Physical compatibility of colistin with analgesics during simulated Y-site administration.

PURPOSE: Special consideration is needed when intravenous drugs are administered simultaneously using a Y-site connector. This study aimed to investigate the physical compatibility of colistin with 6 analgesics at concentrations commonly used in clinical practice. METHODS: A pharmaceutical preparation of colistin was dissolved according to the manufacturer's instructions and diluted to a concentration of 1.5 mg/mL or 0.67 mg/mL (of colistin base). Simulated administration via Y-site infusion set was performed by mixing 5 mL of colistin solution with an equal volume of a solution of one of 6 intravenous analgesics. Infusion solutions of ibuprofen, ketoprofen, metamizole sodium, morphine sulfate, paracetamol, and tramadol hydrochloride were studied. For each analgesic tested, concentrates for injection were diluted with 2 solvents, resulting in 11 different combinations with each concentration of the colistin solution. The mixtures were visually inspected, and their turbidity was measured directly after mixing and at 3 consecutive time points (30, 60, and 120 minutes). Additionally, the pH of the mixtures was measured after 120 minutes and compared with the pH of the analgesic and the colistin solutions. RESULTS: During visual inspection with the unaided eye, no precipitate formation or gas evolution was observed in any of the tested analgesics except for sodium metamizole, where the yellow color of the solutions was observed. For samples containing the mixture of ibuprofen and colistin, the turbidity measurements revealed the presence of turbidity in the studied mixtures. The greatest change in pH relative to the value immediately after preparation was noted for combinations of ketoprofen and morphine sulfate with the tested antibiotic. CONCLUSION: Colistin was found to be incompatible with ibuprofen and metamizole sodium formulations. It should also not be combined with morphine sulfate due to the significant differences in the pH value of the preparations. The colistin 0.67 mg/mL and 1.5 mg/mL infusion solutions were physically compatible with ketoprofen, tramadol hydrochloride, and paracetamol.

Food Insecurity: Is Leagility a Potential Remedy?

In the wake of the COVID-19 pandemic, and Ukraine-Russian conflict, both significant geo-political and socio-economic shocks to the global food system and food insecurity has risen across the world. One potential remedy to reduce the level of food insecurity is to move from a lean just-in-time food system to one where there is more resilience through greater agility both in routine supply operations and also in the event of an emergency situation. The aim of this critical perspectives paper was to firstly reflect on the concepts of lean, agility, and 'leagility'. Then, this study considered the ability of individual organisations and the whole food system to be resilient, adaptive, enable the elimination of waste, reduce inefficiency, and assure the consistent delivery to market requirements in terms of both volume, safety, and quality. Promoting the concept of leagility together with advocating resilient, sustainable practices that embed buffer and adaptive capacity, this paper positions that increasing digitalisation and improving business continuity planning can ensure effective operationalisation of supply chains under both normal and crisis situations, ultimately reducing the risk of food insecurity at personal, household, and community levels.

Commercially available SARS-CoV-2 RT-qPCR diagnostic tests need obligatory internal validation.

Although infection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) does not appear to be as serious a threat to public health as it was in 2020-2021, the increased transmissibility of multiple Omicron descendants may constitute a continuous challenge for health care systems, and reliable detection of new variants is still imperative. This study evaluates the performance of three SARS-CoV-2 diagnostic tests: Novel Coronavirus (2019-nCoV) Real Time Multiplex RT-PCR Kit (Liferiver); Vitassay qPCR SARS-CoV-2 (Vitaassay) and TaqPath COVID­19 CE-IVD RT-PCR Kit (Thermo Fisher Scientific). The analytical sensitivity of the assays as well as their specificity were determined with the use of synthetic nucleic acid standards and clinical samples. All assays appeared to be 100% specific for SARS-CoV-2 RNA in general and the Omicron variant in particular. The LOD determined during this validation was 10 viral RNA copies/reaction for Liferiver and TaqPath and 100 viral RNA copies for Vitassay. We cannot exclude that the LOD for the Vitassay might be lower and close to the manufacturer's declared value of ≥ 20 genome copies/reaction, as we obtained 90% positive results for 10 viral RNA copies/reaction. Mean Ct values at the concentration of 10 viral RNA copies/reaction for the Liferiver, Vitassay and TaqPath kits (35, 37 and 33, respectively) were significantly lower than the cutoff values declared by the manufacturers (≤ 41, ≤ 40 and ≤ 37, respectively). We suggest reporting outcomes based on LOD and cutoff Ct values determined during internal validation rather than those declared by the assays' producers.

