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The Covid-19 pandemic has resulted in Britain’s biggest debt in over 60 years. However, the country also needs to invest over £600 billion in infrastructure to stimulate economic recovery as well as meet its target of net zero greenhouse gas emissions by 2050. While the UK government’s private finance initiative model for procuring public infrastructure has fallen out of favour, private investment can deliver major public benefits if properly managed. This paper highlights both good and bad outcomes of private finance initiatives around the world, and suggests how they can best be used to support the UK government’s long-term aspirations to ‘build back better’ and meet its climate targets. The key is to focus on specific projects and to structure deals to provide quality, value for money and longevity.

PROBLEM Due to the number of children diagnosed with attention deficit hyperactivity disorder (ADHD), increased risk of these children having comorbidities and/or an adverse childhood experience and insufficient documentation of the Diagnostic and Statistical manual of Mental Disorders, fifth edition (DSM-5) criteria for an ADHD diagnosis, an ADHD evaluation program was developed for a child presenting for an initial ADHD evaluation. METHODS A quantitative design method evaluated provider's documentation by the percentage of DSM-5 criteria met before and after the implementation of the ADHD program. Descriptive statistics evaluated the system change by the percentage of providers who utilized the ADHD template and the use of the unspecified ADHD International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10) code, F90.9 by the percentage of code use before and after implementation of the ADHD program. FINDINGS The two-tailed Mann-Whitney U test was significantly based on p

Evidence showing that the immature brain is vulnerable to seizure-induced damage has been accumulating for decades. Clinical data have always suggested that some early-life seizures are associated with negative sequelae, but clinical observations are frequently obscured by multiple uncontrolled contributing factors and can rarely establish causality. Determining with certainty that seizures, per se, can cause neuronal death and can irreversibly disrupt critical developmental processes, required the development of suitable model systems. Several experimental seizure models clearly show that the immature brain can sustain neuronal injury as a result of uncontrolled seizure activity and that even in the absence of observable neuronal death, the developing brain is selectively vulnerable to interruptions of required growth programs. Severe early-life seizures inhibit DNA, RNA, and protein synthesis, and they can reduce the accumulation of myelin and synaptic markers in the developing nervous system, leading to functional delays in development. Depending on the seizure pathway involved, and the developmental period under study, classic neurodegeneration, excitotoxicity, and apoptosis can result in permanent damage to critical neural networks in the temporal lobe and in many other brain regions. This conclusion is further supported by recent clinical studies showing that prolonged febrile status epilepticus can lead to hippocampal injury, which evolves into hippocampal atrophy and hippocampal sclerosis. A growing body of experimental data demonstrates that the metabolic compromise and cellular loss produced by seizures during critical phases of brain development negatively affect later hippocampal physiology including learning and memory functions in maturity.

The design, synthesis, characterization, and biological activity of a series of platinum(IV) prodrugs containing the axial ligand 3-(4-phenylquinazoline-2-carboxamido)propanoate (L3) are reported. L3 is a derivative of the quinazolinecarboxamide class of ligands that binds to the translocator protein (TSPO) at the outer mitochondrial membrane. The cytotoxicities of cis,cis,trans-[Pt(NH3)2Cl2(L3)(OH)] (C-Pt1), cis,cis,trans-[Pt(NH3)2Cl2(L3)(BZ)] (C-Pt2), trans-[Pt(DACH)(OX)(L3)(OH)] (C-Pt3), and trans-[Pt(DACH)(OX)(L3)(BZ)] (C-Pt4) (DACH: R,R-diaminocyclohexane, BZ: benzoate, OX: oxalate) in MCF-7 breast cancer and noncancerous MCF-10A epithelial cells were assessed and compared with those of cisplatin, oxaliplatin, and the free ligand L3. Moreover, the cellular uptake, ROS generation, DNA damage, and the effect on the mitochondrial function, mitochondrial membrane potential, and morphology were investigated. Molecular interactions of L3 in the TSPO binding site were studied using molecular docking. The results showed that complex C-Pt1 is the most effective Pt(IV) complex and exerts a multimodal mechanism involving DNA damage, potent ROS production, loss of the mitochondrial membrane potential, and mitochondrial damage.

Simple Summary Colorectal cancer is the third most common type of cancer in the world. Immune cells and normal supporting cells (MSCs) within a tumour affect patient survival and change how well treatments work. This research aimed to develop a more relevant 3D cancer model that combines MSCs and immune cells with cancer cells to test the effects of multiple cell types on tumour growth. We successfully developed a 3D model that shows that MSCs and immune cells can change the cancer-supporting environment around the tumour cells. We show that combining MSCs and immune cells with cancer cells can increase the level of immune-suppressing molecules they release and change immunotherapeutic drug targets on the cancer cells, similar to changes seen in human tumours. Using this 3D model for research may be better for testing new drugs than traditional 2D methods and could enable the identification of new drug targets. Abstract Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. CRC develops in a complex tumour microenvironment (TME) with both mesenchymal stromal cells (MSCs) and immune infiltrate, shown to alter disease progression and treatment response. We hypothesised that an accessible, affordable model of CRC that combines multiple cell types will improve research translation to the clinic and enable the identification of novel therapeutic targets. A viable gelatine-methacrloyl-based hydrogel culture system that incorporates CRC cells with MSCs and a monocyte cell line was developed. Gels were analysed on day 10 by PCR, cytokine array, microscopy and flow cytometry. The addition of stromal cells increased transcription of matrix remodelling proteins FN1 and MMP9, induced release of tumour-promoting immune molecules MIF, Serpin E1, CXCL1, IL-8 and CXCL12 and altered cancer cell expression of immunotherapeutic targets EGFR, CD47 and PD-L1. Treatment with PD153035, an EGFR inhibitor, revealed altered CRC expression of PD-L1 but only in gels lacking MSCs. We established a viable 3D model of CRC that combined cancer cells, MSCs and monocytic cells that can be used to research the role the stroma plays in the TME, identify novel therapeutic targets and improve the transitional efficacy of therapies.

