Explorations of the chemical constitution and aqueous solution status of caries-arresting silver(I)-diammine fluoride and silver(I)-fluoride products using high-resolution 19F NMR analysis. Spectroscopic and SEM investigations of their interactions with human saliva: evidence for the in vivo salivary-catalysed autoconstruction of Ag/AgCl-based nanoparticles (IV-SCAN)-part I.

Introduction: Silver(I)-diammine fluoride (SDF) and silver(I)-fluoride (SF) complexes have been successfully employed for the arrest of dental caries for many years. However, to date there are very few studies available reporting on the molecular structural compositional and solution status of these agents [typically applied as highly-concentrated 38% (w/v) solutions]. Here, we explored the solution status and chemical constitution of commercially-available SDF and SF products, and secondly investigated the multicomponent interplay of these products with biomolecules present in intact human whole-mouth salivary supernatants (WMSSs) in vitro. Methods: High-resolution 19F NMR analysis was employed to explore SDF and SF product solutions, and to determine WMSS fluoride (F-) concentrations, whereas ammonia (NH3) release form SDF was tracked by 1H NMR spectroscopy. SEM and thin-film FTIR-ATR analyses were employed to explore the atomic and molecular compositions of sequentially-generated AgCl deposits and chromophoric Ag/AgCl nanoparticles (CSNPs); the time-dependent generation of the latter was followed spectrophotometrically. Results: 19F NMR spectra of aqueous SF solutions contained a very broad F- signal (Δv1/2 70 Hz), demonstrating that much of its solvated F- content was rapidly exchanging with Ag(I) on the NMR timescale, but those of SDF had a much sharper resonance, similar to that of "free" F- (4 Hz). Moreover, further NMR results revealed that a popular SDF product contained high molar excesses of both F- and NH3. Treatment of WMSSs with SDF and SF generated an off-white precipitate, which slowly developed into CSNPs at 23°C; SEM demonstrated high contents of both silver and chloride in this material (ca.1:1 atomic content ratio). FTIR-ATR analysis found that the CSNPs formed contained a range of salivary biomolecules, which appear to encapsulate the Ag/AgCl core (significant thiocyanate contents were also found). In conclusion, NMR results acquired demonstrated that SF, but not SDF, product solutions feature rapidly-exchanging F - between its "free" and Ag(I)-bound forms, and that SDF contains large excesses of both F- and its NH3 ligands. Characterised AgCl deposits and CSNPs were sequentially produced from the interactions of these complexes with WMSS biomolecules. Discussion: In view of their well-known microbicidal and cariostatic properties, the observed autobioconstruction of CSNPs involving salivary catalysis is of much therapeutic significance.

Further research into alternative carrier solvents for the detection of latent fingermarks.

A number of solvents, (Solstice PF, Opteon SF33 and Amolea AS-300), are compared to the recommended carrier solvent of HFE7100 for the ninhydrin and 1,2-indandione formulations. As the supply of HFE7100 will cease by the end of 2025, suitable alternatives are required in the short-term to ensure the detection of latent fingermarks on porous surfaces is still effective. Although these solvents, with the exception of Amolea AS-300, are classified as per- and polyfluoroalkyl substances (PFAS); they are not classed as hazardous. The alternatives in this study have a low global warming potential and atmospheric lifetime and are volatile, non-flammable and non-ozone depleting, in addition to other desirable properties such as a high wetting-index. During Phase 2 trials with deposited fingermarks, HFE7100 provided the best performing results followed by Opteon SF33, Solstice PF and Amolea AS-300. A significant difference with a negligible effect size was observed for ninhydrin formulations (p-value 0.00179; ε2 0.00418) while a significant difference with a weak effect size was observed for 1,2-indanedione formulations (p-value 2.095 ×10-10; ε2 0.0167). Furthermore, HFE7100 provided the least ink diffusion and the brightest 1,2-indanedione luminosity (significant difference with a moderate effect size p-value 1.772 ×10-13; ε2 0.0434) but the HFE formulation turned cloudy more quickly and needed regular replacements. Phase 3 pseudo-operational trials of 100 porous items followed a similar trend whereby HFE7100 formulations detected the highest number of marks followed by Opteon SF33 and Solstice PF. Although HFE7100 is still the best performing carrier solvent, this study demonstrates that, in the short-term, Opteon SF33 and Solstice PF may have potential as non-flammable replacement carrier solvents while developing the long-term goal of solvent-less methods.

