Parallel Analysis Research Articles

Accelerating adverse pregnancy outcomes research amidst rising medication use: parallel retrospective cohort analyses for signal prioritization

BackgroundPregnant women are significantly underrepresented in clinical trials, yet most of them take medication during pregnancy despite the limited safety data. The objective of this study was to characterize medication use during pregnancy and apply propensity score matching method at scale on patient records to accelerate and prioritize the drug effect signal detection associated with the risk of preterm birth and other adverse pregnancy outcomes.MethodsThis was a retrospective study on continuously enrolled women who delivered live births between 2013/01/01 and 2022/12/31 (n = 365,075) at Providence St. Joseph Health. Our exposures of interest were all outpatient medications prescribed during pregnancy. We limited our analyses to medication that met the minimal sample size (n = 600). The primary outcome of interest was preterm birth. Secondary outcomes of interest were small for gestational age and low birth weight. We used propensity score matching at scale to evaluate the risk of these adverse pregnancy outcomes associated with drug exposure after adjusting for demographics, pregnancy characteristics, and comorbidities.ResultsThe total medication prescription rate increased from 58.5 to 75.3% (P < 0.0001) from 2013 to 2022. The prevalence rate of preterm birth was 7.7%. One hundred seventy-five out of 1329 prenatally prescribed outpatient medications met the minimum sample size. We identified 58 medications statistically significantly associated with the risk of preterm birth (P ≤ 0.1; decreased: 12, increased: 46).ConclusionsMost pregnant women are prescribed medication during pregnancy. This highlights the need to utilize existing real-world data to enhance our knowledge of the safety of medications in pregnancy. We narrowed down from 1329 to 58 medications that showed statistically significant association with the risk of preterm birth even after addressing numerous covariates through propensity score matching. This data-driven approach demonstrated that multiple testable hypotheses in pregnancy pharmacology can be prioritized at scale and lays the foundation for application in other pregnancy outcomes.

3D Fluorescence Spectroscopy Combined With Chemometrics as a Tool for Control of Imprinted Protein Purification From Template Molecules

ABSTRACTImprinted proteins (IPs) are promising alternatives to natural recognition systems, such as biological receptors or antibodies. One of the crucial stages during development of IPs is removal of the template molecules from its complex with the protein. In this study, bovine serum albumin was imprinted in the presence of 4‐hydroxycoumarin (4‐HC); purification of IPs were carried out by dialysis, and fluorescence 3D spectroscopy was used to monitor the IP purification process. Excitation–emission matrix (EEM) was further investigated via several chemometric algorithms (principal component analysis [PCA], parallel factor analysis [PARAFAC], and independent components analysis [ICA]). We found that the models using PARAFAC and ICA worked better than those of PCA. It was shown that PARAFAC and ICA analyses allow not only to recognize IP sample with signal close to nonimprinted protein, but also to provide recommendations on the optimal dialysis time.

How Can the Coping Strategies Mediate the Relationship Among COVID-19 Stress, Depression, and Anxiety?

The coronavirus disease-2019 (COVID-19) pandemic has had a severe impact on mental health. To explore the underlying mechanisms that influence mental health, a critical question is whether different types of coping strategies may mediate the relationships between COVID-19 related stress and mental health. Recruited between October 19 and 24, 2021, a total of 500 participants aged 20 to 69 years completed an online survey to evaluate the COVID-19 stress, coping orientation, depression and state anxiety. The period corresponded to the highest level of COVID-19 restrictions (level 4) immediately before the adjusted restriction to level 3. Parallel mediation analyses were conducted using structural equation modeling. Distinct mediation effects of the COVID-19 stress (i.e., fear of infection, difficulties of social distancing, anger toward others) through three types of coping strategies (i.e., functional, dysfunctional, seeking support) were found. Fear of infection was likely to be related to functional coping and dysfunctional coping. Social distancing model indicated dysfunctional coping and seeking support, while anger toward others model was associated with functional coping and seeking support. The results highlight the different relationships between COVID-19 stress and mental health coping strategies. The identification of these mediation pathways offers guidance for designing effective interventions and support systems to promote psychological well-being during challenging times like the COVID-19 pandemic.

