The Context of Sexual Risk among African-American Female College Students

Objective: To assess the sexually transmitted infection (STI) awareness, sexual risk behaviors, and related contextual factors of African-American female college students. Participants: Eighty-nine African-American first year female students attending a majority public four-year college in the southern U.S. participated in the study in Spring, 2006. Methods: Participants completed an anonymous self-administered paper-and-pencil survey and received a $15 cash incentive. Results: Participants were highly knowledgeable and aware about STIs and their consequences. While this awareness translated into low levels of risk for many, still others engaged in behaviors and maintained beliefs that could potentially put them at high risk for contracting STIs. Conclusions: Given the disproportionate rates of STIs among young African-American females, researchers must not ignore the non-behavioral factors (i.e. beliefs and perceptions) that may influence sexual risk behaviors to help in determining optimal methods for intervention and prevention among young African-American females

Altered expression of platelet factor 4 and basic fibroblast growth factor correlates with the inhibition of tumor growth in mice

Herein, we describe the effects of Taxol on endothelioma cell growth and migration in vitro and on vascular tumor growth in vivo. The effects of Taxol on endothelioma cell growth were determined using the crystal violet assay, while cell migration was measured using the xCELLIgence Real-Time Cell Analysis system. To study the effects of Taxol on tumor growth, mice were inoculated with endothelioma cells to induce vascular tumor development and were treated with the drug. At termination, tissue samples from Taxol-treated and control mice were stained with hematoxylin and eosin for histological examination, while blood samples were collected for hematological analysis, as well as for the analysis of the expression of angiogenic markers. In vitro, Taxol inhibited cell growth and migration. The drug also inhibited vascular tumor growth in mice, and this correlated with a recovery of mice from thrombocytopenia. Array analysis of blood samples from mice revealed that there was an increase in the expression of platelet factor 4 and a suppression of the proangiogenic molecule basic fibroblast growth factor in Taxol-treated animals. Our findings suggest that Taxol may have potential in the treatment of vascular tumors.University of Pretoria and the National Research Foundation (NRF), grant 84430.http://www.journals.elsevier.com/biomedicine-and-pharmacotherapy/hb201

Hemangiomas - current therapeutic strategies

Hemangiomas are benign neoplasms of the vasculature frequently encountered in children. Several studies have shown that these tumors are characterized by excessive angiogenesis. Although benign, the lesions can present with complications, and may thus require treatment. There are multiple therapeutic options available for patients with problematic or life threatening hemangiomas, some of which have serious side effects. Randomized clinical trials and evidence-based studies on the efficacy of these treatments is still lacking. The recognition that excessive angiogenesis underlies hemangiogenesis offers an opportunity for the development of safer therapeutic strategies that are based on the inhibition of angiogenesis. We review medical therapies currently employed in the management of hemangiomas and the role of angiogenesis inhibition in hemangioma therapy.http://www.intjdevbiol.co

Frontline Allied Health Professionals in a Tertiary Children’s Hospital: Moving Forward Research Capacity, Culture and Engagement

Higher levels of research activity within healthcare contexts are known to result in improvements to staff and patient satisfaction as well as treatment outcomes. In the United Kingdom (UK), clinical academic careers for Allied Health Professionals (AHPs) are a key priority development area. This article presents the results of a study that aimed to scope the research capacity of four AHP professions in a tertiary children’s hospital using the Research Capacity and Culture Tool. This tool captures individuals’ views of success or skill required for a number of research-related items within the three domains of individual, team and organisation. Response rate ranged between 45-71% across the four groups. Reported barriers to carrying out research included a lack of time, clinical work taking priority, and lack of suitable backfill (i.e., employing a therapist to cover the clinical post for the AHP to complete research activity). Motivators, on the other hand, included skill development, career advancement, and increased job satisfaction. As a first step to strengthen research skills, a systematic process was used to devise a suite of supportive strategies targeting the individuals’ perceived gaps in their research abilities across four pillars: (i) awareness, (ii) accessibility, (iii) opportunity and capacity, and (iv) knowledge and skills. This process drew on previously published accounts of successful research capacity and culture development, as well as the unique needs of staff at this tertiary children’s hospital. The outcome of this process was a structured framework to support research capacity, culture and engagement. The specific details of this framework are reported in this article together with further recommendations to promote research capacity, culture and engagement amongst AHPs

Inhibition of hemangioma development in a syngeneic mouse model correlates with bcl-2 suppression and the inhibition of Akt kinase activity

