Several studies have shown that erythropoietin (EPO) has neuroprotective or neuroreparative actions on diseases of the nervous system and that improves oligodendrocyte (OL) differentiation and myelination in vivo and in vitro. This study aims at investigating the early molecular mechanisms for the pro-myelinating action of EPO at the gene expression level. For this purpose, we used a differentiating OL precursor cell line, rat central glia-4 cells. Cells were differentiated or not, and then treated with EPO for 1 or 20 h. RNA was extracted and changes in the gene expression profile were assessed using microarray analysis. Experiments were performed in biological replicates of n = 4. Differentiation alone changed the expression of 11% of transcripts (2,663 out of 24,272), representing 2,436 genes, half of which were upregulated and half downregulated. At 20 h of treatment, EPO significantly affected the expression of 99 genes that were already regulated by differentiation and of 150 genes that were not influenced by differentiation alone. Analysis of the transcripts most upregulated by EPO identified several genes involved in lipid transport (e.g., Cd36) and lipid metabolism (Ppargc1a/Pgc1alpha, Lpin1, Pnlip, Lpin2, Ppard, Plin2) along with Igf1 and Igf2, growth factors known for their pro-myelinating action. All these genes were only induced by EPO and not by differentiation alone, except for Pnlip which was highly induced by differentiation and augmented by EPO. Results were validated by quantitative PCR. These findings suggest that EPO might increase remyelination by inducing insulin-like growth factors and increasing lipid metabolism.

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How to save £20 000 and 780 staff hours a year on a single ward-by making one climate friendly change Hospitals are finding that sustainable healthcare can bring triple wins-for the planet, for patients and staff, and for the bottom line. Involving staff and patients is key, as Florence Wedmore found out at the Royal College of Physicians' conference last month Florence Wedmore sustainability fellow Gareth Murcutt, a renal technical manager at the Royal Free Hospital in London, remembers his "eureka moment." After the pandemic his clinical director had asked him to look at sustainability-but at first it wasn't his top priority, he told Medicine 2023, the Royal College of Physicians' annual conference, held in March.

Ageing is associated with deficits in cognitive control, including attention and working memory processes. However, how ageing influences the interactions between these cognitive systems is not well understood. The present study compared the oculomotor behavior and search performance of two different age groups in a well established memory-guided visual selection paradigm. The results show that ageing can lead to impairments in the way memory representations bias the control of attention, which notably dissociate in the early stages of oculomotor orientation in search and the later process of attentional disengagement from memory distracters. The implications of these findings for theories of cognitive ageing are discussed.

Background Patients with language barriers have worse health outcomes. To promote equitable care, efforts must be made to ensure effective communication with patients, including providing professional translation. In a busy, overstretched health service this can be difficult to achieve. Language translators can reduce barriers, improve safety and ensure impartiality. Description of the Problem Aims - To understand the quality of translation and explore interventions that could improve this in a busy diverse hospital in East London. Methods A quality improvement project in the Medical Admissions Unit of the Royal London Hospital was completed over two years. Patients with language barriers were identified, methods of translation were analysed and interventions to improve access to independent translation were introduced. Results Cycle 1- All medical admissions over a two-week period were analysed. 36 patients had documented evidence of a language barrier with 7 (19.4%) having independent professional translation. 20 (55.6%) patients had family members providing translation, for 4 patients limited English was used and previous documentation was used for 3 patients. Cycle 2- Posters and information leaflets were disseminated regarding how to access translation services. There was no improvement in the types of translation used. Only 1 patient had impartial professional translation, out of 43 patients identified. Cycle 3- Advocates (Bengali speaking professional translators) were made available on the ward twice a week. Results showed no significant improvement, with only 6 (10%) identified having impartial professional translation. However staff and patient feedback has been positive. Lessons Impartial professional translation is essential in reducing barriers and delivering equitable health care. This can be difficult to achieve in busy healthcare services. Education alone is not enough. Good accessibility to translation services is paramount in promoting usage. Key messages • Healthcare services often fall short of providing impartial professional translation. • Education alone is not enough. Good accessibility to translation services is paramount in promoting usage.