Traumatic spinal cord injury (SCI) results in complex neurological dysfunction. Astrocytes react in response to SCI by undergoing proliferation and migrating to the injury site, resulting in astrogliosis. Neural stem cells (NSCs) have been proposed as a promising therapeutic strategy to promote neurogenesis following transplantation post SCI. In this study the antigenic and morphological phenotype of astrocytes, and the pattern of galectin expression was examined following SCI. Female Sprague Dawley rats were contused at thoracic (T) level T9 and treated with Cyclosporin-A (CsA) and/or NSCs 1 week post-injury. CsA and NSC treatment led to increased glial fibrillary acidic protein (GFAP), brain lipid binding protein (BLBP) and vimentin expression. Quiescent and reactive astrocytes were the most abundant cell morphology observed. Astrocytes co-localised with galectin-1 (Gal-1) and galectin-3 (Gal-3). Gal-1 expression was increased in both CsA and CSA + NSC treated animals 2 weeks post-treatment. Treatment with CsA and/or NSCs offers many prospective beneficial effects. A detailed revelation of how astrocytes are heterogeneously responsive to SCI, in addition to their affinity to galectins and response to CsA and NSCs is shown in this study. The current study’s findings support the potential application of NSCs as a novel therapeutic tool in the treatment of SCI.

Community engagement is a central component of archaeology. Whether it is initiated through local, state, or national regulatory frameworks or as part of academic research, working with stakeholders is often structurally incorporated into project plans. However, what defines a community, and how this conception impacts archaeological practice is frequently not problematized. This conversation discusses the practice of archaeology as it engages with communities, and some of the difficulties encountered. If archaeology is going to be a holistically engaged discipline it must take seriously the complexities of communities and the impacts of its practice.

Sanchez, Jennifer/0000-0001-8448-0678 WOS: 000442017800003 PubMed: 32133037 Background/Aims: The Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) has demonstrated reliability and validity in the general population; yet the psychometric properties have not been tested among rehabilitation populations, such as persons experiencing chronic musculoskeletal pain. The objective of the current study was to examine the factorial structure and psychometric properties of the BREQ-2 in a sample of adults with chronic musculoskeletal pain. Methods: Adults with chronic musculoskeletal pain (n=211) were recruited from clinical and community networks in the United States. Data were collected using a cross-sectional online survey and analysed using confirmatory factor analysis, multiple indicators multiple causes analysis, and correlational techniques. Participants completed the BREQ-2 and other measures relevant to self-determination theory, including outcome expectancies, self-efficacy and family and friend support for physical activity and exercise. Findings: Results indicated the intercorrelated model fit the data well. The five factors of amotivation, external regulation, introjected regulation, identified regulation and intrinsic regulation toward physical activity and exercise demonstrated good reliability and construct validity. Conclusions: This study provides evidence of factorial and construct validity for the BREQ-2 among people with chronic musculoskeletal pain. Implications for rehabilitation practitioners and researchers are discussed. National Institute on Disability and Rehabilitation Research of the U.S. Department of Education [H133B100034]; National Institute of Mental HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH) [T32 MH073553-11] This work was supported by the National Institute on Disability and Rehabilitation Research of the U.S. Department of Education under Grant H133B100034 and the National Institute of Mental Health Grant under Grant T32 MH073553-11.

SummaryObjective To evaluate acute and long-term effects of intravenous brivaracetam (BRV) and BRV + diazepam (DZP) combination treatment in a rat model of self-sustaining status epilepticus (SSSE). Methods Rats were treated with BRV (10 mg/kg) 10 min after initiation of perforant path stimulation (PPS) as early treatment; or BRV (10–300 mg/kg), DZP (1 mg/kg), or BRV (0.3–10 mg/kg) + DZP (1 mg/kg) 10 min after the end of PPS (established SSSE). Seizure activity was recorded electrographically for 24 h posttreatment (acute effects), and for 1 week at 6–8 weeks or 12 months' posttreatment (long-term effects). All treatments were compared with control rats using one-way analysis of variance (ANOVA) and Bonferroni's test, or Kruskal-–Wallis and Dunn's multiple comparison tests, when appropriate. Results Treatment of established SSSE with BRV (10–300 mg/kg) resulted in dose-dependent reduction in SSSE duration and cumulative seizure time, achieving statistical significance at doses ≥100 mg/kg. Lower doses of BRV (0.3–10 mg/kg) + low-dose DZP (1 mg/kg) significantly reduced SSSE duration and number of seizures. All control rats developed spontaneous recurrent seizures (SRS) 6–8 weeks after SSSE, whereas seizure freedom was noted in 2/10, 5/10, and 6/10 rats treated with BRV 200 mg/kg, 300 mg/kg, and BRV 10 mg/kg + DZP, respectively. BRV (10–300 mg/kg) showed a dose-dependent trend toward reduction of SRS frequency, cumulative seizure time, and spike frequency, achieving statistical significance at 300 mg/kg. Combination of BRV (10 mg/kg) + DZP significantly reduced SRS frequency, cumulative seizure time, and spike frequency. In the 12-month follow-up study, BRV (0.3–10 mg/kg) + low-dose DZP markedly reduced SRS frequency, cumulative seizure time, and spike frequency, achieving statistical significance at some doses. Early treatment of SSSE with BRV 10 mg/kg significantly reduced long-term SRS frequency. Significance These findings support clinical evaluation of BRV for treatment of status epilepticus or acute repetitive seizures.