Upside-Down Adsorption: The Counterintuitive Influences of Surface Entropy and Surface Hydroxyl Density on Hydrogen Spillover.

Although hydrogen spillover is often invoked to explain anomalies in catalysis, spillover remains a poorly understood phenomenon. Hydrogen spillover (H*) is best described as highly mobile H atom equivalents that arise when H2 migrates from a metal nanoparticle to an oxide or carbon support. In the 60 years since its discovery, few methods have become available to quantify or characterize H*-support interactions. We recently showed in situ infrared spectroscopy and volumetric chemisorption can quantify reversible H2 adsorption on Au/TiO2 catalysts, where adsorbed hydrogen exists as H* and interacts with titania surface hydroxyl (TiOH) groups. Here, we report parallel thermogravimetric analysis and Fourier transform infrared spectroscopy methods for systematically manipulating the surface TiOH density. We examine the role of surface hydroxylation on spillover thermodynamics using van't Hoff studies to determine apparent adsorption enthalpies and entropies at constant H* coverage, which is necessary to maintain constant H* translational entropy. Although surface TiOH groups are the likely adsorption sites, the data show removing hydroxyl groups increases spillover. This surprising finding─that adsorption increases as the adsorption site density decreases─is associated with improved thermodynamics on dehydroxylated surfaces. A strong adsorption enthalpy-entropy correlation implicates the changing surface entropy of the titania support itself (i.e., an initial state effect) is deeply intertwined with the H* configurational entropy. These effects are surprising and should apply to all low-coverage adsorbates where entropy terms dominate more traditional enthalpic considerations. Moreover, this study points toward a kinetic test for invoking spillover in a reaction mechanism: namely, in situ dehydroxylation should enhance spillover processes.

Measuring the dynamic balance of integration and segregation underlying consciousness, anesthesia, and sleep in humans

Consciousness requires a dynamic balance of integration and segregation in brain networks. We report an fMRI-based metric, the integration-segregation difference (ISD), which captures two key network properties: network efficiency (integration) and clustering (segregation). With this metric, we quantify brain state transitions from conscious wakefulness to unresponsiveness induced by the anesthetic propofol. The observed changes in ISD suggest a profound shift towards the segregation of brain networks during anesthesia. A common unimodal-transmodal sequence of disintegration and reintegration occurs in brain networks during, respectively, loss and return of responsiveness. Machine learning models using integration and segregation data accurately identify awake vs. unresponsive states and their transitions. Metastability (dynamic recurrence of non-equilibrium transient states) is more effectively explained by integration, while complexity (diversity of neural activity) is more closely linked with segregation. A parallel analysis of sleep states produces similar findings. Our results demonstrate that the ISD reliably indexes states of consciousness.

Examining Retention Methods in Factor Analysis: A Comparison of Polychoric and Pearson Correlations for Categorical and Continuous Data.

In the last two decade, it has become clear that retention methods must utilize polychoric correlation instead of Pearson correlation to eliminate drawbacks such as underestimation of the magnitude of the relationship between latent variables that result in spurious findings (Bernstein &amp; Teng, 1989). In the present study, the literature review will be examined and compared using Monte Carlo simulation to determine the most parsimonious method of retention for categorical data. With continuous variables, the majority of researchers still implement Cattell’s scree test (Henson &amp; Roberts, 2006) and Kaiser-Guttman-1 rule (Velicer et al., 2000), because these procedures are the default in popular statistical packages, such as SPSS and SAS. The present study will examine two of the most accurate methods: MAP (Minimum Average Partial) and PA (Parallel Analysis) along with Very Simple Structure (VSS) with categorical variables.

Macroscopic Monograin Nano-Gyroid Thin Films in 4-inch Scale Through Shear-Rolling and Subsequent Solvent Annealing.

