Using a participatory approach to identify priorities to advance LHS implementation at an academic medical center.

Introduction: Like many other academic medical centers, the University of Alabama at Birmingham (UAB) aspires to adopt learning health system (LHS) principles and practices more fully. Applying LHS principles establishes a culture where clinical and operational practices constantly generate questions and leverage information technology (IT) and methodological expertise to facilitate systematic evaluation of care delivery, health outcomes, and the effects of improvement initiatives. Despite the potential benefits, differences in priorities, timelines, and expectations spanning an academic medical center's clinical care, administrative operations, and research arms create barriers to adopting and implementing an LHS.

Adsorption, uptake and toxicity of micro- and nanoplastics: Effects on terrestrial plants and aquatic macrophytes.

Plastic pollution is a new, pressing, environmental topic. Microplastics are considered contaminants of emerging concern and, consequently, microplastic research has grown exponentially in the last decade. Here, current knowledge regarding the impacts of micro- and nanoplastics on terrestrial plants and aquatic macrophytes is discussed, with a special focus on adsorption, uptake and toxicological effects.

Supporting Caregivers During COVID-19: Transforming Compassionate Care From a Way of Doing to Being.

The expectation by colleagues that fellow clinicians deftly manage the stresses of practice often predisposes healthcare professionals involved in an adverse event to experience isolation, blame, and shame. The peer support model has since been recognized as an important component of institutional wellness and follows a well-described and structured method. Although peer support programs have traditionally been established to support caregivers involved in adverse medical events, the relevance and applicability of these programs have found substantial traction across broader crisis domains.

Beyond plastic microbeads - Short-term feeding of cellulose and polyester microfibers to the freshwater amphipod Gammarus duebeni.

Monitoring studies have revealed the presence of large numbers of natural as well as anthropogenic microfibers, plastic and non-plastic, in environmental samples. However, the interaction of organisms with microfibers is largely understudied. This is the first ecotoxicological study that compares short-term feeding of anthropogenic plastic and non-plastic microfibers on a consumer (leaf-shredding detritivores) species.

Rapid fragmentation of microplastics by the freshwater amphipod Gammarus duebeni (Lillj.).

Microplastics have become ubiquitous in all environments. Yet, their environmental fate is still largely unknown. Plastic fragmentation is a key component of plastic degradation, which is mostly caused by abiotic processes over prolonged time scales.

Preliminary Psychometric Evaluation of the Nurse Anesthesia and the Aftermath of Perioperative Catastrophes Survey and the Ways of Coping Questionnaire.

The National Academy of Medicine recognizes medical errors as a leading cause of death in the United States. Hospitals nationwide have acted to improve patient safety, quality of care, and system processes; however, no standards mandate assessment of the emotional impact of perioperative catastrophes on healthcare professionals. A cross-sectional descriptive study using a sample of 196 Certified Registered Nurse Anesthetists (CRNAs) tested the psychometric properties of an adapted version of the Perioperative Catastrophes Survey and administered this survey along with the Ways of Coping Questionnaire to measure CRNAs' perceptions, experiences, and responses associated with perioperative catastrophes.

Wood ash residue causes a mixture of growth promotion and toxicity in Lemna minor.

The use of wood as a sustainable biofuel results in the generation of residual wood ash. The ash contains high amounts of plant macronutrients such as phosphorus, potassium, calcium as well as several micronutrients. To explore the potential use of wood ash as a fertiliser, the growth enhancing properties of Sitka spruce (Picea sitchensis Bong.

Investigation of the genotoxic potential of the marine biotoxins azaspiracid 1-3.

Azaspiracids (AZAs) are the most recently discovered group of biotoxins and are the cause of azaspiracid shellfish poisoning (AZP) in humans. To date over thirty analogues have been identified. However, toxicological studies of AZAs are limited due to the lack of availability of toxins and toxin standards.

Assessment of emerging biotoxins (pinnatoxin G and spirolides) at Europe's first marine reserve: Lough Hyne.

