186 research outputs found
Follow up of a cohort of intravenous heroin users in north and south central Dublin and in Dun Laoghaire.
Three studies of intravenous heroin users, in electoral wards in the north and south of central Dublin and in Dun Laoghaire, were undertaken in 1982-84. One hundred and one out of 203 intravenous injectors in these three studies are known to have been tested in Dublin for infection by the Human Immunodeficiency Virus (HIV) and 87 of the 101, or 86% are HIV Positive. Ninety two had also been tested for Hepatitis B infection (Hab) and 76 of the 92 were positive for the hepatitis antigen. The majority of those at present known to be HIV Positive in the Republic of Ireland are, or were, intravenous drug users
East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series
Academic geriatric medicine in Leicester
.
There has never been a better time to consider joining us. We have recently appointed a
Professor in Geriatric Medicine, alongside Tom Robinson in stroke and Victoria Haunton,
who has just joined as a Senior Lecturer in Geriatric Medicine. We have fantastic
opportunities to support students in their academic pursuits through a well-established
intercalated BSc programme, and routes on through such as ACF posts, and a successful
track-record in delivering higher degrees leading to ACL post. We collaborate strongly
with Health Sciences, including academic primary care. See below for more detail on our
existing academic set-up.
Leicester Academy for the Study of Ageing
We are also collaborating on a grander scale, through a joint academic venture focusing
on ageing, the ‘Leicester Academy for the Study of Ageing’ (LASA), which involves the
local health service providers (acute and community), De Montfort University; University
of Leicester; Leicester City Council; Leicestershire County Council and Leicester Age UK.
Professors Jayne Brown and Simon Conroy jointly Chair LASA and have recently been
joined by two further Chairs, Professors Kay de Vries and Bertha Ochieng. Karen
Harrison Dening has also recently been appointed an Honorary Chair.
LASA aims to improve outcomes for older people and those that care for them that takes
a person-centred, whole system perspective. Our research will take a global perspective,
but will seek to maximise benefits for the people of Leicester, Leicestershire and Rutland,
including building capacity. We are undertaking applied, translational, interdisciplinary
research, focused on older people, which will deliver research outcomes that address
domains from: physical/medical; functional ability, cognitive/psychological; social or
environmental factors. LASA also seeks to support commissioners and providers alike for
advice on how to improve care for older people, whether by research, education or
service delivery. Examples of recent research projects include: ‘Local History Café’
project specifically undertaking an evaluation on loneliness and social isolation; ‘Better
Visits’ project focused on improving visiting for family members of people with dementia
resident in care homes; and a study on health issues for older LGBT people in Leicester.
Clinical Geriatric Medicine in Leicester
We have developed a service which recognises the complexity of managing frail older
people at the interface (acute care, emergency care and links with community services).
There are presently 17 consultant geriatricians supported by existing multidisciplinary
teams, including the largest complement of Advance Nurse Practitioners in the country.
Together we deliver Comprehensive Geriatric Assessment to frail older people with
urgent care needs in acute and community settings.
The acute and emergency frailty units – Leicester Royal Infirmary
This development aims at delivering Comprehensive Geriatric Assessment to frail older
people in the acute setting. Patients are screened for frailty in the Emergency
Department and then undergo a multidisciplinary assessment including a consultant
geriatrician, before being triaged to the most appropriate setting. This might include
admission to in-patient care in the acute or community setting, intermediate care
(residential or home based), or occasionally other specialist care (e.g. cardiorespiratory).
Our new emergency department is the county’s first frail friendly build and includes
fantastic facilities aimed at promoting early recovering and reducing the risk of hospital
associated harms.
There is also a daily liaison service jointly run with the psychogeriatricians (FOPAL); we
have been examining geriatric outreach to oncology and surgery as part of an NIHR
funded study.
We are home to the Acute Frailty Network, and those interested in service developments
at the national scale would be welcome to get involved.
Orthogeriatrics
There are now dedicated hip fracture wards and joint care with anaesthetists,
orthopaedic surgeons and geriatricians. There are also consultants in metabolic bone
disease that run clinics.
Community work
Community work will consist of reviewing patients in clinic who have been triaged to
return to the community setting following an acute assessment described above.
Additionally, primary care colleagues refer to outpatients for sub-acute reviews. You will
work closely with local GPs with support from consultants to deliver post-acute, subacute,
intermediate and rehabilitation care services.
