Ethnic inequalities during clinical placement: A qualitative study of student nurses' experiences within the London National Health Service.

AIM: To understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups. DESIGN: A qualitative thematic analysis with an inductive approach. METHODS: Data from semi-structured interviews with 21 London (United Kingdom) hospital-based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement. RESULTS: Five main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as "ward culture") providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS. CONCLUSION: These initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity. IMPACT: Ward culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it.

Graphene woven fabric-polydimethylsiloxane piezoresistive films for smart multi-stimuli responses.

The outstanding properties of graphene, including its electromechanical property, could be engineered for wearable electronic sensor platforms. The tubular graphene weaved into a mesh or graphene woven fabrics (GWF) has been reported as one of the most sensitive materials for deformation detection, as well as a promising temperature sensor. Herein, we present the performance of our developed flexible, stretchable, and multiple sensitive sensors fabricated from GWF embedded in polydimethylsiloxane (PDMS) film substrate. The GWF/PDMS sensor shows a pressure sensitivity of 0.0142 kPa-1 in a wide linearity range of 0-20 kPa, an outstanding Gauge factor (GF) of 582 at a strain of 6.2 %, and a very high positive sensitivity of 0.0238 °C-1 in the temperature range of 25-80 °C. A practical application as a high sensitivity air pressure sensor able to measure low pressures (in the range of Pa to kPa) was also demonstrated. This sensor platform having desirable performance characteristics is an excellent candidate for wearable devices in the healthcare sector.

Race, ethnicity and COVID-19 vaccination: a qualitative study of UK healthcare staff.

OBJECTIVE: COVID-19-related inequities experienced by racial and ethnic minority groups including healthcare professionals mirror wider health inequities, which risk being perpetuated by lower uptake of vaccination. We aim to better understand lower uptake among racial and ethnic minority staff groups to inform initiatives to enhance uptake. DESIGN: Twenty-five semi-structured interviews were conducted (October 2020-January 2021) with UK-based healthcare staff. Data were inductively and thematically analysed. RESULTS: Vaccine decision-making processes were underpinned by an overarching theme, 'weighing up risks of harm against potential benefits to self and others'. Sub-themes included 'fear of harm', 'moral/ethical objections', 'potential benefits to self and others', 'information and misinformation', and 'institutional or workplace pressure'. We identified ways in which these were weighted more heavily towards vaccine hesitancy for racial and ethnic minority staff groups influenced by perceptions about institutional and structural discrimination. This included suspicions and fear around institutional pressure to be vaccinated, racial injustices in vaccine development and testing, religious or ethical concerns, and legitimacy and accessibility of vaccine messaging and communication. CONCLUSIONS: Drawing on a critical race perspective, we conclude that acknowledging historical and contemporary abuses of power is essential to avoid perpetuating and aggravating mistrust by de-contextualising hesitancy from the social processes affecting hesitancy, undermining efforts to increase vaccine uptake.

Fractal Design for Advancing the Performance of Chemoresistive Sensors.

The rapid advancement of internet of things (IoT)-enabled applications along with connected automation in sensing technologies is the heart of future intelligent systems. The probable applications have significant implications, from chemical process monitoring to agriculture, mining, space, wearable electronics, industrial manufacturing, smart cities, and point-of-care (PoC) diagnostics. Advancing sensor performance such as sensitivity to detect trace amounts (ppb-ppm) of analytes (gas/VOCs), selectivity, portability, and low cost is critical for many of these applications. These advancements are mainly achieved by selecting and optimizing sensing materials by their surface functionalization and/or structural optimization to achieve favorable transport characteristics or chemical binding/reaction sites. Surprisingly, the sensor geometry, shapes, and patterns were not considered as critical parameters, and most of these sensors were designed by following simple planar and interdigitated electrode geometry. In this study, we introduce a new bioinspired fractal approach to design chemoresistive sensors with fractal geometry, which grasp the architecture of fern leaves represented by the geometric group of space-filling curves of fractal patterns. These fractal sensors were printed by an extrusion process on a flexible substrate (PET) using specially formulated graphene ink as a sensing material, which provided significant enhancement of the active surface area to volume ratio and allowed high-resolution fractal patterning along with a reduced current transportation path. To demonstrate the advantages and influence of fractal geometry on sensor performance, here, three different kinds of sensors were fabricated based on different fractal geometrics (Sierpinski, Peano, and Hilbert), and the sensing performance was explored toward different VOC analytes (e.g., ethanol, methanol, and acetone). Among all these fractal-designed sensors including interdigitate sensors, the Hilbert-designed printed sensor shows enhanced sensing properties in terms of fast response time (6 s for 30 ppm), response value (14%), enhanced detection range (5-100 ppm), high selectivity, and low interference to humidity (up to RH 80%) for ethanol at room temperature (20 °C). Moreover, a significant improvement of this sensor performance was observed by applying the mechanical deformation (positive bending) technique. The practical application of this sensor was successfully demonstrated by monitoring food spoilage using a commercial box of strawberries as a model. Based on these presented results, this biofractal biomimetic VOC sensor is demonstrated for a prospective application in food monitoring.

