Comparing the effectiveness of polymer debriding devices using a porcine wound biofilm model

Objective: Debridement to remove necrotic and/or infected tissue and promote active healing remains a cornerstone of contemporary chronic wound management. While there has been a recent shift toward less invasive polymer-based debriding devices, their efficacy requires rigorous evaluation.Approach: This study was designed to directly compare monofilament debriding devices to traditional gauze using a wounded porcine skin biofilm model with standardized application parameters. Biofilm removal was determined using a surface viability assay, bacterial counts, histological assessment, and scanning electron microscopy (SEM).Results: Quantitative analysis revealed that monofilament debriding devices outperformed the standard gauze, resulting in up to 100-fold greater reduction in bacterial counts. Interestingly, histological and morphological analyses suggested that debridement not only removed bacteria, but also differentially disrupted the bacterially-derived extracellular polymeric substance. Finally, SEM of post-debridement monofilaments showed structural changes in attached bacteria, implying a negative impact on viability.Innovation: This is the first study to combine controlled and defined debridement application with a biologically relevant ex vivo biofilm model to directly compare monofilament debriding devices.Conclusion: These data support the use of monofilament debriding devices for the removal of established wound biofilms and suggest variable efficacy towards biofilms composed of different species of bacteria

Determination of suitable housekeeping genes for normalisation of quantitative real time PCR analysis of cells infected with human immunodeficiency virus and herpes viruses

The choice of an appropriate housekeeping gene for normalisation purposes has now become an essential requirement when designing QPCR experiments. This is of particular importance when using QPCR to measure viral and cellular gene transcription levels in the context of viral infections as viruses can significantly interfere with host cell pathways, the components of which traditional housekeeping genes often encode. In this study we have determined the reliability of 10 housekeeping genes in context of four heavily studied viral infections; human immunodeficiency virus type 1, herpes simplex virus type 1, cytomegalovirus and varicella zoster virus infections using a variety of cell types and virus strains. This provides researchers of these viruses with a shortlist of potential housekeeping genes to use as normalisers for QPCR experiments

The effect of differing intensities of acute cycling on preadolescent academic achievement

The present study examined the effects of differing intensity levels of acute exercise on preadolescent academic ability. In a repeated measures design, 18 preadolescent participants (mean age±S.D.=9.8±1.4 years: 9 male and 9 female) completed the Wide Range Achievement Test (WRAT 4) following 20 minutes of rest, 20-minutes on a cycling ergometer at 50% maximal heart rate reserve (HRR), and 20-minutes on a cycling ergometer at 75% HRR on separate days. Exercise was found to improve spelling irrespective of intensity level. Moderate levels of exercise improved reading although the effect of high levels of intensity is less clear. Both intensity levels impaired arithmetic, whilst sentence comprehension was unaffected. These findings further support the past research that indicates acute bouts of exercise can selectively improve cognition in preadolescent children. However, the present study finds no support for the notion that increasing the intensity of exercise accentuates benefits. © 2013 © 2013 European College of Sport Science

The impact of water on slip system activity in olivine and the formation of bimodal crystallographic preferred orientations

Crystallographic preferred orientations (CPOs) in olivine are widely used to infer the mechanisms, conditions, and kinematics of deformation of mantle rocks. Recent experiments on water-saturated olivine were the first to produce a complex CPO characterised by bimodal orientation distributions of both [100] and [001] axes and inferred to form by combined activity of (001)[100], (100)[001], and (010)[100] slip. This result potentially provides a new microstructural indicator of deformation in the presence of elevated concentrations of intracrystalline hydrous point defects and has implications for the interpretation of seismic anisotropy. Here, we document a previously unexplained natural example of this CPO type in a xenolith from Lesotho and demonstrate that it too may be explained by elevated concentrations of hydrous point defects. We test and confirm the hypothesis that combined (001)[100], (100)[001], and (010)[100] slip were responsible for formation of this CPO by (1) using high-angular resolution electron backscatter diffraction to precisely characterise the dislocation types present in both the experimental and natural samples and (2) employing visco-plastic self-consistent simulations of CPO evolution to assess the ability of these slip systems to generate the observed CPO. Finally, we utilise calculations based on effective-medium theory to predict the anisotropy of seismic wave velocities arising from the CPO of the xenolith. Maxima in S-wave velocities and anisotropy are parallel to both the shear direction and shear plane normal, whereas maxima in P-wave velocities are oblique to both, adding complexity to interpretation of deformation kinematics from seismic anisotropy.D. Wallis, L.N. Hansen, and A.J. Wilkinson acknowledge support from the Natural Environment Research Council Grant NE/M000966/1. M. Tasaka acknowledges support through a JSPS Research Fellowship for Young Scientists (26-4879) and the Japan Society for the Promotion of Science (16K17832). D.L. Kohlstedt acknowledges support through NASA Grant NNX15AL53G. K.M. Kumamoto acknowledges support through NSF Division of Earth Science grants 1255620 and 1625032

