The mouth,stomach and intestines

The gastrointestinal (GI) tract comprises a long tube with anatomical and functional specializations, beginning at the mouth and ending at the anus. The histology of the tract wall is relatively regular from the oesophagus to the large intestine and comprises mucosa, submucosa, muscularis and serosa layers. The tract functions primarily in digestion and absorption of nutrients, which begins in the mouth with the chewing and mixing of food with saliva. Small boluses of food are then swallowed during a complex reflex process and make their way through the oesophagus to the stomach, where they can be stored while further digestion takes place. Gastric contents are slowly emptied into the small intestine, where the majority of digestion and absorption occurs, before any undigested components are moved into the large intestine. The final absorption of water and electrolytes takes place here to produce a stool that only contains around 100–200 mL of water. The large intestine has a diverse bacterial population that contributes to digestion and can influence the health of an individual. Each component of the digestive tract has secretions that contribute to digestive function, as well as immunity and the excretion of waste.     

The development of a nanocrystalline apatite reinforced crosslinked hyaluronic acid–tyramine composite as an injectable bone cement

We have developed an injectable bone cement composed of nanocrystalline apatite and crosslinked hyaluronic acid–tyramine conjugates (HA–Tyr). This bone cement was formed via the oxidative coupling of tyramine moieties catalyzed by hydrogen peroxide (H₂O₂) and horseradish peroxidise (HRP). The bone cement set within 60 s after H₂O₂ and HRP were added to the apatite/HA–Tyr pastes. The mechanical strength of the apatite/HA–Tyr cement was tuned by varying the apatite loading and H₂O₂ concentration. This rapid enzyme-mediated setting of our bone cement results in minimal heat release (ΔH = ?11.39 J/g) as compared to conventional bone cements. The crystalline phase and crystallite size (20 nm) of the apatitic phase in our bone cement matched that of trabecular bone. The storage modulus (G′), yield stress (σ_y), and compressive stiffness (E_c) of our bone cement prepared with different apatite loadings and H₂O₂ concentrations were measured, and optimized at G′ = 40 MPa, σ_y = 0.308 MPa and E_c = 2.270 MPa when the cement was formed with 0.4 g/ml of apatite, 0.61 units/ml of HRP and 6.8 mm of H₂O₂. Our biocompatible bone cement also successfully healed small bone and joint defects in mice within 8 weeks.     

Searching for an immunogenetic factor that will illuminate susceptibility to non-tuberculous mycobacterial disease

The incidence of pulmonary non-tuberculous mycobacteria (NTM) disease in otherwise healthy adults is increasing as the population ages. The organisms are ubiquitous so susceptibility probably reflects a deficiency in a protective immune response. Here we investigate if singlenucleotide polymorphisms (SNP) affecting cytokines, chemokines and their receptors associate with pulmonary NTM disease. Samples from NTM patients (n = 79) and healthy controls (n = 188) were genotyped using TaqMan probes. Of the 16 SNPs assessed, IL28B-rs8099917^*TG (rs8099917; P = 0.01, OR = 2.2), TNFA-1031^*CC (rs1799964; p = 0.02, OR = 0.48) and IL10-1082^*AA (rs1800896; P = 0.001, OR = 0.33) were significantly associated with NTM disease. IL28B-rs8099917 and IL10-1082 have been associated with perturbations of the Th1/Th2 balance, whilst TNFA-1031^*CC associates with sensory neuropathy in HIV patients. IL10-1082 warrants further investigation because we observed high production of IL-10 in blood mononuclear cells from NTM patients.     

Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen being chronically enlarged and of a firm consistency. Where co-endemic, the two parasites are thought to synergistically exacerbate hepatosplenomegaly. Here, two potential health consequences, i.e. dilation of the portal vein (indicative of increased portal pressure) and stunting of growth, were investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with dilation. Dilation of the portal vein was exacerbated by S. mansoni infection in an intensity-dependent manner. The prevalence of growth stunting was not associated with either relative exposure rates to malarial infection or with S. mansoni infection status but was significantly associated with hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.     

Young people's perspectives on addressing UK health inequalities: utopian visions and preferences for action

Introduction

It is increasingly recognised by UK researchers and population health advocates that an important impetus to effective policy action to address health inequalities is activation of public dialogue about the social determinants of health and how inequalities might be addressed. The limited body of existing scholarship reaches varying conclusions on public preferences for responding to health inequalities but with consensus around the importance of tackling poverty. Young people's perspectives remain underexplored despite their increasingly visible role in activism across a range of policy issues and the potential impact of widening inequalities on their generation's health and wellbeing.

