Life Sciences: Recent submissions
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Barriers and enablers to healthcare system uptake of direct oral anticoagulants for stroke prevention in atrial fibrillation: a qualitative interview study with healthcare professionals and policy makers in EnglandObjective: To better understand the factors influencing the uptake of direct oral anticoagulants (DOACs) across different health economies in National Health Service England from the perspective of health professionals and other health economy stakeholders. Design: Qualitative interview study using a critical realism perspective and informed by the Diffusion of Innovations in Service Organisations model. Setting: Three health economies in the North of England, United Kingdom. Participants: Healthcare professionals involved in the management of patients requiring oral anticoagulants, stakeholders involved in the implementation of DOACs and representatives of pharmaceutical industry companies and patient support groups. Intervention: Semistructured interviews (face-to-face or telephone) were conducted with 46 participants. Interviews were analysed using the Framework method. Results: Identified factors having an impact on the uptake of DOACs were grouped into four themes: perceived value of the innovation, clinician practice environment, local health economy readiness for change, and the external health service context. Together, these factors influenced what therapy options were offered and prescribed to patients with atrial fibrillation. The interviews also highlighted strategies used to improve or restrict the uptake of DOACs and tensions between providing patient-centred care and managing financial implications for commissioners. Conclusions: The findings contribute to the wider literature by providing a new and in-depth understanding on the uptake of DOACs. The findings may be applicable to other new medicines used in chronic health conditions.
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Can Personality Traits Predict Students’ Satisfaction with Blended Learning during the COVID-19 Pandemic?The present study aimed to assess the impact of personality traits on student satisfaction with blended learning which many higher education institutions have adopted since the COVID-19 pandemic in the UK. Personality traits were assessed using the International Personality Item Pool and student satisfaction was recorded on a 7-point Likert scale. Data analysis of 72 undergraduate students revealed that low extraversion and high neuroticism predicted higher levels of student satisfaction. Implications are discussed considering the current pandemic with a view of increasing student satisfaction and in-turn improving National Student Survey results that impact on Teaching Excellence Framework scores and league tables.
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Viewing Contact Sports as a Safeguarding Issue... Sustaining a sport-related concussion (SRC) has been associated with negative consequences to emotion and cognition in recent years,4,5 and head impacts are no different.1 Moreover, there is a consistent link reported with neurodegenerative diseases such as motor-neuron disease, Parkinson’s disease, and dementia. Although this is well-known within the scientific community, and becoming so in the general population, we still place children at risk. Promoting attitude change toward SRC and head impacts in sport is difficult enough with adults as many are accustomed to the way their contact sports are played and spectated. However, a redeeming feature for many researchers is that the evidence is there, and the rhetoric is being discussed in the mainstream media across the world.
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Providing a clearer insight into how sport-related concussion and physical pain impact mental health, cognition, and quality of lifeSport-related concussion (SRC) and physical pain are both associated with poor mental health, impaired cognition, and reduced quality of life. Despite SRC and physical pain often co-occurring, there is little research that investigates these two factors together, and therefore it is difficult to conclude which of these contributes to the negative outcomes asso ciated with them. Therefore, the present study aimed to investigate the effect of SRC and physical pain on mental health, cognitive ability, and quality of life. Depression was measured using the Center for Epidemiological Studies Depression Scale, anxiety was assessed using the State-Trait Anxiety Inventory while the SF-12 recorded health-related quality of life. A trail making task (TMT) assessed cognitive flexibility of participants. Analysis of 83 participants (43 concussed) revealed that SRC led to reduced accuracy on TMT(A) and (B), whereas physical pain was responsible for poorer mental health and reduced quality of life. This study highlights the influence that SRC has on cognitive ability and the impact that physical pain has on mental health and quality of life. With this information, we are better placed to predict the negative consequences of SRC and physical pain and therefore tailor support accordingly.
