Recruitment of dendritic cells and macrophages during T cell-mediated synovial inflammation

Adoptive transfer of adjuvant-induced arthritis was used in this study to examine local macrophages and dendritic cells (DCs) during T cell-mediated synovial inflammation. We studied the influx of CD11b+CD11c+ putative myeloid DCs and other non-lymphoid CD45+ cells into synovium-rich tissues (SRTs) of the affected hind paws in response to a pulse of autoreactive thoracic duct cells. Cells were prepared from the SRTs using a collagenase perfusion-digestion technique, thus allowing enumeration and phenotypic analysis by flow cytometry. Numbers of CD45+ cells increased during the first 6 days, with increases in CD45+MHC (major histocompatibility complex) II+ monocyte-like cells from as early as day 3 after transfer. In contrast, typical MHC II- monocytes, mainly of the CD4- subset, did not increase until 12 to 14 days after cell transfer, coinciding with the main influx of polymorphonuclear cells. By day 14, CD45+MHC IIhi cells constituted approximately half of all CD45+ cells in SRT. Most of the MHC IIhi cells expressed CD11c and CD11b and represented putative myeloid DCs, whereas only approximately 20% were CD163+ macrophages. Less than 5% of the MHC IIhi cells in inflamed SRT were CD11b-, setting a maximum for any influx of plasmacytoid DCs. Of the putative myeloid DCs, a third expressed CD4 and both the CD4+ and the CD4- subsets expressed the co-stimulatory molecule CD172a. Early accumulation of MHC IIhiCD11c+ monocyte-like cells during the early phase of T cell-mediated inflammation, relative to typical MHC II- blood monocytes, suggests that recruited monocytes differentiate rapidly toward the DC lineage at this stage in the disease process. However, it is possible also that the MHC IIhiCD11c+ cells originate from a specific subset of DC-like circulating mononuclear cells

Effect of Vitamin E, Lutein, Selenium and Oil Mixture Added to Feed and Cooking Length on Yolk Color and Egg Quality

The aim of this research was to determine the quality of eggs laid by Tetra SL hens fed standard diet (B) or diet supplemented with 100 mg vitamin E/kg+200 mg/kg lutein+0.5 mg/kg selenium+5% oil mixture (BK). The effect of treatment was determined for yolk color values (P0.05). However, the treatment had statistically significant effect (P0.05)

Increase of the Lutein Content in Hens' Eggs

Lutein is a plant pigment that belongs to the xantophyll group of carotenoids. In nature it is widespread (prevalent) in green leafy vegetables (spinach, kale, collard greens, lettuce) but also in peppers, tangerines, corn and egg yolk. Since it cannot be synthesized in the body it has to be taken with food. In human body lutein is concentrated in the retina and macula lutea and its content in those tissues rises with increased intake through food or supplements. It has antioxidant activity, protects eyes from high-energy blue light and helps in reducing the risk of developing age-related macular degeneration and cataracts. Until now, lutein was used in poultry industry mostly for pigmenting broiler's meat and skin and egg yolk and lately there have been more studies whose goal is to increase lutein content in yolk and production of enriched, functional food. Although table egg is not the best source of lutein, studies have shown that its bioavailability in human body is higher from lipid matrix of yolk compared with lutein from vegetable sources or food supplements. The egg is highly nutritious food because it contains high-quality proteins with balanced amino acid composition, essential fatty acids, minerals and vitamins necessary for proper functioning of the body and with increased content of lutein it becomes a value-added product. Addition of natural or synthetic sources of lutein in mixtures for laying hens enables the transfer of lutein through hen's metabolism into egg yolk. The increase of lutein content in yolk is noticeable already after one week of feeding the hens with modified mixtures although it takes a longer time for its content to be stabilized. Egg with increased content of lutein in yolk represents quality and accessible source of lutein in human nutrition. Consumption of enriched eggs contributes to increased intake of lutein as well as its accumulation in the human organism

What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys

Objectives: To synthesise results of population surveys assessing knowledge and attitudes about prevention and treatment of dementia. Methods: MEDLINE, EMBASE, PsycINFO, and grey literature were searched for English language entries published between 2012 and May 2017. Survey questions were grouped using an inductive approach and responses were pooled. Results: Thirty-four eligible studies and four grey literature items were identified. Surveys were conducted in Europe, the US, Eastern Asia, Israel, and Australia. Nearly half of respondents agreed that dementia is a normal and non-preventable part of ageing, but belief in the potential for prevention may be improving over time. The role of cardiovascular risk factors was poorly understood overall. Less than half of respondents reported belief in the availability of a cure for dementia. The value of seeking treatment was highly endorsed. Conclusions: Results suggest that knowledge about the potential for dementia prevention and treatment remains poor but may be improving over time. Knowledge among those living in low- and middle-income countries are largely unknown, presenting challenges for the development of National action plans consistent with World Health Organization directives.Monica Cations, Gorjana Radisic, Maria Crotty, Kate E. Lave

