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We aimed to determine the clinical effect of dietary supplementation with low dose omega-3-polyunsaturated fatty acids on disease activity and endothelial function in patients with systemic lupus erythematosus. A 24 week randomised double-blind placebo-controlled parallel trial of the effect of 3g of omega-3-polyunsaturated fatty acids on 60 patients with SLE was performed. Serial measurements of disease activity using the revised Systemic Lupus Activity Measure (SLAM-R) and British Isles Lupus Assessment Group index of disease activity for SLE (BILAG), endothelial function using flow mediated dilation of the brachial artery (FMD), oxidative stress using platelet 8-isoprostanes and analysis of platelet membrane fatty acids were taken at baseline, 12 and 24 weeks. In the fish oil group there was a significant improvement at 24 weeks in SLAM-R (from 9.4±3.0 to 6.3±2.5, p<0.001); in BILAG (from 13.6±6.0 to 6.7±3.8, p<0.001); in FMD (from 3.0% (-0.5-8.2) to 8.9% (1.3-16.9), p<0.001) and in platelet 8-isoprostanes (from 177pg/mg protein (23 - 387) to 90 pg/mg protein (32 - 182), p = 0.007). Low dose dietary supplementation with omega-3 fish oils in SLE not only has a therapeutic effect on disease activity but also improves endothelial function and reduces oxidative stress and may therefore confer cardiovascular benefits. [ABSTRACT FROM AUTHOR]

Aims: Delafloxacin is a fluoroquinolone antibiotic recently approved by the FDA for treatment of acute bacterial skin and skin structure infections (ABSSSI). Delafloxacin was assessed for phototoxicity potential compared with a known phototoxic fluoroquinolone. Methods: A Phase 1, investigator-blind, placebo/active-controlled, randomized, parallel-group study was conducted in 52 healthy male and female volunteers who received 200 or 400 mg of oral delafloxacin, 400 mg oral lomefloxacin or placebo once daily for 6 days. This study evaluated the photosensitizing potential and possible wavelength dependency of delafloxacin by comparing the response of the skin to ultraviolet A (UVA), ultraviolet B (UVB) and visible radiation prior to and during administration of delafloxacin, lomefloxacin as a positive control, or placebo. Adverse events were monitored throughout the study. Results: Forty-seven subjects completed six days of dosing, and no evidence of phototoxicity was seen with delafloxacin. Delafloxacin at 200 and 400 mg day−1 and placebo did not demonstrate differences in percent change from baseline in minimal erythema dose at all tested wavelengths (295–430 nm) by monochromator and solar simulator. Lomefloxacin, the positive control, had statistically significant differences (p ＜ 0.05) at UVA wavelengths of 335 and 365 ± 30 nm 24 hours after radiation exposure (maximum response). The phototoxic index results were significantly higher for lomefloxacin at 335 nm and 365 nm compared to placebo and delafloxacin. Conclusions: 200 and 400 mg of delafloxacin administered for 6 days were well tolerated in healthy adult volunteers. Delafloxacin and placebo failed to demonstrate a phototoxic effect but lomefloxacin, the positive control, demonstrated moderate phototoxicity. [ABSTRACT FROM AUTHOR]

• The paper provides a lifing approach for the polycrystalline nickel alloy RR1000. • The paper uses a novel approach of a temperature dependent version of the Walker strain equation. • The paper investigates the effects of inclusions on the fatigue life of RR1000 at high temperature. The development of high strength alloys with complex chemistries has led to modern nickel disc alloys being produced through a powder metallurgy process which often produces melt anomalies within the material microstructure. The current research investigates the effect of these melt anomalies on overall lifing approaches for the alloy RR1000, utilised here in its fine grained form. A Walker strain approach is applied to investigate the effect of temperature and R ratio on lifing parameters, and a temperature dependent version of the equation is suggested and used to produce predictions of notched specimen fatigue behaviour. It is found that hard particle inclusions dominate fatigue failures at long fatigue lives whereas failure occurred at the peened surface for shorter fatigue lives. However, lifing approaches were able to provide good fits across the entire data set irrespective of this behaviour change. [ABSTRACT FROM AUTHOR]

