Interface geriatrics: evidence-based care for frail older people with medical crises.

Frail older people are at risk of long hospital stays, and there is growing emphasis on identifying alternative care pathways in the community. Rapid decisions to discharge older people may not always serve the patient well. Specialist assessment from geriatricians could improve outcomes.

Fabrication of polymer microstructures for MEMS: sacrificial layer micromolding and patterned substrate micromolding.

Two soft lithography based fabrication techniques are employed for fabricating mechanically independent, freely suspended polymer microstructure from poly(n-propyl methacrylate) (PPMA), poly(methyl methacrylate) (PMMA), and polystyrene. Both methods involve a micromolding process followed by thermal bonding to the substrate. The first method, sacrificial layer micromolding, uses a water soluble sacrificial layer, allowing functional structures to be released by immersion in water. The second method, patterned substrate micromolding, uses a permanent substrate patterned via photolithography. Functional regions of the polymer MEMS are suspended over the voids in the photoresist pattern. The processes have been applied to the fabrication of polymer microstructures with a variety of geometries for specific applications. Devices have included microcantilevers, beams, and other more complicated microstructures. The thermal molding process is conceivably applicable to the fabrication of microstructures from a wide variety of thermoplastic polymers, allowing material selection to be tailored based on application.

Analysis of recombinant monoclonal antibody isoforms by electrospray ionization mass spectrometry as a strategy for streamlining characterization of recombinant monoclonal antibody charge heterogeneity.

A therapeutic recombinant monoclonal antibody analyzed by cation-exchange chromatography exhibited a heterogeneous profile composed of approximately 10 isoforms. The peaks were isolated and characterized by electrospray quadrupole time-of-flight mass spectrometry (ESI-q-TOF-MS), N-terminal Edman sequencing, peptide mapping, and other techniques. Acidic (lower pI) peaks were found to represent deamidated and sialyated species. Higher pI peaks were found to contain N- and C-terminal heavy-chain variants. Biological activities of the more abundant isoforms were found to be comparable. An approach streamlining the characterization of antibody charge heterogeneity is proposed.

Development of a chip-based capillary gel electrophoresis method for quantification of a half-antibody in immunoglobulin G4 samples.

A method based on microfluidic technology was developed to support quantitative analysis of recombinant monoclonal immunoglobulin G4 (IgG4) antibody samples. The assay was performed on an Agilent 2100 Bioanalyzer in combination with the Protein 200 Plus LabChip Kit and the Protein 200 Plus assay software. Capillary electrophoresis principles have been transferred to a chip format that integrates all separation, staining, virtual destaining, and detection steps. The method is referred to in this paper as chip-based capillary gel electrophoresis (GelChip-CE method). The GelChip-CE method under nonreducing conditions proved to be a quantitative test for half-antibody determination in IgG4 samples. Similar to the traditional nonreducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) method, the GelChip-CE method includes a denaturing step prior to separation. We showed that denaturing the sample by heating resulted in an artificial increase in the amount of half-antibody detected, which could be prevented by addition of N-ethylmaleimide to the sample buffer. The GelChip-CE method allowed for analysis of IgG4 samples with more accuracy, higher precision, and a faster turnaround time than SDS-PAGE and reversed-phase high-performance liquid chromatography (RP-HPLC).