The Gibco™ CTS™ Rotea™ system story-a case study of industry-academia collaboration.

The Gibco™ CTS™ Rotea™ Counterflow Centrifugation System is an automated cell processing device developed for manufacturing cell therapy products. The developer (Scinogy Pty Ltd) collaborated with Thermo Fisher Scientific to successfully launch the product in late 2020, completing product development from concept to international sales in <3years. This article describes the origin story of the Rotea system and how a chance meeting between a co-inventor of the Rotea system and an academic cell biologist took the invention from a garage workshop to the world stage. We describe the contribution of academic research to the innovation value chain and importance of academic institutions being industry-ready to support such collaborations.

Impact of COVID-19 pandemic on emergency department attendances for young people.

INTRODUCTION: There are concerns that the COVID-19 pandemic is having an indirect negative impact on young people. We aimed to assess the impact of the pandemic on emergency department (ED) presentations and admissions. DESIGN: We analysed ED presentations and admissions from a 5-year period (April 2016-February 2021). An interrupted time series analysis was used to estimate the presentations and admissions that would have been seen in year 5 without the pandemic using the data from years 1 to 4. These estimations were used to calculate the difference between the expected and the observed presentations and admissions during the pandemic year. RESULTS: There were 166 459 presentations over 5 years. There was a 38.1% (95% CI 33.9% to 42.3%) reduction in presentations during the pandemic with no variation by sex, age, deprivation or ethnicity. Largest reductions were associated with children being home schooled rather than with lockdowns. For admissions, there was a 23.4% (17.4% to 29.4%) reduction, less for 5-17 year age group. Infection and asthma/wheeze presentations reduced by around 60% with smaller reductions for mental health and trauma. There was no change for surgical presentations, burns/scolds or allergic reactions. There was an increase in females aged 11-17 years presenting with mental health issues during the pandemic. CONCLUSIONS: During the pandemic, there was a substantial reduction in both ED presentations and admissions. The differential impact on specific presentations suggests this was due to the impact of social distancing and reduced social mixing rather than widening of health inequality or increased barriers to care. TRIAL REGISTRATION NUMBER: NCT04893122.

The Agricultural Conservation Planning Framework Financial and Nutrient Reduction Tool: A planning tool for cost effective conservation.

We have developed an add-on tool for use with the Agricultural Conservation Planning Framework (ACPF) that features a multistate financial analysis and field-scale nitrogen (N) reduction tool for use when analyzing different ACPF conservation scenarios. Financial and expected field-scale N loss data are used to calculate total long-term cost and cost effectiveness of various conservation plans. Unique to the ACPF Financial and Nutrient Reduction Tool is the ability to identify individual treatment areas for each practice evaluated, allowing users to create combinatorial conservation planning scenarios drawing from multiple ACPF-identified conservation practices. Financial data account for direct long-term annualized costs for best management practice (BMP) installation and management in Iowa and Minnesota. Opportunity costs of BMPs that retire cropland are spatially determined according to weighted-average crop productivity indices and land rent relationships. The tool quantifies the N requirements for each field, based on 6-yr land-use data, and evaluates the proportion of N likely to be lost from the field as nitrate load via leaching. Financial analyses that can be accomplished by using the ACPF are illustrated in case study watershed scenarios in Iowa and Minnesota. In Iowa, featured scenarios range from 26 to 31% reduction in total nitrate, for a total cost between US$0.580 million and $2.3 million per year, respectively. In Minnesota, example scenarios range from 28 to 51% total nitrate reduction, for total costs of $1.7 million to $2.1 million per year. Tradeoffs in BMP selection related to N reduction outcome and cost are also demonstrated.

An ultrasonography-based approach for tissue modelling to inform photo-therapy treatment strategies.

Currently, diagnostic medicine uses a multitude of tools ranging from ionising radiation to histology analysis. With advances in piezoelectric crystal technology, high-frequency ultrasound imaging has developed to achieve comparatively high resolution without the drawbacks of ionising radiation. This research proposes a low-cost, non-invasive and real-time protocol for informing photo-therapy procedures using ultrasound imaging. We combine currently available ultrasound procedures with Monte Carlo methods for assessing light transport and photo-energy deposition in the tissue. The measurements from high-resolution ultrasound scans are used as input for optical simulations. Consequently, this provides a pipeline that will inform medical practitioners for better therapy strategy planning. While validating known inferences of light transport through biological tissue, our results highlight the range of information such as temporal monitoring and energy deposition at varying depths. This process also retains the flexibility of testing various wavelengths for individual-specific geometries and anatomy.

