Evaluation of immune responses to influenza vaccination in chronic obstructive pulmonary disease

Background: Given that viral infections are common triggers for exacerbations of Chronic Obstructive Pulmonary Disease (COPD), current clinical guidelines recommend that all patients receive annual influenza vaccinations. A detailed examination of the immune response to vaccination in COPD has not previously been undertaken, so this study aimed to compare immune responses to influenza vaccination between COPD patients and healthy subjects. Methods: Twenty one COPD patients and fourteen healthy subjects were recruited and cellular immune function was assessed pre- and post- vaccination with trivalent inactivated influenza vaccine. Results: One month after vaccination, H1N1 specific antibody titres were significantly lower in COPD patients than in healthy controls (p=0.02). Multivariate analysis demonstrated that post vaccination antibody titres were independently associated with COPD, but not with age or smoking status. Innate immune responses to the vaccine preparation did not differ between the two populations. Serum concentrations of IL-21, a cytokine that is important for B cell development and antibody synthesis, were also lower in COPD patients than in healthy subjects (p<0.01). In vitro functional differences were also observed, with fewer proliferating B cells expressing CD27 (p=0.04) and reduced T-cell IFN-γ synthesis (p<0.01) in COPD patients, relative to healthy subjects. Conclusions: In conclusion, COPD was associated with altered immune responses to influenza vaccination compared to healthy controls with reductions in both T-cell and B-cell function. These findings provide a foundation for future research aimed at optimising the effectiveness of influenza vaccination in COPD.

Limited utility of exercise stress testing in the evaluation of suspected acute coronary syndrome in patients aged less than 40 years with intermediate risk features

Objective National guidelines for management of intermediate risk patients with suspected acute coronary syndrome, in whom AMI has been excluded, advocate provocative testing to final risk stratify these patients into low risk (negative testing) or high risk (positive testing suggestive of unstable angina). Adults less than 40 years have a low pretest probability of acute coronary syndrome. The utility of exercise stress testing in young adults with chest pain suspected of acute coronary syndrome who have National Heart Foundation intermediate risk features was evaluated Methods A retrospective analysis of exercise stress testing performed on patients less than 40 years was evaluated. Patients were enrolled on a chest pain pathway and had negative serial ECGs and cardiac biomarkers before exercise stress testing to rule-out acute coronary syndrome. Chart review was completed on patients with positive stress tests. Results The 3987 patients with suspected intermediate risk acute coronary syndrome underwent exercise stress testing. One thousand and twenty-seven (25.8%) were aged less than 40 years (age 33.3 ± 4.8 years). Four of these 1027 patients had a positive exercise stress test (0.4% incidence of positive exercise stress testing). Of those, three patients had subsequent non-invasive functional testing that yielded a negative result. One patient declined further investigations. Assuming this was a true positive exercise stress test, the incidence of true positive exercise stress testing would have been 0.097% (95% confidence interval: 0.079–0.115%) (one of 1027 patients). Conclusions Routine exercise stress testing has limited value in the risk stratification of adults less than 40 years with suspected intermediate risk of acute coronary syndrome

Manufacturing and use of human placenta-derived mesenchymal stromal cells for phase I clinical trials: Establishment and evaluation of a protocol

Background/Aim. Mesenchymal stromal cells (MSCs) have been utilised in many clinical trials as an experimental treatment in numerous clinical settings. Bone marrow remains the traditional source tissue for MSCs but is relatively hard to access in large volumes. Alternatively, MSCs may be derived from other tissues including the placenta and adipose tissue. In an initial study no obvious differences in parameters such as cell surface phenotype, chemokine receptor display, mesodermal differentiation capacity or immunosuppressive ability, were detected when we compared human marrow derived- MSCs to human placenta-derived MSCs. The aim of this study was to establish and evaluate a protocol and related processes for preparation placenta-derived MSCs for early phase clinical trials. Methods. A full-term placenta was taken after delivery of the baby as a source of MSCs. Isolation, seeding, incubation, cryopreservation of human placentaderived MSCs and used production release criteria were in accordance with the complex regulatory requirements applicable to Code of Good Manufacturing Practice manufacturing of ex vivo expanded cells. Results. We established and evaluated instructions for MSCs preparation protocol and gave an overview of the three clinical areas application. In the first trial, MSCs were co-transplanted iv to patient receiving an allogeneic cord blood transplant as therapy for treatmentrefractory acute myeloid leukemia. In the second trial, MSCs were administered iv in the treatment of idiopathic pulmonary fibrosis and without serious adverse effects. In the third trial, MSCs were injected directly into the site of tendon damage using ultrasound guidance in the treatment of chronic refractory tendinopathy. Conclusion. Clinical trials using both allogeneic and autologous cells demonstrated MSCs to be safe. A described protocol for human placenta-derived MSCs is appropriate for use in a clinical setting, relatively inexpensive and can be relatively easily adjusted to a different set of regulatory requirements, as applicable to early phase clinical trials.

