The gendered context of women charged with violent offences in the forensic psychiatric setting.

Background: Women charged with violent offences may be referred by courts for forensic psychiatric assessment to determine whether mental disorder or intellectual disability impacts their fitness to stand trial and/or criminal responsibility. The profile of these women is a poorly researched area in South Africa. Aim: This study examined the socio-demographic, offence-related, and clinical profile of South African women charged with violent offences referred for forensic assessment. Setting: Fort England Hospital (FEH), a forensic psychiatric institution in the Eastern Cape. Methods: The clinical records of 173 women referred by courts for forensic psychiatric evaluation over a 24-year period (1993-2017) to FEH were systematically reviewed. Results: Most women were single, black mothers with dependent children, who were unemployed and socio-economically impoverished. Many had backgrounds of pre-offence mental illness, alcohol use and alleged abuse. The majority were first-time offenders whose victims were known to them. Most child victims were biological children killed by their mothers. Likely primary motives for violence were related to psychopathology in half of cases, and interpersonal conflict in a third. Forensic assessment most frequently confirmed psychotic disorders and dual diagnoses. Half the cases were fit to stand trial and under half were criminally responsible. Conclusion: Violent female offending occurs within a gendered context, with high rates of prior trauma, alcohol use and psychosocial distress in perpetrators. An emphasis on gender-sensitive psychosocial interventions is required. Contribution: This study highlights the nature and context of violent offending by women referred for forensic psychiatric assessment in South Africa.

Viscoelasticity of a carbon nanotube-laden air-water interface.

The viscoelasticity of a carbon nanotube (CNT)-laden air-water interface was characterized using two different experimental methods. The first experimental method used a Langmuir-Pockels (LP) trough coupled with a pair of oscillating barriers. The second method is termed the Bicone-Trough (BT) method, where a LP trough was custom-built and fit onto a rheometer equipped with a bicone fixture to standardize the preparation and conditioning of a particle-laden interface especially at high particle coverages. The performance of both methods was evaluated by performing Fast Fourier Transform (FFT) analysis to calculate the signal-to-noise ratios (SNR). Overall, the rheometer-based BT method offered better strain control and considerably higher SNRs compared to the Oscillatory Barriers (OB) method that oscillated barriers with relatively limited positional and speed control. For a CNT surface coverage of 165 mg/m2 and a frequency of 100 mHz, the interfacial shear modulus obtained from the OB method increased from 39 to 57 mN/m as the normal strain amplitude increased from 1 to 3%. No linear viscoelastic regime was experimentally observed for a normal strain as small as 0.5%. In the BT method, a linear regime was observed below a shear strain of 0.1%. The interfacial shear modulus decreased significantly from 96 to 2 mN/m as the shear strain amplitude increased from 0.025 to 10%.

Large-scale smart bioreactor with fully integrated wireless multivariate sensors and electronics for long-term in situ monitoring of stem cell culture.

Achieving large-scale, cost-effective, and reproducible manufacturing of stem cells with the existing devices is challenging. Traditional single-use cell-bag bioreactors, limited by their rigid and single-point sensors, struggle with accuracy and scalability for high-quality cell manufacturing. Here, we introduce a smart bioreactor system that enables multi-spatial sensing for real-time, wireless culture monitoring. This scalable system includes a low-profile, label-free thin-film sensor array and electronics integrated with a flexible cell bag, allowing for simultaneous assessment of culture properties such as pH, dissolved oxygen, glucose, and temperature, to receive real-time feedback for up to 30 days. The experimental results show the accurate monitoring of time-dynamic and spatial variations of stem cells and myoblast cells with adjustable carriers from a plastic dish to a 2-liter cell bag. These advances open up the broad applicability of the smart sensing system for large-scale, lower-cost, reproducible, and high-quality engineered cell manufacturing for broad clinical use.

Deep learning delay coordinate dynamics for chaotic attractors from partial observable data.

