Traumatic hyphaema following successive vacuum and forceps-assisted delivery

Hyphaema can cause corneal staining and is a potential risk for glaucoma. We report a case of a neonate with isolated traumatic hyphaema following a prolonged delivery with the consecutive use of vacuum and forceps. A review the literature discusses reports of ophthalmic injuries associated with assisted vaginal deliveries.peer-reviewe

Improving Quality of Care in Acute Cardiology

Acute cardiac care has changed dramatically over the past decennia. In coronary care and general intensive care units, information technology was introduced for arrhythmia monitoring and other signal processing. More recently, information technology has been applied to assist clinical decision making. Chapter 1 provides a definition for clinical decision support systems (CDSS) in critical care and describes factors for successful implementation of such systems. Subsequent chapters present three groups of studies designed to improve patient care (I) using information technology to assist rapid diagnosis and treatment in patients with evolving myocardial infarction, (II) better managing the multitude of monitoring alarms and (III) improving glucose regulation in patients at an intensive cardiac care unit

Fragile X Syndrome Therapeutics: Translation, Meet Translational Medicine

Fragile X syndrome, a common cause of intellectual disability and autism, is thought to occur due to abnormal regulation of neuronal protein synthesis. A study by Osterweil et al. (2013), in this issue, demonstrates that the HMG-CoA reductase inhibitor lovastatin can normalize protein synthesis and also reduce audiogenic seizures in Fmr1 knockout mice

Freeform Fabrication of Stochastic and Ordered Cellular Structures

Cellular materials provide a unique challenge to SFF technology. Such materials have unique properties of low mass, high strength, and good insulation properties. To produce such cellular structures, SFF systems require a designed microstructure with a feature size significantly lower than the resolution of the process. In this paper, we examine means of producing stochastic foams using the instability of a viscous thread and various methods for production of closed celled foams. These techniques allow for the production of foams without the need for pre-described cell structures. Such foams, when made from elastic materials can act as novel actuating materials.Mechanical Engineerin

Effect of Atogepant for Preventive Migraine Treatment on Patient-Reported Outcomes in the Randomized, Double-blind, Phase 3 ADVANCE Trial

Atogepant; Preventive treatment; MigraineAtogepant; Tractament preventiu; MigranyaAtogepant; Tratamiento preventivo; MigrañaBackground and Objectives The oral calcitonin gene–related peptide receptor antagonist atogepant is indicated for the preventive treatment of episodic migraine. We evaluated changes in patient-reported outcomes with atogepant in adults with migraine. Methods In this phase 3, 12-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group trial (ADVANCE), adults with 4–14 migraine days per month received atogepant (10, 30, or 60 mg) once daily or placebo. Secondary endpoints included changes from baseline in Migraine-Specific Quality-of-Life Questionnaire (MSQ) version 2.1 Role Function–Restrictive (RFR) domain at week 12 and mean monthly Activity Impairment in Migraine–Diary (AIM-D) Performance of Daily Activities (PDA) and Physical Impairment (PI) domains across the 12-week treatment period. Exploratory endpoints included change in MSQ Role Function–Preventive (RFP) and Emotional Function (EF) domains; AIM-D total scores; and change in Headache Impact Test (HIT)–6 scores. Results Of 910 participants randomized, 873 comprised the modified intent-to-treat population (atogepant: 10 mg [n = 214]; 30 mg [n = 223]; and 60 mg [n = 222]; placebo [n = 214]). All atogepant groups demonstrated significantly greater improvements vs placebo in MSQ RFR that exceeded minimum clinically meaningful between-group difference (3.2 points) at week 12 (least-square mean difference [LSMD] vs placebo: 10 mg [9.9]; 30 mg [10.1]; 60 mg [10.8]; all p < 0.0001). LSMDs in monthly AIM-D PDA and PI scores across the 12-week treatment period improved significantly for the atogepant 30 (PDA: −2.54; p = 0.0003; PI: −1.99; and p = 0.0011) and 60 mg groups (PDA: −3.32; p < 0.0001; PI: −2.46; p < 0.0001), but not for the 10 mg group (PDA: −1.19; p = 0.086; PI: −1.08; p = 0.074). In exploratory analyses, atogepant 30 and 60 mg were associated with nominal improvements in MSQ RFP and EF domains, other AIM-D outcomes, and HIT-6 scores at the earliest time point (week 4) and throughout the 12-week treatment period. Results varied for atogepant 10 mg. Discussion Atogepant 30 and 60 mg produced significant improvements in key patient-reported outcomes including MSQ-RFR scores and both AIM-D domains. Nominal improvements also occurred for other MSQ domains and HIT-6, reinforcing the beneficial effects of atogepant as a new treatment for migraine prevention.Allergan, now AbbVie, sponsored the study

