Experiences of cancer patients in receiving dietary advice from healthcare professionals and of healthcare professionals in providing this advice– a systematic review

Purpose: This systematic review investigated qualitative and quantitative studies exploring patients and healthcare professionals’ (HCP) experience of nutrition care throughout the cancer journey. Methods: Five databases were systematically searched for studies reporting on patient and healthcare professionals’ experience of nutrition advice. Results: Fifteen studies including 374 patients and 471 healthcare professionals were included. Findings indicate that patients desire more specific nutrition advice supported by members of the multidisciplinary team and delivered in appropriate and understandable language. Healthcare professionals have highlighted a lack of time, funding, dietetic roles, and knowledge as barriers to integrating nutrition as a standard part of cancer care. Five themes were identified (current provision of nutrition advice, optimal provision of nutrition advice, tension between patient values and nutritional or HCP priorities, providing evidence-based nutrition care, and practical barriers to nutrition advice provision). Conclusions: Further work is essential to better understand and address identified barriers and improve the provision of nutrition advice to this population. Implications for Cancer Survivors: Findings from this review will guide the delivery of nutrition advice for cancer survivors.</p

The smartphone as a platform for wearable cameras in health research

Background: The SenseCam, a small camera that is worn on the chest via a lanyard, is increasingly being deployed in a health research. However, the SenseCam is not yet in widespread use due to a variety of factors. It is proposed that the ubiquitous smartphone can provide a more accessible alternative to the SenseCam. Purpose: To perform an initial evaluation of the potential of the smartphone to become an alternative to the SenseCam. Methods: Adults were supplied with a smartphone running lifelogging software which they wore on a lanyard. Participants wore the smartphone for up to a day and the resulting lifelog data was both manually annotated and automatically analyzed for the presence of visual concepts. The results were compared to prior work using the SenseCam. Results: In total 166,000 smartphone photos were gathered from 47 individuals, along with associated sensor readings. The average time spent wearing the device across all users was 5 hours and 39 minutes (± 4 hours 11 minutes SD). A subset of 36,698 photos was selected for manual annotation by 5 researchers. Software analysis of these photos supports the automatic identification of activities to a similar level of accuracy as for SenseCam images in a previous study. Conclusions: Many aspects of the functionality of a SenseCam can largely be replicated, and in some cases enhanced, by the ubiquitous smartphone platform. This makes the smartphone a good candidate for a new generation of wearable sensing devices in health research, due to its widespread use across many populations. It is envisioned that the smartphone will provide a compelling alternative to the dedicated SenseCam hardware for a number of users and application areas. This will be achieved by integrating new types of sensor data, leveraging the smartphone’s real-time connectivity and rich user interface, and providing support for a range of relatively sophisticated applications

Severe platelet dysfunction in NHL patients receiving ibrutinib is absent in patients receiving acalabrutinib

The Bruton’s tyrosine kinase (Btk) inhibitor ibrutinib induces platelet dysfunction and causes increased risk of bleeding. Off-target inhibition of Tec is believed to contribute to platelet dysfunction and other side-effects of ibrutinib. The second generation Btk inhibitor acalabrutinib was developed with improved specificity for Btk over Tec. We investigated platelet function in patients with Non-Hodgkin Lymphoma (NHL) receiving ibrutinib or acalabrutinib by aggregometry and by measuring thrombus formation on collagen under arterial shear. Both patient groups had similarly dysfunctional aggregation responses to collagen and collagen-related peptide (CRP-XL) and comparison with mechanistic experiments in which platelets from healthy donors were treated with the Btk inhibitors suggested that both drugs inhibit platelet Btk and Tec at physiological concentrations. Only ibrutinib caused dysfunctional thrombus formation, while size and morphology of thrombi following acalabrutinib treatment were of normal size and morphology. We found that ibrutinib but not acalabrutinib inhibited SFKs and that SFKs have a critical role in platelet adhesion to collagen that is likely to underpin unstable thrombus formation observed in ibrutinib patients. We found that platelet function was enhanced by increasing levels of vWF and FVIII ex vivo by addition of intermediate purity FVIII (haemate P) to blood from patients, resulting in consistently larger thrombi. We conclude that acalabrutinib avoids major platelet dysfunction associated with ibrutinib therapy, and platelet function may be enhanced in patients with B-cell NHL by increasing plasma vWF and FVIII

Trust in Forensic Science Evidence: Project Launch Event Report

The project focuses on the role and value of forensic science in the criminal justice system. It seeks to explore current perceptions of trust, and tackle public (dis)trust in forensic science evidence, both DNA and digital. By exploring the marginalised groups' perception regarding forensic evidence (DNA and digital evidence), the project will develop insights into how public understanding is shaped around preparing, sharing, and presenting forensic evidence in the end-to-end crime scene to courtroom journey. The launch event offered the project team a chance to interact with a wide range of stakeholders - from forensic science, policing, government, private sectors and academia - and grasp their perspectives on public’s trust in forensic science

Trust in Forensic Science Evidence - Project launch event report 2024

This report captures the key themes from a launch event of an ESRC-funded project titled ‘Trust in Forensic Science Evidence in the Criminal Justice System: The Experience of Marginalised Groups’. The event offered the project team a chance to interact with a wide range of forensic science stakeholders across the UK, including forensic science practitioners, and representatives of policing, government, private sectors, and academia, and grasp their perspectives on the public’s trust in forensic science. The event provided useful insights into how the research team may approach their research, highlighting the importance of stakeholder and user engagement in policy and public-focused research

