An additional introduced species of Nuttallanthus (Plantaginaceae) in Australia

Nuttallanthus texanus (Scheele) D.A.Sutton (Plantaginaceae) has been identified as occurring in southern Queensland and eastern New South Wales, Australia. This species had not previously been distinguished from Nuttallanthus canadensis (L.) D.A.Sutton. Both species are naturalised and spread by seed. The two species can be distinguished by floral and seed morphological differences

Enhanced Engraftment of a Very Low-Dose Cord Blood Unit in an Adult Haemopoietic Transplant by Addition of Six Mismatched Viable Cord Units

The report describes the feasibility of the addition of multiple viable HLA-mismatched unrelated cord blood units, to a low cell number matched unrelated cord, to assist clinical engraftment. An ablative stem cell transplant was performed in an adult with relapsed acute lymphoblastic leukaemia (ALL), using a single HLA-matched cord blood unit (mononuclear cell dose 0.8 × 107), supported by six mismatched cord blood units (one unit per 10 kg recipient weight). No adverse reaction occurred following the infusion of mismatched units and engraftment of the suboptimal-dose matched unit occurred rapidly, with no molecular evidence of engraftment of mismatched cords. Early molecular remission of ALL was demonstrated using a novel PCR for a mitochondrial DNA mutation in the leukaemic clone. The cell dose of the matched cord was well below that recommended to engraft a 70 kg recipient. We suggest that a factor or factors in the mismatched cords enhanced/supported engraftment of the matched cord

Complexity and Community Context: Learning from the Evaluation Design of a National Community Empowerment Programme

Community empowerment interventions, which aim to build greater individual and community control over health, are shaped by the community systems in which they are implemented. Drawing on complex systems thinking in public health research, this paper discusses the evaluation approach used for a UK community empowerment programme focused on disadvantaged neighbourhoods. It explores design choices and the tension between the overall enquiry questions, which were based on a programme theory of change, and the varied dynamic socio-cultural contexts in intervention communities. The paper concludes that the complexity of community systems needs to be accounted for through in-depth case studies that incorporate community perspectives

Rapid detection of heart failure using a spectroscopic liquid biopsy

Heart disease is growing annually across the globe with numbers expected to rise to 46% of the population by 2030. Early detection is vital for several reasons, firstly it improves the long-term prognosis of the patient by admitting them through the appropriate pathway faster, secondly it reduces healthcare costs by streamlining diagnosis and finally, in combination with management or treatment, it can prevent the progression of the disease which in turn improves the patient’s quality of life. Therefore, there lies an increasing need to develop assays which can rapidly detect heart disease at an early stage. The Dxcover® liquid biopsy platform employs infrared spectroscopy and artificial intelligence, to quickly analyse minute amounts of patient serum. In this study, discrimination between healthy controls and diseased patients was obtained with an area under the receiver operating characteristic curve (AUC) of 0.89. When assessing the heart failure vs all patients, which is most akin to what would be observed in a triage setting, the model when tuned to a minimum of 45% specificity yielded a sensitivity of 89% and an NPV of 0.996, conversely when sensitivity was set at a 45% minimum, the specificity was 96%, giving an NPV of 0.991 when using a 1.5% prevalence. Other models were assessed in parallel, but the performance of the ORFPLS model was overall superior to the other models tested. In this large scale (n = 404) proof-of-concept study, we have shown that the Dxcover liquid biopsy platform has the potential to be a viable triage tool in emergency and routine situations for the diagnosis of heart failure

Partner randomized controlled trial: study protocol and coaching intervention

<p>Abstract</p> <p>Background</p> <p>Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice.</p> <p>Methods and design</p> <p>This paper describes the protocol for a randomized controlled trial (RCT) to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1) effective use of controller medications, 2) effective use of rescue medications and 3) monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview.</p> <p>The primary outcomes were the mean change in 1) the child's asthma control score, 2) the parent's quality of life score, and 3) the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications, having maintenance care visits at least twice a year, and an asthma action plan. Cost-effectiveness of the intervention was also measured.</p> <p>Discussion</p> <p>Twenty-two practices (66 physicians) were randomized (11 per treatment group), and 950 families with a child 3-12 years old with persistent asthma were enrolled. A description of the coaching intervention is presented.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier <a href="http://www.clinicaltrials.gov/ct2/show/NCT00860834">NCT00860834</a>.</p

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Creating a space for young women's voices: Using participatory 'video drama' in Uganda

This article draws upon research that explored the experiences of young women in relation to sexual health in Uganda with a view to enhancing gender-sensitive strategies. We have coined the phrase ‘participatory video drama’ to describe the exploratory methodology that the young women participants in our research used to present stories about their lives. The aim of this article is to suggest that ‘participatory video’ (PV) and ‘participatory video drama’ (PVD) are innovative methodological tools to utilise when working with participants who experience voicelessness in their everyday lives. We contribute to an emerging body of work around this methodology by suggesting that the process of PV provides a novel and engaging platform for participants to express their experiences. PVD further creates spaces for the performative exploration of embedded power relations and is therefore informative and has the potential to be transformatory and empowering