Lessons for a learning health system: Effectively communicating to patients about research with their health information and biospecimens.

Introduction: Sharing patient health information and biospecimens can improve health outcomes and accelerate breakthroughs in medical research. But patients generally lack understanding of how their clinical data and biospecimens are used or commercialized for research. In this mixed methods project, we assessed the impact of communication materials on patient understanding, attitudes, and perceptions.

Retrospective evaluation of computed tomographic-guided Tru-Cut biopsies in 16 dogs and 14 cats with nasal cavity mass lesions.

Background: Approximately 80% of nasal masses in dogs and 91% of nasal masses in cats are reported to be malignant, but the currently reported diagnostic rate of neoplasia is 54% using blind or rhinoscopic biopsy techniques.

Hypothesis/objectives: Describe the technique of computed tomography (CT)-guided Tru-Cut (Tru-Cut biopsy needle, Merit Medical Systems, Utah, USA) nasal biopsies in cats and dogs to determine the diagnostic rate of neoplasia on the first round of sampling and to evaluate the safety of the technique.

Animals: Thirty client-owned animals, 16 dogs and 14 cats, that had CT-guided nasal biopsies performed to investigate nasal masses.

Identifying Patient Safety Competencies for Healthcare Staff Treating Children and Young People With Intellectual Disability in Hospitals: A Delphi Study.

Background: Children and young people with intellectual disability have poor healthcare and are at risk of patient safety events due to lack of staff training and consensus on competencies for safe and quality care. For the adoption of reasonable adjustments in mainstream paediatric healthcare clinical competencies needed to be adapted to an existing patient safety education framework.

Methods: Thirteen experts in intellectual disability health and patient safety participated in an eDelphi survey aimed at reaching consensus on core competencies required of the paediatric healthcare workforce.

The effects of drone transportation on blood component quality: A prospective randomised controlled laboratory study.

The use of uncrewed aerial vehicles (drones) has increased over the last decade. However, their application in healthcare has not been fully examined, in part, due to regulations preventing flight beyond the visual line of sight. This prospective randomised controlled laboratory study aimed to determine whether the in vitro quality of packed red blood cell components is maintained when transported by drone, beyond visual line of sight.

Using a prognostic medical device for early identification of pressure ulcers: protocol for study design.

Background: An objective, physiological measurement taken using a medical device may reduce the incidence of pressure ulcers through earlier detection of problems signs before visual signs appear. Research in this field is hampered by variations in clinical practice and patient-level confounders.

Aim: The authors outline key considerations for designing a protocol for a study to assess the efficacy and safety of a prognostic medical device in reducing pressure ulcer incidence in a hospital, including comparators, randomisation, sample size, ethics and practical issues.

Insights for clinical management from the real-life data of the centralized West of Scotland biliary cancer clinic.

Background: With the increasing of novel therapeutics for the treatment of Biliary Tract Cancers (BTC), and the need to assess their socio-economic impacts for national licence approvals, it is as important as ever to have real-life data in national populations.

Methods And Results: We performed an audit of the first 2 year-activity (Sep 2019-Sep 2021) of the centralized West-of-Scotland-BTC clinic. 122 patients accessed the service, including 68% with cholangiocarcinoma (CCA), 27% with gallbladder cancer (GBC), and 5% with ampulla of Vater carcinoma with biliary phenotype (AVC).

Modelling esophageal adenocarcinoma and Barrett's esophagus with patient-derived organoids.

Currently, esophageal adenocarcinoma (EAC) research is hindered by a dearth of adequate models to study this disease. Traditional cell line and genetically engineered mouse models are lacking in biological and physiological significance, whilst the inefficiency of patient-derived xenografts limit their potential applications. This review describes the landscape of EAC research using patient-derived organoids (PDOs).

Caspase-2 protects against ferroptotic cell death.

Caspase-2, one of the most evolutionarily conserved members of the caspase family, is an important regulator of the cellular response to oxidative stress. Given that ferroptosis is suppressed by antioxidant defense pathways, such as that involving selenoenzyme glutathione peroxidase 4 (GPX4), we hypothesized that caspase-2 may play a role in regulating ferroptosis. This study provides the first demonstration of an important and unprecedented function of caspase-2 in protecting cancer cells from undergoing ferroptotic cell death.

Scale-Up of Protein Purification: Downstream Processing Issues.

Large-scale chromatography operations continue to occupy the central position in the overall strategy for downstream processing and purification of therapeutic protein products for human use. As the biopharmaceutical industry looks forward to embracing new therapeutic modalities such as viral vector-mediated gene therapy, it is becoming evident that chromatographic separations will be also be crucial for success in that discipline. The current industry focus on cell culture intensification strategies that can result in increased process efficiency and lower cost of goods is presenting challenges to the robustness and economics of chromatography processes.

Mixed-Mode Chromatography and Its Role in Monoclonal Antibody Purification.

As the biopharmaceutical industry matures and embraces process intensification methodologies allied to the emergence of newer personalized medicines, a key constant is the regulatory need to purify products that satisfy the criteria of safety, quality, and efficacy in each batch of released product destined for clinical use. Downstream processing operations and in particular chromatographic separations continue to play a key role in manufacturing strategies with the industry being well served by commercially available resins that provide different options to purify a particular target molecule of interest. In recent years, mixed-mode chromatography, a technique based on multimode interactions between ligands and proteins, had attracted much attention.

Not getting in too deep: A practical deep learning approach to routine crystallisation image classification.