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Person-centred deprescribing for patients living with frailty: a qualitative interview study and proposal of a collaborative model(1) Present deprescribing experiences of patients living with frailty, their informal carers and healthcare professionals; (2) interpret whether their experiences are reflective of person-centred/collaborative care; (3) complement our findings with existing evidence to present a model for person-centred deprescribing for patients living with frailty, based on a previous collaborative care model. Qualitative design in English primary care (general practice). Semi-structured interviews were undertaken immediately post-deprescribing and 5/6 weeks later with nine patients aged 65+ living with frailty and three informal carers of patients living with frailty. Fourteen primary care professionals with experience in deprescribing were also interviewed. In total, 38 interviews were conducted. A two-staged approach to data analysis was undertaken. Three themes were developed: attitudes, beliefs and understanding of medicines management and responsibility; attributes of a collaborative, person-centred deprescribing consultation; organisational factors to support person-centred deprescribing. Based on these findings and complementary to existing evidence, we offer a model for person-centred deprescribing for patients living with frailty. Previous models of deprescribing for patients living with frailty while, of value, do not consider the contextual factors that govern the implementation and success of models in practice. In this paper, we propose a novel person-centred model for deprescribing for people living with frailty, based on our own empirical findings, and the wider evidence base.
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An exploration of the changing understandings of physical impairment and disability in early medieval England: a bioarchaeological, funerary, and historical approachThis paper explores experiences and perceptions of physical impairment and disability in early medieval England, contrasting pre-Christian (AD 5th–early 7th centuries) and Christian (AD late 8th–11th centuries) communities through a combination of bioarchaeological, clinical, funerary, historical, and theoretical analyses. By comparing understandings of physical impairment and disability in the pre-Christian and Christian periods, this paper investigates how political rearrangements and the growing power of the Church might have influenced changing contemporary perceptions of physical impairment and disability. This research has found that the funerary treatment of individuals with physical impairment in the pre-Christian period was extremely variable within and between cemeteries, and there is evidence for arguably positive, normative, and potentially negative burial treatment. Although mortuary treatment of Christian-era individuals with physical impairment was somewhat variable, this variation was much more subtle. This reflects the overall Christian-era pattern in burial form, and strongly negative or positive mortuary treatment was not identified among the individuals with physical impairment. Based on this evidence, it is proposed that administrative and judicial standardisation, conversion to Christianity, and the spread of Christian morals and doctrine influenced the reduction in mortuary variability observed in individuals with physical impairment and/or disability in the 8th–11th centuries in England.
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Excessive growth hormone promotes joint degeneration and chondrocyte metabolic dysfunction in miceMany patients with acromegaly, a hormonal disorder with excessive growth hormone (GH), report pain in joints. The objective of this study is to characterize the joint pathology of mice with over-expression of either bovine GH (bGH) or a GH receptor antagonist (GHa). We also investigate the effect of GH on regulation of chondrocyte cellular metabolism. Knee joints from mice over-expressing bGH or GHa and WT were histologically and μCT analyzed for OA pathologies. Additionally, cartilage from bGH mice was used for metabolomics. Mouse primary chondrocytes from WT or bGH mice with or without Pegvisomant (Peg) treatment were used for Q-PCR and Seahorse Respirometry analysis. Both male and female bGH mice at ~13 months had increased knee joint degeneration, which is characterized by loss of cartilage structure, expansion of hypertrophic chondrocytes, synovitis, and subchondral plate thinning. The joint pathologies were also demonstrated by significantly higher OARSI and Mankin scores in bGH compared with WT mice. Metabolomics revealed changes of a wide range of metabolic pathways in bGH mice including beta-alanine metabolism, tryptophan metabolism, lysine degradation, and ascorbate and aldarate metabolism. Also, bGH chondrocytes upregulated fatty acid oxidation (FAO) and increased expression of Col10a. Joints of GHa mice are remarkably protected from developing age-associated joint degeneration with smooth articular joint surface. These studies uncover that an excessive amount of GH promotes joint degeneration in mice, whereas antagonizing GH action through a GHa protects mice from OA development, which is associated with chondrocyte metabolic dysfunction and hypertrophic changes.