Effectiveness of Early Rehabilitation with Exergaming in Virtual Reality on Gait in Patients after Total Knee Replacement.

Total knee replacement (TKR) is the treatment of choice for advanced stages of osteoarthritis but it requires good postoperative rehabilitation. This study aimed to assess the effectiveness of exercises using virtual reality to improve gait parameters in patients after TKR. Fifty-nine patients 7−14 days after TKR surgery were divided into a study group (VRG, n = 38) and a control group (CG, n = 21). Both groups underwent the same 4-week rehabilitation protocol. The VRG group had 12 additional nonimmersive virtual reality game sessions on the Virtual Balance Clinic prototype system at 30 min each, focusing on gait and balance improvement. Spatiotemporal, force and foot plantar pressure parameters were collected on an instrumented treadmill during a 30 s walk. The most significant improvement was in the symmetry indices of forefoot force, maximum forefoot force, loading response time, and preswing time (p < 0.05) in both groups. Gait speed increased by 31.25% and 44% in the VRG and CG groups, respectively (p < 0.005). However, the extra exergaming sessions did not significantly improve rehabilitation outcomes. Therefore, additional VR training does not improve gait better than standard rehabilitation alone, but the improvement of gait, especially its symmetry, is significant within the first six weeks after surgery.

Nonlinear and Linear Measures in the Differentiation of Postural Control in Patients after Total Hip or Knee Replacement and Healthy Controls.

Primary osteoarthritis treatments such as a total hip (THR) or knee (TKR) replacement lead to postural control changes reinforced by age. Balance tests such as standing with eyes open (EO) or closed (EC) give a possibility to calculate both linear and nonlinear indicators. This study aimed to find the group of linear and/or nonlinear measures that can differentiate healthy people and patients with TKR or THR from each other. This study enrolled 49 THR patients, 53 TKR patients, and 16 healthy controls. The center of pressure (CoP) path length, sample entropy (SampEn), fractal dimension (FD), and the largest Lyapunov exponent (LyE) were calculated separately for AP and ML directions from standing with EO/EC. Cluster analysis did not result in correct allocation to the groups according to all variables. The discriminant model included LyE (ML-EO, ML-EC, AP-EC), FD (AP-EO, ML-EC, AP-EC), CoP-path AP-EC, and SampEn AP-EC. Regression analysis showed that all nonlinear variables depend on the group. The CoP path length is different only in THR patients. It was concluded that standing with EC is a better way to assess the amount of regularity of CoP movement and attention paid to maintain balance. Nonlinear measures better differentiate TKR and THR patients from healthy controls.

Comparison of the Purchasing Behaviour of Polish and United Kingdom Consumers in the Organic Food Market during the COVID-19 Pandemic.

The main objective of the study was to compare young consumer purchasing behaviour towards organic food in Poland (PL) and the United Kingdom (UK), countries with different levels of organic market maturity. The study was conducted by means of an online survey questionnaire during the COVID-19 pandemic between December 2020 and February 2021. The sample consisted of 862 PL and 161 UK consumers. 31% of PL respondents and 58.4% of UK respondents indicated they purchase organic products. Descriptive statistics, the Mann-Whitney U test and the two proportion Z test were used for statistical analyses. The results indicate that young consumers pay particular attention to the freshness and quality of consumed products. Concern for their own health and that of their loved ones, as well as the desire to eat better-quality products were the main motivations for the respondents to purchase organic products. Organic vegetables and fruits, eggs, dairy products, and meat and meat products, were among the most frequently purchased products in the studied cohorts. Experts (e.g., a dietitian, physician) were declared to be the first source of information concerning food products for young consumers. Next, family members were indicated. Social media content (PL respondents) and information from websites managed by institutions (UK respondents) were mentioned as the third source. UK consumers preferred short supply chains. The present study can be used by government bodies and companies to select the most effective communication channels for education and advertising and to develop effective commercial strategies aimed at young consumers.

