Ophiorrhiza mungos-Mediated Silver Nanoparticles as Effective and Reusable Adsorbents for the Removal of Methylene Blue from Water

Green synthesis of silver nanoparticles (AgNPs) using a plant extract has attracted significant attention in recent years. It is found as an alternative for other physicochemical approaches because of its simplicity, low cost, and eco-friendly rapid steps. In the present study, Ophiorrhiza mungos (Om)-mediated AgNPs have been shown to be effective bioadsorbents for methylene blue (MB) dye removal (88.1 ± 1.74%) just after 1 h at room temperature in the dark from an aqueous medium for the first time. Langmuir and Freundlich isotherms fit the experimental results having the correlation coefficient constants R2 = 0.9956 and R2 = 0.9838, respectively. From the Langmuir fittings, the maximum adsorption capacity and adsorption intensity were found to be 80.451 mg/g and 0.041, respectively, indicating the excellent performance and spontaneity of the process. Taking both models under consideration, interestingly, our findings indicated a fairly cooperative multilayer adsorption that might have been governed by chemisorption and physisorption, whereas the adsorption kinetics followed the pseudo-second-order kinetics mechanism. The positive and low values of enthalpy (ΔH0 = 4.91 kJ/mol) confirmed that adsorption is endothermic and physical in nature; however, the negative free energy and positive entropy value (ΔS0 = 53.69 J/mol K) suggested that the adsorption is spontaneous. The biosynthesized adsorbent was successfully reused up to the fifth cycle. A proposed reaction mechanism for the adsorption process of MB dye onto Om-AgNPs is suggested. The present study may offer a novel finding such as an effective and sustainable approach for the removal of MB dye from water using biosynthesized Om-AgNPs as reusable adsorbents at a comparatively faster rate at a low dose for industrial applications.

End-of-life practices in 11 German intensive care units : Results from the ETHICUS-2 study

BACKGROUND

End-of-life care is common in German intensive care units (ICUs) but little is known about daily practice.

OBJECTIVES

To study the practice of end-of-life care.

METHODS

Prospectively planned, secondary analysis comprising the German subset of the worldwide Ethicus‑2 Study (2015-2016) including consecutive ICU patients with limitation of life-sustaining therapy or who died.

RESULTS

Among 1092 (13.7%) of 7966 patients from 11 multidisciplinary ICUs, 967 (88.6%) had treatment limitations, 92 (8.4%) died with failed CPR, and 33 (3%) with brain death. Among patients with treatment limitations, 22.3% (216/967) patients were discharged alive from the ICU. More patients had treatments withdrawn than withheld (556 [57.5%] vs. 411 [42.5%], p < 0.001). Patients with treatment limitations were older (median 73 years [interquartile range (IQR) 61-80] vs. 68 years [IQR 54-77]) and more had mental decision-making capacity (12.9 vs. 0.8%), advance directives (28.6 vs. 11.2%), and information about treatment wishes (82.7 vs 33.3%, all p < 0.001). Physicians reported discussing treatment limitations with patients with mental decision-making capacity and families (91.3 and 82.6%, respectively). Patient wishes were unknown in 41.3% of patients. The major reason for decision-making was unresponsiveness to maximal therapy (34.6%).

CONCLUSIONS

Treatment limitations are common, based on information about patients' wishes and discussion between stakeholders, patients and families. However, our findings suggest that treatment preferences of nearly half the patients remain unknown which affects guidance for treatment decisions.

Designing Biomimetic Conductive Gelatin-Chitosan-Carbon Black Nanocomposite Hydrogels for Tissue Engineering

