The effect of platelet rich plasma on the treatment of androgenetic alopecia compared to placebo

Objective: To assess the efficacy of plasma rich proteins (PRP) compared to placebo in the treatment of androgenetic alopecia (AGA). Design: Systematic literature review Methods: Searches were done in PubMed utilizing the terms PRP, plasma rich protein, autologous activated PRP, autologous activated plasma rich protein, androgenetic alopecia, placebo, hair count, hair density, hair follicles, hair loss, therapeutic effect, growth factors, dermatology, and regenerative medicine. Articles were excluded if they were published before 2013, involved animal studies, compared minoxidil only in their research, included only female participants, non-English articles, studies with no quantifiable data, review research articles, and injections besides the scalp Results: A meta-analysis yielded five adequate articles meeting both the inclusion and exclusion criteria including 143 patients. All five studies resulted in beneficial outcomes and statistically significant results in patients treated with PRP. Conclusion: PRP injections revealed clinically significant improvement in hair growth and density along with overall patient satisfaction. PRP injections were shown to be well tolerated with mild pain and without any major adverse effect

The Platreef magma event at the world-class Turfspruit Ni-Cu-PGE deposit: implications for mineralisation processes and the Bushveld Complex stratigraphy

The Platreef Ni-Cu-PGE deposit as identified on the farm Turfspruit, northern limb of the Bushveld Complex, extends westwards and down-dip from the surface exposure. The orebody transitions with increasing depth from highly contaminated ‘Platreef-style’ mineralisation to a dominant magmatic stratigraphy hosting ‘Merensky-style’ mineralisation associated with persistent chromitites in the Flatreef and Deep Platreef. Four drill holes sampling each sector of the orebody have been examined to determine; the origin of the stratigraphy, the controls on the Ni-Cu-PGE mineralisation and the relationship of the Platreef to the wider Bushveld Complex. Orthomagmatic processes, operating at depth in a staging chamber, are proposed to be dominant in generating the high PGE tenors in sulphides (> 600 ppm) and a magmatic platinum-group mineral (PGM) assemblage consisting of; Pt/Pd sulphides, Pt-Fe alloys, Pt-tellurides and laurite. This is supported by magmatic δ34S values (av. +2 ‰) determined in sulphides in unaltered pyroxenites. Two stages of crustal contamination affected the development of the Platreef orebody on Turfspruit: (1) early-stage contamination homogenised in the parental magma at depth in a staging chamber; (2) in situ contamination through interaction with the footwall sediments of the Duitschland Formation (DF). The lithostratigraphy of the DF varies between the carbonate-dominated Upper DF and the shale-dominated Lower DF; which, results in mineralogical and geochemical heterogeneity across the deposit. This variability is especially evident in the δ34S values with contaminated δ34S signatures identified throughout the shallow Platreef (up to +19.6‰) and a systematic increase to heavy isotopic values (> +10 ‰) with depth is recorded in the Deep Platreef; in contrast, sulphides in the Flatreef give mainly magmatic δ34S values. The presence of elevated δ34S values in the Deep Platreef corresponds with a progressive decoupling of PGE grade from sulphides and the introduction of arsenide and antimonide PGMs. The stratigraphic position of the Platreef, directly below the Main Zone, has led previous workers to conclude that it correlates with the Upper Critical Zone. This work, however, suggests that the relationship is more complex. The magmatic lineage of the Platreef across Turfspruit represents a ‘hybrid’ composition with contrasting Cr/MgO and Ce/Sm ratios, which consistently plot within the Critical and Main Zone ranges, respectively. Furthermore, there is no systematic increase in the Pt/Pd ratio with depth; this represents a key test of models proposing their lateral continuity. The northern limb is proposed as a discrete system, part of a larger network of sills and magma chambers, operating independently but connected at depth to the wider Bushveld Complex

White blood cell differentials in dogs with congestive heart failure (CHF) in comparison to those in dogs without cardiac disease

Objectives: To investigate if dogs with congestive heart failure (CHF) have significant leukogram changes and for associations between leukogram, disease severity and survival time. Methods: Retrospective study of CHF patients (n=75) due to myxomatous degenerative valvular disease (MVMD) or dilated cardiomyopathy (DCM) and healthy controls (n=75). Haematology results and analyses of WBC variables were compared between CHF dogs and controls. From echocardiographic results of CHF dogs, indicators of disease severity were retrieved and associations were explored between these variables, survival time and leukogram results. Results: Total WBC count (