A common problem in time-series analysis is to predict dynamics with only scalar or partial observations of the underlying dynamical system. For data on a smooth compact manifold, Takens' theorem proves a time-delayed embedding of the partial state is diffeomorphic to the attractor, although for chaotic and highly nonlinear systems, learning these delay coordinate mappings is challenging. We utilize deep artificial neural networks (ANNs) to learn discrete time maps and continuous time flows of the partial state. Given training data for the full state, we also learn a reconstruction map. Thus, predictions of a time series can be made from the current state and several previous observations with embedding parameters determined from time-series analysis. The state space for time evolution is of comparable dimension to reduced order manifold models. These are advantages over recurrent neural network models, which require a high-dimensional internal state or additional memory terms and hyperparameters. We demonstrate the capacity of deep ANNs to predict chaotic behavior from a scalar observation on a manifold of dimension three via the Lorenz system. We also consider multivariate observations on the Kuramoto-Sivashinsky equation, where the observation dimension required for accurately reproducing dynamics increases with the manifold dimension via the spatial extent of the system.

Hormone replacement therapy (conjugated oestrogens plus bazedoxifene) for post-menopausal women with symptomatic hand osteoarthritis: primary report from the HOPE-e randomised, placebo-controlled, feasibility study.

Background: Symptomatic hand osteoarthritis is more common in women than in men, and its incidence increases around the age of menopause, implicating oestrogen deficiency. No randomised controlled trials of hormone replacement therapy (HRT) have been done in people with hand osteoarthritis. We aimed to determine the feasibility and acceptability of a form of HRT (conjugated oestrogens plus bazedoxifene) in post-menopausal women with painful hand osteoarthritis. Methods: The HOPE-e feasibility study was a randomised, double-blind, placebo-controlled trial, for which we recruited women aged 40-65 years, for whom 1-10 years had passed after their final menstrual period, with definite hand osteoarthritis and at least two painful hand joints. Participants were recruited across three primary or secondary care sites and from the community and were randomly assigned (1:1) to receive conjugated oestrogens plus bazedoxifene or placebo, orally once every day for 24 weeks, before weaning for 4 weeks until the end of the study. The primary feasibility outcomes were rates of identification, recruitment, randomisation, retention, and compliance of eligible participants, and the likelihood of unmasking. The secondary objective was to generate proof-of-concept quantitative and qualitative data on the acceptability of proposed clinical outcomes for a full trial and adverse events. We used an intention-to-treat analysis, and criteria for progression to a full trial were pre-defined as recruitment of at least 30 participants across all sites in 18 months; a dropout rate of less than or equal to 30% of randomised individuals; and acceptability to the majority of participants, including acceptable rates of adverse events. Due to the COVID-19 pandemic, the recruitment window was reduced to 12-15 months. A proportionately reduced minimum sample size of 22 was judged to be sufficient to test feasibility. This trial was registered at ISRCTN, ISRCTN12196200. Findings: From May 9, 2019 to Dec 31, 2020, 434 enquiries or referrals were received. We did 96 telephone pre-screens; of the 35 eligible participants, seven were excluded as ineligible at the telephone or face-to-face screening and 28 (80% [95% CI 63-92]) were randomly assigned. Of the 406 who were not randomly assigned, 250 (62%) were ineligible (with contraindicated medications accounting for 50 [20%] of these), 101 (25%) did not respond to further enquiries, and 55 (14%) chose not to proceed (with the most common reason being not wanting to take a hormone-based drug). All 28 randomised participants completed all follow-up assessments with high compliance and outcome measure completeness. All three adverse event-related treatment withdrawals were in the placebo group. No serious adverse events were reported. Participants and investigators were successfully masked (participant Bang's blinding index placebo group 0·50 [95% CI 0·25-0·75]). The trial met the prespecified criteria for progression to a full trial. Interpretation: This first-ever feasibility study of a randomised controlled trial of HRT for post-menopausal women with painful hand osteoarthritis met its progression criteria, although it was not powered to detect a clinical effect. This outcome indicates that a full trial of an HRT in this population is feasible and acceptable and identifies potential refinements with regard to the design of such a trial. Funding: Research for Patient Benefit programme, National Institute for Health Research.

Development of a stem cell spheroid-laden patch with high retention at skin wound site.