We don’t do Google, we do massive attacks: Notes on creative R&D collaborations

The article presents findings from an exploratory study investigating the nature of collaborative research and development in creative industries. Participants in the study are two creative SMEs with extensive experience of participating in collaborative projects. A collective case study approach is adopted with data collected on the factors impinging on the effectiveness of such collaborations. Findings are presented at the macro and micro levels of such collaborations. The paper concludes with a summary of some of the challenges faced by small creative SMEs when collaborating with other organizations during the research and development process

Joint British Society consensus recommendations for magnetic resonance imaging for patients with cardiac implantable electronic devices

Magnetic Resonance Imaging (MRI) is increasingly a fundamental component of the diagnostic pathway across a range of conditions. Historically, the presence of a cardiac implantable electronic device (CIED) has been a contraindication for MRI, however, development of MR Conditional devices that can be scanned under strict protocols has facilitated the provision of MRI for patients. Additionally, there is growing safety data to support MR scanning in patients with CIEDs that do not have MR safety labelling or with MR Conditional CIEDs where certain conditions are not met, where the clinical justification is robust. This means that almost all patients with cardiac devices should now have the same access to MRI scanning in the National Health Service as the general population. Provision of MRI to patients with CIED, however, remains limited in the UK, with only half of units accepting scan requests even for patients with MR Conditional CIEDs. Service delivery requires specialist equipment and robust protocols to ensure patient safety and facilitate workflows, meanwhile demanding collaboration between healthcare professionals across many disciplines. This document provides consensus recommendations from across the relevant stakeholder professional bodies and patient groups to encourage provision of safe MRI for patients with CIEDs

Oxidation of the cysteine-rich regions of parkin perturbs its E3 ligase activity and contributes to protein aggregation

<p>Abstract</p> <p>Background</p> <p>Accumulation of aberrant proteins to form Lewy bodies (LBs) is a hallmark of Parkinson's disease (PD). Ubiquitination-mediated degradation of aberrant, misfolded proteins is critical for maintaining normal cell function. Emerging evidence suggests that oxidative/nitrosative stress compromises the precisely-regulated network of ubiquitination in PD, particularly affecting parkin E3 ligase activity, and contributes to the accumulation of toxic proteins and neuronal cell death.</p> <p>Results</p> <p>To gain insight into the mechanism whereby cell stress alters parkin-mediated ubiquitination and LB formation, we investigated the effect of oxidative stress. We found significant increases in oxidation (sulfonation) and subsequent aggregation of parkin in SH-SY5Y cells exposed to the mitochondrial complex I inhibitor 1-methyl-4-phenlypyridinium (MPP^<b>+</b>), representing an <it>in vitro </it>cell-based PD model. Exposure of these cells to direct oxidation via pathological doses of H₂O₂induced a vicious cycle of increased followed by decreased parkin E3 ligase activity, similar to that previously reported following S-nitrosylation of parkin. Pre-incubation with catalase attenuated H₂O₂accumulation, parkin sulfonation, and parkin aggregation. Mass spectrometry (MS) analysis revealed that H₂O₂reacted with specific cysteine residues of parkin, resulting in sulfination/sulfonation in regions of the protein similar to those affected by parkin mutations in hereditary forms of PD. Immunohistochemistry or gel electrophoresis revealed an increase in aggregated parkin in rats and primates exposed to mitochondrial complex I inhibitors, as well as in postmortem human brain from patients with PD with LBs.</p> <p>Conclusion</p> <p>These findings show that oxidative stress alters parkin E3 ligase activity, leading to dysfunction of the ubiquitin-proteasome system and potentially contributing to LB formation.</p

Fab@Home Model 3: A More Robust, Cost Effective and Accessible Open Hardware Fabrication Platform

Solid Freeform Fabrication is transitioning from an industrial process and research endeavor towards a ubiquitous technology in the lives of every designer and innovator. In order to speed this transition Fab@Home Model 3 was created with the goal of expanding the user base of SFF technology by lowering the skill and price barriers to entry while enabling technology developers to leverage their core competencies more efficiently. The result is a device, which is modular with respect to tool heads, fabrication processes, and electronics controls, costs under $1000, and requires only a simple tool set to assemble.Mechanical Engineerin