Maintaining medical team communication using video conferencing during the COVID-19 lockdown.

COVID-19 is a global pandemic of unprecedented proportions. It has resulted in changes to all aspects of our lives. The impact on medicine has been significant. Clear and effective communication during these times is vital. We present an evaluation of the use of video conferencing (VC) and offer a simple format to structure meetings for their effectiveness and promotion of team communication and wellbeing.

New applications of electron diffraction in the pharmaceutical industry: polymorph determination by using a combination of electron diffraction and synchrotron X-ray powder diffraction techniques.

Electron diffraction has been recently used in the pharmaceutical industry to study the polymorphism in crystalline drug substances. While conventional X-ray diffraction patterns could not be used to determine the cell parameters of two forms of the microcrystalline GP IIb/IIIa receptor antagonist roxifiban, a combination of electron single-crystal and synchrotron powder diffraction techniques were able to clearly distinguish the two polymorphs. The unit-cell parameters of the two polymorphs were ultimately determined using new software routines designed to take advantage of each technique's unique capabilities. The combined use of transmission electron microscopy (TEM) and synchrotron patterns appears to be a good general approach for characterizing complex (low-symmetry, large-unit-cell, micron-sized) polymorphic pharmaceutical compounds.

Crystalline versus amorphous content of lumaxistrade mark analog XP280 using X-ray and electron diffraction methods.

In the course of the development of Lumaxistrade mark (roxifiban), the physical state of XP280 (the besylate salt of the active metabolites of roxifiban) and SC887 (the mesylate salt of the free base of roxifiban) were characterized. Powder X-ray diffraction patterns of XP280 were ambiguous in that a high degree of background signal was present and potentially indicative of the existence of an amorphous phase. Herein the results of combined synchrotron X-ray diffraction and electron microscopy (diffraction and imaging) studies on XP280 and SC887 are reported. The combination of these two techniques allowed an unambiguous assessment of the crystallinity, as well as determination of four of the unit cell parameters of XP280 and complete determination of the unit cell parameters for SC887.

Polymorph determination for the GP IIb/IIIa antagonist, roxifiban, using a combination of electron diffraction and synchrotron X-ray powder diffraction techniques.

Unit cell parameters of two polymorphs of roxifiban have been determined by a combination of transmission electron microscopy (TEM) single-crystal and synchrotron X-ray powder diffraction techniques. While it was difficult to differentiate the two forms by their standard X-ray diffraction patterns, the high-resolution synchrotron patterns clearly showed striking differences. Unit cells for the two forms required the use of cell parameters derived from TEM diffraction patterns. The two unit cells are, not surprisingly, very similar except for a doubling of one of the axes for form II. The combined use of TEM and synchrotron patterns appears to be a good general approach for characterizing complex (low-symmetry, large unit cell) polymorphs.

The Kinetic Significance of V5 in n-Butane Oxidation Catalyzed by Vanadium Phosphates

Maleic anhydride, a precursor to polyester resins, is made by oxidation of n-butane over vanadium phosphate catalysts. This system is of general interest because it is the only heterogeneously catalyzed, alkane-selective oxidation reaction in commercial use. Time-resolved in situ x-ray absorption spectroscopy shows that when either alphaI-VOPO4/SiO2 or (VO)2P2O7/SiO2 catalysts are exposed to n-butane, the rate of maleic anhydride formation is proportional to the rate of decay of V5+ species in the catalyst. Thus V5+ species are kinetically significant for the production of maleic anhydride and not just for the production of by-products. The results also suggest that V5+ species may play a role in the initial hydrogen abstraction from n-butane, the rate-determining step in the reaction sequence. V4+ sites appear to be responsible for by-product formation.

Still participating after all these years: a study of life task participation in later life.

