SrFeO3-δ: a novel Fe4+ ↔ Fe2+ redox mediated pseudocapacitive electrode in aqueous electrolyte.

Pseudocapacitors offer both high energy and high power, making them suitable for grid-scale electrochemical energy storage to harness renewable energy produced from sun, wind, and tides. To overcome performance degradation in terms of cycling fading and lower specific capacitance values at high charge/discharge rates of electrochemical pseudocapacitors based on transition-metal oxides, perovskite-structured SrFeO3-δ was envisaged as a negative electrode that harnesses the Fe4+/3+ and Fe3+/2+ redox couple to deliver superior performance. SrFeO3-δ offers high specific capacitances of ca. 733 F g-1 at a scan rate of 1 mV s-1 and ca. 743 F g-1 at a current density of 1 A g-1 and demonstrates excellent cyclic stability over 2500 repeated cycles with capacitance retention of >92%, achieving 94% coulombic efficiency. The good cycling stability is attributed to the inherent metallic electrical conductivity of SrFeO3-δ and the fortuitous tendency of the robust cation framework structure to accommodate flexible oxygen content. The surface capacitive and diffusion-controlled contributions for capacitance are about ∼30% and ∼70%, respectively, at peak current and a scan rate equivalent to 1 mV s-1. The higher capacitance and stable performance make SrFeO3-δ an economical and abundant pseudocapacitive electrode.

Nanocrystalline ß-NiS: a redox-mediated electrode in aqueous electrolyte for pseudocapacitor/supercapacitor applications.

Currently, enhancing the performance of electrochemical supercapacitors is the subject of intense research to fulfill the ever-increasing demand for grid-scale energy storage and delivery solution, thereby utilizing the full potential of renewable energy resources and decreasing our dependence on fossil fuels. Metal sulfides, such as cobalt sulfide (CoS), nickel sulfide (NiS), molybdenum sulfide (MoS), copper sulfide (CuS), and others, have recently emerged as a promising class of active electrode materials, alongside other supercapacitor electrode materials, due to their relatively high specific capacitance values and exceptional reversible redox reaction activities. The synthesis, characterizations, and electrochemical performances of single-phase nanocrystalline ß-NiS are presented here and the electrode based on this material shows a specific capacitance of 1578 F g-1 at 1 A g-1 from the galvanostatic discharge profile, whereas a capacitance of 1611 F g-1 at 1 mV s-1 was obtained through the CV curve in 2 M KOH aqueous electrolyte. Additionally, the electrode also performs well in neutral 0.5 M Na2SO4 electrolytes resulting in specific capacitance equivalent to 403 F g-1 at 1 mV s-1 scan rate. The high charge storage capacity of the material is due to the superior intercalative (inner) charge storage coupled with the surface (outer) charges stored by the ß-NiS electrode and was found to be 72% and 28%, respectively, in aqueous 2 M KOH electrolyte. This intercalative charge storage mechanism is also responsible for its excellent cycling stability. Additionally, we assembled aqueous asymmetric supercapacitors (ASCs) with activated carbon (AC) as the negative electrode and the ß-NiS electrode as the positive electrode. The combination of the ß-NiS electrode and AC with excellent cycling stability resulted in the highest specific energy equivalent to ∼163 W h kg-1 and a specific power of ∼507 W kg-1 at 1 A g-1 current rate.

Identification and characterization of 20 novel pathogenic variants in 60 unrelated Indian patients with mucopolysaccharidoses type I and type II.

Mucopolysaccharidoses (MPS), a subgroup of lysosomal storage disorders, are caused due to deficiency of specific lysosomal enzyme involved in catabolism of glycosaminoglycans. To date more than 200 pathogenic variants in the alpha-l-iduronidase (IDUA) for MPS I and ∼500 pathogenic variants in the iduronate-2-sulphatase (IDS) for MPS II have been reported worldwide. The mutation spectrum of MPS type I and MPS type II disorders in Indian population is not characterized yet. In this study, we carried out clinical, biochemical, molecular and in silico analyses to establish the mutation spectrum of MPS I and MPS II in the Indian population. We conducted molecular analysis for 60 MPS-affected patients [MPS I (n = 30) (Hurler syndrome = 17, Hurler-Scheie syndrome = 13), and MPS II (n = 30) (severe = 18, attenuated = 12)] and identified a total of 44 [MPS I (n = 22) and MPS II (n = 22)] different pathogenic variants comprising missense, nonsense, frameshift, gross deletions and splice site variants. A total of 20 [MPS I (n = 14), and MPS II (n = 6)] novel pathogenic sequence variants were identified in our patient cohort. We found that 32% of pathogenic variants detected in IDUA were recurrent and 25% in MPS II. This is the first study revealing the mutation spectrum of MPS I and MPS II patients in the Indian population.