BACKGROUND: Hemangiomas are benign vascular tumors that are characterised by excessive angiogenesis. While there is no definitive treatment for these tumors, several angiogenesis inhibitors, including bleomycin, have been employed. To better understand the mechanism of bleomycin in accelerating haemangioma regression, we investigated the effects of the drug on hemangiomagenesis using a previously described mouse hemangioma model. MATERIALS AND METHODS: The effects of bleomycin were tested in mice injected with endothelioma cells to induce hemangioma development. At termination, tissue samples from bleomycin-treated and control mice were stained with hematoxylin and eosin for histological examination. Bcl-2, flk-1 and vWF expression were studied by immunofluorescence microscopy. Hematological analysis was undertaken using a hemocounter. Akt activity was analyzed in tissue homogenates and endothelioma cells using ELISA. Also, caspase activity was analysed in endothelioma cells by ELISA. RESULTS: Bleomycin inhibited tumor growth in vivo in a dose-dependant manner. Our findings also revealed that bleomycin inhibited Akt activation and suppressed bcl-2. In vitro bleomycin increased caspase activation. CONCLUSION: Our observations reveal possible mechanisms for the inhibitory effects of bleomycin on hemangiomagenesis, and raise the possibility that bcl-2 might be an important therapeutic target in the treatment of hemangiomas.The National Research Foundation, the Medical Research Council and the University of Pretoria.http://www.springerlink.com/content/101769

Secondary and tertiary transfer of latent fingermarks using a sticky note – A feasibility study

Latent fingermarks are enhanced in order to be visible and available for comparison to determine source. Once a fingermark has been identified to a source, the activity that led to it being left on a particular surface may need to be determined. It has been previously shown that under certain conditions fingermarks initially deposited onto a surface (the primary transfer) can be transferred on to another substrate through direct contact – secondary transfer. This study investigates the possibility of secondary and subsequent tertiary transfer using sticky notes. To explore secondary transfer, fingermarks were deposited directly onto two different brands of sticky notes, spanning the adhesive and non-adhesive areas, and then placed in direct contact with paper for up to 72 h under a 5 kg weight. For some donors, there was transfer of fingermarks from the sticky note to the paper, with better results for the adhesive areas. The quality of the transferred fingermarks was dependent on initial fingermark quality and the transferred fingermark was a mirror image of the original. The type of paper used as the secondary substrate was also shown to have an effect. Given the adhesive nature of sticky notes tertiary transfer was also investigated and the potential to lift fingermarks from a glass slide and transfer them onto paper or a second glass slide. In the case of transfer to paper, there were only tertiary transferred fingermarks considered to be of useful quality (score 3 or 4) in 6% of samples and a further 33% of samples were detected but provided evidence of contact only (score 1 or 2) (n = 120). For transfer to glass, tertiary transferred samples were of poorer quality with no useful fingermarks and only 3% of samples scoring 1 or 2 (n = 120). The latter was in part due to the deposition of sticky note adhesive traces obscuring the fingermarks. In the case of tertiary transfer, fingermarks on the final tertiary surface were in the correct orientation. This work demonstrates that whilst tertiary transfer of fingermarks is possible under the laboratory conditions used, the likelihood of the effective transfer of a useful and potentially identifiable fingermark is in reality low

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Assessing pre-linguistic communication in young people with profound intellectual and multiple disabilities (PIMD)

Children with Profound Intellectual and Multiple Disabilities (PIMD) experience profound impairments in communication, remaining pre-linguistic communicators across their lifespan. Whilst the majority will receive speech and language therapy (SLT) input, shortcomings in current approaches to SLT assessment for this group have been identified by existing research and were further explored through a survey study carried out for this thesis. These included a lack of agreement around which prelinguistic skills might be significant and a reliance on indirect methods of information gathering. In response to these issues, this thesis explored the use of structured sampling techniques to measure behaviours relating to joint attention (JA) in children with PIMD and addressed the following questions. 1) What patterns of JA behaviour are demonstrated by young people with PIMD? 2) Are these patterns of behaviour affected by the ability to fix and shift gaze? 3) Are structured probes an effective means of eliciting information about JA behaviours? A continuum of behaviours underpinning JA was derived from the developmental literature. Structured probes were devised to elicit these behaviours and were administered to seventeen participants with PIMD aged 4-16 on three separate occasions. Since target behaviours involved gaze fixation and gaze shifting between objects and people, a novel measure of these functional vision skills was also administered. Performance on the probes was compared to performance in less structured settings. Results indicated that young people with PIMD can be differentiated by the profiles of JA behaviours they demonstrate. These profiles were significantly correlated with their functional vision abilities but were not associatednot associated with background measures of cognitive and motor skills or with scores on the Communication Matrix (Rowland, 2004). Structured probes were an effective means of assessing JA behaviours, providing a controlled environment and multiple opportunities for participants to demonstrate capacity which was not always revealed by alternative means of information gathering. Findings of this thesis suggest that current approaches to communication assessment for people with PIMD might be enhanced by the increased use of structured sampling and a shared focus on behaviours relating to joint attention