Mesenchymal stem cells such as human adipose tissue-derived stem cells (hADSCs) have been used as a representative therapeutic agent for tissue regeneration because of their high proliferation and paracrine factor-secreting abilities. However, certain points regarding conventional ADSC delivery systems, such as low cell density, secreted cytokine levels, and cell viability, still need to be addressed for treating severe wounds. In this study, we developed a three-dimensional (3D) cavity-structured stem cell-laden system for overdense delivery of cells into severe wound sites. Our system includes a hydrophobic surface and cavities that can enhance the efficiency of cell delivery to the wound site. In particular, the cavities in the system facilitate hADSC spheroid formation, increasing therapeutic growth factor expression compared with 2D cultured cells. Our hADSC spheroid-loaded patch exhibited remarkably improved cell localization at the wound site and dramatic therapeutic efficacy compared to the conventional cell injection method. Taken together, the hADSC spheroid delivery system focused on cell delivery, and stem cell homing effect at the wound site showed a significantly enhanced wound healing effect. By overcoming the limitations of conventional cell delivery methods, our overdense cell delivery system can contribute to biomedical and clinical applications.

Mercury Lα1 High Energy Resolution Fluorescence Detected X-ray Absorption Spectroscopy: A Versatile Speciation Probe for Mercury.

Mercury is in some sense an enigmatic element. The element and some of its compounds are a natural part of the biogeochemical cycle; while many of these can be deadly poisons at higher levels, environmental levels in the absence of anthropogenic contributions would generally be below the threshold for concern. However, mercury pollution, particularly from burning fossil fuels such as coal, is providing dramatic and increasing emissions into the environment. Because of this, the environmental chemistry and toxicology of mercury are of growing importance, with the fate of mercury being vitally dependent upon its speciation. X-ray absorption spectroscopy (XAS) provides a powerful tool for in situ chemical speciation, but is severely limited by poor spectroscopic energy resolution. Here, we provide a systematic examination of mercury Lα1 high energy resolution fluorescence detected XAS (HERFD-XAS) as an approach for chemical speciation of mercury, in quantitative comparison with conventional Hg LIII-edge XAS. We show that, unlike some lighter elements, chemical shifts in the Lα1 X-ray fluorescence energy can be safely neglected, so that mercury Lα1 HERFD-XAS can be treated simply as a high-resolution version of conventional XAS. We present spectra of a range of mercury compounds that may be relevant to the environmental and life science research and show that density functional theory can produce adequate simulations of the spectra. We discuss strengths and limitations of the method and quantitatively demonstrate improvements both in speciation for complex mixtures and in background rejection for low concentrations.

Delivery of a spheroids-incorporated human dermal fibroblast sheet increases angiogenesis and M2 polarization for wound healing.

Low cell engraftment is a major problem in tissue engineering. Although various methods related with cell sheets have been attempted to resolve the issue, low cell viability due to oxygen and nutrient depletion remains an obstacle toward advanced therapeutic applications. Cell therapy using fibroblasts is thought of as a good alternative due to the short doubling times of fibroblasts together with their immunomodulatory properties. Furthermore, three-dimensional (3D) fibroblasts exhibit unique angiogenic and inflammation-manipulating properties that are not present in two-dimensional (2D) forms. However, the therapeutic effect of 3D fibroblasts in tissue regeneration has not been fully elucidated. Macrophage polarization has been widely studied, as it stimulates the transition from the inflammation to the proliferation phase of wound healing. Although numerous strategies have been developed to achieve better polarization of macrophages, the low efficacy of these strategies and safety issues remain problematic. To this end, we introduced a biocompatible flat patch with specifically designed holes that form a spheroids-incorporated human dermal fibroblast sheet (SIS) to mediate the activity of inflammatory cytokines for M2 polarization and increase angiogenic efficacy. We further confirmed in vivo enhancement of wound healing with an SIS-laden skin patch (SISS) compared to conventional cell therapy.

Hand Osteoarthritis: investigating Pain Effects of estrogen-containing therapy (HOPE-e): a protocol for a feasibility randomised placebo-controlled trial.

