Mechanically Adaptive Mixed Ionic-Electronic Conductors Based on a Polar Polythiophene Reinforced with Cellulose Nanofibrils.

Conjugated polymers with oligoether side chains are promising mixed ionic-electronic conductors, but they tend to feature a low glass transition temperature and hence a low elastic modulus, which prevents their use if mechanical robust materials are required. Carboxymethylated cellulose nanofibrils (CNF) are found to be a suitable reinforcing agent for a soft polythiophene with tetraethylene glycol side chains. Dry nanocomposites feature a Young's modulus of more than 400 MPa, which reversibly decreases to 10 MPa or less upon passive swelling through water uptake.

Assessing the transferability and reproducibility of 3D in vitro liver models from primary human multi-cellular microtissues to cell-line based HepG2 spheroids.

To reduce, replace, and refine in vivo testing, there is increasing emphasis on the development of more physiologically relevant in vitro test systems to improve the reliability of non-animal-based methods for hazard assessment. When developing new approach methodologies, it is important to standardize the protocols and demonstrate the methods can be reproduced by multiple laboratories. The aim of this study was to assess the transferability and reproducibility of two advanced in vitro liver models, the Primary Human multicellular microtissue liver model (PHH) and the 3D HepG2 Spheroid Model, for nanomaterial (NM) and chemical hazard assessment purposes.

Next-generation risk assessment of chemicals - Rolling out a human-centric testing strategy to drive 3R implementation: The RISK-HUNT3R project perspective.

In many industrial sectors, there is a need for reliable ways to evaluate the safety of chemicals with methods anchored to human biology and pathology. For this purpose, many animal-free new approach methods (NAMs) have been developed and implemented in various stages of risk assessment. Now it is time to assemble individual NAMs into a comprehensive next-generation risk assessment (NGRA) strategy.

Application of high-throughput transcriptomics for mechanism-based biological read-across of short-chain carboxylic acid analogues of valproic acid.

Chemical read-across is commonly evaluated without specific knowledge of the biological mechanisms leading to observed adverse outcomes in vivo. Integrating data that indicate shared modes of action in humans will strengthen read-across cases. Here we studied transcriptomic responses of primary human hepatocytes (PHH) to a large panel of carboxylic acids to include detailed mode-of-action data as a proof-of-concept for read-across in risk assessment.

Preoperative multimodal protocol reduced postoperative nausea and vomiting in patients undergoing mastectomy with reconstruction.

Background: Mastectomy with immediate reconstruction is a high-risk cohort for postoperative nausea and vomiting (PONV). Known risk factors for PONV include female gender, prior PONV history, nonsmoker, age < 50, and postoperative opioid exposure. The objective of this observational, cohort analysis was to determine whether a standardized preoperative protocol with nonopioid and anti-nausea multimodal medications would reduce the odds of PONV.

Fluorescent tagging of endogenous Heme oxygenase-1 in human induced pluripotent stem cells for high content imaging of oxidative stress in various differentiated lineages.

Tagging of endogenous stress response genes can provide valuable in vitro models for chemical safety assessment. Here, we present the generation and application of a fluorescent human induced pluripotent stem cell (hiPSC) reporter line for Heme oxygenase-1 (HMOX1), which is considered a sensitive and reliable biomarker for the oxidative stress response. CRISPR/Cas9 technology was used to insert an enhanced green fluorescent protein (eGFP) at the C-terminal end of the endogenous HMOX1 gene.

When a Pharmacist Health Assessment Simulation Becomes a Real Patient-Provider Experience.

This commentary presents two simulated pharmacist training events during which concerning medical issues were discovered. The simulation exercises, the pharmacist's responsibility in those exercises, and the need to plan for unexpected findings when conducting simulation events are discussed.

New approach methods (NAMs) supporting read-across: Two neurotoxicity AOP-based IATA case studies.

Read-across approaches are considered key in moving away from in vivo animal testing towards addressing data-gaps using new approach methods (NAMs). Ample successful examples are still required to substantiate this strategy. Here we present and discuss the learnings from two OECD IATA endorsed read-across case studies.

Highly Stable Indacenodithieno[3,2-]thiophene-Based Donor-Acceptor Copolymers for Hybrid Electrochromic and Energy Storage Applications.