Food Safety Governance and Guardianship: The Role of the Private Sector in Addressing the EU Ethylene Oxide Incident.

Sesame seeds within the European Union (EU) are classified as foods not of animal origin. Two food safety issues associated with sesame seeds have emerged in recent years, i.e., Salmonella contamination and the presence of ethylene oxide. Fumigation with ethylene oxide to reduce Salmonella in seeds and spices is not approved in the EU, so its presence in sesame seeds from India was a sentinel incident sparking multiple trans-European product recalls between 2020-2021. Following an interpretivist approach, this study utilises academic and grey sources including data from the EU Rapid Alert System for Food and Feed (RASFF) database to inform a critical appraisal of current EU foods not of animal origin legislation and associated governance structures and surveillance programs. This is of particular importance as consumers are encouraged towards plant-based diets. This study shows the importance of collaborative governance utilizing data from company testing and audits as well as official regulatory controls to define the depth and breadth of a given incident in Europe. The development of reflexive governance supported by the newest technology (e.g., blockchain) might be of value in public-private models of food safety governance. This study contributes to the literature on the adoption of risk-based food safety regulation and the associated hybrid public-private models of food safety governance where both regulators and private organizations play a vital role in assuring public health.

Illicit Alcohol: Public Health Risk of Methanol Poisoning and Policy Mitigation Strategies.

Illicit (unrecorded) alcohol is a critical global public health issue because it is produced without regulatory and market oversight with increased risk of safety, quality and adulteration issues. Undertaking iterative research to draw together academic, contemporary and historic evidence, this paper reviews one specific toxicological issue, methanol, in order to identify the policy mitigation strategies of interest. A typology of illicit alcohol products, including legal products, illegal products and surrogate products, is created. A policy landscape matrix is produced that synthesizes the drivers of illicit alcohol production, distribution, sale and consumption, policy measures and activity related signals in order to inform policy development. The matrix illustrates the interaction between capabilities, motivations and opportunities and factors such as access, culture, community norms and behavior, economic drivers and knowledge and information and gives insight into mitigation strategies against illicit alcohol sale and consumption, which may prove of value for policymakers in various parts of the world.

Considering Fraud Vulnerability Associated with Credence-Based Products Such as Organic Food.

Organic foods carry a premium price. They are credence-based foods, i.e., it is difficult for consumers to evaluate the premium aspects of organic food under normal use. In global supply chains, organic food is purchased on institutional trust (certification, logos, standards) rather than on relational trust. Relying on institutional trust makes consumers vulnerable to criminals who intentionally label conventional product as organic or develop sophisticated organized crime networks to defraud businesses and consumers. The aim of this research is to explore cases of organic fraud that are emergent from academic and gray literature searches to identify ways to strengthen future capabilities to counter illicit activities in a globalized food environment. Each case is considered in terms of perpetrator motivations (differentiated as economic, cultural, and behaviorally orientated drivers), the mode of operation (simple or organized), the guardians involved/absent, and the business and supply chain level vulnerabilities the cases highlight. The study finds that institutional trust is particularly vulnerable to fraud. Supply chain guardians need to recognize this vulnerability and implement effective controls to reduce the likelihood of occurrence. However, in some cases considered in the study, the guardians themselves were complicit in the illicit behavior, further increasing consumer vulnerability. Future research needs to consider how additional controls can be implemented, without increasing supply chain friction that will impact on food trade and supply, that can ensure consumers are purchasing what they believe they are paying for.

Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance.

