chiasmatic/hypothalamic and midline tumors, seven had confirmed BRAF pathway alterations including neurofibromatosis type 1 (2). Fourteen patients had more than one progression and three had radiotherapy. No deaths were documented, PFS at 11 and 15 months was 71.5% ± 13.9% and 44.7% ± 17.6% respectively. At the end of follow-up 40% of patients has radiologically stable disease, three patients progressed shortly after completion of bevacizumab and two showed mixed response with progression of cystic component. Rapid visual improvement was seen in 6/8 patients, resolution of endocrine symptoms in 2/4 and motor function improvement in 4/6. No relation between histology or BRAF status and treatment response was observed. Treatment-limiting toxicities included grade 4 proteinuria (2) and hypertension (2) managed with cessation (1) and pausing of therapy plus antihypertensives (1). In conclusion, bevacizumab is well tolerated and appears most effective for rapid tumor control to preserve vision and improve morbidity.
The structure of alkyl ester sulfonate surfactant micelles: The impact of different valence electrolytes and surfactant structure on micelle growth

Wang Z, Li P, Ma K, Chen Y, Penfold J, Thomas RK, et al.

J Colloid Interface Sci, 2019 Sep 05;557:124-134.
PMID: 31518834 DOI: 10.1016/j.jcis.2019.09.016

The ester sulfonate anionic surfactants are a potentially valuable class of sustainable surfactants. The micellar growth, associated rheological changes, and the onset of precipitation are important consequences of the addition of electrolyte and especially multi-valent electrolytes in anionic surfactants. Small angle neutron scattering, SANS, has been used to investigate the self-assembly and the impact of different valence electrolytes on the self-assembly of a range of ester sulfonate surfactants with subtly different molecular structures. The results show that in the absence of electrolyte small globular micelles form, and in the presence of NaCl, and AlCl3 relatively modest micellar growth occurs before the onset of precipitation. The micellar growth is more pronounced for the longer unbranched and branched alkyl chain lengths. Whereas changing the headgroup geometry from methyl ester to ethyl ester has in general a less profound impact. The study highlights the importance of relative counterion binding strengths and shows how the surfactant structure affects the counterion binding and hence the micelle structure. The results have important consequences for the response of such surfactants to different operational environments.

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