CIME4R: Exploring iterative, AI-guided chemical reaction optimization campaigns in their parameter space.

Chemical reaction optimization (RO) is an iterative process that results in large, high-dimensional datasets. Current tools allow for only limited analysis and understanding of parameter spaces, making it hard for scientists to review or follow changes throughout the process. With the recent emergence of using artificial intelligence (AI) models to aid RO, another level of complexity has been added. Helping to assess the quality of a model's prediction and understand its decision is critical to supporting human-AI collaboration and trust calibration. To address this, we propose CIME4R-an open-source interactive web application for analyzing RO data and AI predictions. CIME4R supports users in (i) comprehending a reaction parameter space, (ii) investigating how an RO process developed over iterations, (iii) identifying critical factors of a reaction, and (iv) understanding model predictions. This facilitates making informed decisions during the RO process and helps users to review a completed RO process, especially in AI-guided RO. CIME4R aids decision-making through the interaction between humans and AI by combining the strengths of expert experience and high computational precision. We developed and tested CIME4R with domain experts and verified its usefulness in three case studies. Using CIME4R the experts were able to produce valuable insights from past RO campaigns and to make informed decisions on which experiments to perform next. We believe that CIME4R is the beginning of an open-source community project with the potential to improve the workflow of scientists working in the reaction optimization domain. SCIENTIFIC CONTRIBUTION: To the best of our knowledge, CIME4R is the first open-source interactive web application tailored to the peculiar analysis requirements of reaction optimization (RO) campaigns. Due to the growing use of AI in RO, we developed CIME4R with a special focus on facilitating human-AI collaboration and understanding of AI models. We developed and evaluated CIME4R in collaboration with domain experts to verify its practical usefulness.

Convolutional neural network framework for the automated analysis of transition metal X-ray photoelectron spectra.

X-ray photoelectron spectroscopy is an indispensable technique for the quantitative determination of sample composition and electronic structure in diverse research fields. Quantitative analysis of the phases present in XP spectra is usually conducted manually by means of empirical peak fitting performed by trained spectroscopists. However, with recent advancements in the usability and reliability of XPS instruments, ever more (inexperienced) users are creating increasingly large data sets that are harder to analyze by hand. In order to aid users with the analysis of large XPS data sets, more automated, easy-to-use analysis techniques are needed. Here, we propose a supervised machine learning framework based on artificial convolutional neural networks. By training such networks on large numbers of artificially created XP spectra with known quantifications (i.e., for each spectrum, the concentration of each chemical species is known), we created universally applicable models for auto-quantification of transition-metal XPS data that are able to predict the sample composition from spectra within seconds. Upon evaluation against more traditional peak fitting methods, we showed that these neural networks achieve competitive quantification accuracy. The proposed framework is shown to be flexible enough to accommodate spectra containing multiple chemical elements and measured with different experimental parameters. The use of dropout variational inference for the determination of quantification uncertainty is illustrated.

Open-Source Chromatographic Data Analysis for Reaction Optimization and Screening.

Automation and digitalization solutions in the field of small molecule synthesis face new challenges for chemical reaction analysis, especially in the field of high-performance liquid chromatography (HPLC). Chromatographic data remains locked in vendors' hardware and software components, limiting their potential in automated workflows and data science applications. In this work, we present an open-source Python project called MOCCA for the analysis of HPLC-DAD (photodiode array detector) raw data. MOCCA provides a comprehensive set of data analysis features, including an automated peak deconvolution routine of known signals, even if overlapped with signals of unexpected impurities or side products. We highlight the broad applicability of MOCCA in four studies: (i) a simulation study to validate MOCCA's data analysis features; (ii) a reaction kinetics study on a Knoevenagel condensation reaction demonstrating MOCCA's peak deconvolution feature; (iii) a closed-loop optimization study for the alkylation of 2-pyridone without human control during data analysis; (iv) a well plate screening of categorical reaction parameters for a novel palladium-catalyzed cyanation of aryl halides employing O-protected cyanohydrins. By publishing MOCCA as a Python package with this work, we envision an open-source community project for chromatographic data analysis with the potential of further advancing its scope and capabilities.