Individuals with autism spectrum disorder (ASD) are completing high school with reasonable expectations for postsecondary success. College educators are likely ill prepared to provide appropriate support for these students. Based on personal interviews with a diverse group of students with autism, this study (a) amplifies these students’ voices, (b) describes tensions between their public and private identities, (c) outlines the academic, social, emotional, self-advocacy, and communication challenges they face in college, and (d) proposes both general principles and specific practices that could be leveraged to facilitate postsecondary success for students with autism.

Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu’s (2009) revised World Health Organization’s International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI).Method: One hundred eighty-seven adults with SCI were recruited to take an online survey including measurement scales representing each component of the revised ICF model: Functioning, Activities, Participation, Environmental Factors, Personal Factors, and Quality Of Life. Path analysis was used to evaluate the hypothesized relationships among the ICF components.Results: A respecified path model revealed a strong model-to-data fit, χ2(3, N = 187) = 6.84; p = .08; goodness-of-fit index (GFI) = .99; comparative fit index (CFI) = .99; and root mean square error of approximation (RMSEA) = .08. Taking into account all of the ICF components, CSE had the strongest direct effect on life satisfaction (β = .40, p < .01).Conclusion: This study supports CSE as a significant and direct predictor of life satisfaction in persons with SCI, indicating that CSE may be an important target for intervention in a biopsychosocial approach toward SCI rehabilitation. These findings provide a basis for future research to investigate the role of CSE in quality of life among people with varying health conditions.

The current goal of cell sheet engineering technology is to provide an improved approach for more predictive and effective generation of viable tissue-like constructs. Success requires validation and characterization of cell sheet growth and detachment. In this study, we perform qualitative and quantitative assessments of cell sheets lifted from thin spin-coated poly(N-isopropylacrylamide)films.

Serious mental illness (SMI) is a persistent mental health condition that significantly impacts functioning in multiple life domains, especially the work domain (Dunn, Wewiorski, & Rogers, 2010). Difficulties with work functioning and finding or maintaining employment can be detrimental to the health-related quality of life and overall well-being of individuals with SMI. The staggering low rates of employment (20% to 25%) for people with schizophrenia and related disorders exert a heavy health and economic burden to society. In the United States, annual costs are estimated at $ 113 billion on mental health treatment alone (Centers for Disease Control and Prevention, 2011; Mark, Levit, Vandivort-Warren, Buck, & Coffey, 2011; Mechanic, Bilder, & McAlpine, 2002), with the majority of individuals served expressing a desire to secure employment as a recovery goal (National Alliance on Mental Illness, 2015). Effective vocational rehabilitation services can lead to better employment outcomes and community integration for individuals with SMI (Cook et al., 2007), yet these practices are not widespread as only a small minority of those with SMI have access to evidence-based programs in psychiatric rehabilitation (Corrigan, 2004; Substance Abuse and Mental Health Services Administration, 2015).To improve recovery outcomes, the field of mental health is implementing a paradigm shift by encouraging consumers to be self-determined and active participants in all aspects of the treatment and rehabilitation process, including medication, interventions, and employment (Corrigan et ah, 2012). Using principles of self-determination to guide mental health services can foster self-determined motivation, thus reducing mental health symptoms and enhancing treatment engagement (Saperstein, Fiszdon, & Bell, 2011; Strauser, 2014). The theory of self-determination (SDT; Deci & Ryan, 1985) describes how human beings achieve goals, reach self-actualization, and experience a higher quality of life while in treatment, healthcare, or other contexts that support the realization of fundamental human needs, including competency, autonomy, and relatedness or feelings of connectedness to others (Reeve, Nix, & Hamm, 2003; Ryan & Deci, 2000). Self-determined individuals are more capable of dealing with setbacks or difficulties related to their goals, whereas individuals less self-determined are prone to giving up, especially if contingent rewards are removed. For people with SMI, experiencing substantial personal (e.g., premorbid occupational functioning, cognitive functioning, severity of illness) and contextual barriers (e.g., work disincentives, perceived workplace stigma) to gainful employment, can be difficult to overcome without a self-determined recovery goal to sustain engagement in vocational rehabilitation services (Fitzgerald et ah, in press).Competency is a key construct in the SDT framework. In recent research, it has been found to be significantly associated with outcome expectancy, treatment adherence, and vocational rehabilitation outcomes (Chou, Ditchman, Pruett, Chan, & Hunter, 2009; Corbiere, Mercier, & Lesage, 2004; Fitzgerald, Chan et ah, 2015; Ventura, Salanova, & Llorens, 2015). People with SMI, in particular, may encounter negative experiences that contribute to low work-related competence, such as nonworking role models, self-stigma, perceived job discrimination, disruption in education, and unconstructive opinions from co-workers (Corbiere et ah, 2004; Larson, 2008). With longer periods of unemployment, perceived competence declines even further and the barriers to employment may seem insurmountable. Improving one's vocational competency can facilitate the process of overcoming barriers to employment and can result in concrete action steps toward competitive employment. In order to further evaluate and implement practices focusing on self-determination as a framework in psychiatric rehabilitation settings, it is important to develop and validate brief, reliable and valid measures to operationalize competency along with other SDT constructs. …

