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Patient-derived xenografts (PDXs) are resected human tumors engrafted into mice for preclinical studies and therapeutic testing. It has been proposed that the mouse host affects tumor evolution during PDX engraftment and propagation, affecting the accuracy of PDX modeling of human cancer. Here, we exhaustively analyze copy number alterations (CNAs) in 1,451 PDX and matched patient tumor (PT) samples from 509 PDX models. CNA inferences based on DNA sequencing and microarray data displayed substantially higher resolution and dynamic range than gene expression-based inferences, and they also showed strong CNA conservation from PTs through late-passage PDXs. CNA recurrence analysis of 130 colorectal and breast PT/PDX-early/PDX-late trios confirmed high-resolution CNA retention. We observed no significant enrichment of cancer-related genes in PDX-specific CNAs across models. Moreover, CNA differences between patient and PDX tumors were comparable to variations in multiregion samples within patients. Our study demonstrates the lack of systematic copy number evolution driven by the PDX mouse host., Analysis of copy number alterations in 1,451 patient-derived xenografts (PDXs) and matched patient tumor samples shows strong conservation from patient tumors through late-passage PDXs and a lack of systematic copy number evolution driven by the mouse host.

Aim To investigate/evaluate the impact of hospital transfers on breastfeeding outcomes for infants requiring neonatal intensive care and to explore approaches to supporting lactation and breastfeeding. Methods A national study of two cohorts of infants admitted to the nine neonatal intensive care units (NICUs) in New South Wales (NSW) Australia using data sourced from a prospectively collected NICUS data collection. Results A total of 7829 infants were admitted to the nine NICUs in NSW for two 18-month cohorts (2012/2013 and 2015/2016) and were included in the study. These infants experienced 17 238 transfers to 107 different hospitals during the study period. Multiple transfers and low gestational age were independently associated with lower breastfeeding rates at hospital discharge across both cohorts. Extremely preterm infants and those with the greatest number of hospital transfers are least likely to be breastfed at time of discharge. Breastfeeding rates remained unchanged over time. The level of lactation support varied across NICUs. Conclusion This study highlights the challenges of establishing and maintaining breastfeeding for infants requiring intensive care who have had multiple hospital transfers for continuing or specialist care. There is wide variation in lactation support across facilities. The importance of a consistent approach, education programmes and the provision of appropriate lactation support is emphasised.

Infants hospitalised in neonatal intensive care units require interventions for lifesaving care and to meet basic human needs. Evidence that stress influences neurodevelopment suggests the effects of caregiving in the neonatal intensive care unit (NICU) warrant further investigation to assess links with infant developmental outcomes. This review explores the effects of nurse-delivered caregiving in the NICU on infant physiological and behavioural responses, and longer-term developmental outcomes (behaviour and temperament). CINHAL, MEDLINE and PsychINFO were systematically searched for studies in peer-reviewed journals related to nurse-delivered caregiving and developmental outcomes. Synthesis of the literature identified altered physiological and behavioural responses as immediate effects of caregiving in neonatal settings, and non-optimal developmental outcomes. Results indicate that caregiving is not innocuous. Yet, little is known about nurses’ perceptions of the effects of caregiving. Identifying the care components that influence development is essential to minimise the potentially adverse impact of the NICU experience on infants and families.

There is a growing awareness that cells grown in 3D better model in vivo behavior than those grown in 2D. In this protocol, we describe a simple and tunable 3D hydrogel, suitable for culturing cells and tissue in a setting that matches their native environment. This is particularly important for researchers investigating the initiation, growth, and treatment of cancer where the interaction between cells and their local extracellular matrix is a fundamental part of the model.

BackgroundDevelopmental care consists of a range of clinical, infant-focused, and family-focused interventions designed to modify the neonatal intensive care environment and caregiving practices to reduce stressors on the developing brain. Since the inception of developmental care in the early 1980s, it has been recommended and adopted globally as a component of routine practice for neonatal care. Despite its application for almost 40 y, little is known of the attitude of neonatal nurses in Australia towards the intervention.Aims and objectivesThe objective of this study was to establish Australian neonatal nurse perceptions of developmental care and explore associations between developmental care education levels of the nurses and personal beliefs in the application of developmental care.DesignThis involves a cross-sectional survey design.MethodsAn online questionnaire was completed by 171 neonatal nurses. Participants were members of the Australian College of Neonatal Nursing (n = 783). Covariate associations between key components of developmental care and respondents' geographical location, place of employment, professional qualifications, and developmental care education level were analysed. The reporting of this study is in accordance with the Enhancing the Quality and Transparency of Health Research Checklist for Reporting Results of Internet E-Surveys.ResultsDifferences were observed between groups for geographical location, place of employment, and professional qualification level. Rural nurses were less likely to support the provision of skin-to-skin care (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.2-1.8) than nurses in a metropolitsan unit. Nurses working in a neonatal intensive care unit and nurses with postgraduate qualifications were more likely to support parental involvement in care ([OR: 2.3, 95% CI: 0.9-6.2] and [OR: 2.1, 95% CI: 0.6-7.4], respectively). Rural respondents were more likely to have attended off-site education (OR: 3.6, 95% CI: 1.3-9.9) than metropolitan respondents.ConclusionThe application of developmental care in Australia may be influenced by inadequate resources and inequitable access to educational resources, and similar challenges have been reported in other countries. Overcoming the challenges requires a focused education strategy and support within and beyond the neonatal intensive care unit.

