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To determine the rate of hospital admissions for infection after transperineal biopsy of prostate (TPB) with single-dose cephazolin prophylaxis using a prospective database. Between April 2013 and February 2016, 577 patients undergoing TPB had 2 g of cephazolin given intravenously at induction of anaesthesia. Data collected from these patients included age, PSA, prostate volume, number of cores taken and post-operative complications. No patients were readmitted to hospital with infection post-TPB. Seven patients developed acute urinary retention, and one patient developed clinical prostatitis that was treated with oral antibiotics in the community. It is safe to use single-dose cephazolin only as antibiotic prophylaxis prior to TPB, negating the need for quinolones. This study supports Australia’s current Therapeutic Guidelines recommendation for TPB prophylaxis and the existing evidence that sepsis post-TPB is a rare complication. Whether any antibiotic prophylaxis is needed at all for TPB is the subject of a future study.

The internalization of nanoparticles into cells is critical for effective nanoparticle mediated drug delivery. To investigate the kinetics and mechanism of internalization of nanoparticles into cells we have developed a DNA molecular sensor, termed the Specific Hybridization Internalization Probe - SHIP. Self-assembling polymeric ‘pHlexi’ nanoparticles were functionalized with a Fluorescent Internalization Probe (FIP) and the interactions with two different cell lines (3T3 and CEM cells) were studied. The kinetics of internalization were quantified and chemical inhibitors that inhibited energy dependent endocytosis (sodium azide), dynamin dependent endocytosis (Dyngo-4a) and macropinocytosis (5-(N-ethyl-N-isopropyl) amiloride (EIPA)) were used to study the mechanism of internalization. Nanoparticle internalization kinetics were significantly faster in 3T3 cells than CEM cells. We have shown that ~90% of the nanoparticles associated with 3T3 cells were internalized, compared to only 20% of the nanoparticles associated with CEM cells. Nanoparticle uptake was via a dynamin-dependent pathway, and the nanoparticles were trafficked to lysosomal compartments once internalized. SHIP is able to distinguish between nanoparticles that are associated on the outer cell membrane from nanoparticles that are internalized. This study demonstrates the assay can be used to probe the kinetics of nanoparticle internalization and the mechanisms by which the nanoparticles are taken up by cells. This information is fundamental for engineering more effective nanoparticle delivery systems. The SHIP assay is a simple and a high-throughput technique that could have wide application in therapeutic delivery research.

This paper gives an account of three training workshops using dramatherapy techniques and subsequent conversations with participants on the phenomenon of shame. It gives an overview of shame from a psychological, socio-cultural, psychotherapeutic and dramatherapeutic perspective before giving a reflective account of the workshop experience. Although not intended to be a piece of formal research, our journey was rooted in a phenomenological enquiry: exploring the group's subjective experience and the meaning we create from this. The authors premise is that shame is experienced when early relationships are disrupted and become mis-attuned and that dramatherapy has a unique role to play in the exploration and recovery from the shame-based experience.

Facial flushing in rosacea is often induced by trigger events. However, trigger causation mechanisms are currently unclear. This study tested the central hypothesis that rosacea causes sympathetic and axon reflex-mediated alterations resulting in trigger-induced symptomatology. Twenty rosacea patients and age/sex-matched controls participated in one or a combination of symptom triggering stressors. In protocol 1, forehead skin sympathetic nerve activity (SSNA; supraorbital microneurography) was measured during sympathoexcitatory mental (2-min serial subtraction of novel numbers) and physical (2-min isometric handgrip) stress. In protocol 2, forehead skin blood flow (laser-Doppler flowmetry) and transepithelial water loss/sweat rate (capacitance hygrometry) were measured during sympathoexcitatory heat stress (whole body heating by perfusing 50°C water through a tube-lined suit). In protocol 3, cheek, forehead, forearm, and palm skin blood flow were measured during nonpainful local heating to induce axon reflex vasodilation. Heart rate (HR) and mean arterial pressure (MAP) were recorded via finger photoplethysmography to calculate cutaneous vascular conductance (CVC; flux·100/MAP). Higher patient transepithelial water loss was observed (rosacea 0.20 ± 0.02 vs. control 0.10 ± 0.01 mg·cm−2·min−1, P < 0.05). HR and MAP changes were not different between groups during sympathoexcitatory stressors or local heating. SSNA during early mental (32 ± 9 and 9 ± 4% increase) and physical (25 ± 4 and 5 ± 1% increase, rosacea and controls, respectively) stress was augmented in rosacea (both P < 0.05). Heat stress induced more rapid sweating and cutaneous vasodilation onset in rosacea compared with controls. No axon reflex vasodilation differences were observed between groups. These data indicate that rosacea affects SSNA and that hyperresponsiveness to trigger events appears to have a sympathetic component.