Methods

Six groups of young people (39 in total) from two UK cities (Glasgow and Leeds) were engaged in online workshops to explore views on health inequalities and potential solutions. Inspired by calls to employ notions of utopia, artist–facilitators and researchers supported participants to explore the evidence, debating solutions and imagining a more desirable society, using visual and performance art. Drawing together data from discussions and creative outputs, we analysed participants' perspectives on addressing health inequalities across four domains: governance, environment, society/culture and economy.

Findings

Proposals ranged from radical, whole-systems change to support for policies currently being considered by governments across the United Kingdom. The consensus was built around embracing more participatory, collaborative governance; prioritising sustainability and access to greenspace; promoting inclusivity and eliminating discrimination and improving the circumstances of those on the lowest incomes. Levels of acceptable income inequality, and how best to address income inequality were more contested. Individual-level interventions were rarely presented as viable options for addressing the social inequalities from which health differences emanate.

Conclusion

Young people contributed wide-ranging and visionary solutions to debates around addressing the enduring existence of health inequalities in the United Kingdom. Their reflections signal support for ‘upstream’ systemic change to achieve reductions in social inequalities and the health differences that flow from these.

Public Contribution

An advisory group of young people informed the development of project plans. Participants shaped the direction of the project in terms of substantive focus and were responsible for the generation of creative project outputs aimed at influencing policymakers.     

Ziprasidone suppresses olanzapine-induced increases in ingestive behaviour in the rat

Many atypical antipsychotic drugs, such as olanzapine, induce significant weight gain. However, ziprasidone produces minimal weight gain, the mechanism of which remains unclear. The aim of the present study was to investigate whether ziprasidone would reduce the acute effect of olanzapine on feeding behaviour. The results suggest that ziprasidone suppresses the significant increases in food intake produced by olanzapine, indicating that it has an intrinsic protective mechanism against drug-induced increases in food intake.     

'Combined vaccines are like a sudden onslaught to the body's immune system': parental concerns about vaccine 'overload' and 'immune-vulnerability'

The recent controversy surrounding the safety of the measles, mumps, and rubella vaccine (MMR) has heightened parents' concerns about the safety of vaccines, and led some to believe that giving vaccines in a combined form may 'overload' children's immune systems. However, to date no studies have been published examining how British parents conceptualise the notion of 'immune-overload' or how they relate this concept to their own children. Eighteen focus groups were conducted with parents between November 2002 and March 2003. The literature on vaccine decision-making suggests that parents base their immunisation decisions on two key risks: those posed by the diseases, and those associated with the vaccines aimed at preventing those diseases. Our study suggested that for some parents a third factor plays an important role, namely their assessment of the ability of their child's immune system to 'cope' with the challenge of combined vaccines, or to fight the disease. We conclude that although there is no scientific evidence that supports parents' fears about combined vaccines causing 'immune-overload', policy makers need to recognise these concerns if they are to successfully persuade parents that combined vaccines are safe.     

Emerging Prognostic and Predictive Biomarkers for Triple Negative Breast Cancer

Triple negative breast cancer (TNBC) is associated with a poor prognosis especially in the advanced setting and continues to pose a challenge for oncologists worldwide. Several biomarkers for this disease have been described. Recently the heterogeneity of TNBC has changed our perspective toward this disease. Differential response of TNBC to chemotherapy, poor prognosis of patients with residual disease following neoadjuvant chemotherapy, and the immunogenicity underlying TNBC make the management of this disease even more complex. Multiple signaling pathways and dynamic pathway programming are the hallmarks of TNBC. Newer trials for this disease therefore, need to be innovative and include biomarker enrichment and adaptive designs. This article highlights the emerging prognostic and predictive biomarkers for TNBC and discusses possible targets for future therapeutic strategies.     

The stigmatisation of abortion: a qualitative analysis of print media in Great Britain in 2010

The media play a significant part in shaping public perceptions of health issues, and abortion attracts continued media interest. Detailed examination of media constructions of abortion may help to identify emerging public discourse. Qualitative content analysis was used to examine if and how the print media in contributes to the stigmatisation of abortion. Articles from seven British and five Scottish national newspapers from 2010 were analysed for overall framings of abortion and emergent themes, including potentially stigmatising discursive constructs and language. Abortion was found to be presented using predominantly negative language and discursive associations as ‘risky’, and in association with other ‘discredited’ social practices. Key perspectives were found to be absent or marginalised, including those of women who have sought abortion. Few articles framed abortion as a positive and legitimate choice. Negative media representations of abortion contribute to the stigmatisation of the procedure and of women who have it, and reflect a discrediting of women's reproductive decision-making. There is a need to challenge the notion that abortion stigma is inevitable, and to encourage positive framings of abortion in the media and other public discourse.