Critical analysis of methods to determine growth, control and analysis of biofilms for potential non-submerged antibiofilm surfaces and coatings.

The potential uses for antibiofilm surfaces reach across different sectors with significant resultant economic, societal and health impact. For those interested in using antibiofilm surfaces in the built environment, it is important that efficacy testing methods are relevant, reproducible and standardised where possible, to ensure data outputs are applicable to end-use, and comparable across the literature. Using pre-defined keywords, a review of literature reporting on antimicrobial surfaces (78 articles), within which a potential application was described as non-submerged/non-medical surface or coating with antibiofilm action, was undertaken. The most used methods utilized the growth of biofilm in submerged and static systems. Quantification varied (from most to least commonly used) across colony forming unit counts, non-microscopy fluorescence or spectroscopy, microscopy analysis, direct agar-contact, sequencing, and ELISA. Selection of growth media, microbial species, and incubation temperature also varied. In many cases, definitions of biofilm and attempts to quantify antibiofilm activity were absent or vague. Assessing a surface after biofilm recovery or assessing potential regrowth of a biofilm after initial analysis was almost entirely absent. It is clear the field would benefit from widely agreed and adopted approaches or guidance on how to select and incorporate end-use specific conditions, alongside minimum reporting guidelines may benefit the literature.

From pelvic radiation to social isolation: a qualitative study of survivors' experiences of chronic bowel symptoms after pelvic radiotherapy.

PURPOSE: We explored survivors' experiences of chronic bowel symptoms following pelvic radiotherapy, strategies employed in living with these symptoms, effects on daily activities, and roles at home and in the workplace. METHODS: Semi-structured interviews were conducted with 28 individuals (10 gynaecological, 14 prostate, four anal/rectal cancer survivors) who had completed pelvic radiotherapy at least six months prior to data collection and who had experience of bowel symptoms during this post-treatment period. Reflexive thematic analysis was undertaken. RESULTS: We propose four themes describing a process leading from experience of symptoms to withdrawal from activities and roles. These are (1) losing control (the experience of unintended anal leakage or discharge); (2) experiencing embarrassment and fear (the experience of embarrassment or fear of embarrassment as a result of discharge becoming public); (3) managing and reacting (acting to reduce the likelihood of discharge or to prevent this becoming public); and (4) restriction and withdrawal (avoiding specific activities or situations so as to reduce or remove the risk of embarrassment). Returning to the workplace presented additional challenges across these themes. CONCLUSIONS: Impacts of chronic bowel symptoms can be severe. Survivors employ a variety of methods and strategies in living with their symptoms. Some of these support continued role fulfilment but some constitute a withdrawal from pre-treatment roles. Current healthcare provision and statutory protections fail to fully meet needs following pelvic radiotherapy. IMPLICATIONS FOR CANCER SURVIVORS: There is a need to develop and implement evidence-based services and supported self-management programmes for survivors experiencing chronic bowel problems post-radiotherapy.

Can atopic eczema and psoriasis coexist? A systematic review and meta-analysis.

Importance: Previous studies report both coexistence and mutual exclusivity of atopic eczema (AE) and psoriasis, but these have not been appraised systematically. Knowledge of such disease association throws light on disease mechanisms and may influence therapeutic choices. Objective: To summarise evidence for AE and psoriasis occurring in the same person at the same point in time. Planned primary outcome was the incidence, prevalence or risk of psoriasis or eczema. Methods: Ovid MEDLINE and Ovid Embase were searched from inception to 1st February 2020. The search strategy was built around the key terms 'atopic eczema', 'psoriasis' and 'co-existence'. Observational studies (cohort, case-control, cross-sectional and case-series) with a minimum of 10 consecutive patients were included. There were no restrictions on participants, geography or language. Studies were selected, data extracted and critically appraised by two independent reviewers. Data were extracted on the method of diagnosis: health professional (dermatologist, criteria, other), self-reported, not specified. Study quality was assessed using validated Joanna Brigg's Institute critical appraisal tools. A random-effects model was used to combine studies. The effect of study quality on the pooled estimate was investigated using stratification. Heterogeneity was explored by subgroup analysis. Results: This review included 31 studies and 20 523 individuals with psoriasis and 1 405 911 with AE. Eight studies reported the prevalence of AE in those with psoriasis and values ranged from 0.17% to 20%: the pooled prevalence was 2% (95% confidence interval [CI]: 1, 3). Seven studies reported the prevalence of psoriasis in those with AE and values ranged from 0.3% to 12.6%; the pooled prevalence was 2% (95% CI: 1, 3). Ten studies were assessed as low risk of bias. Geographical area, method of diagnosis, setting and whether the assessment of diagnosis was blinded, partly contributed to the heterogeneity. Conclusions: This review provides some evidence for the coexistence of AE and psoriasis. Clinicians should be aware of coexistence at diagnosis, when selecting therapies and when reviewing poor response to treatment.

Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations.

