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We report a new, autonomous Lab-on-Chip (LOC) microfluidic pH sensor with a 6000 m depth capability, ten times the depth capability of the state of the art autonomous spectrophotometric sensor. The pH is determined spectrophotometrically using purified meta -Cresol Purple indicator dye offering high precision (<0.001 pH unit measurement reproducibility), high frequency (every 8 min) measurements on the total proton scale from the surface to the deep ocean (to 600 bar). The sensor requires low power (3 W during continuous operation or ∼1300 J per measurement) and low reagent volume (∼3 μL per measurement) and generates small waste volume (∼2 mL per measurement) which can be retained during deployments. The performance of the LOC pH sensor was demonstrated on fixed and moving platforms over varying environmental salinity, temperature, and pressure conditions. Measurement accuracy was +0.003 ± 0.022 pH units ( n = 47) by comparison with validation seawater sample measurements in coastal waters. The combined standard uncertainty of the sensor in situ pH T measurements was estimated to be ≤0.009 pH units at pH 8.5, ≤ 0.010 pH units at pH 8.0, and ≤0.014 pH units at pH 7.5. Integrated on autonomous platforms, this novel sensor opens new frontiers for pH observations, especially within the largest and most understudied ecosystem on the planet, the deep ocean.

Ageing is associated in many organisms with a reduction in motor movements. We have previously shown that the rate of feeding movements of the pond snail, Lymnaea, decreased with age but the underlying cause is not fully understood. Here, we show that dopamine in the cerebro-buccal complex is an important signalling molecule regulating feeding frequency in Lymnaea and that ageing is associated with a decrease in CNS dopamine. A proteomic screen of young and old CNSs highlighted a group of proteins that regulate stress responses. One of the proteins identified was 14-3-3, which can enhance the synthesis of dopamine. We show that the Lymnaea 14-3-3 family exists as three distinct isoforms. The expression of the 29 kDa isoform (14-3-3Lym3) in the cerebro-buccal complex decreased with age and correlated with feeding rate. Using a 14-3-3 antagonist (R18) we were able to reduce the synthesis of L-DOPA and dopamine in ex vivo cerebro-buccal complexes. Together these data suggest that an age-related reduction in 14-3-3 can decrease CNS dopamine leading to a consequential reduction in feeding rate., (© 2020 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

We report a single-blinded randomized controlled trial comparing acupuncture to sham (non-penetrating) needling for relief of symptoms of basal thumb joint arthritis. Seventy acupuncture naive patients with basal thumb joint arthritis were randomized to receive true acupuncture or sham needling with 35 patients in each arm. Blinded baseline and post-treatment assessments included visual analogue pain scores for different grips and movement. Function was assessed using the Nelson questionnaire. Both groups showed statistically and clinically significant improvements in pain at week one post-treatment compared with baseline, but there was no difference between the treatment groups. The pain relief was comparable with published data for some standard treatments. Acupuncture did not perform better than sham needling in this study, indicating that pain relief may have been achieved through non-specific mechanisms. Level of evidence: I.

Background: There are limited respite services for palliative care patients and their families in the Northern Territory (NT). The high prevalence of complex chronic diseases, limited access to primary care services, and the poor living situations of many Aboriginal and Torres Strait Islander Australians result in high hospitalisation rates and pressure on tertiary health services. Palliative Care NT identified a need for a flexible, community based, culturally appropriate respite service in Alice Springs. It was of particular interest to assess the impact of the respite service on the extent to which hospital resources were accessed by this population of patients., Methods: Respite service use and hospital use data were collected over two time periods: the 12 months prior to the establishment of the service; and the first 10 months of the operation of the service. The financial implications of the facility were assessed in terms of the National Weighted Activity Unit (NWAU). Of primary interest in this study was the impact of the respite service on admissions to the Emergency Department (ED), to the Wards, and to the Intensive Care Unit (ICU). The amount of ventilator hours consumed was also of interest., Results: Overall, there was a mean cost saving of $1882.50 per episode for hospital admissions with a reduction in: hospital admissions; mean length of stay; Intensive Care Unit (ICU) hours; and ventilator hours., Conclusions: The establishment of the respite service has met an important and unmet need in Alice Springs: provision of respite where none has existed before. The service did assist with savings to the health department which could contribute to the cost of the facility over time. Two features of the respite facility that may have contributed to the savings generated were the enhanced coordination of care for patients with complex chronic diseases, as well as improved medication compliance and symptom management.