The authors examined in 618 older Americans the extent to which individual levels of life satisfaction were connected to participation in the shared tasks of late adulthood (e.g., community service and social life participation). Participation in these shared tasks was an important predictor of life satisfaction, controlling for health, self-reported vitality, social support, individual differences in congeniality, organizational affiliation, and prior levels of satisfaction. Social life participation was particularly important for retirees in predicting life satisfaction, more so than for study participants who were still able to derive enjoyment from work activity. This difference between retired and nonretired subjects was especially pronounced for men and illustrates how the important domains of activity shift with sociocultural expectations and opportunities of a given life phase.

To whom do people turn when things go poorly? Task orientation and functional social contacts.

Using experience-sampling data the authors examined distinct benefits and uses of social support. As expected, emotional support buffered negative psychological states, and informational support appeared to facilitate mastery-related states, among individuals who had previously reported low well-being. An examination of social pursuits revealed that these distinct kinds of support were sought by individuals who were especially likely to need them. Participants focused on outcomes in their social lives, and therefore especially likely to be emotionally distressed when social pursuits go poorly, responded to poor social well-being by spending time with emotional supporters. Participants focused on improvement in their social lives responded to poor social well-being by spending time with others who could provide information to facilitate self-improvement--people who personified their self-ideals.

Tuberculosis risk in the hospital dental practice.

Tuberculosis has re-emerged as a serious public health concern. Multidrug-resistant strains and an increase in the number of high-risk groups are posing a difficult problem for health care providers. The risk of TB transmission in hospital dental practices is potentially increasing. A 20-question survey was mailed to the membership of the American Association of Hospital Dentists, addressing various issues relating to tuberculosis. One hundred thirty-two surveys were analyzed. Twelve per cent of respondents reported at least one TB skin test conversion by a dental provider within the past year at their institution. Five respondents reported one dental provider contracting TB through patient contact. Oral TB was reported in 21 cases. Over 34% reported that active TB patients are not isolated to negative-pressure isolation rooms, 45% reported that patients are allowed to frequent public areas, and only 59% believed that drug compliance monitoring was adequate. Over 86% support TB screening in the Hospital Dental Practice. It was concluded that Hospital Dental Practice personnel may be at increased risk for exposure to TB. Dental providers must exercise strict TB prevention and employ meticulous referral and follow-up procedures for high-risk patients.

An immunohistochemical and in situ hybridization study of insulin-like growth factor I within fetal neuron cell cultures.

Fetal neuron cell cultures (NCC) from 22 day gestation and 18 day gestation fetal rabbit brain were studied for the presence of insulin-like growth factor I (IGF I). The 22 day gestation NCC were incubated in an IGF I free/insulin free/serum free medium. The 18 day gestation NCC were incubated in: (1) IGF I free/insulin free/serum free medium, (2) IGF I containing medium (100 ng)/serum free medium, and (3) serum containing medium. The 22 day gestation NCC survived in the IGF I free/insulin free/serum free medium. Furthermore, IGF I was detected in the medium by RIA from day one to day ten of incubation. In contrast, the 18 day gestation NCC did not survive in the IGF I free/insulin free/serum medium, but survived in the serum medium. When the 18 day gestation NCC were incubated in the serum free medium containing 100 ng IGF I the cells survived for a period of 2-3 days. Immunoreactive IGF I was found within the 22 day gestation NCC incubated in the IGF I free/insulin free/serum free medium and 18 day gestation NCC in serum medium. Likewise, IGF I mRNA was found only within the 22 day gestation NCC. Internalization studies of IGF I have shown that the peptide was internalized from the medium by the two different gestational age NCC's studied. IGF I receptors were found in both 22 day gestation and 18 day gestation NCC. In conclusion IGF I may promote cell survival in early stages of brain development, and may be of exogenous origin. In contrast the 22 day gestation NCC are capable of producing and secreting IGF I, and indeed appear to respond to this growth factor in an autocrine fashion.

Immunohistochemical and in situ hybridization study of an insulin-like substance in fetal neuron cell cultures.