The gyroid structure from self-assembly is highly attractive for optical applications such as photonic crystals and metamaterials. However, due to the direction-dependent nature of these applications, achieving a monograin-level structure over a large area has remained challenging. In this study, the fabrication of unidirectionally oriented anisotropic nanocylinders of polystyrene-block-polydimethylsiloxane (PS-b-PDMS) is reported block copolymer thin films up to a 4-inch scale via a shear-rolling process, followed by solvent annealing to induce phase transition to nearly monograin gyroid structures. Grazing-incidence small-angle X-ray scattering (GISAXS) analysis and cross-sectional scanning electron microscope (SEM) images in the direction parallel to the shear-rolling direction reveal the preferential orientation with the (111) plane onto the YZ axis of the film, while only the (110) plane on the YZ axis of the film is observed in the perpendicular direction, with grain sizes approaching single-grain levels. For metamaterial applications, the PDMS domain is selectively removed, and gold is electroplated to produce monograin gold gyroid films.

Analytical Figures of Merit in Univariate, Multivariate, and Multiway Calibration: What Have We Learned? What Do We Still Need to Learn?

ABSTRACTAn overview of the status of the research in analytical figures of merit is provided, including all calibration scenarios from univariate to multivariate and multiway analytical protocols. Both linear and nonlinear multivariate models are considered. Starting with the simplest multivariate model, inverse least‐squares regression, the basic concepts of sensitivity, sample leverage, and limit of detection are introduced. The extension to other multivariate models is discussed, as well as to nonlinear models based on radial basis functions, kernel partial least‐squares, and multilayer feed‐forward artificial neural networks. Finally, multiway calibration models are discussed, including multilinear decomposition models such as parallel factor analysis (PARAFAC) and multivariate curve resolution–alternating least‐squares (MCR‐ALS). In the latter case, recent developments concerning the pervasive phenomenon of rotational ambiguity are discussed. Unfinished works and areas where further research efforts are needed to develop closed‐form expressions and to fully understand their meaning are included.

Cross-national Psychometric Evaluation of the Jefferson Scale of Empathy-Medical Student Version.

This study aimed to examine the factorial structure of the Jefferson Scale of Empathy-Medical student version (JSE-S) and assess items' discriminatory ability at higher and lower empathy levels in medical student populations from different countries and languages. JSE-S datasets were retrieved from previous studies of 4113 first- and/or second-year medical students from Switzerland, Portugal, Italy, Brazil, France, Spain, New Zealand, UK, Ireland, Mexico, and Peru. Parallel principal component analyses and item response theory were applied. Excluding item 18, the Compassionate Care subscale emerged in five samples (Switzerland, Portugal, Italy, France and UK/Ireland), Perspective Taking in three (Switzerland, Portugal and UK/Ireland) and Walking in Patient's Shoes in five (Switzerland, Portugal, Spain, UK/Ireland and Mexico/Peru). All subscales had items providing overlapping information. The JSE-S subscales had reliable high test performance at low empathy levels, while when the JSE-S increased, the standard error also increased. There was no consistent support across countries for the JSE-S three-factorial structure. Items provided redundant information and discriminatory power decreased when aiming to differentiate students at high empathy levels. A JSE-S revision to improve cross-cultural comparability, results' generalizability and validity should focus on suppressing or reformulating items that cannot differentiate medical students' empathy.

Drug-Induced Differential Gene Expression Analysis on Nanoliter Droplet Microarrays: Enabling Tool for Functional Precision Oncology.

Drug-induced differential gene expression analysis (DGEA) is essential for uncovering the molecular basis of cell phenotypic changes and understanding individual tumor responses to anticancer drugs. Performing high throughput DGEA is challenging due to the high cost and labor-intensive multi-step sample preparation protocols. In particular, performing drug-induced DGEA on cancer cells derived from patient biopsies is even more challenging due to the scarcity of available cells. A novel, miniaturized, nanoliter-scale method for drug-induced DGEA is introduced, enabling high-throughput and parallel analysis of patient-derived cell drug responses, overcoming the limitations and laborious nature of traditional protocols. The method is based on the Droplet Microarray (DMA), a microscope glass slide with hydrophilic spots on a superhydrophobic background, facilitating droplet formation for cell testing. DMA allows microscopy-based phenotypic analysis, cDNA extraction, and DGEA. The procedure includes cell lysis for mRNA isolation and cDNA conversion followed by droplet pooling for qPCR analysis. In this study, the drug-induced DGEA protocol on the DMA platform is demonstrated using patient-derived chronic lymphocytic leukemia (CLL) cells. This methodology is critical for DGEA with limited cell numbers and promise for applications in functional precision oncology. This method enables molecular profiling of patient-derived samples after drug treatment, crucial for understanding individual tumor responses to anticancer drugs.