Using a relatively small training set of ~16 thousand images from macromolecular crystallisation experiments, we compare classification results obtained with four of the most widely-used convolutional deep-learning network architectures that can be implemented without the need for extensive computational resources. We show that the classifiers have different strengths that can be combined to provide an ensemble classifier achieving a classification accuracy comparable to that obtained by a large consortium initiative. We use eight classes to effectively rank the experimental outcomes, thereby providing detailed information that can be used with routine crystallography experiments to automatically identify crystal formation for drug discovery and pave the way for further exploration of the relationship between crystal formation and crystallisation conditions.

Management of a stingray barb laceration and suspect envenomation in a dog.

This case report describes the successful management of a stingray laceration and suspected envenomation using a combination of opioid analgesia, heat compression, antimicrobial therapy, surgical debridement and closure. Stingray envenomation in the dog is a rare clinical presentation and is yet to be documented in the Australian veterinary literature. Envenomation can be markedly painful and may cause swelling and local tissue necrosis.

Does point-of-care ultrasonography improve diagnostic accuracy in emergency department patients with undifferentiated hypotension? An international randomized controlled trial from the SHOC-ED investigators.

Purpose: Point-of-care ultrasonography (POCUS) is an established tool in the management of hypotensive patients in the emergency department (ED). We compared the diagnostic accuracy of a POCUS protocol versus standard assessment without POCUS in patients with undifferentiated hypotension.

Methods: This was an international, multicenter randomized controlled trial included three EDs in North America and three in South Africa from September 2012 to December 2016.

Paper Spray Ionization Ion Mobility Mass Spectrometry of Sebum Classifies Biomarker Classes for the Diagnosis of Parkinson's Disease.

Parkinson's disease (PD) is the second most common neurodegenerative disorder, and identification of robust biomarkers to complement clinical diagnosis will accelerate treatment options. Here, we demonstrate the use of direct infusion of sebum from skin swabs using paper spray ionization coupled with ion mobility mass spectrometry (PS-IM-MS) to determine the regulation of molecular classes of lipids in sebum that are diagnostic of PD. A PS-IM-MS method for sebum samples that takes 3 min per swab was developed and optimized.

Tumor-Infiltrating Neutrophils after Neoadjuvant Therapy are Associated with Poor Prognosis in Esophageal Cancer.

Background: In esophageal cancer (EC), there is a paucity of knowledge regarding the interplay between the tumor immune microenvironment and response to neoadjuvant treatment and, therefore, which factors may influence outcomes. Thus, our goal was to investigate the changes in the immune microenvironment with neoadjuvant treatment in EC by assessing the expression of immune related genes and their association with prognosis.

Methods: We examined the transcriptome of paired pre- and post-neoadjuvant treated EC specimens.

Eprenetapopt triggers ferroptosis, inhibits NFS1 cysteine desulfurase, and synergizes with serine and glycine dietary restriction.

The mechanism of action of eprenetapopt (APR-246, PRIMA-1) as an anticancer agent remains unresolved, although the clinical development of eprenetapopt focuses on its reported mechanism of action as a mutant-p53 reactivator. Using unbiased approaches, this study demonstrates that eprenetapopt depletes cellular antioxidant glutathione levels by increasing its turnover, triggering a nonapoptotic, iron-dependent form of cell death known as ferroptosis. Deficiency in genes responsible for supplying cancer cells with the substrates for de novo glutathione synthesis (, , and ), as well as the enzymes required to synthesize glutathione ( and ), augments the activity of eprenetapopt.

Data-driven approach to mitigate quality impact of hygroscopic pharmaceutical raw materials throughout the supply chain.

The challenges of working with hygroscopic pharmaceutical raw materials can have a significant impact on the industry's ability to make high-quality medicines. In order to mitigate the impact to the manufacturing process or product quality it is critical to understand the hygroscopicity of the raw materials across the entire supply chain so that the proper management strategies can be implemented, from the raw material manufacturing to the use of the raw material in the drug manufacturing process. Employing suitable controls protects these materials from physical and chemical changes due to moisture uptake such as caking or hydrolysis.

Perinatal complications and maximising lamb survival in an adolescent paradigm characterised by premature delivery and low birthweight.

The competition for nutrients in overnourished and still-growing adolescent sheep negatively impacts gestation length, colostrum supply and lamb birthweight, all of which may affect neonatal morbidity and survival to weaning. Herein perinatal complications and the requirement for supplementary feeding were analysed in relation to gestational-intake, and the degree of premature delivery and prenatal growth-restriction exhibited. Pregnancies were established by embryo transfer and the mean/standard deviation (SD) gestation length and birthweight of the optimally-fed control group (n = 100) was used to define early delivery and reduced birthweight categories (1.

MiNDAUS partnership: a roadmap for the cure and management of motor Neurone disease.

An innovative approach to patient management, evidence-based policy development, and clinical drug trials is required to provide personalized care and to improve the likelihood of finding an effective treatment for Motor Neurone Disease (MND). The MiNDAus Partnership builds on and extends existing national collaborations in a targeted approach to improve the standard and coordination of care for people living with MND in Australia, and to enhance the prospects of discovering a cure or treatment. Relationships have been developed between leading clinical and research groups as well as patient-centered organizations, care providers, and philanthropy with a shared vision.

Sonographic Findings of Left Ventricular Dysfunction to Predict Shock Type in Undifferentiated Hypotensive Patients: An Analysis From the Sonography in Hypotension and Cardiac Arrest in the Emergency Department (SHoC-ED) Study.

Introduction Patients that present to the emergency department (ED) with undifferentiated hypotension have a high mortality rate. Hypotension can be divided into four categories: obstructive, hypovolemic, distributive, and cardiogenic. While it is possible to have overlapping or concomitant shock states, being able to differentiate between cardiogenic shock and the other categories is important as it entails a different treatment regime and extra cautions.