Background: The potential for an exotic disease incursion is a significant concern for the United Kingdom (UK) equine industry. Horse owners’ perceptions of, and attitudes towards, exotic diseases can influence decisions to adopt disease preparedness strategies. The objectives of this study were to describe horse owners’ 1) perceptions of the term ‘exotic disease’, and 2) attitudes towards their risk of being affected by an exotic disease. In order to address these objectives, qualitative content analysis was undertaken on data collected using two open-ended survey questions. Results: Horse owners (n = 423) perceived exotic diseases as 1) belonging somewhere else, and 2) a dangerous threat to their horse(s). The term ‘exotic’ was associated with being foreign, non-native, and out-of-place in the UK. Attitudes towards exotic disease risk were summarised into four categories: 1) responsible horse owners prevent disease, 2) horse owners need support to stop disease spread, 3) risk depends on proximity to the ‘risky’ horse, and 4) some risk is inevitable. A ‘responsible’ owner was aware of health hazards and took actions to protect their horse from disease. Reliance on others, including stakeholders, to uphold disease prevention in the community led to feeling vulnerable to disease threats. When evaluating risk, horse owners considered which horses were the ‘riskiest’ to their horse’s health (horses that travelled, participated in competitions, or were simply unfamiliar) and avoided situations where they could interact. Despite undertaking disease prevention measures, the perceived uncontrollable nature of exotic diseases led some owners to feel an incursion was inevitable. Conclusions: Without accounting for horse owners’ perceptions of, and attitudes towards, exotic diseases, recommendations to increase preparedness may be ineffective. Improved communication among stakeholders in the industry may assist in clarifying expectations for exotic disease-specific prevention measures. A collaborative approach among horse owners and stakeholders is recommended to improve disease preparedness within the industry.

A life cycle assessment (LCA) is conducted on a low-energy industrial building under construction in Thailand. The building has a gross floor area of 14,938 m2 and a 20-year lifetime. As energy-saving initiatives need to expand beyond the established domain of low-energy residential and commercial buildings, this study demonstrates the successful application of active and passive energy-saving measures to a large, energy-efficient industrial building—the first to be surveyed by an LCA. LED lighting, minimal air conditioning, and passive ventilation architecture reduce operation phase burdens. As a result, the manufacturing phase yields largest impacts in primary energy demand (71%), global warming potential (60%), and four other environmental impact categories. This is largely attributable to steel and concrete production and a higher embodied energy quantity per material. Additionally, four scenarios—a base case, recycling case, photovoltaic system scenario, and combined recycling/photovoltaic scenario—are simulated to evaluate strategies for further energy reduction. Analysis indicates that significant life cycle energy savings can be achieved through recycling (29%) and a rooftop PV system (64%). The combination of both enhancements compensates for all manufactured material embodied energies and results in a building with zero or sub-zero total life cycle energy demand. Buildings that are already low-energy can further reduce environmental impacts through inclusion of the aforementioned approaches in design and implementation.

The international nature of the equine industry provides opportunities for the spread of infectious diseases between countries. While incursions of exotic diseases into the United Kingdom (UK) equine population have been rare, the potential socioeconomic and welfare impacts are a significant concern. However, little is known about leisure horse owners’ ability or willingness to prepare for an exotic disease incursion. The objectives of this study were to describe UK leisure horse owners’ awareness and perceptions of exotic diseases, and to identify clusters of horse owners characterised by their awareness and perceived risk of exotic diseases. A cross-sectional study of leisure horse owners in the UK was conducted between April and July 2018. Participants (n = 403) completed an online questionnaire with questions pertaining to demographics, experiences with endemic diseases, and awareness and perceptions of exotic diseases. Hierarchical cluster analysis was used to identify groups of participants that were similar in regard to their awareness and perceived risk of exotic diseases. Participants identified a median of 3 (IQR 2 – 4) exotic diseases, with the most recognised exotic diseases being African horse sickness and West Nile virus. The most frequently mentioned clinical signs that participants thought were associated with exotic diseases included high temperature (57.2%), discharge (46.5%), and lack of energy (41.2%). Hierarchical cluster analysis identified three clusters of participants: 1) those who were aware of exotic diseases and perceived a high amount of risk (n = 78); 2) those who were aware of exotic diseases but perceived a low amount of risk (n = 111); and 3) those who were less aware of exotic diseases and perceived a low amount of risk (n = 214). Efforts to communicate the relevance and consequences of exotic diseases to horse owners should consider the potential difference in receptiveness among horse owners in each cluster. Further investigations are required to determine the implications of horse owners’ perceived risk on exotic disease preparedness.

Objective To decrease the incidence of bloodstream infection (BSI) for neonates 48 h, for a total of 33 933 bed days and 14 447 central line days. There was a significant decrease from 2012 to 2014 in BSI/1000 bed days (7.8±3.0 vs 3.8±1.1, p=0.000), CLABSI/1000 bed days (4.6±2.1 vs 2.1±0.8, p=0.003), CLABSI/1000 central line days (9.9±4.3 vs 5.4±1.7, p=0.012) and antibiotic days/100 bed days (31.1±4.3 vs 25.5±4.2, p=0.046). Conclusions This study demonstrates a >50% reduction in BSI in extremely premature neonates from D3 to 35 following a collaborative quality improvement project to reduce neonatal infection across an NICU network, supported by timely provision of data.