Variations in Oncology Consultations: How Dictation Allows Variations to be Documented in Standardized Ways

In-between 2016 and 2017 a new hospital information system (HIS) was introduced at several hospitals in Denmark radically changing the core work practices for a majority of the healthcare professionals. Promptly, the new HIS began to receive criticism from healthcare professionals for failing to live up to proclaimed expectations. To fully understand the problems experienced by the healthcare professionals we need to understand the fundamental nature of the work prior to the implementation. In this paper, we investigate patient consultations as they were performed prior to the implementation of the HIS at an oncology department. Reporting from a 1.5 year-long study, we find patient consultations were organized in three sequential activities: review, interaction, and documentation. Further, we find that the dictaphone served as a key artifact allowing physicians to enact flexibility in documentation while simultaneously providing them with the capability to communicate and coordinate with the medical secretaries. Our empirical findings suggest that the medical secretaries are critical for structured documentation of variations in health data and are the cornerstones that allow physicians to enact sentimental efforts when interacting with patients. These insights prove important in understanding the criticism aimed at the new HIS implementation since the implementation removed the dictaphone as a key artifact and instead introduced a new organizational structure where documentation was assumed accomplished in parallel with patient interaction. The transformation consequently shifted work, previously performed by the medical secretaries, to the physicians.     

Functions of emulsifiers in food systems

The function of food grade emulsifiers in various food products (emulsions, starch based food, yeast raised bakery products, etc.) are reviewed. The stability of emulsions against coalescence of dispersed droplets is among other factors dependent on monoor multimolecular interfacial films with viscoelastic properties formed by adsorbed emulsifier molecules. Agglomeration of fat globules in whippable emulsion is needed to obtain desired foam stability and texture and can be controlled by lipophilic emulsifiers. Complex formation with starch components (amylose) is influenced both by the chemical structure of an emulsifier and by its physical behaviour in water. Interaction with proteins takes place primarily with anionic emulsifiers or very hydrophilic, nonionic types, which thereby improves the rheological properties of wheat gluten. Emulsifiers are also used as crystal modifying agents in fats where polymorphic changes during storage creates texture problems.     

Total Synthesis of desB30 Insulin Analogues by Biomimetic Folding of Single‐Chain Precursors

Insulin is a peptide hormone consisting of 51 amino acids in two chains with three disulfide bridges. Human insulin and various analogues are used for the treatment of diabetes and are produced recombinantly at ton scale. Herein, we report the chemical synthesis of insulin by the step‐wise, Fmoc‐based, solid‐phase synthesis of single‐chain precursors with solubilising extensions, which under redox conditions, spontaneously fold with the correct pairing of the three disulfide bridges. The folded, single‐chain, insulin precursors can be transformed into bioactive two‐chain desB30 insulin by the simultaneous removal of the solubilising extension (4–5 residues) and the chain‐bridging C‐peptide (3–5 residues) by employing Achromobacter lyticus protease—a process well‐known from the yeast‐based recombinant production of insulin. The overall yields of synthetic insulins were as much as 6 %, and the synthetic process was straightforward and not labour intensive.     

Effects of Emulsifiers on Protein-Fat Interaction in Ice Cream Mix during Ageing I: Quantitative Analyses

Ageing of ice cream mix at 0 to 10°C for a minimum of 3 up to 24 hours prior to ice cream production in the ice cream machine is generally used to improve various physical properties. During ageing the fat phase of the mix crystallizes and protein is slowly desorbed from the surface of the fat globules. In the presence of emulsifiers fat crystallization and protein desorption is distinctly enhanced resulting in increased agglomeration of fat globules during ice cream manufacture which is important for the formation and stability of the final ice cream. The effect of emulsifiers on ageing is due to their strong interfacial activity at low temperature.     

Content of some organic acids in cloudberry (Rubus chamaemorus L.)

Cloudberry (Rubus chamaemorus L.) is very resistant to deterioration by micro-organisms and has a good keeping quality. In the present study the natural content of some organic acids, often used as food preservatives, has been determined by gas chromatography. Benzoic acid was found in the greatest amount (about 50 mg/100 g cloudberry). Sorbic acid, salicylic acid, ?-hydroxy-, methyl-?-hydroxy-and propyl-?-hydroxy-benzoic acid were found in smaller amounts (less than 1 mg/100 g cloudberry).The amount of benzoic acid changes very little with the degree of ripeness or place of growth.     

Heat inactivation and pH optima of peroxidase and catalase in carrot,swede and Brussels sprouts

Heat inactivation and pH optima of the enzymes peroxidase and catalase were studied in carrot, swede and Brussels sprouts. There were differences in the heat stabilities of the peroxidases from different vegetables, but all peroxidases were more heat stable than the catalases. From the pH profiles and the heat stability curves it was concluded that both the peroxidases and catalases in the three vegetable species are somewhat different. Lipoxygenase and phenolase activities were not detected by the methods used.     