A rapid synthesis of molecularly imprinted polymer nanoparticles for the extraction of performance enhancing drugs (PIEDs).

It is becoming increasingly more significant to detect and separate hormones from water sources, with the development of synthetic recognition materials becoming an emerging field. The delicate nature of biological recognition materials such as the antibodies means the generation of robust viable synthetic alternatives has become a necessity. Molecularly imprinted nanoparticles (NanoMIPs) are an exciting class that has shown promise due the generation of high-affinity and specific materials. While nanoMIPs offer high affinity, robustness and reusability, their production can be tricky and laborious. Here we have developed a simple and rapid microwaveable suspension polymerisation technique to produce nanoMIPs for two related classes of drug targets, Selective Androgen Receptor Modulators (SARMs) and steroids. These nanoMIPs were produced using one-pot microwave synthesis with methacrylic acid (MAA) as the functional monomer and ethylene glycol dimethacrylate (EGDMA) as a suitable cross-linker, producing particles of an approximate range of 120-140 nm. With the SARMs-based nanoMIPs being able to rebind 94.08 and 94.46% of their target molecules (andarine, and RAD-140, respectively), while the steroidal-based nanoMIPs were able to rebind 96.62 and 96.80% of their target molecules (estradiol and testosterone, respectively). The affinity of nanoMIPs were investigated using Scatchard analysis, with Ka values of 6.60 × 106, 1.51 × 107, 1.04 × 107 and 1.51 × 107 M-1, for the binding of andarine, RAD-140, estradiol and testosterone, respectively. While the non-imprinted control polymer (NIP) shows a decrease in affinity with Ka values of 3.40 × 104, 1.01 × 104, 1.83 × 104, and 4.00 × 104 M-1, respectively. The nanoMIPs also demonstrated good selectivity and specificity of binding the targets from a complex matrix of river water, showing these functional materials offer multiple uses for trace compound analysis and/or sample clean-up.

Locked down: Ontological security and the experience of COVID-19 while living in poor-quality housing.

The aim of the paper is to illustrate how the housing system in the United Kingdom (UK) has contributed to creating vulnerabilities during the COVID-19 pandemic. Drawing on the concept of ontological security we look at how living with housing insecurity whilst enduring poor housing conditions has impacted the lives of those living in households. The paper draws on semi-structured interviews with 50 residents and 8 housing professionals. The findings outline the grinding impact of the pandemic on the ontological security of residents and the coping strategies adopted by a wider range of households who are now increasingly vulnerable. A number of people went into lockdown in vulnerable situations, experiencing deep inequalities and living in poorly maintained homes. This has weakened the ontological security experienced by many households. These represent significant failings of the housing system and housing policy impacting on the health and wellbeing of a wider cohort of people creating additional vulnerabilities.

Understanding the mental health impacts of poor quality private-rented housing during the UK's first COVID-19 lockdown.

This paper examines the mental health impacts of poor quality private-rented housing in the north of England during the UK's first COVID-19 lockdown. The paper draws on data collected from semi-structured telephone interviews with 40 renters in the private-rented sector. We use the Power Threat Meaning Framework to highlight how substandard housing was a social and material vulnerability which, underpinned by powerlessness, resulted in threats that created and exacerbated the mental-ill health of precarious private renters. The paper suggests the pandemic and increased time spent in unhealthy places of residence can create stresses at a time of broader structural fragility, and calls for the greater engagement and integration of health practitioners in the future development of housing policy at all levels.

