Towards a microfluidics platform for the continuous manufacture of organic and inorganic nanoparticles.

In the last decade, microfluidics has opened new avenues for the synthesis of nanomaterials. However, the adoption of this production technique has been limited to a few high-value, low-production-volume organic nanoparticles. While there are several technical factors that can be attributed to this slow adoption, an important aspect to consider is the lack of a unified platform capable of producing a wide range of nanomaterials. In this work, we highlight a micro-mixing platform that can manufacture both organic and in-organic nanoparticles over a wide size range (nm-µm). We show that the platform can predictably and reproducibly create size and shape-controlled formulations with high homogeneity through input flow parameters. We further explore parallelization of this platform and discuss key technical constraints for high-volume production. We believe that the platform presented in this work can accelerate the adoption of nanomaterials relevant to a range of industries that encompass pharmaceutics, diagnostics, and cosmeceuticals.

An evaluation of the psychometric properties of the Purdue Pharmacist Directive Guidance Scale using SPSS and R software packages.

BACKGROUND: The Purdue Pharmacist Directive Guidance (PPDG) Scale was developed to assess patients' perceptions of the level of pharmacist-provided (1) instruction and (2) feedback and goal-setting-2 aspects of pharmaceutical care. Calculations of its psychometric properties stemming from SPSS and R were similar, but distinct differences were apparent. OBJECTIVE: Using SPSS and R software packages, researchers aimed to examine the construct validity of the PPDG using a higher order factoring procedure; in tandem, McDonald's omega and Cronbach's alpha were calculated as means of reliability analyses. METHODS: Ninety-nine patients with either type I or type II diabetes, aged 18 years or older, able to read and write English, and who could provide written-informed consent participated in the study. Data were collected in 8 community pharmacies in New Mexico. Using R, (1) a principal axis factor analysis with promax (oblique) rotation was conducted, (2) a Schmid-Leiman transformation was attained, and (3) McDonald's omega and Cronbach's alpha were computed. Using SPSS, subscale findings were validated by conducting a principal axis factor analysis with promax rotation; strict parallels and Cronbach's alpha reliabilities were calculated. RESULTS: McDonald's omega and Cronbach's alpha were robust, with coefficients greater than 0.90; principal axis factor analysis with promax rotation revealed construct similarities with an overall general factor emerging from R. CONCLUSIONS: Further subjecting the PPDG to rigorous psychometric testing revealed stronger quantitative support of the overall general factor of directive guidance and subscales of instruction and feedback and goal-setting.

Site of infection rather than vancomycin MIC predicts vancomycin treatment failure in methicillin-resistant Staphylococcus aureus bacteraemia.

BACKGROUND: Therapeutic use of vancomycin is characterized by decreased susceptibilities and increasing reports of clinical failures. Few studies have examined the clinical outcomes of patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia treated with vancomycin. The primary objective was to compare clinical outcomes of patients with MRSA bacteraemia treated according to standard of care practices. METHODS: Patients were included if: (i) admitted to University of New Mexico Hospital between 2002 and 2009; (ii) ≥18 years of age; (iii) had one blood culture positive for MRSA; and (iv) received vancomycin. Clinical outcomes were defined as cure, failure (relapse of infection 30 days after completion of therapy, death or change in therapy) or unevaluable. Patient demographics, source of bacteraemia, treatment regimen, and microbiological characteristics were determined. RESULTS: Two hundred patients with MRSA bacteraemia were included. Sixty-one patients were unevaluable, leaving 139 patients for the final analysis. Seventy-two (51.8%) patients were cured and 67 (48.2%) experienced vancomycin failure. Vancomycin MIC(90) was 2 mg/L for both groups by Etest. Patients with endocarditis (P = 0.02) or pneumonia (P = 0.02) were more likely to fail therapy. Panton-Valentine leucocidin, loss of agr functionality and strain type were not predictors of outcomes in this study. CONCLUSIONS: High failure rates were observed in patients with MRSA bacteraemia treated with vancomycin, despite high vancomycin troughs and low rates of nephrotoxicity. Predictors of vancomycin failure included endocarditis and pneumonia. In these situations, vancomycin provides suboptimal therapy.

Psychometric properties of the Purdue Pharmacist Directive Guidance (PPDG) Scale in a sample of diabetes patients in the Southwestern United States.

Despite the fairly widespread adoption of the 10-item Purdue Pharmacist Directive Guidance Scale (PPDG) over the last decade, only one study has assessed its psychometric properties. The present study examined the validity and reliability of the scale in a sample of 99 diabetic patients in the Southwestern United States. Principal axis factor analysis with Varimax rotation yielded two factors, "Instruction" and "Feedback and Goal Setting," similar to those found when the scale was originally developed. Cronbach's alphas for the total scale and the two factors were 0.95, 0.95, and 0.92, respectively. The scale and the two factors correlated significantly and positively with number of visits by patients to the pharmacist in the past 3 mo. These results provide further evidence for the internal consistency, and construct and criterion-related validities of the scale.