Introduction We previously reported on a series of sudden and unexpected deaths in Donegal patients (EPA 2015). We are now presenting some initial data on a Suicide Crisis intervention service established in February 2015 as part of the response to the increasing service user suicides in Co. Donegal, Ireland. The Donegal Suicide Crisis Assessment Nurse (SCAN) is a nurse led service which works closely with General Practitioners (GP's), mainstream mental health services, and non-statutory service providers. Objectives/aims Our audit presents the activity of SCAN service in Donegal over the February-August 2015 period. Method We extracted the demographic data pertaining to the referrals from the SCAN data-base using R software for statistical analysis. Results There were ( n = 65) referrals during the five-month study period (41.5% men and 51% women). There were ( n = 60) 90.9% referrals for suicidal ideations, ( n = 6) 9.1% for engagement in deliberate self-harm and ( n = 9) 13.6% following suicidal attempts. Alcohol misuse was a significant issue in ( n = 16) 24.2% referrals. The mean age was 36.0 years (SD = 16.0 years); 40.7 years (SD = 16.8 years) for males, and 32.7 years (SD = 14.8 years) for females. The male-female age difference was significant ( P = 0.0461). The majority of patients ( n = 24) were seen the following day. There were ( n = 16) who were seen the same day of referral. Only ( n = 5) were seen two days after their referral, with ( n = 4) patients seen the third day or more. Conclusion The SCAN service in Donegal is growing month-by-month. Males referred tend to be significantly older than females, otherwise, no demographic difference was apparent. [ABSTRACT FROM AUTHOR]

Background: Many patients with Enterococcus faecalis endocarditis are clinically stable and able to leave hospital before completing antibiotic treatment, but data are lacking regarding some outpatient treatment options., Objectives: To assess the outcomes for adults with E. faecalis endocarditis receiving outpatient parenteral antimicrobial therapy (OPAT) with continuous infusion IV benzylpenicillin plus bolus/continuous infusion IV ceftriaxone., Patients and Methods: We retrospectively reviewed adults who received at least 2 weeks duration of OPAT for E. faecalis endocarditis with the above treatment regimen in the Auckland and Christchurch regions between July 2019 and September 2022., Results: Forty-four patients met inclusion criteria. Fifteen were female (34%). The median age was 80 (IQR 71.5 to 84) years. Twenty-two (50%) had prosthetic valve (PV), 15 (34%) native valve (NV), 3 (7%) NV and/or cardiac implantable electronic device (CIED) infection, 3 (7%) PV and/or CIED infection, and 1 (2%) repaired valve endocarditis. Patients received a median of 16.5 days inpatient and 28 days OPAT antibiotic treatment. The 12 month outcome was cure ( n  = 25; 57%), antibiotic suppression ( n  = 9; 20%), relapse ( n  = 2; 5%; both possible) or death ( n  = 8; 18%). Compared with a historical cohort treated with OPAT continuous infusion IV benzylpenicillin plus bolus IV gentamicin, there was no difference in the relapse rate., Conclusions: This study adds to the accumulating evidence supporting the treatment of E. faecalis endocarditis with OPAT continuous infusion IV benzylpenicillin plus bolus/continuous infusion IV ceftriaxone. This is an option for patients requiring further antibiotic treatment at the time of hospital discharge., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Aims: The viability of cardiac resynchronization therapy (CRT) in inotrope-dependent heart failure (HF) has been a matter of debate., Methods and Results: We searched Medline, EMBASE, Scopus, and the Cochrane Library until 31 December 2022. Studies were included if (i) HF patients required inotropic support at CRT implantation; (ii) patients were ≥18 years old; and (iii) they provided a clear definition of 'inotrope dependence' or 'inability to wean'. A meta-analysis was performed in R (Version 3.5.1). Nineteen studies comprising 386 inotrope-dependent HF patients who received CRT (mean age 64.4 years, 76.9% male) were included. A large majority survived until discharge at 91.1% [95% confidence interval (CI): 81.2% to 97.6%], 89.3% were weaned off inotropes (95% CI: 77.6% to 97.0%), and mean discharge time post-CRT was 7.8 days (95% CI: 3.9 to 11.7). After 1 year of follow-up, 69.7% survived (95% CI: 58.4% to 79.8%). During follow-up, the mean number of HF hospitalizations was reduced by 1.87 (95% CI: 1.04 to 2.70, P < 0.00001). Post-CRT mean QRS duration was reduced by 29.0 ms (95% CI: -41.3 to 16.7, P < 0.00001), and mean left ventricular ejection fraction increased by 4.8% (95% CI: 3.1% to 6.6%, P < 0.00001). The mean New York Heart Association (NYHA) class post-CRT was 2.7 (95% CI: 2.5 to 3.0), with a pronounced reduction of individuals in NYHA IV (risk ratio = 0.27, 95% CI: 0.18 to 0.41, P < 0.00001). On univariate analysis, there was a higher prevalence of males (85.7% vs. 40%), a history of left bundle branch block (71.4% vs. 30%), and more pronounced left ventricular end-diastolic dilation (274.3 ± 7.2 vs. 225.9 ± 6.1 mL)., Conclusions: CRT appears to be a viable option for inotrope-dependent HF, with some of these patients seeming more likely to respond., (© 2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)