Electrostatic Adsorption Behaviors of Polymer Plates to a Droplet.

Electrostatic transfer and adsorption of electrically conductive polymer-coated poly(ethylene terephthalate) plates from a particle bed to a water droplet were studied, with the influence of plate thickness and shape observed. After synthesis and confirmation of the particles' properties using stereo and scanning electron microscopies, elemental microanalysis, and water contact angle measurement, the electric field strength and droplet-bed separation distance required for transfer were measured. An electrometer and high-speed video footage were used to measure the charge transferred by each particle, and its orientation and adsorption behavior during transfer and at the droplet interface. The use of plates of consistent square cross section allowed the impact of contact-area-dependent particle cohesion and gravity on the electrostatic transfer of particles to be decoupled for the first time. The electrostatic force required to extract a plate was directly proportional to the plate mass (thickness), a trend very different from that previously observed for spherical particles of varied diameter (mass). This reflected the different relationship between mass, surface area, and cohesive forces for spherical and plate-shaped particles of different sizes. Thicker plates transferred more charge to the droplet, probably due to their remaining at the bed at higher field strengths. The impact of plate cross-sectional geometry was also assessed. Differences in the ease of transfer of square, hexagonal, and circular plates seemed to depend only on their mass, while other aspects of their comparative behavior are attributed to the more concentrated charge distribution present on particles with sharper vertices.

Impact of surface free energy on electrostatic extraction of particles from a bed.

HYPOTHESIS: Electrostatic extraction of particles from a bed to a pendent droplet to form liquid marbles has previously been investigated with respect to particle conductivity, size and shape, however, interparticle forces have not been specifically interrogated. If cohesion is the dominant force within the particle bed, then particles will be more readily extracted with reduced surface free energy. EXPERIMENTS: Glass particles were surface-modified using various alkyltrichlorosilanes. The surface free energy was measured for each sample using colloid probe atomic force microscopy (AFM) and sessile drop measurements on similarly modified glass slides. The ease of electrostatic particle extraction of each particle sample to a pendent droplet was compared by quantifying the electric field force required for successful extraction as a function of the measured surface free energy. FINDINGS: Surface free energy calculated from sessile droplet measurements and AFM were not in agreement, as work of adhesion of a liquid droplet on a planar substrate is not representative of the contact between particles. Ease of electrostatic extraction of particles was observed to generally decrease as a function of AFM-derived surface free energy, confirming this is a critical factor in electrostatic delivery of particles to a pendent droplet. Roughness was also shown to inhibit particle extraction.

Interparticle Repulsion of Microparticles Delivered to a Pendent Drop by an Electric Field.

We report an unusually large spacing observed between microparticles after delivery to the surface of a pendent water droplet using a DC nonuniform electrostatic field, primarily via dielectrophoresis. The influence of particle properties was investigated using core particles, which were either coated or surface-modified to alter their wettability and conductivity. Particles that exhibited this spacing were both hydrophobic and possessed some dielectric material exposed to the external field, such as a coating or exposed dielectric core. The origin of this behavior is proposed to be the induced dipole-dipole repulsion between particles, which increases with particle size and decreases when the magnitude of the electric field is reduced. When the particles were no longer subjected to an external field, this large interparticle repulsion ceased and the particles settled to the bottom of the droplet under the force of gravity. We derive a simple model to predict this spacing, with the dipole-dipole repulsion balanced against particle weight. The external electric field was calculated using the existing electric field models. The spacing was found to be dependent on particle density and the induced dipole moment as well as the number of particles present on the droplet interface. As the number of particles increased, a decrease in interparticle spacing was observed.

Drug-induced hepatocellular injury due to herbal supplement ashwagandha.

A 39-year-old female presented with a one-week history of jaundice and nausea after taking an over-the-counter herbal supplement containing ashwagandha root extract. Initial investigations revealed a hepatocellular pattern of liver enzyme abnormality with jaundice. Investigations, including viral serology, liver specific autoantibodies and an ultrasound scan of the abdomen, were unremarkable. Liver biopsy showed an acute cholestatic hepatitis with confluent necrosis but no features of chronicity. These histopathological findings differ to that of a previously reported case. Review of recent literature revealed that some clinical features and the time course of liver injury were similar to previous reports of ashwagandha drug-induced liver injury (DILI). The patient received treatment with ursodeoxycholic acid. We compare this case to previous reported cases of ashwagandha DILI and discuss the biochemical and histopathological features of ashwagandha DILI, therapeutic strategies and the importance of recognising herbal supplements as a possible cause of DILI.

Influence of particle size on extraction from a charged bed - toward liquid marble formation.

