Tailoring immunisation service delivery in a disadvantaged community in Australia; views of health providers and parents

Publication date: Available online 6 April 2018
Source:Vaccine
Author(s): Susan Thomas, Patrick Cashman, Fakhrul Islam, Loretta Baker, Katrina Clark, Julie Leask, Robb Butler, David N. Durrheim
In 2014 the Australian immunisation target was raised from 90% to 95% of children to be fully immunised. A national priority is to identify geographic areas of low coverage and implement strategies to improve immunisation rates. Using The World Health Organization's Tailoring Immunization Programmes (TIP) Guidelines, the aim of this study was to identify areas of low immunisation coverage for children in the Hunter New England Local Health District, New South Wales, and to gain a deeper understanding of the factors influencing immunisation in those areas in order to develop tailored strategies for increasing immunisation coverage. Data from the Australian Immunisation Register was used to identify geographic areas of low coverage. Data from interviews and focus groups with parents and service providers were used to gain a deeper understanding of the factors influencing immunisation in those areas. The regional city of Maitland in New South Wales was identified as having a persistently high number and relatively high proportion of children not fully immunised (n = 427, 15.4% in 2016). Themes from 59 stakeholder interviews and focus groups included; (i) limited engagement with health services unless the need is urgent, (ii) multi-dimensional access barriers to immunisation services in Maitland, (iii) a flexible, supportive family centred, primary health care approach, utilising strong partnerships, is most likely to be effective in increasing childhood immunisation rates in Maitland, (iv) data can be used more effectively to inform service providers about trends and individual children not fully immunised. TIP guidelines proved useful for identifying areas of low coverage and providing an understanding of determining factors and the strategies most likely to be effective. Understanding the complex problems many parents face and the access barriers that contribute to low immunisation coverage is essential in developing appropriate solutions. Finding ways to support parents and remove those barriers can contribute to higher coverage. In Maitland, targeted outreach and home visiting has been implemented in consultation with community and health service representatives to ensure that the children from socially disadvantaged populations identified do not miss out on vaccination.



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Contrast-Enhanced Ultrasound-Guided Fine-Needle Aspiration for Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer

Publication date: Available online 6 April 2018
Source:Ultrasound in Medicine & Biology
Author(s): Jieyu Zhong, De-sheng Sun, Wei Wei, Xiaoling Liu, Jun Liu, Xiaoqin Wu, Yusen Zhang, Haiyu Luo, Yongbin Li
The purpose of this study was to assess whether translymphatic contrast-enhanced ultrasound (CEUS) combined with fine-needle aspiration (FNA) can be used pre-operatively to assess the status of axillary lymph nodes in early-stage breast cancer patients. Furthermore, we wanted to determine whether this less invasive method could potentially be a pre-operative surgical strategy. One hundred sixty-four sentinel lymph nodes (SLNs) were detected by CEUS after intradermal injection of microbubbles in 126 cases. One hundred twenty of 126 cases (95.24%) were accurately diagnosed with the SLN-FNA method. All 6 false-negative cases were due to micrometastasis or macrometastasis. There were no false-positive results after CEUS-guided FNA biopsy based on post-operative histopathological results. In conclusion, translymphatic CEUS combined with SLN-FNA is a less traumatic approach that has high accuracy in the pre-operative evaluation of axillary lymph node status. It might have the potential to be as reliable an indicator for axillary lymph node dissection as SLN biopsy.



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Fabrication of Blue-Fluorescent Nanodiamonds Modified with Alkyl Isocyanate for Cellular Bioimaging

Publication date: Available online 5 April 2018
Source:Colloids and Surfaces B: Biointerfaces
Author(s): Rae-Hyung Kang, Seung Woon Baek, Tae-Kyung Ryu, Sung-Wook Choi
This paper describes the fabrication of water-dispersible nanodiamond (ND) clusters with blue fluorescence for cellular bioimaging. Poly(ethylene glycol) carboxyl methyl acid (mPEG-COOH) and alkyl isocyanates with different chain lengths were conjugated onto the surface of the ND clusters for water dispersibility and fluorescence via carbodiimide chemistry. The relative fluorescence intensity was increased with the increases in the chain length of alkyl isocyanate and also their conjugated concentration. The ND clusters (average size of 37.6 nm and zeta potential of 26.6 mV) with mPEG-COOH and octadecyl isocyanate (ODI) emitted relatively higher blue fluorescence intensity under excitation at 350 nm as well as favorable water dispersibility. After cellular uptake of the ND clusters, blue fluorescence inside the cells was confirmed by confocal laser scanning microscopy. The ND clusters conjugated with mPEG-COOH and ODI can potentially be used for cellular bioimaging.

Graphical abstract

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Facile Synthesis of the Nitrogen-Doped Graphene Quantum Dots at Low Temperature for Cellular Labeling

Publication date: Available online 5 April 2018
Source:Materials Research Bulletin
Author(s): Yuqian Pang, Hui Gao, Luhao Lai, Xiaolong Li
A facile one-step approach is developed for the large-scale synthesis of nitrogen doped graphene quantum dot (N-GQDs) at low temperature by using citric acid (CA) as the precursor. The emission wavelength of the N-GQDs is nearly excitation-dependent, which may mirror the effects from particles of different sizes and distribution of different emissive sites on nanoparticles. Moreover, the products are then tested with live Hela cells for the extraordinary biocompatibility. The cellular viability is remained to be 100% even after a 48 h exposure with the high N-GQDs concentration of 200 µg mL^-1 and this survival rate is really much higher than that have been reported previously. The as-prepared N-GQDs with negligible inherent toxicity exhibit excellent biological applications such as bio-imaging and cell tracking.

