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The Hoarder, the Oniomaniac and the Fashionista in me::A life histories perspective on self-concept and consumption practices
No full textIncreased negative media attention has focused on the environmental impacts the fashion industry has on the natural environment, thereby calling for solutions, focused on clothing purchase, use and end-of-life treatment. This research explores the relationship between consumers and their clothing consumption (from purchase through to disposal), through the lens of life histories, and thus exploring what impacts on end-of-life clothes treatment. The novelty of this study lies within connecting fashion consumption practices with the self-concept in the context of clothing consumption (pre- purchase through to disposal), from an individual’s life history perspective. This qualitative enquiry utilised life histories, thereby conducting 20 in-depth semi-structured interviews that were analysed through a grounded approach. Findings indicate that fashion consumption is heavily influenced by an individual’s ‘self’, in that those that have a positive perception of themselves have reduced shopping habits, whilst those with a negative perception increase them. Our results show that our participants go through various consumption practices (hoarder, oniomaniac, and ‘fashionista’) that co-exist within them and are influenced by the individual’s self. Our study calls for more intergenerational studies exploring fashion consumption and disposal and the effects on the sel
Uterine remodelling bleeds into the second trimester: digitalised historic samples illuminate vascular adaptation to pregnancy
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Feasibility of a multiparametric MRI protocol for imaging biomarkers associated with neoadjuvant radiotherapy for soft tissue sarcoma
No full textObjectivesSoft tissue sarcoma (STS) is a rare malignancy with a 5 year overall survival rate of 55%. Neoadjuvant radiotherapy is commonly used in preparation for surgery, but methods to assess early response are lacking despite pathological response at surgery being predictive of overall survival, local recurrence and distant metastasis. Multiparametric MR imaging (mpMRI) is used to assess response in a variety of tumours but lacks a robust, standardised method. The overall aim of this study was to develop a feasible imaging protocol to identify imaging biomarkers for further investigation.MethodsFifteen patients with biopsy-confirmed STS suitable for preoperative radiotherapy and radical surgery were imaged throughout treatment. The mpMRI protocol included anatomical, diffusion weighted and dynamic contrast-enhanced imaging, giving estimates of apparent diffusion coefficient (ADC) and the area under the enhancement curve at 60 s (iAUC60). Histological analysis of resected tumours included detection of CD31, Ki67, HIF and calculation of a hypoxia score.ResultsThere was a significant reduction in T1 at visit 2 and in ADC at visit 3. Significant associations were found between hypoxia and pre-treatment iAUC60, pre-treatment ADC and mid-treatment iAUC60. There was also statistically significant association between mid-treatment ADC and Ki67. ConclusionsThis work showed that mpMRI throughout treatment is feasible in patients with STS having neoadjuvant radiotherapy. The relationships between imaging parameters, tissue biomarkers and clinical outcomes warrant further investigation.Advances in KnowledgempMRI based biomarkers have good correlation with STS tumour biology and are potentially of use for evaluation of radiotherapy response.<br/
Probing anisotropic mechanical behaviour in Carbamazepine Form III
No full textNanoindentation measurement of the mechanical properties of the (020), (002) and (101) crystal faces in carbamazepine (CBZ) form III revealed that the (020) face had a greater elastic modulus and hardness than the (002) and (101) faces, which had similar modulus and hardness values. Atomic Force Microscopy (AFM) imaging of the indents showed that whilst no surface plastic displacement was observed around the residual indents on the (020) face, indents on both (002) and (101) faces nucleated cracks in multiple orientations and showed slip bands parallel to (020). The computed compliance matrix of CBZ form III was in good agreement with the experimental results and predicted anisotropic stiffness, with E(020) > E(002) > E(101). Modelling also revealed that the molecular flexibility of CBZ results in a less stiff material than that of an equivalent rigid compound. Indentation in one direction results in the opening of the CBZ-butterfly wings whilst in the other two results in their closing. Molecular dynamics simulations confirmed the primary (020) slip plane, consistent with the AFM images of the indents. It was also found that shear on the primary (020) slip plane, requires of the breaking and forming of CBZ hydrogen bonded dimers. The slip plane, (020), was identified as having the lowest structural rugosity and hydrogen bonding density but not the lowest attachment energy