The interactions between particles and the role of their physical properties are not well understood for the electrostatic formation of liquid marbles. Here we focus initially on the impact of increasing particle diameter (notionally 20 to 140 µm) on the ease of particle extraction from an advancing bed of charged particles beneath an earthed, suspended water droplet. A larger particle diameter increased the ease of extraction, due to decreased interparticle cohesion, with increased potential applied to the particle bed. Whilst particle extraction is a crucial step in liquid marble formation, transport to the droplet and subsequent coating and stabilisation of the liquid is also significant. Further investigation highlighted that the smaller particle diameters afforded increased liquid stabilisation due to increased coverage and smaller interstitial spaces between particles on the liquid surface. Optimal conditions for controllable liquid marble formation using electrostatics was postulated as a trade-off between drop-bed separation distance, applied potential and kinetics of coating when studying impact of particle size. Furthermore, preliminary modelling, utilising weakest-link statistics and fracture mechanics, of the experimental data was undertaken to focus on development of the relationship between particle properties and extractability in the presence of electrostatics. This model represents a step towards predicting the suitability of particles for use in the electrostatic formation of liquid marbles prior to undertaking experimental work.

pH-Responsive Particle-Liquid Aggregates-Electrostatic Formation Kinetics.

Liquid-particle aggregates were formed electrostatically using pH-responsive poly[2-(diethylamino)ethyl methacrylate] (PDEA)-coated polystyrene particles. This novel non-contact electrostatic method has been used to assess the particle stimulus-responsive wettability in detail. Video footage and fractal analysis were used in conjunction with a two-stage model to characterize the kinetics of transfer of particles to a water droplet surface, and internalization of particles by the droplet. While no stable liquid marbles were formed, metastable marbles were manufactured, whose duration of stability depended strongly on drop pH. Both transfer and internalization were markedly faster for droplets at low pH, where the particles were expected to be hydrophilic, than at high pH where they were expected to be hydrophobic. Increasing the driving electrical potential produced greater transfer and internalization times. Possible reasons for this are discussed.

An Electrostatic Method for Manufacturing Liquid Marbles and Particle-Stabilized Aggregates.

We have developed a method for transferring particles from a powder bed to a liquid droplet using an electric field. This process has been used to create liquid marbles with characteristics not normally found in those formed by direct contact methods such as rolling. It has also been used to manufacture hydrophilic particle-liquid aggregates and more complex layered aggregates incorporating both hydrophobic and hydrophilic particles. This article briefly outlines the electrostatic aggregation method itself, the materials used and structures formed thus far, and explores the rich fundamental physics and chemistry underpinning the process as they are understood at present.

Electrostatic formation of polymer particle stabilised liquid marbles and metastable droplets - Effect of latex shell conductivity.

HYPOTHESIS: Particle cohesion and conductivity affects the electrostatically driven transport of particles to a suspended water droplet. The conditions at which liquid marbles and particle stabilised liquid droplets form are a function of these parameters. EXPERIMENT: Particle beds placed below an earthed pendent water drop had a negative potential applied, thus inducing an opposing positive charge on the liquid, which results in particle transfer and eventual coating of the liquid drop. Experiments where both the particle bed was constantly moved slowly toward the droplet, and the particle bed remained at a fixed, small separation distance were completed. These enabled the investigation of a number of variables that influence successful aggregate formation, including separation distance between the droplet and particle bed, coating mechanism and kinetics of the transfer process. FINDINGS: Monodisperse polystyrene core particles with polypyrrole shells of various cohesiveness and conductivity were observed to behave differently in the presence of the applied potential, where the least cohesive and conductive sample (polystyrene) required the smallest separation distance, i.e. the greatest field strength for particle transfer. Increasing conductivity of the particle shell decreases the field strength required for particle transfer, and thus an increase was observed in separation distance at which particles were observed to move to the air-water interface. The transfer kinetics followed the same trend where the least conductive and cohesive sample was the slowest to coat the air-water interface, and vice-versa. Since an increase in cohesion hinders particle transfer, it is concluded that particle conductivity is of greater importance in the electrostatic aggregation process.

Formation of Liquid Marbles Using pH-Responsive Particles: Rolling vs Electrostatic Methods.

