Hybrid Mass Spectrometry Applied across the Production of Antibody Biotherapeutics.

Post expression from the host cells, biotherapeutics undergo downstream processing steps before final formulation. Mass spectrometry and biophysical characterization methods are valuable for examining conformational and stoichiometric changes at these stages, although typically not used in biomanufacturing, where stability is assessed via bulk property studies. Here we apply hybrid MS methods to understand how solution condition changes impact the structural integrity of a biopharmaceutical across the processing pipeline.

The Use of Virtual Patients to Provide Feedback on Clinical Reasoning: A Systematic Review.

Purpose: Virtual patients (VPs) are increasingly used in health care professions education to support clinical reasoning (CR) development. However, the extent to which feedback is given across CR components is unknown, and guidance is lacking on how VPs can optimize CR development. This systematic review sought to identify how VPs provide feedback on CR.

Intra-prostatic tumour evolution, steps in metastatic spread and histogenomic associations revealed by integration of multi-region whole-genome sequencing with histopathological features.

Background: Extension of prostate cancer beyond the primary site by local invasion or nodal metastasis is associated with poor prognosis. Despite significant research on tumour evolution in prostate cancer metastasis, the emergence and evolution of cancer clones at this early stage of expansion and spread are poorly understood. We aimed to delineate the routes of evolution and cancer spread within the prostate and to seminal vesicles and lymph nodes, linking these to histological features that are used in diagnostic risk stratification.

Mitochondrial electron transport chain defects modify Parkinson's disease phenotypes in a Drosophila model.

Introduction: Mitochondrial defects have been implicated in Parkinson's disease (PD) since complex I poisons were found to cause accelerated parkinsonism in young people in the early 1980s. More evidence of mitochondrial involvement arose when many of the genes whose mutations caused inherited PD were discovered to be subcellularly localized to mitochondria or have mitochondrial functions. However, the details of how mitochondrial dysfunction might impact or cause PD remain unclear.

Computable Guidelines and Clinical Decision Support for Cervical Cancer Screening and Management to Improve Outcomes and Health Equity.

Cervical cancer is highly preventable when precancerous lesions are detected early and appropriately managed. However, the complexity of and frequent updates to existing evidence-based clinical guidelines make it challenging for clinicians to stay abreast of the latest recommendations. In addition, limited availability and accessibility to information technology (IT) decision supports make it difficult for groups who are medically underserved to receive screening or receive the appropriate follow-up care.

Characterization of convergent thickening, a major convergence force producing morphogenic movement in amphibians.

The morphogenic process of convergent thickening (CT) was originally described as the mediolateral convergence and radial thickening of the explanted ventral involuting marginal zone (IMZ) of gastrulae (Keller and Danilchik, 1988). Here, we show that CT is expressed in sectors of the IMZ, which transitions to expressing convergent extension (CE) involution. CT occurs without CE and drives symmetric blastopore closure in ventralized embryos.

Accelerated osteoarthritis in women with polycystic ovary syndrome: a prospective nationwide registry-based cohort study.

Background: Osteoarthritis (OA) is the most common form of arthritis with multiple risk factors implicated including female sex and obesity. Metabolic dysregulation associated with obesity leading to metabolic syndrome is a proposed component of that association. Polycystic ovary syndrome (PCOS) commonly affects women of reproductive age and these women are at higher risk of developing metabolic syndrome and thus likely to represent a high-risk group for early OA development.

A Cross-Sectional Study of Retired Great British Olympians (Berlin 1936-Sochi 2014): Olympic Career Injuries, Joint Health in Later Life, and Reasons for Retirement from Olympic Sport.

Background: The relationship between Olympic career sport injury and the long-term musculoskeletal health of the elite athlete remains unclear. This study describes the lifetime prevalence of medical attention injuries that occurred during training and/or competition as part of the athlete's Olympic career, reasons for retirement from Olympic sport, and the point prevalence of pain and osteoarthritis (OA) among retired Great Britain's (GB) Olympians.

Methods: This cross-sectional study involved distributing a questionnaire to retired GB Olympians who had competed at 36 Olympic Games between Berlin 1936 and Sochi 2014.

A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital.

Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI.

Incidence of central line related/associated bloodstream infections in an acute hospital.