Conductive nanocomposites play a significant role in tissue engineering by providing a platform to support cell growth, tissue regeneration, and electrical stimulation. In the present study, a set of electroconductive nanocomposite hydrogels based on gelatin (G), chitosan (CH), and conductive carbon black (CB) was synthesized with the aim of developing novel biomaterials for tissue regeneration application. The incorporation of conductive carbon black (10, 15 and 20 wt.%) significantly improved electrical conductivity and enhanced mechanical properties with the increased CB content. We employed an oversimplified unidirectional freezing technique to impart anisotropic morphology with interconnected porous architecture. An investigation into whether any anisotropic morphology affects the mechanical properties of hydrogel was conducted by performing compression and cyclic compression tests in each direction parallel and perpendicular to macroporous channels. Interestingly, the nanocomposite with 10% CB produced both anisotropic morphology and mechanical properties, whereas anisotropic pore morphology diminished at higher CB concentrations (15 and 20%), imparting a denser texture. Collectively, the nanocomposite hydrogels showed great structural stability as well as good mechanical stability and reversibility. Under repeated compressive cyclic at 50% deformation, the nanocomposite hydrogels showed preconditioning, characteristic hysteresis, nonlinear elasticity, and toughness. Overall, the collective mechanical behavior resembled the mechanics of soft tissues. The electrical impedance associated with the hydrogels was studied in terms of the magnitude and phase angle in dry and wet conditions. The electrical properties of the nanocomposite hydrogels conducted in wet conditions, which is more physiologically relevant, showed a decreasing magnitude with increased CB concentrations, with a resistive-like behavior in the range 1 kHz-1 MHz and a capacitive-like behavior for frequencies <1 kHz and >1 MHz. Overall, the impedance of the nanocomposite hydrogels decreased with increased CB concentrations. Together, these nanocomposite hydrogels are compositionally, morphologically, mechanically, and electrically similar to native ECMs of many tissues. These gelatin-chitosan-carbon black nanocomposite hydrogels show great promise for use as conducting substrates for the growth of electro-responsive cells in tissue engineering.

Size controlled biosynthesis of silver nanoparticles using Ophiorrhiza mungos, Ophiorrhiza harrisiana and Ophiorrhiza rugosa aqueous leaf extract and their antimicrobial activity

In this work, the aqueous leaf extracts of three Ophiorrhiza genus species, namely Ophiorrhiza mungos (Om), Ophiorrhiza harrisiana (Oh) and Ophiorrhiza rugosa (Or), have been used as the reducing and capping agents to control the size of AgNPs, Om-AgNPs, Oh-AgNPs and Or-AgNPs, respectively and found to be an effective antimicrobial agent against a wide range of bacteria and fungi. The biosynthesized AgNPs were studied by UV-Visible spectrophotometer, powder X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray, transmission electron microscopy (TEM) and Fourier transform infrared spectrometer (FTIR). The average particle sizes of Om-AgNPs, Oh-AgNPs and Or-AgNPs were measured as 17 nm, 22 nm and 26 nm, respectively, and observed to be spherical and face-centered cubic crystals. The antibacterial test of synthesized AgNPs was performed against Staphylococcus aureus, Bacillus cereus, Escherichia coli, and Vibrio cholerae where the maximum antibacterial activity was observed by reducing the nano-size and increasing the silver content of AgNPs. The antifungal effect of these three types of AgNPs on Penicillium notatum and Aspergillus niger was also evaluated and their growth with AgNPs concentrations of 450 μg/mL was inhibited up to 80-90% and 55-70%, respectively. The size-control synthesis of AgNPs using the Ophiorrhiza genus species is presented here for the first time where the synthesized AgNPs showed higher stability and antimicrobial activities. Therefore, this study might lead to synthesize AgNPs with different morphologies using plant extracts of the same genus but from different species and provide strong encouragement for future applications in treating infectious diseases.

Association of food habit with the COVID-19 severity and hospitalization: A cross-sectional study among the recovered individuals in Bangladesh