Aqueous dispersions of micrometer-sized, monodisperse polystyrene (PS) particles carrying pH-responsive poly[2-(diethylamino)ethyl methacrylate] (PDEA) colloidal stabilizer on their surfaces were dried under ambient conditions at pH 3.0 and 10.0. The resulting dried cake-like particulate materials were ground into powders and used as a stabilizer to fabricate liquid marbles (LMs) by rolling and electrostatic methods. The powder obtained from pH 3.0 aqueous dispersion consisted of polydisperse irregular-shaped colloidal crystal grains of densely packed colloids which had hydrophilic character. On the other hand, the powder obtained from pH 10.0 aqueous dispersion consisted of amorphous and disordered colloidal aggregate grains with random sizes and shapes, which had hydrophobic character. Reflecting the hydrophilic-hydrophobic balance of the dried PDEA-PS particle powders, stable LMs were fabricated with distilled water droplets by rolling on the powders prepared from pH 10.0, but the water droplets were adsorbed into the powders prepared from pH 3.0. In the electrostatic method, where an electric field assists transport of powders to a droplet surface, the PDEA-PS powders prepared from pH 3.0 jumped to an earthed pendant distilled water droplet to form a droplet of aqueous dispersion. Conversely the larger powder aggregates prepared from pH 10.0 did not jump due to cohesion between the hydrophobic PDEA chains on the PS particles, resulting in no LM formation.

Giant Pickering Droplets: Effect of Nanoparticle Size and Morphology on Stability.

The interaction between a pair of millimeter-sized nanoparticle-stabilized n-dodecane droplets was analyzed using a high-speed video camera. The droplets were grown in the presence of either poly(glycerol monomethacrylate)-poly(benzyl methacrylate) (PGMA-PBzMA) diblock copolymer spheres or poly(glycerol monomethacrylate)-poly(2-hydroxypropyl methacrylate)-poly(benzyl methacrylate) (PGMA-PHPMA-PBzMA) triblock copolymer worms prepared by polymerization-induced self-assembly. The effect of nanoparticle morphology on droplet coalescence was analyzed by comparing 22 nm spheres to highly anisotropic worms with a mean worm width of 26 nm and comparable particle contact angle. Both morphologies lowered the interfacial tension, providing direct evidence for nanoparticle adsorption at the oil-water interface. At 0.03 w/v % copolymer, an aging time of at least 90 s was required to stabilize the n-dodecane droplets in the presence of the worms, whereas no aging was required to produce stable droplets when using the spheres, suggesting faster diffusion of the latter to the surface of the oil droplets. The enhanced stability of the sphere-coated droplets is consistent with the higher capillary pressure in this system as the planar interfaces approach. However, the more strongly adsorbing worms ultimately also confer stability. At lower copolymer concentrations (≤0.01 w/v %), worm adsorption promoted droplet stability, whereas the spheres were unable to stabilize droplets even after longer aging times. The effect of mean sphere diameter on droplet stability was also assessed while maintaining an approximately constant particle contact angle. Small spheres of either 22 or 41 nm stabilized n-dodecane droplets, whereas larger spheres of either 60 or 91 nm were unable to prevent coalescence when the two droplets were brought into contact. These observations are consistent with the greater capillary pressure stabilizing the oil-water interfaces coated with the smaller spheres. Addition of an oil-soluble polymeric diisocyanate cross-linker to either the 60 or the 91 nm spheres produced highly stable colloidosomes, thus confirming adsorption of these nanoparticles.

The Health, Functioning and Wellbeing Summary Traffic Light Communication Tool: a survey of families' views.

AIM: To ascertain families' views about the utility of the Health, Functioning and Wellbeing Summary (HFWS) in positively supporting communication in clinics. METHOD: The HFWS was co-developed with families and members of the multidisciplinary team. A sequential convenience sample of 60 families who attended clinics in Sunderland, UK in 2015 agreed to participate and answered eight questions about their views on the tool's usefulness. Data were recorded and analysed in Microsoft Excel. RESULTS: All families agreed that they had been able to discuss everything they had wanted to discuss with the doctor. All of the serious concerns that they had recorded on the HFWS had been addressed in the consultation. Most (58 out of 60; 97%) reported that the tool was easy to understand and complete, and 57 out of 60 (95%) reported that it helped them to gather their thoughts about what they wanted to discuss. Consultations that used the tool were thought to better address the needs of 49 out of 60 families (87.1%), than those in which it was not used. INTERPRETATION: The HFWS was acceptable to most families surveyed, improved communication from their perspective, and ensured that the issues that mattered most to them were addressed in medical consultations. The tool has been translated into a number of other languages. Its acceptability and utility in other settings requires further study.

Synthetic α-Hydroxytropolones Inhibit Replication of Wild-Type and Acyclovir-Resistant Herpes Simplex Viruses.