Fabrication and evaluation of 1 Ah silver/metal hydride cells

Silver/metal hydride (Ag/MH) cells of about 1 Ah capacity have been fabricated and their discharge characteristics at different rates of discharge, faradaic efficiency, cycle life and a.c. impedance have been evaluated. These cells comprise metal-hydride electrodes prepared by employing similar to 60 mu m powder of an AB(2)-Laves phase alloy of nominal composition Zr0.5Ti0.5V0.6Cr0.2Ni1.2 with PTFE binder on a nickel-mesh substrate as the negative plates and commercial-grade silver electrodes as the positive plates. The cells are positive limited and exhibit two distinct voltage plateaus characteristic of two-step reduction of AgO to Ag during their low rates of discharge between C/20 and C/10. This feature is, however, absent when the cells are discharged at C/5 rate. On charging the cells to 100% of their capacity, the faradaic efficiency is found to be 100%. The impedance of the Ag/MH cell is essentially due to the impedance of the silver electrodes, since MH electrodes offer negligible impedance. The cells may be subjected to a large number of charge-discharge cycles with little deterioration.

Synthesis of 2-(5-((5-(4-chlorophenyl)furan 2-yl)methylene)-4-oxo-2-thioxo-thiazolidi n-3-yl)acetic acid derivatives and evaluation of their cytotoxicity and induction of apoptosis in human leukemia cells

In order to explore the anticancer effect associated with the thiazolidinone framework, several 2-(5-((5-(4-chlorophenyl)furan-2-yl)methylene)-4-oxo-2-thioxothiazolidin-3-yl)acetic acid derivatives 5(a-1) were synthesized. Variation in the functional group at C-terminal of the thiazolidinone led to set of compounds bearing amide moiety. Their chemical structures were confirmed by H-1 NMR, IR and Mass Spectra analysis. These thiazolidinone compounds containing furan moiety exhibits moderate to strong antiproliferative activity in a cell cycle stage-dependent and dose dependent manner in two different human leukemia cell lines. The importance of the electron donating groups on thiazolidinone moiety was confirmed by MTT and Trypan blue assays and it was concluded that the 4th position of the substituted aryl ring plays a dominant role for its anticancer property. Among the synthesized compounds, 5e and 5f have shown potent anticancer activity on both the cell lines tested. To rationalize the role of electron donating group in the induction of cytotoxicity we have chosen two molecules (5e and 5k) having different electron donating group at different positions. LDH assay, Flow cytometric analysis and DNA fragmentation suggest that 5e is more cytotoxic and able to induce the apoptosis. (C) 2009 Elsevier Ltd. All rights reserved.

Improving SEA procedures within Italian regions: Towards a more effective evaluation of urban sustainability

Sustainable urban development, a major issue at global scale, will become more relevant according to population growth predictions in developed and developing countries. Societal and international recognition of sustainability concerns led to the development of specific tools and procedures, known as sustainability assessments/appraisals (SA). Their effectiveness however, considering that global quality life indicators have worsened since their introduction, has promoted a re-thinking of SA instruments. More precisely, Strategic Environmental Assessment (SEA), – a tool introduced in the European context to evaluate policies, plans, and programmes (PPPs), – is being reconsidered because of several features that seem to limit its effectiveness. Over time, SEA has evolved in response to external and internal factors dealing with technical, procedural, planning and governance systems thus involving a shift of paradigm from EIA-based SEAs (first generation protocols) towards more integrated approaches (second generation ones). Changes affecting SEA are formalised through legislation in each Member State, to guide institutions at regional and local level. Defining SEA effectiveness is quite difficult. Its’ capacity-building process appears quite far from its conclusion, even if any definitive version can be conceptualized. In this paper, we consider some European nations with different planning systems and SA traditions. After the identification of some analytical criteria, a multi-dimensional cluster analysis is developed on some case studies, to outline current weaknesses.