Relationship of DNA methylation and gene expression in idiopathic pulmonary fibrosis.

RATIONALE: Idiopathic pulmonary fibrosis (IPF) is an untreatable and often fatal lung disease that is increasing in prevalence and is caused by complex interactions between genetic and environmental factors. Epigenetic mechanisms control gene expression and are likely to regulate the IPF transcriptome. OBJECTIVES: To identify methylation marks that modify gene expression in IPF lung. METHODS: We assessed DNA methylation (comprehensive high-throughput arrays for relative methylation arrays [CHARM]) and gene expression (Agilent gene expression arrays) in 94 patients with IPF and 67 control subjects, and performed integrative genomic analyses to define methylation-gene expression relationships in IPF lung. We validated methylation changes by a targeted analysis (Epityper), and performed functional validation of one of the genes identified by our analysis. MEASUREMENTS AND MAIN RESULTS: We identified 2,130 differentially methylated regions (DMRs; <5% false discovery rate), of which 738 are associated with significant changes in gene expression and enriched for expected inverse relationship between methylation and expression (P < 2.2 × 10(-16)). We validated 13/15 DMRs by targeted analysis of methylation. Methylation-expression quantitative trait loci (methyl-eQTL) identified methylation marks that control cis and trans gene expression, with an enrichment for cis relationships (P < 2.2 × 10(-16)). We found five trans methyl-eQTLs where a methylation change at a single DMR is associated with transcriptional changes in a substantial number of genes; four of these DMRs are near transcription factors (castor zinc finger 1 [CASZ1], FOXC1, MXD4, and ZDHHC4). We studied the in vitro effects of change in CASZ1 expression and validated its role in regulation of target genes in the methyl-eQTL. CONCLUSIONS: These results suggest that DNA methylation may be involved in the pathogenesis of IPF.

First Report of a 16Sr I-B Phytoplasma Associated with Phyllody and Stem Fasciation of Flax (Linum usitatissimum) in India.

Flax or linseed is grown as a fiber or oilseed crop in tropical and temperate regions. It is commercially cultivated in many countries of the world including Canada, China, India, the United States, Ethiopia, Pakistan, Russia, Poland, and Argentina (1). In December 2013, symptoms suggestive of phytoplasma infection were noticed on flax in different experimental fields of Central Research Institute for Jute and Allied Fibres (CRIJAF) research farm, Barrackpore, India, and the incidence was less than 2%. Because incidence of phytoplasma diseases are increasing worldwide, occurrence of a phytoplasma in a new geographical area poses an imminent threat. The infected plants showed floral virescence, phyllody, and stem fasciation (flattened stem). Floral malformation was very conspicuous with abnormal structures replacing normal flowers. All the floral parts, including petals, turned into green leaves. Total DNA was extracted from leaf mid veins of three symptomatic and three asymptomatic plants using a DNeasy Plant Mini Kit (Qiagen). PCR was carried out with the phytoplasma-specific universal P1/P7 primer set followed by nested primer pair R16F2n/R16R2 (2), resulting in DNA amplicons that were 1.8 kb and 1.2 kb, respectively, in all symptomatic samples tested. No amplification was observed with DNA from symptomless samples. This suggested association of a phytoplasma with the disease. The five purified nested PCR products were cloned in a pGEM-T Easy vector (Promega) and sequenced. One of the sequences that proved to be identical to the others was deposited in GenBank (Accession No. KJ417660). The consensus sequence was analyzed by NCBI BLAST and found to share 99% similarity with the 16Sr DNA sequence of the 'Candidatus Phytoplasma asteris' reference strain (GenBank HQ828108), which belongs to 16SrI group. The phylogenetic tree based on 16SrDNA sequence of phytoplasmas belonging to group 16SrI and other distinct phytoplasma groups also showed that the phytoplasma clustered with members of group 16SrI (3). The nested PCR product of R16F2n/R16R2 was digested using restriction enzymes AluI, BfaI, BstU, HhaI, HpaI, KpnI, MseI, and RsaI. The RFLP patterns were compared with those of known phytoplasma strains (2) and they matched the patterns for aster yellows subgroup B (16Sr I-B). Subsequently, the iPhyClassifier 16Sr group/subgroup classification based on similarity (4) analyses showed that the studied strain had 16SrDNA sequences in the 16SrI-B group with a similarity coefficient of 1.00. To the best of our knowledge, this is the first report of 16SrI-B phytoplasma associated with flax in India. References: (1) K. P. Akhtar et al. Phytoparasitica 41:383, 2013. (2) I. M. Lee et al. Int. J. Syst. Evol. Microbiol. 54:337, 2004. (3) N. Saitou and M. Nei. Mol. Biol. Evol. 4:406, 1987. (4) Y. Zhao et al. Int. J. Syst. Evol. Microbiol. 59:2582, 2009.