Herpes simplex virus 1 (HSV-1) and HSV-2 remain major human pathogens despite the development of anti-HSV therapeutics as some of the first antiviral drugs. Current therapies are incompletely effective and frequently drive the evolution of drug-resistant mutants. We recently determined that certain natural troponoid compounds such as ß-thujaplicinol readily suppress HSV-1 and HSV-2 replication. Here, we screened 26 synthetic α-hydroxytropolones with the goals of determining a preliminary structure-activity relationship for the α-hydroxytropolone pharmacophore and providing a starting point for future optimization studies. Twenty-five compounds inhibited HSV-1 and HSV-2 replication at 50 µM, and 10 compounds inhibited HSV-1 and HSV-2 at 5 µM, with similar inhibition patterns and potencies against both viruses being observed. The two most powerful inhibitors shared a common biphenyl side chain, were capable of inhibiting HSV-1 and HSV-2 with a 50% effective concentration (EC50) of 81 to 210 nM, and also strongly inhibited acyclovir-resistant mutants. Moderate to low cytotoxicity was observed for all compounds (50% cytotoxic concentration [CC50] of 50 to >100 µM). Therapeutic indexes ranged from >170 to >1,200. These data indicate that troponoids and specifically α-hydroxytropolones are a promising lead scaffold for development as anti-HSV drugs provided that toxicity can be further minimized. Troponoid drugs are envisioned to be employed alone or in combination with existing nucleos(t)ide analogs to suppress HSV replication far enough to prevent viral shedding and to limit the development of or treat nucleos(t)ide analog-resistant mutants.

Mechanisms for the clustering of inertial particles in the inertial range of isotropic turbulence.

In this paper, we consider the physical mechanism for the clustering of inertial particles in the inertial range of isotropic turbulence. We analyze the exact, but unclosed, equation governing the radial distribution function (RDF) and compare the mechanisms it describes for clustering in the dissipation and inertial ranges. We demonstrate that in the limit Str≪1, where Str is the Stokes number based on the eddy turnover time scale at separation r, the clustering in the inertial range can be understood to be due to the preferential sampling of the coarse-grained fluid velocity gradient tensor at that scale. When Str≳O(1) this mechanism gives way to a nonlocal clustering mechanism. These findings reveal that the clustering mechanisms in the inertial range are analogous to the mechanisms that we identified for the dissipation regime [see New J. Phys. 16, 055013 (2014)]. Further, we discuss the similarities and differences between the clustering mechanisms we identify in the inertial range and the "sweep-stick" mechanism developed by Coleman and Vassilicos [Phys. Fluids 21, 113301 (2009)]. We show that the idea that initial particles are swept along with acceleration stagnation points is only approximately true because there always exists a finite difference between the velocity of the acceleration stagnation points and the local fluid velocity. This relative velocity is sufficient to allow particles to traverse the average distance between the stagnation points within the correlation time scale of the acceleration field. We also show that the stick part of the mechanism is only valid for Str≪1 in the inertial range. We emphasize that our clustering mechanism provides the more fundamental explanation since it, unlike the sweep-stick mechanism, is able to explain clustering in arbitrary spatially correlated velocity fields. We then consider the closed, model equation for the RDF given in Zaichik and Alipchenkov [Phys. Fluids 19, 113308 (2007)] and use this, together with the results from our analysis, to predict the analytic form of the RDF in the inertial range for Str1, which, unlike that in the dissipation range, is not scale invariant. The results are in good agreement with direct numerical simulations, provided the separations are well within the inertial range.

Improving Antibiotic De-Escalation in Suspected Ventilator-Associated Pneumonia: An Observational Study With a Pharmacist-Driven Intervention.

BACKGROUND: Recommendations for treatment of ventilator-associated pneumonia (VAP) emphasize early empiric broad-spectrum antibiotics. However, appropriate antibiotic de-escalation is also critical for optimal patient care. MATERIALS AND METHODS: We examined how often intensivists in our institution appropriately de-escalated antibiotics in cases of suspected VAP, and whether decision support by intensive care unit pharmacists could improve rates of antibiotic targeting and early antibiotic discontinuation in low-risk patients. MAIN RESULTS: A total of 92 (observation phase = 50; intervention phase = 42) patients with suspected VAP were identified. During the observation phase, 39 cases yielded positive sputum cultures, but in only 23 (59%) were antibiotics targeted to culture results. This rate improved during the intervention phase when 29 (91%) of 32 cases with positive cultures were targeted (P value .003). There were 48 cases in which the risk of pneumonia was considered low. Of the 26 low-risk cases in the observation phase, 5 (19%) had antibiotics discontinued early versus 5 (23%) of the 22 cases in the intervention phase. CONCLUSIONS: Decision support by clinical pharmacists significantly improved rates of appropriate antibiotic targeting in cases of culture-positive suspected VAP but did not have a significant effect on early antibiotic discontinuation in patients at low risk of true pneumonia.