Background: It was assumed that dietary habits might influence the status of COVID-19 patients. Aim: We aimed at the identification of association of dietary habits with the COVID-19 severity and hospitalization. Methods: It was a retrospective cross-sectional study (n = 1025). We used bivariate and multivariate analyses to correlate the association between self-reported dietary patterns and COVID-19 severity and hospitalization. Results: Dietary habits (black tea, milked tea, pickles, black caraway seeds, honey, fish, fruits, vegetables, garlic, onion and turmeric) were identified with lower risk of COVID-19 severity and hospitalization. Interestingly, the consumption frequency (one-, two- or three-times/day) of rice - the staple food in Bangladesh - was not associated with COVID-19 severity and hospitalization for comorbid patients. In contrast, a moderate rice-eating habit (two times/day) was strongly associated with the lower risk of severity and hospitalization for non-comorbid patients. However, for both comorbid and non-comorbid patients, consumption of black tea, milked tea, pickles and honey were associated with a lower likelihood of severity and hospitalization. Overall, a high consumption (three-times/day) of fish, fruits and vegetables, a moderate consumption of garlic, onion and turmeric spices and a daily intake of black/milked tea, and honey were associated with reduced risk of COVID-19 severity and hospitalization. Conclusions: To reduce the severity of COVID-19, a habitual practice of intaking black tea, milked tea, black caraway seeds and honey along with dietary habit (rice, fish and vegetables) and with a moderate consumption of ginger, garlic, onion, mixed aromatic spices (cinnamon + cardamom + cloves) and turmeric might be suggested.

Association of comorbidities with the COVID-19 severity and hospitalization: A study among the recovered individuals in Bangladesh

Objectives

We aimed at the identification of the association of comorbidities with the COVID-19 severity and hospitalization.

Methods

It is a retrospective cross-sectional study to investigate the variation in age, sex, dwelling, comorbidities, and medication with the COVID-19 severity and hospitalization by enrolling 1025 recovered individuals while comparing their time of recovery with or without comorbidities.

Results

COVID-19 patients mostly suffered from fever. The predominant underlying medical conditions in them were hypertension (HTN) followed by diabetes mellitus (DM). Patients with cardiovascular disease (CVD) (54.3%) and hepatic disorders (HD) (43.6%) experienced higher severity. The risk of symptomatic cases was higher in aged (odds ratio, OR = 1.04, 95% CI = 1.02-1.06) and comorbid (OR = 1.87, 95% CI = 1.34-2.60) patients. T-test confirmed the differences between the comorbid and non-comorbid patients' recovery duration. The presence of multiple comorbidities increased the time of recovery (15-27 days) and hospitalization (20-40%). Increased symptomatic cases were found for patients having DM+HTN whereas CVD+Asthma patients were found with higher percentage of severity. Besides, DM+CKD (chronic kidney disease) was associated with higher hospitalization rate. Higher odds of severity were found for DM+CVD (OR = 4.42, 95% CI = 1.81-10.78) patients. Hospitalization risk was also increased for them (OR = 5.14, 95% CI = 2.02-13.07). Moreover, if they had HTN along with DM+CVD, they were found with even higher odds (OR = 6.82, 95% CI = 2.37-19.58) for hospitalization.

Conclusion

Our study indicates that people who are aged, females, living in urban area and have comorbid conditions are at a higher risk for developing COVID-19 severity. Clinicians and health management authorities should prioritize these high-risk groups to reduce mortality attributed to the disease.

Degradation-Dependent Stress Relaxing Semi-Interpenetrating Networks of Hydroxyethyl Cellulose in Gelatin-PEG Hydrogel with Good Mechanical Stability and Reversibility

The mechanical milieu of the extracellular matrix (ECM) plays a key role in modulating the cellular responses. The native ECM exhibits viscoelasticity with stress relaxation behavior. Here, we reported the preparation of degradation-mediated stress relaxing semi-interpenetrating (semi-IPN) polymeric networks of hydroxyethyl cellulose in the crosslinked gelatin-polyethylene glycol (PEG) architecture, leveraging a newly developed synthesis protocol which successively includes one-pot gelation under physiological conditions, freeze-drying and a post-curing process. Fourier transform infrared (FTIR) confirmed the formation of the semi-IPN blend mixture. A surface morphology analysis revealed an open pore porous structure with a compact skin on the surface. The hydrogel showed a high water-absorption ability (720.00 ± 32.0%) indicating the ability of retaining a hydrophilic nature even after covalent crosslinking with functionalized PEG. Detailed mechanical properties such as tensile, compressive, cyclic compression and stress relaxation tests were conducted at different intervals over 28 days of hydrolytic degradation. Overall, the collective mechanical properties of the hydrogel resembled the mechanics of cartilage tissue. The rate of stress relaxation gradually increased with an increasing swelling ratio. Hydrolytic degradation led to a marked increase in the percentage dissipation energy and stress relaxation response, indicating the degradation-dependent viscoelasticity of the hydrogel. Strikingly, the hydrogel maintained the structural stability even after degrading two-thirds of its initial mass after a month-long hydrolytic degradation. This study demonstrates that this semi-IPN G-PEG-HEC hydrogel possesses bright prospects as a potential scaffolding material in tissue engineering.

