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Meta-analysis reveals an inverse relationship between Alzheimer's disease and cancer
No full textRecent reports have suggested an inverse relationship between Alzheimer's disease (AD) and cancer, although the underlying mechanism remains unclear. We performed an epidemiological meta-analysis to assess cancer likelihood in AD patients and vice versa and explored the role of APOE in tumor immunity across 33 The Cancer Genome Atlas (TCGA) cancer types. Our analysis revealed that people with AD are epidemiologically less likely to develop cancer than individuals without AD (RR: 0.53), and cancer patients are less likely to develop AD than non-cancer patients (RR: 0.61). Notably, APOE expression was positively associated with anti-tumor immune signatures and prevalent in early-stage tumors. This research reveals that AD patients are less likely to develop cancer and vice versa, pinpoints APOE gene as a risk factor for AD with anti-tumor activity, and provides new insight into the epidemiologically observed inverse relationship between both diseases.</p
Addressing ageism: how nurses can tackle bias in the care of older people
No full textThis article, the fourth in the series on stigmatisation, introduces the concept of ageism in healthcare, focusing on its practical implications and challenges for older individuals. Ageism – encompassing stereotypes, prejudice and discrimination based on age – manifests in explicit discriminatory acts, implicit biases and systemic inequalities. This article explores the effect of ageism on healthcare, from under-representation in clinical research to biased attitudes among healthcare providers, and examines the intersectionality of ageism with other forms of discrimination, particularly gender bias. It also discusses strategies to combat ageism, emphasising person-centred care, education and policy reforms to ensure older people receive equitable, high-quality care.<br/
Antifungal stewardship in the UK: where are we now?
No full textBackgroundAntifungal stewardship (AFS) is the judicious use of today’s antifungal agents with the aim of improving patient outcomes and preserving their future effectiveness. Antifungal resistance (AFR) is increasing globally, with more patients at risk of Invasive Fungal Disease (IFD), highlighting the urgent need to standardize AFS practices in the UK. The aim of this position paper is to understand the current AFS landscape in the UK.MethodsA virtual panel discussion was held from September to October 2023 on an online platform followed by a virtual meeting with nine healthcare professionals from across the UK selected for their expertise on IFD management and AFS. The discussion was structured across four topics: current AFS landscape, key elements of an AFS programme, diagnostics and diagnostic stewardship, and unmet needs in education and training. A thematic analysis was carried out. The results represent the collated and summarized views from these activities.Results and discussionParticipants reported barriers to implementing AFS and its integration within antimicrobial stewardship (AMS) programmes in the UK. The primary challenge identified was a lack of resources, including funding and staff time. Sub-optimal fungal diagnostics and limited mycology expertise was reported as a barrier to AFS, clinical IFD and AFR surveillance. Approaches to combatting these challenges may include investing in formal mycology networks to serve as centres of clinical expertise and diagnostic hubs.ConclusionNational standards for AFS services and associated outcome metrics need to be established to set a benchmark for centres to improve AFS.<br/
Reservoir-type subcutaneous implantable devices containing porous rate controlling membranes for sustained delivery of risperidone
No full textImplantable drug delivery systems are crucial for achieving sustained delivery of active compounds to specific sites or systemic circulation. In this study, a novel reservoir-type implant combining a biodegradable rate-controlling membrane with a drug-containing core prepared using direct compression techniques is developed. The membrane is composed of poly(caprolactone) (PCL), and risperidone (RIS) served as the model drug. Characterization of both membranes and direct compressed pellets includes hardness testing, optical coherence tomography, mercury intrusion porosimetry, and surface morphology observation. In vitro release studies of RIS reveal that higher drug loading in the pellets extended-release duration up to 70 days when incorporated into membranes with four layers. Increasing the number of membrane layers slows the release rate further, ranging from 70 to 170 days depending on membrane thickness. Biocompatibility studies demonstrate that these implantable devices are non-toxic and biocompatible with cells in vitro. In vivo studies conduct in male Wistar rats demonstrate sustained release of RIS, with plasma levels showing a significant increase post-implantation at a relatively constant rate for up to 49 days. These results indicate that the developed implants have the potential to provide long-acting drug delivery to the systemic circulation.<br/
Rapid metabolic fingerprinting meets machine learning models to identify authenticity and detect adulteration of essential oils with vegetable oils: Mentha and Ocimum study
No full textEssential oils (EOs) are gaining popularity due to their potent antibacterial properties, as well as their applications in food preservation and flavor enhancement, offering growth opportunities for the food industry. However, their widespread use as food preservatives is limited by authenticity challenges, primarily stemming from adulteration with cheaper oils. This study investigated a rapid, cost-effective, and non-destructive method for assessing the authenticity of widely used Mentha and Ocimum EOs. The proposed approach integrates Fourier transform near-infrared (FT-NIR) spectroscopy with machine learning to enable rapid metabolic fingerprinting of EOs. Four Mentha species and three Ocimum species were analysed, and the system was tested on market samples adulterated with vegetable oils. The approach achieved exceptional performance, with Q2, R2, and accuracy exceeding 0.98, alongside specificity and sensitivity greater than 98 %. These findings demonstrated that FT-NIR, combined with machine learning, offers a highly efficient solution for addressing authenticity and adulteration issues in EOs.</p