Fixated Threat Assessment Centers: preventing harm and facilitating care in public figure threat cases and those thought to be at risk of lone-actor grievance-fueled violence.

The rediscovery of the importance of mental illness in the risk assessment and management of those who threaten, approach, and harm public figures has led to a new way of dealing with those that threaten public figures. This approach emphasises the role of "fixation" which may be defined as an intense preoccupation pursued to an abnormally intense degree. It integrates a threat assessment paradigm with the literature on stalking. The need for such an approach was highlighted in research on the prevalence of harassment of public figures. Psychiatry has a key role in this approach which sees mental health clinicians and Police work together in Fixated Threat Assessment Centres (FTACs). An FTAC functions by assessing the level of concern and sharing information to facilitate interventions that are often mental health based. The purpose is not the hopeless task of identifying those who will go on to perpetrate serious violence, rather to intervene in the group they emerge from, to prevent harm. As well as decreasing risk to the persons fixated upon, this approach improves care to the mentally disordered people who harass and threaten them and, in doing so, decreases the likelihood of their criminalization while enhancing their quality of life. As expertise in the area has grown, policing and security agencies in several countries have expanded the FTAC model to cover individuals thought at risk of lone-actor grievance-fueled violence, a term that captures both different forms of mass killing and lone actor terrorism.

Construct validation of the Narcissistic Admiration and Rivalry Questionnaire in Spanish-speaking countries: Assessment of the reliability, structural and external validity and cross-cultural equivalence.

A recent re-operationalisation of grandiose narcissism has resulted in the distinction of two narcissistic strategies based on the cognitive, affective-motivational and behavioural dynamics: admiration (assertive self-enhancement) and rivalry (antagonistic self-protection). The Narcissistic Admiration and Rivalry Questionnaire (NARQ) was developed to assess this model with two higher-order dimensions. However, cross-validations of the NARQ have not been extensively conducted across diverse population groups and languages. This study aimed to test the internal and external validity (through the relation with envy and self-esteem), reliability and cross-cultural equivalence of the Spanish version of the NARQ. The psychometric properties were evaluated in a Spanish sample (N = 310), and cross-cultural equivalence was tested in participants from Chile (N = 234) and Colombia (N = 256). The results supported the reliability and validity of the Spanish NARQ, as well as the cross-cultural equivalence across Spanish-speaking countries. In addition, we discuss obtained differences across Spanish, Chilean and Colombian sample within two narcissistic strategies.

Resident Education in Laryngeal Stroboscopy and Perceptual Voice Evaluation: An Assessment.

OBJECTIVES: To evaluate otolaryngology residents' level of confidence and understanding in interpreting laryngeal stroboscopy. METHODS: Otolaryngology residents from three residency programs with fellowship-trained laryngologists on faculty were invited to participate. An assessment consisting of a survey and five stroboscopic exams was administered. Each exam consisted of questions on perceptual voice evaluation, laryngoscopic findings, and stroboscopic findings. Scores were compared to answers provided by three fellowship-trained laryngologists. RESULTS: Thirty-eight of 47 invited residents (80.8%) enrolled in the study. On a five-point likert scale, residents reported low confidence (median = 2, range = 1-4) in interpreting stroboscopy, regardless of training program (P = 0.81). Mean assessment scores were 56.5% ± 11.9, with scores in perceptual voice evaluation = 68.5% ± 10.6; laryngoscopy = 70.2% ± 12.8; and stroboscopy = 45.3% ± 17.8. Residents performed worse on stroboscopy questions compared to laryngoscopy questions (P < 0.0001). There was a significant difference in scores by postgraduate year (P = 0.03), but not by institution (P = 0.34). A moderately positive correlation between reported level of confidence and overall scores (ρ = .47, P = 0.003) was demonstrated. CONCLUSIONS: Despite didactic and clinical exposure, residents report low confidence in interpreting stroboscopy and scored lower on stroboscopy-specific questions compared to other assessment items. Additional resources and learning opportunities are needed to improve resident confidence and comprehension of stroboscopy.