Exercises in virtual reality (VR) have recently become a popular form of rehabilitation and are reported to be more effective than a standard rehabilitation protocol alone. The aim of this study was to assess the efficacy of adjunct VR training in improving postural control in patients after total knee replacement surgery (TKR). Forty-two patients within 7-14 days of TKR were enrolled and divided into a VR group and a control group (C). The C group underwent standard postoperative rehabilitation. The VR group additionally attended twelve 30-min exercise sessions using the Virtual Balance Clinic prototype system. Balance was assessed on the AMTI plate in bipedal standing with and without visual feedback before and after the four-week rehabilitation. Linear measures and sample entropy of CoP data were analyzed. After four weeks of rehabilitation, a significant reduction in parameters in the sagittal plane and ellipse area was noted while the eyes remained open. Regression analysis showed that sample entropy depended on sex, body weight, visual feedback and age. Based on the sample entropy results, it was concluded that the complexity of the body reaction had not improved. The standing-with-eyes-closed test activates automatic balance mechanisms and offers better possibilities as a diagnostic tool.

Using the rapid alert system for food and feed: potential benefits and problems on data interpretation.

The Rapid Alert System for Food and Feed (RASFF), where competent authorities in each Member State (MS) submit notifications on the withdrawal of unsafe or illegal products from the market, makes a significant contribution to food safety control in the European Union. The aim of this paper is to frame the potential challenges of interpreting and then acting upon the dataset contained within the RASFF system. As it is largest cause of RASFF notifications, the lens of enquiry used is mycotoxin contamination. The methodological approach is to firstly iteratively review existing literature to frame the problem, and then to interrogate the RASFF system and analyze the data available. Findings are that caution should be exercised in using the RASFF database both as a predictive tool and for trend analysis, because iterative changes in food law impact on the frequency of regulatory sampling associated with border and inland regulatory checks. The study highlights the variability of engagement by MSs with the RASFF database, influencing generalisability of the trends noted. As importing countries raise market standards, there are wider food safety implications for the exporting countries themselves. As this is one of the first studies articulating the complexities and opportunities of using the RASFF database, this research makes a strong contribution to literature.

Chemical stability of fructans in apple beverages and their influence on chronic constipation.

The aim of this study was to analyse the concentration of reducing sugars in beverages based on apple juice with the addition of 2 and 4% of native and high polymerized inulin as well as oligofructose. Moreover, the effect of the consumption of this potentially prebiotic beverage containing highly polymerized inulin (12 g per 300 mL) on constipation was analysed. Pasteurization of the studied beverages followed by 120-day storage at ambient temperature, carried out in three independent trials, did not cause the hydrolysis of fructans into reducing sugars. Sensory analysis showed that the presence of fructans in beverages based on apple juice did not change the colour, clarity, odour, flavour, sweetness and acidity in comparison to apple juice. A placebo-controlled, randomized study involving 20 volunteers of age 20-29 with symptoms related to chronic constipation showed that the consumption of juice enriched with highly polymerized inulin significantly (p≤ 0.05) increased the frequency of bowel movements and facilitated defecation. The final conclusion is that fructans in beverages based on apple juice are chemically stable, do not affect sensory sensation and can help those with chronic constipation.

3D-Printed Multilayer Sensor Structure for Electrical Capacitance Tomography.

Presently, Electrical Capacitance Tomography (ECT) is positioned as a relatively mature and inexpensive tool for the diagnosis of non-conductive industrial processes. For most industrial applications, a hand-made approach for an ECT sensor and its 3D extended structure fabrication is used. Moreover, a hand-made procedure is often inaccurate, complicated, and time-consuming. Another drawback is that a hand-made ECT sensor's geometrical parameters, mounting base profile thickness, and electrode array shape usually depends on the structure of industrial test objects, tanks, and containers available on the market. Most of the traditionally fabricated capacitance tomography sensors offer external measurements only with electrodes localized outside of the test object. Although internal measurement is possible, it is often difficult to implement. This leads to limited in-depth scanning abilities and poor sensitivity distribution of traditionally fabricated ECT sensors. In this work we propose, demonstrate, and validate experimentally a new 3D ECT sensor fabrication process. The proposed solution uses a computational workflow that incorporates both 3D computer modeling and 3D-printing techniques. Such a 3D-printed structure can be of any shape, and the electrode layout can be easily fitted to a broad range of industrial applications. A developed solution offers an internal measurement due to negligible thickness of sensor mount base profile. This paper analyses and compares measurement capabilities of a traditionally fabricated 3D ECT sensor with novel 3D-printed design. The authors compared two types of the 3D ECT sensors using experimental capacitance measurements for a set of low-contrast and high-contrast permittivity distribution phantoms. The comparison demonstrates advantages and benefits of using the new 3D-printed spatial capacitance sensor regarding the significant fabrication time reduction as well as the improvement of overall measurement accuracy and stability.