Mineralization of 3D Osteogenic Model Based on Gelatin-Dextran Hybrid Hydrogel Scaffold Bioengineered with Mesenchymal Stromal Cells: A Multiparametric Evaluation

Gelatin–dextran hydrogel scaffolds (G-PEG-Dx) were evaluated for their ability to activate the bone marrow human mesenchymal stromal cells (BM-hMSCs) towards mineralization. G-PEG-Dx1 and G-PEG-Dx2, with identical composition but different architecture, were seeded with BM-hMSCs in presence of fetal bovine serum or human platelet lysate (hPL) with or without osteogenic medium. G-PEG-Dx1, characterized by a lower degree of crosslinking and larger pores, was able to induce a better cell colonization than G-PEG-Dx2. At day 28, G-PEG-Dx2, with hPL and osteogenic factors, was more efficient than G-PEG-Dx1 in inducing mineralization. Scanning electron microscopy (SEM) and Raman spectroscopy showed that extracellular matrix produced by BM-hMSCs and calcium-positive mineralization were present along the backbone of the G-PEG-Dx2, even though it was colonized to a lesser degree by hMSCs than G-PEG-Dx1. These findings were confirmed by matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI), detecting distinct lipidomic signatures that were associated with the different degree of scaffold mineralization. Our data show that the architecture and morphology of G-PEG-Dx2 is determinant and better than that of G-PEG-Dx1 in promoting a faster mineralization, suggesting a more favorable and active role for improving bone repair.

Progress in the mechanical modulation of cell functions in tissue engineering

In mammals, mechanics at multiple stages-nucleus to cell to ECM-underlie multiple physiological and pathological functions from its development to reproduction to death. Under this inspiration, substantial research has established the role of multiple aspects of mechanics in regulating fundamental cellular processes, including spreading, migration, growth, proliferation, and differentiation. However, our understanding of how these mechanical mechanisms are orchestrated or tuned at different stages to maintain or restore the healthy environment at the tissue or organ level remains largely a mystery. Over the past few decades, research in the mechanical manipulation of the surrounding environment-known as substrate or matrix or scaffold on which, or within which, cells are seeded-has been exceptionally enriched in the field of tissue engineering and regenerative medicine. To do so, traditional tissue engineering aims at recapitulating key mechanical milestones of native ECM into a substrate for guiding the cell fate and functions towards specific tissue regeneration. Despite tremendous progress, a big puzzle that remains is how the cells compute a host of mechanical cues, such as stiffness (elasticity), viscoelasticity, plasticity, non-linear elasticity, anisotropy, mechanical forces, and mechanical memory, into many biological functions in a cooperative, controlled, and safe manner. High throughput understanding of key cellular decisions as well as associated mechanosensitive downstream signaling pathway(s) for executing these decisions in response to mechanical cues, solo or combined, is essential to address this issue. While many reports have been made towards the progress and understanding of mechanical cues-particularly, substrate bulk stiffness and viscoelasticity-in regulating the cellular responses, a complete picture of mechanical cues is lacking. This review highlights a comprehensive view on the mechanical cues that are linked to modulate many cellular functions and consequent tissue functionality. For a very basic understanding, a brief discussion of the key mechanical players of ECM and the principle of mechanotransduction process is outlined. In addition, this review gathers together the most important data on the stiffness of various cells and ECM components as well as various tissues/organs and proposes an associated link from the mechanical perspective that is not yet reported. Finally, beyond addressing the challenges involved in tuning the interplaying mechanical cues in an independent manner, emerging advances in designing biomaterials for tissue engineering are also explored.

