Embedding changes in legislation for organ and tissue donation across England and Jersey

Cathy Miller, Louise Hubner (louise.hubner@nhsbt.nhs.uk), Sonya Paterson, Bobbee Cotter, Phil Walton, Helen Bentley, and Claire Roberts, of NHS Blood and Transplant.

Population-scale longitudinal mapping of COVID-19 symptoms, behaviour and testing

Despite the widespread implementation of public health measures, coronavirus disease 2019 (COVID-19) continues to spread in the United States. To facilitate an agile response to the pandemic, we developed How We Feel, a web and mobile application that collects longitudinal self-reported survey responses on health, behaviour and demographics. Here, we report results from over 500,000 users in the United States from 2 April 2020 to 12 May 2020. We show that self-reported surveys can be used to build predictive models to identify likely COVID-19-positive individuals. We find evidence among our users for asymptomatic or presymptomatic presentation; show a variety of exposure, occupational and demographic risk factors for COVID-19 beyond symptoms; reveal factors for which users have been SARS-CoV-2 PCR tested; and highlight the temporal dynamics of symptoms and self-isolation behaviour. These results highlight the utility of collecting a diverse set of symptomatic, demographic, exposure and behavioural self-reported data to fight the COVID-19 pandemic.

Population-scale Longitudinal Mapping of COVID-19 Symptoms, Behavior, and Testing Identifies Contributors to Continued Disease Spread in the United States

Despite social distancing and shelter-in-place policies, COVID-19 continues to spread in the United States. A lack of timely information about factors influencing COVID-19 spread and testing has hampered agile responses to the pandemic. We developed How We Feel, an extensible web and mobile application that aggregates self-reported survey responses, to fill gaps in the collection of COVID-19-related data. How We Feel collects longitudinal and geographically localized information on users' health, behavior, and demographics. Here we report results from over 500,000 users in the United States from April 2, 2020 to May 12, 2020. We show that self- reported surveys can be used to build predictive models of COVID-19 test results, which may aid in identification of likely COVID-19 positive individuals. We find evidence among our users for asymptomatic or presymptomatic presentation, as well as for household and community exposure, occupation, and demographics being strong risk factors for COVID-19. We further reveal factors for which users have been SARS-CoV-2 PCR tested, as well as the temporal dynamics of self- reported symptoms and self-isolation behavior in positive and negative users. These results highlight the utility of collecting a diverse set of symptomatic, demographic, and behavioral self- reported data to fight the COVID-19 pandemic.

IGH@ translocations are prevalent in teenagers and young adults with acute lymphoblastic leukemia and are associated with a poor outcome

PURPOSE

To determine the prevalence and prognostic association of immunoglobulin heavy chain (IGH@) translocations in acute lymphoblastic leukemia (ALL).

PATIENTS AND METHODS

The cohort comprised 3,269 patients treated on either the UKALL2003 trial for children and adolescents (1 to 24 years old) or the UKALLXII trial for adolescents and adults (15 to 59 years old). High-throughput fluorescent in situ hybridization was used to detect IGH@ translocations.

RESULTS

We identified IGH@ translocations in 5% of patients with ALL (159 of 3,269 patients), in patients with both B-cell (148 of 2,863 patients) and T-cell (11 of 408 patients) disease. Multiple partner genes were identified including CRLF2 (n = 35), five members of the CEPB gene family (n = 17), and ID4 (n = 11). The level of the IGH@-positive clone varied and indicated that some IGH@ translocations were primary events, whereas others were secondary aberrations often associated with other established aberrations. The age profile of patients with IGH@ translocations was distinctive, with a median age of 16 years and peak incidence of 11% among 20- to 24-year-old patients. Among patients with B-cell precursor ALL who were Philadelphia chromosome negative, those with an IGH@ translocation had an inferior overall survival compared with other patients (UKALL2003: hazard ratio, 2.37; 95% CI, 1.34 to 4.18; P = .003; UKALLXII: hazard ratio, 1.73; 95% CI, 1.22 to 2.47; P = .002). However, this adverse effect was not independent of age or minimal residual disease status and did not seem to be driven by an increased risk of relapse.

CONCLUSION

IGH@ translocations define a genetic feature that is frequent among adolescents and young adults with ALL. Although associated with an adverse outcome in adults, it is not an independent prognostic factor in children and adolescents.