Summary Treatment of status epilepticus (SE) in infants and children is challenging. There is a recognition that a broad set of developmental processes need to be considered to fully appreciate the physiologic complexity of severe seizures, and seizure outcomes, in infants and children. The development and use of basic models to elucidate important mechanisms will help further our understanding of these processes. Here we review some of the key experimental models and consider several areas relevant to treatment that could lead to productive translational research. Terminating seizures quickly is essential. Understanding pharmacoresistance of SE as it relates to receptor trafficking will be critical to seizure termination. Once a severe seizure is terminated, how will the developing brain respond? Basic studies suggest that there are important acute and long‐term histopathologic, and pathophysiologic, consequences that, if left unaddressed, will produce long‐lasting deficits on the form and function of the central nervous system. To fully utilize the evidence that basic models produce, age‐ and development‐ and model‐specific frameworks have to be considered carefully. Studies have demonstrated that severe seizures can cause perturbations to developmental processes during critical periods of development that lead to life‐long deficits. Unfortunately, some of the drugs that are commonly used to treat seizures may also produce negative outcomes by enhancing Cl‐‐mediated depolarization, or by accelerating programmed cell death. More research is needed to understand these phenomena and their relevance to the human condition, and to develop rational drugs that protect the developing brain from severe seizures to the fullest extent possible.

Microcapsules made of sodium cellulose sulphate (SCS) and poly-diallyl-dimethyl-ammonium chloride (pDADMAC) have been employed to encapsulate a wide range of established cell lines for several applications. However, little is known about the encapsulation of primary cells including human mesenchymal stem cells (hMSCs). Human MSCs are of interest in regenerative medicine applications due to pro-angiogenic, anti-inflammatory and immunomodulatory properties, which result from paracrine effects of this cell type. In the present work we have encapsulated primary hMSCs and hMSC-TERT immortalized cells and compared their behavior and in vitro angiogenic potential. We found that, although both cell types were able to secret angiogenic factors such as VEGF, there was a marked reduction of primary hMSC viability compared to hMSC-TERT cells when cultured in these microcapsules. Moreover, this applied to other primary cell cultures such as primary human fibroblasts but not to other cell lines such as human embryonic kidney 293 (HEK293) cells. We found that the microcapsule membrane had a molecular weight cut-off below a critical size, which caused impairment in the diffusion of essential nutrients and had a more detrimental effect on the viability of primary cell cultures compared to cell lines and immortalized cells.

Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) is a death ligand cytokine known for its cytotoxic activity against malignantly transformed cells. TRAIL induces cell death through binding to death receptors DR4 and DR5. The inhibitory decoy receptors (DcR1 and DcR2) co-expressed with death receptor 4 (DR4)/DR5 on the same cell can block the transmission of the apoptotic signal. Here, we show that DcRs also regulate TRAIL sensitivity at a supracellular level and thus represent a mechanism by which the microenvironment can diminish tumour TRAIL sensitivity. Mathematical modelling and layered or spheroid stroma–extracellular matrix–tumour cultures were used to model the tumour microenvironment. By engineering TRAIL to escape binding by DcRs, we found that DcRs do not only act in a cell-autonomous or cis-regulatory manner, but also exert trans-cellular regulation originating from stromal cells and affect tumour cells, highlighting the potent inhibitory effect of DcRs in the tumour tissue and the necessity of selective targeting of the two death-inducing TRAIL receptors to maximise efficacy.

The function of Notch signaling was previously studied in two cnidarians, Hydra and Nematostella, representing the lineages Hydrozoa and Anthozoa, respectively. Using pharmacological inhibition in Hydra and a combination of pharmacological and genetic approaches in Nematostella, it was shown in both animals that Notch is required for tentacle morphogenesis and for late stages of stinging cell maturation. Surprisingly, a role for Notch in neural development, which is well documented in bilaterians, was evident in embryonic Nematostella but not in adult Hydra. Adult neurogenesis in the latter seemed to be unaffected by DAPT, a drug that inhibits Notch signaling. To address this apparent discrepancy, we studied the role of Notch in Hydractinia echinata, an additional hydrozoan, in all life stages. Using CRISPR-Cas9 mediated mutagenesis, transgenesis, and pharmacological interference we show that Notch is dispensable for Hydractinia normal neurogenesis in all life stages but is required for the maturation of stinging cells and for tentacle morphogenesis. Our results are consistent with a conserved role for Notch in morphogenesis and nematogenesis across Cnidaria, and a lineage-specific loss of Notch dependence in neurogenesis in hydrozoans.

The primary aim of this investigation was to determine the biocompatibility and cell culture potential of a newly designed class of thermoresponsive polymers. The attractiveness of these polymers lies in the fact that they swell rather than dissolve when the temperature is reduced below their respective lower critical solution temperature, due to the incorporation of octadecyl methacrylate (ODMA). The ODMA monomer acts as a physical crosslinker, preventing polymer dissolution upon temperature reduction. Two polymers were studied in this investigation poly(N isorpoylacrylamide (NIPAm)(99.25%)-co-ODMA(0.75%)) and poly(NIPAm(65%)-co-N-tert-butylacrylamide (NtBAm)(34.25%)-co-ODMA(0.75%)). Thin thermoresponsive films of the polymers were prepared via spin coating. 3T3 cells were then seeded on the prepared films and cell viability was assessed quantitatively through cell viability and activity assays and qualitatively by light microscopy. Cells were successfully seeded and grown on the poly(NIPAm-co-ODMA) and poly(NIPAm-co-NtBAm-co-ODMA) copolymer films after film modification with cell adhesion promoters (CAPs). Cell sheets successfully detached from the CAP coated poly(NIPAm-co-ODMA) platforms upon temperature reduction.