Polysaccharides on gelatin-based hydrogels differently affect chondrogenic differentiation of human mesenchymal stromal cells

Selection of feasible hybrid-hydrogels for best chondrogenic differentiation of human mesenchymal stromal cells (hMSCs) represents an important challenge in cartilage regeneration. In this study, three-dimensional hybrid hydrogels obtained by chemical crosslinking of poly (ethylene glycol) diglycidyl ether (PEGDGE), gelatin (G) without or with chitosan (Ch) or dextran (Dx) polysaccharides were developed. The hydrogels, namely G-PEG, G-PEG-Ch and G-PEG-Dx, were prepared with an innovative, versatile and cell-friendly technique that involves two preparation steps specifically chosen to increase the degree of crosslinking and the physical-mechanical stability of the product: a first homogeneous phase reaction followed by directional freezing, freeze-drying and post-curing. Chondrogenic differentiation of human bone marrow mesenchymal stromal cells (hBM-MSC) was tested on these hydrogels to ascertain whether the presence of different polysaccharides could favor the formation of the native cartilage structure. We demonstrated that the hydrogels exhibited an open pore porous morphology with high interconnectivity and the incorporation of Ch and Dx into the G-PEG common backbone determined a slightly reduced stiffness compared to that of G-PEG hydrogels. We demonstrated that G-PEG-Dx showed a significant increase of its anisotropic characteristic and G-PEG-Ch exhibited higher and faster stress relaxation behavior than the other hydrogels. These characteristics were associated to absence of chondrogenic differentiation on G-PEG-Dx scaffold and good chondrogenic differentiation on G-PEG and G-PEG-Ch. Furthermore, G-PEG-Ch induced the minor collagen proteins and the formation of collagen fibrils with a diameter like native cartilage. This study demonstrated that both anisotropic and stress relaxation characteristics of the hybrid hydrogels were important features directly influencing the chondrogenic differentiation potentiality of hBM-MSC.

Impedance-Based Monitoring of Mesenchymal Stromal Cell Three-Dimensional Proliferation Using Aerosol Jet Printed Sensors: A Tissue Engineering Application

One of the main hurdles to improving scaffolds for regenerative medicine is the development of non-invasive methods to monitor cell proliferation within three-dimensional environments. Recently, an electrical impedance-based approach has been identified as promising for three-dimensional proliferation assays. A low-cost impedance-based solution, easily integrable with multi-well plates, is here presented. Sensors were developed using biocompatible carbon-based ink on foldable polyimide substrates by means of a novel aerosol jet printing technique. The setup was tested to monitor the proliferation of human mesenchymal stromal cells into previously validated gelatin-chitosan hybrid hydrogel scaffolds. Reliability of the methodology was assessed comparing variations of the electrical impedance parameters with the outcomes of enzymatic proliferation assay. Results obtained showed a magnitude increase and a phase angle decrease at 4 kHz (maximum of 2.5 kΩ and -9 degrees) and an exponential increase of the modeled resistance and capacitance components due to the cell proliferation (maximum of 1.5 kΩ and 200 nF). A statistically significant relationship with enzymatic assay outcomes could be detected for both phase angle and electric model parameters. Overall, these findings support the potentiality of this non-invasive approach for continuous monitoring of scaffold-based cultures, being also promising in the perspective of optimizing the scaffold-culture system.

Chitosan-based scaffold counteracts hypertrophic and fibrotic markers in chondrogenic differentiated mesenchymal stromal cells

Cartilage tissue engineering remains problematic because no systems are able to induce signals that contribute to native cartilage structure formation. Therefore, we tested the potentiality of gelatin-polyethylene glycol scaffolds containing three different concentrations of chitosan (CH; 0%, 8%, and 16%) on chondrogenic differentiation of human platelet lysate-expanded human bone marrow mesenchymal stromal cells (hBM-MSCs). Typical chondrogenic (SOX9, collagen type 2, and aggrecan), hypertrophic (collagen type 10), and fibrotic (collagen type 1) markers were evaluated at gene and protein level at Days 1, 28, and 48. We demonstrated that 16% CH scaffold had the highest percentage of relaxation with the fastest relaxation rate. In particular, 16% CH scaffold, combined with chondrogenic factor TGFβ3, was more efficient in inducing hBM-MSCs chondrogenic differentiation compared with 0% or 8% scaffolds. Collagen type 2, SOX9, and aggrecan showed the same expression in all scaffolds, whereas collagen types 10 and 1 markers were efficiently down-modulated only in 16% CH. We demonstrated that using human platelet lysate chronically during hBM-MSCs chondrogenic differentiation, the chondrogenic, hypertrophic, and fibrotic markers were significantly decreased. Our data demonstrate that only a high concentration of CH, combined with TGFβ3, creates an environment capable of guiding in vitro hBM-MSCs towards a phenotypically stable chondrogenesis.

