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Too old for a paediatric emergency department? It’s complex
No full textBackground: In Ireland, the paediatric emergency department (PED) is tasked with acute healthcare provision to children and adolescents under 16 years of age. The population > 15 years attending the PED remains undescribed. Aims: The objective of the study is to describe the presentations of patients > 15 years to the PED of a national tertiary academic paediatric hospital. Methods: A retrospective review of electronic records identifying all patients (> 15 years) who presented from January 2014 to December 2015. Patient demographics, presenting complaint, diagnosis, treatment and disposition were recorded. Results: A total of 71,082 patients attended during the study period; of whom, 426 (0.6%) patients were aged 16 to 61 years. Over half were identified as having clearly defined chronic complex conditions. Three hundred and forty-five (89%) patients were known to the hospital paediatric services and under the care of specialist with 131 (34%) patients admitted locally, all of whom had chronic complex conditions (CCC). There was a total of 44 (11%) patients who presented to the PED with de novo issues and had a variety of acute presenting complaints with minor injuries, syncope and chest pain being most common. Conclusion: This is the first Irish study demonstrating a significant population (> 15 years) with medical complexity that requires a suite of services in a paediatric hospital which is accessed in an unscheduled manner through an emergency department. We recommend further research to describe paediatric CCC attending Irish emergency and hospital services
Genomic epidemiological analysis of SARS-CoV-2 household transmission
No full textFamily clusters have contributed significantly to the onward spread of SARS-CoV-2. However, the dynamics of viral transmission in this setting remain incompletely understood. We describe the clinical and viral-phylogenetic characteristics of a family cluster of SARS-CoV-2 infections with a high attack rate, and explore how whole-genome sequencing (WGS) can inform outbreak investigations in this context. In this cluster, the first symptomatic case was a 22-month-old infant who developed rhinorrhoea and sneezing 2 days prior to attending a family gathering. Subsequently, seven family members in attendance at this event were diagnosed with SARS-CoV-2 infections, including the infant described. WGS revealed indistinguishable SARS-CoV-2 genomes recovered from the adults at the gathering, which were closely related genetically to B.1 lineage viruses circulating in the local community. However, a divergent viral sub-lineage was recovered from the infant and another child, each harbouring a distinguishing spike substitution (N30S). This suggested that the infant was unlikely to be the primary case, despite displaying symptoms first, and additional analysis of her nasopharyngeal swab revealed a picornavirus co-infection to account for her early symptoms. Our findings demonstrate how WGS can elucidate the transmission dynamics of SARS-CoV-2 infections within household clusters and provide useful information to support outbreak investigations. Additionally, our description of SARS-CoV-2 viral lineages and notable variants circulating in Ireland to date provides an important genomic-epidemiological baseline in the context of vaccine introduction
Influence of chaperone-like activity of caseinomacropeptide on the gelation behaviour of whey proteins at pH 6.4 and 7.2.
No full textThe effect of caseinomacropeptide (CMP) on the heat-induced denaturation and gelation of whey proteins (2.5–10%, w/v) at pH 6.4 and 7.2, at a whey protein:CMP ratio of 1:0.9 (w/w), was investigated using differential scanning calorimetry (DSC), oscillatory rheology (90 °C for 20 min) and confocal microscopy. Greater frequency-dependence in the presence of CMP suggested that the repulsive interactions between CMP and the whey proteins affected the network generated by the non-heated whey protein samples. At pH 6.4 or 7.2, CMP increased the temperature of denaturation of β-lactoglobulin by up to 3 °C and increased the gelation temperature by up to 7 °C. The inclusion of CMP strongly affected the structure of the heat-induced whey protein gels, resulting in a finer stranded structure at pH 6.4 and 7.2. The presence of CMP combined with a lower heating rate (2 °C/min) prevented the formation of a solid gel of whey proteins after heating for 20 min at 90 °C and at pH 7.2. These results show the potential of CMP for control of whey protein denaturation and gelation.Dairy Levy Research Trus
Improving the chromatographic selectivity of β-lactam residue analysis in milk using phenyl-column chemistry prior to detection by tandem mass spectrometry
No full textAnalyte isobaric interferences can limit the development of a comprehensive analytical method for the quantitative liquid chromatography-tandem mass spectrometry profiling of an important cohort of veterinary drugs. In this work, a selective chromatographic separation was developed for the analysis of 32 β-lactam antibiotic residues (12 penicillins, 14 cephalosporins, five carbapenems and faropenem) in milk samples. A range of analytical columns with different stationary phases and mobile phases were evaluated for retention and separation of the β-lactam compounds. Results showed that, among the columns tested, only phenyl-hexyl could adequately separate ampicillin from cephalexin and amoxicillin from cefadroxil, which had shown isobaric interferences on a number of stationary phases. Chromatography was performed using a water/acetonitrile binary gradient with formic acid and ammonium acetate. The β-lactam residues were extracted from the milk samples using a water:acetonitrile solution and purified by C18 dispersive solid-phase extraction (d-SPE) clean-up, followed by concentration under nitrogen and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) determination. Analytes were monitored in positive electrospray ionisation mode (ESI(+)). Possible interfering matrix effects were overcome by using 13 internal standards. The method was fully validated according to 2002/657/EC guidelines, showing satisfactory performance characteristics. Under within-laboratory reproducibility conditions, trueness and precision ranged from 91 to 130% and from 1.4 to 38.6%, respectively. Decision limits (CCα) were in the range 2.1–133 μg kg−1. Limits of detection (LODs) and quantitation (LOQs) ranged between 0.0090 and 1.5 μg kg−1 and from 0.030 to 5.0 μg kg−1, respectively.The FIRM programme administered by the Irish Department of Agriculture, Food and the Marin