Surface composition of AgPd single-atom alloy catalyst in an oxidative environment.

Single-atom alloys (SAAs) have recently gained considerable attention in the field of heterogeneous catalysis research due to their potential for novel catalytic properties. While SAAs are often examined in reactions of reductive atmospheres, such as hydrogenation reactions, in the present work, we change the focus to AgPd SAAs in oxidative environments since Pd has the highest catalytic activity of all metals for oxidative reactions. Here, we examine how the chemical reactivity of AgPd SAAs differs from its constituent Pd in an oxidative atmosphere. For this purpose, electronic structure changes in an Ag0.98Pd0.02 SAA foil in 1 mbar of O2 were studied by in situ x-ray photoemission spectroscopy and compared with the electronic structure of a Pd foil under the same conditions. When heated in an oxidative atmosphere, Pd in Ag0.98Pd0.02 partly oxidizes and forms a metastable PdOx surface oxide. By using a peak area modeling procedure, we conclude that PdOx on Ag0.98Pd0.02 is present as thin, possibly monolayer thick, PdOx islands on the surface. In comparison to the PdO formed on the Pd foil, the PdOx formed on AgPd is substantially less thermodynamically stable, decomposing at temperatures about 270 °C lower than the native oxide on Pd. Such behavior is an interesting property of oxides formed on dilute alloys, which could be potentially utilized in catalytic oxidative reactions such as methane oxidation.

Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study.

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014⁻2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25⁻34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

Does nurses' role, health or symptoms influence their personal use of ingestible complementary and alternative medicines?

OBJECTIVES: To investigate the influence of work-related characteristics, health, health behaviours and symptoms on ingestible biologically-based Complementary and Alternative Medicine (CAM) use within the Australian nursing and midwifery workforce. BACKGROUND: CAM use is widespread worldwide, but there is little research into nurses' and midwives' personal use of ingestible CAM in Australia. METHODS: An online survey in 2014-15 used validated instruments and items to examine use of ingestible biologically-based CAM (herbs, foods and vitamins, minerals, amino acids, enzymes and other supplements), and the health and work-related characteristics of 5041 nurses and midwives recruited through the New South Wales Nurses and Midwives Association and professional networks. RESULTS: A small proportion of nurses (6.8%) identified as personal CAM users. Most were female, older, worked in foundational roles (frontline Registered and Enrolled Nurses/Midwives) and used one CAM, most commonly a multivitamin, although Vitamin D, Fish Oil, Calcium and Glucosamine±Chondroitin were also common. In comparison to non-users, CAM users were less likely to take sick days or indulge in risky drinking, but more likely to be symptomatic (with stiff joints, bodily/joint pain, severe tiredness, allergies, indigestion/heartburn), diagnosed with osteoarthritis and to adhere to healthy diet recommendations. CONCLUSIONS: Findings showed a credible pattern of front line workers with physically demanding workloads that impact their physical health and are linked to frequent symptoms, using CAM treatments and achieving some success in being able to continue working and avoid sickness absence. Further investigation is warranted to protect and maintain the health of the nursing and midwifery workforce.

Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation.

AIM: To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce. BACKGROUND: The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion. DESIGN: The study used a modified Delphi design conducted between September and November 2015. METHODS: Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility. RESULTS: Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups. CONCLUSIONS: Study findings prompt consideration of health promotion opportunities to support nurses' health and well-being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health.

Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives.

AIM: To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave. BACKGROUND: Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity. DESIGN: This was a cross-sectional survey conducted in 2014-2015. METHOD: The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave. RESULT: Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age; higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age; in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being. CONCLUSION: Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention.

Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review.

