Connecting Contemporary Trauma Care to Florence Nightingale's Visionary Work.

The impact of Florence Nightingale's visionary work continues to influence the delivery of nursing care in the contemporary emergency department (ED). Her foundational work in the Crimean War resulted in data-based recommendations for using the environment to promote healing and wellness among sick and wounded British soldiers. She advocated for attention to environmental details, including ventilation, air, warmth, drainage, cleanliness, natural light, and low noise levels. These important environmental concepts play a significant role in the nursing management of trauma patients in today's ED. This article features an application of Nightingale's environmental concepts to a trauma patient case exemplar and demonstrates the enduring impact of her work for trauma patients who receive care in the ED.

Hyperlipidemia-induced metabolic changes in regulatory T cells result in altered function.

Regulatory T cells (Tregs) play a critical role in maintaining self-tolerance and controlling inflammation. However, physiologically relevant conditions that alter Treg function and drive disease pathogenesis are poorly understood and few have been defined. We have previously shown that induction of hyperlipidemia in mice results in changes in Tregs that reduce their function. Here, we set out to examine mechanisms by which hyperlipidemia alters Tregs. Using live-cell metabolic assays, we observed that induction of hyperlipidemia increases metabolism in Tregs but not conventional T cells. Increased metabolism resulted from preferential activation of the serine/threonine kinase Akt2 (PKB-ß). Expression of a constitutively activated form of Akt2 in CD4 T cells was sufficient to increase glycolysis in Tregs and drive changes in Treg subsets. Induction of hyperlipidemia did not alter Treg metabolism in mice lacking Akt2. Activation of Akt2 was sufficient to drive the production of inflammatory cytokines by Tregs. We suggest that hyperlipidemia alters Treg function through effects on metabolism via Akt2 activation thereby promoting plasticity and decreased function of FoxP3+ T cells.

Role of the Complement Pathway in Inflammatory Skin Diseases: A Focus on Hidradenitis Suppurativa.

Although the role of immune dysregulation in hidradenitis suppurativa (HS) has yet to be elucidated, recent studies identified several complement abnormalities in patients with HS. The complement system serves a critical role in the modulation of immune response and regulation of cutaneous commensal bacteria. Complement is implicated in several inflammatory skin diseases including systemic lupus erythematosus, angioedema, pemphigus, bullous pemphigoid, and HS. A model of HS pathogenesis is proposed, integrating the role of commensal bacteria, cutaneous immune responses, and complement dysregulation. The role of complement in disease pathogenesis has led to the development of novel anticomplement agents and clinical trials investigating the efficacy of such treatments in HS.

Hyperlipidemia and Allograft Rejection.

PURPOSE OF REVIEW: Advances in the development of immunosuppressive drug regimens have led to impressive survival rates in the year following organ transplantation. However rates of long-term graft dysfunction remain undesirably high. Recently it has been shown that co-morbidities in the patient population may affect graft survival. In mouse models, hyperlipidemia, a co-morbidity present in the majority of cardiac transplant patients, can significantly alter T cell responses to cardiac and skin allografts, and accelerate graft rejection. Here we review recent advances in our understanding of how alterations in lipids affect immune function and graft survival. RECENT FINDINGS: Recent work in humans has highlighted the importance of controlling low density lipoprotein (LDL) levels in transplant recipients to reduce the development of chronic allograft vasculopathy (CAV). High serum levels of cholesterol containing particles leads to extensive immune system changes to T cell proliferation, differentiation and suppression. Changes in B cell subsets, and the ability of antigen presenting cells to stimulate T cells in hyperlipidemic animals may also contribute to increased organ allograft rejection. SUMMARY: Cholesterol metabolism is a critical cellular pathway for proper control of immune cell homeostasis and activation. Increasing evidence in both human, and in mouse models shows that elevated levels of serum cholesterol can have profound impact on the immune system. Hyperlipidemia has been shown to increase T cell activation, alter the development of T helper subsets, increase the inflammatory capacity of antigen presenting cells (APC) and significantly accelerate graft rejection in several models.