Donor insulin therapy in intensive care predicts early outcomes after pancreas transplantation
No full textIntroduction: Approximately 50% of organ donors develop hyperglycaemia on intensive care, which is managed with insulin therapy. We aimed to determine the relationships between donor insulin use (DIU) and graft failure in pancreas transplantation. Methods: United Kingdom (UK) Transplant Registry organ donor data were linked with national data from the UK solid pancreas transplant programme. All pancreas transplants performed between 2004 and 2016 with complete follow-up data were included. Logistic regression models determined associations between DIU and causes of graft failure within 3 months. Area under Receiver Operating Characteristic (ROC) curves and Net Reclassification Improvement (NRI) assessed the added value of DIU as a predictor of graft failure. Results: In 2168 pancreas transplant recipients (mean [SD] age: 42 [8] years; body mass index [BMI]: 23.5 [3.4] kg/m2), 1112 (51%) donors were insulin-treated. DIU was associated with a higher risk of graft loss from isolated islet failure: Odds Ratio, 95% CI 1.79 (1.05-3.07), p=0.03 and this relationship was duration/dose-dependent. DIU was also associated with a higher risk of graft loss from anastomotic leak 2.72 [1.07-6.92], p=0.04 and a lower risk of graft loss from thrombosis (0.62 [0.39-0.96], p=0.03), although duration/dose-dependent relationships was only identified in pancreas transplant alone/pancreas after kidney transplant (PTA/PAK) recipients with grafts failing due to thrombosis (0.86 [0.74-0.99], p=0.03). The relationship between donor insulin characteristics and isolated islet failure remained significant after adjusting for potential confounders: DIU 1.75 1.02-2.99), p=0.04; duration 1.08 (1.01-1.16), p=0.03. In multivariable analyses, donor insulin characteristics remained significant predictors of lower risk of graft thrombosis in PTA/PAK recipients: DIU (0.34 [0.13-0.90], p=0.03); insulin duration/dose 0.02 (0.001-0.85), p=0.04. When data on insulin was added to models predicting isolated islet failure a significant improvement in discrimination and risk reclassification was observed in all models: no DIU aROC 0.56; DIU aROC 0.57, p=0.86; NRI 0.28, p<0.00001; insulin duration aROC 0.60, p=0.47; NRI 0.35, p<0.00001. Conclusions: DIU predicts graft survival in pancreas transplant recipients. This assessment could help improve donor selection and thereby improve patient and graft outcomes
Site-directed differentiation of human adipose derived mesenchymal stem cells to nucleus pulposus cells using an injectable hydroxyl-functional diblock copolymer worm gel
No full textAdipose-derived mesenchymal stem cells (ASCs) have been identified for their promising therapeutic potential to regenerate and repopulate the degenerate intervertebral disk (IVD), which is a major cause of lower back pain. The optimal cell delivery system remains elusive but encapsulation of cells within scaffolds is likely to offer a decisive advantage over the delivery of cells in solution by ensuring successful retention within the tissue. Herein we evaluate the use of a fully synthetic, thermoresponsive poly(glycerol monomethacrylate)-poly(2-hydroxypropyl methacrylate) (PGMA-PHPMA) diblock copolymer worm gel that mimics the structure of hydrophilic glycosaminoglycans. The objective was to use this gel to direct differentiation of human ASCs towards a nucleus pulposus (NP) phenotype, with or without the addition of discogenic growth factors TGFB or GDF-6. Accordingly, human ASCs were incorporated into a cold, free-flowing aqueous dispersion of the diblock copolymer, gelation induced by warming to 37 ◦C and cell culture was conducted for 14 days with or without growth factors to assess the expression of characteristic NP markers compared to those produced when using collagen gels. The shear-thinning nature of the biocompatible worm gel enabled encapsulated human ASCs to be injected into the IVD using a 21G needle. Moreover, we find significantly higher gene expression levels of ACAN, SOX9, KRT8 and KR18 for ASCs encapsulated within worm gels compared to collagen scaffolds, regardless of the growth factors employed. In summary, such wholly synthetic worm gels offer considerable potential as an injectable cell delivery scaffold for the treatment of degenerate disk disease by promoting the transition of ASCs towards an NP phenotype
