Electrical Impedance Spectroscopy Quantifies Skin Barrier Function in Organotypic In Vitro Epidermis Models.

3 D human epidermal equivalents (HEEs) are a state-of-the-art organotypic culture model in pre-clinical investigative dermatology and regulatory toxicology. Here, we investigated the utility of electrical impedance spectroscopy (EIS) for non-invasive measurement of HEE epidermal barrier function. Our setup comprised a custom-made lid fit with 12 electrode pairs aligned on the standard 24-transwell cell culture system. Serial EIS measurements for seven consecutive days did not impact epidermal morphology and readouts showed comparable trends to HEEs measured only once. We determined two frequency ranges in the resulting impedance spectra: a lower frequency range termed EISdiff correlated with keratinocyte terminal differentiation independent of epidermal thickness and a higher frequency range termed EISSC correlated with stratum corneum thickness. HEEs generated from CRISPR/Cas9 engineered keratinocytes that lack key differentiation genes FLG, TFAP2A, AHR or CLDN1 confirmed that keratinocyte terminal differentiation is the major parameter defining EISdiff. Exposure to pro-inflammatory psoriasis- or atopic dermatitis-associated cytokine cocktails lowered the expression of keratinocyte differentiation markers and reduced EISdiff. This cytokine-associated decrease in EISdiff was normalized after stimulation with therapeutic molecules. In conclusion, EIS provides a non-invasive system to consecutively and quantitatively assess HEE barrier function and to sensitively and objectively measure barrier development, defects and repair.

[Child psychiatric learning goals for general psychiatric training: a Delphi study]. / Leerdoelen over kinder- en jeugdpsychiatrie in de opleiding psychiatrie: een delphistudie.

BACKGROUND: The new Dutch training plan for psychiatrists puts more emphasis on life course psychiatry. Subsequently, adjustments in the educational program regarding child and adolescent psychiatric knowledge, skills and attitudes are needed. AIM: A broadly supported agreement and consensus on Dutch national learning objectives of education in child and adolescent psychiatry. METHOD: With a modified Delphi method, a set of preliminary learning objectives formulated by a working group of experts was presented to trainees (n = 9), adult psychiatrists (n = 12), child and adolescent psychiatrists (n = 17) and adult patients and their relatives (n = 15). In two rounds, the learning objectives were commented on, supplemented, scored for relevance and prioritized. RESULTS: Out of 27 original learning objectives, 20 were assessed as important or necessary by over 80% of the respondents (knowledge 7/9, skills 8/10, attitudes 5/8). Two learning objectives were rejected (less than 60% considered these to be important or necessary). Seven learning objectives were re-assessed in a second round as these were modified (5) or added (2). Four of them were rated as important or necessary by over 80% of participants. The following goals were most often prioritized: knowledge about healthy development and intergenerational issues; ability to make contact with children and families and to integrate protective and risk factors of the child and environment; and knowing one’s own limitations of child psychiatric themes. CONCLUSION: A Delphi study helped gain support from stakeholders for adjustments in training and education by creating consensus about child psychiatric learning goals for general psychiatric training.

Microfluidic desalination techniques and their potential applications.

In this review we discuss recent developments in the emerging research field of miniaturized desalination. Traditionally desalination is performed to convert salt water into potable water and research is focused on improving performance of large-scale desalination plants. Microfluidic desalination offers several new opportunities in comparison to macro-scale desalination, such as providing a platform to increase fundamental knowledge of ion transport on the nano- and microfluidic scale and new microfluidic sample preparation methods. This approach has also lead to the development of new desalination techniques, based on micro/nanofluidic ion-transport phenomena, which are potential candidates for up-scaling to (portable) drinking water devices. This review assesses microfluidic desalination techniques on their applications and is meant to contribute to further implementation of microfluidic desalination techniques in the lab-on-chip community.

Building capacity for nurse-led research.

AIM: To discuss factors that have influenced the development of research capacity among nurses in lower and middle-income countries (LMICs). BACKGROUND: Concerned health scientists have addressed the importance of building research capacity among health professionals. Strengthening capacity specifically among LMIC nurses has been infrequently discussed. Without the requisite educational preparation or an enabling environment for research, nurses are unlikely to either demand research capacity-building opportunities or initiate research examining nursing practice and health system challenges. METHODS: A scan was conducted of nine internationally funded research capacity-building initiatives to identify programme targeting and the proportion of nurse trainees. A literature review examined graduate and post-graduate training opportunities for LMIC nurses, and barriers and enablers to nurses' involvement in research. Informal consultations were held with nurse leaders in 15 LMICs and leaders of eight LMIC nursing organizations. FINDINGS: The scan found a generic targeting of health professionals with a very low percentage of nurse trainees. Programmes specifically targeting nurses did attract and prepare a significant number of nurses. Factors limiting nurses' involvement in research include hierarchies of power among disciplines, scarce resources, a lack of graduate and post-graduate education opportunities, few senior mentors, and prolonged underfunding of nursing research. CONCLUSIONS: Fully engaging LMIC nurses in health services research may yield pragmatic and evidence-informed service delivery and policy recommendations. Investments in supports for nursing research capacity may enrich global health policy effectiveness and improve quality of care.

Hyperventilation and anxiety: alcohol withdrawal symptoms decreasing with prolonged abstinence.

We previously presented evidence that hyperventilatory and anxiety symptoms are the result of physically dependent alcohol use rather than a premorbid condition. The purpose of the present study was to examine the effect of prolonged abstinence versus resumption of dependent drinking on those symptoms. Two questionnaires (a hyperventilation complaint checklist and Spielberger's Anxiety Inventory) were presented twice to 15 ss, once during an inpatient treatment and once after a median followup period of 17 months. Six ss were abstinent for the entire period, 3 were abstinent with 1 or 2 slips and 6 ss were drinking in a dependent way again for at least 6 months. In the abstinent or abstinent-with-slips group, a significant decrease over time in hyperventilatory symptoms and trait (but not state) anxiety could be found, whereas in the dependent drinking group there was a significant increase in hyperventilatory symptoms and state (but not trait) anxiety. An extended followup in 5 abstinent ss showed a continued decrease in those symptoms. These results provide further evidence for the hypothesis that hyperventilation and anxiety are part of a subacute alcohol withdrawal syndrome.

Hyperventilation, anxiety, craving for alcohol: a subacute alcohol withdrawal syndrome.

Hyperventilation leading to respiratory alkalosis is part of the acute alcohol withdrawal syndrome On the basis of clinical observations and a literature review on withdrawal symptoms the following was hypothesized: (a) hyperventilation is also part of a subacute alcohol withdrawal syndrome and (b) hyperventilation appears together with anxiety and craving for alcohol. These hypotheses were tested in a sample of 37 male alcoholic inpatients, abstinent for periods from several weeks to 9 months. Subjects were administered a questionnaire dealing with drinking history and craving for alcohol during abstinence, the Spielberger Anxiety Inventory and a hyperventilation complaint checklist. Subjects' disposition to hyperventilation was assessed during a physiological measurement session. Results show that hyperventilatory symptoms, anxiety and craving for alcohol appear together. Moreover, the severity of hyperventilatory and anxiety symptomatology is positively correlated with the duration of physically dependent alcohol use but not with the duration of excessive drinking per se, irrespective of age. These results corroborate the hypotheses outlined before.