AIM: The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses. BACKGROUND: There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace. DESIGN: Integrative mixed method review. DATA SOURCES: Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative. REVIEW METHODS: An integrative literature review was undertaken. Quality appraisal of included studies used standardized checklists. A social-ecological framework was used to examine workplace facilitators and constraints to healthy eating, derived from the literature. Emergent themes were identified by thematic analysis. RESULTS: Review participants were Registered, Enrolled and/or Nurse Assistants primarily working in hospitals in middle or high income countries. The majority of studies reported barriers to healthy eating related to adverse work schedules, individual barriers, aspects of the physical workplace environment and social eating practices at work. Few facilitators were reported. Overall, studies found the workplace exerts a considerable negative influence on nurses' dietary intake. CONCLUSION: Reorientation of the workplace to promote healthy eating among nurses is required.

'Mental health day' sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics.

AIM: To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as 'mental health days'. BACKGROUND: The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a 'mental health day' as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. DESIGN: Online cross-sectional survey. METHODS: Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of 'mental health day' reportage were determined using logistic regression. RESULTS: Fifty-four percentage of the n = 5041 nurse and midwife respondents took 'mental health days'. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. CONCLUSION: Specific characteristics of nurses and midwives who report taking 'mental health day' sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.

The personal cancer screening behaviours of nurses and midwives.

AIM: The aim of this study was to identify the personal cancer screening behaviours of nurses and midwives in New South Wales, Australia, and identify factors predictive of cancer screening uptake. BACKGROUND: The nursing workforce may have a higher risk for some cancers and is ageing. In Australia, more than 40% are over 50 years - an age where cancer incidence rises rapidly, but when screening may reduce cancer mortality. Nurses and midwives are important health role models for the population, but their engagement in cancer screening is unknown. DESIGN: A cross-sectional survey conducted in 2014-2015. METHODS: Data were obtained from the 'Fit for the Future' study on 5041 working nurses and midwives in New South Wales, Australia and analyses were conducted on subsets of age-eligible respondents. Demographic, geographical and occupational data were analysed in relation to population-based screening for breast, cervical and bowel cancers and opportunistic screening for prostate and skin cancer screening participation, in line with Australian recommendations. RESULTS: Nurses' and midwives' recent screening rates were higher than the Australian general population across relevant age groups. Compared with full-time nurses and midwives, part-time/casual/pool workers were significantly more likely to undertake cervical, breast and bowel screening. Compared with those working office hours, shift workers were significantly less likely to undertake breast and bowel screening, but more likely to undertake skin screening. CONCLUSIONS: Disparities in reported screening prevalence and factors predictive of screening uptake indicate opportunities for targeted strategies to inform and/or promote workforce engagement with screening programmes and protect the health of this ageing workforce.

Does nurses' health affect their intention to remain in their current position?

AIM: To investigate and describe nurses' and midwives' physical health, rates of symptoms and disease, and to determine if these factors contribute to intention to leave. BACKGROUND: The nursing and midwifery workforce is ageing yet little is known about their physical health or its relationship to intention to leave. METHODS: An online survey of health and work-related assessments was distributed through the New South Wales Nurses and Midwives Association and professional contacts. RESULTS: Nurses and midwives (n = 5041) reported good-very good health overall. With 22.2% intending to leave in the next 12 months, older age, better perceived health and job satisfaction, regional residence and not working shifts predicted no intention to leave while breathing problems predicted intention to leave. CONCLUSIONS: Study findings flag the importance of health as an influence on intention to leave. Alongside job satisfaction and shift-working, health presents opportunities for workplace initiatives to maintain nurses in the workforce. IMPLICATIONS FOR NURSING MANAGEMENT: Educators, managers and policy makers should heed the significant influence of health for retention of staff and consider what strategies may mitigate health risks for this workforce.

Eating soup with nails of pig: thematic synthesis of the qualitative literature on cultural practices and beliefs influencing perinatal nutrition in low and middle income countries.