Ni0.5Co0.5S nano-chains: a high-performing intercalating pseudocapacitive electrode in asymmetric supercapacitor (ASC) mode for the development of large-scale energy storage devices.

Grid-scale energy storage solutions are necessary for using renewable energy sources efficiently. A supercapattery (supercapacitor + battery) has recently been introduced as a new variety of hybrid devices that engage both capacitive and faradaic charge storage processes. Nano-chain architectures of Ni0.5Co0.5S electrode materials consisting of interconnected nano-spheres are rationally constructed by tailoring the surface structure. Nano-chains of the bimetallic sulfide Ni0.5Co0.5S are presented to have a superior charge storage capacity. The Ni0.5Co0.5S nano-chain electrode presents a capacitance of 2001.6 F g-1 at 1 mV s-1, with a specific capacity of 267 mA h g-1 (1920 F g-1) at 1 A g-1 in 4 M KOH aqueous electrolyte through the galvanostatic charge-discharge (GCD) method. The reason behind the high charge storage capacity of the materials is the predominant redox-mediated diffusion-controlled pseudocapacitive mechanism coupled with surface capacitance (electrosorption), as the surface (outer) and intercalative (inner) charges stored by the Ni0.5Co0.5S electrodes are close to 46.0% and 54.0%, respectively. Additionally, a Ni0.5Co0.5S//AC two electrode full cell operating in asymmetric supercapacitor cell (ASCs) mode in 4 M KOH electrolyte exhibits an impressive energy density equivalent to 257 W h kg-1 and a power density of 0.73 kW kg-1 at a current rate of 1 A g-1.

Characterization of different road dusts in opencast coal mining areas of India.

Dust from haul and transport roads are the major source of air pollution in opencast coal mining areas. Dust generated during mining operations pollutes air which causes different health problems. Various available techniques are implemented in the field to minimize and control dust in mining areas. However, they are not very effective because dust deposited on road surfaces are not removed by these techniques. For effective control of dust in opencast mining areas, it has to be regularly collected from road surfaces and may be converted into solid form, and subsequently can be used as a domestic fuel considering its physicochemical properties. The present paper describes a comparative study of qualitative and quantitative aspects of road dust samples of four coalfields of India. The pH of the dust was found to be in the range of 5.1-7.7. Moisture, ash, volatile matter, fixed carbon, water-holding capacity, bulk density, and specific gravity of dust samples were found to be in the range of 0.5-3.0%, 45-76%, 12.6-20.0%, 10.2-45.3%, 21.17-31.71%, 1.15-1.70, and 1.73-2.30 g cm(-3), respectively. Observing the overall generation and characteristics of coal dust, it is suggested that coal dust from haul and transport roads of mining areas can be effectively collected and used as domestic fuel.

Reinforcement of nanoporous lanthanum-doped zinc borate by vanadium selenide nanosheets for improved tribological activity.