TNF-α concentrations in pre-operative synovial fluid for predicting early post-operative function and pain after fast-track total knee arthroplasty.

BACKGROUND: Tumor necrosis factor-alpha (TNF-α) helps regulate neuroinflammation and anxiety and could conceivable predict early post-operative pain and function after fast-track total knee arthroplasty (TKA). METHODS: In patients with severe osteoarthritic knees undergoing TKA, we assessed: the correlations between pre-operative concentrations of TNF-α in synovial fluid; pre- and six-week post-operative knee function and pain; pre- and post-operative anxiety; pre- and post-operative synovial fluid concentrations of cartilage oligomeric matrix protein (COMP); age and body mass index (BMI). RESULTS: Of 100 enrolled patients, 78 had evaluable TNF-α data, and 58 had evaluable COMP data. Pre-operative TNF-α concentrations were inversely correlated with post-operative pain scores during walking (rS=-0.26, P=0.03) and with change of pain at rest during six weeks after TKA (rs=-0.28, P=0.03) and were directly correlated with a higher post-operative Knee Society score (KSS) (rS=0.43, P<0.001) and with greater increases in this score during six weeks after TKA (rS=0.33, P=0.001). Mean TNF-α concentrations were higher in the 39 patients reporting any pre-operative pain at rest than in 36 patients reporting no pre-operative pain (P=0.015) and were the only independent predictor of pre-operative pain at rest (OR=13, P=0.02). Independent predictors of better post-operative knee function were higher log-transformed TNF-α concentrations (ß=0.38, P=0.002) and male sex (ß=0.28, P=0.02). CONCLUSIONS: High levels of pre-operative TNF-α concentrations could be used as an independent predictor of better knee function at six weeks of follow-up. In patients with lower pre-operative TNF-α concentrations, post-operative pain management may improve the early outcome of the operated joint.

Eating behaviours of middle- and secondary-school pupils from the upper Silesian region in Poland.

BACKGROUND: Eating behaviours of school-aged youth condition their emotional and psychophysical development. Moreover, they influence the effectiveness of learning and affect one's health and the quality of life at older age. OBJECTIVE: The objective of the study was the evaluation of eating behaviours of the group of pupils from cities of the Upper Silesian region, as well as the identification of differences between middle-school and secondary-school pupils' eating behaviours. MATERIALS AND METHODS: 902 pupils (474 middle-school and 428 secondary-school pupils) participated in the study. The research materials included questionnaires prepared by the author of the study, containing the questions about the pupils' eating habits. RESULTS: The middle-school pupils constituted 52.5% of the 902 pupils and the secondary-school pupils were 47.5% of the total. On average, 38.2% of the pupils consumed 4 meals daily. Wholemeal bread and/or groats were eaten daily by 34.4% of the pupils. Milk and/or milk drinks were consumed by 56.3% of the pupils every day and 33.5% of the respondents had also fermented milk drinks daily. 61.3% of the participants declared eating meat at least once a day and 44.9% of the pupils had fish once or twice a week. Vegetables and fruit were eaten daily by 61.4% and 66.6% of the pupils respectively. Sweets were consumed at least once a day by 50.6% of the pupils. Occasional consumption of fast-food products and ready-made meals was declared by 63.9% and 49.7% of the pupils respectively. CONCLUSIONS: Eating behaviours of the discussed group of pupils are mostly incorrect. There were differences found between the middle-school and secondary-school pupils' eating habits. The differences concerned the frequency of eating cheese and curd cheese, fruit, leguminous plant seeds, sweets, fast food products, sweetened drinks and ready-to made food products. KEY WORDS: eating behaviours, eating habits, eating frequency, pupils.

Frequency of G2677T/A and C3435T polymorphisms of MDR1 gene in preeclamptic women.