Is cancer prevention influenced by the built environment? A multidisciplinary scoping review.

The built environment is a significant determinant of human health. Globally, the growing prevalence of preventable cancers suggests a need to understand how features of the built environment shape exposure to cancer development and distribution within a population. This scoping review examines how researchers across disparate fields understand and discuss the built environment in primary and secondary cancer prevention. It is focused exclusively on peer-reviewed sources published from research conducted in Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States from 1990 to 2017. The review captured 9958 potential results in the academic literature, and this body of results was scoped to 268 relevant peer-reviewed journal articles indexed across 13 subject databases. Spatial proximity, transportation, land use, and housing are well-understood features of the built environment that shape cancer risk. Built-environment features predominantly influence air quality, substance use, diet, physical activity, and screening adherence, with impacts on breast cancer, lung cancer, colorectal cancer, and overall cancer risk. The majority of the evidence fails to provide direct recommendations for advancing cancer prevention policy and program objectives for municipalities. The expansion of interdisciplinary work in this area would serve to create a significant population health impact.

Multistate modeling and simulation of patient trajectories after allogeneic hematopoietic stem cell transplantation to inform drug development.

We present a case study for developing clinical trial scenarios in a complex progressive disease with multiple events of interest. The idea is to first capture the course of the disease in a multistate Markov model, and then to simulate clinical trials from this model, including a variety of hypothesized drug effects. This case study focuses on the prevention of graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (HSCT). The patient trajectory after HSCT is characterized by a complex interplay of various events of interest, and there is no established best method of measuring and/or analyzing treatment benefits. We characterized patient trajectories by means of multistate models that we fitted to a subset of the Center for International Blood and Marrow Transplant Research (CIBMTR) database. Events of interest included acute GvHD of grade III or IV, severe chronic GvHD, relapse of the underlying disease, and death. The transition probability matrix was estimated using the Aalen-Johansen estimator, and patient characteristics were identified that were associated with different transition rates. In a second step, clinical trial scenarios were simulated from the model assuming various drug effects on the background transition rates, and the operating characteristics of different endpoints and analysis strategies were compared in these scenarios. This helped devise a drug development strategy in GvHD prevention after allogeneic HSCT. More generally, multistate models provide a rich framework for exploring complex progressive diseases, and the availability of a corresponding simulation machinery provides great flexibility for clinical trial planning.

A gas trapping method for high-throughput metabolic experiments.

Research into cellular metabolism has become more high-throughput, with typical cell-culture experiments being performed in multiwell plates (microplates). This format presents a challenge when trying to collect gaseous products, such as carbon dioxide (CO2), which requires a sealed environment and a vessel separate from the biological sample. To address this limitation, we developed a gas trapping protocol using perforated plastic lids in sealed cell-culture multiwell plates. We used this trap design to measure CO2 production from glucose and fatty acid metabolism, as well as hydrogen sulfide production from cysteine-treated cells. Our data clearly show that this gas trap can be applied to liquid and solid gas-collection media and can be used to study gaseous product generation by both adherent cells and cells in suspension. Since our gas traps can be adapted to multiwell plates of various sizes, they present a convenient, cost-effective solution that can accommodate the trend toward high-throughput measurements in metabolic research.

Toward Personalized Dosimetry with 32P Microparticle Therapy for Advanced Pancreatic Cancer.