Bloodstream infection related to a central venous catheter in the intensive care unit is a substantial clinical and economic problem. The aim of the study was to examine the incidence of central line related bloodstream infections and central line associated bloodstream infections in Our Lady of Lourdes Hospital, Drogheda, during a six month period, using an active patient based prospective surveillance method. CLRBSI rate in ICU/HDU was 0.

Caffeine and clinical change in a patient with schizophrenia on a long-stay ward.

We report a case of a 33-year-old male patient with schizophrenia, who showed significant and persistent changes in psychotic and mood symptoms relating to his caffeine intake.

An audit of incomplete involuntary admissions to an approved Irish centre.

Objectives: With the implementation of the Mental Health Act 2001 (M HA 2001) in November 2006, there was an expectation of reduction in the overall involuntary admission rate, particularly as those with a sole diagnosis of substance misuse were specifically excluded from the definition of mental disorder. The aim of this audit cycle was to ascertain this rate and to audit the process of the referral, transfer, assessment and subsequent management of the patients whose admission orders were not completed by the consultant psychiatrists (CPs) following referral for involuntary admission to an approved centre. In addition, the authors wished to ascertain if the recommendations of Audit 2003 were implemented.

Recovery After Psychosis (RAP): a compassion focused programme for individuals residing in high security settings.

Background: The aim of the study was to evaluate the effectiveness of a recovery group intervention based on compassionate mind training, for individuals with psychosis. In particular, the objective was to improve depression, to develop compassion towards self, and to promote help seeking.

Method: A within-subjects design was used.

Valuing temporary and chronic health states associated with breast screening.

The aim of this study was to derive quality of life values for the four key breast screening outcomes (true negative, false positive, true positive and false negative), including the quality of life effects of the screening and treatment processes. In doing so, methodological issues in health status measurement were explored, in particular the valuation of temporary health states. The true negative and false positive descriptions were temporary health states, lasting for short term durations (12 months) and the true positive and false negative outcomes were chronic health states lasting for long term durations (rest of life).

Ill health retirement--guidelines for occupational physicians. Association of Local Authority Medical Advisors (working party).

These guidelines have been produced by a working party of the Association of Local Authority Medical Advisors to help doctors arrive at equitable decisions when assessing applications for ill health retirement. The general guidelines are intended to apply to all pension schemes and the specific ones to those such as The Local Government Pension Scheme where there is a requirement for the applicant to have permanent ill health.

Neopterin levels in alcohol-dependent patients.

Chronic alcohol exposure appears to suppress cell-mediated immunity which may contribute to the high incidence of infections among alcohol-dependent patients. We measured serum neopterin, as a marker of macrophage function and T-lymphocyte activation, in 26 alcohol-dependent patients. The mean serum neopterin in these patients was significantly lower than the mean serum neopterin in matched controls.

The time trade-off technique: how do the valuations of breast cancer patients compare to those of other groups?

The time trade-off method was incorporated into a study of valuation of health states following treatment for breast cancer. A major aim of the work was to determine whether different groups give different valuations. The time trade-off technique was simple and quick to administer, acceptable to subjects, and produced different values in different groups.

Effects of feedback of information on clinical practice: a review.

Objective: To establish what is known about the role of feedback of statistical information in changing clinical practice.

Design: Review of 36 studies of interventions entailing the use of statistical information for audit or practice review, which used a formal research design.

Subjects: Papers identified from computer searches of medical and health service management publications, of which 36 describing studies of interventions designed to influence clinical care and including information feedback from clinical or administrative data systems were reviewed.

The incidence of fire setting and associated psychopathology of children attending a child psychiatric outpatients.

Fire setting can be a serious form of anti-social behaviour. A study of 79 consecutive out-patient attenders at a Child Guidance Clinic found a rate of 15 (18.9%).

d-fenfluramine/prolactin response throughout the menstrual cycle: evidence for an oestrogen-induced alteration.

The prolactin (PRL) response to fenfluramine (FEN), a serotonin (5-HT) releasing agent, is used as an index of 5-HT sensitivity in studying disorders associated with central 5-HT abnormality. Plasma oestrogen levels are known to augment PRL responses to a variety of stimuli. In order to examine the effect that ovarian steroids have on this response nine, healthy women were tested twice at three time points in the menstrual cycle: early follicular, mid-cycle and late luteal phase with either d-FEN, a more specific 5-HT agent than the racemic mixture, or placebo.