Nuclear factor I-C overexpression promotes monocytic development and cell survival in acute myeloid leukemia

Nuclear factor I-C (NFIC) belongs to a family of NFI transcription factors that binds to DNA through CAATT-boxes and are involved in cellular differentiation and stem cell maintenance. Here we show NFIC protein is significantly overexpressed in 69% of acute myeloid leukemia patients. Examination of the functional consequences of NFIC overexpression in HSPCs showed that this protein promoted monocytic differentiation. Single-cell RNA sequencing analysis further demonstrated that NFIC overexpressing monocytes had increased expression of growth and survival genes. In contrast, depletion of NFIC through shRNA decreased cell growth, increased cell cycle arrest and apoptosis in AML cell lines and AML patient blasts. Further, in AML cell lines (THP-1), bulk RNA sequencing of NFIC knockdown led to downregulation of genes involved in cell survival and oncogenic signaling pathways including mixed lineage leukemia-1 (MLL-1). Lastly, we show that NFIC knockdown in an ex vivo mouse MLL::AF9 pre-leukemic stem cell model, decreased their growth and colony formation and increased expression of myeloid differentiation markers Gr1 and Mac1. Collectively, our results suggest that NFIC is an important transcription factor in myeloid differentiation as well as AML cell survival and is a potential therapeutic target in AML

On the relationships between applied force, photography technique, and the quantification of bruise appearance

Bruising is an injury commonly observed within suspect cases of assault or abuse, yet how a blunt impact initiates bruising and influences its severity is not fully understood. Furthermore, the standard method of documenting a bruise with colour photography is known to have limitations which influence the already subjective analysis of a bruise. This research investigated bruising using a standardised blunt impact, delivered to 18 volunteers. The resulting bruise was imaged using colour, cross polarised (CP) and infrared photography. Timelines of the L*a*b* colour space were determined from both colour and CP images for up to 3 weeks. Overall, no single photographic technique out-performed the others, however CP did provide greater contrast than colour photography. L*a*b* colour space timelines were not attributable any physiological characteristics. Whilst impact force negatively correlated with BMI (R2 = 0.321), neither were associated with any measure of bruise appearance. Due to the inter-subject variability in the bruise response to a controlled infliction, none of the methods in the current study could be used to reliably predict the age of a bruise or the severity of force used in creating a bruise. A more comprehensive approach combining impact characteristics, tissue mechanics, enhanced localised physiological measures and improvements in quantifying bruise appearance is likely to be essential in removing subjectivity from their interpretation

Dynamic Blood-Brain Barrier Regulation in Mild Traumatic Brain Injury

Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (mTBI), especially concussion which, by definition, is characterized by a normal CT. To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast extravasation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on MRI and multiple biomechanical parameters indicating the severity of impacts recorded using instrumented mouthguards in professional MMA fighters. MMA fighters were examined pre-fight for a baseline and again within 120 h post-competitive fight, whereas rugby players were examined pre-season and again post-season or post-match in a subset of cases. DCE-MRI, serological analysis of BBB biomarkers, and an analysis of instrumented mouthguard data, was performed. Here, we provide pilot data that demonstrate disruption of the BBB in both professional MMA fighters and rugby players, dependent on the level of exposure. Our data suggest that biomechanical forces in professional MMA and adolescent rugby can lead to BBB disruption. These changes on imaging may serve as a biomarker of exposure of the brain to repetitive subconcussive forces and mTBI

Reducing alcohol harms whilst minimising impact on hospitality businesses: ‘Sweetspot’ policy options

Background During COVID-19, hospitality businesses (e.g. bars, restaurants) were closed/restricted whilst off-sales of alcohol increased, with health consequences. Post-covid, governments face lobbying to support such businesses, but many health services remain under pressure. We appraised ‘sweetspot’ policy options: those with potential to benefit public services and health, whilst avoiding or minimising negative impact on the hospitality sector. Methods We conducted rapid non-systematic evidence reviews using index papers, citation searches and team knowledge to summarise the literature relating to four possible ‘sweetspot’ policy areas: pricing interventions (9 systematic reviews (SR); 14 papers/reports); regulation of online sales (1 SR; 1 paper); place-shaping (2 SRs; 18 papers/reports); and violence reduction initiatives (9 SRs; 24 papers/reports); and led two expert workshops (n = 11). Results Interventions that raise the price of cheaper shop-bought alcohol appear promising as ‘sweetspot’ policies; any impact on hospitality is likely small and potentially positive. Restrictions on online sales such as speed or timing of delivery may reduce harm and diversion of consumption from on-trade to home settings. Place-shaping is not well-supported by evidence and experts were sceptical. Reduced late-night trading hours likely reduce violence; evidence of impact on hospitality is scant. Other violence reduction initiatives may modestly reduce harms whilst supporting hospitality, but require resources to deliver multiple measures simultaneously in partnership. Conclusions Available evidence and expert views point to regulation of pricing and online sales as having greatest potential as ‘sweetspot’ alcohol policies, reducing alcohol harm whilst minimising negative impact on hospitality businesses