Dunedin Household Energy Study

The study, undertaken for the Dunedin City Council, interviewed 19 Dunedin households about their household behavior, decision-making and aspirations with regards their heating and transport choices. The households represented all four ‘energy cultures’ clusters and a wide demographic range. Key findings include: 1. In general, participants were aware of the environmental implications of their heating and transport choices. Many were interested in making changes (for a variety of reasons, not just environmental). Some had already made significant low-carbon changes or were planning to do so but faced barriers. 2. Most households already used low-carbon forms of heating (wood fires or heat pumps). Some used scarcely any heating. One household used coal for heating. 3. Households with floor, ceiling and wall insulation reported greater satisfaction with warmth than those that had only floor and/or ceiling insulation. There did not seem to be any consistent relationship between warmth satisfaction and the presence of double glazing. 4. Some households made conscious use of the sun for passive heating. Many were also interested in solar water heating and solar generation (PV). 5. Households were mainly reliant on the use of private cars for transport. Two used public transport on occasion. Two had electric vehicles. Public transport was scarcely used, with a major barrier being its lack of convenience. 6. Although many interviewees were interested in acquiring electric vehicles, there was concern and confusion about their environmental impacts. This appeared to be a major barrier in addition to the up-front cost barrier. 7. Household heating choices were largely driven by notions of comfort. In contrast, their transport choices were largely driven by the desire for independence and time-efficiency. 8. There was generally a greater willingness to make changes to material assets than changes to behavior. This is particularly interesting because material changes are usually far more costly than behavioural changes

Trends in hospital admissions during transition from paediatric to adult services for young people with learning disabilities or autism: Population-based cohort study

Summary Background Transition from paediatric to adult health care may disrupt continuity of care, and result in unmet health needs. We describe changes in planned and unplanned hospital admission rates before, during and after transition for young people with learning disability (LD), or autism spectrum disorders (ASD) indicated in hospital records, who are likely to have more complex health needs. Methods We developed two mutually exclusive cohorts of young people with LD, and with ASD without LD, born between 1990 and 2001 in England using national hospital admission data. We determined the annual rate of change in planned and unplanned hospital admission rates before (age 10–15 years), during (16–18 years) and after (19–24 years) transition to adult care using multilevel negative binomial regression models, accounting for area-level deprivation, sex, birth year and presence of comorbidities. Findings The cohorts included 51,291 young people with LD, and 46,270 autistic young people. Admission rates at ages 10–24 years old were higher for young people with LD (54 planned and 25 unplanned admissions per 100 person-years) than for autistic young people (17/100 and 16/100, respectively). For young people with LD, planned admission rates were highest and constant before transition (rate ratio [RR]: 0.99, 95% confidence interval [CI] 0.98–0.99), declined by 14% per year of age during (RR: 0.86, 95% CI: 0.85–0.88), and remained constant after transition (RR: 0.99, 95% CI: 0.99–1.00), mainly due to fewer admissions for non-surgical care, including respite care. Unplanned admission rates increased by 3% per year of age before (RR: 1.03, 95% CI: 1.02–1.03), remained constant during (RR: 1.01, 95% CI: 1.00–1.03) and increased by 3% per year after transition (RR: 1.03, 95% CI: 1.02–1.04). For autistic young people, planned admission rates increased before (RR: 1.06, 95% CI: 1.05–1.06), decreased during (RR: 0.95, 95% CI: 0.93–0.97), and increased after transition (RR: 1.05, 95%: 1.04–1.07). Unplanned admission rates increased most rapidly before (RR: 1.16, 95% CI: 1.15–1.17), remained constant during (RR: 1.01, 95% CI: 0.99–1.03), and increased moderately after transition (RR: 1.03, 95% CI: 1.02–1.04). Interpretation Decreases in planned admission rates during transition were paralleled by small but consistent increases in unplanned admission rates with age for young people with LD and autistic young people. Decreases in non-surgical planned care during transition could reflect disruptions to continuity of planned/respite care or a shift towards provision of healthcare in primary care and community settings and non-hospital arrangements for respite care. Funding National Institute for Health Research Policy Research Programme

Detection of β-alanyl aminopeptidase as a biomarker for Pseudomonas aeruginosa in the sputum of patients with cystic fibrosis using exogenous volatile organic compound evolution