BACKGROUND: Hand osteoarthritis (OA) is a common condition, causing pain, stiffness and reduced quality of life. Incidence is higher amongst women, particularly around the age of the menopause. Whilst the relationship between sex hormones and OA has been studied in vitro, in epidemiological studies and in clinical trials of hormone replacement therapy (HRT), this study is the first to investigate the effect of estrogen-containing therapy on hand pain in post-menopausal women with symptomatic hand OA in a randomised study design. METHODS: This is a feasibility study of a double-blinded placebo-controlled intervention with 1:1 randomisation to either a combination of conjugated estrogens 0.45 mg and bazedoxifene acetate 20 mg (Duavive) or placebo. The target population is post-menopausal women with symptomatic hand OA, aiming to recruit 60-90 study participants. The primary objective is to assess the feasibility of a future fully powered randomised controlled trial (RCT). Participants will take the study medication for 24 weeks and be followed up for 28 weeks after randomisation. The primary outcomes used to determine feasibility are eligible participant identification rates and routes; recruitment, randomisation and retention rates of eligible participants; study medication compliance; and the likelihood of unintentional unblinding. Secondary outcomes include measures of hand pain, function, appearance and menopausal symptoms. An end of study questionnaire and focus groups will help to refine the final protocol for a full study. DISCUSSION: Identifying new treatments for symptomatic hand OA is a recognised research priority. The study will help us to understand whether there are sufficient interested and eligible individuals in this target population who would consider HRT for their hand symptoms. It will provide proof-of-concept RCT data on the effects of HRT on hand pain and other clinically relevant outcomes in this population. The study will gain valuable information on the feasibility of a full RCT and how best to run this. The findings will be published in a peer-reviewed journal and presented at a relevant conference. TRIAL REGISTRATION: ISRCTN12196200 registered on 15 January 2019.

Alcohol use during pregnancy: prevalence and patterns in selected Buffalo City areas, South Africa.

The high rate of foetal alcohol spectrum disorders, which results from alcohol consumption during pregnancy, is of concern in South Africa. The aims of this research were to establish the prevalence, patterns and factors associated with alcohol use amongst pregnant women attending antenatal clinics in two former township areas of Buffalo City, South Africa. A survey was conducted using a structured questionnaire that included socio-demographic questions, and the Alcohol Use Test (AUDIT). The questionnaire was administered in English, Afrikaans or isiXhosa by healthcare providers trained in its administration. Consecutive sampling was used, with all willing women presenting at public clinics offering antenatal care in the two townships being invited to participate. Of the 18 clinics operating in the two townships, 16 were willing to participate, resulting in a sample of 1028 women over a nine-month period. Data were analysed in Medcalc using descriptive statistics, one-way analysis of variance, independent samples t-test and a multivariable binary logistic regression analysis. Two-thirds of the sample did not drink alcohol, but results showed high levels of risky alcohol use: 20.1% on the total AUDIT scale, and 16.8% on the AUDIT-C scale. The following variables were found to be significantly associated with risky drinking: age; race; report of intimate partner violence (IPV); and other regular drinker in the home. Employment status, education status, relationship status, parity and gestation were not associated with risky drinking. Interventions aimed at reducing alcohol use during pregnancy should address: drinking youth cultures; drinking norms within the home; and intimate partner violence. Future studies should include additional mental and physical health variables.

Anterior gradient 2 increases long-chain fatty acid uptake via stabilizing FABP1 and facilitates lipid accumulation.

Anterior gradient 2 (AGR2), a protein disulfide isomerase (PDI), is a well-established oncogene. Here, we found that Agr2-/- mice had a decreased fat mass and hepatic and serum lipid levels compared with their wild-type littermates after fasting, and exhibited reduced high-fat diet (HFD)-induced fat accumulation. Transgenic mice overexpressing AGR2 (Agr2/Tg) readily gained fat weight on a HFD but not a normal diet. Proteomic analysis of hepatic samples from Agr2-/- mice revealed that depletion of AGR2 impaired long-chain fatty acid uptake and activation but did not affect de novo hepatic lipogenesis. Further investigations led to the identification of several effector substrates, particularly fatty acid binding protein-1 (FABP1) as essential for the AGR2-mediated effects. AGR2 was coexpressed with FABP1, and knockdown of AGR2 resulted in a reduction in FABP1 stability. Physical interactions of AGR2 and FABP1 depended on the PDI motif in AGR2 and the formation of a disulfide bond between these two proteins. Overexpression of AGR2 but not a mutant AGR2 protein lacking PDI activity suppressed lipid accumulation in cells lacking FABP1. Moreover, AGR2 deficiency significantly reduced fatty acid absorption in the intestine, which might be resulted from decreased fatty acid transporter CD36 in mice. These findings demonstrated a novel role of AGR2 in fatty-acid uptake and activation in both the liver and intestine, which contributed to the AGR2-mediated lipid accumulation, suggesting that AGR2 is an important regulator of whole-body lipid metabolism and down-regulation of AGR2 may antagonize the development of obesity.