Evaluation and treatment of the acutely injured worker.

The primary care NP has a significant opportunity to meet the special healthcare needs of the occupational community. While NPs routinely diagnose and treat workers, writing return-to-work restrictions can pose a challenge.

AFM studies of metal deposition: instantaneous nucleation and the growth of cobalt nanoparticles on boron-doped diamond electrodes.

In situ atomic force microscopy (AFM) is used to study the growth of cobalt nuclei on a boron doped diamond electrode under potentiostatic control. The rate of growth of the nuclei at the electrode surface is monitored using AFM as a function of time at different deposition potentials. The nucleation of cobalt nuclei is found to be "instantaneous" and the growth of the nuclei is shown to be kinetically rather than diffusionally controlled over periods of tens and hundreds of seconds. At very short times (<10 seconds) the kinetics of nucleation are apparent.

The detection of nitrate using in-situ copper nanoparticle deposition at a boron doped diamond electrode.

Electrochemical deposition from a 0.1 M sodium sulphate solution, containing Cu2+ (adjusted to pH 3 with hydrochloric acid) produced a well defined copper nanoparticle deposit on the surface of a boron doped diamond electrode. Changing conditions such as potential (-0.8, -1.0 and -1.2 V), time (5, 2 and 0.5 s) and concentration of Cu2+ (500, 250 and 100 microM) was found to give copper nanoparticles of varying size and particle density. The electrocatalytic properties of the copper surface towards nitrate reduction were explored. An in-situ copper nanoparticle production method was developed for the detection of nitrate; this involves electrodeposition, followed by linear sweep voltammetry for the reduction of nitrate and then application of a stripping potential to renew the electrode surface. The linear sweep was discovered to have homogenised the size of the nanoparticles but their number density was still dependant on the initial conditions of deposition. Some particles were still present at the surface after the stripping potential had been applied but repetitions of the procedure showed these did not have an effect on subsequent deposits. Optimisation of the method lead to applying a deposition potential of -0.8 V, at a BDD electrode for 5 s in a 0.1 M sodium sulphate solution (pH 3) containing 100 microM Cu2+ followed by a linear sweep at 1 V/s; this yielded a limit of detection of 1.5 microM nitrate. The analytical applicability of the technique was evaluated for nitrate detection in a natural mineral water sample and was found to agree well with that stated by the manufacturer.

4-Nitrobenzylamine partially intercalated into graphite powder and multiwalled carbon nanotubes: characterization using X-ray photoelectron spectroscopy and in situ atomic force microscopy.

We report the characterization of partial intercalation of 4-nitrobenzylamine (4-NBA) into edge-plane or edge-plane-like defect sites on the surface of both graphite powder and "bamboo-like" multiwalled carbon nanotubes (MWCNTs) using X-ray photoelectron spectroscopy (XPS). By comparing the XPS spectra of 4-NBA derivatized graphite powder and MWCNTs with that of graphite powder treated with benzylamine in a similar fashion, we conclude that benzylamine itself does not undergo partial intercalation. Using in situ atomic force microscopy, we are able to observe the partial intercalation of 4-NBA into an edge-plane-like "step" defect on the surface of a highly ordered pyrolytic graphite crystal in real time. Together these observations provide further evidence for the partial intercalation of 4-NBA and lead us to propose a new hypothesis to explain this phenomenon.

Electrochemical cell for surface analysis.

We present a simple cost-effective design for an HOPG electrode that is well suited to voltammetric experiments accompanied by surface analysis. The utility of the electrode is demonstrated by an AFM study on the morphology of electrodeposited MoO2 nanowires. The design can be applied to a wide range of electrode materials.

Fabrication, characterisation and voltammetric studies of gold amalgam nanoparticle modified electrodes.

