Milk-Derived Carbon Quantum Dots: Study of Biological and Chemical Properties Provides Evidence of Toxicity.

Carbon dots (CDs) are carbon-based zero-dimensional nanomaterials that can be prepared from a number of organic precursors. In this research, they are prepared using fat-free UHT cow milk through the hydrothermal method. FTIR analysis shows C=O and C-H bond presence, as well as nitrogen-based bond like C-N, C=N and -NH2 presence in CDs, while the absorption spectra show the absorption band at 280 ± 3 nm. Next, the Biuret test was performed, with the results showing no presence of unreacted proteins in CDs. It can be said that all proteins are converted in CDs. Photo luminance spectra shows the emission of CDs is 420 nm and a toxicity study of CDs was performed. The Presto Blue method was used to test the toxicity of CDs for murine hippocampal cells. CDs at a concentration of 4 mg/mL were hazardous independent of synthesis time, while the toxicity was higher for lower synthesis times of 1 and 2 h. When the concentration is reduced in 1 and 2 h synthesized CDs, the cytotoxic effect also decreases significantly, ensuring a survival rate of 60-80%. However, when the synthesis time of CDs is increased, the cytotoxic effect decreases to a lesser extent. The CDs with the highest synthesis time of 8 h do not show a cytotoxic effect above 60%. The cytotoxicity study shows that CDs may have a concentration and time-dependent cytotoxic effect, reducing the number of viable cells by 40%.

Eco Friendly Synthesis of Carbon Dot by Hydrothermal Method for Metal Ions Salt Identification.

In this work, we report the synthesis method of carbon quantum dots (CDs) using the one-step method for fast and effective metal ion determination. Ascorbic acid was used as an inexpensive and environmentally friendly precursor. High-pressure and high-temperature reactors were used for this purpose. Microscopic characterization revealed the size of CDs was in the range of 2-6 nm and they had an ordered structure. The photoluminescence properties of the CDs depend on the process temperature, and we obtained the highest PL spectra for 6 h of hydrothermal reaction. The maximum emission spectra depend poorly on synthesis time. Further characterization shows that CDs are a good contender for sensing Fe3+ in aqueous systems and can detect concentrations up to 0.49 ppm. The emission spectra efficiency was enhanced by up to 200% with synthesis time.

Implementation and sustainability of a medication reconciliation toolkit: A mixed methods evaluation.

PURPOSE: MARQUIS (Multi-Center Medication Reconciliation Quality Improvement Study) provided participating hospitals with a toolkit to assist in developing robust medication reconciliation programs. Here we describe hospitals' implementation of the MARQUIS toolkit, barriers and facilitators, and important factors that may enhance the spread and sustainability of the toolkit. METHODS: We used a mixed methods, quantitative-qualitative study design. We invited site leaders of the 5 hospitals that participated in MARQUIS to complete a Web-based survey and phone interview. The Consolidated Framework for Implementation Research guided question development. We analyzed the collected data using descriptive statistics (for survey responses) and thematic content analysis (for interview results). RESULTS: Site leaders from each MARQUIS hospital participated. They reported that MARQUIS toolkit implementation augmented their hospitals' existing but limited medication reconciliation practices. Survey results indicated executive leadership support for toolkit implementation but limited institutional support for hiring staff (reported by 20% of respondents) and/or budgetary support for implementation (reported by 60% of respondents). Most participating hospitals (80%) shifted staff responsibilities to support medication reconciliation. Interview findings showed that inner setting (ie, organizational setting) and process factors (eg, designation of champions) both inhibited and facilitated implementation. Hospitals adopted a variety of toolkit interventions (eg, discharge medication counseling) using a range of implementation strategies, including development of educational tools and tip sheets for staff members and electronic health record templates. CONCLUSION: Despite limited institutional support, hospitals can successfully implement, spread, and sustain the MARQUIS toolkit by shifting staff responsibilities, adding pharmacy staff, and using a variety of strategies to facilitate implementation. Although leadership support and resources for data collection and dissemination facilitated implementation, limited staff buy-in and competing priorities may hinder implementation.

A real-time nursing intervention reduces dysglycemia and improves best practices in noncritically ill hospitalized patients.

BACKGROUND: Dysglycemia is prevalent in hospitalized patients and is associated with poor clinical outcomes. Educational interventions insufficiently improve best practices in managing dysglycemia. OBJECTIVE: To reduce dysglycemia by improving best practices for inpatient glycemic control. DESIGN: Interrupted time series. SETTING: A community teaching hospital. PATIENTS: A total of 653 adult, noncritically ill, nonobstetric patients. INTERVENTION: A real-time nursing intervention (RTNI). A charge nurse issued a verbal invitation to the physician to utilize the existing glycemic control order set for patients with dysglycemia. MEASUREMENTS: (1) Lone correctional insulin (LCI) usage; (2) potentially inappropriate oral hypoglycemic medication (PIOHM) usage; (3) patient day-weighted mean glucose (PDWMG; ie, mean glucose for each hospital day, averaged across all hospital days); (4) the percent of patients with PDWMG >180 mg/dL; and (5) the prevalence of severe hypoglycemia. RESULTS: The use of LCI regimens decreased from 48% to 30% (P < 0.01) during the RTNI period and the rate of potentially inappropriate oral hypoglycemic medications (PIOHMs) usage was reduced from 29% to 13% (P < 0.01). PDWMG decreased from 166 mg/dL to 156 mg/dL (P = 0.04). After removal of the RTNI, outcome measures were not significantly different from baseline, with the exception of PIOHM use, which remained lower at 19% in the postintervention group (P = 0.04). CONCLUSIONS: An RTNI promoting a best-practice glycemic control order set was successful in modestly lowering mean glucose levels and substantially reducing the use of LCI and PIOHMs.