Expanding Per- and Polyfluoroalkyl Substances Coverage in Nontargeted Analysis Using Data-Independent Analysis and IonDecon.

Per- and polyfluoroalkyl substances (PFAS) are widespread, persistent environmental contaminants that have been linked to various health issues. Comprehensive PFAS analysis often relies on ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry (UHPLC HRMS) and molecular fragmentation (MS/MS). However, the selection and fragmentation of ions for MS/MS analysis using data-dependent analysis results in only the topmost abundant ions being selected. To overcome these limitations, All Ions fragmentation (AIF) can be used alongside data-dependent analysis. In AIF, ions across the entire m/z range are simultaneously fragmented; hence, precursor-fragment relationships are lost, leading to a high false positive rate. We introduce IonDecon, which filters All Ions data to only those fragments correlating with precursor ions. This software can be used to deconvolute any All Ions files and generates an open source DDA formatted file, which can be used in any downstream nontargeted analysis workflow. In a neat solution, annotation of PFAS standards using IonDecon and All Ions had the exact same false positive rate as when using DDA; this suggests accurate annotation using All Ions and IonDecon. Furthermore, deconvoluted All Ions spectra retained the most abundant peaks also observed in DDA, while filtering out much of the artifact peaks. In complex samples, incorporating AIF and IonDecon into workflows can enhance the MS/MS coverage of PFAS (more than tripling the number of annotations in domestic sewage). Deconvolution in complex samples of All Ions data using IonDecon did retain some false fragments (fragments not observed when using ion selection, which were not isotopes or multimers), and therefore DDA and intelligent acquisition methods should still be acquired when possible alongside All Ions to decrease the false positive rate. Increased coverage of PFAS can inform on the development of regulations to address the entire PFAS problem, including both legacy and newly discovered PFAS.

Efficiency of Radiolabeling Eggs Before and After Microwave Cooking for Gastric Emptying Scintigraphy Studies.

The accuracy and reproducibility of nuclear medicine gastric emptying scintigraphy (GES) require strict adherence to the Society of Nuclear Medicine and Molecular Imaging standardized protocol, which contains precise instructions for meal ingredients and preparation. Previous research demonstrated that many laboratories were using whole eggs in the test meal as opposed to the guideline-recommended liquid egg whites and that some laboratories were attempting to radiolabel the egg by adding the radiotracer after cooking. This study aimed to document the labeling efficiency of 99mTc-sulfur colloid (SC) added to whole eggs before and after microwave cooking. Methods: Whole eggs were mixed with 99mTc-SC before and after microwave cooking. The radiolabeling stability of the eggs was tested after 2 and 4 h of incubation in gastric fluid simulated using just hydrochloric acid (HCl) and using HCl with pepsin. Results: The experiment showed that no matter what the testing condition, radiolabeling by adding 99mTc-SC to whole eggs before cooking resulted in a significantly higher labeling efficiency than radiolabeling by squirting the 99mTc-SC on eggs after cooking. This finding persisted over time, with the precooking method still showing significantly higher radiolabeling at 2 and 4 h after the egg was placed in the incubation medium for both gastric fluid mediums. For simulated gastric fluid with pepsin at 2 h, the labeling was significantly higher, at 73.3%, when the radiotracer was added before cooking than the 43.3% when added after cooking (P < 0.001). The results of this study further showed that when egg labeling efficiency was tested in HCl without pepsin, the labeling was less stable than when tested in HCl with pepsin. In the HCl-only medium, the labeling efficiency decreased significantly between 2 and 4 h for both radiolabeling methods. Conclusion: The results of this study demonstrated that the addition of 99mTc-SC to whole eggs after cooking resulted in considerably inferior binding of the radiotracer to the eggs and that binding deteriorated significantly over time. The study further demonstrated that the results of radiolabeling efficiency varied depending on whether HCl or HCl with pepsin was used to simulate gastric fluid. Radiolabeling stability decreased over time when HCl without pepsin was used. The findings emphasize the criticality of adhering to the standardized meal and preparation, as alternate cooking methods have different radiolabeling efficiencies.

Experiences of the Kansas Extended Care Permit Providers: A descriptive study.

Purpose: A total of 40 states to date have expanded the role of dental hygienists with the goal of improving access to basic oral health services for underserved populations. In Kansas, legislative changes have resulted in the Extended Care Permit (ECP) designation. The purpose of this study is to describe the experiences of registered dental hygienists in Kansas holding ECP certificates (ECP RDH) as of July of 2014.Methods: Secondary data analysis was performed utilizing data collected from a survey conducted in 2014 by Oral Health Kansas. All registered ECP RDH's were sent the 32-item survey via Survey Monkey®. Descriptive statistical analyses consisted of frequency distributions, and measures of central tendency. Inferential analyses using t-tests and ANOVA were conducted to compare groups.Results: A total of 73 responses were received from the (n= 176) surveys that were e-mailed for a 41% response rate. Of the clinicians who responded, 80%, worked at least part-time and in school settings. The most consistent barriers to providing care were the inability to directly bill insurance (52%), financial sustainability (42%) and physical requirements (42%). Follow-up tests found significant differencs between clinician groups when examining barriers.Conclusion: Although the ECP legislation appears to be expanding access to care for citizens in Kansas, significant barriers still exist in making this a viable model for oral healthcare delivery.

Nursing shared governance: leading a journey of excellence.

This article describes how a community hospital engaged nurses through the nursing shared governance model to select a PPM that aligned nursing values and priorities with the organization's vision and mission.