The possible roles of selected B vitamins in the development and progression of sarcopenia are reviewed. Age-related declines in muscle mass and function are associated with huge and increasing costs to healthcare providers. Falls and loss of mobility and independence due to declining muscle mass/function are associated with poor clinical outcomes and their prevention and management are attractive research targets. Nutritional status appears a key modifiable and affordable intervention. There is emerging evidence of sarcopenia being the result not only of diminished anabolic activity but also of declining neurological integrity in older age, which is emerging as an important aspect of the development of age-related decline in muscle mass/function. In this connection, several B vitamins can be viewed as not only cofactors in muscle synthetic processes, but also as neurotrophic agents with involvements in both bioenergetic and trophic pathways. The B vitamins thus selected are examined with respect to their relevance to multiple aspects of neuromuscular function and evidence is considered that requirements, intakes or absorption may be altered in the elderly. In addition, the evidence base for recommended intakes (UK recommended daily allowance) is examined with particular reference to original datasets and their relevance to older individuals. It is possible that inconsistencies in the literature with respect to the nutritional management of sarcopenia may, in part at least, be the result of compromised micronutrient status in some study participants. It is suggested that in order, for example, for intervention with amino acids to be successful, underlying micronutrient deficiencies must first be addressed/eliminated.

Melanin-concentrating hormone in peripheral circulation in the human.

Melanin-concentrating hormone (MCH) is a hypothalamic neuropeptide with a well-characterised role in energy homeostasis and emergent roles in diverse physiologic functions such as arousal, mood and reproduction. Work to date has predominantly focused on its hypothalamic functions using animal models; however, little attention has been paid to its role in circulation in humans. The aims of this study were to (a) develop a radioimmunoassay for the detection of MCH in human plasma; (b) establish reference ranges for circulating MCH and (c) characterise the pattern of expression of circulating MCH in humans. A sensitive and specific RIA was developed and cross-validated by RP-HPLC and MS. The effective range was 19.5-1248 pg MCH/mL. Blood samples from 231 subjects were taken to establish a reference range of 19.5-55.4 pg/mL for fasting MCH concentrations. There were no significant differences between male and female fasting MCH concentrations; however, there were correlations between MCH concentrations and BMI in males and females with excess fat (P < 0.001 and P = 0.020) and between MCH concentrations and fat mass in females with excess fat (P = 0.038). Plasma MCH concentrations rose significantly after feeding in a group of older individuals (n = 50, males P = 0.006, females P = 0.023). There were no robust significant correlations between fasting or post-prandial MCH and resting metabolic rate, plasma glucose, insulin or leptin concentrations although there were correlations between circulating MCH and leptin concentrations in older individuals (P = 0.029). These results indicate that the role of circulating MCH may not be reflective of its regulatory hypothalamic role.

Thermal analysis and devolatilization kinetics of cotton stalk, sugar cane bagasse and shea meal under nitrogen and air atmospheres.

Thermal degradation, reactivity and kinetics for biomass materials cotton stalk (CS), sugarcane bagasse 1 (SB1), sugarcane bagasse 2 (SB2) and shea meal (SM) have been evaluated under pyrolysis (N(2)) and oxidising (dry air) conditions, using a non-isothermal thermogravimetric method (TGA). In the cases of CS and SB1 the peak temperatures were 51 degrees C higher for pyrolysis compared with oxidative degradation, whereas for SB2 and SM the difference was approximately 38 degrees C. However, the differences in the rates of weight loss were significantly higher under oxidising conditions for all the materials studied. Maximum rate of weight loss (%s(-1)) under pyrolysis conditions ranged from 0.10 to 0.18 whereas these values accelerated to the range of 0.19-0.28 under oxidising conditions, corresponding to respective peak temperatures. Samples ranked in order of reactivity (R(M)x10(3)) (%s(-1) degrees C(-1)) are CS=1.31 approximately SM=1.30>SB2=1.14>SB1=0.94 for air and CS=0.54>SB2=0.49>SB1=0.45>SM=0.31 for nitrogen. Shea meal exhibited a complex char combustion behaviour indicating that there may be two distinct types of char derived from fibrous and woody components in the original material. Activation energy calculations were based on the Arrhenius correlation.

Economic analysis of an early discharge rehabilitation service for older people.

OBJECTIVE: to measure the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in Nottingham, UK. DESIGN: data were collected during a randomised controlled trial. METHODS: cost and cost-effectiveness analyses were conducted from the perspective of service providers (health and social services) over a period of 12 months. Resource variables included were the EDRS intervention, the initial acute hospital admission (from randomisation), readmission to hospital, hospital outpatient visits, stays in nursing and residential homes, general practitioner contact, community health services and social services. The effectiveness measure was the EuroQol EQ-5D score, from which quality-adjusted life years (QALY) were calculated. Cost-effectiveness was calculated as cost per QALY gained. RESULTS: at 12 months the mean untransformed total cost for the EDRS was 8,361 pound sterling compared to 10,088 pound sterling for usual care, a saving of 1,727 pound sterling (P = 0.05). Cost-effectiveness acceptability curves showed a high probability that the EDRS was cost effective across a range of monetary values for a QALY. CONCLUSIONS: the Nottingham EDRS was likely to be more cost effective than usual care.