An electrochemical anti-fouling method, based upon the generation of chlorine from seawater, was applied to a proprietary design of Lab on a Chip conductivity, temperature and dissolved oxygen sensor. The method was evaluated using PCR after a six-week field trial in which it significantly reduced the burden of bacterial biofouling., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: In the Northern Territory (NT) there is a lack of respite services available to palliative care patients and their families. Indigenous people in the NT suffer substantially higher rates of poorly controlled chronic disease and premature mortality associated with poor heath than the Australian population as a whole. The need for a flexible, community based, culturally appropriate respite service in Alice Springs was identified and, after the service had been operating for 10 months, a qualitative evaluation was conducted to investigate the experiences of people involved in the use and operation of the service., Methods: Semi-structured interviews were conducted with patients, carers, referrers, and stakeholders. A total of 20 people were interviewed. Interpretative Phenomenological Analysis was used inductively to analyse the transcripts. Two case studies are also described which illustrate in greater detail the impact the respite service has had on people's lives., Results: From the semi-structured interviews, two superordinate themes along with a number of sub themes were developed. The two superordinate themes described both "The Big Picture" considerations as well as the pragmatics of "Making the Service Work". The sub themes highlighted issues such as being stuck at home and the relief that respite provided. The case studies poignantly illustrate the difference the respite service made to the quality of life of two patients., Discussion: The findings clearly indicate an improvement in quality of life for respite patients and their carers. The respite service enabled improved care coordination of chronic and complex patients as well as improved medication compliance and symptom management. As a result of this evaluation a number of recommendations to continue and improve the service are provided.

Background: Rheumatoid arthritis (RA) is the most common idiopathic inflammatory arthritis affecting 0.8 % of the population. It can cause significant hand and wrist damage and dysfunction. Recent advances in anti-rheumatic treatments have the potential to decrease the prevalence of hand deformities in patients with RA. Our aim was to investigate whether there has been a decline over 22-years in the number of hand surgical procedures being undertaken for patients with RA and whether this correlates with the introduction of new anti-rheumatic therapies., Methods: We performed a retrospective, population-based (Derbyshire) study of all patients with RA who underwent hand surgery at the Pulvertaft Hand Centre from 1990 to 2012. Index procedures included (1) teno-synovectomy and soft tissue procedures, (2) wrist arthrodesis/arthroplasty and (3) finger arthrodesis., Results: A total of 297 procedures were performed in 153 Derbyshire patients with RA over the 22-year period, with mean age at surgery 59 years (range 24-88 years). The female to male ratio was 2.5:1. The overall trend showed a peak in 2004 and a subsequent decline thereafter. This coincides with an increasing tendency by local rheumatologists to introduce earlier and more intensive conventional disease-modifying drugs and biological therapies for more resistant disease., Conclusions: There has been a decline in the number of hand surgery procedures being performed on patients with RA during our 22-year population-based study. It indicates that medical treatments and strategies have been successful at preventing disease progression.

Introduction: In resource-poor areas, infectious diseases may be important causes of morbidity among individuals infected with the Human T-Lymphotropic Virus type 1 (HTLV-1). We report the clinical associations of HTLV-1 infection among socially disadvantaged Indigenous adults in central Australia., Methodology and Principal Findings: HTLV-1 serological results for Indigenous adults admitted 1(st) January 2000 to 31(st) December 2010 were obtained from the Alice Springs Hospital pathology database. Infections, comorbid conditions and HTLV-1 related diseases were identified using ICD-10 AM discharge morbidity codes. Relevant pathology and imaging results were reviewed. Disease associations, admission rates and risk factors for death were compared according to HTLV-1 serostatus. HTLV-1 western blots were positive for 531 (33.3%) of 1595 Indigenous adults tested. Clinical associations of HTLV-1 infection included bronchiectasis (adjusted Risk Ratio, 1.35; 95% CI, 1.14-1.60), blood stream infections (BSI) with enteric organisms (aRR, 1.36; 95% CI, 1.05-1.77) and admission with strongyloidiasis (aRR 1.38; 95% CI, 1.16-1.64). After adjusting for covariates, HTLV-1 infection remained associated with increased numbers of BSI episodes (adjusted negative binomial regression, coefficient, 0.21; 95% CI, 0.02-0.41) and increased admission numbers with strongyloidiasis (coefficient, 0.563; 95% CI, 0.17-0.95) and respiratory conditions including asthma (coefficient, 0.99; 95% CI, 0.27-1.7), lower respiratory tract infections (coefficient, 0.19; 95% CI, 0.04-0.34) and bronchiectasis (coefficient, 0.60; 95% CI, 0.02-1.18). Two patients were admitted with adult T-cell Leukemia/Lymphoma, four with probable HTLV-1 associated myelopathy and another with infective dermatitis. Independent predictors of mortality included BSI with enteric organisms (aRR 1.78; 95% CI, 1.15-2.74) and bronchiectasis (aRR 2.07; 95% CI, 1.45-2.98)., Conclusion: HTLV-1 infection contributes to morbidity among socially disadvantaged Indigenous adults in central Australia. This is largely due to an increased risk of other infections and respiratory disease. The spectrum of HTLV-1 related diseases may vary according to the social circumstances of the affected population.

