Evaluation of a Surgical Intervention to Experimentally Compare CO2 Laser to Scalpel Incisions, Added Growth Factor, and Suture Material to Reduce Cutaneous Scarring

Introduction The goal of this study was to determine if the repair of full thickness skin incisions in an animal model could be improved by using a CO2 laser vs. scalpel, commercial vs. swine intestinal submucosa (SIS) sutures, and addition of exogenous nerve growth factor (NGF). Materials and Methods A rat model was used to evaluate the following tissue components: prevalence of mast cell granules, thickness of epidermis, organization of collagen, infiltration of tissue into SIS, neutrophil presence around suture holes, and granulation tissue production around suture holes. Results Added NGF led to a significant decrease in the number of granules in mast cells following laser incisions. A significant number of neutrophils were detected in skin following laser incision without added NGF. Added NGF significantly increased the band iv of granulation tissue for both types of incision methods however, the laser resulted in a significantly wider band of granulation tissue with or without added NGF. A thicker epithelium was apparent following use of laser as was the level of collagen organization. Added NGF significantly increased incorporation of skin elements into SIS sutures. The use of the laser without NGF resulted in greatest collagen organization, number of mast cell granules, and neutrophils, and significantly greater vascularization. Discussion The greater extent and duration of granulation tissue proliferation following laser incision may be attributable to an inappropriately high laser dosage. Collagen organization improves with laser use. Incorporation of tissue into SIS sutures was promoted by adding NGF, but unaffected by surgical technique. Increased vascularity following laser incision suggested blood vessels re-opened or angiogenesis occurred post-surgery. With added NGF, epidermal width following laser incision was even greater in contrast to the scalpel incised group. Depending upon the intent of the surgeon, the use of surgical modality, suture material, or additional exogenous NGFs has to be tailored to the specific patient and desired outcom

Efficient analysis of data streams

Data streams provide a challenging environment for statistical analysis. Data points can arrive at a high velocity and may need to be deleted once they have been observed. Due to these restrictions, standard techniques may not be applicable to the data streaming scenario. This leads to the need for data summaries to represent the data stream. This thesis explores how data summaries can be used to perform clustering and classification on data streams across a broad range of applications. Spectral clustering is one such technique which prior to this work has not been applicable to the data streaming setting due to the high computation involved. CluStream is an existing method which uses micro-clusters to summarise data streams. We present two algorithms which utilise these micro-cluster summaries to enable spectral clustering to be performed on data streams. The methods were tested on simulated data streams, as well as textured images and hand-written digits. Distributed acoustic sensing is used to monitor oil flow at various depths throughout an oil well. Vibrations are recorded at very high resolutions, up to 10000 observations a second at each depth. Unfortunately, corruption can occur in the signal and engineers need to know where corruption occurs. We develop a method which treats the multiple time series as a high-dimensional clustering problem and uses the cluster labels to identify changes within the signal. The final piece of work concerns identifying areas of activity within a video stream, in particular CCTV footage. It is more efficient if this classification stage is performed on a compressed version of the video stream. In order to reconstruct areas of activity in the original video a recovery algorithm is needed. We present a comparison of the performance of two recovery algorithms and identify an ideal range for the compression ratio

Neuro-ophthalmological syndrome 3-methylglutaconic aciduria: a molecular and functional study of the B6; C3-Opa3L122P mouse model

Introduction: OPA3 is the causative gene of the autosomal recessive, multi-systemic neuro- ophthalmological syndrome, 3-methylglutaconic aciduria Type III (MGA-III) and Autosomal Dominant Optic Atrophy and Cataract (ADOAC). Early onset bilateral optic atrophy is a common characteristic of both disorders where retinal ganglion cells (RGCs) are lost. Purpose: To investigate the pathophysiology of the disease and function of the OPA3 protein we generated a novel ENU-induced mutant mouse carrying the missense mutation p.L122P in exon 2 of Opa3 which is predicted to alter tertiary protein structure. Methods: Visual function was assessed using optokinetic nystagmus and pupillary light reflex. Histology explored retinal degeneration and metabolic dysfunction. Rotarod, wirehang and open field analysed neurological, neuromuscular and behavioural aspects of the disease. Genomic structure of Opa3 was re-examined using RT-PCR and bio-informatic programs characterized possible upstream transcription factor binding sites (TFBS). Results: Opa3 ' mice displayed a multi-systemic disease, including decreased life span and weight, extra-pyramidal dysfunction, neuro-muscular defect, craniofacial defects, reduction in intra-abdominal white adipose tissue, elevated marrow adiposity and severe hepatic steatosis. Opa3'' are functionally blind but pupillary function was essentially intact. Histology showed loss of RGCs and other cell types through postnatal development onwards. RT-PCR identified a third exon and analysis of 53 TFBS identified suggests a role for Opa3 in retinal and craniofacial development, cellular stress response/apoptosis and adipogenesis. Conclusions: Opa3 / display many aspects of human MGA-III syndrome and phenotypes not observed such as craniofacial defects and a profound disturbance in lipid metabolism. Opa3 is thought to be involved in the mevalonate shunt and leucine degradation metabolic pathways. Defects in these pathways can cause a build up of 3-methylglutaconic acid and 3- methylglyaric acid in the inner mitochondrial membrane which may have a profound affect on mitochondrial metabolism particularly in high energy demand tissues such as retina, heart and neurons