Stable doping of indacenodithieno[3,2-]thiophene (IDTT) structures enables easy color tuning and significant improvement in the charge storage capacity of electrochromic polymers, making use of their full potential as electrochromic supercapacitors and in other emerging hybrid applications. Here, the IDTT structure is copolymerized with four different donor-acceptor-donor (DAD) units, with subtle changes in their electron-donating and electron-withdrawing characters, so as to obtain four different donor-acceptor copolymers. The polymers attain important form factor requirements for electrochromic supercapacitors: desired switching between achromatic black and transparent states (*** 45.

NAM-supported read-across: From case studies to regulatory guidance in safety assessment.

The use of new approach methodologies (NAMs) in support of read-across (RAx) approaches for regulatory purposes is a main goal of the EU-ToxRisk project. To bring this forward, EU-ToxRisk partners convened a workshop in close collaboration with regulatory representatives from key organizations including European regulatory agencies, such as the European Chemicals Agency (ECHA) and the European Food Safety Authority (EFSA), as well as the Scientific Committee on Consumer Safety (SCCS), national agencies from several European countries, Japan, Canada and the USA, as well as the Organisation for Economic Cooperation and Development (OECD). More than a hundred people actively participated in the discussions, bringing together diverse viewpoints across academia, regulators and industry.

In Vitro Three-Dimensional Liver Models for Nanomaterial DNA Damage Assessment.

Whilst the liver possesses the ability to repair and restore sections of damaged tissue following acute injury, prolonged exposure to engineered nanomaterials (ENM) may induce repetitive injury leading to chronic liver disease. Screening ENM cytotoxicity using 3D liver models has recently been performed, but a significant challenge has been the application of such in vitro models for evaluating ENM associated genotoxicity; a vital component of regulatory human health risk assessment. This review considers the benefits, limitations, and adaptations of specific in vitro approaches to assess DNA damage in the liver, whilst identifying critical advancements required to support a multitude of biochemical endpoints, focusing on nano(geno)toxicology (e.

Adsorption Evaluation for the Removal of Nickel, Mercury, and Barium Ions from Single-Component and Mixtures of Aqueous Solutions by Using an Optimized Biobased Chitosan Derivative.

In this experimental study, the use of 5-hydroxymethyl-furfural (HMF) organic compound as a grafting agent to chitosan natural polymer (CS) was examined. One optimized chitosan derivative was synthesized, and then tested (CS-HMF), in order to uptake nickel, mercury, and barium metal ions from single- and triple-component (multi-component) aqueous solutions. The characterization of the material before and after the metal uptake was achieved by scanning electron microscopy (SEM).

Low-gap zinc porphyrin as an efficient dopant for photomultiplication type photodetectors.

A new zinc porphyrin, named as Por4IC, was synthesized, which through extension of conjugation and an enhancement of planarity and donor-acceptor interactions exhibits a very low band gap. The molecule was able to efficiently facilitate a photomultiplication effect in blend with P3HT which was assisted by electron trapping followed by hole tunneling injection from the Al electrode giving rise to a high external quantum efficiency of 22 182% and a specific detectivity of 4.4 × 10 Jones at 355 nm and at -15 V bias.

A Novel Technique for the Removal of Elastic Intramedullary Nail in Pediatric Long Bones: A Technical Note.

Elastic stable intramedullary nails have been commonly used to treat unstable long bone fractures in children. The nail tip at the insertion site can cause problems. The nail tip should be of optimal length as a prominent nail tip or a short nail tip, or both, may cause different sets of problems.

Setting the stage for next-generation risk assessment with non-animal approaches: the EU-ToxRisk project experience.

In 2016, the European Commission launched the EU-ToxRisk research project to develop and promote animal-free approaches in toxicology. The 36 partners of this consortium used in vitro and in silico methods in the context of case studies (CSs). These CSs included both compounds with a highly defined target (e.

Chitosan Grafted with Biobased 5-Hydroxymethyl-Furfural as Adsorbent for Copper and Cadmium Ions Removal.