The rapid prototyping of a reversible and one step moulded compartmentalised neuron glass/PDMS device with a thin wall barrier directly adjacent to the reservoirs is presented. A simple moulding technique to produce these devices results in a barrier of 560 μm where the 3 μm deep by 8 μm wide channels can be reversibly fabricated in either the glass base or PDMS compartmentalised mould depending on the type of application required. Using glass substrates with commercially laser engraved microchannels, both the PDMS planar and PDMS channelled device can be easily fabricated in a standard laboratory. The compartmentalised device has several advantages including good experimental accessibility and versatility with a variety of end user applications.

The electrokinetic transport behavior of λ-DNA (48 kbp) in 20 nm-high fused-silica nanoslits in the presence of short-chain PVP is investigated. Mobility and video data show a number of phenomena that are typical of DNA transport through gels or polymer solutions, thus indicative of rigid migration obstacles in the DNA pathway. Calculations show that a several nanometer thin layer of wall-adsorbed PVP ('nano-gel') can provide such a rigid obstacle matrix to the DNA. Such ultrathin wall-adsorbed polymer layers represent a new type of matrix for electrokinetic DNA separation., (Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The mini C-arm image intensifier (mini C-arm) has now become an established diagnostic tool in the hand surgery outpatient department. This study reviews the use of the mini C-arm and formal radiographs (X-rays) in the outpatient hand surgery setting. X-rays provide a standard image whereas the mini C-arm can obtain non-standard images to aid diagnosis and treatment. The mini C-arm enables the clinician to obtain dynamic images and perform interventions such as manipulations or injections. The mini C-arm results in a significantly lower radiation exposure for the patients than a formal X-ray. Use of the mini C-arm may be cheaper, and can lead to a shorter outpatient visit with less travel between hospital departments., (Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Microelectrode amperometry is uniquely suited for characterising the dynamics of neurotransmitter release, as it offers unparalleled spatial and temporal resolution. We have used carbon fibre microelectrodes to study release of the monoamine neurotransmitter serotonin (5-HT) and the gaseous transmitter nitric oxide (NO) in intact central nervous system of the water snail, Lymnaea stagnalis. Analysis of spontaneous vesicular release of 5-HT and depolarisation-induced release of NO reveals significant differences with ageing that may be associated with changes in protein structure and function.

A hybrid microfluidic device that uses hydrodynamic forces to separate human plasma from blood cells has been designed and fabricated and the advantageous effects of temperature and flow rates are investigated in this paper. The blood separating device includes an inlet which is reduced by approximately 20 times to a small constrictor channel, which then opens out to a larger output channel with a small lateral channel for the collection of plasma. When tested the device separated plasma from whole blood using a wide range of flow rates, between 50 microl min(-1) and 200 microl min(-1), at the higher flow rates injected by hand and at temperatures ranging from 23 degrees C to 50 degrees C, the latter resulting in an increase in the cell-free layer of up to 250%. It was also tested continuously using between 5% and 40% erythrocytes in plasma and whole blood without blocking the channels or hemolysis of the cells. The mean percentage of plasma collected after separation was 3.47% from a sample of 1 ml. The percentage of cells removed from the plasma varied depending on the flow rate used, but at 37 degrees C ranged between 95.4 +/- 1% and 97.05 +/- 05% at 100 microl min(-1) and 200 microl min(-1), respectively. The change in temperature also had an effect on the number of cells removed from the plasma which was between 93.5 +/- 0.65% and 97.01 +/- 0.3% at 26.9 degrees C and 37 degrees C, respectively, using a flow rate of 100 microl min(-1). Due to its ability to operate in a wide range of conditions, it is envisaged that this device can be used in in vitro 'lab on a chip' applications, as well as a hand-held point of care (POC) device.

