Effect of pH on the catalytic electrooxidation of NADH using different two-electron mediators immobilised on zirconium phosphate

A detailed study is reported on the electrocatalytic oxidation of β-nicotinamide adenine dinucleotide at three different carbon paste electrodes modified with redox mediators commonly used in bioelectrochemistry, viz. Meldola blue, methylene green and riboflavin, adsorbed on zirconium phosphate. Cyclic voltammetric investigations of these chemically modified electrodes performed in aqueous tris buffer solutions at different pHs allowed us to conclude that the immobilised redox species presented very stable redox properties, with midpoint potentials (E_m, ?125, ?40, and ?140 mV versus SCE for Meldola blue, methylene green and riboflavin, respectively) virtually independent of the pH of the contacting solution. The second-order rate constant for electrocatalytic oxidation of NADH as well as its pH dependence (from 6 to 8) were evaluated from rotating disk electrode (RDE) experiments, using the Koutecky–Levich approach.     

Developing a Virtual Equity Hub: Adapting the Tumor Board Model for Equity in Cancer Care

We define cancer equity as all people having as the same opportunity for cancer prevention, treatment, and survivorship care. However, marginalized populations continue to experience avoidable and unjust disparities in cancer care, access to clinical trials, and cancer survival. Racial and ethnic minorities, and individuals with low socioeconomic status, Medicaid insurance, limited health literacy, disabilities, and mental health disorders are more likely to experience delays to cancer diagnosis and less likely to receive guideline-concordant cancer care. These disparities are impacted by the social determinants of health including structural discrimination, racism, poverty, and inequities in access to healthcare and clinical trials. There is an urgent need to develop and adapt evidence-based interventions in collaboration with community partners that have potential to address the social determinants of health and build capacity for cancer care for underserved populations. We established the Virtual Equity Hub by developing a collaborative network connecting a comprehensive cancer center, academic safety net hospital, and community health centers and affiliates. The Virtual Equity Hub utilizes a virtual tumor board, an evidence-based approach that increases access to multi-specialty cancer care and oncology subspecialty expertise. We adapted the tumor board model by engaging person-centered teams of multi-disciplinary specialists across health systems, addressing the social determinants of health, and applying community-based research principles with a focus on populations with poor cancer survival. The virtual tumor board included monthly videoconferences, case discussion, sharing of expertise, and a focus on addressing barriers to care and trial participation. Specifically, we piloted virtual tumor boards for breast oncology, neuro-oncology, and individuals with cancer and serious mental illness. The Virtual Equity Hub demonstrated promise at building capacity for clinicians to care for patients with complex needs and addressing barriers to care. Research is needed to measure the impact, reach, and sustainability of virtual equity models for patients with cancer.

Despite rapid advances in cancer treatment, disparities in cancer care persist. This article describes a virtual tumor board developed to provide a collaborative network of multi-disciplinary specialists, which showed promise at building capacity for clinicians to care for patients with complex needs and addressing barriers to care.     

Diffusionless electron transfer of microperoxidase-11 on gold electrodes

Microperoxidase-11, MP-11, is made by proteolytic digestion of cytochrome c, cyt. c. It consists of a polypeptide of 11 amino residues attached covalently to the heme. Given that MP-11 has a more exposed heme than the complete protein, it would seem that electron transfer, ET, between immobilized MP-11 and electrodes would be at least as fast as for intact cyt. c. However, while the maximal heterogeneous ET rate for immobilized cyt. c is around 1000 s^?1, that reported previously for immobilized MP-11 does not exceed 20 s^?1. This work attempts to understand this difference in measured ET rates. The MP-11 was immobilized on gold electrodes using several protocols: (electrode A) the immobilization was done following a previously published carbodiimide based recipe yielding ET rates of the order of 20 s^?1; (B) MP-11 was bound to gold electrodes by Lomant’s reagent and gave an ET rate close to 4000 s^?1; (C) physisorbed MP-11 on gold electrodes with a self assembled monolayer, SAM, of alkane thiols gave an ET rate approaching 2000 s^?1 for the shortest length alkane thiol. Inspection of the immobilization chemistries suggests that the procedure employed in producing electrodes B and C are likely to lead to a monolayer or less of immobilized MP-11 while the procedure employed for electrode A may lead to a film comprised of a multilayer of MP-11. The presence of such a film on electrode A complicates the ET process since the MP-11 in the layer adjacent to the electrode could have fast ET rates while the MP-11 in the outer layers may have significantly slower ET rates. The net result would be an apparent ET rate constant which is much smaller than the value for the first layer. The measurements and calculations are presented in support of such an interpretation.     