How Does Participation in Formal Education or Learning for Older People Affect Wellbeing and Cognition? A Systematic Literature Review and Meta-Analysis.

Objective: To determine the effect of later-life formal education or learning on quality of life (QOL), wellbeing, mood, and cognition. Methods: A systematic literature review of interventional clinical trials and observational studies was conducted for adults aged ≥55 years who had undertaken formal education or learning programs. Outcome measures included physical activity, happiness, affective and behavioral symptoms, cognitive function, and QOL. Bias was assessed using funnel plots, Egger's test, and leave1out analysis. Results: From 32 studies identified, we showed qualitative increases in cognitive function, life satisfaction, and self-confidence associated with learning. A meta-analysis revealed a significant pooled mean difference in MMSE scores (0.40, 95% confidence intervals = [0.12, 0.67]). Although there was a low risk of publication bias there was a high risk of sampling bias. Conclusion: Participation in formal education or learning contributed to increased wellbeing, QOL, healthy cognitive function, self-dependency, and a sense of belonging in older adults.

A Structured Cognitive Intervention Pathway as a decision-support tool for non-pharmacological interventions within a dementia care service (Innovative practice).

Individual cognitive interventions for Alzheimer's disease have been shown to be beneficial and cost effective when evaluated as sole interventions. However, there is a need for a systematic, person-centric, structured approach to guide non-pharmacological intervention selection based on disease stage, symptoms, outcome assessment, and individual requirements. Our Structured Cognitive Intervention Pathway aims to facilitate the selection of first-line, or subsequent, non-pharmacological management for people with Alzheimer's disease living at home and in elderly care facilities. We discuss the Pathway's conceptual basis and evaluation of implementation as a decision-support tool within a dementia care service in China.

Contribution of Time, Taxonomy, and Selective Antimicrobials to Antibiotic and Multidrug Resistance in Wastewater Bacteria.

The use of nontherapeutic broad-spectrum antimicrobial agents triclosan (TCS) and benzalkonium chloride (BC) can contribute to bacterial resistance to clinically relevant antibiotics. Antimicrobial-resistant bacteria within wastewater may reflect the resistance burden within the human microbiome, as antibiotics and pathogens in wastewater can track with clinically relevant parameters during perturbations to the community. In this study, we monitored culturable and resistant wastewater bacteria and cross-resistance to clinically relevant antibiotics to gauge the impact of each antimicrobial and identify factors influencing cross-resistance profiles. Bacteria resistant to TCS and BC were isolated from wastewater influent over 21 months, and cross-resistance, taxonomy, and monthly changes were characterized under both antimicrobial selection regimes. Cross-resistance profiles from each antimicrobial differed within and between taxa. BC-isolated bacteria had a significantly higher prevalence of resistance to "last-resort antibiotic" colistin, while isolates resistant to TCS exhibited higher rates of multidrug resistance. Prevalence of culturable TCS-resistant bacteria decreased over time following Food and Drug Administration (FDA) TCS bans. Cross-resistance patterns varied according to sampling date, including among the most clinically important antibiotics. Correlations between strain-specific resistance profiles were largely influenced by taxonomy, with some variations associated with sampling date. The results reveal that time, taxonomy, and selection by TCS and BC impact features of cross-resistance patterns among diverse wastewater microorganisms, which could reflect the variety of factors influencing resistance patterns relevant to a community microbiome.

Tungsten Ligand-Based Sulfur-Atom-Transfer Catalysts: Synthesis, Characterization, Sustained Anaerobic Catalysis, and Mode of Aerial Deactivation.