This article presents the fabrication and characterisation of a high-speed detection micro-Coulter counter with two-dimensional (2D) adjustable aperture and differential impedance detection. The developed device has been fabricated from biocompatible and transparent materials (polymer and glass) and uses the principle of hydrodynamic focusing in two dimensions. The use of a conductive solution for the sample flux and non-conductive solutions for the focalising fluxes provides an adjustable sample flow where particles are aligned and the resistive response concentrated, consequently enhancing the sensitivity and versatility of the device. High-speed counting of 20 microm polystyrene particles and 5 microm yeast cells with a rate of up to 1,000 particles/s has been demonstrated. Two-dimensional focusing conditions have been used in devices with physical cross-sectional areas of 180 microm x 65 microm and 100 microm x 43 microm, respectively, in which particles resulted undetectable in the absence of focusing. The 2D-focusing conditions have provided, in addition, increased detection sensitivity by a factor of 1.6 as compared to 1D-focusing conditions.

This study utilised the pond snail, Lymnaea to examine the contribution that alterations in serotonergic signalling make to age-related changes in feeding. Age-related decreases in 5-HIAA levels in feeding ganglia were positively correlated with a decrease in the number of sucrose-evoked bites and negatively correlated with an increase in inter-bite interval, implicating alterations in serotonergic signalling in the aged phenotype. Analysis of the serotonergic cerebral giant cell (CGC) input to the protraction motor neurone (B1) demonstrated that fluoxetine (10-100 nM) increased the amplitude/duration of the evoked EPSP in both young and middle aged but not in old neurones, suggesting an age-related attenuation of the serotonin transporter. 5-HT evoked a concentration-dependent increase in the amplitude/duration of B1 EPSP, which was greater in old neurones compared to both young and middle aged. Conversely, the 5-HT-evoked depolarisation and conditional bursting of the swallow motor neurone (B4) were attenuated in old neurones, functions critical for a full feeding rhythm. The CGCs' ability to excite B1 was blocked by cinanserin but not by methysergide. Conversely, the CGC to B4 connection was completely blocked by methysergide and only partially by cinanserin suggesting that age-related changes may be receptor-specific. In summary, synapse-specific attenuation of the CGC-B4 connection and enhancement of the CGC-B1 connection would slow the swallow phase and maintain protraction, consistent with behavioural observations.

We have fabricated a six individual addressable gold working electrode microarray. The device is wirebonded to an eight-pin DIL package that can be easily interconnected to an external multi-channel potentiostat. A polyion complex film coating on the electrode surface provides a suitable coating for the growth of cells. The responses of oxygen and nitric oxide were assessed on uncoated and coated devices using electroanalytical methods. The film coating reduced the diffusion current by approximately 20% in both cases. No changes in the electrochemical mechanism were observed. Simultaneous recordings were obtained for 2 h in the presence of the cells, thus the device is stable for the duration of the bioanalytical measurements. Measurements were conducted to study the simultaneous changes in oxygen and nitric oxide levels in cultured fibroblast cells in the presence of growth hormones that cause cell proliferation. Increases in oxygen consumption of the cells were coupled with increases in nitric oxide levels when in the presence of the growth hormones. Use of a biological detergent to cause an oxidative burst resulted in a large increase in the current for potentials set to detect nitric oxide and oxygen.

Mini C-arm image intensifiers are used commonly in surgery of the upper limb. With relatively low doses of emitted ionising radiation, portability and superior quality of image, they are a useful aid to the operating surgeon. However, these benefits are not so often used outside the theatre setting. This paper examines the use of a mini C-arm image intensifier in the out-patient clinic and presents an audit of 100 consecutive out-patients. We reviewed the potential benefits and effects on their care pathway. We also look at the specific radiation protection issues of the mini C-arm image intensifier in the out-patients clinic. We believe use of the mini C-arm image intensifier in the out-patient setting may speed treatment and reduce the cost of treatment.

Multiple film-coated nitric oxide sensors have been fabricated using Nafion and electropolymerized polyeugenol or o-phenylenediamine on 30-microm carbon fiber disk electrodes. This is a rare study that utilizes disk electrodes rather than the widely used protruding tip microelectrodes in order to measure from a biological environment. These electrodes have been used to evaluate the differences in nitric oxide release between two different identified neurons in the pond snail, Lymnaea stagnalis. These results show the first direct measurements of nitric oxide release from individual neurons. The electrodes are very sensitive to nitric oxide with a detection limit of 2.8 nM and a sensitivity of 9.46 nA microM-1. The sensor was very selective against a variety of neurochemical interferences such as ascorbic acid, uric acid, and catecholamines and secondary oxidation products such as nitrite. Nitric oxide release was measured from the cell bodies of two neurons, the cerebral giant cell (CGC) and the B2 buccal motor neuron, in the intact but isolated CNS. A high-Ca2+/high-K+ stimulus was capable of evoking reproducible release. For a given stimulus, the B2 neuron released more nitric oxide than the CGC neuron; however, both cells were equally suppressed by the NOS inhibitor l-NAME.