BACKGROUND: The perinatal period, i.e. pregnancy, childbirth and early infancy, is a significant transition period where the biological and the social strongly intersect. In low and middle-income countries the disease burden arising from the perinatal period, is still substantial. The perinatal period is also a crucial window of opportunity for reducing undernutrition and its long term adverse effects. METHODS: We explored qualitative research conducted in low resource settings around the perinatal continuum over the past two decades, with a particular focus on the 'cultural' realm, to identify common themes influencing maternal and infant nutrition. We systematically searched electronic databases from 1990 to 2014, including MEDLINE, EMBASE, PsycINFO, Scopus and Cumulative Index to Nursing and Allied Health Literature, using relevant search terms including traditional beliefs, practices, pregnancy, childbirth, developing countries etc. Adapted Consolidated Criteria for Reporting Qualitative Health Research and Critical Appraisal Skills Programme criteria were used to determine quality of studies. We synthesised the literature thematically, enabled by NVivo 10 software. RESULTS: Most studies showed cultural support for breastfeeding, although most traditional societies delayed breastfeeding due to colostrum being considered 'dirty'. A range of restrictive practices through pregnancy and the post- partum period were revealed in Asia, Latin America and Africa. There was a strong cultural understanding of the healing power of everyday foods. A wide range of good foods and bad foods continued to have currency through the perinatal continuum, with little consensus between groups of what was beneficial versus harmful. Cross-cutting themes that emerged were 1) the role of the woman/mother/wife as strong and good; 2) poverty restricting women's nutrition choices; 3) change being constant, but the direction of change unpredictable. CONCLUSIONS: A rich and diverse repertoire of cultural practices and beliefs influenced perinatal nutrition. Results from this synthesis should influence public health policymakers and practitioners, to tailor contextually specific, culturally responsive perinatal nutrition interventions to optimise health and wellbeing of mother-infant dyads. Ideally these interventions should build on culturally sanctioned life affirming behaviours such as breastfeeding, promoting post-partum rest and recovery, while modifying the potentially harmful aspects of other cultural practices in the perinatal period.

How natural is the supernatural? Synthesis of the qualitative literature from low and middle income countries on cultural practices and traditional beliefs influencing the perinatal period.

OBJECTIVE: to review qualitative research studies conducted in low resource settings around the perinatal continuum over the past two decades, with particular focus on the cultural realm; to identify common themes in the research-base, in order to provide policy direction for culturally appropriate perinatal interventions. DESIGN: systematic literature search of electronic databases from 1990 to 2014, including Medline, Embase, CINAHL and PsycINFO, using relevant search terms such as traditional beliefs, practices, pregnancy, childbirth; established criteria used to determine quality of studies; and thematic synthesis of the literature enabled by NVivo 10 software. SETTING: low and middle income countries using the World Bank classification. FINDINGS: religious and spiritual beliefs strongly influenced behaviour over the perinatal period. Beliefs in supernatural influences, particularly malevolent forces were widespread, such that pregnancy was concealed in many parts of Africa and Asia. In most low resource settings, pregnancy and childbirth were seen as normal phenomena. Rituals played an important part for women and their infants, reinforced by inter-generational support. Cross-cutting themes that emerged were: (1) the role of women as mothers, demonstrating their'goodness' by bearing pain and suffering; (2) the idea of the 'natural' incorporating the supernatural; and (3) negotiating change across generations. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: a diverse repertoire of cultural practices influences perinatal well-being across low resource settings. Health practitioners and policy-makers need to acknowledge the primacy of women's reproductive roles, the cultural constructions of motherhood; that supernatural forces are believed to exert powerful influences on the health of mother and infant; that inter-generational tensions result in resisting or embracing change. Public health planners and practitioners need to take culture seriously, not ignore the contribution of culture in shaping women's behaviours and choices throughout the perinatal continuum and deliver contextually specific, culturally responsive care to optimise perinatal health and well-being.