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The monks of San Millán: Investigating the transition between pre-monastic and monastic diet using carbon and nitrogen isotope ratios in incremental dentineFrom the early Medieval period, Christian monasteries were wealthy and powerful, and played a central role in both religious and political life. Those who entered the monasteries did so at the age of 7-8 years and were drawn from a wide range of social strata. From that point, they were subject to the dietary rules imposed by the rules of each monastic order. In order to assess the origins and diet of 10 monks who lived in the monastery of San Millán de la Cogolla Yuso (La Rioja, Spain) during the 17th – 18th century, collagen from small sections of human dentine (representing the childhood diet) and from ribs (an average of the last 5 - 10 years of adult diet) was measured to establish lifetime variations in the isotope ratios of carbon (δ13C) and nitrogen (δ15N). Bulk collagen δ13C (overall mean= -18.2‰ +/-0.4) and δ15N (overall mean= 12.6‰ +/-0.8) values from the ribs suggest 2 adult cohorts: one with a diet based on C3 plants and a high intake of protein from meat or dairy products and some marine resources and a second cohort with some C4 plant consumption alongside meat and dairy. Data from the dentine sections revealed different dietary patterns during the period of tooth formation among the monks, suggesting that 4 of them entered the monastery after consuming lower status diets during childhood.
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Chain-Extendable Crosslinked Hydrogels Using Branching RAFT ModificationFunctional crosslinked hydrogels were prepared from 2-hydroxyethyl methacrylate (HEMA) and acrylic acid (AA). The acid monomer was incorporated both via copolymerization and chain extension of a branching, reversible addition–fragmentation chain-transfer agent incorporated into the crosslinked polymer gel. The hydrogels were intolerant to high levels of acidic copolymerization as the acrylic acid weakened the ethylene glycol dimethacrylate (EGDMA) crosslinked network. Hydrogels made from HEMA, EGDMA and a branching RAFT agent provide the network with loose-chain end functionality that can be retained for subsequent chain extension. Traditional methods of surface functionalization have the downside of potentially creating a high volume of homopolymerization in the solution. Branching RAFT comonomers act as versatile anchor sites by which additional polymerization chain extension reactions can be carried out. Acrylic acid grafted onto HEMA–EGDMA hydrogels showed higher mechanical strength than the equivalent statistical copolymer networks and was shown to have functionality as an electrostatic binder of cationic flocculants.
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In jars: The integration of historical anatomical and pathological potted specimens in undergraduate educationAcross the UK, many anatomy departments possess historical potted wet cadaveric specimen collections, such as organs preserved in fluid-filled jars. Although considered obsolete by some for anatomical education, there is immense potential for their utilisation in teaching, particularly in institutes that have limited access to cadavers or have had body donation rates impacted by the Covid-19 pandemic. Another benefit of historical potted cadaveric specimens is that severe pathology, often not seen today, can be observed by the student. The aim of this study was to understand students' opinions and attitudes towards the use of historical anatomical and pathological potted wet specimen collections in undergraduate science teaching. Following their integration into the anatomy program of a Clinical Sciences degree, seventy-seven undergraduate students completed a five-point Likert questionnaire on their perspective for the integration of the historical potted specimens in anatomical education. This study was approved by the Research Ethics committee at the University of Bradford RESULTS: The study demonstrated that 90 % of students found the collection useful in teaching, 92 % would like to see the collection used more in teaching, and 76 % of students found that the collection encouraged them to consider medical ethics and the donor. In conclusion, the survey findings suggest that further utilisation of historical potted wet specimen collections would be useful in the teaching of anatomy and that these collections could potentially encourage conversations on post-mortem bodily integrity, ethics, and organ donation.