Pyrolysis of flame retardant brominated polyester composites.

A series of three flame retardant, thermoset polyester/styrene composite wastes were pyrolysed in a static-bed reactor. The wastes contained different proportions of brominated polyester resin. Higher char and gas yields were observed on the pyrolysis of the brominated samples than for a similar non-brominated sample. The pyrolysis gas composition showed a small, but significant influence of pyrolysis temperature and by the use of brominated resin. In all cases, over 95wt % of the bromine originally present in the composite ended up in the condensable products. Thermo-gravimetric analysis indicated that the presence of brominated polyester resins decreased the temperatures at which the main decomposition region started and the maximum rate of weight loss was observed. The global apparent activation energy of decomposition was between 83 and 97kJ mol(-1).

Pyrolysis of composite plastic waste.

Several different composite plastics were pyrolysed in a fixed bed reactor at final temperatures between 350 and 800 degrees C. The composites studied were polyester, phenolic, epoxy, vinylester, polypropylene and PET resins, reinforced with glass and/or carbon fibre. The product yields of oil gas and solid residue were determined together with a detailed composition of the derived gases. There was evidence to suggest that calcium carbonate filler, present in the polyester and phenolic composites, decomposed to form carbon dioxide at 800 degrees C, which was subsequently involved in char gasification reactions. Polyester, phenolic and epoxy composites generated highly aromatic, oxygenated condensable products. There was no noticeable correlation between the composition of these products and the final pyrolysis temperature. The tensile strength of recovered glass fibre was lower than that of virgin fibre and decreased markedly as the final pyrolysis temperature increased from 650 to 800 degrees C.

A placebo controlled investigation of the effects of tryptophan or placebo on subjective and objective measures of fatigue.

OBJECTIVE: To examine the effect of L-tryptophan administration on subjective and objective measures of fatigue in healthy volunteers. SUBJECTS: Six healthy volunteers (4M:2F) were recruited from staff and students at the College. SETTING: Department of Human Nutrition, St. Bartholomews and the Royal London School of Medicine and Dentistry. DESIGN: Subjects were tested for central and peripheral fatigue using a visual analogue scale, flicker fusion frequency, grip strength, reaction time and wrist ergometry. In addition, plasma free tryptophan concentrations and Trp:LNAA ratio were determined. Measurements were made before, and at 1, 2, 3 and 4 h after drinking one of two test drinks. The drinks were of either caffeine free diet Coca-Cola (placebo) or caffeine free diet Coca-Cola plus L-tryptophan (30 mg/kg: active drink). Each of the six subjects was tested after placebo and active drink with a one week washout period between test days. RESULTS: Subjective fatigue was significantly increased following tryptophan compared to placebo (P < 0.002), and objective measures of central fatigue were significantly increased by tryptophan compared to placebo (flicker fusion frequency: P < 0.001; reaction time P < 0.001). No significant changes in grip strength were found following tryptophan compared to placebo, but a significant increase in ergometric work output was seen (P < 0.001). CONCLUSION: Tryptophan ingestion in the quantity 30 mg/kg leads to increased subjective and central fatigue. Increases in work output observed following tryptophan may be as a result of a reduced perception of discomfort during ergometry.

Post-prandial changes in measures of fatigue: effect of a mixed or a pure carbohydrate or pure fat meal.

OBJECTIVES: To assess the changes in measures of fatigue after meals of varying composition, and to compare the relation of the fatigue with changes in the plasma tryptophan:large neutral amino acids (Trp:LNAA) ratio. SUBJECTS: Sixteen healthy volunteers were recruited from staff and students at the College. DESIGN: Subjects were tested for central and peripheral fatigue using a visual analogue scale, flicker fusion frequency, grip strength, reaction time and wrist ergometry. In addition, plasma amino acid concentrations and Trp:LNAA ratio were determined. Measurements were made before, and at 1, 2, 3 and 4 h after drinking one of three liquid test meals. The meals were isoenergetic (1672 kJ) and were of mixed carbohydrate, fat and protein, or of pure carbohydrate or pure fat. SETTING: Department of Human Nutrition. RESULTS: Subjects consuming the pure carbohydrate meal reported more subjective feelings of fatigue and had slower reaction times. Aspects of central fatigue were greater in subjects consuming a pure fat meal. The Trp:LNAA ratio was depressed in those consuming a pure fat or mixed meal and raised only after pure carbohydrate. CONCLUSIONS: Central and subjective fatigue may be influenced by raised plasma free tryptophan to competitor amino acid ratios induced by carbohydrate intake but other aspects of central arousal are affected by fat intake.