Rational Design and Development of Anisotropic and Mechanically Strong Gelatin-Based Stress Relaxing Hydrogels for Osteogenic/Chondrogenic Differentiation

Rational design and development of tailorable simple synthesis process remains a centerpiece of investigational efforts toward engineering advanced hydrogels. In this study, a green and scalable synthesis approach is developed to formulate a set of gelatin-based macroporous hybrid hydrogels. This approach consists of four sequential steps starting from liquid-phase pre-crosslinking/grafting, unidirectional freezing, freeze-drying, and finally post-curing process. The chemical crosslinking mainly involves between epoxy groups of functionalized polyethylene glycol and functional groups of gelatin both in liquid and solid state. Importantly, this approach allows to accommodate different polymers, chitosan or hydroxyethyl cellulose, under identical benign condition. Structural and mechanical anisotropy can be tuned by the selection of polymer constituents. Overall, all hydrogels show suitable structural stability, good swellability, high porosity and pore interconnectivity, and maintenance of mechanical integrity during 3-week-long hydrolytic degradation. Under compression, hydrogels exhibit robust mechanical properties with nonlinear elasticity and stress-relaxation behavior and show no sign of mechanical failure under repeated compression at 50% deformation. Biological experiment with human bone marrow mesenchymal stromal cells (hMSCs) reveals that hydrogels are biocompatible, and their physicomechanical properties are suitable to support cells growth, and osteogenic/chondrogenic differentiation, demonstrating their potential application for bone and cartilage regenerative medicine toward clinically relevant endpoints.

3D gelatin-chitosan hybrid hydrogels combined with human platelet lysate highly support human mesenchymal stem cell proliferation and osteogenic differentiation

Bone marrow and adipose tissue human mesenchymal stem cells were seeded in highly performing 3D gelatin–chitosan hybrid hydrogels of varying chitosan content in the presence of human platelet lysate and evaluated for their proliferation and osteogenic differentiation. Both bone marrow and adipose tissue human mesenchymal stem cells in gelatin–chitosan hybrid hydrogel 1 (chitosan content 8.1%) or gelatin–chitosan hybrid hydrogel 2 (chitosan 14.9%) showed high levels of viability (80%–90%), and their proliferation and osteogenic differentiation was significantly higher with human platelet lysate compared to fetal bovine serum, particularly in gelatin–chitosan hybrid hydrogel 1. Mineralization was detected early, after 21 days of culture, when human platelet lysate was used in the presence of osteogenic stimuli. Proteomic characterization of human platelet lysate highlighted 59 proteins mainly involved in functions related to cell adhesion, cellular repairing mechanisms, and regulation of cell differentiation. In conclusion, the combination of our gelatin–chitosan hybrid hydrogels with hPL represents a promising strategy for bone regenerative medicine using human mesenchymal stem cells.

Unveiling spin-glass transition and antiferromagnetic order by μSR studies in spin-chain Sm2BaNiO5

We report the zero-field and longitudinal field muon spin relaxation studies in a spin-chain compound Sm₂BaNiO₅. Two magnetic transitions, that have not been previously detected by the heat capacity and magnetization measurements, are confirmed at 46 and 9 K. The antiferromagnetic order is suggested at 46 K. Analysis of the muon spin polarization unveils the spin-glass transition at 9 K. Time-field scaling relation of the muon spin polarization verifies the spin-spin autocorrelation function following the cut-off power law, which is approximated by the Ogielski form, as employed numerically for characterizing the spin-glasses.

Dynamic freedom: substrate stress relaxation stimulates cell responses

An elastic substrate stores cell-induced forces, while a viscoelastic substrate dissipates these forces through matrix reorganization and facilitates cell proliferation and differentiation.