Novel Glycomimetics Protect Against Glycated Low-Density Lipoprotein-Induced Vascular Calcification In Vitro by Attenuation of the RAGE/ERK/CREB Pathway

Heparan sulphate (HS) can act as a co-receptor on the cell surface and alterations in this process underpin many pathological conditions. We have previously described the usefulness of mimics of HS (glycomimetics) in protection against β-glycerophosphate-induced vascular calcification and in the restoration of the functional capacity of diabetic endothelial colony-forming cells in vitro. This study aims to investigate whether our novel glycomimetic compounds can attenuate glycated low-density lipoprotein (g-LDL)-induced calcification by inhibiting RAGE signalling within the context of critical limb ischemia (CLI). We used an established osteogenic in vitro vascular smooth muscle cell (VSMC) model. Osteoprotegerin (OPG), sclerostin and glycation levels were all significantly increased in CLI serum compared to healthy controls, while the vascular calcification marker osteocalcin (OCN) was down-regulated in CLI patients vs. controls. Incubation with both CLI serum and g-LDL (10 µg/mL) significantly increased VSMC calcification vs. controls after 21 days, with CLI serum-induced calcification apparent after only 10 days. Glycomimetics (C2 and C3) significantly inhibited g-LDL and CLI serum-induced mineralisation, as shown by a reduction in alizarin red (AR) staining and alkaline phosphatase (ALP) activity. Furthermore, secretion of the osteogenic marker OCN was significantly reduced in VSMCs incubated with CLI serum in the presence of glycomimetics. Phosphorylation of cyclic AMP response element-binding protein (CREB) was significantly increased in g-LDL-treated cells vs. untreated controls, which was attenuated with glycomimetics. Blocking CREB activation with a pharmacological inhibitor 666-15 replicated the protective effects of glycomimetics, evidenced by elevated AR staining. In silico molecular docking simulations revealed the binding affinity of the glycomimetics C2 and C3 with the V domain of RAGE. In conclusion, these findings demonstrate that novel glycomimetics, C2 and C3 have potent anti-calcification properties in vitro, inhibiting both g-LDL and CLI serum-induced VSMC mineralisation via the inhibition of LDLR, RAGE, CREB and subsequent expression of the downstream osteogenic markers, ALP and OCN

Women’s experiences of receiving care for pelvic organ prolapse: a qualitative study

Background Pelvic organ prolapse is a common urogenital condition affecting 41–50% of women over the age of 40. To achieve early diagnosis and appropriate treatment, it is important that care is sensitive to and meets women’s needs, throughout their patient journey. This study explored women’s experiences of seeking diagnosis and treatment for prolapse and their needs and priorities for improving person-centred care. Methods Twenty-two women receiving prolapse care through urogynaecology services across three purposefully selected NHS UK sites took part in three focus groups and four telephone interviews. A topic guide facilitated discussions about women’s experiences of prolapse, diagnosis, treatment, follow-up, interactions with healthcare professionals, overall service delivery, and ideals for future services to meet their needs. Data were analysed thematically. Results Three themes emerged relating to women’s experiences of a) Evaluating what is normal b) Hobson’s choice of treatment decisions, and c) The trial and error of treatment and technique. Women often delayed seeking help for their symptoms due to lack of awareness, embarrassment and stigma. When presented to GPs, their symptoms were often dismissed and unaddressed until they became more severe. Women reported receiving little or no choice in treatment decisions. Choices were often influenced by health professionals’ preferences which were subtly reflected through the framing of the offer. Women’s embodied knowledge of their condition and treatment was largely unheeded, resulting in decisions that were inconsistent with women’s preferences and needs. Physiotherapy based interventions were reported as helping women regain control over their symptoms and life. A need for greater awareness of prolapse and physiotherapy interventions among women, GPs and consultants was identified alongside greater focus on prevention, early diagnosis and regular follow-up. Greater choice and involvement in treatment decision making was desired. Conclusions As prolapse treatment options expand to include more conservative choices, greater awareness and education is needed among women and professionals about these as a first line treatment and preventive measure, alongside a multi-professional team approach to treatment decision making. Women presenting with prolapse symptoms need to be listened to by the health care team, offered better information about treatment choices, and supported to make a decision that is right for them

