Evaluating digital diabetic retinopathy screening in people aged 90 years and over

To evaluate the effectiveness of digital diabetic retinopathy screening in patients aged 90 years and over.MethodsThis is a retrospective analysis of 200 randomly selected patients eligible for diabetic retinopathy screening aged 90 years and over within the Birmingham, Solihull, and Black Country Screening Programme.ResultsOne hundred and seventy-nine (90%) patients attended screening at least once. 133 (74%) annual screening after their first screen, of whom 59% had no detectable diabetic retinopathy; 38 (21%) were referred for ophthalmology clinical assessment-36 for nondiabetic retinopathy reasons and two for diabetic maculopathy. Cataract accounted for 50% of all referrals for ophthalmology clinical assessment. Of the 133 patients placed on annual screening, 93 (70%) were screened at least once more. In terms of level of diabetic retinopathy, assessability or other ocular pathologies, 8 improved, 51 remained stable, and 31 deteriorated. Of the latter, 19 patients were referred for ophthalmology clinical assessment; none of these for diabetic retinopathy.ConclusionsScreening provides opportunistic identification of important nondiabetic retinopathy eye conditions. However, in view of the low identification rate of sight-threatening diabetic retinopathy in patients aged 90 years and over, and the current mission statement of the NHS Diabetic Eye Screening Programme, systematic annual diabetic retinopathy screening may not be justified in this age group of patients, but rather be performed in optometric practice

Cementomimetics—constructing a cementum-like biomineralized microlayer via amelogenin-derived peptides

This is the published version. Copyright 2012 Nature Publishing GroupCementum is the outer-, mineralized-tissue covering the tooth root and an essential part of the system of periodontal tissue that anchors the tooth to the bone. Periodontal disease results from the destructive behavior of the host elicited by an infectious biofilm adhering to the tooth root and left untreated, may lead to tooth loss. We describe a novel protocol for identifying peptide sequences from native proteins with the potential to repair damaged dental tissues by controlling hydroxyapatite biomineralization. Using amelogenin as a case study and a bioinformatics scoring matrix, we identified regions within amelogenin that are shared with a set of hydroxyapatite-binding peptides (HABPs) previously selected by phage display. One 22-amino acid long peptide regions referred to as amelogenin-derived peptide 5 (ADP5) was shown to facilitate cell-free formation of a cementum-like hydroxyapatite mineral layer on demineralized human root dentin that, in turn, supported attachment of periodontal ligament cells in vitro. Our findings have several implications in peptide-assisted mineral formation that mimic biomineralization. By further elaborating the mechanism for protein control over the biomineral formed, we afford new insights into the evolution of protein–mineral interactions. By exploiting small peptide domains of native proteins, our understanding of structure–function relationships of biomineralizing proteins can be extended and these peptides can be utilized to engineer mineral formation. Finally, the cementomimetic layer formed by ADP5 has the potential clinical application to repair diseased root surfaces so as to promote the regeneration of periodontal tissues and thereby reduce the morbidity associated with tooth loss

Through English as a Window: Defining 'Being Chinese' in the 21st Century

China's international relations have been an influential factor determining Chinese self-perceptions and how 'foreigners' and one of their languages, English, are perceived in the country. Between the eighteenth and twentieth centuries, China's defeats in wars and humiliations by foreign countries (mainly from the West) made English a language of 'barbarians', 'military aggressors' and 'anti-Communists'. There is, and has always been, the distinction between 'Chinese' and 'the world' which is reflected in the principle of 'Chinese learning for essence (ti), Western learning for utility (yong)'. The entry into the World Trade Organization (WTO) in 2001 and the Beijing Olympics in 2008 have signified the most active participation of China in the global community. As a global language, English is promoted as the principal language of trade partners, scientists and tourists, an essential tool for modernisation and a vehicle to ensure China's voices are heard. Despite the eagerness to integrate into the global community, globalisation has opened up China to the world and, in learning English, Chinese people are more exposed to western cultural values and beliefs. This has presented challenges to their sense of Chinese identity. This chapter explores the idea of 'being Chinese' through the status of English in today's China. It shows that the idea is less constrained by previous ideologies about learning English and more defined within Chinese people's own imagination of 'being modern' and 'being global'. English does not seem to threaten the sense of 'being Chinese', but rather, it is another dimension of Chinese identity

Overexpression of prostate stem cell antigen is associated with gestational trophoblastic neoplasia

Aims: Hydatidiform mole (HM) is the most common type of gestational trophoblastic disease. A proportion of patients with HM develop gestational trophoblastic neoplasia (GTN) requiring chemotherapy. The aim was to identify differentially expressed genes that are associated with development of GTN. Methods and results: Using cDNA microarray, differential expression of prostate stem cell antigen (PSCA) was identified in HMs that developed GTN compared with those that spontaneously regressed. Significant overexpression of PSCA RNA (P = 0.037) and protein (P < 0.05) in aggressive HM was verified by real-time polymerase chain reaction (PCR) and immunohistochemical analysis in 10 first-trimester placentas, 36 HM that subsequently regressed and 11 HM that developed GTN. A high level of PSCA expression was also found in three choriocarcinomas and three placental site trophoblastic tumours. A positive correlation was observed between PSCA expression and proliferation and apoptotic indices as assessed by Ki67 (P = 0.01), mcm7 (P = 0.001) and M30 (P = 0.016), as well as p53 (P < 0.01), p21 WAF1/CIP1 (P < 0.01) and mdm2 (P = 0.002) expression. Conclusions: Overexpression of PSCA is associated with development of GTN in HM. PSCA probably plays a role in the regulation of cell growth through p53-related signaling pathways. © 2008 The Authors.link_to_subscribed_fulltex

The reactivity of N-heterocyclic carbenes and their precursors with [Ru-3(CO)(12)]

© Royal Society of Chemistry 2008The ambient temperature reaction of the N-heterocyclic carbenes (NHCs) 1,3-dimesitylimidazol-2-ylidene (IMes) and 1,3-bis(2,6-diisopropylphenyl)imidazol-2-ylidene (IDipp) with the triruthenium cluster [Ru3(CO)12], in a 3:1 stoichiometric ratio, results in homolytic cleavage of the cluster to quantitatively afford the complexes [Ru(CO)4(NHC)] (1; NHC = IMes, 2; NHC = IDipp). Reaction of the 2-thione or hydrochloride precursors to IMes, i.e. SIMes and IMes.HCl, with the same triruthenium cluster affords the complexes [Ru4(mu4-S)2(CO)9(IMes)2] (3) and [Ru4(mu4-S)(CO)10(IMes)2] (4) (3:1 and 2:1 reaction), and [{Ru(mu-Cl)(CO)2(IMes)}2] (7) (3:1 reaction) respectively. By contrast, the complex [Ru3(mu3-S)2(CO)7(IMeMe)2] (6), where IMeMe is 1,3,4,5-tetramethylimidazol-2-ylidene, is the sole product of the 2:1 stoichiometric reaction of SIMeMe with [Ru3(CO)12]. Compounds 1-4, 6 and 7 have been structurally characterised by single crystal X-ray diffraction.Michael I. Bruce, Marcus L. Cole, Ricky S. C. Fung, Craig M. Forsyth, Matthias Hilder, Peter C. Junk and Kristina Konsta