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Stromal vascular fraction cells from individuals who have previously undergone radiotherapy retain their pro-wound healing propertiesBeneficial effects have been observed following the transplant of lipoaspirates containing adipose-derived stem cells into chronic wounds caused by oncologic radiotherapy. It is not yet certain whether adipose-derived stem cells are resistant to radiation exposure. Therefore, the aims of this study were to isolate stromal vascular fraction from human breast tissue exposed to radiotherapy and determine the presence of adipose-derived stem cells. Stromal vascular fraction from irradiated donor tissue was compared to commercially sourced pre-adipocytes. Immunocytochemistry was used to determine the presence of adipose-derived stem cell markers. Conditioned media from stromal vascular fraction isolated from irradiated donors was used as a treatment in a scratch wound assay of dermal fibroblasts also isolated from irradiated donors and compared to pre-adipocyte conditioned media and serum free control. This is the first report of human stromal vascular fraction being cultured from previously irradiated breast tissue. Stromal vascular fraction conditioned media from irradiated donors had a similar effect in increasing the migration of dermal fibroblasts from irradiated skin to pre-adipocyte conditioned media from healthy donors. Therefore, the ability of adipose-derived stem cells in the stromal vascular fraction to stimulate dermal fibroblasts in wound healing appears to be preserved following radiotherapy. This study demonstrates that stromal vascular fraction from irradiated patients is viable, functional and may have potential for regenerative medicine techniques following radiotherapy.
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Exploration of meaning, motivation, and preparedness to care amongst the one-child policy generation in ChinaIn China there is a cultural expectation (Xiao, -filial piety) that offspring should provide care for their parents. However, the sustainability of this is threatened by the impact of the One-Child Policy (OCP) (1979-2015), which has resulted in a diminution in numbers of children available to care, rapid urbanisation and increase in the number of women in employment. In this context, the objective was to explore the motivations, meaning, and preparedness for future caregiving of offspring affected by the OCP. We adopted a constructivist position using a hermeneutic phenomenology approach and interviewed eight current and prospective caregivers aged 20-35 years about future caregiving responsibilities. Data were obtained through in-depth interviews, analysed using reflective Thematic Analysis. Three prominent themes: (i) Caregiving beliefs, (ii) Caregiving conditions and (iii) Contextual factors were identified under an overarching theme "Competing pressures-meanings, motivation and preparedness". Despite the inherent stress, participants envisaged providing or organising care in the future to fulfil Xiao, and most viewed long-term care settings as unviable. Ultimately, the findings suggested that the actual performance of caregiving would not always measure up to ideal expectations, resulting in 'filial discrepancy' that is, a gap between societal expectations for caregiving to older relatives and actual caregiving performance. This could adversely impact the caregivers and quality of care provided. The findings highlighted the urgent need to develop culturally attuned services, including education and training for family caregivers, health and social care professionals.
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Stabilisation of acrylic latexes containing silica nanoparticles for dirt repellent coating applicationsThis study examines the feasibility of using colloidal silica nanoparticles as active agents in high concentration waterborne polymer latex formulations. We showed that distributing the silica throughout the waterborne emulsion formed a composite coating material with a hydrophilic surface that consequently reduced exterior dirt pickup. Two grades of silica nanoparticles were studied, one using sodium stabilisation and another using epoxysilane modification to introduce glycidox-ypropyltrimethoxysilane surface functionality. Rheological study of the waterborne latex on mixing showed that there was an immediate pH responsive interaction between the silica sols and the polymer latex. Once loading of sodium charge stabilised silica NPs exceeded the volume required for heteroflocculation to occur the mixture demonstrated the potential to gel on standing – a process which took weeks, or months, to occur depending on the pH and relative concentrations used. At least fifty percent silane modification to the NP surface was found to be necessary to maintain a stable colloidal dispersion for long term storage of the waterborne latex. Despite this both grades of silica were found to imbue reductions in dirt pickup when applied to exterior masonry concrete studies over a 3-month weathering test
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DNA dioxygenases Tet2/3 regulate gene promoter accessibility and chromatin topology in lineage-specific loci to control epithelial differentiationExecution of lineage-specific differentiation programs requires tight coordination between many regulators including Ten-eleven translocation (TET) family enzymes, catalyzing 5-methylcytosine oxidation in DNA. Here, by using Keratin 14–Cre–driven ablation of Tet genes in skin epithelial cells, we demonstrate that ablation of Tet2/Tet3 results in marked alterations of hair shape and length followed by hair loss. We show that, through DNA demethylation, Tet2/Tet3 control chromatin accessibility and Dlx3 binding and promoter activity of the Krt25 and Krt28 genes regulating hair shape, as well as regulate interactions between the Krt28 gene promoter and distal enhancer. Moreover, Tet2/Tet3 also control three-dimensional chromatin topology in Keratin type I/II gene loci via DNA methylation–independent mechanisms. These data demonstrate the essential roles for Tet2/3 in establishment of lineage-specific gene expression program and control of Dlx3/Krt25/Krt28 axis in hair follicle epithelial cells and implicate modulation of DNA methylation as a novel approach for hair growth control.
