Stable isotope profile (C, N, O, S) of Irish raw milk: Baseline data for authentication

Grass-based milk production is a major contributor to Irish agricultural output. The study characterized the Irish milk pool using stable isotope ratio analysis of carbon, nitrogen, oxygen and sulphur. Authentic raw milk samples were collected from 50 farms on five occasions over 13 months. Mean values of −27.11, 6.79, −3.27 and 6.16‰ were obtained for δ13C, δ15N, δ18O and δ34S, respectively. δ13C values reflected a high level of grass input and values increased with increasing cereal concentrate feed input (P < 0.001). δ18O values were most negative in spring. There was a significant interaction between feed and season for δ13C and δ15N values (P < 0.05), with the impact of concentrate feeding most evident in spring. δ34S values were lowest at the highest level of concentrate input (P < 0.05). The isotopic values reported here describe the Irish milk pool and may offer the potential to discriminate Irish milk and dairy products from similar commodities from other countries

Acute kidney disease and renal recovery : consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of > 90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process. For patients in whom pathophysiologic processes are ongoing, the term acute kidney disease (AKD) has been proposed to define the course of disease after AKI; however, definitions of AKD and strategies for the management of patients with AKD are not currently available. In this consensus statement, the Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients. We also make recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Development of the Selection Procedure for a Measurement of the Ratio of Branching Fractions RpK=B(Λb0→pKμ+μ−)/B(Λb0→pKe+e−)R_{pK}={\cal B}(\Lambda_b^0 \rightarrow pK\mu^+\mu^-)/{\cal B}(\Lambda_b^0 \rightarrow pKe^+e^-) as a Test of Lepton Universality

A selection procedure for the non-rare decays $\Lambda_b^0 \to pK^-J/\psi(\to \ell^+\ell^-)$ (where $\ell = \mu,e$) is presented, involving PID selection, removal of peaking backgrounds and multivariate analysis. Unforeseen delays in the acquisition of up to date stripping lines have slowed progress, but a verification of the selection through the measurement of ${\cal B}(\Lambda_b^0 \to pK^-J/\psi(\to \mu^+\mu^-))/{\cal B}(\Lambda_b^0 \to pK^-J/\psi(\to e^+e^-))$ is expected very soon. The same selection will then be used to isolate the rare decays $\Lambda_b^0 \to pK^-\ell^+\ell^-$ (where $\ell = \mu,e$) in order to make the first ever observation of the decay $\Lambda_b^0 \to pK^-e^+e^-$, and to test lepton universality by making the first ever measurement of $R_{pK} = {\cal B}(\Lambda_b^0 \to pK^-\mu^+\mu^-)/{\cal B}(\Lambda_b^0 \to pK^-e^+e^-)$. The expected sources of systematic error are also discussed

Breast cancer cells mediate endothelial cell activation, promoting von Willebrand Factor release, tumour adhesion and transendothelial migration.

Background: Breast cancer results in a three- to four-fold increased risk of venous thromboembolism (VTE), which is associated with reduced patient survival. Despite this, the mechanisms underpinning breast cancer-associated thrombosis remain poorly defined. Tumor cells can trigger endothelial cell (EC) activation resulting in increased von Willebrand factor (VWF) secretion. Importantly, elevated plasma VWF levels constitute an independent biomarker for VTE risk. Moreover, in a model of melanoma, treatment with low molecular weight heparin (LMWH) negatively regulated VWF secretion and attenuated tumor metastasis. Objective: To investigate the role of VWF in breast cancer metastasis and examine the effect of LMWH in modulating EC activation and breast tumor transmigration. Methods: von Willebrand factor levels were measured by ELISA. Primary ECs were used to assess tumor-induced activation, angiogenesis, tumor adhesion, and transendothelial migration. Results and conclusion: Patients with metastatic breast cancer have markedly elevated plasma VWF:Ag levels that also correlate with poorer survival. MDA-MB-231 and MCF-7 breast cancer cells induce secretion of VWF, angiopoietin-2, and osteoprotegerin from ECs, which is further enhanced by the presence of platelets. Vascular endothelial growth factor-A (VEGF-A) plays an important role in modulating breast cancer-induced VWF release. Moreover, VEGF-A from breast tumor cells also contributes to a pro-angiogenic effect on ECs. VWF multimers secreted from ECs, in response to tumor-VEGF-A, mediate adhesion of breast tumor cells along the endothelium. LMWH inhibits VWF-breast tumor adhesion and transendothelial migration. Our findings highlight the significant crosstalk between tumor cells and the endothelium including increased VWF secretion which may contribute to tumor metastasis.</p