A reassuring presence: An evaluation of Bradford District Hospice at Home service

Within the United Kingdom, a developing role for primary care services in cancer and palliative care has resulted in an increase in palliative home care teams. The provision of professional care in the home setting seeks to provide necessary services and enhanced choice for patients whose preference is to die at home. A mismatch between patient preference for home death and the actual number of people who died at home was identified within Bradford, the locality of this study. In response to this mismatch, and reflecting the policy environment of wishing to enhance community service provision, the four Primary Care Trusts (PCTs) in the city sought to offer support to patients who wished to remain in their own homes through the final stages of a terminal illness. To offer this support they set up a dedicated hospice at home team. This would provide services and support for patients in achieving a dignified, symptom free and peaceful death, allowing families to maximise time spent together. The aim of the study was to evaluate the Bradford hospice at home service from the perspective of carers, nurses and General Practitioners. Postal questionnaires were sent to carers (n = 289), district nurses (n = 508) and GP's (n = 444) using Bradford's hospice at home service. Resulting quantitative data was analysed using the Statical Package for Social Sciences (SPSS) and qualitative data was analysed using grounded theory techniques. The data from carers, district nurses and GPs provide general support for the Bradford hospice at home service. Carers valued highly the opportunity to 'fulfil a promise' to the individual who wished to be cared for at home. District nurses and GPs cited the positive impact of access to specialist expertise. This was a 'reassuring presence' for primary healthcare teams and offered 'relief of carer anxiety' by providing prompt, accessible and sensitive care. Carers and health professionals welcomed the increased possibility of patients being cared for at home. The study identified the need to focus on improving skill levels of staff and on ensuring continuity of care

PROPEL: implementation of an evidence based pelvic floor muscle training intervention for women with pelvic organ prolapse: a realist evaluation and outcomes study protocol

Abstract Background Pelvic Organ Prolapse (POP) is estimated to affect 41%–50% of women aged over 40. Findings from the multi-centre randomised controlled “Pelvic Organ Prolapse PhysiotherapY” (POPPY) trial showed that individualised pelvic floor muscle training (PFMT) was effective in reducing symptoms of prolapse, improved quality of life and showed clear potential to be cost-effective. However, provision of PFMT for prolapse continues to vary across the UK, with limited numbers of women’s health physiotherapists specialising in its delivery. Implementation of this robust evidence from the POPPY trial will require attention to different models of delivery (e.g. staff skill mix) to fit with differing care environments. Methods A Realist Evaluation (RE) of implementation and outcomes of PFMT delivery in contrasting NHS settings will be conducted using multiple case study sites. Involving substantial local stakeholder engagement will permit a detailed exploration of how local sites make decisions on how to deliver PFMT and how these lead to service change. The RE will track how implementation is working; identify what influences outcomes; and, guided by the RE-AIM framework, will collect robust outcomes data. This will require mixed methods data collection and analysis. Qualitative data will be collected at four time-points across each site to understand local contexts and decisions regarding options for intervention delivery and to monitor implementation, uptake, adherence and outcomes. Patient outcome data will be collected at baseline, six months and one year follow-up for 120 women. Primary outcome will be the Pelvic Organ Prolapse Symptom Score (POP-SS). An economic evaluation will assess the costs and benefits associated with different delivery models taking account of further health care resource use by the women. Cost data will be combined with the primary outcome in a cost effectiveness analysis, and the EQ-5D-5L data in a cost utility analysis for each of the different models of delivery. Discussion Study of the implementation of varying models of service delivery of PFMT across contrasting sites combined with outcomes data and a cost effectiveness analysis will provide insight into the implementation and value of different models of PFMT service delivery and the cost benefits to the NHS in the longer term

