Public Health England and Co-Production with the Fetal Anomaly Screening Programme.

As the new Cell-free DNA (Cf-DNA) prenatal screening test for Down syndrome was being introduced into the UK's fetal anomaly screening program, Down syndrome charities had an opportunity to participate. An experience of co-production where we were the minority voice then followed. This paper explores that process and our experience as a charity. Institutional and societal structures meant that it was difficult to be heard and a significant amount of bias was noted within the program. Consequently, our viewpoints were often considered and then dismissed. However, at times we were listened to, and feel that there were some valuable changes made resulting from our involvement. The end product was far from reflective of all that we stand for, and there are still lessons to be learned in England about the need to place a higher value on minority voices of lived experience in a co-production exercise.

Clotting during autologous hematopoietic progenitor cells collection.

Autologous hematopoietic progenitor cell (HPC) transplant through peripheral blood mobilization and leukapheresis is a standard treatment for many patients with hematopoietic malignancies. Although leukapheresis is usually completed with no complications, we present a case in which the hematopoietic progenitor cells clotted during collection. The patient had no history of hypercoagulopathy. It was identified that the anticoagulant infusion line was partially constricted by a blood warmer clamp. The machine did not alarm. Most of the multiple Food and Drug Administration reports of clotting occurring during apheresis procedures were due to the patients' preexisting hypercoagulopathy or insufficient anticoagulant solution being used. The machine alarmed in most of these cases. Our case demonstrates that inadequate anticoagulation can occur during an HPC collection procedure without activation of an alarm.

Bioimprinted polymer platforms for cell culture using soft lithography.

BACKGROUND: It is becoming recognised that traditional methods of culture in vitro on flat substrates do not replicate physiological conditions well, and a number of studies have indicated that the physical environment is crucial to the directed functioning of cells in vivo. In this paper we report the development of a platform with cell-like features that is suitable for in vitro investigation of cell activity. Biological cells were imprinted in hard methacrylate copolymer using soft lithography. The cell structures were replicated at high nanometre scale resolution, as confirmed by atomic force microscopy. Optimisation of the methacrylate-based co-polymer mixture for transparency and biocompatibility was performed, and cytotoxicity and chemical stability of the cured polymer in cell culture conditions were evaluated. Cells of an endometrial adenocarcinoma cell line (Ishikawa) were cultured on bioimprinted substrates. RESULTS: The cells exhibited differential attachment on the bioimprint substrate surface compared to those on areas of flat surface and preferentially followed the pattern of the original cell footprint. CONCLUSIONS: The results revealed for the first time that the cancer cells distinguished between behavioural cues from surfaces that had features reminiscent of themselves and that of flat areas. Therefore the imprinted platform will lend itself to detailed studies of relevant physical substrate environments on cell behaviour. The material is not degraded and its permanency allows reuse of the same substrate in multiple experimental runs. It is simple and does not require expensive or specialised equipment. In this work cancer cells were studied, and the growth behaviour of the tumour-derived cells was modified by alterations of the cells' physical environment. Implications are also clear for studies in other crucial areas of health, such as wound healing and artificial tissues.

Human respiratory mechanics demonstration model.

Respiratory mechanics is a difficult topic for instructors and students alike. Existing respiratory mechanics models are limited in their abilities to demonstrate any effects of rib cage movement on alveolar and intrapleural pressures. We developed a model that can be used in both large and small classroom settings. This model contains digital pressure displays and computer integration for real-time demonstration of pressure changes that correspond to the different phases of breathing. Moving the simulated diaphragm and rib cage causes a volume change that results in pressure changes visible on the digital sensors and computer display. Device testing confirmed the model's ability to accurately demonstrate pressure changes in proportion to physiological values. Classroom testing in 427 surveyed students showed improved understanding of respiratory concepts (P < 0.05). We conclude that our respiratory mechanics model is a valuable instructional tool and provide detailed instructions for those who would like to create their own.