Nanoporous zinc borate (ZB) and 10% lanthanum-doped porous zinc borate (LZB) were synthesized to explore the role of porosity and doping in zinc borate during lubrication. HR-SEM, TEM, and HR-TEM authenticated nanoporous structures. The tribological properties of their blends with paraffin oil (PO) were compared by employing ASTM D4172 and ASTM D5183 norms on a four-ball tester. Vanadium selenide nanosheets (VSe2) were used to reinforce the structure of LZB for further advancement of the tribological properties. The superiority of the LZB/VSe2 over LZB and VSe2 nanosheets could be adjudged by tribological data. The porosity and lanthanum doping have yielded commendable tribological activity. The VSe2 nanosheets have strengthened the LZB matrix. The other constituent oxides of tribofilm from the LZB matrix, based on EDX analysis and XPS studies of the worn surface, ZnO, B2O3, La2O3, and V2O5, have abetted lubrication. The AFM and SEM investigations of wear track corroborated the tribological results.

Treatment of retinopathy of prematurity.

Retinopathy of prematurity is a potentially blinding disorder of premature infants. Retinal ablation of the avascular retina originally described using cryotherapy but now most commonly undertaken with laser photocoagulation, reduces the unfavourable structural outcomes and improves the functional visual acuity outcome. The CRYO-ROP study showed the long-term benefit of treatment of threshold disease compared with no treatment, however even with cryoablation 44.4% of treated eyes had a visual acuity of 6/60 or worse at 10 year follow-up. The ETROP study of earlier treatment for high-risk pre-threshold disease, rather than treatment at threshold, has shown that pre-threshold treatment of type 1 disease produces a significantly improved outcome. Despite treatment some infants develop retinal detachment for which various surgical treatments have been described, although not always with a good functional outcome. Future treatment modalities may include the use of anti-VEGF therapies.

Incidental gallbladder carcinoma: Utility of histopathological evaluation of routine cholecystectomy specimens.

BACKGROUND: Incidental gallbladder carcinoma (IGBC) is rare cancer diagnosed during or after cholecystectomy done for benign gallbladder disease. The concern whether routine histopathological examination is needed for all cholecystectomy specimens still remains debatable. MATERIALS AND METHODS: Twenty patients diagnosed with IGBC over a period of 2 years were retrospectively reviewed. Clinical details including clinical presentation, preoperative ultrasound (USG) findings, and macroscopic features were retrieved. Diagnosis of IGBC was confirmed on microscopic examination, and staging was done using the tumor node metastasis staging system. RESULTS: Of the 4800 cholecystectomy specimens retrieved, diagnosis of IGBC was rendered in twenty cases (0.41%). Mean patient age was 50.65 years with a female preponderance. Preoperative USG detected an increase in wall thickness in six cases (30%) in contrast to gross examination which revealed the same in 55% (11/20) cases. Mucosal ulceration was observed in two cases (10%) of IGBC and seven cases (35%) did not reveal any preoperative or macroscopic findings suggestive of malignancy. Associated cholelithiasis was observed in 14 cases. Final diagnosis of IGBC was made on histomorphological assessment with tumor cells infiltrating the lamina propria in three cases (pT1b), muscularis propria in 15 cases (pT1b), and serosa in the remaining 2 cases (pT2). CONCLUSION: IGBC is a clinical masquerader which often evades the eye of a radiologist and comes as pathological surprise. Histopathological examination of cholecystectomy specimens remains the gold standard for the detection of this occult, yet notorious malignancy and assessment of the depth of invasion in IGBC guide further management.

Metamagnetic transition and observation of spin-fluctuations in the antiferromagnetic Heusler compound Pd2MnIn.