Stroke Medicine
24/7 thrombolysis and TIA services. The latter is considered one of the best in the UK
and along with the high standard of vascular surgery locally means one of the best
performances regarding carotid intervention
Comparison of Citrate-Fluoride-EDTA with Fluoride-EDTA Additives to Stabilize Plasma Glucose Measurements in Women Being Screened during Pregnancy with an Oral Glucose Tolerance Test: A Prospective Observational Study
APRIL is a novel clinical chemo-resistance biomarker in colorectal adenocarcinoma identified by gene expression profiling
<p>Abstract</p> <p>Background</p> <p>5-Fluorouracil(5FU) and oral analogues, such as capecitabine, remain one of the most useful agents for the treatment of colorectal adenocarcinoma. Low toxicity and convenience of administration facilitate use, however clinical resistance is a major limitation. Investigation has failed to fully explain the molecular mechanisms of resistance and no clinically useful predictive biomarkers for 5FU resistance have been identified. We investigated the molecular mechanisms of clinical 5FU resistance in colorectal adenocarcinoma patients in a prospective biomarker discovery project utilising gene expression profiling. The aim was to identify novel 5FU resistance mechanisms and qualify these as candidate biomarkers and therapeutic targets.</p> <p>Methods</p> <p>Putative treatment specific gene expression changes were identified in a transcriptomics study of rectal adenocarcinomas, biopsied and profiled before and after pre-operative short-course radiotherapy or 5FU based chemo-radiotherapy, using microarrays. Tumour from untreated controls at diagnosis and resection identified treatment-independent gene expression changes. Candidate 5FU chemo-resistant genes were identified by comparison of gene expression data sets from these clinical specimens with gene expression signatures from our previous studies of colorectal cancer cell lines, where parental and daughter lines resistant to 5FU were compared. A colorectal adenocarcinoma tissue microarray (n = 234, resected tumours) was used as an independent set to qualify candidates thus identified.</p> <p>Results</p> <p>APRIL/TNFSF13 mRNA was significantly upregulated following 5FU based concurrent chemo-radiotherapy and in 5FU resistant colorectal adenocarcinoma cell lines but not in radiotherapy alone treated colorectal adenocarcinomas. Consistent withAPRIL's known function as an autocrine or paracrine secreted molecule, stromal but not tumour cell protein expression by immunohistochemistry was correlated with poor prognosis (p = 0.019) in the independent set. Stratified analysis revealed that protein expression of APRIL in the tumour stroma is associated with survival in adjuvant 5FU treated patients only (n = 103, p < 0.001), and is independently predictive of lack of clinical benefit from adjuvant 5FU [HR 6.25 (95%CI 1.48-26.32), p = 0.013].</p> <p>Conclusions</p> <p>A combined investigative model, analysing the transcriptional response in clinical tumour specimens and cancers cell lines, has identified APRIL, a novel chemo-resistance biomarker with independent predictive impact in 5FU-treated CRC patients, that may represent a target for novel therapeutics.</p
Biomechanical simulations of the scoliotic deformation process in the pinealectomized chicken: a preliminary study
<p>Abstract</p> <p>Background</p> <p>The basic mechanisms whereby mechanical factors modulate the metabolism of the growing spine remain poorly understood, especially the role of growth adaptation in spinal disorders like in adolescent idiopathic scoliosis (AIS). This paper presents a finite element model (FEM) that was developed to simulate early stages of scoliotic deformities progression using a pinealectomized chicken as animal model.</p> <p>Methods</p> <p>The FEM includes basic growth and growth modulation created by the muscle force imbalance. The experimental data were used to adapt a FEM previously developed to simulate the scoliosis deformation process in human. The simulations of the spine deformation process are compared with the results of an experimental study including a group of pinealectomized chickens.</p> <p>Results</p> <p>The comparison of the simulation results of the spine deformation process (Cobb angle of 37°) is in agreement with experimental scoliotic deformities of two representative cases (Cobb angle of 41° and 30°). For the vertebral wedging, a good agreement is also observed between the calculated (28°) and the observed (25° – 30°) values.</p> <p>Conclusion</p> <p>The proposed biomechanical model presents a novel approach to realistically simulate the scoliotic deformation process in pinealectomized chickens and investigate different parameters influencing the progression of scoliosis.</p
Reactome: a database of reactions, pathways and biological processes
Reactome (http://www.reactome.org) is a collaboration among groups at the Ontario Institute for Cancer Research, Cold Spring Harbor Laboratory, New York University School of Medicine and The European Bioinformatics Institute, to develop an open source curated bioinformatics database of human pathways and reactions. Recently, we developed a new web site with improved tools for pathway browsing and data analysis. The Pathway Browser is an Systems Biology Graphical Notation (SBGN)-based visualization system that supports zooming, scrolling and event highlighting. It exploits PSIQUIC web services to overlay our curated pathways with molecular interaction data from the Reactome Functional Interaction Network and external interaction databases such as IntAct, BioGRID, ChEMBL, iRefIndex, MINT and STRING. Our Pathway and Expression Analysis tools enable ID mapping, pathway assignment and overrepresentation analysis of user-supplied data sets. To support pathway annotation and analysis in other species, we continue to make orthology-based inferences of pathways in non-human species, applying Ensembl Compara to identify orthologs of curated human proteins in each of 20 other species. The resulting inferred pathway sets can be browsed and analyzed with our Species Comparison tool. Collaborations are also underway to create manually curated data sets on the Reactome framework for chicken, Drosophila and rice
Niche of harmful alga Aureococcus anophagefferens revealed through ecogenomics