Automated precision weighing: leveraging 2D video feature analysis and machine learning for live body weight estimation of broiler chickens
No full textThe measurement of bird live weight during the production cycle is an important management practice in commercial broiler farming. However, the accuracy and practicalities of current weighing methods are limited. This paper proposes a non-invasive system that uses low-cost, overhead conventional cameras combined with computer vision and AI techniques to automatically weigh broiler chickens. The main objectives were to: (i) evaluate 2D video feature descriptors, together with regression modelling, to predict the live weight of broilers; (ii) establish the impact of posture (i.e. sitting/standing) and bird age on the accuracy of weight estimation; (iii) assess the feasibility of the camera-weighing system to monitor weight at different bird ages. In the first experiment, a video feature analysis was performed to evaluate the accuracy of 2D feature descriptors (ellipse axes, ellipse area, bounding box width, bounding box height) to predict the weight of broilers. Individual birds were manually weighed to establish a reference weight. The relationship between the feature sets and the reference weight was evaluated using six multivariate regression models. The approach was tested on two groups of broilers aged 23 (n=21 broilers) and 35 (n=23 broilers) days old, weighing between 570 to 2980g. In experiment 2, the best performing feature set and linear regression modelling from experiment 1 were applied to a larger number of birds across a greater age range (5 to 35 days old, n=222 broilers). To be more representative of the intended application of this technology, footage was recorded from the feeding area of a commercial broiler house and an automated chicken detector and tracking method was applied. The model was retrained using reference weights from experiment 2 (ranging from 100 to 3085g) to refine model performance. In experiment 1, the posture feature did not improve weight estimation whilst age improved the performance of all models. The accuracy of body weight estimation was greatest when bird age and the minor ellipse axis (x,y endpoints of the maximum points that are perpendicular to the longest line that can be drawn through an object) were used as model features. In experiment 2, the model showed the poorest performance in 5-day old birds with a mean relative error of 12.1 ± 7.9%. Overall, however, the model could estimate the weight of a broiler chicken with a mean relative error of 7.0 ± 5.8%. The results indicate that the analysis of 2D image features using video analytics and regression modelling is a promising method of obtaining rapid, cost-effective and accurate estimates of broiler live weight
An examination of the factors that influence consumer intention to purchase higher welfare meat and milk
No full textMepolizumab real-world effectiveness in severe asthma with an eosinophilic phenotype and overlapping severe allergic asthma
No full textBackgroundSome patients with severe asthma have overlapping allergic and eosinophilic phenotypes and may be eligible for anti-eosinophilic or anti-IgE biologics.ObjectiveThis post hoc sub-analysis assessed real-world mepolizumab effectiveness in patients with overlapping allergic and eosinophilic phenotypes, using 1-year data from the international, prospective REALITI-A study.MethodsThe clinically significant asthma exacerbation (CSE) rate was assessed 1 year prior to (pre-treatment) and following (follow-up) mepolizumab treatment, stratified by baseline total IgE levels (tIgE; <60, 60–<190, 190–<550, and ≥550 kU/L), atopic status (yes/no/unknown), prior omalizumab use (yes/no), geographic baseline omalizumab eligibility (eligible/non-eligible), and baseline tIgE level and blood eosinophil count (BEC) threshold combinations (<81 or ≥81 kU/L and <300 or ≥300 cells/µL).ResultsOverall, 822 patients were included. CSEs occurred in 760 (93%) patients pre-treatment and 398 (49%) during follow-up. CSE rate (RR[95% CI]) was reduced in follow-up across all tIgE subgroups (<60 [n=173]: 0.31[0.25, 0.37]; 60–<190 [n=176]: 0.30[0.25, 0.36]; 190–<550 [n=170]: 0.26[0.20, 0.33]; ≥550 kU/L [n=155]: 0.28[0.23, 0.35]) and irrespective of atopic status (yes [n=422]: 0.29[0.26, 0.33]; no [n=52]: 0.33[0.23, 0.47]; unknown [n=348]: 0.28[0.24, 0.32]), prior omalizumab use (yes [n=151]: 0.37[0.30, 0.45]; no [n=671]: 0.27[0.24, 0.30]) or eligibility (eligible (n=349): 0.29[0.25, 0.34]; non-eligible [n=191]: 0.32[0.27, 0.38]). Furthermore, the CSE rate was reduced across all tIgE (kU/L) and BEC (cells/µL) combinations (<81/<300 [n=53]: 0.34[0.24, 0.47], <81/≥300 [n=103]: 0.33[0.26, 0.41], ≥81/<300 [n=98]: 0.36[0.28, 0.47], ≥81/≥300 [n=249]: 0.26[0.22, 0.31]).ConclusionMepolizumab demonstrates real-world effectiveness in reducing exacerbations in patients with severe asthma and an eosinophilic phenotype, regardless of any overlapping allergic phenotype.<br/
A systematic review of clinical practice guidelines for the assessment and management of pain in neonates
No full textPurposeThis systematic review provides a content analysis of the specific recommendations provided within existing clinical practice guidelines for the assessment and management of procedural pain in neonates.MethodsA structured search was completed in November 2021 in MEDLINE, Embase, and CINAHL to identify relevant clinical practice guidelines. Clinical practice guidelines were quality assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument.Results20 clinical practice guidelines were included. Recommendations and evidence provided within the guidelines for the assessment and management of procedural pain in neonates was variable.ConclusionsImprovements are required in relation to the vagueness of recommendations and inconsistencies.Clinical implicationsTranslating evidence into practice is a complicated process that requires behavioural change amongst healthcare professionals. The Evidence-Based Practice for Improving Quality an adaptable multifaceted intervention can be implemented to change behaviour and reduce the evidence to practice gap.<br/