A novel, rapid and sensitive analytical method has been developed and applied to 105 sputum samples from patients with cystic fibrosis, including 5 samples from post-lung transplant patients. This new method is specifically targeted to measure β-alanyl aminopeptidase activity which is characteristic of some important Gram-negative pathogens. Of relevance to this study are Pseudomonas aeruginosa and pathogens of the Burkholderia cepacia complex both of which are commonly associated with respiratory infections as well as increased morbidity and mortality in adult cystic fibrosis patients. The analytical method involves the addition of a novel enzyme substrate (i.e. 3-amino-N-(3-fluorophenyl)propanamide) that interacts with β-alanyl aminopeptidase to generate an exogenous volatile organic compound 3-fluoroaniline (LOD 0.02 μg mL−1; LOQ 0.06 μg mL−1). 3-Fluoroaniline was determined at 20 times above its calculated limit of quantification in the sputum samples by HS-SPME-GC-MS and then the results compared with standard culture methods and bacterial identification using MALDI-TOF-MS. Detection of 3-fluoroaniline was possible after only 8 h incubation of the sputum samples with a 95% success rate; this increased to 100% at 24 h which was well within the typical routine timeframe of 48 h. To our knowledge, this is the first demonstration of detection of P. aeruginosa by use of a custom-designed substrate to liberate a detectable and unique VOC. The very high negative predictive value (100% in this study) means such an assay could be appropriate as a screening technique for patients who are not yet colonized by this pathogen

Identification of key enzymes responsible for protolimonoid biosynthesis in plants: Opening the door to azadirachtin production

Limonoids are natural products made by plants belonging to the Meliaceae (Mahogany) and Rutaceae (Citrus) families. They are well known for their insecticidal activity, contribution to bitterness in citrus fruits, and potential pharmaceutical properties. The best known limonoid insecticide is azadirachtin, produced by the neem tree (Azadirachta indica). Despite intensive investigation of limonoids over the last half century, the route of limonoid biosynthesis remains unknown. Limonoids are classified as tetranortriterpenes because the prototypical 26-carbon limonoid scaffold is postulated to be formed from a 30-carbon triterpene scaffold by loss of 4 carbons with associated furan ring formation, by an as yet unknown mechanism. Here we have mined genome and transcriptome sequence resources for 3 diverse limonoid-producing species (A. indica, Melia azedarach, and Citrus sinensis) to elucidate the early steps in limonoid biosynthesis. We identify an oxidosqualene cyclase able to produce the potential 30-carbon triterpene scaffold precursor tirucalla-7,24-dien-3β-ol from each of the 3 species. We further identify coexpressed cytochrome P450 enzymes from M. azedarach (MaCYP71CD2 and MaCYP71BQ5) and C. sinensis (CsCYP71CD1 and CsCYP71BQ4) that are capable of 3 oxidations of tirucalla-7,24-dien-3β-ol, resulting in spontaneous hemiacetal ring formation and the production of the protolimonoid melianol. Our work reports the characterization of protolimonoid biosynthetic enzymes from different plant species and supports the notion of pathway conservation between both plant families. It further paves the way for engineering crop plants with enhanced insect resistance and producing high-value limonoids for pharmaceutical and other applications by expression in heterologous hosts

Barriers and facilitators to primary care research: views of GP trainees and trainers

Background: Primary care plays an important role in the conception and delivery of transformational research but GP engagement lacks, prompting calls for the promotion of academic opportunities in primary care. Aim: To identify potential barriers and facilitators amongst GP trainees and trainers in primary care research to inform support given by Local Clinical Research Networks (LCRNs). Design & setting: A cross sectional online survey was developed and distributed by the CRN to GP trainees and trainers in the North East and North West. Method: The survey covered areas including demographics, career intentions, current and potential engagement with research as well as their general understanding of research in primary care, that included barriers and facilitators to primary care research. Results: Trainees had low intentionality to pursue research and half of trainees did not engage with any research activity. Despite 1 in five trainees reporting intentions to include research in their career, only 1% would undertake a solely academic career. Medical school region is the only strongly associated factor with academic career intention. Just under 30% of trainers reported engagement in research, but far fewer (8.6%) were interested in contributing to research, and only 10% felt prepared to mentor in research. Conclusion: Among trainees, there is limited engagement in, and intentionality to pursue research and this is crucially reflected by responses from trainers. This study identifies the need for LCRN’s to assist with training in research mentoring and skills, funding opportunities and to develop resources to promote research in primary care

Complex scaffold remodeling in plant triterpene biosynthesis

Triterpenes with complex scaffold modifications are widespread in the plant kingdom. Limonoids are an exemplary family that are responsible for the bitter taste in citrus (e.g., limonin) and the active constituents of neem oil, a widely used bioinsecticide (e.g., azadirachtin). Despite the commercial value of limonoids, a complete biosynthetic route has not been described. We report the discovery of 22 enzymes, including a pair of neofunctionalized sterol isomerases, that catalyze 12 distinct reactions in the total biosynthesis of kihadalactone A and azadirone, products that bear the signature limonoid furan. These results enable access to valuable limonoids and provide a template for discovery and reconstitution of triterpene biosynthetic pathways in plants that require multiple skeletal rearrangements and oxidations