Author Posting. © The Author(s), 2011. This is the author's version of the work. It is posted here by permission of National Academy of Sciences for personal use, not for redistribution. The definitive version was published in Proceedings of the National Academy of Sciences 108 (2011): 4352-4357, doi:10.1073/pnas.1016106108.Harmful algal blooms (HABs) cause significant economic and ecological damage worldwide. Despite considerable efforts, a comprehensive understanding of the factors that promote these blooms has been lacking because the biochemical pathways that facilitate their dominance relative to other phytoplankton within specific environments have not been identified. Here, biogeochemical measurements demonstrated that the harmful 43 Aureococcus anophagefferens outcompeted co-occurring phytoplankton in estuaries with elevated levels of dissolved organic matter and turbidity and low levels of dissolved inorganic nitrogen. We subsequently sequenced the first HAB genome (A. anophagefferens) and compared its gene complement to those of six competing phytoplankton species identified via metaproteomics. Using an ecogenomic approach, we specifically focused on the gene sets that may facilitate dominance within the environmental conditions present during blooms. A. anophagefferens possesses a larger genome (56 mbp) and more genes involved in light harvesting, organic carbon and nitrogen utilization, and encoding selenium- and metal-requiring enzymes than competing phytoplankton. Genes for the synthesis of microbial deterrents likely permit the proliferation of this species with reduced mortality losses during blooms. Collectively, these findings suggest that anthropogenic activities resulting in elevated levels of turbidity, organic matter, and metals have opened a niche within coastal ecosystems that ideally suits the unique genetic capacity of A. anophagefferens and thus has facilitated the proliferation of this and potentially other HABs.Joint Genome Institute is supported by the Office of Science of the U.S. Department of Energy under Contract No. DE-AC02-05CH11231. Efforts were also supported by awards from New York Sea Grant to Stony Brook University, National Oceanic and Atmospheric Administration Center for Sponsored Coastal Ocean Research award #NA09NOS4780206 to Woods Hole Oceanographic Institution, NIH grant GM061603 to Harvard University, and NSF award IOS-0841918 to The University of Tennessee
Tubulin Binds to the Cytoplasmic Loop of TRESK Background K+ Channel In Vitro.
The cytoplasmic loop between the second and third transmembrane segments is pivotal in the regulation of TRESK (TWIK-related spinal cord K+ channel, K2P18.1, KCNK18). Calcineurin binds to this region and activates the channel by dephosphorylation in response to the calcium signal. Phosphorylation-dependent anchorage of 14-3-3 adaptor protein also modulates TRESK at this location. In the present study, we identified molecular interacting partners of the intracellular loop. By an affinity chromatography approach using the cytoplasmic loop as bait, we have verified the specific association of calcineurin and 14-3-3 to the channel. In addition to these known interacting proteins, we observed substantial binding of tubulin to the intracellular loop. Successive truncation of the polypeptide and pull-down experiments from mouse brain cytosol narrowed down the region sufficient for the binding of tubulin to a 16 amino acid sequence: LVLGRLSYSIISNLDE. The first six residues of this sequence are similar to the previously reported tubulin-binding region of P2X2 purinergic receptor. The tubulin-binding site of TRESK is located close to the protein kinase A (PKA)-dependent 14-3-3-docking motif of the channel. We provide experimental evidence suggesting that 14-3-3 competes with tubulin for the binding to the cytoplasmic loop of TRESK. It is intriguing that the 16 amino acid tubulin-binding sequence includes the serines, which were previously shown to be phosphorylated by microtubule-affinity regulating kinases (MARK kinases) and contribute to channel inhibition. Although tubulin binds to TRESK in vitro, it remains to be established whether the two proteins also interact in the living cell
HIV testing within general practices in Europe : A mixed-methods systematic review
Funding Information: This work was supported by IWT (Belgium) and the ANRS (France) through the framework of HIVERA JTC 2014. Publisher Copyright: © 2018 The Author(s).Background: Late diagnosis of HIV infection remains a key challenge in Europe. It is acknowledged that general practitioners (GPs) may contribute greatly to early case finding, yet there is evidence that many diagnostic opportunities are being missed. To further promote HIV testing in primary care and to increase the utility of available research, the existing evidence has been synthesised in a systematic review adhering to the PRISMA guidelines. Methods: The databases PubMed, Scopus and Embase were searched for the period 2006-2017. Two authors judged independently on the eligibility of studies. Through a mixed-methods systematic review of 29 studies, we provide a description of HIV testing in general practices in Europe, including barriers and facilitators. Results: The findings of the study show that although various approaches to target patients are used by GPs, most tests are still carried out based on the patient's request. Several barriers obstruct HIV testing in general practice. Included are a lack of communication skills on sexual health, lack of knowledge about HIV testing recommendations and epidemic specificities, difficulties with using the complete list of clinical HIV indicator diseases and lack of experience in delivering and communicating test results. The findings also suggest that the provision of specific training, practical tools and promotion programmes has an impact on the testing performance of GPs. Conclusions: GPs could have an increased role in provider-initiated HIV-testing for early case finding. To achieve this objective, solutions to the reported barriers should be identified and testing criteria adapted to primary healthcare defined. Providing guidance and training to better identify priority groups for HIV testing, as well as information on the HIV epidemic's characteristics, will be fundamental to increasing awareness and testing by GPs.publishersversionPeer reviewe
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