Costs and economic evaluations of Quality Improvement Collaboratives in healthcare: a systematic review

BACKGROUND:In increasingly constrained healthcare budgets worldwide, efforts to improve quality and reduce costs are vital. Quality Improvement Collaboratives (QICs) are often used in healthcare settings to implement proven clinical interventions within local and national programs. The cost of this method of implementation, however, is cited as a barrier to use. This systematic review aims to identify and describe studies reporting on costs and cost-effectiveness of QICs when used to implement clinical guidelines in healthcare. METHODS:Multiple databases (CINAHL, MEDLINE, PsycINFO, EMBASE, EconLit and ProQuest) were searched for economic evaluations or cost studies of QICs in healthcare. Studies were included if they reported on economic evaluations or costs of QICs. Two authors independently reviewed citations and full text papers. Key characteristics of eligible studies were extracted, and their quality assessed against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Evers CHEC-List was used for full economic evaluations. Cost-effectiveness findings were interpreted through the Johanna Briggs Institute 'three by three dominance matrix tool' to guide conclusions. Currencies were converted to United States dollars for 2018 using OECD and World Bank databases. RESULTS:Few studies reported on costs or economic evaluations of QICs despite their use in healthcare. Eight studies across multiple healthcare settings in acute and long-term care, community addiction treatment and chronic disease management were included. Five were considered good quality and favoured the establishment of QICs as cost-effective implementation methods. The cost savings to the healthcare setting identified in these studies outweighed the cost of the collaborative itself. CONCLUSIONS:Potential cost savings to the health care system in both acute and chronic conditions may be possible by applying QICs at scale. However, variations in effectiveness, costs and elements of the method within studies, indicated that caution is needed. Consistent identification of costs and description of the elements applied in QICs would better inform decisions for their use and may reduce perceived barriers. Lack of studies with negative findings may have been due to publication bias. Future research should include economic evaluations with societal perspectives of costs and savings and the cost-effectiveness of elements of QICs. TRIAL REGISTRATION:PROSPERO registration number: CRD42018107417.Lenore de la Perrelle, Gorjana Radisic, Monica Cations, Billingsley Kaambwa, Gaery Barbery and Kate Lave

High performance MMICs with submillimeter wave InP-based HEMTs

This paper presents some recently developed MMICs based on a 0.1-/spl mu/m gate-length InAlAs/InGaAs/InP HEMT process with an f/sub max/ above 600 GHz. InP-based HEMTs provide more power gain and lower noise at higher frequencies than any other transistor, including GaAs-based pHEMTs. A number of state-of-the-art InP HEMT MMICs will be presented. This includes a 150-205 GHz amplifier with 15 dB of gain, a broadband 60-140 GHz amplifier with 25 mW output power at 140 GHz, a high gain Ka-band LNA and static frequency-divider circuits operating at clock rates above 45 GHz. The high frequency performance of a next-generation 0.08-/spl mu/m-gate InAlAsSb/InAlAs/InGaAs/InP HEMT technology will also be presented

How, why and under what circumstances does a quality improvement collaborative build knowledge and skills in clinicians working with people with dementia? A realist informed process evaluation

In increasingly constrained health and aged care services, strategies are needed to improve quality and translate evidence into practice. In dementia care, recent failures in quality and safety have led the WHO to prioritise the translation of known evidence into practice. While quality improvement collaboratives have been widely used in healthcare, there are few examples in dementia care. We describe a recent quality improvement collaborative to improve dementia care across Australia and assess the implementation outcomes of acceptability and feasibility of this strategy to translate known evidence into practice. A realist-informed process evaluation was used to analyse how, why and under what circumstances a quality improvement collaborative built knowledge and skills in clinicians working in dementia care. This realist-informed process evaluation developed, tested and refined the programme theory of a quality improvement collaborative. Data were collected pre-intervention and post-intervention using surveys and interviews with participants (n=28). A combined inductive and deductive data analysis process integrated three frameworks to examine the context and mechanisms of knowledge and skill building in participant clinicians. A refined program theory showed how and why clinicians built knowledge and skills in quality improvement in dementia care. Six mechanisms were identified: motivation, accountability, identity, collective learning, credibility and reflective practice. These mechanisms, in combination, operated to overcome constraints, role boundaries and pessimism about improved practice in dementia care. A quality improvement collaborative designed for clinicians in different contexts and roles was acceptable and feasible in building knowledge, skills and confidence of clinicians to improve dementia care. Supportive reflective practice and a credible, flexible and collaborative process optimised quality improvement knowledge and skills in clinicians working with people with dementia.Lenore de la Perrelle, Monica Cations, Gaery Barbery, Gorjana Radisic, Billingsley Kaambwa, Maria Crotty, Janna Anneke Fitzgerald, Susan Kurrle, Ian Cameron, Craig Whitehead, Jane Thompson, Kate Lave