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There is currently an unmet need for the supply of autologous, patient-specific stem cells for regenerative therapies in the clinic. Mesenchymal stem cell differentiation can be driven by the material/cell interface suggesting a unique strategy to manipulate stem cells in the absence of complex soluble chemistries or cellular reprogramming. However, so far the derivation and identification of surfaces that allow retention of multipotency of this key regenerative cell type have remained elusive. Adult stem cells spontaneously differentiate in culture, resulting in a rapid diminution of the multipotent cell population and their regenerative capacity. Here we identify a nanostructured surface that retains stem-cell phenotype and maintains stem-cell growth over eight weeks. Furthermore, the study implicates a role for small RNAs in repressing key cell signalling and metabolomic pathways, demonstrating the potential of surfaces as non-invasive tools with which to address the stem cell niche. On standard tissue culture platforms, mesenchymal stem cells tend to spontaneously differentiate with the loss of multi-lineage potential. Now, a robust and reproducible nanotopographical platform has been shown to maintain stem cell phenotype and promote stem cell growth over several months whilst implicating mechanisms for the observed stem cell behaviour

Alzheimer’s disease (AD) is the most prevalent form of dementia. Despite decades of research following several theoretical and clinical lines, all existing treatments for the disorder are purely symptomatic. AD research has traditionally been focused on neuronal and glial dysfunction. Although there is a wealth of evidence pointing to a significant vascular component in the disease, this angle has been relatively poorly explored. In this review, we consider the various aspects of vascular dysfunction in AD, which has a significant impact on brain metabolism and homeostasis and the clearance of β-amyloid and other toxic metabolites. This may potentially precede the onset of the hallmark pathophysiological and cognitive symptoms of the disease. Pathological changes in vessel haemodynamics, angiogenesis, vascular cell function, vascular coverage, blood-brain barrier permeability and immune cell migration may be related to amyloid toxicity, oxidative stress and apolipoprotein E (APOE) genotype. These vascular deficits may in turn contribute to parenchymal amyloid deposition, neurotoxicity, glial activation and metabolic dysfunction in multiple cell types. A vicious feedback cycle ensues, with progressively worsening neuronal and vascular pathology through the course of the disease. Thus, a better appreciation for the importance of vascular dysfunction in AD may open new avenues for research and therapy.

Little is known about pediatric caregivers' perceptions of religious or spiritual (R/S) care provided by physicians. We conducted a qualitative, semistructured interview study to understand perceptions of pediatric caregivers toward physician-led R/S care. Participants were 20 primary caregivers whose children were hospitalized and receiving palliative care services. Interviews were audio recorded, transcribed verbatim, and analyzed using constant comparative methods. Three recurrent themes emerged regarding physician-led R/S care: (1) Most caregivers view providing R/S care as a positive sign of physician empathy, while a minority (3/20) prefer to keep R/S and medical care separate, (2) many caregivers prefer R/S care from a physician with whom they have a close relationship and/or share a faith background, and (3) physicians should open the door, but allow families to lead conversations about R/S care. Caregivers have mixed perceptions on physicians engaging in R/S care; most prefer that families set the direction of R/S care for themselves and their loved ones. Physicians should be trained to evaluate families' spiritual backgrounds and needs in ways that respectfully open the door to these conversations.

As the military and intelligence communities re-tool for the 21st century, the long and contentious debate about the role of social scientists in national security environments is dividing the disciplines with renewed passion. Yet, research shows that most scholars have a weak understanding of what today's security institutions actually are and what working in them entails. This book provides an essential new foundation for the debate, with fine-grained accounts of the complex and varied work of cultural, physical, and linguistic anthropologists and archaeologists doing security-related work in governmental and military organizations, the private sector, and NGOs. In candid and provocative dialogues, leading anthropologists interrogate the dilemmas of ethics in practice and professional identity. Anthropologists in the SecurityScape is essential reading for anyone who wishes to understand or influence the relationship between anthropology and security in the twenty-first century.