Seaweed Components as Potential Modulators of the Gut Microbiota
No full textMacroalgae, or seaweeds, are a rich source of components which may exert beneficial effects on the mammalian gut microbiota through the enhancement of bacterial diversity and abundance. An imbalance of gut bacteria has been linked to the development of disorders such as inflammatory bowel disease, immunodeficiency, hypertension, type-2-diabetes, obesity, and cancer. This review outlines current knowledge from in vitro and in vivo studies concerning the potential therapeutic application of seaweed-derived polysaccharides, polyphenols and peptides to modulate the gut microbiota through diet. Polysaccharides such as fucoidan, laminarin, alginate, ulvan and porphyran are unique to seaweeds. Several studies have shown their potential to act as prebiotics and to positively modulate the gut microbiota. Prebiotics enhance bacterial populations and often their production of short chain fatty acids, which are the energy source for gastrointestinal epithelial cells, provide protection against pathogens, influence immunomodulation, and induce apoptosis of colon cancer cells. The oral bioaccessibility and bioavailability of seaweed components is also discussed, including the advantages and limitations of static and dynamic in vitro gastrointestinal models versus ex vivo and in vivo methods. Seaweed bioactives show potential for use in prevention and, in some instances, treatment of human disease. However, it is also necessary to confirm these potential, therapeutic effects in large-scale clinical trials. Where possible, we have cited information concerning these trialsH2020 Marie Skłodowska-Curie Action
The impact of the COVID-19 pandemic and its related restrictions on people with pre-existent mental health conditions: A scoping review
No full textContext: Globally, governments have introduced a variety of public health measures including restrictions and reducing face-to-face contact, to control the spread of COVID-19. This has implications for mental health services in terms of support and treatment for vulnerable groups such as people with pre-existent mental health conditions. However, there is limited evidence of the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. Objectives: To identify the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions.
Methods: A scoping review of the literature was employed. Eight electronic databases (PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL, Scopus, Academic Search Complete) were searched and 2566 papers identified. 30 papers met the criteria for this review and findings were summarised under three key review
questions. Results: COVID-19 and its related restrictions have had a notable effect on people with pre-existent mental health conditions. Public health restrictions have contributed to increased levels of social isolation, loneliness, and reduced opportunities for people to connect with others. Reduced access to health services and treatments has
compounded matters for those seeking support. Exacerbation and deterioration of symptoms are commonly reported and can lead to greater susceptibility to COVID-19 infection. Implications: The importance of proactive planning, alternative accessible healthcare services and supports for vulnerable and at-risk groups is illuminated. Increased monitoring, early intervention and individually tailored care strategies are advocated. Recommendations revolve around the the need for enhanced provision of remote support strategies facilitated using technology enhanced resources
Embedding sustainability in engineering education through interactive industrial design case studies
No full textThe need for the integration of industrial concepts and applications of sustainability in engineering education is a priority for universities and especially for engineering courses. To deliver the concepts and benefits of sustainable engineering design to students requires something more than just a theoretical overview. The use of case studies in engineering education is well established and a mature concept. The scope and criticality of sustainable development is increasingly complex and diverse and continues to change and adapt as the climate crises deepens. The biotechnology industry is perhaps the youngest of all of the process industries and is changing and adapting rapidly. Combine these two changing dynamics and the result is a compelling argument for interactive design case studies. The design of a manufacturing process within the biopharmaceutical industry is based on various criteria such as capital investment, operating costs, process reliability and safety with an overarching focus on patient safety. While environmental impact and sustainability is a critical area from a global perspective, it has not been a key consideration within the industry with relatively little research into the environmental impact of adopting different processes and technologies. There is a growing demand for multiproduct, flexible facilities with approaches such as modular strategies facilitating easy adaptation for different processes. This places an increasing emphasis on support services such as buffer preparation, where overheads are increasing and bottlenecks are developing. The supply of buffer solutions in particular, accounts for a large proportion of a facility’s footprint, labour, equipment and operating costs. To alleviate the potential bottlenecks, reduce the impact on capital and operational expenditure and improve sustainability, alternative philosophies for buffer management must be considered. Buffer preparation offers an ideal opportunity for collaboration with case studies as it represents a common problem within the industry in a non-competitive space, which has a clear demand for fresh thinking. While there are significant variations in core process technology, buffer preparation remains a key aspect of facility design across differing modalities. This research aims to demonstrate the benefit of exploring the industrial sustainability design space in conjunction with third level engineering education. This synergy with utilise Interactive Design Sessions utilising approaches such as Finite Capacity Analysis to demonstrate the environmental impact of operational strategy and technology utilisation (such as Single Use Technology and inline buffer preparation) on buffer preparation within the biopharmaceutical industry, highlighting the synergy between more sustainable production and a reduction in the cost of manufacturing