A new approach to three-dimensional monitoring of surface changes in lakes: application of three-way data analysis model in Lake Burdur, Turkey.

Lakes are areas of ecological significance that host a wide range of living species. Therefore, monitoring changes in lake surfaces is critical for ecosystem preservation. Since conventional methods based on one-dimensional data analysis have limited capacity to analyze complex systems, they may not always produce the desired results in examining surface change. In this regard, a novel approach based on a three-way analysis model of a multi-temporal dataset was improved for the first time to monitor surface changes in Lake Burdur between 2014 and 2023 in terms of latitude, longitude, and year modes. The newly proposed approach, based on the deconvolution of a multi-temporal data series, provided a new way and an alternative approach with a three-dimensional perspective for the simultaneous prediction of changes in latitude, longitude, and relative quantity profiles of Lake Burdur between 2014 and 2023. The proposed approach is based on the parallel factor analysis (PARAFAC) modeling of the multi-temporal datasets. The change in the lake surface as water levels were monitored from latitudinal and longitudinal profiles was obtained by applying the PARAFAC model to the multi-temporal data array. In the same model, the change in lake water surface over the years was determined from the relative quantity profile. The results obtained from the three-way analysis model were compared with the results provided by the conventional method. It was concluded that the findings of this study could provide valuable information to researchers and policymakers in developing effective strategies to analyze changes in lake surfaces in future studies.

TGIRT-seq of Inflammatory Breast Cancer Tumor and Blood Samples Reveals Widespread Enhanced Transcription Impacting RNA Splicing and Intronic RNAs in Plasma.

Inflammatory breast cancer (IBC) is the most aggressive and lethal breast cancer subtype but lacks unequivocal genomic differences or robust biomarkers that differentiate it from non-IBC. Here, Thermostable Group II intron Reverse Transcriptase RNA-sequencing (TGIRT-seq) revealed myriad differences in tumor samples, Peripheral Blood Mononuclear Cells (PBMCs), and plasma that distinguished IBC from non-IBC patients and healthy donors across all tested receptor-based subtypes. These included numerous differentially expressed protein-coding gene and non-coding RNAs in all three sample types, a granulocytic immune response in IBC PBMCs, and over- expression of antisense RNAs, suggesting wide-spread enhanced transcription in both IBC tumors and PBMCs. By using TGIRT-seq to quantitate Intron-exon Depth Ratios (IDRs) and mapping reads to both genome and transcriptome reference sequences, we developed methods for parallel analysis of transcriptional and post-transcriptional gene regulation. This analysis identified numerous differentially and non-differentially expressed protein-coding genes in IBC tumors and PBMCs with high IDRs, the latter reflecting rate-limiting RNA splicing that negatively impacts mRNA production. Mirroring gene expression differences in tumors and PBMCs, over-represented protein-coding gene RNAs in IBC patient plasma were largely intronic RNAs, while those in non- IBC patients and healthy donor plasma were largely mRNA fragments. Potential IBC biomarkers in plasma included T-cell receptor pre-mRNAs and intronic, LINE-1, and antisense RNAs. Our findings provide new insights into IBC and set the stage for monitoring disease progression and response to treatment by liquid biopsy. The methods developed for parallel transcriptional and post- transcriptional gene regulation analysis have potentially broad RNA-seq and clinical applications.

Short-Wave Infrared Upconverting Nanoparticles.