Knowledge brokerage and research utilisation: a discussion document prepared for the Australian Government Department of Health and Ageing

In mid 2009 the Australian Department of Health and Ageing (DoHA) funded the Australian Primary Health Care Research Institute (APHCRI) to undertake a project on Knowledge Brokerage (KB). The aim of the project was to develop a model through which APHCRI, DoHA and other key stakeholders could work together over the next iteration of APHCRI’s contract for translating research evidence into Australian primary health care systems and services. The KB model would support the Commonwealth’s health reform agenda through facilitating the dissemination of research findings to policy makers and enabling policy makers to pose research questions addressing their need for evidence to support policy development. The KB project undertaken by APHCRI has three components;  A comprehensive literature review  A workshop of key stakeholders to identify different models of KB, work towards identifying the key components of successful models and to devise a framework to support effective knowledge translation  A review of the processes used by APHCRI to fund research and the effectiveness of the synthesis and transfer of knowledge generated by APHCRI-funded research to date. This document reports on the outcomes of these three components and offers recommendations for future action.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Headteacher Recruitment, Retention and Professional Development in Wales: Challenges and Opportunities

This article explores issues of headteacher recruitment, retention and professional development in Wales, within the context of the wider educational policy reforms which, since 2011, have introduced greater external accountability into schools. The paper argues that these reforms have resulted in changes to headteachers' professional roles and identities and that some aspects have militated against headteachers' cultivation and exercising of their 'professional capital' (Hargreaves and Fullan, 2012). The data is derived from thirty semi-structured interviews conducted with headteachers, deputy and assistant heads throughout Wales. Participants' accounts articulate concerns that greater accountability within the Welsh system is acting as a disincentive to headteacher recruitment, and that head-teachers often lack independent sources of support, advice and mentoring, which they can access without the burden of additional scrutiny and accountability. The article concludes by offering a series of observations and recommendations to inform recent renewed efforts to create a new support infrastructure and framework for the development of educational leadership in Wales

Are you handling genital oedema confidently?

Men, women or children can suffer from oedema (swelling) of the genitalia. When differential diagnosis has excluded acute trauma or pathology and swelling remains, the condition may be diagnosed as genital lymphoedema, a chronic condition that increases the relative risk of cellulitis. Diagnosis of genital oedema is often delayed due to problems with patient and health professional behaviour, in terms of embarrassment, lack of confidence or lack of knowledge. Awareness of this condition and knowledge on how to manage it will go a long way in helping both patients and clinicians overcome the challenges of addressing genital oedema. This article describes the authors' experiences in managing genital oedema. It also briefly discusses a new international project that seeks to identify the knowledge and training that health professionals need to manage this condition more confidently

Percutaneous Coronary Intervention: Developments in the Last 12 Months

In 2018, there were several studies that significantly added to the field of interventional cardiology. Research was focused on understanding the role of percutaneous coronary intervention (PCI) in various clinical syndromes, optimizing outcomes for high-risk lesion subsets, and building an evidence base for greater adoption of PCI guided by physiology and intracoronary imaging. In the area of innovation, novel and iterative developments in drug-eluting stents (DES) and scaffold platforms were compared with current generation DES. This article summarizes the research from last year which has had the most impact on PCI techniques and clinical care

Kinesthetic Evaluation of Surgical Interventions To Improve Physiologic Performance

Background: The evaluation of rat movement patterns is pertinent when studying the particular influence an injury may have on ambulation. Previous studies have found that these animals will alter their load-bearing away from the injured limb. Change also occurs in the stride width between the immobilized limb and the opposite hind limb. The Functional indices for print length (PL), distance between first and fifth digits or toe spreading (TS), distance between second and fourth digits or intermediary toes (IT), and toe to opposite foot (TOF), was determined for each of the experimental groups. The focus of the present study was to evaluate ambulatory function throughout the healing period and to compare results to presurgical ambulatory function following the experimental interventions; laser induced gastrocnemius lacerations versus cold knife as well as the effect of exogenous nerve growth factor (NGF) injections into the muscle wound

Impact of cytological sampling on EGFR mutation testing in stage III-IV lung adenocarcinoma

Objectives. There have been advances in the identification and understanding of molecular subsets of lung cancer, defined by specific oncogenic aberrations. A number of actionable genetic alterations have been identified, such as the epidermal growth factor receptor (EGFR) mutation. We aimed to establish the reasons why patients were not undergoing EGFR mutation testing at the time of histological diagnosis. Methods. The records of 70 patients with advanced adenocarcinoma of the lung managed through a single multidisciplinary team at a single institution were reviewed. Data were collected on method of tumour sample collection, whether this was sent for EGFR testing, and the result. Results. Seventy patients were identified. In 21/25 (84%) cases, cytological sampling was sufficient for EGFR mutation analysis, compared with 40/45 (89%) cases with histological sampling. EGFR mutation testing was not carried out in 22/70 (31.4%) patients. There was insufficient tumour sample for EGFR testing in 9/22 (40.9%) patients. Other reasons for not testing included poor patient fitness and problems in the diagnostic pathway. Conclusions. In this series, cytological tumour sampling was not the predominant reason why cancers failed to have EGFR mutation status established