This study describes the development and cell culture application of nanometer thick photocrosslinkable thermoresponsive polymer films prepared by physical adsorption. Two thermoresponsive polymers, poly(N-isopropylacrylamide (NIPAm)-co-acrylamidebenzophenone (AcBzPh)) and poly(NIPAm-co-AcBzPh-co-N-tertbutylacrylamide) are investigated. Films are prepared both above and below the polymers' lower critical solution temperatures (LCSTs) and cross-linked, to determine the effect, adsorption preparation temperature has on the resultant film. The films prepared at temperatures below the LCST are smoother, thinner, and more hydrophilic than those prepared above. Human pulmonary microvascular endothelial cell (HPMEC) adhesion and proliferation are superior on the films produced below the polymers LCST compared to those produced above. Cells sheets are detached by simply lowering the ambient temperature to below the LCST. Transmission electron, scanning electron, and light microscopies indicate that the detached HPMEC sheets maintain their integrity.

Physical adsorption was used to produce nanometer thick thermoresponsive films with a view to nonenzymatic cell detachment. Two polymers were investigated, poly-(N-isopropylacrylamide) and poly (N-isopropylacrylamide-co-N-tertbutylacrylamide). Substrates were prepared above and below the polymers’ LCST to investigate the effect of polymer conformation on the prepared substrates. Endothelial cells were seeded on the prepared films; cell proliferation was higher on the films produced below the polymers’ LCST than on those prepared above and cells detached from the surfaces upon temperature reduction. Physical adsorption of poly-(N-isopropylacrylamide)–based films is a viable approach to produce substrates compliant with cell growth and temperature modulated detachment.

Introduction: Stress fractures (SFx) are one of the most common and debilitating overuse injuries seen in military recruits, and they are also problematic for nonmilitary athletic populations. The goal of this randomized double-blind, placebo-controlled study was to determine whether a calcium and vitamin D intervention could reduce the incidence of SFx in female recruits during basic training. Materials and Methods: We recruited 5201 female Navy recruit volunteers and randomized them to 2000 mg calcium and 800 IU vitamin D/d or placebo. SFx were ascertained when recruits reported to the Great Lakes clinic with symptoms. All SFx were confirmed with radiography or technetium scan according to the usual Navy protocol. Results: A total of 309 subjects were diagnosed with a SFx resulting in an incidence of 5.9% per 8 wk. Using intention-to-treat analysis by including all enrolled subjects, we found that the calcium and vitamin D group had a 20% lower incidence of SFx than the control group (5.3% versus 6.6%, respectively, p = 0.0026 for Fisher's exact test). The per protocol analysis, including only the 3700 recruits who completed the study, found a 21% lower incidence of fractures in the supplemented versus the control group (6.8% versus 8.6%, respectively, p = 0.02 for Fisher's exact test). Conclusions: Generalizing the findings to the population of 14,416 women who entered basic training at the Great Lakes during the 24 mo of recruitment, calcium and vitamin D supplementation for the entire cohort would have prevented ∼187 persons from fracturing. Such a decrease in SFx would be associated with a significant decrease in morbidity and financial costs.

Microcapsules made of sodium cellulose sulphate (SCS) and poly-diallyl-dimethyl-ammonium chloride (pDADMAC) have been employed to encapsulate a wide range of established cell lines for several applications. However, little is known about the encapsulation of primary cells including human mesenchymal stem cells (hMSCs). Human MSCs are of interest in regenerative medicine applications due to pro-angiogenic, anti-inflammatory and immunomodulatory properties, which result from paracrine effects of this cell type. In the present work we have encapsulated primary hMSCs and hMSC-TERT immortalized cells and compared their behavior and in vitro angiogenic potential. We found that, although both cell types were able to secret angiogenic factors such as VEGF, there was a marked reduction of primary hMSC viability compared to hMSC-TERT cells when cultured in these microcapsules. Moreover, this applied to other primary cell cultures such as primary human fibroblasts but not to other cell lines such as human embryonic kidney 293 (HEK293) cells. We found that the microcapsule membrane had a molecular weight cut-off below a critical size, which caused impairment in the diffusion of essential nutrients and had a more detrimental effect on the viability of primary cell cultures compared to cell lines and immortalized cells.

Summary: Purpose: Cell transplantation into the brain is an aggressive clinical alternative. The hopes of treating diseases like intractable temporal lobe epilepsy have been subdued because the preclinical successes thus far have shown only slowing of epileptogenesis, or suppression of electrically induced seizures. Because the hallmark of epilepsy is spontaneous seizures, the clinical relevance of these studies has been questioned. The purpose of this study was to establish that cells genetically engineered to produce γ-aminobutyric acid (GABA) could suppress spontaneous seizures in an accepted model of temporal lobe epilepsy. Methods: Conditionally immortalized neurons were engineered to produce GABA under the control of tetracycline. These cells were transplanted into the substantia nigra of spontaneously seizing animals. After transplantation, the animals were monitored for 3 days immediately after surgery and again for 3 days beginning 7–8 days after surgery. Seizures and epileptiform spikes were recorded and later analyzed with detection software combined with video monitoring. Results: Animals that received genetically engineered GABA-producing cells had significantly fewer spontaneous seizures than did animals that received control cells, or animals that received GABA-producing cells plus doxycycline at the observation period starting 1 week after transplantation. A significant suppression of epileptiform spikes also was noted between the group that received GABA-producing cells and the group that received the same cells but were given doxycycline. The engineered cells show evidence of integration with the host but limited survival. Conclusions: These data demonstrate that genetically engineered cells have the ability to suppress spontaneous seizures when transplanted into seizure-modulating nuclei. This is an important step toward defining a clinical potential for this approach in epilepsy. The fact that the gene of interest can be regulated suggests that individualizing transplant therapy may be possible.

