An Ultra-clean Multilayer Apparatus for Collecting Size Fractionated Marine Plankton and Suspended Particles.

The distributions of many trace elements in the ocean are strongly associated with the growth, death, and re-mineralization of marine plankton and those of suspended/sinking particles. Here, we present an all plastic (Polypropylene and Polycarbonate), multi-layer filtration system for collection of suspended particulate matter (SPM) at sea. This ultra-clean sampling device has been designed and developed specifically for trace element studies. Meticulous selection of all non-metallic materials and utilization of an in-line flow-through procedure minimizes any possible metal contamination during sampling. This system has been successfully tested and tweaked for determining trace metals (e.g., Fe, Al, Mn, Cd, Cu, Ni) on particles of varying size in coastal and open ocean waters. Results from the South China Sea at the South East Asia Time-Series (SEATS) station indicate that diurnal variations and spatial distribution of plankton in the euphotic zone can be easily resolved and recognized. Chemical analysis of size-fractionated particles in surface waters of the Taiwan Strait suggests that the larger particles (>153 µm) were mostly biologically derived, while the smaller particles (10 - 63 µm) were mostly composed of inorganic matter. Apart from Cd, the concentrations of metals (Fe, Al, Mn, Cu, Ni) decreased with increasing size.

A retrospective descriptive analysis of patient adherence to dabigatran at a large academic medical center.

BACKGROUND: Clinical trials evaluating the efficacy of dabigatran followed a very strict protocol, which included close monitoring and follow-up. Patients followed in this controlled environment had an average medication possession ratio (MPR) greater than 0.95. However, very few studies have evaluated patient adherence to dabigatran in a real-world setting. Other studies of chronic medications indicate patients are not reliably adherent to twice daily regimens. Adherence to therapy is particularly important for direct thrombin inhibitors because there may be a risk of increased thromboembolic events associated with poor adherence to these agents.  OBJECTIVE: To identify the MPR for patients prescribed dabigatran at a large academic medical center and affiliated clinics.  METHODS: This retrospective descriptive study evaluated the MPR for patients prescribed dabigatran between January 1, 2012, and December 31, 2012. Patients included in this study had to receive dabigatran for a minimum of 3 months, have a primary care physician or cardiologist at the medical center or affiliated clinics, and must not use a mail order pharmacy. Patient MPR was calculated based on prescriptions picked up from the patient. RESULTS: After screening 400 patients, 159 patients met eligibility criteria. The mean MPR for the patients in this study was 0.63. Overall, 43% of the patients had an MPR of less than 0.80, and the mean MPR for this subgroup was 0.39 ± 0.27; 57% of the study population had an MPR of 0.80 or higher, with a mean MPR of 0.94 ± 0.08. There was a significantly higher proportion of men (67.7%, P = 0.0112) and a larger number of "as needed medications" prescribed (1.73 vs. 0.86, P = 0.0039) in patients with an MPR less than 0.80. There were 5 patients hospitalized during the study period (3 for bleeding, 1 for confusion, and 1 death not related to dabigatran therapy).  CONCLUSIONS: The relatively low mean MPR seen in this study may indicate that there is a need for improved anticoagulation services and follow-up for patients taking dabigatran.

In vivo analysis of trapeziometacarpal joint arthrokinematics during multi-directional thumb motions.

BACKGROUND: The investigation of the joint arthrokinematics of the trapeziometacarpal joint is critical to comprehend the causative mechanism underlying this common form of osteoarthritis. Therefore, the purpose of this study is to evaluate the arthrokinematics of the trapeziometacarpal joint during thumb postures in vivo. METHODS: Fifteen healthy participants were enrolled in this study. Static computed tomography images of the 1st metacarpal bone and trapezium were taken at specific thumb postures during thumb flexion-extension, abduction-adduction, and circumduction motions. Images were analyzed to examine the joint gliding, expressed as displacement of the centroid of the articular surface of the 1st metacarpal bone, relative to the trapezium. The gliding ratio, defined as joint gliding in each direction normalized to the dimension of the trapezium joint surface in the given direction, was computed and compared between different thumb motions. FINDINGS: The results indicate that thumb motions influenced joint gliding. The centroids of the articular surface of the 1st metacarpal bone were primarily located at the central and dorsal-radial regions while executing these motions. The maximum joint gliding of the 1st metacarpal bone occurred in the radial-ulnar direction when performing abduction-adduction, and in the dorsal-volar direction while performing flexion-extension and circumduction, with the gliding ratio values of 42.35%, 51.65%, and 51.85%, respectively. INTERPRETATION: Activities that involved abduction-adduction in the trapeziometacarpal joint caused greater joint gliding in the ulnar-radial direction, while flexion-extension resulted in greater joint gliding in the dorsal-volar and distal-proximal directions. Understanding normal joint kinematics in vivo may provide insights into the possible mechanism leading to osteoarthritis of the trapeziometacarpal joint, and help to improve the design of implants.