Graphene ink for 3D extrusion micro printing of chemo-resistive sensing devices for volatile organic compound detection.

Printed electronic sensors offer a breakthrough in the availability of low-cost sensor devices for improving the quality of human life. Conductive ink is the core of printing technology and also one of the fastest growing sector among all ink industries. Among many developed conductive inks, graphene-based inks are especially recognized as very promising for future fabrication of devices due to their low cost, unique properties, and compatibility with various platforms such as plastics, textiles, and paper. The development of graphene ink formulations for achieving high conductivity and high resolution printing is highly realized in 2D inkjet printing. Unfortunately, the ongoing development of graphene inks is possibly hampered by the non-uniform particle size and structures (e.g., different shapes and number of layers), which adversely affect printing resolution, conductivity, adhesion, and structural integrity. This study presents an environmentally sustainable route to produce graphene inks specifically designed for 3D extrusion-printing. The application of the prepared ink is demonstrated by mask-free automatic patterning of sensing devices for the detection of volatile organic compounds (VOCs). The sensing devices fabricated with this new ink display high-resolution patterning (average height/thickness of ∼12 µm) and a 10-fold improvement in the surface area/volume (SA/V) ratio compared to a conventional drop casting method. The extrusion printed sensors show enhanced sensing characteristics in terms of sensitivity and selectivity towards trace amount of VOC (e.g. 5 ppm ethanol) at room temperature (20 °C), which highlights that our method has highly promising potential in graphene printing technology for sensing applications.

Functional inks and extrusion-based 3D printing of 2D materials: a review of current research and applications.

Graphene and related 2D materials offer an ideal platform for next generation disruptive technologies and in particular the potential to produce printed electronic devices with low cost and high throughput. Interest in the use of 2D materials to create functional inks has exponentially increased in recent years with the development of new ink formulations linked with effective printing techniques, including screen, gravure, inkjet and extrusion-based printing towards low-cost device manufacturing. Exfoliated, solution-processed 2D materials formulated into inks permits additive patterning onto both rigid and conformable substrates for printed device design with high-speed, large-scale and cost-effective manufacturing. Each printing technique has some sort of clear advantages over others that requires characteristic ink formulations according to their individual operational principles. Among them, the extrusion-based 3D printing technique has attracted heightened interest due to its ability to create three-dimensional (3D) architectures with increased surface area facilitating the design of a new generation of 3D devices suitable for a wide variety of applications. There still remain several challenges in the development of 2D material ink technologies for extrusion printing which must be resolved prior to their translation into large-scale device production. This comprehensive review presents the current progress on ink formulations with 2D materials and their broad practical applications for printed energy storage devices and sensors. Finally, an outline of the challenges and outlook for extrusion-based 3D printing inks and their place in the future printed devices ecosystem is presented.

Norborn-2-en-7-ones as physiologically-triggered carbon monoxide-releasing prodrugs.