Split-half and parallel reliabilities of the Purdue Pharmacist Directive Guidance Scale.

Using R and SPSS, various forms of split-half and parallel reliabilities were calculated. Robust split-half and parallel reliability coefficients for the Purdue Pharmacist Directive Guidance Scale are presented with coefficients greater than .84.

The impact of bittering agents on pediatric ingestions of antifreeze.

BACKGROUND: Legislation requiring bittering of antifreeze enables assessment of the impact on frequency, volume, and severity of pediatric antifreeze ingestions. METHODS: US poison control data for antifreeze ingestions in children younger than 5 years were analyzed comparing 232 ingestions occurring in states after enactment of bittering requirements with 6218 cases occurring in states (or at times) where bittering was not required. RESULTS: The frequency of pediatric antifreeze ingestions was unchanged after implementation of bittering in Oregon and California. The medical outcome distribution, median volume ingested, and observed clinical effects were no different in bittered compared with nonbittered groups. Likewise, the rates of hospital admission, critical care treatment, and use of alkalinization, hemodialysis, or intubation showed no differences with bittering. CONCLUSION: Despite the appealing logic of limiting the ingested volume and thereby the severity of poisonings by adding aversive agents, and despite promising results in volunteer studies, bittering agents do not decrease the frequency or severity of pediatric antifreeze poisonings. The addition of bittering agents to household products cannot be justified based on actual poisoning data.

An evaluation of youth empowerment tobacco prevention programs in the Southwest.

Evaluation research pertaining to the development of assessment instruments that fully capture the facets of empowerment prevention perspectives among youth are sparse. With funding from the American Legacy Foundation, the University of New Mexico Center for Health Promotion and Disease Prevention, in partnership with the New Mexico State Department of Health, developed a measure of individual empowerment. Drawing from the various bodies of literature in adolescent development, substance abuse prevention, and program/coalition building, a questionnaire was developed to capture facets of individual empowerment as it pertains to tobacco prevention efforts among youth within New Mexico. Utilizing a sample of 112 youth participants, principal axis factor analysis with Varimax rotation revealed four valid sub-scales entitled active participation, empowerment efficacy, external organizational involvement, and participant satisfaction. Internal consistency reliabilities were satisfactory with Cronbach's alpha ranging from .78 to .84. Regression mediation analysis revealed that active participation mediated the relationship of empowerment efficacy and self-esteem. Challenges associated with conceptualizing and assessing empowerment among youth are discussed.

The impact of bittering agents on suicidal ingestions of antifreeze.

BACKGROUND: Legislation requiring the addition of bittering agents to antifreeze enables assessment of the impact on frequency, volume and severity of suicidal antifreeze ingestions. METHODS: U.S. poison control data were analyzed comparing 130 suicidal antifreeze ingestions occurring in two states after enactment of bittering requirements with 3,493 cases occurring in states (or at times) where bittering was not required. RESULTS: The frequency of suicidal antifreeze ingestions was unchanged after implementation of bittering. The volume implicated, medical outcome distribution, and use of antidotes, hemodialysis, intubation, or critical care, showed no significant difference between bittered and non-bittered groups. Bittering was not a significant contributor (positively or negatively) in predicting lethal or life-threatening medical outcomes. CONCLUSION: The addition of bittering agents to antifreeze for the purpose of limiting the frequency or severity of suicidal ingestions could not be justified using U.S. poison control data.

In vivo light scattering measurements for detection of precancerous conditions of the cervix.

OBJECTIVE: To examine the utility of in vivo elastic light scattering measurements to diagnose high grade squamous interepithelial lesions (HSIL) of the cervix. METHODS: A newly developed fiber optic probe was used to measure light transport in the cervical epithelium of 36 patients undergoing standard colposcopy. Both unpolarized and polarized light transport were measured in the visible and near-infrared. Spectroscopic results of 29 patients were compared with histopathology of the measured sites using ROC curves, MANOVA and logistic regression. RESULTS: Three spectroscopic parameters are statistically different for HSIL compared with low-grade lesions and normal tissue. When these three spectroscopic parameters are combined, retrospective sensitivities and specificities for HSIL versus non-HSIL are 100% and 80%, respectively. CONCLUSIONS: Reflectance measurements of elastically scattered light show promise as a non-invasive, real-time method to discriminate HSIL from other abnormalities and normal tissue. These results compare favorably with those obtained by fluorescence alone and by fluorescence combined with light scattering.