Ultrasonic treatment: A cohort review on bioactive compounds, allergens and physico-chemical properties of food
No full textImplementation of ultrasonic for the extraction of bioactive compounds and retention of physico-chemical properties is an important technology. This technology applies physical and chemical phenomena for the extraction of compounds. Ultrasonic assisted extraction causes less damaging effect on quality properties of food as compared to the conventional extraction technique. The present review article focuses on the degradation of various bioactive compounds as a result of ultra-sonication which include vitamins, carotenoids and phenolic compounds. This review article also discusses the influence of ultrasonic extraction on the physico-chemical properties of extracted food products. In addition, the paper explores the effect of ultrasonication on food allergenicity through changes in solubility, hydrophobicity, molecular weight as well as conformational changes
of the allergens, a direct result of increase in temperature and pressure during cavitation proces
Engineering accreditation objectives and their relationship to the quality assurance standards for engineering education programmes in Ireland
No full textAll programmes of study in Institutes of Technology in Ireland are subjected to internal programmatic review in five yearly cycles to ensure that the education programmes meet the quality assurance standards and are fit for purpose. In addition engineering and construction programmes undergo voluntary external accreditation by their respective professional bodies. Both processes differ in their focus and intent and the preparation required by the programme teams and managers. The two processes emphasise different aspects of engineering education. From the research literature, it has emerged that these assessment types are used worldwide, in varying ways and in regular cycles, for the quality assurance of engineering education programmes. Both the programmatic review and accreditation processes have evolved and diverged over time. Engineers Ireland has formally accredited all University and Institutes of Technology engineering programmes in Ireland since 1982. Engineering education programmes which satisfy the appropriate criteria laid down in the Engineers Ireland accreditation documents are deemed to meet the education standard required of individuals seeking one of the registered titles of Chartered Engineer, Associate Engineer and Engineering Technician. The Engineers Ireland accreditation process is consistent with international best practice and this is verified by their inclusion in international mutual recognition agreements. Significant consultation has taken place with the gatekeepers of these processes which includes the Registrars and Heads of Faculty in Higher Education Institutions, Quality and Qualifications Ireland (QQI) and the Registrar of Engineers Ireland. Incorporation of the programmatic review and accreditation processes into a single quality assurance process has long been an ambition of these gatekeepers. To achieve this ambition, it is imperative to determine whether it is possible to align the objectives of both processes. Twenty four triangulation documents were prepared comparing the QQI Engineering Award Standards, the QQI Professional Award Type Descriptors and the Engineers Ireland Accreditation Criteria. This allowed for comparison across the three engineering professional titles, their equivalent Irish National Framework of Qualifications levels for the three quality strands of knowledge, skill and competence and the five sub- strands of Mathematics and Sciences, Design and Development, Information Technology, Business Context and Engineering Practice. Even though there are differences in wording between the standards, there is over ninety percent alignment between all three sets of objectives in terms of their intent
What works? Sustainability grand challenges in engineering curricula via experiential learning
No full textToday’s complex global problems necessitate engineering solutions that not only consider sustainability, but include elements of design and creativity. Unfortunately, many engineering programs do not train students to think in terms of multiple contexts and at various scales. We often constrain students’ creativity to think within the narrow parameters of their specialization. Engineering educators face a difficult task of training students with both technical competencies and sustainability consciousness to tackle 21st century challenges. If we are to positively contribute to society, then we need to fundamentally change the way scientists, social scientists, and engineers are educated (Bielefeldt 2013). Two successful models for implementing sustainability grand challenges into engineering curricula have emerged in practice and in literature: stand-alone courses versus modules that are integrated into many courses. Engineering programs implement the stand-alone course-based model by establishing one to two distinct courses designed to address sustainability grand challenges and design in depth. One example of this is senior design. Conversely, engineering programs implement the modular-based model by integrating sustainability grand challenges and design throughout a host of existing courses and weave student exposure throughout the curriculum. These modules can be via ready-made modules, but more often than not faculty develop their own modules. The goal of this research was to evaluate the two models for implementing sustainability and to provide succinct recommendations and lessons learned for engineering programs tasked with integrating sustainability into their curricula. We review the implementation results of three sustainability courses, fourteen sustainability-themed modules, and senior design. We track progress towards responding to ABET Program Criterion related to sustainability and Civil Engineering Body of Knowledge 2nd edition (BOK2) Outcome 10: Sustainability. Results compare outcomes of students’ senior design project from universities implementing the two different approaches. And finally, we present the results of a formative and summative surveys of hundreds of students who participated in classes implemented throughout the project as well as faculty perceptions and barriers to implementation