Graphical abstract

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Removing own-limb visual input using mixed reality (MR) produces a “telescoping” illusion in healthy individuals

Publication date: 16 July 2018
Source:Behavioural Brain Research, Volume 347
Author(s): Mikkel Thøgersen, John Hansen, Lars Arendt-Nielsen, Herta Flor, Laura Petrini
The purpose of the present study was to assess changes in body perception when visual feedback was removed from the hand and arm with the purpose of resembling the visual deprivation arising from amputation. The illusion was created by removing the visual feedback from the participants' own left forearm using a mixed reality (MR) and green screen environment.Thirty healthy persons (15 female) participated in the study. Each subject experienced two MR conditions, one with and one without visual feedback from the left hand, and a baseline condition with normal vision of the limb (no MR). Body perception was assessed using proprioceptive drift, questionnaires on body perception, and thermal sensitivity measures (cold, warm, heat pain and cold pain detection thresholds). The proprioceptive drift showed a significant shift of the tip of the index finger (p<0.001) towards the elbow in the illusion condition (mean drift: −3.71 cm). Self-report showed a significant decrease in ownership (p<0.001), shift in perceptual distortions, (e.g. "It feels as if my lower arm has become shorter") (p=0.025), and changes in sensations of the hand (tingling, tickling) (p=0.025). A significant decrease was also observed in cold detection threshold (p<0.001), i.e. the detection threshold was cooler than for the control conditions.The proprioceptive drift together with the self-reported questionnaire showed that the participants felt a proximal retraction of their limb, resembling the telescoping experienced by phantom limb patients. The study highlights the influence of missing visual feedback and its possible contribution to phantom limb phenomena.



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The p75 neurotrophin receptor might mediate sepsis-induced synaptic and cognitive impairments

Publication date: 16 July 2018
Source:Behavioural Brain Research, Volume 347
Author(s): Muhuo Ji, Hongmei Yuan, Shanwu Yuan, Jiangyan Xia, Jianjun Yang
Systemic inflammation induces cognitive impairment, yet the mechanism involved in this process is unclear. Neurotrophin receptor p75 (p75^NTR) signaling is a key pathological factor contributing to neurobehavioral abnormalities in many neurodegenerative diseases. However, the role of p75^NTR signaling in the regulation of sepsis-induced cognitive impairment remains largely to be elucidated. In this study, systemic inflammation was induced by cecal ligation and puncture (CLP). Neurobehavioral performances were evaluated by open field, novel object recognition, and fear conditioning tests. The expressions of proinflammatory cytokines (tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), IL-6, IL-10), apoptosis marker cleaved caspase-3, ionized calcium binding adaptor molecule 1 (IBA1), proBDNF, p75^NTR, c-Jun N-terminal kinase (JNK), and pJNK in the hippocampus were determined by enzyme-linked immunosorbent assay, western blot analysis, and immunofluorescence. The synaptic marker in the CA1 region of the hippocampus was assessed by Golgi staining. In the present study, we showed that systemic inflammation induced cognitive impairment, which was accompanied by increased expressions of hippocampcal proBDNF and p75^NTR. Of note, we found that LM11A-31, an orally available, blood-brain barrier-permeant small-molecule p75^NTR signaling modulator significantly reversed the sepsis-induced cognitive impairment and restored most of the abnormal biochemical parameters. Taken together, our study suggests that proBDNF/p75^NTR signaling pathway might play a key role in the development of sepsis-induced cognitive impairment, whereas specific p75^NTR inhibitor may provide a novel therapeutic approach for this disorder and possible other neurodegenerative diseases.



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Behavioral and psychological symptoms of dementia (BPSD) and impaired cognition reflect unsuccessful neuronal compensation in the pre-plaque stage and serve as early markers for Alzheimer’s disease in the APP23 mouse model

Publication date: 16 July 2018
Source:Behavioural Brain Research, Volume 347
Author(s): Anna Pfeffer, Tonia Munder, Stefanie Schreyer, Charlotte Klein, Justyna Rasińska, York Winter, Barbara Steiner
Recent research on Alzheimer's disease (AD) focuses on processes prior to amyloid-beta plaque deposition accounting for the progress of the disease. However, early mechanisms of AD are still poorly understood and predictors of the disease in the pre-plaque stage essential for initiating an early therapy are lacking. Behavioral and psychological symptoms of dementia (BPSD) and potentially impaired cognition may serve as predictors and early clinical diagnostic markers for AD. To investigate potential BPSD and cognitive impairments in association with neuronal cell development as such markers for AD in the pre-plaque stage, female APP23 mice at eight, 19 and 31 weeks of age and corresponding control animals were tested for BPSD (elevated zero maze; sucrose preference test), motor coordination (rotarod), spatial memory and reversal learning (Morris water maze) and hippocampal neurogenesis as a neuronal correlate for hippocampus-dependent behavior. To evaluate a potential therapeutic effect of physical, cognitive and social stimulation, animals were exposed to environmental enrichment (EE) for one, twelve or 24 weeks from five weeks of age. In APP23, decreased anxiety accompanied increased agitation from eight weeks of age. Impairment of spatial memory and learning flexibility prior to plaque deposition involved an insufficient use of spatial search strategies associated with an unsuccessful compensatory increase of neurogenesis. EE had an overall beneficial effect on behavior and neurogenesis and thus constitutes a therapeutic tool to slow disease progression. BPSD, cognition and associated impaired neurogenesis complement clinical diagnostic markers for pre-plaque AD and contribute to an early detection essential to halt disease progression.



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