We report detailed investigations on the structural, magnetic, magneto-transport and calorimetric aspects of a partially ordered Heusler compound Pd2MnIn. The sample shows antiferomagnetic (AFM) state below around 120 K, though positive paramagnetic Curie temperature signifies a complex magnetic ground state with the presence of both ferromagnetic (FM) and AFM correlations. A clear spin-flop type metamagnetic transition is observed as evident from the magnetization and resistivity data. However, non-saturation of magnetization even at 145 kOe of applied field implies that the high field state may be a spin canted state, originating from the enhanced FM correlations by field induced conduction electron spin polarization. The sample shows a profound quadratic temperature dependence of resistivity below about 20-25 K indicating a spin-fluctuation dominated low temperature region. Previous electronic structure calculations show the existence of a subtle balance between superexchange mediated AFM state and an RKKY (Ruderman-Kittel-Kasuya-Yoshida) interaction mediated FM state in Pd2MnIn. Such competing AFM-FM correlations can be accounted for the observed spin fluctuations.

An unusual case of retinopathy of prematurity.

AIMS: Stage 3 retinopathy of prematurity (ROP) usually develops in the very small babies. An infant born at 30 (2) weeks' gestation and of birth weight 2102 g was found to have stage 3 ROP bilaterally. The unusual severity of the disease in a child of birth weight >2000 g prompted further investigation. The aim was to look for any genetic causes for ROP. METHODS: Chromosomal analysis followed by vasculoendothelial growth factor (VEGF) analysis. RESULTS: Unbalanced translocation 18p (monosomy) and 6p (trisomy). Overexpression of VEGF. CONCLUSIONS: Overexpression of VEGF contributed to the unusual severity of ROP in this relatively large baby.

Survival and prognostic factors for glioblastoma multiforme: Retrospective single-institutional study.

INTRODUCTION: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults. The standard management has been maximum surgical resection followed by adjuvant radiotherapy with concurrent chemotherapy followed by adjuvant chemotherapy. Although the survival rate of patients with GBM has improved with recent advancements in treatment, the prognosis remains generally poor. The median survival rates are in the range of 9-12 months and 2-year survival rates are in the range of 8%-12%. MATERIALS AND METHODS: A single-institution retrospective review of 61 patients of GBM from 2012 to 2014. Data regarding patient factors, disease factors, and treatment factors were collected and survival has been calculated. RESULTS: A total of 61 patients with GBM were analyzed. GBM is commonly seen in sixth decade of life. Male to female ratio is 2.6:1. The right side of the brain is commonly involved with right frontal lobe being the most common site. The median follow-up was 4.6 months. The median survival of our patients was 8 months. The 1-year and 2-year survival rates were 20% and 3.27%, respectively. CONCLUSIONS: The overall survival and prognosis in patients with GBM remains poor despite of constant research and studies. Concurrent chemoradiotherapy followed by adjuvant chemotherapy with temozolomide should be used after maximal resection to improve the survival.

Effect of inorganic fertilizer and farmyard manure on soil physical properties, root distribution, and water-use efficiency of soybean in Vertisols of central India.

A field experiment was conducted on a Vertisol for three consecutive years (1998-2000) to study the effects of combined use of inorganic fertilizer (NPK) and organic manure (farmyard manure) on soil physical properties, water-use efficiency, root growth and yield of soybean [Glycine max (L.) Merr.] in a soybean-mustard cropping system. Application of 10 Mg farmyard manure and recommended NPK (NPK+FYM) to soybean for three consecutive years improved the organic carbon content of the surface (0-15 cm) soil from an initial value of 4.4 g kg(-1) to 6.2 g kg(-1) and also increased seed yield and water-use efficiency by 103% and 76%, respectively, over the control. The surface (0-15 cm) soil of the plots receiving both farmyard manure and recommended NPK had larger mean weight diameter (0.50 mm) and a higher percentage of water stable aggregates (55%) than both the inorganically fertilized (NPK) (0.44 mm and 49%) and unfertilized control plots (0.41 mm and 45.4%). The saturated hydraulic conductivity (13.32 x 10(-6) m s(-1)) of the NPK+FYM treatment of the 0-7.5 cm depth was also significantly greater than that of the NPK (10.53 x 10(-6) m s(-1)) and control (8.61 x 10(-6) m s(-1)) treatments. The lowest bulk density (1.18 Mg m(-3)) in the 0-7.5 cm layer was recorded in NPK+FYM whereas it was highest in the control plots (1.30 Mg m(-3)). However, at sub-surface (22.5-30 cm) layer, fertilizer and manure application had little effect on bulk density and saturated hydraulic conductivity. Root length density (RLD) up to the 30 cm depth was highest in the NPK+FYM plots and it was 31.9% and 70.5% more than NPK and control plots. The RLD showed a significant and negative correlation (r=-0.88( * *)) with the penetration resistance.

