Mental well-being interventions in the military: The ten key principles.

Organisations including the United Kingdom Armed Forces should seek to implement mental health interventions to increase the psychological well-being of their workforce. This editorial briefly presents ten key principles that military forces should consider before implementing such interventions. These include job-focused training; evaluating interventions; the use of internal versus external training providers; the role of leaders; unit cohesion, single versus multiple session psychological interventions; not overgeneralising the applicability of interventions; the need for repeated skills practice; raising awareness and the fallibility of screening.

The lady with the dragon tattoo.

BACKGROUND: Though the skin is affected in sarcoidosis in about one-third of cases, granulomatous tattoo reactions are an unusual manifestation of the disease. It is important phenomenon to recognize, as it frequently leads to the diagnosis of systemic sarcoidosis. CASE PRESENTATION: A 35-year-old Caucasian female with multiple tattoos presented with a 5-week history of tenderness of the black dye in a tattoo depicting a dragon. She also described a 15-month history of fatigue, polyarthralgia, and mild dyspnea. Skin biopsy demonstrated multiple dermal non-caseating granulomata with associated tattoo ink. Further investigation revealed the presence of systemic sarcoidosis. Her symptoms and skin changes improved with conservative management. CONCLUSION: Sarcoidal tattoo reactions in those without systemic sarcoidosis are a rare occurrence, and their presence should prompt a search for systemic involvement. The accurate identification of skin involvement in sarcoidosis is important, as it tends to occur early in the course of disease, and the skin is a readily accessible site for biopsy, allowing for prompt diagnosis.

3D printed metal columns for capillary liquid chromatography.

Coiled planar capillary chromatography columns (0.9 mm I.D. × 60 cm L) were 3D printed in stainless steel (316L), and titanium (Ti-6Al-4V) alloys (external dimensions of ~5 × 30 × 58 mm), and either slurry packed with various sized reversed-phase octadecylsilica particles, or filled with an in situ prepared methacrylate based monolith. Coiled printed columns were coupled directly with 30 × 30 mm Peltier thermoelectric direct contact heater/cooler modules. Preliminary results show the potential of using such 3D printed columns in future portable chromatographic devices.

Coaxial additive manufacture of biomaterial composite scaffolds for tissue engineering.

An inherent difficulty associated with the application of suitable bioscaffolds for tissue engineering is the incorporation of adequate mechanical characteristics into the materials which recapitulate that of the native tissue, whilst maintaining cell proliferation and nutrient transfer qualities. Biomaterial composites fabricated using rapid prototyping techniques can potentially improve the functionality and patient-specific processing of tissue engineering scaffolds. In this work, a technique for the coaxial melt extrusion printing of core-shell scaffold structures was designed, implemented and assessed with respect to the repeatability, cell efficacy and scaffold porosity obtainable. Encapsulated alginate hydrogel/thermoplastic polycaprolactone (Alg-PCL) cofibre scaffolds were fabricated. Selective laser melting was used to produce a high resolution stainless steel 316 L coaxial extrusion nozzle, exhibiting diameters of 300 µm/900 µm for the inner and outer nozzles respectively. We present coaxial melt extrusion printed scaffolds of Alg-PCL cofibres with ~0.4 volume fraction alginate, with total fibre diameter as low as 600 µm and core material offset as low as 10% of the total diameter. Furthermore the tuneability of scaffold porosity, pore size and interconnectivity, as well as the preliminary inclusion, compatibility and survival of an L-929 mouse fibroblast cell-line within the scaffolds were explored. This preliminary cell work highlighted the need for optimal material selection and further design reiteration in future research.

Alcohol-related admissions to an intensive care unit in Dublin.

BACKGROUND: Excessive alcohol consumption is ingrained in Irish society and is known to have significant adverse health consequences, including adverse outcomes for critically ill patients. Previous assessments of alcohol-related intensive care unit (ICU) admissions were felt to have underestimated the scale of this problem. AIMS: A study was designed to objectively measure alcohol-related ICU workload. METHODS: We prospectively recorded the number of patients who were admitted to St James's Hospital ICU as a result of alcohol misuse during a 6-month period in 2008. Admission diagnosis, Acute physiology and Chronic Health Evaluation Score 2 (APACHE 2), ICU length of stay and 30-day mortality were recorded. RESULTS: The study group occupied 16.7% of the total available ICU bed-days, experienced longer stays and higher mortality. CONCLUSION: This study adds to the data available on the scale of alcohol-related problems amongst Irish healthcare system patients. Prioritisation of primary preventative strategies is necessary.

Monocyte chemotactic protein-1 secreted by primary breast tumors stimulates migration of mesenchymal stem cells.

PURPOSE: Major barriers to effective adenovirus-based gene therapy include induction of an immune response and tumor-specific targeting of vectors. The use of mesenchymal stem cells (MSC) as systemic delivery vehicles for therapeutic genes has been proposed as a result of their combined ability to home in on the tumor site and evade the host immune response. This study is aimed at investigating factors mediating homing of human MSCs to breast cancer primary cultures and cell lines in vitro and in vivo. EXPERIMENTAL DESIGN: Fluorescently labeled MSCs were given to mice bearing breast cancer xenografts, and tumor tissue was harvested to detect MSC engraftment. MSC migration in response to primary breast tumors in vitro was quantified, and chemokines secreted by tumor cells were identified. The role of monocyte chemotactic protein-1 (MCP-1) in cell migration was investigated using antibodies and standards of the chemokine. Serum MCP-1 was measured in 125 breast cancer patients and 86 healthy controls. RESULTS: Engrafted MSCs were detected in metastatic breast tumors in mice after systemic administration. There was a significant increase in MSC migration in response to primary breast tumor cells in vitro (6-fold to 11-fold increase). Tumor explants secreted a variety of chemokines including GROalpha, MCP-1, and stromal cell-derived factor-1alpha. An MCP-1 antibody caused a significant decrease (37-42%) in MSC migration to tumors. Serum MCP-1 levels were significantly higher in postmenopausal breast cancer patients than age-matched controls (P < 0.05). CONCLUSIONS: These results highlight a role for tumor-secreted MCP-1 in stimulating MSC migration and support the potential of these cells as tumor-targeted delivery vehicles for therapeutic agents.