This work investigates the application of 5-hydroxymethyl-furfural (HMF) as a grafting agent to chitosan (CS). The material produced was further modified by cross-linking. Three different derivatives were tested with molecular ratios CS/HMF of 1:1 (CS-HMF1), 2:1 (CS-HMF2) and 10:1 mol/mol (CS-HMF3)) to remove Cu and Cd from aqueous solutions.

Gin and tonic: A recipe for success.

Introduction: As members of a profession that supports lifelong learning, faculty and students must both engage in a bi-directional learning partnership that promotes competence, critical inquiry, and a focus on growth and investment in relationships.

Perspective: We are all part of a profession that ought to develop learners and leaders, help make each other resilient, and create a forum for innovative thinking and putting patients at the center of our care. We cannot solely focus on one job.

Short-Term Clinical and Quality Outcomes Have Inconsistent Changes From a Quality Improvement Initiative to Increase Access to Physical Therapy in the Cardiovascular and Surgical ICU.

Unlabelled: Studies of mobility during critical illness have mostly examined transitions from immobility (passive activities) or limited mobility to active "early mobility."

Design: Observational analysis of a quality improvement initiative.

Setting: Two ICUs (surgical ICU, cardiovascular ICU) at a tertiary academic medical center.

Standard preoperative use of nonopioid multi-modal medications for patients undergoing mastectomy with immediate reconstruction and the effect on postoperative opioid needs.

Standardized nonopioid preoperative protocol effects perioperative opioids. Combined use of acetaminophen, pregabalin, celecoxib, and transdermal scopolamine (APCS), in mastectomy with immediate subpectoral reconstruction procedures. Retrospective (2014-2017) cohort study (n = 305) examined treatment groups; APCS, no treatment (NONE), and partial combination APCS (OTHER), employing multivariable gamma regression models controlling preoperative and perioperative variables, examining postoperative opioid use (oral morphine equivalents, OME) and hospital stay (hours, LOS).

Acid Suppression to Prevent Gastrointestinal Bleeding in Patients With Ventricular Assist Devices.

Background: The high incidence of gastrointestinal bleeding (GIB) in patients with ventricular assist devices (VAD) is well known, but there is limited evidence to support the use of proton pump inhibitors (PPIs) or histamine receptor antagonists (H2RA) for preventing GIB in patients with VAD.

Materials And Methods: The surgical ICU and VAD databases within a large regional academic cardiac mechanical support and transplant center were queried for patients who underwent VAD implantation between 2010 and 2014. An observational cohort study was conducted to identify which acid suppressing drug regimen was associated with the fewest number of GIB events within 30 d after VAD implantation: PPI, H2RA, or neither.

Perioperative antibiotics should be used for placement of implanted central venous ports: A propensity analysis evaluating risk.

Objective: To quantify risk for CRI based on PABX use in CVAP placement for cancer patients.

Summary Background Data: Central venous access ports (CVAP) are totally implanted devices used for chemotherapy. There is a temporal risk for catheter related infection (CRI) to insertion and perioperative prophylactic antibiotics (PABX) use is a contested issue among practitioners.

Predicting ICU readmission among surgical ICU patients: Development and validation of a clinical nomogram.

Background: Unplanned intensive care unit readmission within 72 hours is an established metric of hospital care quality. However, it is unclear what factors commonly increase the risk of intensive care unit readmission in surgical patients. The objective of this study was to evaluate predictors of readmission among a diverse sample of surgical patients and develop an accurate and clinically applicable nomogram for prospective risk prediction.

Outcomes When Using Adjunct Dexmedetomidine with Propofol Sedation in Mechanically Ventilated Surgical Intensive Care Patients.

Compare the duration of mechanical ventilation between patients receiving sedation with continuous infusions of propofol alone or combination with the use of dexmedetomidine and propofol. Retrospective, propensity matched (1:1) cohort study, employing eight variables chosen a priori for matching. Timing of exposure to dexmedetomidine initiation was incorporated into a matching algorithm.

Single intervention for a reduction in portable chest radiography (pCXR) in cardiovascular and surgical/trauma ICUs and associated outcomes.

Purpose: Studies suggest that "on-demand" radiography is equivalent to daily routine with regard to adverse events. In these studies, provider behavior is controlled. Pragmatic implementation has not been studied.