Physical compatibility of Normosol-R with critical care medications used in patients with COVID-19 during simulated Y-site administration.

PURPOSE: Guidelines from the National Institutes of Health support the use of balanced crystalloid solutions such as Normosol-R (Hospira, Lake Forest, IL) for patients with coronavirus disease 2019 (COVID-19). However, their clinical utility is hindered by a lack of Y-site compatibility data that is essential for use in patients with limited intravenous access. The objective of this study was to determine the physical compatibility of selected intensive care unit medications with Normosol-R. METHODS: The study involved laboratory simulation of Y-site compatibility. Medications tested included amiodarone, caspofungin, dexmedetomidine, dobutamine, dopamine, epinephrine, levofloxacin, norepinephrine, pantoprazole, phenylephrine, piperacillin/tazobactam, vancomycin, and vasopressin. Tests performed were visual assessment with Tyndall light, turbidity measurement, and pH assessment. Tests were performed immediately after mixing (with the exception of turbidity testing) and after 1 hour and 4 hours. RESULTS: Incompatibility was defined as observation of haze, gas, particulate, or color change or admixture turbidity above 0.3 or above 0.5 nephelometric turbidity unit (NTU), depending on whether the baseline turbidity was less than or greater than 0.5 NTU, respectively. Analysis of solubility and compatibility based on change from baseline to admixture pH in relation to the reported -log of the acid dissociation constant (pKa) was performed. There was no evidence of visual incompatibility for any of the admixtures when mixed with Normosol-R. Turbidity exceeded the defined threshold with pantoprazole, phenylephrine, and highly concentrated norepinephrine. Pantoprazole was the only test medication with a significant pH change when compared to its pKa. CONCLUSION: Normosol-R is compatible for Y-site administration with all tested medications except for pantoprazole, phenylephrine, and highly concentrated norepinephrine, allowing for potential increased use in patients with COVID-19.

COPSOQ III in Germany: validation of a standard instrument to measure psychosocial factors at work.

BACKGROUND: Over the last almost 20 years COPSOQ (Copenhagen Psychosocial Questionnaire) has become a well-established instrument to measure psychosocial stress at work. In Germany, a first validated version of COPSOQ was introduced in 2005. After the COPSOQ international network took over responsibility for the development of COPSOQ, a new version was published in 2019 (COPSOQ III). The German version of this questionnaire is now to be validated. METHODS: Measurement qualities of German COPSOQ III are explored in adherence to the to the usual requirements of a validation study as defined by DIN EN ISO 10075-3. A sample of observations from more than 250,000 participants surveyed with the COPSOQ in Germany is used for univariate and multivariate statistical analysis. RESULTS: With its 84 items the German COPSOQ III includes all psychosocial work factors that are internationally obligatory and is still compatible with almost 70% of the content in the 2005 German version. Typical psychometric properties of the questionnaire (e. g., validity and reliability) are either good or very good for most of the 84 items and 31 scales. Beyond basic results, congruences with widely used theoretical approaches like the Demand-Control(-Support) model or the Job Demands-Resources model are generally satisfactory. CONCLUSIONS: With the launch of COPSOQ III in Germany, new workplace psychosocial aspects could be explored. Like the preceding version, the questionnaire is a highly useful instrument for research as well as for risk assessment in enterprises. COSPQO III covers a multitude of theoretical approaches and gives comprehensive information on psychosocial working conditions to deduce actions for their improvement.

Structure-activity relationships among random nylon-3 copolymers that mimic antibacterial host-defense peptides.

Host-defense peptides are natural antibiotics produced by multicellular organisms to ward off bacterial infection. Since the discovery of these molecules in the 1980s, a great deal of effort has been devoted to elucidating their mechanisms of action and to developing analogues with improved properties for possible therapeutic use. The vast majority of this effort has focused on materials composed of a single type of molecule, most commonly a peptide with a specific sequence of alpha-amino acid residues. We have recently shown that sequence-random nylon-3 copolymers can mimic favorable properties of host-defense peptides, and here we document structure-activity relationships in this polymer family. Although the polymers are heterogeneous in terms of subunit order and stereochemistry, these materials display structure-activity relationships comparable to those that have been documented among host-defense peptides and analogous synthetic peptides. Previously such relationships have been interpreted in terms of a specific and regular folding pattern (usually an alpha-helix), but our findings show that these correlations between covalent structure and biological activity do not require the adoption of a specific or regular conformation. In some cases our observations suggest alternative interpretations of results obtained with discrete peptides.