Maximising nurse-patient communication in the emergency department.

Effective communication in the emergency department (ED) is vital for ensuring safe patient care and supporting optimal patient outcomes and satisfaction. However, such settings are often noisy, fast paced and unpredictable, which can make nurse-patient communication challenging. Effective communication requires the appropriate knowledge and skills underpinned by clarity, mutual understanding, respect and empathy. However, maximising nurse-patient communication requires various practical and strategic measures, ranging from addressing the environmental challenges of the ED and meeting patients' individual communication needs, to implementing quality control measures and supporting mentorship, reflection and education in practice. This article offers an overview of some of the practical and strategic measures nurses of all levels and experience can apply to maximise nurse-patient communication in the ED.

Ensuring effective intercultural communication in the emergency department.

Globalisation and migration trends are reflected in emergency departments (EDs), which increasingly care for patients and employ staff from diverse cultural and/or ethnic backgrounds. EDs are busy, pressured and unpredictable environments where effective communication with patients and families is challenging at the best of times. This is compounded by language and cultural barriers experienced by patients and families whose background differs from the prevailing culture. Cultural differences and language comprehension may also be a challenge for overseas nurses recruited to the ED, who may need support from colleagues and organisations. ED nurses therefore need to be competent in intercultural communication. This involves combining optimal interpersonal skills with cultural awareness, knowledge and sensitivity.

Novel alanine serine cysteine transporter 2 (ASCT2) inhibitors based on sulfonamide and sulfonic acid ester scaffolds.

The neutral amino acid transporter alanine serine cysteine transporter 2 (ASCT2) belongs to the solute carrier 1 (SLC1) family of transport proteins and transports neutral amino acids, such as alanine and glutamine, into the cell in exchange with intracellular amino acids. This amino acid transport is sodium dependent, but not driven by the transmembrane Na+ concentration gradient. Glutamine transport by ASCT2 is proposed to be important for glutamine homoeostasis in rapidly growing cancer cells to fulfill the energy and nitrogen demands of these cells. Thus, ASCT2 is thought to be a potential anticancer drug target. However, the pharmacology of the amino acid binding site is not well established. Here, we report on the synthesis and characterization of a novel class of ASCT2 inhibitors based on an amino acid scaffold with a sulfonamide/sulfonic acid ester linker to a hydrophobic group. The compounds were designed based on an improved ASCT2 homology model using the human glutamate transporter hEAAT1 crystal structure as a modeling template. The compounds were shown to inhibit with a competitive mechanism and a potency that scales with the hydrophobicity of the side chain. The most potent compound binds with an apparent affinity, K i, of 8 ± 4 µM and can block the alanine response with a K i of 40 ± 23 µM at 200 µM alanine concentration. Computational analysis predicts inhibitor interactions with the binding site through molecular docking. In conclusion, the sulfonamide/sulfonic acid ester scaffold provides facile synthetic access to ASCT2 inhibitors with a potentially large variability in chemical space of the hydrophobic side chain. These inhibitors will be useful chemical tools to further characterize the role of ASCT2 in disease as well as improve our understanding of inhibition mechanisms of this transporter.

Managing Risks Due to Ingredient Variability in Food Production.

Managing the design of products and the efficient execution of the manufacturing processes needed to produce them is an endeavor fraught with all manner of risks for manufacturing enterprises large and small. In certain industries, such as the food manufacturing industry, the problems and risks can be even greater. This is because the processes necessary for a food product's manufacture must be designed not only to meet quality, cost, and efficiency targets, but also to have an innate flexibility to cope with the unavoidable variability in the characteristics of the ingredients used to produce the desired product. In the food manufacturing industry and in related industries such as pharmaceutical manufacturing, the problem of identifying vendor sources for ingredients that have acceptable characteristics, managing the acquisition of those ingredients, and then modifying the manufacturing process to cope with the inherent variability in ingredients acquired at different times is an ongoing concern that can expose a company to severe risks. In this paper, a case study will be presented that illustrates how smart manufacturing (SM) approaches can be applied to reduce the risks due to ingredient variability to, and increase the efficiency of, a food production network. Smart manufacturing integrates best-of-breed solutions from manufacturing and non-manufacturing arenas to solve manufacturing problems and offers great hope for manufacturers. The SM solution described in this paper is built upon what is called the Smart Manufacturing Platform, a software and services platform being developed by the Smart Manufacturing Leadership Coalition.

CCM-3/STRIPAK promotes seamless tube extension through endocytic recycling.

The mechanisms governing apical membrane assembly during biological tube development are poorly understood. Here, we show that extension of the C. elegans excretory canal requires cerebral cavernous malformation 3 (CCM-3), independent of the CCM1 orthologue KRI-1. Loss of ccm-3 causes canal truncations and aggregations of canaliculular vesicles, which form ectopic lumen (cysts). We show that CCM-3 localizes to the apical membrane, and in cooperation with GCK-1 and STRIPAK, promotes CDC-42 signalling, Golgi stability and endocytic recycling. We propose that endocytic recycling is mediated through the CDC-42-binding kinase MRCK-1, which interacts physically with CCM-3-STRIPAK. We further show canal membrane integrity to be dependent on the exocyst complex and the actin cytoskeleton. This work reveals novel in vivo roles of CCM-3·STRIPAK in regulating tube extension and membrane integrity through small GTPase signalling and vesicle dynamics, which may help explain the severity of CCM3 mutations in patients.

NLRP7 and the Genetics of Hydatidiform Moles: Recent Advances and New Challenges.

NOD-like receptor proteins (NLRPs) are emerging key players in several inflammatory pathways in Mammals. The first identified gene coding for a protein from this family is Nlrp5 and was originally called Mater for "Maternal Antigen That Mouse Embryos Require" for normal development beyond the two-cell stage. This important discovery was followed by the identification of other NLRPs playing roles in inflammatory disorders and of the first maternal-effect gene in humans, NLRP7, which is responsible for an aberrant form of human pregnancy called hydatidiform mole (HM). In this review, we recapitulate the various aspects of the pathology of HM, highlight recent advances regarding NLRP7 and its role in HM and related forms of reproductive losses, and expand our discussion to other NLRPs with a special emphasis on those with known roles in mammalian reproduction. Our aim is to facilitate the genetic complexity of recurrent fetal loss in humans and encourage interdisciplinary collaborations in the fields of NLRPs and reproductive loss.