This study reports a novel nanoparticle system with simple and modular one-step assembly, which can respond intelligently to biologically relevant variations in pH. Importantly, these particles also show the ability to induce escape from the endosomal/lysosomal compartments of the cell, which is integral to the design of efficient polymeric delivery systems. The nanoparticles were formed by the nanoprecipitation of pH-responsive poly(2-(diethylamino)ethyl methacrylate) (PDEAEMA) and poly(2-(diethylamino)ethyl methacrylate)-b-poly(ethylene glycol) (PDEAEMA-b-PEG). Rhodamine B octadecyl ester perchlorate was successfully encapsulated within the hydrophobic core of the nanoparticle upon nanoprecipitation into PBS at pH 8. These particles disassembled when the pH was reduced below 6.8 at 37 °C. Cellular experiments showed the successful uptake of the nanoparticles into the endosomal/lysosomal compartments of 3T3 fibroblast cells. The ability to induce escape from the endosomes was demonstrated by the use of calcein, a membrane-impermeable fluorophore. The modular nature of these particles combined with promising endosomal escape capabilities make these dual component PDEAEMA nanoparticles useful for drug and gene delivery applications.

Myocardial infarction (MI) induces cardiac remodeling. This may increase the susceptibility of the infarcted heart to subsequent ischemic events. While chronic angiotensin II blockade is cardioprotective post-MI, the acute effects of angiotensin II in ischemia-reperfusion injury (IR) remains unclear. In the present study, we tested whether angiotensin II administration altered recovery of left ventricular (LV) function to IR in hearts from sham and MI rats. Echocardiography, LV pressure-volume relationships, and IR performance were established in subsets of sham ( N = 27) and MI hearts ( N = 41). IR was conducted in red-cell-perfused Langendorff hearts (60 minutes of low-flow ischemia; 30 minutes of reperfusion) during vehicle or angiotensin II infusions (10 −7 M). MI hearts were dilated and had reduced fractional shortening and blunted systolic elastance ( p < 0.05). Despite systolic dysfunction in MI, functional recovery to IR was similar to sham. Angiotensin II significantly worsened IR performance in sham ( p < 0.05), but not MI. The effect of angiotensin II on in vitro cardiomyocyte survival under various pH conditions was also tested. Acidosis increased cardiomyocyte death and angiotensin II potentiated this effect. We conclude that IR performance is similar between sham and MI hearts and that MI hearts are resistant to angiotensin II-induced cardiac dysfunction in response to IR.

Warm-up of 267 competitors at British Dressage affiliated competitions was observed, including competitors at novice (N) (n = 104), medium (M) (n = 65), Prix St Georges (PSG) (n = 60) and Grand Prix (GP) (n = 38) levels. Competitions were classified as local (n = 103), regional (n = 57) and national championship (n = 107) events. Overall, the mean warm-up duration for competitors at dressage competitions was 29 min 53 s. Total warm-up duration was 25 min 23 s ± 10 min 2 s (mean ± SD) at N level; 31 min 32 s ± 11 min 32 s at M level; 32 min 53 s ± 11 min 19 s at PSG and 34 min 34 s ± 10 min 10 s at GP. Mean proportion of walk, trot and canter at each level was N: walk = 39.26%, trot = 40.31%, canter = 20.43%; M: walk = 43.77%, trot = 32.54%, canter = 23.69%; PSG: walk = 38.53%, trot = 31.03%, canter = 30.43% and GP: walk = 38.79%, trot = 33.26%, canter = 27.95%. There was no effect of rider experience, but level and type of competition affected the proportion of time spent in different paces and total time of warm-up, which was increased at higher levels and championships. Increased warm-up time and specific warm-up design were positively associated with final score at novice and Prix St Georges levels.

The engagement of UK local authorities is vital if national government is to meet its\ud climate change commitments. However, with no mandatory targets at local government\ud level, other drivers must explain engagement. Using a Geographic Information System,\ud this study compares the spatial distribution of action on climate change based on past\ud actions and stated intentions to a suite of relevant independent variables. The Action\ud Index created is among the first to quantify climate change engagement beyond a simple\ud binary measure and provides a useful comparative study to recent work in the US. The\ud Index enables investigation of both mitigation and adaptation, which show different\ud trends in relation to some variables. The study shows that action is strongest where the\ud voting habits of the local population suggest environmental concern and where\ud neighbouring local authorities are also engaging in action on climate change. Physical\ud vulnerability to the effects of climate change is a motivator for action only where the\ud dangers are obvious. Action is less likely where other resource intensive issues such as\ud crime and housing exist within a local authority area.

(1996). METAPHOR, SYMBOL AND THE HEALING PROCESS IN DRAMATHERAPY. Dramatherapy: Vol. 18, No. 2, pp. 2-5.

Background and Purpose— The Clot Lysis: Evaluating Accelerated Resolution of IVH (CLEAR IVH) program is assessing the efficacy of intraventricular recombinant tissue-type plasminogen activator (rtPA) for spontaneous intraventricular hemorrhage (IVH). This subanalysis assesses the effect of dose of rtPA by region on clearance of IVH. Methods— Sixty-four patients within 12 to 24 hours of spontaneous IVH were randomized to placebo or 0.3 mg, 1 mg, or 3 mg of rtPA twice daily through an extraventricular drain. Twelve subregions of the ventricles were scored from 0 to 4. Effect of dose on IVH clearance to 50% of baseline score was compared by survival analysis for all regions combined and by subregion. Models including ventricular region, dose, and baseline score were compared by Cox proportional hazards. Results— IVH score reduced faster across all regions with increasing rtPA dose (clearance to 50%: log-rank P P P =0.005). Conclusions— rtPA accelerates resolution of IVH. This effect is dose-dependent, is greatest in the midline ventricles, and least in the posterolateral ventricles. Clinical Trial Registration— URL: www.clinicaltrials.gov . Unique identifier: NCT00650858.