Active and passive sampling methods were employed over a four-month period, at a site off the South-West coast of Ireland, to characterise the occurrence of cyclic imines in the water column. The marine toxins 13-desmethyl-SPXC, 20-methyl SPXG toxins and pinnatoxin G were detected using active sampling from Diaion HP-20 resin. Seven water depths were sampled to determine stratification of the toxins in the water column using Solid Phase Adsorption and Toxin Tracking (SPATT).

Does the marine biotoxin okadaic acid cause DNA fragmentation in the blue mussel and the pacific oyster?

Two bivalve species of global economic importance: the blue mussel, Mytilus edulis and the pacific oyster, Crassostrea gigas were exposed in vivo, to the diarrhoetic shellfish toxin okadaic acid (OA), and impacts on DNA fragmentation were measured. Shellfish were exposed using two different regimes, the first was a single (24 h) exposure of 2.5 nM OA (∼0.

Application of passive (SPATT) and active sampling methods in the profiling and monitoring of marine biotoxins.

Solid phase adsorbent and toxin tracking (SPATT) enables temporally and spatially integrated monitoring of biotoxins in aquatic environments. Monitoring using two adsorbent resins was performed over a four-month period at Lough Hyne Marine Reserve, Ireland. A range of Diarhettic Shellfish Poisoning (DSP) toxins were detected from SPATT extracts throughout the study period.

Elucidation of the mass fragmentation pathways of the polyether marine toxins, dinophysistoxins, and identification of isomer discrimination processes.

Rationale: Most of the liquid chromatography/mass spectrometry (LC/MS) methods that have been developed for the analysis of Diarrhetic Shellfish Poisoning (DSP) toxins in shellfish and algae samples have been unable to differentiate the isomers okadaic acid (OA) and dinophysistoxin-2 (DTX2), unless separated by chromatography. Since there are many bioconversion products of these compounds it is imperative to determine characteristic product ions, which can provide unequivocal identification of OA and DTX2 and their analogs.

Methods: Using electrospray ionization, the fragmentation processes for two types of precursor ions, [M+Na](+) and [M-H](-), of the polyether marine toxins, dinophysistoxins (DTXs), were studied using a hybrid linear ion trap Orbitrap mass spectrometer which provided high mass accuracy data in combination with multiple tandem mass (MS(n)) spectra.

Alumina nanoparticles enhance growth of Lemna minor.

The industrial use of nanoparticles is rapidly increasing, and this has given rise to concerns about potential biological impacts of engineered particles released into the environment. So far, relatively little is known about uptake, accumulation and responses to engineered nanoparticles by plants. In this study, the effects of alumina nanoparticles on growth, morphology and photosynthesis of Lemna minor were quantified.

Mussels increase xenobiotic (azaspiracid) toxicity using a unique bioconversion mechanism.

Azaspiracid Poisoning (AZP) is a human toxic syndrome which is associated with the consumption of bivalve shellfish. Unlike other shellfish, mussels contain a large array of azaspiracid analogs, many of which are suspected bioconversion products. These studies were conducted to elucidate the metabolic pathways of azaspiracid (AZA1) in the blue mussel (Mytilus edulis) and revealed that the main biotransformation product was the more toxic demethyl analog, AZA3.

Food contaminant analysis at ultra-high mass resolution: application of hybrid linear ion trap - orbitrap mass spectrometry for the determination of the polyether toxins, azaspiracids, in shellfish.

The biotoxins, azaspiracids (AZAs), from marine phytoplankton accumulate in shellfish and affect human health by causing severe gastrointestinal disturbance, diarrhea, nausea and vomiting. Specific and sensitive methods have been developed and validated for the determination of the most commonly occurring azaspiracid analogs. An LTQ Orbitrap mass spectrometer is a hybrid instrument that combines linear ion trap (LIT) mass spectrometry (MS) with high-resolution Fourier transform (FT) MS and this was exploited to perform simultaneous ultra-high-resolution full-scan MS analysis and collision-induced dissociation (CID) tandem mass spectrometry (MS/MS).

Shellfish toxicity: human health implications of marine algal toxins.