The UK Neovascular AMD Database Report 3: inter-centre variation in visual acuity outcomes and establishing real-world measures of care.

PurposeInternational variations in visual acuity (VA) outcomes of eyes treated for neovascular age-related macular degeneration (nAMD) are well-documented, but intra-country inter-centre regional variations are not known. These data are important for national quality outcome indicators. We aimed to determine intra-country and inter-centre regional variations in outcomes for treatment of nAMD.Patients and methodsProspective multicentre national database study of 13 UK centres that treated patients according to a set protocol (three loading doses, followed by Pro-Re-Nata retreatment). A total of 5811 treatment naive eyes of 5205 patients received a total of 36 206 ranibizumab injections over 12 months.ResultsMean starting VA between centres varied from 48.9 to 59.9 ETDRS letters. Mean inter-centre VA change from baseline to 12 months varied from +6.9 letters to -0.6 letters (mean of +2.5 letters). The proportion of eyes achieving VA of 70 letters or more varied between 21.9 and 48.7% at 12 months. Median number of injections (visits) at each centre varied from 5 to 8 (9 to 12), with an overall median of 6 (11). Age, starting VA, number of injections, and visits, but not gender were significantly associated with variation in these VA outcomes (P<0.01). Significant variation between centres persisted even after adjusting for these factors.ConclusionThere are modest differences in VA outcomes between centres in the UK. These differences are influenced, but not completely explained, by factors such as patient age, starting VA, number of injections, and visits. These data provide an indication of the VA outcomes that are achievable in real-world settings.

Structure and stability of gamma-crystallins. II. Differences in microenvironments and spatial arrangements of cysteine residues.

The gamma-crystallin fractions II, III and IV from calf eye lens were treated with the thiol-specific fluorescent probe 2-(4'-maleimidylanilino)naphthalene-6-sulfonate (MIANS), in order to determine the reactivity of the seven (gamma-II) or six (gamma-III, gamma-IV) cysteine residues. Two classes of reactive cysteines were distinguished by variations in fluorescence intensity with increasing molar excess of the probe, and approximately three cysteines were nonreactive in each gamma-crystallin. From the position of the emission maximum, it is apparent that MIANS-labeled cysteines of gamma-IV are in the least hydrophobic environment. Fluorescence energy transfer was observed from tryptophan to MIANS-labeled cysteines in both gamma-II and gamma-III crystallins, with efficiencies of 86% and 89%, respectively, but not in gamma-IV crystallin. We suggest that the spatial arrangements and microenvironments of cysteine residues of gamma-crystallins are sufficiently different from each other to account for the variations in fluorescence characteristics of the MIANS-labeled proteins and the lack of energy transfer in gamma-IV crystallins.

Structure and stability of gamma-crystallins. I. Spectroscopic evaluation of secondary and tertiary structure in solution.

The three major bovine gamma-crystallin fractions (gamma-II, gamma-III and gamma-IV) are known to have closely related (80-90%) amino acid sequences and three-dimensional folding of the polypeptide backbone. Their chiroptical and emission properties, as measured by circular dichroism (CD) and fluorescence, are now shown to differ distinctly. The far-ultraviolet CD spectra indicate that all three gamma-crystallins have predominantly beta-sheet conformation (45-60%) with only subtle differences in secondary structure. The fluorescence emission maxima of gamma-II, gamma-III and gamma-IV, due to the four tryptophan residues, appear at 324, 329 and 334 nm, respectively, suggesting that tryptophan residues are buried in environments of decreasing hydrophobicity. Corresponding differences in quantum yield may be due to fluorescence quenching by neighboring sulfur-containing residues. Titratable tyrosines are maximal for gamma-III, as manifested from difference absorption spectra at alkaline pH. The near-ultraviolet CD spectra differ in position, magnitude and sign of tryptophan and tyrosine transitions. In addition, a characteristic CD maximum at 235 nm, presumably due to tyrosine-tyrosine exciton interactions, differs in magnitude for each gamma-crystallin. This study shows that the environment and interactions of the aromatic residues of the individual gamma-crystallin fractions are quite different. These variations in tertiary structure may be significant, in terms of stability of gamma-crystallins towards aggregation and denaturation, for understanding lens transparency and cataract formation in general.