Optical technologies enable real-time, noninvasive analysis of complex systems but are limited to discrete regions of the optical spectrum. While wavelengths in the short-wave infrared (SWIR) window (typically, 1700-3000 nm) should enable deep subsurface penetration and reduced photodamage, there are few luminescent probes that can be excited in this region. Here, we report the discovery of lanthanide-based upconverting nanoparticles (UCNPs) that efficiently convert 1740 or 1950 nm excitation to wavelengths compatible with conventional silicon detectors. Screening of Ln3+ ion combinations by differential rate equation modeling identifies Ho3+/Tm3+ or Tm3+ dopants with strong visible or NIR-I emission following SWIR excitation. Experimental upconverted photoluminescence excitation (U-PLE) spectra find that 10% Tm3+-doped NaYF4 core/shell UCNPs have the strongest 800 nm emission from SWIR wavelengths, while UCNPs with an added 2% or 10% Ho3+ show the strongest red emission when excited at 1740 or 1950 nm. Mechanistic modeling shows that addition of a low percentage of Ho3+ to Tm3+-doped UCNPs shifts their emission from 800 to 652 nm by acting as a hub of efficient SWIR energy acceptance and redistribution up to visible emission manifolds. Parallel experimental and computational analysis shows rate equation models are able to predict compositions for specific wavelengths of both excitation and emission. These SWIR-responsive probes open a new IR bioimaging window, and are responsive at wavelengths important for vision technologies.

Luxury or Cultural Tourism Activities? The Role of Narcissistic Personality Traits and Travel-Related Motivations.

This study aimed to examine the role of travel-related motivations and preferences for activities (such as learning about local culture, relaxation and entertainment, status and social recognition, escape and curiosity, and experience) in the relationship between narcissistic personality traits and the preference for luxury tourism versus cultural tourism. A sample of 1342 Israeli community members was analyzed. The methodology utilized parallel mediation analyses to assess how different forms of narcissism (extraverted, antagonistic, neurotic, and communal) were associated with the desire for luxury tourism over cultural tourism, as mediated by various travel-related motivations. The results indicated that narcissistic personality traits were generally associated with a preference for luxury tourism, primarily through indirect associations via travel motivations such as relaxation and entertainment, status and social recognition, and experience. The conclusion highlights the implications for understanding how specific travel-related motivations influence tourism preferences among individuals with varying levels of narcissistic traits, suggesting that tourism management strategies could benefit from a nuanced approach to personality in marketing.

Sex-specific co-developmental trajectories of childhood victimization among elementary school students: Relations to social behavior

This study aimed to identify sex-specific co-developmental trajectories of multiple forms of childhood victimization: family maltreatment (FM), psychological maltreatment by teachers (PMT), and peer victimization (PV), and their relations to prosocial and delinquent behaviors among elementary school students. A total of 4378 Chinese elementary school students (Mage = 9.93; SD = 0.92; 55.14% boys) participated in assessments on five occasions, using six-month intervals. Parallel process latent class growth model analyses revealed three trajectories for boys: Congruent-low (75.64%), High-PV, Moderate-FM and PMT (14.62%), and Moderate-PV, High-FM and PMT (9.74%). Similarly, girls exhibited three trajectories: Congruent-low (81.11%), Moderate-PMT, High-FM and PV (10.54%), and High-PMT, Moderate-FM and PV (8.35%). The results indicated that boys were more susceptible than girls to three forms of childhood victimization. Furthermore, boys were especially vulnerable to co-occurring FM and PMT. In contrast, girls were more vulnerable to co-occurring FM and PV. Additionally, after experiencing childhood victimization, girls showed a greater hindrance in prosocial behavior development, whereas boys exhibited a more significant increase in delinquent behavior. These findings underscore the importance of considering sex differences in understanding multiple forms of childhood victimization and provide important insights for prevention and intervention efforts.