Modeling past event feedback through biomarker dynamics in the multi-state event analysis for cardiovascular disease data
No full textIn cardiovascular studies, we often observe ordered multiple events along disease progression, which are essentially a series of recurrent events and terminal events with competing risk structure. One of the main interest is to explore the event specific association with the dynamics of longitudinal biomarkers. New statistical challenge arises when the biomarkers carry information from the past event history, providing feedbacks for the occurrences of future events, and particularly when these biomarkers are only intermittently observed with measurement errors. In this paper, we propose a novel modelling framework where the recurrent events and terminal events are modelled as multi-state process and the longitudinal covariates that account for event feedbacks are described by random effects models. Considering the nature of long-term observation in cardiac studies, flexible models with semiparametric coefficients are adopted. To improve computation efficiency, we develop an one-step estimator of the regression coefficients and derive their asymptotic variances for the computation of the confidence intervals, based on the proposed asymptotically unbiased estimating equation. Simulation studies show that the naive estimators which either ignore the past event feedbacks or the measurement errors are biased. Our method achieves better coverage probability, compared to the naive methods. The model is motivated and applied to a dataset from the Atherosclerosis Risk in Communities Study
Treatment outcomes for small cell carcinoma of the bladder: results from a UK patient retrospective cohort study
No full textBackground: Small cell carcinoma of the bladder (SCCB) is rare, accounting for under 1% of all bladder carcinomas. It is aggressive and outcomes are poor due to early metastatic spread. Owing to its rarity, there are limitations on data to propose standardised management pathways. Patients and methods: We conducted a retrospective analysis of patients presenting with pure or predominant histology SCCB to 26 UK institutions between 2006 and 2016. Data cut-off date was 1/2/2018. We report on patient characteristics, treatment received and subsequent clinical outcomes. Results: 409 eligible patients were included. 306 (74.8%) were male, median age was 71 years (range 35-96) and 189 (46.2%) had pure histology SCCB. At data cut-off, 301 patients (73.6%) have died. Median overall survival (OS) was 15.9 (95% confidence interval (CI) 13.2-18.7) months. 200 patients (48.9%), were confirmed to have bladder confined disease (N0 M0), with a median OS of 28.3 (95% CI 20.9-35.8) months, versus 12.7 (95% CI 10.9-14.6) months for 172 (42.1%) patients with confirmed N1-3 and/or M1 disease (hazard ratio 2.03, 95% CI 1.58-2.60, p=<0.001). 247 patients (61.5%) received primary chemotherapy, with a median OS of 21.6 (95% CI 15.5-27.6) months, versus 9.1 (95% CI 5.4-12.8) months in those who did not (HR 0.46, 95%CI 0.37-0.59, p=<0.001). Choice of chemotherapy agent did not alter outcomes. For those with bladder confined disease, 61 patients (30.5%) had cystectomy and 104/200 (52.0%) had radiotherapy. Survival outcomes were similar despite choice of cystectomy or radiotherapy. Only 6 patients (1.5%) were identified to have brain metastases at any time point. Conclusions: This is the largest retrospective study of all stage SCCB to date. Patients have a poor prognosis overall but with improved survival in those able to receive chemotherapy and with organ confined disease. Brain metastases are rare
Developing guidance for psychological professionals on inpatient mental health wards during the COVID-19 pandemic
No full textDue to the challenges faced by mental health inpatient psychological professionals working during the COVID-19 pandemic, we aimed to produce guidelines on best practice through consultations with psychological professionals, patients and ward staff