A prodrug strategy for the release of the gasotransmitter CO at physiological pH, based upon 3a-bromo-norborn-2-en-7-one Diels-Alder cycloadducts of 2-bromomaleimides and 2,5-dimethyl-3,4-diphenylcyclopentadienone has been developed. Examples possessing protonated amine and diamine groups showed good water solubility and thermal stability. Half-lives for CO-release in TRIS-sucrose buffer at pH 7.4 ranged from 19 to 75 min at 37 °C and 31 to 32 h at 4 °C. Bioavailability in rats was demonstrated by oral gavage and oCOm-21 showed a dose dependent vasorelaxant effect in pre-contracted rat aortic rings with an EC50 of 1.6 ± 0.9 µM. Increased intracellular CO levels following oCOm-21 exposure were confirmed using a CO specific fluorescent probe.

Assessing the Mitochondrial Membrane Potential in Cells and In Vivo using Targeted Click Chemistry and Mass Spectrometry.

The mitochondrial membrane potential (Δψm) is a major determinant and indicator of cell fate, but it is not possible to assess small changes in Δψm within cells or in vivo. To overcome this, we developed an approach that utilizes two mitochondria-targeted probes each containing a triphenylphosphonium (TPP) lipophilic cation that drives their accumulation in response to Δψm and the plasma membrane potential (Δψp). One probe contains an azido moiety and the other a cyclooctyne, which react together in a concentration-dependent manner by "click" chemistry to form MitoClick. As the mitochondrial accumulation of both probes depends exponentially on Δψm and Δψp, the rate of MitoClick formation is exquisitely sensitive to small changes in these potentials. MitoClick accumulation can then be quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). This approach enables assessment of subtle changes in membrane potentials within cells and in the mouse heart in vivo.

The CYP2B6*6 allele significantly alters the N-demethylation of ketamine enantiomers in vitro.

Ketamine is primarily metabolized to norketamine by hepatic CYP2B6 and CYP3A4-mediated N-demethylation. However, the relative contribution from each enzyme remains controversial. The CYP2B6*6 allele is associated with reduced enzyme expression and activity that may lead to interindividual variability in ketamine metabolism. We examined the N-demethylation of individual ketamine enantiomers using human liver microsomes (HLMs) genotyped for the CYP2B6*6 allele, insect cell-expressed recombinant CYP2B6 and CYP3A4 enzymes, and COS-1 cell-expressed recombinant CYP2B6.1 and CYP2B6.6 protein variant. Effects of CYP-selective inhibitors on norketamine formation were also determined in HLMs. The two-enzyme Michaelis-Menten model best fitted the HLM kinetic data. The Michaelis-Menten constants (K(m)) for the high-affinity enzyme and the low-affinity enzyme were similar to those for the expressed CYP2B6 and CYP3A4, respectively. The intrinsic clearance for both ketamine enantiomers by the high-affinity enzyme in HLMs with CYP2B6*1/*1 genotype were at least 2-fold and 6-fold higher, respectively, than those for CYP2B6*1/*6 genotype and CYP2B6*6/*6 genotype. The V(max) and K(m) values for CYP2B6.1 were approximately 160 and 70% of those for CYP2B6.6, respectively. N,N'N'-triethylenethiophosphoramide (thioTEPA) (CYP2B6 inhibitor, 25 µM) and the monoclonal antibody against CYP2B6 but not troleandomycin (CYP3A4 inhibitor, 25 µM) or the monoclonal antibody against CYP3A4 inhibited ketamine N-demethylation at clinically relevant concentrations. The degree of inhibition was significantly reduced in HLMs with the CYP2B6*6 allele (gene-dose P < 0.05). These results indicate a major role of CYP2B6 in ketamine N-demethylation in vitro and a significant impact of the CYP2B6*6 allele on enzyme-ketamine binding and catalytic activity.

A new metabotropic glutamate receptor agonist with in vivo anti-allodynic activity.

As part of the vital search towards improved therapeutic agents for the treatment of neuropathic pain, the central nervous system glutamate receptors have become a major focus of research. Outlined herein are the syntheses of two new biologically active 3'-cycloalkyl-substituted carboxycyclopropylglycines, utilizing novel synthetic chemistry. The reaction between substituted 1,2-dioxines and an aminophosphonate furnished the cyclopropane core in a single step with all required stereochemistry of pendant groups. In vitro binding assays at metabotropic glutamate receptors revealed selective activity. In vivo testing in a rodent model of neuropathic pain indicated one amino acid significantly and dose-dependently decreased mechanical allodynia.