Patients Access to Medicines - A Critical Review of the Healthcare System in Kenya.

Access to affordable, safe, effective, and quality-assured medicines by a patient is important for good health outcomes. Unfortunately, there is sparse literature published on the pharmaceutical enablers that may increase the sale of a substandard and falsified (SF) medicine to a patient in Kenya. The review highlights some of the factors that may facilitate the entry of SF medicines into the legitimate pharmaceutical supply chain and discusses their impact on patient access to medicines. Lack of essential medicines in public health facilities is an important factor that may contribute to increased demand for medicine-related out-of-pocket expenses from private health facilities, thus a likelihood for a patient purchasing SF medicine from unlicensed and illegal medicine outlets or unregulated websites. The need to increase medicine availability in the public sector by the Ministry of Health (MOH) is emphasized in addition to the strengthening of public procurement to cushion it from corruption and mismanagement. In addition, the MOH should promote local pharmaceutical manufacturing and implement a medicine pricing containment policy to avoid abuse and prevent overexploitation of patients, increase medicine price transparency, and reduce pharmaceutical supply chain distortion. Recommended regulatory reviews include accreditation of unlicensed illegal medicine outlets to facilitate accountability, regulatory oversight, and active surveillance. The national post-market surveillance regulatory capacity should be strengthened to improve rational medicine use. A 3-year diploma course should be replaced with a shorter 1- or 2-year pharmaceutical support staff training not eligible to superintend a pharmacy. The recommended legislative review includes a mandatory clause to enforce generic prescribing and the implementation of generic substitution by health workers. Unethical manipulative pharmaceutical marketing practices should carry stiffer penalties to deter malpractice. Future research areas include investigation of medicine prescribing and dispensing practices, medicine consumption studies, medicine price differences within different health sub-sectors, and between licensed pharmacies and unlicensed illegal medicine outlets.

On a knife edge: A preliminary investigation of clothing damage using rounded-tip knives.

Bladed weapons are frequently encountered in violent crime offences including street based and armed robberies, murder, sexual assaults and terrorism. A study was conducted involving four frequently encountered clothing fabrics: t-shirt (knitted cotton), denim jeans (twill woven cotton), long sleeved top (knitted synthetic blend), and skirt (non-woven faux leather) and five knives to investigate any damage resulting from a downward stabbing motion, with 300 stabs in total. Any resultant penetrating severance damage was then photographed, measured and analysed. Statistical analysis revealed significant differences between the stab hole size and shape, as a consequence of the design of a bladed weapon (in particular, the tip shape) that caused it. There is a notable correlation between the Assure knife (rounded tip) and no resulting severance damage, as the fabric surfaces were not breached with this knife. This suggests a clear alternative to pointed tip knife blades. These findings will be of interest to investigators of knife crime offences, crime-reduction units, knife manufacturers and practitioners, who share the goal of identifying a safer alternative to conventional knife blade design.

The effect of paint type on the development of latent fingermarks on walls.

Despite recent advances in DNA technology, fingermark evidence remains a fundamental method of ascertaining an individual's identity. Latent fingermarks are the commonest type of fingermark encountered at crime scenes. The Fingermark Visualisation Manual provides crime scene practitioner's with sequential information regarding which enhancement processes are best suited for a range of deposition surfaces (Bandey et al., 2014) [1]. However, there are still many surfaces, such as painted walls where more knowledge is required regarding which development techniques provide optimum results. In this study, four paint types were tested (matt, silk, bathroom and eggshell). Fingermarks were deposited on painted simulated walls and aged for 1 day, 1 week and 1 month. Fingermarks were developed by three processes highlighted as the most frequently used by practitioners (magnetic granular powder, magneta flake powder and ninhydrin). The results showed that overall black magnetic granular powder outperformed both magneta flake powder and ninhydrin on all paint types. This contradicts current UK guidelines for enhancement of fingermarks on matt painted walls, as black magnetic granular powder is not a recommended process at present. SEM and SEM-EDX analysis showed distinct differences between matt paint and the three non-matt paints tested, which provides an explanation for the results obtained.