"Near misses" in a cataract theatre: how do we improve understanding and documentation?

AIM: Near miss event reporting is widely used in industry to highlight potentially unsafe areas or practice. The aim of this study was to see if a descriptive method of recording near misses was an appropriate method for use in an ophthalmic operating theatre and to quantify how many untoward events were recorded using this system. METHODS: The study was wholly conducted in a cataract theatre in the United Kingdom. The theatre nurse assigned to the patient in their journey through the operating theatre was asked to note any untoward events. As, at present, there is no consensus definition of near misses in ophthalmology the nurses recorded, in free text, any events that they considered to be a deviation from the normal routine in that theatre. RESULTS: Of the 500 cases randomly chosen, 96 "deviations from normal routine" were described in 93 patients-that is, 19% of cases. All forms distributed to the nurses were returned (100% response rate). The commonest abnormal events were intraoperative (69), with a lesser number being recorded preoperatively (27). When these events were further classified, it was thought that 25 could be classified as near misses. One true adverse event was recorded during the study. CONCLUSIONS: The results suggest that experienced nursing staff in an ophthalmic theatre are a reliable source for collecting data regarding near misses. A consensus is now required to define near misses in ophthalmology and to devise a user friendly input system that can use these definitions to consistently record these potentially vital events.

The incidence of prescribing errors in an eye hospital.

BACKGROUND: Relatively little is known about the incidence of prescribing errors and there has been no work on this in a single specialty ophthalmic hospital. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. This study is an attempt in, the setting of an eye hospital, to try to identify and attribute these medication errors. METHODS: The study setting was a single specialty eye hospital geographically separated from the main general hospital. Pharmacists prospectively recorded the number of errors of prescribing during a 4 week period at an eye hospital in UK. The errors were categorised as error of prescription writing or drug error. Potential significance of the errors was not addressed. RESULTS: Overall 144/1952 (8%) prescription sheets had errors. 7% of the total errors were errors of prescription writing while 1% were drug errors. The majority of errors were made by junior doctors and no drug errors were made by senior doctors. The outpatients department had by far the highest prevalence of errors. CONCLUSION: Certain areas within the hospital and certain grades of staff are more prone to drug errors. Further study is required to look at the reasons why this is so and what systems can be put in place to reduce these errors.

Autoimmune mechanisms of atherosclerosis.

Accumulating evidence supports an autoimmune mechanism as one of the prime pathogenic processes involved in the development of atherosclerosis. So far, three proteins, including heat shock proteins (HSPs), oxidized low-density lipoprotein (oxLDL), and beta2 glycoprotein1 (beta2GP1) have been recognized as autoantigens. It has been demonstrated that risk factors for atherosclerosis, such as hypercholesterolemia, hypertension, infections, and oxidative stress, evoke increased expression of HSPs in cells of atherosclerotic lesions. Autoantibody levels against HSPs are significantly increased in patients with atherosclerosis and T lymphocytes specifically responding to these autoantigens have been demonstrated within atherosclerotic plaques. Subcutaneous immunization of animals with HSP65 induced atheroma formation in the arterial wall. Furthermore, circulating immunoglobulin (Ig) G and IgM oxidized low-density lipoprotein (oxLDL) antibodies are present in the plasma of animals and humans and form immune complexes with oxLDL in atherosclerotic lesions. These antibodies closely correlate with the progression and regression of atherosclerosis in murine models. Interestingly, recent reports demonstrated that pneumococcal vaccination to LDL receptor-deficient mice results in elevation of anti-oxLDL IgM Ab EO6, which is inversely correlated with the development of atherosclerosis. Finally, it has been observed that autoantigen beta2GP1 localizes in the atheroma and that autoantibodies to beta2GP1 are correlated with the incidence of atherosclerosis in patients. Hence, these autoimmune reactions to HSPs, oxLDL and beta2GP1 can contribute to the initiation and progression of atherosclerosis.