Objective—To use magnetic resonance (MR) imaging to describe and compare the anatomic distribution of a lipid contrast medium injected via the retrobulbar and Peterson nerve block techniques in heads of bovine cadavers. Design—Original study. Sample—5 grossly normal heads obtained from cattle at necropsy. Procedure—Standardized techniques for the modified retrobulbar and Peterson nerve blocks were established. Each cadaver had 1 treatment performed on a randomly selected side of the head; the second treatment was performed on the alternate side of the head. Injections were performed with canola oil, which is an MR-positive contrast medium. Images of heads in the transverse and dorsal planes were obtained with a 3.0 Tesla short-bore MR system. Results—The retrobulbar technique was characterized by widespread distribution of the contrast medium around the periorbital structures; further distribution of the medium was detected along the optic nerve and in the ethmoid turbinates and nasopharynx. After the Peterson nerve block technique, contrast medium was repeatedly located in the pterygopalatine fossa, but distribution to surrounding structures was minimal. Conclusions and Clinical Relevance—Results indicate that the retrobulbar injection technique results in a greater distribution of contrast medium to the target nerves and surrounding structures, compared with that achieved via the Peterson nerve block technique. This may explain the previously reported clinical impression that the retrobulbar block is more reliable than the Peterson nerve block but is associated with a greater risk of complications. (J Am Vet Med Assoc 2003;223:852–855)

Purpose To examine with magnetic resonance imaging (MRI)/magnetic resonance spectroscopy (MRS) the long-term effects of cariporide in a canine cardiac ischemia/reperfusion model. Materials and Methods Twenty-two beagles underwent a 2-hour occlusion followed by 10 days of reperfusion. Cine MRI and 31P MRS were performed to monitor function and metabolism of the heart in the control (N = 10) and cariporide (N = 12) groups. Radioactively labeled microspheres were injected to determine coronary blood flow, and contrast-enhanced ex vivo MRI assessed infarct volumes. Results Cariporide produced a significant reduction vs. controls, in intracellular pH, during ischemia (P < 0.05) and at days 3 and 10 postreperfusion (P < 0.0005). Functional recovery of the myocardium was significantly improved immediately upon reperfusion (percent of baseline: 63.5% ± 3.5% for controls, 90.5% ± 7.2% for cariporide) and at day 3, but not by day 10. Normalized infarct ratios (IRs) were similar for controls and cariporide (0.58 ± 0.08, 0.58 ± 0.06, respectively). Conclusion Cariporide augments early functional recovery, while delaying normalization of intracellular pH following ischemia/reperfusion, but confers neither long-term functional or metabolic protection nor, most importantly, myocardial salvage. J. Magn. Reson. Imaging 2003;17:136–141. © 2002 Wiley-Liss, Inc.

To compare the long-term functional and metabolic effects of propofol or isoflurane general anesthesia in a canine model of ischemia/reperfusion.Using magnetic resonance (MR) techniques, we monitored both regional metabolism ((31)P MR spectroscopy) and systolic function of the heart ((1)H MR imaging) throughout a two-hour occlusion of the left anterior descending coronary artery and ten days of reperfusion. Twenty-two beagles were randomized into isoflurane and propofol general anesthesia groups (n = 10, n = 12 respectively). Contrast-enhanced MR imaging was used to measure infarct size (% of left ventricle that was necrotic) and coronary blood flow was determined using radioactively labelled microspheres.Cardiac metabolism, as monitored by intracellular pH and high-energy phosphate ratios, was not significantly different between the two groups throughout the protocol. Relative to propofol, isoflurane reduced the depression of left ventricular ejection fraction (EF) during the ischemic period [isoflurane 68.5% +/- 4.2%, propofol 58.3% +/- 2.0% of baseline (B); P = 0.04], propofol increased the recovery of EF at day three (isoflurane 63.9% +/- 4.3%, propofol 74.0% +/- 2.5% of B; P = 0.05). By day ten, EF in both groups was similar. Infarct sizes were also similar at day ten (isoflurane 15.7% +/- 3.0%, propofol 13.2% +/- 2.2%). Normalizing these by the region at risk (volume of tissue with low blood flow during the occlusion) to assess infarct ratios was also not significant (isoflurane 0.58% +/- 0.08%, propofol 0.54% +/- 0.07%).There were no significant differences between the two anesthetic groups at day ten, suggesting that any apparent dissimilarities in early cardiovascular effects were short-term only. These results indicate that isoflurane and propofol produce equivalent long-term cardiovascular effects following ischemia/reperfusion.