Improving Crop Health, Performance, and Quality in Organic Spring Wheat Production: The Need to Understand Interactions between Pedoclimatic Conditions, Variety, and Fertilization

Organic wheat production systems have lower yields compared with intensive conventional production and often do not achieve the grain protein content and quality thresholds set by millers and bakers. In contrast, organic production methods were reported to result in higher concentrations of nutritionally desirable micronutrients and lower concentrations of the toxic metal Cd in wheat grain and wholegrain flour. However, although N-availability and variety characteristics are known to affect both gain yields and bread-making quality, the exact reasons for the yield gap and differences in grain processing and nutritional quality between organic and conventional spring wheat production in the UK are poorly understood. The overall aim of this study was therefore to determine to what extent changes in variety choice and fertilization regimes may reduce the yield gap and improve processing quality without affecting nutritional quality in organic spring wheat production. To achieve this aim, we compared crop health, yield, grain processing, and nutritional quality parameters in spring wheat produced using (i) six contrasting spring wheat varieties grown with a standard fertilization regime and (ii) one variety widely used by organic farmers (Paragon) with nine different fertilization regimes in (iii) three UK sites/farms with contrasting pedoclimatic conditions. Significant differences in foliar disease severity, grain yield, and quality parameters were detected between six contrasting spring wheat varieties when grown under organic management regimes. Specifically, the varieties Paragon and Tybalt were identified as the best-performing varieties with respect to foliar disease resistance and grain yield under organic farming conditions and also produced high processing and nutritional quality across the three UK sites. However, the highest grain yields were obtained by Paragon at the Gilchester site and Tybalt at the Sheepdrove and Courtyard sites, while the highest protein contents were produced by Tybalt at the Gilchester site and Paragon at the Sheepdrove and Courtyard sites, which suggests that there is a need for site-specific wheat variety selection in the UK organic sector. Although organic fertilizer input type and level also affected wheat performance, differences between fertilization regimes were smaller than those observed between the five contrasting varieties, which suggests that improvements in spring wheat breeding/selection have a greater potential for increasing crop yield and quality in the organic sector compared with changes to fertilization practices. Overall, results suggest it is feasible to breed/select spring wheat varieties that combine high protein, vitamin E, and micronutrients with low toxic metal (Cd, Pb) concentrations when produced under organic farming conditions. These findings also support the hypothesis that differences in variety choice by organic and conventional farmers have contributed to the differences in nutritional quality between organic and conventional wheat products reported in previous studies

Influenza nucleoprotein delivered with aluminium salts protects mice from an influenza virus that expresses an altered nucleoprotein sequence

Influenza virus poses a difficult challenge for protective immunity. This virus is adept at altering its surface proteins, the proteins that are the targets of neutralizing antibody. Consequently, each year a new vaccine must be developed to combat the current recirculating strains. A universal influenza vaccine that primes specific memory cells that recognise conserved parts of the virus could prove to be effective against both annual influenza variants and newly emergent potentially pandemic strains. Such a vaccine will have to contain a safe and effective adjuvant that can be used in individuals of all ages. We examine protection from viral challenge in mice vaccinated with the nucleoprotein from the PR8 strain of influenza A, a protein that is highly conserved across viral subtypes. Vaccination with nucleoprotein delivered with a universally used and safe adjuvant, composed of insoluble aluminium salts, provides protection against viruses that either express the same or an altered version of nucleoprotein. This protection correlated with the presence of nucleoprotein specific CD8 T cells in the lungs of infected animals at early time points after infection. In contrast, immunization with NP delivered with alum and the detoxified LPS adjuvant, monophosphoryl lipid A, provided some protection to the homologous viral strain but no protection against infection by influenza expressing a variant nucleoprotein. Together, these data point towards a vaccine solution for all influenza A subtypes