Regional circulatory distribution of novel cardiac bio-markers and their relationships with haemodynamic measurements.

BACKGROUND: Regional sampling may identify sites of production or removal of novel biomarkers in the circulation; their relationship to haemodynamic measurements may clarify their association with the pathophysiology of heart failure. METHODS: Samples were obtained from up to eight circulatory sites from 22 patients with left ventricular dysfunction undergoing elective cardiac catheterisation. The plasma concentrations (PC) of six biomarkers [mid-regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro-endothelin-1 (CT-proET-1), mid-regional pro-adreno-medullin (MR-proADM), high sensitivity pro-calcitonin (hsPCT), copeptin and galectin-3 (Gal-3)] were measured. RESULTS: Plasma concentrations of MR-proANP were highest in the pulmonary artery (PA) and left ventricle, suggesting myocardial production. Lower concentrations of copeptin, CT-proET-1, MR-proADM and hsPCT were found in the supra-renal inferior vena cava (SRIVC) sample suggesting renal extraction. Plasma concentrations of Galectin-3 varied little by sampling site. Plasma concentrations of MR-proANP (R=0.69, P=0.002), MR-proADM (R=0.51, P=0.03), CT-proET-1 (R=0.60, P=0.009) and Copeptin (R=0.47, P<0.05) measured from PA samples correlated with PA systolic pressure. There was no relation between any measured marker and cardiac index. CONCLUSIONS: Regional sampling shows variation in the plasma concentration of various novel peptides that provides clues to sites of net production and removal. Plasma concentrations of several biomarkers were positively correlated with pulmonary artery pressure.

X-ray spectroscopy for chemistry in the 2-4 keV energy regime at the XMaS beamline: ionic liquids, Rh and Pd catalysts in gas and liquid environments, and Cl contamination in γ-Al2O3.

The 2-4 keV energy range provides a rich window into many facets of materials science and chemistry. Within this window, P, S, Cl, K and Ca K-edges may be found along with the L-edges of industrially important elements from Y through to Sn. Yet, compared with those that cater for energies above ca. 4-5 keV, there are relatively few resources available for X-ray spectroscopy below these energies. In addition, in situ or operando studies become to varying degrees more challenging than at higher X-ray energies due to restrictions imposed by the lower energies of the X-rays upon the design and construction of appropriate sample environments. The XMaS beamline at the ESRF has recently made efforts to extend its operational energy range to include this softer end of the X-ray spectrum. In this report the resulting performance of this resource for X-ray spectroscopy is detailed with specific attention drawn to: understanding electrostatic and charge transfer effects at the S K-edge in ionic liquids; quantification of dilution limits at the Cl K- and Rh L3-edges and structural equilibria in solution; in vacuum deposition and reduction of [Rh(I)(CO)2Cl]2 to γ-Al2O3; contamination of γ-Al2O3 by Cl and its potential role in determining the chemical character of supported Rh catalysts; and the development of chlorinated Pd catalysts in `green' solvent systems. Sample environments thus far developed are also presented, characterized and their overall performance evaluated.

Crystal structure of poly[µ-acetato-bis-[µ-2-oxo-2-(quinolin-8-yl)ethano-ato]tris-odium].

The title compound [Na3(C11H6NO3)2(C2H3O2)] n , crystallized through diffusion of diethyl ether into methanol as needles. There are three crystallographically independent Na(+) cations present, each exhib-it-ing a distorted octa-hedral coordination geometry, two through coordination by five O atoms and one N atom, and one through coordination by six O atoms. A series of inter-molecular O⋯Na and N⋯Na contacts leads to the formation of chains along the a-axis direction.

The in vitro stability of novel cardiovascular and sepsis biomarkers at ambient temperature.