The synthesis, properties, X-ray structures, and catalytic sulfur-atom-transfer (SAT) reactions of W2(µ-S)(µ-S2)(dtc)2(dped)2 [1; dtc = S2CNR2-, where R = Me, Et, iBu, and Bn; dped = S2C2Ph22-] and W2(µ-S)2(dtc)2(dped)2 (2) are reported. These complexes represent the oxidized (1) and reduced (2) forms of anaerobic SAT catalysts operating through the bidirectional, ligand-based half-reaction (µ-S)(µ-S2) ↔ (µ-S)2 + S0. The catalysts are deactivated in air through the formation of catalytically inactive oxo complexes, (dtc)WO(µ-S)(µ-dped)W(dtc)(dped) (3), prompting us to recommend that group 6 SAT activity be assessed under strictly anaerobic conditions.

Regulation of intracellular transition metal ion level with a pH-sensitive inorganic nanocluster to improve therapeutic angiogenesis by enriching conditioned medium retrieved from human adipose derived stem cells.

Cell therapy based on human adipose derived stem cells (hADSCs) is a known potential therapeutic approach to induce angiogenesis in ischemic diseases. However, the therapeutic efficacy of direct hADSC injection is limited by a low cell viability and poor cell engraftment after administration. To improve the outcomes of this kind of approach, various types of nanoparticles have been utilized to improve the therapeutic efficacy of hADSC transplantation. Despite their advantages, the adverse effects of nanoparticles, such as genetic damage and potential oncogenesis based on non-degradable property of nanoparticles prohibit the application of nanoparticles toward the clinical applications. Herein, we designed a transition metal based inorganic nanocluster able of pH-selective degradation (ps-TNC), with the aim of enhancing an hADSC based treatment of mouse hindlimb ischemia. Our ps-TNC was designed to undergo degradation at low pH conditions, thus releasing metal ions only after endocytosis, in the endosome. To eliminate the limitations of both conventional hADSC injection and non-degradable property of nanoparticles, we have collected conditioned medium (CM) from the ps-TNC treated hADSCs and administrated it to the ischemic lesions. We found that intracellular increment of transition metal ion upregulated the hypoxia-inducible factor 1α, which can induce vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) expressions. Based on the molecular mechanism, the secretion of VEGF and bFGF by ps-TNC treated hADSCs showed a significant improvement compared to that of untreated cells. Injecting the CM collected from ps-TNC treated hADSCs into the mouse hindlimb ischemia model (ps-TNC-CM group) showed significantly improved angiogenesis in the lesions, with improved limb salvage and decreased muscle degeneration compared to the group injected with CM collected from normal hADSCs (CM group). This study suggests a novel strategy, combining a known angiogenesis molecular mechanism with both an improvement on conventional stem cell therapy and the circumvention of some limitations still present in modern approaches based on nanoparticles.

Synthesis and characterisation of fifteen-electron dihalo(carbonyl)tungsten(iii) complexes, Tp*WX2(CO) (X = Br, I).

The oxidation of Tp*WIII(NCMe)(CO) [Tp* = hydrotris(3,5-dimethylpyrazol-1-yl)borate] by iodine in refluxing acetonitrile produces paramagnetic Tp*WIIII2(CO), with µeff = 1.70 µB and ν(CO) = 1881 cm-1. The analogous bromo complex, Tp*WIIIBr2(CO) (µeff = 1.72 µB, ν(CO) = 1905 cm-1), is produced by the oxidative decarbonylation of Tp*WI(CO)3 with bromoacetonitrile in refluxing tetrahydrofuran. The crystal structures of both complexes reveal mononuclear, six-coordinate, distorted octahedral metal complexes bearing facial Tp* and mutually cis halide and carbonyl ligands. The structures, magnetic moments and spectroscopic data (including isotropically shifted NMR spectra) are consistent with a low-spin, doublet ground state in these, the first reported, 15-electron, d3 dihalo(carbonyl)-W(iii) complexes.

Microfluidic droplet application for bacterial surveillance in fresh-cut produce wash waters.