PURPOSE: To develop a Monte Carlo model for patient-specific dosimetry of 32P microparticle localized internal radionuclide therapy for advanced pancreatic cancer. METHODS AND MATERIALS: Spherical tumor geometries and a pancreatic phantom were modeled, as well as different 3-dimensional non-uniform clinical pancreatic geometries based on patient-specific ultrasound images. The dosimetry simulations modeled the dose distribution due to the energy spectrum of emitted beta particles. RESULTS: The average dose for small (3-cm diameter) and large (6-cm diameter) spherical tumors was 111 Gy (for 7.6 MBq administered activity) and 128 Gy (for 58 MBq), respectively. For the clinical 3-dimensional geometries, on the basis of patient data, the mean doses delivered to the tumor were calculated to be in the range 102 to 113 Gy, with negligible dose to the pancreas for the smallest tumor volumes. The calculated dose distributions are highly non-uniform. For the largest tumor studied, the pancreas received approximately 6% of the tumor dose (5.7 Gy). Importantly, we found that because the smallest tumor studied exhibited the most dynamic changes in volume in response to the treatment, the dose to tumor and pancreas is significantly underestimated if a static tumor volume is assumed. CONCLUSIONS: These results demonstrate the dosimetry of 32P microparticle localized internal radionuclide therapy for pancreatic cancer and the possibility of developing personalized treatment strategies. The results also highlight the importance of considering the effects of non-uniform dose distributions and dynamic change of tumor mass during treatment on the dosimetry of the tumor and critical organs.

Identifying families with complex needs after an initial child abuse investigation: A comparison of demographics and needs related to domestic violence, mental health, and substance use.

Families with complex needs related to domestic violence, mental health, and substance use have some of the worst child protective services (CPS) outcomes. Although many of these families are identified during a CPS investigation and subsequently referred to home-based postinvestigation services (HBPS), many are re-reported to CPS, so it is important to understand the postinvestigation experiences of this vulnerable group. Therefore, this study compared families with and without complex needs to understand their uniquedemographics, needs, and postinvestigation outcomes. The sample consisted of 2008 caregivers who received HBPS following an initial CPS investigation. The Family Assessment Form (FAF) was used to measure family functioning in eight domains using a 1-5 scale with higher ratings representing worse functioning. Complex needs were indicated by a mean FAF score of 3 or higher for either domestic violence, mental health, or substance use. Using Pearson chi-square analyses and two-sample t-tests, comparisons were made between families with (n=836) and without (n=1172) complex needs. Half of caregivers with complex needs had a history of abuse, 25% had three to five needs, and nearly half had six to eight needs; 90% of caregivers without complex needs had zero to two needs. Furthermore, caregivers with complex needs had higher mean scores for concrete, educational, and clinical needs. These findings highlight the importance of recognizing variation among families referred to HBPS and accurate screening to ensure that families with complex needs are offered and receive services matched to their unique characteristics and needs.

New challenges in adolescent safeguarding.

The environment in which young people are growing up has changed significantly with the growth in social communication, changes in migration patterns and the proliferation of gangs. These changes pose a real and present danger to the health and well-being of young people in the UK and around the world. However, recognition of the safeguarding needs for this group continues to lag behind those of younger children and services often remain patchy and incomplete. We present a review of current safeguarding concerns as well as practical suggestions on their recognition and response for professionals working with young people in all branches of healthcare as well as education and wider society.

The California Linkages Program: Doorway to Housing Support for Child Welfare-Involved Parents.

Housing instability can complicate parents' efforts to provide for their children. Child welfare service agencies have had difficulty adequately serving parents' housing needs due to limited and constrained funding streams. This article integrates the voices of four important stakeholders to illuminate how an innovative model of service system coordination called Linkages addresses housing needs for child welfare-involved parents eligible for public assistance. Facilitated by Linkages, these parents can receive supportive housing services through programs affiliated with the California public assistance program CalWORKs. Personal narratives reflecting the diverse perspectives of stakeholders in the Linkages collaboration-the statewide program director, a child welfare services coordinator, a CalWORKs caseworker, and a parent program participant-shed light on how the collaboration assists parents in attaining case plan goals, and highlights some of the factors facilitating and hindering effective collaboration between the agencies involved. Stakeholders emphasized the value of flexible service approaches, the intensity of the efforts required, the role of advocacy, and the importance of a shared vision between agencies working together to provide housing supports.

Assessment of a semi-quantitative screening method for diagnosis of ethylene glycol poisoning.