Although voltammetry has proved an important tool for unraveling the dynamics of specific neurotransmitter molecules during the past decade, it has been very difficult to monitor more than one neurotransmitter simultaneously. In this work, we present a voltammetric methodology that allows discrimination between dopamine and serotonin, two important neurotransmitter molecules with very similar electrochemical properties, in the presence of high concentrations of ascorbate. We combined the application of a novel large-amplitude/high-frequency voltage excitation with signal processing techniques valid for the analysis of nonstationary and nonlinear phenomena. This allows us to minimize the contribution from capacitance and preserve the faradaic features of the voltammetric response providing us with excellent voltammetric detail. Using appropriate voltage excitation parameters and defining specific regions in the voltage space, so-called voltage windows, we can measure the concentrations of dopamine and serotonin separately or independently in mixed solutions even in the presence of high concentrations of ascorbate. Because of the enhanced voltammetric detail of this new technique, it is also possible to explore effects attributed to interfacial phenomena such as adsorption/desorption and electrode fouling.

Using the CNS of Lymnaea stagnalis a method is described for the rapid analysis of neurotransmitters and their metabolites using high performance liquid chromatography coupled with electrochemical detection. Tissue samples were homogenised in ice-cold 0.1 M perchloric acid and centrifuged. Using a C(18) microbore column the mobile phase was maintained at a flow rate of 100 microl/min and consisted of sodium citrate buffer (pH 3.2)-acetonitrile (82.5:17.5, v/v) with 2 mM decane-sulfonic acid sodium salt. The potential was set at +750 mV versus Ag|AgCl reference electrode at a sensitivity of 50 nA full scale deflection. The detection limit for serotonin was 11.86 ng ml(-1) for a 5 microl injection. Preparation of tissue samples in mobile phase reduced the response to dopamine and serotonin compared with perchloric acid. In addition it was found that the storage of tissue samples at -20 degrees C caused losses of dopamine and serotonin. As a result of optimising the sample preparation and mobile phase the total time of analysis was substantially reduced resulting in a sample preparation and assay time of 15-20 min.

Surface-enhanced resonance Raman scattering (SERRS) of a model derivative of TNT was detected using a microflow cell designed within the framework of the lab-on-a-chip concept, using only the analyte and readily available reagents. The SERRS substrate, silver colloid, was prepared in situ, on-chip, by borohydride reduction of silver nitrate. The silver colloid was imaged within the chip using a white light microscope in either transmission or, due to the high reflectivity of the colloid, reflection mode. A fine stream of colloid approximately 30 microm in width was formed in a 250-microm-wide channel at the point where the colloid preparation reagents met. The chip was designed to produce a concentrated stream of colloid within a laminar regime, such that particles did not readily disperse into the fluid. One result of this was to reduce the effective volume of analysis. Attempts to deliberately disrupt this stream with microstructured pillars, fabricated in the fluidic channels, were unsuccessful. The chip was also designed to have the appropriate dimensions for detection using a modern Raman microscope system, which collects scattering from a very small volume. A dye derived from TNT was used as a model analyte. Quantitative behavior was obtained over 4 orders of magnitude with a detection limit of 10 fmol. This performance is between 1 and 2 orders of magnitude better than that achieved using a macroflow SERRS cell. The technique has the added advantage that both reagent consumption and effluent production are greatly reduced, leading to reduced operating costs and a decreased environmental impact

A micromachined capillary electrophoresis system has been fabricated on a glass device for the separation and indirect fluorescence detection of phenols. Using this device two phenols viz., 2,4-dichlorophenol and pentachlorophenol, were separated within 12 s compared to under 19 min on a conventional capillary electrophoresis system using direct ultraviolet detection. The precision of the glass device ranged from 12.7%-16.7% compared to 0.42%-4.9% for the conventional system. Both systems showed good linearity in the concentration range of 0.8-6.38 mM for the glass device and 5-130 microM for the conventional system. The relationship between temperature and high voltage with baseline drift was also investigated. These results provide a foundation for the development of a miniaturised chemical analysis system for the on-line analysis of phenols in water.