A comparison of the police response to heterosexual versus same-sex intimate partner violence

It has been argued that the police do not respond to domestic calls involving same-sex couples in the same manner as they respond to calls involving heterosexual couples. A major problem facing researchers examining the police response to cases involving same-sex couples has been the lack of adequately sized samples. In this article, the authors utilize the 2000 National Incident Based Reporting System database, which contains 176,488 intimate partner assaults and intimidation incidents reported to 2,819 police departments in 19 states. The key issue examined is whether similar cases involving same-sex and heterosexual couples result in the same police response.

The need for change in nurse education: a literature review

The implementation of the Project 2000 diploma course in 1989 meant that nurse education was moving rapidly from an apprenticeship system of preparation to an education led system in which students have student status. There is nothing new in the idea of student status for nurse learners; it had been suggested over 40 years before it actually came to fruition. This paper critically analyses the literature and looks at the reasons for the need for change in nurse education. An examination is made of the reasons why this change was not implemented earlier. The Project 2000 proposals are then explored with the benefit of hindsight, and the conclusion is reached that there is need for ongoing research to evaluate the impact of the course not that it is the established method of preparation for nurse learners.

The organisation of health care in Nepal

The focus of this paper is to examine the organisation of health care in Nepal from the literature available. After setting the study in context and examining health care in general, a more in-depth, look is taken at Primary Health Care (PHC) and how this recent emphasis is affecting nurse education. This leads into an analysis of whether or not nurses are the most appropriate personnel to deliver PHC. The fundamental issues of improving adult female literacy rates and providing a clean water supply are suggested as means whereby Nepal's health provision could be greatly improved.

Expression of bone morphogenetic proteins in human prostatic adenocarcinoma and benign prostatic hyperplasia

There are important interactions between prostatic tumours and bone. This study was designed to examine whether prostatic tissue can express bone inductive factors, in particular, the Bone Morphogenetic Proteins (BMPs). The polymerase chain reaction (PCR) has been used to screen for the expression of BMPs one to six in the prostatic tissue of patients with benign prostatic hyperplasia (BPH), non-metastatic prostatic adenocarcinoma and metastatic prostatic adenocarcinoma. BMPs were expressed in both benign and malignant prostate tissue and in the prostate tumour cell lines, PC3 and DU145. BMPs were also expressed in ocular melanoma tissue, a tissue which rarely metastasizes to bone. BMP-6 expression was detected in the prostate tissue of over 50% of patients with clinically defined metastatic prostate adenocarcinoma, but was not detected in non-metastatic or benign prostate samples or in ocular melanoma tissue. These findings suggest that the BMPs may play a role in the osteoinductive activity of prostate metastases and that the pattern of expression of BMPs may be important in the pathogenesis of osteoblastic metastases associated with prostate adenocarcinoma.

Detection of mRNA for the transforming growth factor beta family in human articular chondrocytes by the polymerase chain reaction

The Transforming Growth Factor-beta (TGF beta) family of polypeptides elicits diverse biological actions on a wide range of cell types. There are known to be several isoforms of TGF beta coded for by different genes, with possibly differential expression and potencies. We have demonstrated that there is constitutive expression of three forms of transforming growth factor beta in adult human articular chondrocytes. The presence of 10% fetal calf serum in the culture medium may influence expression. The addition of transforming growth factor beta or interleukin 1 beta to the culture medium does not appear to consistently influence the expression of TGF beta by the cells.

Latent HSV-1 infection in mice immunized with a zwitterionic detergent-extracted HSV-1 antigen preparation

A HSV-1 antigen preparation obtained by zwitterionic detergent-extraction of HSV-1 infected Vero cells was investigated for its ability to protect mice against establishment of latent infection in the trigeminal ganglion following HSV-1 challenge by ear scarification. The antigen preparation was shown to induce antibody production and correlation between pre-challenge antibody level and establishment of latency was found. Although immunization did not reduce the overall incidence of ear erythema following challenge the duration of erythema was significantly decreased. Latency in the trigeminal ganglion was also significantly reduced in vaccinated mice and in addition, a correlation was found between the duration of erythema and latency, there being significantly more latent infections in mice with erythema of three or more days duration, than in those with erythema lasting less than three days.

Trypsin inhibitor activity in the field bean (Vicia faba L.)

In vitro evidence is presented for the presence of a heat‐labile inhibitor of trypsin in both cotyledon and testa of the field bean (Vicia faba L.). Inhibitor activity is destroyed by heating at 110°C for 40 min. The inhibitor has, in vitro, approximately one fifth of the strength of an extract of raw soyabeans.