We studied the ability of fetal neuron cell cultures from different rabbit fetal brain gestational ages to produce and secrete an insulin-like substance (ILS). Neurons from 22-day gestation were incubated in serum-containing medium or insulin-free/serum-free medium, and 18-day gestation fetal rabbit neurons were also incubated in serum-free/insulin containing medium and serum-containing medium. The 22-day cultures survived in the serum-containing medium and the insulin-free/serum-free medium. The 18-day cultures died when incubated in the insulin-free/serum-free or serum-free/insulin-containing medium, but survived when incubated in serum-containing medium. Using immunohistochemical and in situ hybridization techniques, ILS and insulin-like mRNA were demonstrated within the 22-day cultures incubated in all media compositions, but not within the 18-day cultures incubated in the serum-containing medium. Ultrastructural studies of the 22-day cultures demonstrated an ILS in the endoplasmic reticulum, Golgi and cytoplasm. Northern blots showed the presence of an insulin-like mRNA within the 22-day gestation neuron cell cultures. Insulin receptor was present in the 22-day cultures, but was absent in the 18-day cultures. In addition, we characterized the ILS from the 22-day cultures incubated in the insulin-free/serum-free medium employing high-performance liquid chromatography (HPLC), radioimmunoassay and Western blots. Analysis by HPLC and Western blots demonstrated the presence of an ILS in the extract. We have shown that while 22-day fetal neuron cultures produce and secrete an insulin-like substance indistinguishable from authentic insulin, neuron cell cultures from early brain development do not express this capability.

Developmental regulation of insulin in the mammalian central nervous system.

We delineated the ontogeny of rabbit brain insulin concentrations to define the regulatory role of development on this hormone in the central nervous system. Employing a sensitive ELISA, we observed higher concentrations in the late gestation fetal brain (approximately 80-90 ng/g) and early neonatal brain (approximately 195 ng/g) in comparison to the adult (approximately 32 ng/g; P less than 0.01). Further, we characterized this hormone to determine the identity of insulin (or an insulin-like substance) in brain. Employing porcine/bovine or rabbit insulin as standards, we observed that brain insulin mimicked authentic insulin in its migration on SDS-polyacrylamide and native gel electrophoresis, immunogenicity on Western blot analysis, and its elution profile on immunoaffinity column chromatographic, and high performance liquid chromatographic separation. We then examined the developmental effects on circulating and cerebrospinal fluid (CSF) radioimmunoassayable insulin levels. No statistically significant differences (ANOVA) existed through development in either the serum or CSF insulin levels. Employing multiple regression analysis, no correlation was evident between brain and either serum or CSF insulin concentration. A search for insulin mRNA by Northern blot analysis yielded minute amounts of atypical large sized transcripts. We conclude that the insulin peptide in the central nervous system closely resembles (or is identical to) circulating insulin in many properties and that there is a developmental increase in brain insulin concentrations, the maximal peak occuring in the late gestation fetus and early neonate. Insulin concentrations in brain demonstrate no conventional relationship to either the serum or CSF insulin levels, suggesting an additional source of peptide, which contributes beyond that which is available via the circulation. The amounts of insulin present within the central nervous system are minute (difficult to detect) but in the range (10-100 ng) where the hormone can interact with either insulin or insulin-like growth factor I (IGF-I) receptors that are abundantly present on developing brain cells, thereby executing the biological function of the hormone.

Synthesis and Single-Crystal X-ray Structure of a Highly Symmetrical C60 Derivative, C60Br24.

C(60) and liquid bromine react to form C(60)Br(24), a crystalline compound isolated as a bromine solvate, C(60)Br(24)(Br(2))(x), The x-ray crystal structure defines a new pattern of addition to the carbon skeleton that imparts a rare high symmetry. The parent C(60) framework is recognizable in C(60)Br(24), but sp(3) carbons at sites of bromination distort the surface, affecting conformations of all of the hexagonal and pentagonal rings. Twenty-four bromine atoms envelop the carbon core, shielding the 18 remaining double bonds from addition. At 150 degrees to 200 degrees C there is effectively quantitative reversion of C(60)Br(24) to C(60) and Br(2).