Titanium (Ti) is used as a load-bearing material in the production of orthopedic devices. The clinical efficacy of these implants could be greatly enhanced by the addition of nanofeatures that would improve the bioactivity of the implants, in order to promote osteo-induction and -conduction of the patient s stem and osteoprogenitor cells, and to enhance osseointegration between the implant and the surrounding bone. Nanofeaturing of Ti is also currently being applied as a tool for the biofunctionalization of commercially available dental implants. In this review, we discuss the different nanofabrication strategies that are available to generate nanofeatures in Ti and the cellular response to the resulting nanofeatures. research, studies and clinical trials are considered, and we conclude with a perspective about the future potential for use of nanotopographical features in a therapeutic setting.

Biological metaphors abound in computational modeling and simulation, inspiring creative and novel approaches to conceptualizing, representing, simulating and analyzing a wide range of phenomena. Proponents of this research suggest that biologically-inspired informatics have practical national security importance, because they represent a new way to analyze sociopolitical dynamics and trends, from terrorist recruitment to cyber warfare. However, translating innovative basic research into useful, usable, adoptable, and trustworthy tools that benefit the daily work of national security experts is challenging. Drawing on several years’ worth of ethnographic fieldwork among national security experts, this paper suggests that information ecology, activity theory, and participatory modeling provide theoretical frameworks and practical suggestions to support design and development of useful, usable, and adoptable modeling and simulation approaches for complex national security challenges.

The American Association of Critical-Care Nurses (AACN) developed a business plan that delineated the need to support development of two three-hour, self-paced simulation e-learning products utilizing new technology to not only build knowledge, but also provide an experience that changes behaviors. The first course, modeled after a train-the-trainer format, uses real-life scenarios and focuses the educational activity to build skill and provide experiences in precepting. The second course utilizes an integrated approach to present to the learner palliative and end-of-life care examples through real-life simulation experiences using video scenarios. Here, McNamara discusses AACN's e-learning programs that build confidence and skills by using technology to provide nurses with real-life scenarios.

AimsThis project was undertaken in the Tyrone and Fermanagh Hospital, an inpatient Psychiatric Unit in Omagh, Northern Ireland. It was recognised that the previous method of medical handover via anonymised WhatsApp messages had several issues including patient data on personal phones, over-reliance on phone apps which have the potential to crash and short messages with limited details were included. The aim of our project was to improve patient safety by improving communication between medical staff members.MethodsThe previous method of medical handover was via text message on messaging platform WhatsApp. A message was sent the morning of handover, to the WhatsApp group.We continued to use a digital platform, but used Microsoft word, and Western Trust email addresses to record and send the handover. At the start of this project, we allowed free space recording, resulting in variation in the handovers.We agreed a minimum number of details to be included to ensure quality of handover, and audited the word documents, to assess the adherence to this.This change, still does not require face to face handover. There have been pros and cons to the change, which will be discussed in this presentation.We reviewed four months’ worth of handovers. They were reviewed for specific elements of essential handover criteria. The areas included Patient Name, H&C, detained or voluntary, admission or review, presenting complaint, patient's history, risks, physical issues, and handover to specific person.It should be noted that the doctors involved were aware of the changes made, and standards being introduced, and therefore were aware that they would be auditing their own handovers. This might have created bias in the subsequent handovers.We then analysed each month to see what percentage of handovers had been concordant with the standards. These data were then represented in graphs, as we will show.ResultsWe identified areas which were performed well when completing handover. The areas which were consistently 100% included the date of handover and patient name or initials. Outstanding jobs were performed in 97.5% of handovers.Areas for improvement identified when collecting results were the status of admission (i.e. voluntary or detained), the main patient risks and use of the document password.100% of the shifts used the new digitalised format for handover using Microsoft word and trust email system.ConclusionWe reviewed the results of the data, which highlighted areas for improvementWe hope to implement a standard performa for handovers, reducing the chance of key information being missed, thereby improving patient safety. We aim to collect data following this 2nd intervention in the next rotation and continue to examine handover processes using PDSA cycles.

McNamara responds to a comment by Houtman regarding social scientists involvement with government agencies. She asserts that such involvement does not automatically imply ethical laxity or blind acceptance of the political status quo.