[Non-beneficial therapy and emotional exhaustion in end-of-life care : Results of a survey among intensive care unit personnel]

BACKGROUND

End-of-life care (EOLC) in the intensive care unit (ICU) is becoming increasingly more common but ethical standards are compromised by growing economic pressure. It was previously found that perception of non-beneficial treatment (NBT) was independently associated with the core burnout dimension of emotional exhaustion. It is unknown whether factors of the work environment also play a role in the context of EOLC.

OBJECTIVE

Is the working environment associated with perception of NBT or clinician burnout?

MATERIAL AND METHODS

Physicians and nursing personnel from 11 German ICUs who took part in an international, longitudinal prospective observational study on EOLC in 2015-2016 were surveyed using validated instruments. Risk factors were obtained by multivariate multilevel analysis.

RESULTS

The participation rate was 49.8% of personnel working in the ICU at the time of the survey. Overall, 325 nursing personnel, 91 residents and 26 consulting physicians participated. Nurses perceived NBT more frequently than physicians. Predictors for the perception of NBT were profession, collaboration in the EOLC context, excessively high workload (each p ≤ 0.001) and the numbers of weekend working days per month (p = 0.012). Protective factors against burnout included intensive care specialization (p = 0.001) and emotional support within the team (p ≤ 0.001), while emotional exhaustion through contact with relatives at the end of life and a high workload were both increased (each p ≤ 0.001).

DISCUSSION

Using the example of EOLC, deficits in the work environment and stress factors were uncovered. Factors of the work environment are associated with perceived NBT. To reduce NBT and burnout, the quality of the work environment should be improved and intensive care specialization and emotional support within the team enhanced. Interprofessional decision-making among the ICU team and interprofessional collaboration should be improved by regular joint rounds and interprofessional case discussions. Mitigating stressful factors such as communication with relatives and high workload require allocation of respective resources.

Magnetoelectric Coupling, Ferroelectricity, and Magnetic Memory Effect in Double Perovskite La3Ni2NbO9

We observe ferroelectricity in an almost unexplored double perovskite La3Ni2NbO9. Ferroelectricity appears below ∼60 K, which is found to be correlated with the significant magnetostriction. A reasonably large value of spontaneous electric polarization is recorded to be ∼260 μC/m(2) at 10 K for E = 5 kV/cm, which decreases signifi- cantly upon application of a magnetic field (H), suggesting considerable magnetoelectric coupling. The dielectric permittivity is also influenced by H below the ferroelectric transition. The magnetodielectric response scales linearly to the squared magnetization, as described by the Ginzburg-Landau theory. Meticulous studies of static and dynamic features of dc magnetization and frequency dependent ac susceptibility results suggest spin-glass state below 29 K. Intrinsic magnetic memory effect is observed from zero-field cooled magnetization and isothermal remanent magnetization studies, also pointing spin-glass state below 29 K. Appearance of ferroelectricity together with a significant magnetoelectric coupling in absence of conventional long-range magnetic order is promising for searching new magnetoelectric materials.

Magnetoelectric coupling and exchange bias effects in multiferroic NdCrO3

We report ferroelectricity around  ∼88 K that appears well below T N (∼25 K), unlike other members of RCrO3 series. A synchrotron diffraction study suggests that the occurrence of ferroelectricity in NdCrO3 is coupled to the structural transformation from centrosymmetric Pnma to a non-centrosymmetric Pna21 space group. A strong magnetoelectric coupling is observed in the electric polarization [P(T)]. This coupling is significantly influenced by the magnetic field cooling effect, suggesting an exchange bias effect in P(T). This exchange bias effect is also revealed by the systematic shift of the magnetic hysteresis loops below T(N). The rare occurrence of an exchange bias effect in both the magnetic and electric polarizations associated with a strong magnetoelectric coupling is of fundamental interest, as well as being attractive for technological applications close to liquid nitrogen temperature.

Magnetic memory in nanocrystalline α-Fe2O3 embedded in reduced graphene oxide

Single phase iron oxide (α-Fe₂O₃) of nearly regular ellipsoidal shape, embedded in reduced graphene oxide (RGO) has been prepared by the chemical route. Memory effect is observed in magnetization study.