Foodborne contamination and associated illness in the United States is responsible for an estimated 48 million cases per year. Increased food demand, global commerce of perishable foods, and the growing threat of antibiotic resistance are driving factors elevating concern for food safety. Foodborne illness is often associated with fresh-cut, ready-to-eat produce commodities due to the perishable nature of the product and relatively minimal processing from farm to the consumer. The research presented here optimizes and evaluates the utility of microfluidic droplets, also termed ultra-miniaturized bioreactors, for rapid detection of viable Salmonella enterica ser. Typhimurium in a shredded lettuce wash water acquired from a major Mid-Atlantic produce processing facility (denoted as Producer) in the U.S. Using a fluorescently-labeled anti-S. Typhimurium antibody and relative fluorescence intensities, paired with in-droplet incubation, S. Typhimurium was detected and identified with 100% specificity in less than 5 h. In initial optimization experiments using S. Typhimurium-spiked sterile water, the relative fluorescence intensity of S. Typhimurium was approximately two times that of the observed relative intensities of five non-S. Typhimurium negative controls at 4-h incubation in droplets containing Rappaport-Vasiliadis (RV) broth at 37°C: relative fluorescence intensity for S. Typhimurium = 2.36 (95% CI: 2.15-2.58), Enterobacter aerogens 1.12 (95% CI: 1.09-1.16), Escherichia coli 700609 = 1.13 (95% CI: 1.09-1.17), E. coli 13706 1.13 (95% CI: 1.07-1.19), E. coli 700891 1.05 (95% CI: 1.03-1.07) and Citrobacter freundii 1.04 (95% CI: 1.03-1.05). S. Typhimurium- and E. aerogens-spiked shredded lettuce wash waters acquired from the Producer were then incubated 4 h in-droplet at 37°C with RV broth. The observed relative fluorescence of S. Typhimurium was significantly higher than that of E. aerogens, 1.56 (95% CI: 1.42-1.71) and 1.10 (95% CI: 1.08-1.12), respectively. While further optimization focusing on compatible concentration methodologies for highly-dilute produce water samples is needed, this application of droplet microfluidics shows great promise in dramatically shortening the time necessary-from days to hours-to confirm viable bacterial contamination in ready-to-eat produce wash waters used throughout the domestic and international food industry.

Review of Biomarkers and Analytical Methods for Organophosphate Pesticides and Applicability to Nerve Agents.

INTRODUCTION: Recent malicious use of chemical warfare agents (CWAs) is a reminder of their severity and ongoing threat. One of the main categories of CWAs is the organophosphate (OP) nerve agents. Presently, there is an urgent need to identify and evaluate OP nerve agent biomarkers that can facilitate identification of exposed individuals post-CWA incident. While exposures to OP nerve agents may be scenario-specific, the public is commonly exposed to OP compounds through the ubiquitous use of OP pesticides, which are chemically related to nerve agents. Therefore, a systematic literature review and methodological quality assessment were conducted for OP pesticide biomarker studies to serve as a baseline to assess if these approaches may be adapted to OP nerve agent exposures. MATERIALS AND METHODS: We conducted a systematic literature review to identify biomarkers of OP pesticide exposures. English language studies of any design that reported primary data on biomarkers for exposures in nonhuman primates or adult human study participants were eligible for inclusion. Using standard criteria for assessing the completeness of reported analytical methods, the quality of study methods was critically evaluated. RESULTS: A total of 1,044 studies of biomarkers of OP pesticide exposure were identified, of which 75 articles satisfied the inclusion and exclusion criteria. These studies described 143 different analyte/sample matrix combinations: 99 host-based biomarkers, 28 metabolites, 12 pesticides, and 4 adducts. The most commonly reported biomarkers were dialkyl phosphate urinary metabolites (22 studies), blood acetylcholinesterase, and plasma butyrylcholinesterase (26 studies each). None of the assessed quality review criteria were fully addressed by all identified studies, with almost all criteria scoring less than 50%. CONCLUSION: Cholinesterase activity may have utility for identifying individuals with exposures surpassing a given threshold of OP nerve agent, but further investigation of how acetylcholinesterase and butyrylcholinesterase levels correlate with observed patient symptoms may be required to ensure accuracy of results. As CWAs and nerve agents are more readily used, more standardized reporting of biomarker measurements are needed to develop new approaches for OP nerve agent biomarkers.