Background Ethylene glycol poisoning remains a rare but important presentation to acute toxicology units. Guidelines recommended that ethylene glycol should be available as an 'urgent' test within 4 h, but these are difficult to deliver in practice. This study assessed a semi-quantitative enzymatic spectrophotometric assay for ethylene glycol compatible with automated platforms. Methods The ethylene glycol method was assessed in 21 samples from patients with an increased anion gap and metabolic acidosis not due to ethylene glycol ingestion, and seven samples known to contain ethylene glycol. All samples were analysed in random order in a blinded manner to their origin on a laboratory spectrophotometer. Results In this study, seven samples were known to contain ethylene glycol at concentrations >100 mg/L. The method correctly identified all seven samples as containing ethylene glycol. No false-positives were observed. Thirteen samples gave clear negative results. Ethylene glycol was present at <20 mg/L in one sample, but this sample remained within the limits of the negative control. Passing-Bablock correlation of estimates of ethylene glycol concentration against results obtained when the samples had been analysed using the quantitative method on an automated analyser showed a good correlation (R = 0.84) but with an apparent under-recovery. Conclusions A semi-quantitative assay for ethylene glycol was able to discriminate well between samples containing ethylene glycol and those with other causes of acidosis. It is a practical small-scale assay for rapid identification of cases of ethylene glycol poisoning.

Outcome and Efficacy of Interventions by a Public Figure Threat Assessment and Management Unit: A Mirrored Study of Concerning Behaviors and Police Contacts Before and After Intervention.

Specialized units for the assessment and management of concerning behaviors towards public figures have been set up in various jurisdictions. Their efficacy has been demonstrated descriptively and in terms of reduction in concern rates. This study of 100 consecutive cases from the Fixated Threat Assessment Centre (FTAC) in the UK uses a novel measure of outcome in the form of reduction in behaviors of concern and in police call-outs/stops, using data culled from police and health service records. It adopts a mirrored design, comparing individuals over 12-month and 2-year periods before and after FTAC intervention. It demonstrates significant reductions in both numbers of individuals involved in, and number of actual incidents of, concerning communication and problematic approach, as well as police call-outs/stops. Most results are consistent across subgroups with regard to gender, previous convictions, concern level, compulsory hospitalization and grievance-driven behavior. Such threat assessment units reduce risky behavior and save police time and, possibly, costs. Copyright © 2016 John Wiley & Sons, Ltd.

The benefits of a joint venture for pathology.

A merger of two foundation trusts' pathology services led to more sophisticated technology, shorter turnaround times and lower costs, as David James explains.

Risk of re-reporting among infants who remain at home following alleged maltreatment.

Maltreatment that begins during infancy is likely to be chronic in duration and developmentally consequential if the appropriate intervention is not delivered. Repeated reports of maltreatment may signal unmet service needs. This study prospectively followed infants who remained at home following an initial report of maltreatment to determine the rate of re-reporting within 5 years. Birth records for all children born in California in 2006 were linked to statewide child protection records through 2012; 5.2% (n = 29,135) of children were reported for abuse or neglect prior to age 1. Following an initial report, 81.9% of infants remained in the home, the majority (60.7%) of whom were re-reported within 5 years. The highest rate of re-reporting was observed among infants whose initial allegation was substantiated and who had a case opened for family maintenance services (69.1%). Infants whose initial allegation was not investigated had re-reporting rates that were equal to or higher than other infants remaining in the home without services. Findings highlight that most families with infants reported for maltreatment are not formally served through the child protection system. High rates of re-reporting underscore the challenge of delivering services that remedy conditions necessitating child protection follow-up and call attention to the importance of accessing data from community service providers.

External quality assessment: best practice.

There is a requirement for accredited laboratories to participate in external quality assessment (EQA) schemes, but there is wide variation in understanding as to what is required by the laboratories and scheme providers in fulfilling this. This is not helped by a diversity of language used in connection with EQA; Proficiency testing (PT), EQA schemes, and EQA programmes, each of which have different meanings and offerings in the context of improving laboratory quality. We examine these differences, and identify what factors are important in supporting quality within a clinical laboratory and what should influence the choice of EQA programme. Equally as important is how EQA samples are handled within the laboratory, and how the information provided by the EQA programme is used. EQA programmes are a key element of a laboratory's quality assurance framework, but laboratories should have an understanding of what their EQA programmes are capable of demonstrating, how they should be used within the laboratory, and how they support quality. EQA providers should be clear as to what type of programme they provide - PT, EQA Scheme or EQA Programme.