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Investigation into the development of novel lanthanide-based luminescent colorants for application to textiles and paper materialsThis article describes the synthesis and application of lanthanide-based luminophores for visualisation under short wavelength ultraviolet (UV) activation (typically 254 nm). Luminophores are chemical compounds which re-emit light of longer wavelength than typical fluorescence and phosphorescence, following photoexcitation, because of efficient energy transfer from the ligands to the lanthanide ion emission levels. The luminophores described in this article are all derived from europium and terbium metal complexes and cover the complete colour gamut. Selection of appropriate ligands allows for water solubility or water insolubility (if required pigment or disperse “dye” applications). Similar to dyeing or printing processes, the anionic complexes can be applied to polyamide fibres or to cellulosic fibres, whereas dispersions of the non-ionic complexes are suitable for polyester or cellulose acetate fibre application. The water-soluble derivatives are also suitable for ink-jet printing and the water-insoluble derivatives are suitable for lithographic or intaglio paper printing. The novel complexes are excited by radiation below 300 nm and thus cannot be activated by sunlight (the earth's atmosphere prevents light below about 300 nm reaching the surface). Accordingly, the photo-stability of the dyed materials and prints obtained is excellent. These materials could be used in security marking applications, for example bank-notes and passports, where they could replace the current fluorophores that are rendered visible under near UV light (typically 365 nm) illumination but exhibit relatively poor photo-stability. The development of an RGB (red, green and blue) colour palette for inkjet printing based on these innovative luminophores will significantly support the design of digitally printed security features.
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Crude and Primitive? Rethinking the dating and construction of dug-out church chests in BritainChests were a ubiquitous part of medieval church furniture across Britain and Europe. Late 19th and early 20th century scholars believed that one type, the dug-out chest, was devoid of technical skill, and as such, confined to the earliest period of chest chronology. Perhaps as a result of the ‘primitive’ label, dug-outs remain relatively under-studied in relation to other types of chests and surprisingly few attempts have been made to validate ideas about their early origin through scientific dating. The current study uses dendrochronology to directly date a selection of dug-out chests, almost doubling the number of dated chests of this type in England and producing the earliest absolute dates for their construction. Five dug-out chests from the case-study counties of Herefordshire and Worcestershire returned dates ranging from the 13th-16th century, showing that they are not chronologically confined to the ‘earliest’ period. This research also demonstrates how analysing extant saw-marks, along with the different methods of attaching chest lids, can assist in dating a chest’s construction. By understanding the tools and processes of construction, this research challenges the existing accepted framework that dug-outs are the ‘crudest’ and ‘most primitive’ type of church chest in the medieval period. Together these findings offer a new methodology and framework for studies of church chests in Britain and Europe.
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Metal-organic frameworks as potential agents for extraction and delivery of pesticides and agrochemicalsPesticide contamination is a global issue, affecting nearly 44% of the global farming population, and disproportionately affecting farmers and agricultural workers in developing countries. Despite this, global pesticide usage is on the rise, with the growing demand of global food production with increasing population. Different types of porous materials, such as carbon and zeolites, have been explored for the remediation of pesticides from the environment. However, there are some limitations with these materials, especially due to lack of functional groups and relatively modest surface areas. In this regard, metal-organic frameworks (MOFs) provide us with a better alternative to conventionally used porous materials due to their versatile and highly porous structure. Recently, a number of MOFs have been studied for the extraction of pesticides from the environment as well as for targeted and controlled release of agrochemicals. Different types of pesticides and conditions have been investigated, and MOFs have proved their potential in agricultural applications. In this review, the latest studies on delivery and extraction of pesticides using MOFs are systematically reviewed, along with some recent studies on greener ways of pest control through the slow release of chemical compounds from MOF composites. Finally, we present our insights into the key issues concerning the development and translational applications of using MOFs for targeted delivery and pesticide control.