Use of postoperative creatinine to predict sustained kidney injury in patients undergoing mesothelioma surgery.

BACKGROUND AND OBJECTIVES: AKI leads to increased morbidity and mortality and progression to chronic kidney injury is a frequent consequence of AKI. Surgical treatment of mesothelioma is associated with increased risk for kidney injury. However, sustained kidney injury may limit therapeutic options for treating residual cancer. This study hypothesized that patients with significant serum creatinine (sCr) elevation within 48 hours of surgery would be at risk for sustained kidney injury. The goal was to determine the best acute sCr measure predictive of sustained kidney injury defined as a 50% increase in sCr from baseline measured 2-4 weeks after surgery. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a prospective, observational cohort of surgical patients with mesothelioma, receiver operator characteristic curves were generated for the 24- and 48-hour absolute difference and relative sCr change over baseline in the derivation cohort (n=279). The prediction was tested in a validation cohort (n=207). The ability of various other AKI definitions to predict sustained kidney injury was evaluated. RESULTS: Sustained kidney injury occurred in 9.8% of patients in the derivation cohort. A ≥59% increase in sCr 48 hours after surgery was most predictive of sustained kidney injury (c statistic=0.78). Among other AKI definitions, a sCr increase of 0.3 mg/dl in 24 hours or 0.5 mg/dl increase in 48 hours (Waikar and Bonventre criteria) also reliably predicted sustained kidney injury. CONCLUSIONS: Development of clinically significant sustained kidney injury can be predicted by acute postoperative sCr elevation in patients treated for mesothelioma.

Candidaemia associated with decreased in vitro fluconazole susceptibility: is Candida speciation predictive of the susceptibility pattern?

BACKGROUND: Candidaemia is often treated with fluconazole in the absence of susceptibility testing. We examined factors associated with candidaemia caused by Candida isolates with reduced susceptibility to fluconazole. METHODS: We identified consecutive episodes of candidaemia at two hospitals from 2001 to 2007. Species identification followed CLSI methodology and fluconazole susceptibility was determined by Etest or broth microdilution. Susceptibility to fluconazole was defined as: full susceptibility (MIC < or = 8 mg/L); and reduced susceptibility (MIC > or = 32 mg/L). Complete resistance was defined as an MIC > 32 mg/L. RESULTS: Of 243 episodes of candidaemia, 190 (78%) were fully susceptible to fluconazole and 45 (19%) had reduced susceptibility (of which 27 were fully resistant). Of Candida krusei and Candida glabrata isolates, 100% and 51%, respectively, had reduced susceptibility. Despite the small proportion of Candida albicans (8%), Candida tropicalis (4%) and Candida parapsilosis (4%) with reduced fluconazole susceptibility, these species composed 36% of the reduced-susceptibility group and 48% of the fully resistant group. In multivariate analysis, independent factors associated with reduced fluconazole susceptibility included male sex [odds ratio (OR) 3.2, P < 0.01], chronic lung disease (OR 2.7, P = 0.01), the presence of a central vascular catheter (OR 4.0, P < 0.01) and prior exposure to antifungal agents (OR 2.2, P = 0.04). CONCLUSIONS: A significant proportion of candidaemia with reduced fluconazole susceptibility may be caused by C. albicans, C. tropicalis and C. parapsilosis, species usually considered fully susceptible to fluconazole. Thus, identification of these species may not be predictive of fluconazole susceptibility. Other factors that are associated with reduced fluconazole susceptibility may help clinicians choose adequate empirical anti-Candida therapy.

Liquid transport in a multi-layer froth.

When a gas is sparged into an aqueous solution of surfactant in a column, a froth layer is formed above the layer of liquid. If water is injected into the rising column of froth at a particular position, two distinct layers are formed in the froth: a wet layer below the injection plane, and a dry layer above it. In this study, a phase coexistence analysis was performed on the three-layer system. Predictions from the governing drift-flux equation were compared, using two different representations of the drainage terms, which had one and two adjustable parameters, respectively. The analysis was used to predict liquid fractions and superficial liquid velocities for the wet and dry froth zones. These were compared to experimental measurements performed with a laboratory froth column. Both versions of the analysis were in good agreement with experiment. That with the single-parameter drainage term (derived from the Richardson-Zaki equation) was marginally superior. Theoretical predictions of the liquid fraction and overflow rate from the dry froth layer are supported by the data. Considerable convective motions were observed in the wet froth layer, driven by differences in density between the entering wash liquid and the surrounding froth.