Pollution of organophosphorus pesticides in the Dongting Lake, China and its relationship with dissolved organic matter: Occurrence, source identification and risk assessment

The escalating global demand for food and industrialization has placed significant pressure on the integrity and management of inland lake ecosystems. Herein, the organophosphorus pesticides (OPPs) pollution status and their relationship with dissolved organic matter (DOM) in Dongting Lake were investigated to identify the ecological risks and potential sources of OPPs. The total concentrations of 18 detected OPPs were in the range of 13.49–375.24 ng/L, with higher concentration observed in east and west lake regions. Among these, fenthion was the dominant contributor, accounting for 64% of total OPPs, posing significant ecological risk to aquatic organisms. Nearly all of sites showed high combined risk of total OPPs. Parallel factor analysis (PARAFAC) and fluorescence regional integration (FRI) technique showed that DOM was mainly composed of terrestrial humic-like and tryptophan-like substances. Moreover, correlation analysis revealed a close association between DOM optical parameters and OPP concentrations. Specifically, OPPs exhibited a significantly positive correlation with tyrosine-like substances, while displaying a negative correlation with fulvic acid-like substances. These results indicated that OPP concentrations may decrease with increasing humification levels and declining tyrosine-like substance contents. This study underscores the critical role of DOM in assessing the occurrence and sources of OPPs in aquatic environments, providing valuable insights for effective environmental management strategies.

Molecular properties of dissolved organic matter leached from microplastics during photoaging process

The occurrence of dissolved organic matter (DOM) derived from microplastics (MPs) and its effect on aquatic systems has attracted great interest recently. However, the photoaging effect on the molecular structure of MP-derived DOM (MP-DOM) remains unclear. This paper presents the characteristics of DOM leached from three commercial MPs, i.e., polyethylene (PE), polypropylene (PP) and polyethylene terephthalate (PET) under UV irradiation. With prolonged aging periods, the surface roughness and oxygen-containing groups on the surface of MPs increase as more DOM leachate is generated. Moreover, the dissolved organic carbon (DOC) content of the leached DOM from PET MPs varies from 0.52 mg/L to 2.25 mg/L, which is higher than PE and PP MPs, due to the larger increased surface reaction area and the cleavage of the benzene ring. According to the excitation-emission matrix and parallel factor analysis (EEM-PARAFAC), the plastic-derived protein/phenolic-like components (C1 and C3) in MP-DOM were changed into photo-induced humic-like components (C2), which were closely related to the intermediates during photo-oxidation. High-performance liquid chromatography-mass spectrometry (HPLC−MS) analysis further identified that the highest proportion of antioxidants (24.8 %∼34.6 %) was contained in MP-DOM. Plasticizers, intermediate additives, and antimicrobial agents were also detected in DOM leachate. Correlation analysis identified that the composition of leached DOM was positively correlated with the surface roughness, the carbonyl index (CI), and the chemical groups of MPs. Moreover, a partial least square structural equation model (PLS−SEM) analysis further verified that the change of morphology and the chemical structure of MPs could affect the DOM structures and fractions directly. This study provides an in-depth understanding of the composition of MP-derived DOM during the aging process, as well as a comprehensive environmental impact assessment of MPs.

Attachment, emotion regulation, and their roles in refugee post-traumatic stress and post-migration living difficulties

ABSTRACT Background: Upon arrival in the host country, refugees and asylum seekers (RAS) experience a range of post-migration living difficulties (PMLD), which are often linked to psychological symptoms such as post-traumatic stress (PTS). Initial research suggests that attachment insecurity partly explains the association between PMLD and psychological symptoms in RAS. However, the mechanisms through which attachment insecurity may act as a mediator are not well understood, though emotion dysregulation is one of the potential candidates. Objectives: This study investigated (1) whether attachment insecurity (i.e. anxiety and avoidance) mediate the association between PMLD and PTS, and (2) whether this mediation model can be extended to emotion dysregulation. Methods: 134 treatment-seeking RAS living in Switzerland completed questionnaires assessing PMLD, attachment insecurity, emotion dysregulation, and PTS. Two models were tested: (1) a parallel mediation analysis with attachment anxiety and avoidance as mediators, and (2) a serial mediation analysis with attachment anxiety as the first and emotion dysregulation as the second mediator. Results: First, PMLD was indirectly associated with PTS through attachment anxiety but not avoidance. Second, the association between PMLD and PTS was further explained by a pathway through attachment anxiety and emotion dysregulation. Conclusions: Although this study is limited by its cross-sectional design, we identified attachment anxiety and emotion dysregulation as potential mechanisms explaining how PMLD affects symptoms of PTS in RAS. Systematically assessing attachment style and addressing emotion regulation may therefore help improve treatment of refugee and asylum-seeking patients.

