Feasibility of Silicon Quantum Dots as a Biomarker for the Bioimaging of Tear Film

This study investigated the fluorescence and biocompatibility of hydrophilic silicon quantum dots (SiQDs) that are doped with scandium (Sc-SiQDs), copper (Cu-SiQDs), and zinc (Zn-SiQDs), indicating their feasibility for the bioimaging of tear film. SiQDs were investigated for fluorescence emission by the in vitro imaging of artificial tears (TheraTears®), using an optical imaging system. A trypan blue exclusion test and MTT assay were used to evaluate the cytotoxicity of SiQDs to cultured human corneal epithelial cells. No difference was observed between the fluorescence emission of Sc-SiQDs and Cu-SiQDs at any concentration. On average, SiQDs showed stable fluorescence, while Sc-SiQDs and Cu-SiQDs showed brighter fluorescence emissions than Zn-SiQDs. Cu-SiQDs and Sc-SiQDs showed a broader safe concentration range than Zn-SiQDs. Cu-SiQDs and Zn-SiQDs tend to aggregate more substantially in TheraTears® than Sc-SiQDs. This study elucidates the feasibility of hydrophilic Sc-SiQDs in studying the tear film’s aqueous layer

‘Missing out’: Reflections on the positioning of ethnographic research within an evaluative framing

Contemporary approaches to evaluating ‘complex’ social and health interventions are opening up spaces for methodologies attuned to examining contextual complexities, such as ethnography. Yet the alignment of the two agendas – evaluative and ethnographic – is not necessarily comfortable in practice. I reflect on experiences of conducting ethnographic research alongside a public health evaluation of a community-based initiative in the UK, using the lens of ‘missing out’ to examine intersections between my own ethnographic concerns and those of the communities under study. I examine potential opportunities posed by the discomfort of ‘missing out’, particularly for identifying the processes and spaces of inclusion and exclusion that contributed both to my ethnographic experiences and to the realities of the communities engaging with the initiative. This reveals productive possibilities for a focus on ‘missing out’ as a form of relating for evaluations of the impacts of such initiatives on health and social inequalities

Population pharmacokinetics of pomalidomide in patients with relapsed or refractory multiple myeloma with various degrees of impaired renal function

Yan Li,1 Xiaomin Wang,2 Edward O’Mara,1 Meletios A Dimopoulos,3 Pieter Sonneveld,4 Katja C Weisel,5 Jeffrey Matous,6 David S Siegel,7 Jatin J Shah,8 Elisabeth Kueenburg,9 Lars Sternas,9 Chloe Cavanaugh,9 Mohamed Zaki,9 Maria Palmisano,1 Simon Zhou1 1Translational Development and Clinical Pharmacology, Celgene Corporation, Summit, NJ, USA; 2Non-Clinical Development and Drug Metabolism and Pharmacokinetics, Celgene Corporation, Summit, NJ, USA; 3Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece; 4Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; 5Department of Hematology, University Hospital Tübingen, Tübingen, Germany; 6Department of Hematology/Oncology, Colorado Blood Cancer Institute, Denver, CO, USA; 7Myeloma Division, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA; 8Department of Lymphoma/Myeloma, Division of Cancer Medicine, MD Anderson Cancer Center, Houston, TX, USA; 9Global Clinical R&D, Celgene Corporation, Summit, NJ, USA Abstract: Pomalidomide is an immunomodulatory drug for treatment of relapsed or refractory multiple myeloma (rrMM) in patients who often have comorbid renal conditions. To assess the impact of renal impairment on pomalidomide exposure, a population pharmacokinetics (PPK) model of pomalidomide in rrMM patients with various degrees of impaired renal function was developed. Intensive and sparse pomalidomide concentration data collected from two clinical studies in rrMM patients with normal renal function, moderately impaired renal function, severely impaired renal function not requiring dialysis, and with severely impaired renal function requiring dialysis were pooled over the dose range of 2 to 4 mg, to assess specifically the influence of the impaired renal function as a categorical variable and a continuous variable on pomalidomide clearance and plasma exposure. In addition, pomalidomide concentration data collected on dialysis days from both the withdrawal (arterial) side and from the returning (venous) side of the dialyzer, from rrMM patients with severely impaired renal function requiring dialysis, were used to assess the extent to which dialysis contributes to the removal of pomalidomide from blood circulation. PPK analyses demonstrated that moderate to severe renal impairment not requiring dialysis has no influence on pomalidomide clearance or plasma exposure, as compared to those patients with normal renal function, while pomalidomide exposure increased approximately 35% in patients with severe renal impairment requiring dialysis on nondialysis days. In addition, dialysis increased total body pomalidomide clearance from 5 L/h to 12 L/h, indicating that dialysis will significantly remove pomalidomide from the blood circulation. Thus, pomalidomide should be administered post-dialysis on the days of dialysis. Keywords: hemodialysis, pomalidomide, population pharmacokinetics, renal impairmen

Development of Healthy Eating and Active Lifestyles for Diabetes, a culturally tailored diabetes self‐management education and support programme for Black‐British adults: A participatory research approach

Aims: To develop an evidence-based, culturally tailored, diabetes self-management education and support programme for Black-British adults, called Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), using participatory methods to engage key stakeholders in the intervention design process. // Methods: Black-British adults living with type 2 diabetes, healthcare professionals and community leaders were engaged in an intervention development study. The intervention structure, format, content and delivery were developed through three phases of participatory research: Phase 1, formative research, involved focus groups and interviews; interactive co-development workshops were conducted in Phase 2; and Phase 3 focused on materials development. // Results: In Phase 1, focus groups and interviews identified the importance of nurturing collectivism, a reliance on informal sources of information/advice, barriers to attending appointments associated with competing priorities of work, travel and carer commitments, and a preference for directness and simple, clear advice/messages. A priority for healthcare professionals was the intervention embedding within current primary care structures and aligning with incentivised targets/metrics. Phase 2 (workshops) highlighted key requirements: avoidance of medical settings, appropriately trained and culturally knowledgeable educators, flexible appointments, preference for verbal and visual information and avoidance of technical/medical terminology. In Phase 3 (materials development), culturally sensitive videos, short films and information booklets were developed to convey educational messages, and food photography was used to provide culturally relevant dietary advice. // Conclusions: Participatory methods provide a means to understand the needs of specific communities. This approach enables the development of healthcare interventions that are sensitive to the needs of service users and providers

Abdominal compartment syndrome in severe acute pancreatitis - When to decompress?

Intra-abdominal hypertension is increasingly reported in patients with severe acute pancreatitis, and is caused by several factors, including visceral edema and ascites associated with massive fluid resuscitation, paralytic ileus and retroperitoneal inflammation. There is a strong relation with early organ dysfunction and mortality in these patients, which makes intra-abdominal hypertension an attractive target for intervention. Several reports conclude that this phenomenon occurs within the first 5 days after admission, and that the kinetics of IAH is important: patients with persistent IAH seem to be at the highest risk for mortality. Several strategies to reduce IAP have been developed, and given the pathophysiology, percutaneous drainage of ascites is a first logical step. However, if conservative measures fail to reduce IAP in a setting with ongoing or worsening organ dysfunction, abdominal decompression is recommended