Mesenchymal Stem Cells (MSCs) are multipotent stromal cells known to migrate specifically to the sites of tumors and metastases, raising potential as tumor-targeted delivery vehicles for therapeutic agents. MSCs secrete exosomes containing genetic material including microRNAs (miRs), that are effectively taken up by cells. Previous work has shown miR-379 to be significantly reduced in breast tumor tissue, highlighting a potential tumor suppressor role. This study aimed to establish a mechanism of action for miR-379, and to engineer MSCs to secrete exosomes enriched with the miR for tumor-targeted delivery. Methods: RNA was isolated from breast tumors and matching lymph node metastases from the same patients, and miR-379 expression quantified by RQ-PCR. HCC1954 breast cancer cells were transduced with lentivirus to express elevated miR-379 (HCC-379) or a control sequence (HCC-NTC). Cells were implanted into the mammary fat pad (MFP) of mice and tumor progression monitored. Subsequently, MSCs were transduced to generate MSC-379 and MSC-NTC. MSC-secreted exosomes were isolated by differential centrifugation, microfiltration and ultracentrifugation. The morphology, size and number of isolated exosomes was characterized using Transmission Electron Microscopy, Western Blot and Nanoparticle Tracking Analysis respectively. Exosomal miRs were analysed by RQ-PCR. MFP tumors were established using HCC1954-luciferase cells, followed by IV injection of MSC-379 or MSC-NTC cells, or sequential doses of exosomes derived from either cell population. Results: miR-379 expression was significantly reduced in lymph node metastases compared to primary tumors from the same patients (p=0.009), supporting a tumor suppressor role. Analysis of HCC-379 and HCC-NTC tumor growth In Vivo showed no difference in tumor size, however an increase in tumour necrosis (5-50%) and decrease in lymph node invasion was observed in HCC-379 tumors. Investigation of a potential role for miR-379 in regulating COX-2, revealed an inverse relationship (r = -0.48, p=0.02) at a mRNA level, further confirmed at a protein level. MSC-379 cells showed no significant change in migratory or proliferative capacity In Vitro. MSC-secreted exosomes were confirmed to be the correct morphology and size (30-120nm), and to express the exosome-associated protein CD63. An increase in miR-379 (>5 fold) was observed in exosomes secreted by MSC-379 compared to MSC-NTC cells. Administration of MSC-379 or MSC-NTC cells, or exosomes derived from either cell population, was well tolerated In Vivo with no adverse effects observed. Monitoring tumor response to therapy using IVIS is ongoing. Conclusion: The data presented supports miR-379 as a potent tumor suppressor in breast cancer, mediated in part through regulation of COX-2. Engineering tumor-targeted MSCs to secrete exosomes enriched with miR-379 holds exciting potential as a novel therapy for breast cancer. Citation Format: Killian P. O'Brien, Katie Gilligan, Sonja Khan, Brian Moloney, Kerry Thompson, Pierce Lalor, Peter Dockery, Helen Ingoldsby, Michael J. Kerin, Roisin M. Dwyer. Engineering Mesenchymal Stem Cells (MSCs) to support tumor-targeted delivery of exosome-encapsulated microRNA-379 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3045. doi:10.1158/1538-7445.AM2017-3045

Introduction: Mesenchymal Stem Cells(MSCs) are multipotent stromal cells that are known to engraft into tumours, raising their potential as tumour-targeted delivery vehicles. MSCs secrete tiny vesicles known as exosomes, which contain genetic material including microRNAs, and are effectively taken up by recipient cells. This study aimed to characterise a tumour-suppressing microRNA, miR-379, and engineer MSCs to secrete exosomes enriched with the microRNA. Methods: The mechanism of action of miR-379 In Vivo was determined through lentivirus-mediated upregulation of miR-379 in breast tumours, and analysis of changes in tumour angiogenesis, proliferation and progression. Subsequently, MSCs were engineered with lenti-379 and any impact on MSC migration, proliferation and morphology was assessed. MSC-secreted exosomes were isolated and characterised using Transmission Electron Microscopy(TEM) and Western Blot. The exosomal microRNA content was analysed by RQ-PCR, and transfer between cell populations visualised using confocal microscopy. Results: While elevated miR-379 expression did not impact tumour size In Vivo, an increase in tumour necrosis and decrease in invasion was observed. MSCs were successfully transduced with miR-379, resulting in a distinct change in cell morphology. Despite this, MSC-379 cells maintained inherent tumour-targeted migratory capacity, with no impact on proliferation observed. MSC-379 derived exosomes were 30-120nm in size and expressed the exosome-associated protein CD63. A 5-fold increase in miR-379 was observed in engineered exosomes. Successful transfer of RFP-labelled MSC-derived exosomes to breast cancer cells was visualised using confocal microscopy. Conclusion: Engineering tumour-targeted MSCs to secrete exosomes enriched with miR-379 holds exciting potential as a novel therapy for breast cancer. Citation Format: O'Brien KP, Khan S, Thompson K, Joyce D, Lalor P, Dockery P, Ingoldsby H, Kerin MJ, Dwyer RM. Engineering mesenchymal stem cells(MSCs) to secrete tumour-suppressing exosomes for breast cancer therapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-04-01.