BACKGROUND: The in vitro stability of a biomarker can determine whether it should be used in clinical practice where long delays between sampling and assay are common. We measured the in vitro stability of five novel biomarkers that are being evaluated for their diagnostic and/or prognostic utility in patients with heart failure: mid-regional pro-atrial natriuretic peptide (MR-proANP), mid-regional pro-adreno-medullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), C-terminal pro-arginine vasopressin (copeptin) and ultrasensitive procalcitonin (PCT). METHODS: Peripheral venous blood samples were obtained from 19 patients with chronic heart failure into four EDTA tubes. The first tubes were centrifuged immediately at 4°C with the other tubes stored at 20°C for 4, 24 or 72 hours (h) before centrifuging. Supernatant plasma was frozen and stored at -80°C until assay. The levels of analyte in samples processed with and without delay were compared using correlation analysis, paired t-tests and Bland-Altman plots. RESULTS: Copeptin and PCT were stable up to 72 h at 20°C in whole blood and MR-proANP and MR-proADM up to 24 h. However, CT-proET-1 showed some signs of degradation after only 4 h with 94% of analyte recovered after 24 h, dropping to 80% after 72 h. CONCLUSIONS: MR-proANP, MR-proADM, copeptin and PCT are stable biomarkers and therefore suitable for introduction into routine clinical practice in a primary or secondary care setting where delays in sample preparation and assay are likely. Ideally, samples for measurement of CT-proET-1 should be centrifuged soon after venepuncture but the analyte is stable enough for most routine clinical purposes.

Confocal Raman spectroscopy of whole hairs.

This paper describes the application of Raman spectroscopy to whole hair fibers. Previously this has proved difficult because the hairs are relatively opaque, and spatial resolution diminishes with depth because of the change in refractive index. A solution is to couple confocal Raman with multivariate curve resolution (MCR) data analysis, which separates spectral differences with depth despite this reduction in resolution. Initially, it is shown that the cuticle can be separated from the cortex, showing the differences in the proteins, which can then be plotted as a function of depth, with the cuticle factor being seen only at the surface as expected. Hairs that had been treated in different ways, e.g., by bleaching, treatment with the active molecule resorcinol followed by rinsing and treatment with a full hair care product, were also examined. In all cases, changes to the hair are identified and are associated with specific parts of the fiber. Since the hair fiber is kept intact, it can be repeatedly treated and measured, hence multistep treatment processes can be followed. This method expands the potential use of Raman spectroscopy in hair research.

On-scene times and critical care interventions for an aeromedical retrieval service.

BACKGROUND: The Emergency Medical Retrieval Service (EMRS) provides an aeromedical retrieval service to remote and rural communities. Most of these facilities are unable to deliver Critical Care Interventions (CCI). CCI are delivered by the EMRS team prior to transfer of the patient to definitive care. This study addresses correlation between total on-scene times (TOST) and level of intervention delivered, and whether there is any variation in TOST between medical and trauma emergencies. METHODS: Prospective data were collected on EMRS secondary retrievals over a 5-year period from GP-led facilities. Data were collected on the CCI undertaken by EMRS during TOST prior to transfer of the patient. Interventions undertaken were scored using TISS-76. Correlation was analysed using Spearman's coefficient and differences between groups analysed using Mann-Whitney tests. Statistical significance was defined as p<0.01. RESULTS: EMRS retrieved 308 patients suitable for inclusion. Complete data were available for 97% of patients (n=300). Underlying diagnosis was trauma in 26% (n=72) and medical in 74% (n=228). There was a significant correlation between TOST and TISS-76 for all EMRS patients. Spearman's coefficient of rank correlation was (ρ)=0.616 with p<0.0001. The median TOST for the medical group was 60 min and for the trauma group 60 min (point estimate for difference 0 min, 95% CI 10 to 10, p=0.951). CONCLUSION: This study demonstrates a significant relationship between TOST on-scene by the retrieval team and the level of intervention delivered to patients. The present data do not support the assertion that there is a difference in TOST for medical and trauma patients.