RCNi Nurse Awards 2017.

Now in their 30th year, the RCNi Nurse Awards exist to showcase the work of innovative and inspirational nurses from all over the UK. The quality of entries in 2017 was as high as ever, bringing to light the outstanding contribution made by nursing staff to enhancing patient safety, outcomes and experience.

Thermodynamic Changes Induced by Intermolecular Interaction Between Ibuprofen and Chitosan: Effect on Crystal Habit, Solubility and In Vitro Release Kinetics of Ibuprofen.

PURPOSE: The direct impact of intermolecular attraction between ibuprofen and chitosan on crystal behaviour, saturated solubility and dissolution efficiency of ibuprofen was investigated in order to expand the drug delivery strategy for ibuprofen. METHODS: Amorphous nanoparticle complex (nanoplex) was prepared by controlled drug-polymer nanoassembly. Intermolecular attraction was confirmed with surface tension, conductivity measurements and FTIR spectroscopy. The nanoplex was characterized using DSC, TGA and SEM. The in vitro release kinetics and mechanism of drug release were evaluated using mathematical models. RESULTS: The cmc of ibuprofen decreased significantly in the nanoplex (1.85 mM) compared with pure ibuprofen (177.62 mM) suggesting a remarkable affinity between the chitosan and ibuprofen. The disappearance of ibuprofen melting peak in the nanoplex and the broadened DSC endothermic peaks of the nanoplex indicate formation of eutectic amorphous product which corresponded to higher saturated solubility and dissolution velocity. Ibuprofen (aspect ratio 5.16 ± 1.15) was converted into spherical nanoparticle complex with particle size of 14.96 ± 1.162-143.17 ± 17.5247 nm (36-345 folds reduction) dictated by chitosan concentration. Pure ibuprofen exhibited burst release while the nanoplexes showed both fast and extended release profiles. DE increased to a maximum (81.76 ± 2.1031%) with chitosan concentrations at 3.28 × 10-3 g/dm3, beyond which retardation occurred steadily. Major mechanism of drug release from the nanoplex was by diffusion however anomalous transport and super case II transport did occur. CONCLUSION: Ibuprofen-chitosan nanoplex exhibited combined fast and extended release profile dictated by chitosan concentration. This study demonstrated the potential application of drug-polymer nanoconjugate design in multifunctional regulated drug delivery.

Local variations in reporting deaths to the coroner in England and Wales: a postcode lottery?

AIMS: In England and Wales, doctors are charged with a responsibility either to report a death to the coroner or issue a medical certificate specifying cause of death. A lack of formal prescriptive or presumptive oversight has resulted in the promulgation by individual coroners of local reporting regimes. The study reported here identified overall and gendered variations in local reporting rates to coroners across the jurisdictions of England and Wales, consistent over time. METHODS: Analysis was performed on Ministry of Justice (MOJ) data pertaining to the numbers and proportions of deaths reported to the coroner by jurisdiction over a 10-year period (2001-2010). Office of National Statistics (ONS) data provided the numbers of deaths registered in England and Wales over the same period to serve as a denominator for the calculation of proportions. Where coroner jurisdictions (and local authorities) had been amalgamated during this period, the combined reported and registered death figures have been included in line with the current jurisdiction areas. RESULTS: While reporting rates for individual jurisdictions were found to be stable over the 10-year period, wide local variations in reporting deaths to coroners were found with no obvious demographic explanation. The gender of the deceased was identified as a major factor in local variation. CONCLUSIONS: The decision to report a death to the coroner varies across jurisdictions. Implications for coronial investigations are discussed and the need for wider research into coroners' decision-making is proposed.