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This paper introduces a cheap simple MWCNTs@paper biosensor for the detection of CA19-9, which is a biomarker of pancreatic cancer. By adding the CA19-9 antibody to the surface of MWCNTs which are deposited on the microporous filter paper, the correlation between the concentration of CA19-9 and resistance of biosensor element was linear due to the site-specific binding of antigen and antibody. The detection range is wide (0 U/mL–at least 1000 U/mL), and even in the low concentration of CA19-9, the linearity remains satisfying. Based on this property, it could be used for the detection of early-stage pancreatic cancer. Besides, this research originally introduces a vacuum freeze-drying method for the long-term preservation of biosensor, prolonging its storage time from 3 h to at least 7 days, which signifcantly promoted its value in practical application. One piece of the MWCNTs@paper biosensor only cost $2 (about 30 times cheaper than ELISA) approximately, and the detection speed is satisfying (2 h, 12 times faster than ELISA), which will possibly increase its opportunity of mass production and clinical practice.

BackgroundAlthough there is evidence of a relationship between religion/ spirituality and mental health, it remains unclear how Brazilian psychiatrists deal with the religion/spirituality of their patients.AimsTo explore whether Brazilian psychiatrists enquire about religion/spirituality in their practice and whether their own beliefs influence their work.MethodFour hundred and eighty-four Brazilian psychiatrists completed a cross-sectional survey on religion/spirituality and clinical practice.ResultsMost psychiatrists had a religious affiliation (67.4%) but more than half of the 484 participants (55.5%) did not usually enquire about patients' religion/spirituality. The most common reasons for not assessing patients' religion/spirituality were ‘being afraid of exceeding the role of a doctor’ (30.2%) and ‘lack of training’ (22.3%).ConclusionsVery religious/spiritual psychiatrists were the most likely to ask about their patients' religion/spirituality. Training in how to deal with a patient's religiosity might help psychiatrists to develop better patient rapport and may contribute to the patient's quicker recovery.

There is a need for an effective and safe emetic agent that dog owners could easily administer to their dogs following veterinary advice in cases of potential poisoning. As a response to this need, a randomised, double-blind, multi-site, clinical field study was performed to assess the efficacy, safety and usability of ropinirole eye drops to induce vomiting in dogs. Ropinirole (target dose 3.75 mg/m2) was applied to eyes of 100 dogs, and 32 dogs received placebo. The drug was administered by the dog owner at a veterinary clinic under the supervision of a veterinarian and led to vomition in 95% of the ropinirole-treated dogs within 30 min. The median time to first vomit was 10 min (range: 3–37 min). None of the dogs receiving placebo vomited in this time period. All owners were able to administer the product and 96% of them assessed the administration to be very easy or easy, which was confirmed by the observing veterinarian. Some ocular signs were seen both with ropinirole and placebo, hyperaemia being the most common. All observed signs were transient and in most cases mild. Ropinirole eye drops provided an effective, safe and reliable means to induce emesis in dogs.

A total of 30 students scoring between 12 and 20 on the Test Anxiety Scale who had been exhibiting an anxious state > 24 hours, and 30 normal control students were recruited. Indices of heart rate variability were recorded using an Actiheart electrocardiogram recorder at 10 minutes before auricular pressing, in the first half of stimulation and in the second half of stimulation. The results revealed that the standard deviation of all normal to normal intervals and the root mean square of standard deviation of normal to normal intervals were significantly increased after stimulation. The heart rate variability triangular index, very-low-frequency power, low-frequency power, and the ratio of low-frequency to high-frequency power were increased to different degrees after stimulation. Compared with normal controls, the root mean square of standard deviation of normal to normal intervals was significantly increased in anxious students following auricular pressing. These results indicated that auricular pressing can elevate heart rate variability, especially the root mean square of standard deviation of normal to normal intervals in students with pre-exam anxiety.

Modern veterinary medicine offers numerous options for treatment and clinicians must decide on the best one to use. Interventions causing short-term harm but ultimately benefitting the animal are often justified as being in the animal's best interest. Highly invasive clinical veterinary procedures with high morbidity and low success rates may not be in the animal's best interest. A working party was set up by the European College of Veterinary Anaesthesia and Analgesia to discuss the ethics of clinical veterinary practice and improve the approach to ethically challenging clinical cases. Relevant literature was reviewed. The 'best interest principle' was translated into norms immanent to the clinic by means of the 'open question argument'. Clinical interventions with potential to cause harm need ethical justification, and suggest a comparable structure of ethical reflection to that used in the context ofin vivoresearch should be applied to the clinical setting. To structure the ethical debate, pertinent questions for ethical decision-making were identified. These were incorporated into a prototype ethical tool developed to facilitate clinical ethical decision-making. The ethical question 'Where should the line on treatment be drawn' should be replaced by 'How should the line be drawn?'

High-throughput sequencing has drastically changed the research of genes responsible for genetic disorders and is now gradually introduced as an additional genetic diagnostic testing in clinical practice. The current debates on the emerging technical, medical and ethical issues as well as the potential optimum use of the available technology are discussed.

This paper summarises issues pertaining to the environmental effects of clinical practice. Using examples of environmental awareness, the concept of environmental auditing is introduced by way of a pointer to actions to limit the environmental impact of dentistry. It is concluded that environmental management and auditing would be advantageous to dentistry.

In clinical practice the authors have found the 2-mm wide Periopaper slightly too large for insertion into the gingival crevice. This study investigated the reliability of Periotron readings for quantitation of gingival fluid when using filter paper strips which are narrower than the Periopaper. The round-ended strips were cut to a standard size 1 mm wide and 15 mm long using a conchotome. A microsyringe was used to deposit 0.1 microliter of four different fluids (distilled water, undiluted horse serum, diluted horse (1:2) and human (1:2) sera) onto Periopaper and the narrow S-690 strips. The moistened end of each strip was placed between the jaws of both the Periotron 600 and the Periotron 6000, and the maximum digital reading was recorded in two series of 20 measurements for each of the four fluids and two strips, giving a total of 640 assessments. A comparison between the two series confirmed the excellent reproducibility of Periotron readings. The comparison between strips revealed from 10% (Periotron 600) to 20% (Periotron 6000) lower readings for the S-690 than for the Periopaper strips for all fluids. The SD of the readings for both the S-690 and the Periopaper strip was low enough to make the difference between strips statistically significant. The slightly lower readings obtained with the narrow S-690 strip were found as reliable as those recorded when using Periopaper.

BackgroundThe appropriate medical treatment test (ATT), included in the Mental Health Act (MHA) (1983, as amended 2007), aims to ensure that detention only occurs when treatment with the purpose of alleviating a mental disorder is available.AimsAs part of the Assessing the Impact of the Mental Health Act (AMEND) project, this qualitative study aimed to assess professionals' understanding of the ATT, and its impact on clinical practice.MethodForty-one professionals from a variety of mental health subspecialties were interviewed. Interviews were coded related to project aims, and themes were generated in an inductive process.ResultsWe found that clinicians are often wholly relied upon for the ATT. Considered treatment varied depending on the patient's age rather than diagnosis. The ATT has had little impact on clinical practice.ConclusionsOur findings suggest the need to review training and support for professionals involved in MHA assessments, with better-defined roles. This may enable professionals to implement the ATT as its designers intended.