Oxygen Isotope Effect and Structural Phase Transitions in La2CuO4-Based Superconductors.

The oxygen isotope effect on the superconducting transition temperature (alpha(o)) varies as a function of x in La2-xSrxCuO(4) and La2-xBaxCuO(4), with the maximum alpha(o) values (alpha(o) >/= 0.5) found for x near 0.12. This unusual x dependence implies that the isotope effect is influenced by proximity to the Abma --> P4(2)/ncm structural phase transition in these systems. Synchrotron x-ray difaction measurements reveal little change in lattice parameters or orthorhombicity due to isotope exchange in strontium-doped materials where alpha(o) > 0.5, eliminating static structural distortion as a cause of the large isotope effects. The anomalous behavior of alpha(o) in both strontium- and barium-doped materials, in combination with the previously discovered Abma --> P4(2)/ncm structural phase-transition in La(1.88)B(0.12)CuO(4), suggests that an electronic contribution to the lattice instability is present and maximizes at approximately 1/8 hole per copper atom. These observations indicate a dose connection between hole doping of the Cu-O sheets, tilting instabilities of the CuO(6) octahedra, and superconductivity in La(2)CuO(4)-based superconductors.

Immunological types of lymphoproliferative disorders in a cohort: a 4-year study.

Immunological testing of malignant cells and serum from most cases of lymphoproliferative disorders (LPD) allows the cell type to be characterised as of B, T or "null" lymphocyte origin. Regional differences in the incidence of neoplasms of these types have been reported. Furthermore, most published series have drawn cases from referral institutions rather than the general population. In order to determine the true incidence of a cohort we surveyed an entire population, that of Tasmania, an island state of Australia with a population of 410,000, during a defined period, the years 1977-1980 inclusive, for the occurrence of LPD. A total of 248 cases was discovered, made up of 133 cases of non-Hodgkin's lymphoma (NHL), 30 of chronic lymphocytic leukaemia (CLL), 18 of acute lymphoblastic leukaemia (ALL), 54 of multiple myeloma (MM), eight of macroglobulinaemia (MGA) and five others. We identified B lymphocytes by the presence of surface membrane immunoglobulin (Smlg) and their ability to rosette with mouse red blood cells, and T lymphocytes by their ability to rosette with sheep red blood cells. Laboratory testing was performed in 201 (81%) of the cases and characterisation of the cell of origin as of B, T or "null" type was successful in 158 (64%). Of these 158, 136 (86%) were B, 4 (3%) T, and 18 (11%) "null". On B cell subtyping by heavy and light chain lg analysis the Tasmanian series, compared with other reports, had an apparent paucity of B-CLL, MM and MGA of lambda subtype (57 k to 12 lambda, k:lambda ratio 4.8:1) and an unusual incidence of B-CLL with the double lg heavy chain combination M+G. Surveys of this type may help to point to environmental or other factors important in the aetiology of LPD.

Erythrocyte membrane proteins in an unusual case of congenital dyserythropoietic anaemia type II (CDA II).

Analysis of the erythrocyte membrane protein of an atypical case of congenital dyserythropoietic anaemia type II (CDA II) by electrophoresis on polyacrylamide gels revealed marked abnormalities. One-dimensional analysis showed a pronounced decrease in levels of B1.1 components, an increase in the level of B1.4 and the appearance of new components in the A region as well as in the C region of the gel. There were no artefacts due either to the presence of early red cells or to abnormally high levels of proteolytic enzyme activity in the CDA II preparations. Two-dimensional analysis confirmed the alterations in membrane components showing two novel A region species not reported in other studies of this disease. Abnormalities in components of such large molecular size may explain the greater degree of membrane perturbation seen in the present case and support the idea that CDA II may embrace more than one disease entity.