OBJECTIVE: Preeclampsia (PE) belongs to main causes of mortality rates of mothers, fetuses and new born children. Polymorphism of MDR1 gene is connected with reduction of P-glycoprotein expression in placenta and increased fetal exposure to xenobiotics. The aim of the study was to determine the frequency of C3435T and G2677T/A polymorphisms of MDR1 gene in pregnant women with preeclampsia. MATERIALS AND METHODS: The study consisted of 180 Polish women including 60 women with PE and 120 healthy pregnant women. Determination of C3435T and G2677T/A polymorphisms of MDR1 gene was performed using PCR-RFLP method. RESULTS: No significant association between genotypes of the examined polymorphisms and the clinical parameters of pregnant women with PE was observed However the interesting tendency to higher prevalence of mutated 2677A allele of G2677T/A MDR1 polymorphism in PE group has been shown (2,50 vs. 0,83% in controls, OR=3,05, ns). CONCLUSIONS: The results of this study suggest no significant effect of examined C3435T and G2677T/A MDR1 polymorphisms in PE pathogenesis. However given the noteworthy results related to mutated 2677A allele of G2677T/A MDR1 polymorphism in preeclamptic women further studies seem to be needed. Nevertheless, the frequency of investigated polymorphisms was consistent with the distribution in other Caucasian populations.

P53 mutations in urinary bladder cancer patients from Central Poland.

The present study aimed at detection of P53 gene mutations in cells of urinary bladder neoplasms, as the mutations may be regarded as an independent prognostic factor for progression and recurrence of tumours. In the study, 82 patients with clinically diagnosed urinary bladder tumour were included. The control was composed of DNA samples from urine and blood of 202 healthy patients. Exons 5-8 of the P53 gene were screened for mutations by using multitemperature single-strand conformational polymorphism (MSSCP) analysis. Samples with abnormal MSSCP patterns were subjected to direct sequencing. The frequency of mutations in exons 5-8 of the P53 gene in patients with bladder cancer was lower (3.3% in grade G1, 24% in G2, and 39% in G3) than the data reported in the literature. We found a higher percentage of polymorphism at codon 213 of the P53 gene in bladder cancer patients (6%), compared with the values in the reference group (2.5%). These results were matched with those of the loss of heterozygosity (LOH) analysis. In conclusion, mutations were found mainly in more advanced histopathological and clinical stages of the disease and at the CIS stage (carcinoma in situ). It cannot be excluded that the observed polymorphism at codon 213 may be a predisposing factor for urinary bladder carcinoma development.

Application of multiplex FISH, CGH and MSSCP techniques for cytogenetic and molecular analysis of transitional cell carcinoma (TCC) cells in voided urine specimens.

Multiplex FISH (UroVysion), Comparative Genomic Hybridization (CGH), and Multitemperature Single-Strand Conformation Polymorphism (MSSCP) were applied for non-invasive diagnosis and prognosis of bladder cancer. The UroVysion test was positive in 80% of patients with pT1 and in 100% of patients with either pT2 or pT3 tumours. Tumours with pT3T4 stages were characterized by high numbers of chromosomal imbalances, detected by CGH. The mutation of the p53 gene was detected in 16% of patients, but only in those with pT2 or pT3 tumours.

Schimke immuno-osseous dysplasia: two cases.

We report two patients with Schimke immuno-osseous dysplasia (SIOD). SIOD is characterised by growth retardation, renal failure, spondylo-epiphyseal dysplasia, specific phenotype and defective cellular immunity. These two children demonstrated a bone dysplasia with characteristic radiographic appearances. We postulate that SIOD should be considered in all cases of growth failure with an unclassifiable bone dysplasia. Repeated urine tests for proteinuria could be helpful in reaching the correct diagnosis.

Syndromic dystelephalangy.

We report an 8-year-old boy with a distinctive facial phenotype, deformities of fingers and toes and limitation of knee movement of unknown etiology. He had a round face, a long nose, a thin upper lip, a small mouth and micrognathia. In spite of microcephaly and retarded speech development secondary to hearing loss his mental development was within normal limits. The most distinctive radiographic abnormality was hypoplasia of the distal end of the middle phalanges with radial deviation of the distal phalanges.