The tabrication, characterisation, and electroanalytical application of gold and gold amalgam nanoparticles on glassy carbon electrodes is examined. Once the deposition parameters for gold nanoparticle electrodes were optimised, the analytical utility of the electrodes was examined in CrIII electroanalysis. It was found that gold nanoparticle modified (Au-NM) electrodes possess higher sensitivity than gold macroelectrodes. In addition, gold amalgam nanoparticle modified (AuHg-NM) electrodes were fabricated and characterised. The response of those electrodes was recorded in the presence of important environmental analytes (heavy metal cations). It was found AuHg-NM electrodes demonstrate a unique voltammetric behaviour and can be applied for electroanalysis when enhanced sensitivity is crucial.

Anodic stripping voltammetry of arsenic(III) using gold nanoparticle-modified electrodes.

A novel method for the detection of arsenic(III) in 1 M HCl at a gold nanoparticle-modified glassy carbon electrode has been developed. The gold nanoparticles were electrodeposited onto the glassy carbon electrode via a potential step from +1.055 to -0.045 V vs SCE for 15 s from 0.5 M H2SO4 containing 0.1 mM HAuCl4. The resulting electrode surfaces were characterized with both AFM and cyclic voltammetry. Anodic stripping voltammetry of arsenic(III) on the modified electrode was performed. After optimization, a LOD of 0.0096 ppb was obtained with LSV.

Sonoelectroanalysis: investigation of bismuth-film-modified glassy carbon electrodes.

Bismuth-modified glassy carbon electrodes have been investigated for their suitability in sonoelectroanalysis. The stability of the bismuth film to the application of ultrasound was assessed via voltammetric and atomic force microscopy (AFM) studies which revealed little ablation at powers up to an intensity of 130 W cm(-2) delivered from a 25-kHz sonic horn. Furthermore, bismuth-film-modified glassy carbon electrodes were evaluated for the sonoelectroanalytical quantification of zinc and cadmium. Detection limits of 2 x 10(-7) M and 6 x 10(-9) M respectively were found after a 60-s deposition time via an acoustically assisted deposition protocol.

An AFM Study of the Correlation of Lead Dioxide Electrocatalytic Activity with Observed Morphology.

PbO2 is widely employed as an electrocatalyst for anodic oxidation processes including the generation of oxygen and the degradation of various organic species in aqueous solution. However, despite extensive investigation, the precise mechanism of action remains obscure. In this paper we establish a previously unrecognized strong correlation between the morphology of the PbO2 deposits and their electrocatalytic activity. Cyclic voltammetric results are described for the electrodeposition of PbO2 on boron-doped diamond (BDD) electrodes from 2.5 mM solutions of lead(II) nitrate in nitric acid at pH values between approximately 0 and 7. A likely change in mechanism is observed around pH 4, consistent with the Pourbaix diagram of lead. The morphology of the PbO2 films is observed as a function of time and potential, using in situ AFM in each of the lead solutions. Information on the growth rates of the films is extracted, and the limitations of using AFM in such an application are discussed. It is shown that the deposit morphology depends strongly on the specific conditions used. The oxidation of a 100 mM glucose solution on electrodes modified by PbO2 deposition at a range of potentials and pH values is used as an indicator of the catalytic activity of the corresponding films, leading to the observation of the correlation between deposit morphology and catalytic activity mentioned above.

Cadmium detection via boron-doped diamond electrodes: surfactant inhibited stripping voltammetry.

The deposition of cadmium on boron-doped diamond is investigated with square-wave anodic stripping voltammetry. The system was investigated in quiescent conditions, in the presence of an acoustic field and then in the presence of the neutral surfactant Triton((R)) X-100. The effect of optimised insonation was to increase the sensitivity from 0.63 (under silent conditions) to 3.78muAmuM(-1) and to reduce the limit of detection by an order of magnitude from 10(-8) to 10(-9)M. Measurements with or without insonation were found to deteriorate in the presence of the surfactant. Studies using AFM and chronoamperometry showed that this was due to inhibition of the deposition of the metal. Comparative data obtained for analogous measurements for copper on glassy carbon in the presence of industrial effluent, which also leads to signal deterioration under silent but not insonated conditions, showed that for this case also it was the nucleation of copper rather than the metal dissolution which was adversely affected.