T-lymphocytes have been previously implicated in protecting dopaminergic neurons in the substantianigra from induced cell death. However, the role of T-cells in neurodegenerative models such as Parkinson's disease (PD) has not been fully elucidated. To examine the role of T-lymphocytes on motor behavior in the 6-hydroxydopamine (6-OHDA) unilateral striatal partial lesion PD rat model, we assessed progression of hemi-parkinsonian lesions in the substantia nigra, induced by 6-OHDA striatal injections, in athymic rats (RNU-/-, T-lymphocyte-deficient) as compared to RNU-/+ rats (phenotypically normal). Motor skills were determined by the cylinder and D-amphetamine sulfate-induced rotational behavioral tests. Cylinder behavioral test showed no significant difference between unilaterally lesioned RNU-/- and RNU-/+ rats. However both unilaterally lesioned RNU-/- and RNU-/+ rats favored the use of the limb ipsilateral to lesion. Additionally, amphetamine-induced rotational test revealed greater rotational asymmetry in RNU-/- rats compared to RNU-/+ rats at two- and six-week post-lesion. Quantitative immunohistochemistry confirmed loss of striatal TH-immunopositive fibers in RNU-/- and RNU-/+ rat, as well as blood-brain-barrier changes associated with PD that may influence passage of immune cells into the central nervous system in RNU-/- brains. Specifically, GFAP immunopositive cells were decreased, as were astrocytic end-feet (AQP4) contacting blood vessels (laminin) in the lesioned relative to contralateral striatum. Flow cytometric analysis in 6-OHDA lesioned RNU-/+rats revealed increased CD4+ and decreased CD8+ T cells specifically within lesioned brain. These results suggest that both major T cell subpopulations are significantly and reciprocally altered following 6-OHDA-lesioning, and that global T cell deficiency exacerbates motor behavioral defects in this rat model of PD.

We describe a model of self-sustaining status epilepticus (SSSE) induced by stimulation of the perforant path in free-running rats. In this model, seizures can be transiently suppressed by intrahippocampal injection of a blocker of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid/ kainate synapses but return in the absence of further stimulation when the drug ceases to act. However, seizures are irreversibly abolished by blockers of N-methyl-D-aspartate receptors given locally or systemically. SSSE is enhanced by substance P and its agonists and blocked by its antagonists. SSSE induces novel expression of substance P-like immunoreactivity in hippocampal principal cells. These changes and those in other limbic peptides may contribute to the maintenance of SSSE and to the modulation of hippocampal excitability during epileptic seizures. NMDA

We have engineered conditionally-immortalized mouse astrocytes to express beta-galactosidase or GAD(65) in a tetracycline-controlled fashion. The engineered cell lines, BASlinbetagal and BASlin65, divide at 33 degrees C but cease division at 39 degrees C. We carried out morphological and biochemical analyses to further understand GABA production and release, and to determine the suitability of these cells for transplantation. Using the BASlinbetagal cell line, we showed a dramatic regulation of beta-galactosidase expression by tetracycline. The BASlin65 cell line showed functional GAD(65) enzymatic activity and GABA production, both of which were suppressed by growth in the presence of tetracycline. When cultured in the absence of tetracycline, BASlin65 cells have a total GABA content equal to or greater than other GABA-ergic cell lines. Immunofluorescence microscopy revealed that GAD(65) had a distinct perinuclear localization and punctate staining pattern. GABA, on the other hand, showed diffuse staining throughout the cytoplasm. BASlin65 cells not only synthesize GABA, they also release it into the extracellular environment. Their ability to produce and release significant amounts of GABA in a tetracycline-regulated manner makes BASlin65 cells a useful cellular model for the study of GABA production and release. Furthermore, their non-tumorigenicity makes them excellent candidates for transplantation into specific regions of the brain to provide a localized and regulatable source of GABA to the local neuronal circuitry.

Although status epilepticus in children is associated with neuronal pathologies, there are few developmental models of status epilepticus which produce damage in the immature brain. We have developed a new model of status epilepticus using systemically injected pilocarpine in immature rabbits pretreated with lithium. Injected animals demonstrated behavioral and electrographic seizures. Behavioral seizures were characterized by sustained or recurrent bouts of clonus in all limbs. The pilocarpine-induced seizures had a 40% mortality. All animals surviving the status epilepticus had hippocampal lesions when evaluated 48 h after the SE. Within the hippocampus, CA1 pyramidal cells were the most vulnerable cell population. Extrahippocampal damage was seen in the majority of animals. Our results show that severe seizures cause hippocampal lesions in the absence of hypoxemia and suggest that the presumed resistance of the immature brain to seizure-induced damage is not a general rule which can be applied to all models or species. © 1997 Elsevier Science B.V. All rights reserved.

Rho GTPases are historically known to be central regulators of actin cytoskeleton reorganization. This affects many processes including cell migration. In addition, members of the Rac subfamily are known to be involved in reactive oxygen species (ROS) production through the regulation of NADPH oxidase (Nox) activity. This review focuses on relationships between Nox-regulated ROS, Rho GTPases, and cytoskeletal reorganization, in the context of cell migration.It has become clear that ROS participate in the regulation of certain Rho GTPase family members, thus mediating cytoskeletal reorganization.The role of the actin cytoskeleton in providing a scaffold for components of the Nox complex needs to be examined in the light of these new advances. During cell migration, Rho GTPases, ROS, and cytoskeletal organization appear to function as a complex regulatory network. However, more work is needed to fully elucidate the interactions between these factors and their potential in vivo importance.Ultrastructural analysis, that is, electron microscopy, particularly immunogold labeling, will enable direct visualization of subcellular compartments. This in conjunction with the analysis of tissues lacking specific Rho GTPases, and Nox components will facilitate a detailed examination of the interactions of these structures with the actin cytoskeleton. In combination with the analysis of ROS production, including its subcellular location, these data will contribute significantly to our understanding of this intricate network under physiological conditions. Based on this, in vivo and in vitro studies can then be combined to elucidate the signaling pathways involved and their targets.