Kates forefoot arthroplasty in rheumatoid arthritis. A 5-year followup study

The longterm results of Kates forefoot arthroplasty in 74 feet of 41 patients with rheumatoid arthritis (RA) after a mean followup of 5.2 years was considered to be good by 38 patients and poor by 3 patients. The average walking distance had doubled. The mean hallux valgus angle was reduced from 46 to 27 degrees. Surgical results proved to depend on the quality of the arc of the remaining stumps, and not on the severity or activity of RA. Reoperations were necessary in 16 feet of 10 patients because of too prominent distal metatarsal stumps. Despite the absence of pain, 28 patients were not satisfied with the function of the hallux. This might be improved by performing arthrodesis of the first metatarsophalangeal joint.

Antimicrobial, insect sterilizing and ovicidal activity of some oxo-vanadium(IV) and oxo-vanadium(V) complexes

Twenty-three newly synthesized mixed-ligand complexes of oxo-vanadium(IV) and oxo-vanadium(V) were studied for antimicrobial activity. Eight of these complexes were found to have microbicidal properties. The complexes [NH4][VO(gl)2]H2O (gl-H2 = glycolic acid) and [VO(ACOAP)(acac-H)]H20 (ACOAP-H2=Schiff base of acetylacetone and orthoaminophenol, acac-H=acetyl-acetone) show broad bactericidal spectra, while the complexes [VO(ACSAM)2]OH (ACSAM-H = Schiff base of acetylacetone and sulphanilamide) and [VO(CSSAM-H)2]H2O (CSSAM-H =Schiff base of 3-carboxy salicylaldehyde and sulphanilamide) possess pronounced antidermatophytic properties. The latter is inhibitory to plant pathogenic fungi as well. Plant tumour producing Agrobacterium tumefaciens is effectively inhibited in vitro by the complex [VO(ACTSC-Na)(acac)]H2O (ACTSC-H2 = condensation product of acetylacetone and thiosemicarbazide). Minimum inhibitory concentrations of all the active complexes are within the values of 0.125-2.00 mg/ml. Out of the 7 active complexes tested for 50% inhibition of conidial germination of Helminthosporium oryzae, a rice plant pathogen, only 1 complex, viz. [VO(acac) (ACACAACD)] (ACACAACD(H)NH4 equal Schiff base of acetylacetone and ammonium 2-amino-1-cyclopentene-1-dithiocarboxylate) shows a positive result. The effective concentration is 0.55 mg/ml. Three vanadium complexes were tested for insect sterilant and ovicidal properties on the red cotton bug, Dysdercus koenigi. The complex [VO(HASA-Na) (acac)]H2O (HASA-H2 = Schiff base of orthohydroxyacetophenone and anthr anilic acid) was found to be a suitable male sterilant.

Antimicrobial, insect sterilizing and ovicidal activity of some cobalt(II) and cobalt(III) complexes

Twenty-one mixed-ligand complexes of cobalt(II) and cobalt(III) have been screened for their antimicrobial, insect sterilizing and ovicidal activities. Three of these cobalt(III) complexes exhibit broad antimicrobial spectra, including against human bacterial pathogens, dermatophytes and plant pathogenic fungi, while one exhibits feeble activity against a human pathogenic bacterium. These results have been compared with the activity of the corresponding cobalt(II) complexes, which have been found to be inactive, while the free ligands show reduced activity compared with the cobalt(III) complexes. Change in biological activity induced by a particular complex appears to be dependent on the composition of the first co-ordination sphere. Two of these complexes showed 50% inhibition of the conidial germination of Helminthosporium oryzae and Alternaria triticina. These results indicate their potential for use against human and plant pathogenic microbes. Minimum inhibitory concentrations of the cobalt(III) complexes were determined. Three of these cobalt(III) complexes have been tested for insect sterilizing and ovicidal activities on Dysdercus koenigi F. Positive sterilizing and ovicidal actions of [Co(BSOP)(NH3)2]NO3 (where BSOP-H2 is the Schiff base derived from salicylaldehyde and orthophenylene-diamine) were obtained. Possible mechanism(s) of all these activities are discussed qualitatively.