Using physicochemical properties to predict the impact of natural dissolved organic carbon on transepithelial potential in the freshwater rainbow trout (Oncorhynchus mykiss) at neutral and acidic pH.

Dissolved organic carbon (DOC) is a complex mixture of molecules that varies in composition based on origin as well as spatial and temporal factors. DOC is an important water quality parameter as it regulates many biological processes in freshwater systems, including the physiological function of the gills in fish. These effects are often beneficial, especially at low pH where DOCs mitigate ion loss and protect active ion uptake. DOCs of different compositions and quality have varied ionoregulatory effects. The molecular variability of DOCs can be characterized using optical and chemical indices, but how these indices relate to the physiological effects exerted by DOCs is not well understood. We tested the effects of five naturally sourced DOCs, at both pH 7 and pH 4, on transepithelial potential (TEP) (a diffusion potential between the blood plasma and the external water) in rainbow trout. The five chosen DOCs have been well characterized and span large differences in physicochemical characteristics. Each of the DOCs significantly influenced TEP, although in a unique manner or magnitude which was likely due to their physicochemical characteristics. These TEP responses were also a function of pH. With the goal of determining which physicochemical indices are predictive of changes in TEP, we evaluated correlations between various indices and TEP at pH 7 and pH 4. The indices included: specific absorbance coefficient at 340nm, molecular weight index, fluorescence index, octanol-water partition coefficient, molecular charge, proton binding index, % humic acid-like, % fulvic acid-like, and % protein-like components by parallel factor analysis on fluorescence data (PARAFAC). Our results demonstrate the novel finding that there are three particularly important indices that are predictors of changes in TEP across pHs in rainbow trout: specific absorbance coefficient at 340nm, octanol-water partition coefficient; and proton binding index.

Implementing a Medicines at Transitions Intervention (MaTI) for patients with heart failure: a process evaluation of the Improving the Safety and Continuity Of Medicines management at Transitions of care (ISCOMAT) cluster randomised controlled trial

BackgroundHeart failure is a major global health challenge incurring a high rate of mortality, morbidity and hospitalisation. Effective medicines management at the time of hospital discharge into the community could reduce poor outcomes for people with heart failure. Within the Improving the Safety and Continuity Of Medicines management at Transitions of care (ISCOMAT) programme, the Medicines at Transitions Intervention (MaTI) was co-designed to improve such transitions, with a cluster randomised controlled trial to test effectiveness. The MaTI includes a patient toolkit and transfer of discharge medicines information to community pharmacy. This paper aims to determine the degree to which the intervention was delivered, and identify barriers and facilitators experienced by staff for the successful implementation of the intervention.MethodsThe study was conducted in six purposively selected intervention sites. A mixed-methods design was employed using hospital staff interviews, structured and unstructured ward observations, and routine trial data about adherence to the MaTI. A parallel mixed analysis was applied. Qualitative data were analysed thematically using the Framework method. Data were synthesised, triangulated and mapped to the Consolidated Framework for Implementation Research (CFIR).ResultsWith limited routines of communication between ward staff and community pharmacy, hospital staff found implementing community pharmacy-related steps of the intervention challenging. Staff time was depleted by attempts to bridge system barriers, sometimes leading to steps not being delivered. Whilst the introduction of the patient toolkit was often completed and valued as important patient education and a helpful way to explain medicines, the medicines discharge log within it was not, as this was seen as a duplication of existing systems. Within the CFIR the most applicable constructs were identified as ‘intervention complexity’ and ‘cosmopolitanism’ based on how well hospitals were networked with community pharmacies, and the availability of hospital resources to facilitate this.ConclusionThe MaTI was generally successfully implemented, particularly the introduction of the toolkit. However, implementation involving community pharmacy was more challenging and more effective communication systems are needed to support wider implementation.Trial registration11/04/2018 ISRCTN66212970. https://www.isrctn.com/ISRCTN66212970.