Prediction of Chronic Inflammation for Inhaled Particles: the Impact of Material Cycling and Quarantining in the Lung Epithelium

On a daily basis, people are exposed to a multitude of health-hazardous airborne particulate matter with notable deposition in the fragile alveolar region of the lungs. Hence, there is a great need for identification and prediction of material-associated diseases, currently hindered due to the lack of in-depth understanding of causal relationships, in particular between acute exposures and chronic symptoms. By applying advanced microscopies and omics to in vitro and in vivo systems, together with in silico molecular modeling, it is determined herein that the long-lasting response to a single exposure can originate from the interplay between the newly discovered nanomaterial quarantining and nanomaterial cycling between different lung cell types. This new insight finally allows prediction of the spectrum of lung inflammation associated with materials of interest using only in vitro measurements and in silico modeling, potentially relating outcomes to material properties for a large number of materials, and thus boosting safe-by-design-based material development. Because of its profound implications for animal-free predictive toxicology, this work paves the way to a more efficient and hazard-free introduction of numerous new advanced materials into our lives.     

Electrodialytic extraction of Cd and Cu from sediment from Sisimiut Harbour, Greenland

A previous study showed that the sediment of Sisimiut Harbour, Greenland is polluted with Cu and Cd to an extent where toxicological effects must be expected. This study was aimed at evaluating the possibility for removing Cu and Cd from this sediment by an electrodialytic method and also to evaluate the removal rate of the two heavy metals. The sediment was suspended in distilled water during application of current. Both heavy metals were removed successfully. The Cu concentration was reduced from 97 to 16mg/kg and the Cd concentration was reduced from 0.55 to 0.03mg/kg after 28 days with an applied current density of 1.2mAcm(-2). However, it was seen that the removal rate decreased considerably after 3 days with an applied current density of 0.5mAcm(-2) and the major part of the two heavy metals was removed during the first 3 days (the Cu concentration was reduced with 74% and the Cd concentration with 80%). Thus a large reduction in concentrations can be obtained relatively fast. During the process of electrodialytic treatment the sediment suspension is acidified and reaches pH 2 after about 3 days (with 0.5mAcm(-2)), where it stabilizes. A comparison with chemical extraction in HNO(3) at about the same pH showed that 50-70% more Cu and 11% more Cd was removed during the electrodialytic treatment.     

The chemistry of Norwegian groundwaters: III. The distribution of trace elements in 476 crystalline bedrock groundwaters, as analysed by ICP-MS techniques

Four hundred and seventy-six groundwater samples from boreholes in Norwegian crystalline bedrock have been analysed by ICP-MS techniques. The results for 53 trace elements are presented as cumulative frequency distribution diagrams and are compared with relevant international drinking water norms. A range of trace elements appear to be enriched in granitic waters and depleted in anorthositic waters which is to be expected as generally granitic rocks are enriched in trace elements above those in anorthosites. A selection of elements which may be toxic in excess when present in drinking water are further discussed (Be, Tl, Th, U, Cd, Pb, As, Ni, and Hg). For uranium, 18% of the samples exceed the American maximum admissible concentration of 20 micrograms/l; 7% of the samples fail to meet the Russian drinking water norms for beryllium of 0.2 microgram/l. For some parameters such as U, Be and Tl, no Norwegian drinking water regulations are set, while the American and the Russian norms differ significantly from each other. Between 0 and 1.5% of the wells exceed Norwegian drinking water norms for each of the other selected elements.     

Pro- and antioxidative activity of protein fractions from pork (longissimus dorsi)

Protein fractions from pork (longissimus dorsi), isolated in search of the factor in meat enhancing non-heme iron absorption, have been analysed for their effect on radical formation and oxidation processes. In heat-treated minced meat samples with the protein fractions incorporated, the water-soluble proteins showed a prooxidative effect on lipid oxidation compared to the salt-soluble and the insoluble proteins, which did not influence oxidation in the meat system relative to control samples. The level of secondary oxidation products in meat samples with water-soluble proteins added was, however, not as high as would be expected from the ability of this protein fraction to initiate oxidation as measured by spin-trapping ESR-spectroscopy in meat emulsions and by oxygen depletion rates in a lipid model system with the protein fraction added. In agreement with this observation, the water-soluble protein fraction was found, in addition to being prooxidative, also to have the highest antioxidative potential of the three protein fractions as measured by spin probing ESR-spectroscopy (Fremy's salt method). The prooxidative activity of the water-soluble proteins was assigned to myoglobin and hemoglobin derivatives (detected spectrophotometrically), emphasising the role of iron-catalysis in oxidative deterioration of meat products.