Five major human toxic syndromes caused by the consumption of shellfish contaminated by algal toxins are presented. The increased risks to humans of shellfish toxicity from the prevalence of harmful algal blooms (HABs) may be a consequence of large-scale ecological changes from anthropogenic activities, especially increased eutrophication, marine transport and aquaculture, and global climate change. Improvements in toxin detection methods and increased toxin surveillance programmes are positive developments in limiting human exposure to shellfish toxins.

The effects of salinity on the Manila clam (Ruditapes philippinarum) using the neutral red retention assay with adapted physiological saline solutions.

This study investigated the internal osmotic regulatory capabilities of the Manila clam (Ruditapes philippinarum) following in vivo exposure to a range of salinities. A second objective was to measure the health status of the Manila clam following exposure to different salinities using the neutral red retention (NRR) assay, and to compare results using a range of physiological saline solutions (PSS). On exposure to seawater of differing salinities, the Manila clam followed a pattern of an osmoconformer, although they seemed to partially regulate their circulatory haemolytic fluids to be hyperosmotic to the surrounding aqueous environment.

Effects of contaminated sediment from Cork Harbour, Ireland on the cytochrome P450 system of turbot.

Hatchery-reared juvenile turbot (Scophthalmus maximus L.) were exposed for 3 weeks, under laboratory conditions, to inter-tidal sediments collected from polluted sites in Cork Harbour (Whitegate and Agahda) and a reference site at Ballymacoda Co., Cork, Ireland.

Peer support: healthcare professionals supporting each other after adverse medical events.

The patient safety movement in healthcare is beginning to openly acknowledge the need to support the human side of adverse medical events in conjunction with evidence-based improvement initiatives. While medical literature has sporadically reported on the emotional impact of adverse events on healthcare professionals, little has been documented on the implementation of support services following these events. This article describes an adverse medical event where open communication and apology catalysed the development and implementation of a structured peer support service for care providers at the Brigham and Women's Hospital following adverse events.

In vitro exposure of jurkat T-cells to industrially important organic solvents in binary combination: interaction analysis.

Humans are frequently exposed to mixtures of environmental pollutants at low levels over prolonged periods of time yet most toxicity studies deal with acute exposure to high concentrations of single chemicals. Investigation of the biological effects and possible toxic interactions during long-term exposure to such mixtures is warranted. Here Jurkat T-cells were exposed to toluene, n-hexane and methyl ethyl ketone in binary combination.

Hepatic biomarkers of sediment-associated pollution in juvenile turbot, Scophthalmus maximus L.

Hatchery-reared turbot (Scophthalmus maximus L.) were exposed for 3 weeks, under laboratory conditions, to sediment collected from polluted sites in Cork Harbour and a reference site at Ballymacoda, Co. Cork, Ireland.

Sub-chronic toxicity of low concentrations of industrial volatile organic pollutants in vitro.

Organic solvents form an important class of pollutants in the ambient air and have been associated with neurotoxicity and immunotoxicity in humans. Here we investigated the biological effects of sub-chronic exposure to industrially important volatile organic solvents in vitro. Jurkat T cells were exposed to toluene, n-hexane and methyl ethyl ketone (MEK) individually for 5 days and solvent exposure levels were confirmed by headspace gas chromatography.

Validation of a method for acute and subchronic exposure of cells in vitro to volatile organic solvents.

In vitro assessment of organic solvents can be problematic as the volatile nature of these compounds makes maintaining a constant exposure level difficult. However, a stable exposure level must be maintained if reliable dose response data are to be obtained. Here we describe a gas-tight glass exposure system which allows prolonged exposure of cultured cells to constant concentrations of volatile organic solvents.

Two-dimensional electrophoresis analysis of glutathione affinity-selected proteins from the clam Tapes semidecussatus: Evidence for tissue-specific expression of redox proteins.

Proteins from gill, digestive gland and mantle of the clam Tapes semidecussatus were selected on glutathione (GSH) agarose to simplify proteomic comparison. Analysis by two-dimensional gel electrophoresis (2D SDS PAGE) revealed tissue-specific patterns of protein expression with some spots common to all tissues. Immunoblotting of gill and digestive gland separations identified some spots as glutathione transferases (GSTs).