Evaluation of a Short,On-Plate Formic Acid Extraction Method for Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry-Based Identification of Clinically Relevant Yeast Isolates

This report describes a short, on-plate formic acid (FA) extraction method for the identification of clinical yeast isolates using matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-TOF MS). A total of 41.1% (78/190) and 63.7% (121/190) of yeasts were identified using species log score thresholds of >2.0 and >1.9, respectively. Overall, 97.4% (185/190) of yeasts were identified in combination with conventional FA extraction.     

An ‘early warning system’ for health needs: surveillance of the quality of clinical services by audit of extra-contractual referrals (ECRs)

Extra-contractual referrals (ECRs) can be a cause of considerable anxiety to purchasing authorities, mainly because of their potential to generate unexpected expenditure. But ECRs can also be used as a tool for monitoring the demand for, and quality of, clinical services. ECRs were studied in the Darlington Health Authority district using a variety of methods including inter-disciplinary meetings, a series of interviews with local GPs, and a questionnaire to general practitioners on 230 consecutive ECRs. The methods and results of the questionnaire study are presented. The commonest reasons for making ECRs included the mistaken belief that a contract existed with the ECR provider, patient dissatisfaction with the local provider, and referral to benefit from shorter waiting lists. ECRs for bone-mass densitometry, orthopaedics, and ear nose and throat services were over-represented. Questionnaire results were validated by comparison with an interview study of all GPs in the district. We conclude that trends in ECRs can be monitored as a convenient ‘early warning system’ to alert purchasing authorities to changes in demand or perceived problems with local provider units. ECR data must be interpreted in the context of further local background information from sources such as GPs and public health physicians. In the case of Darlington, scrutiny of ECRs has led to changes in services and contracts.     

The predictive value of myocardial radioisotope scanning in animals treated with doxorubicin

Thirty-four New Zealand white rabbits were treated with doxorubicin and imaged weekly with Tc-99m pyrophosphate to define the value of abnormal myocardial images in predicting doxorubicin-induced cardiac toxicity. Increased myocardial uptake was detected in most animals on sustained treatment with doxorubicin. A greater proportion of the heart was involved with doxorubicin-related histologic changes in animals with strongly positive myocardial images than in treated animals with moderately positive or normal scans. The myocardial images returned to normal levels 2--6 wk after doxorubicin was discontinued. Five of seven rabbits that received doxorubicin after they had three moderately positive myocardial scans, died from congestive heart failure. Three rabbits whose doxorubicin was discontinued because of scan findings, survived for 6 wk or more before dying from renal failure. The three rabbits who received the highest total dose of doxorubicin died of renal failure without developing abnormal myocardial scans.     

Women's attitudes to urodynamics: a questionnaire survey

Objective To obtain a measure of how well women tolerate urodynamic investigations and to determine
Design Prospective questionnaire survey
Setting A teaching hospital tertiary referral centre urodynamic laboratory.
Participants Three hundred and twenty-four women attending for urodynamic investigations on 33 1 occasions. Questionnaires were returned from 297 women (9 1.7%) with six women returning two questionnaires.
Results Urodynamic investigations were well tolerated by most women, with 45% feeling that the procedure was not as bad as they expected. Moderate or severe anxiety about the test was experienced by 42% and 40% felt moderately or severely embarrassed. Pain was noted by 27% of women during investigation, and by 13% after investigation. Overall distress from the procedure was less in older women and in those who had been referred from a specialist urogynaecology clinic. Distress was higher when difficulties were encountered during the investigation and in women who had investigations other than a standard cystometrogram. Women were likely to find the test less distressing when they felt they had been given adequate information about the test.
Conclusions Although urodynamic investigations are generally well tolerated, there is a significant minority of women who find the test embarrassing, painful and distressing. how well they thought the test was explained.