Improving SEA prodedures within Italian regions: Towards a more effective evaluation of urban sustainability

Sustainable urban development, a major issue at global scale, will become more relevant according to population growth predictions in developed and developing countries. Societal and international recognition of sustainability concerns led to the development of specific tools and procedures, known as sustainability assessments/appraisals (SA). Their effectiveness however, considering that global quality life indicators have worsened since their introduction, has promoted a re-thinking of SA instruments. More precisely, Strategic Environmental Assessment (SEA), – a tool introduced in the European context to evaluate policies, plans, and programmes (PPPs), – is being reconsidered because of several features that seem to limit its effectiveness. Over time, SEA has evolved in response to external and internal factors dealing with technical, procedural, planning and governance systems thus involving a shift of paradigm from EIA-based SEAs (first generation protocols) towards more integrated approaches (second generation ones). Changes affecting SEA are formalised through legislation in each Member State, to guide institutions at regional and local level. Defining SEA effectiveness is quite difficult. Its’ capacity-building process appears quite far from its conclusion, even if any definitive version can be conceptualized. In this paper, we consider some European nations with different planning systems and SA traditions. After the identification of some analytical criteria, a multi-dimensional cluster analysis is developed on some case studies, to outline current weaknesses.

The short-term impact of curative colorectal cancer treatment on physical activity, functional status and quality of life: A systematic review protocol

REVIEW QUESTION/OBJECTIVE The quantitative objectives are to identify the impact of curative colorectal cancer treatment (surgery or adjuvant therapy) on physical activity, functional status and quality of life within one year of treatment or diagnosis. INCLUSION CRITERIA Types of participants: This review will consider studies that include individuals aged 18 years and over who have been diagnosed with colorectal cancer. Types of intervention(s)/phenomena of interest: This review will consider studies that evaluate the impact of curative colorectal cancer treatment: surgery and/or adjuvant therapy. Types of outcomes: This review will consider studies that include the following outcome measures assessed within one year of diagnosis or treatment: Physical activity - any bodily movement produced by skeletal muscles resulting in energy expenditure. Physical activity is not exclusive to exercise; activities can also be walking, housework, occupational or leisure. Physical activity can be measured objectively using pedometers or accelerometers, or subjectively using self-reported measures. Functional status – measured as the capacity to perform all activities of daily living such as walking, showering, and eating; and instrumental activities of daily living such as (but not limited to) grocery shopping, housekeeping and laundry. Quality of life – defined as the individual meaning of mental, physical and psychosocial wellbeing, as measured by validated tools such as SF-36, EORTC-QLQ-C30, or FACT-C.

Evaluation of hospital preparedness for public health emergencies in Sichuan (China)

The aim of this research was to develop a set of reliable, valid preparedness metrics, built around a comprehensive framework for assessing hospital preparedness. This research used a combination of qualitative and quantitative methods which included interview and a Delphi study as well as a survey of hospitals in the Sichuan Province of China. The resultant framework is constructed around the stages of disaster management and includes nine key elements. Factor Analysis identified four contributing factors. The comparison of hospitals' preparedness using these four factors, revealed that tertiary-grade, teaching and general hospitals performed better than secondary-grade, non-teaching and non-general hospitals.

Climate change impacts on northern Australian rangeland livestock carrying capacity: a review of issues

Grazing is a major land use in Australia's rangelands. The 'safe' livestock carrying capacity (LCC) required to maintain resource condition is strongly dependent on climate. We reviewed: the approaches for quantifying LCC; current trends in climate and their effect on components of the grazing system; implications of the 'best estimates' of climate change projections for LCC; the agreement and disagreement between the current trends and projections; and the adequacy of current models of forage production in simulating the impact of climate change. We report the results of a sensitivity study of climate change impacts on forage production across the rangelands, and we discuss the more general issues facing grazing enterprises associated with climate change, such as 'known uncertainties' and adaptation responses (e.g. use of climate risk assessment). We found that the method of quantifying LCC from a combination of estimates (simulations) of long-term (>30 years) forage production and successful grazier experience has been well tested across northern Australian rangelands with different climatic regions. This methodology provides a sound base for the assessment of climate change impacts, even though there are many identified gaps in knowledge. The evaluation of current trends indicated substantial differences in the trends of annual rainfall (and simulated forage production) across Australian rangelands with general increases in most of western Australian rangelands ( including northern regions of the Northern Territory) and decreases in eastern Australian rangelands and south-western Western Australia. Some of the projected changes in rainfall and temperature appear small compared with year-to-year variability. Nevertheless, the impacts on rangeland production systems are expected to be important in terms of required managerial and enterprise adaptations. Some important aspects of climate systems science remain unresolved, and we suggest that a risk-averse approach to rangeland management, based on the 'best estimate' projections, in combination with appropriate responses to short-term (1-5 years) climate variability, would reduce the risk of resource degradation. Climate change projections - including changes in rainfall, temperature, carbon dioxide and other climatic variables - if realised, are likely to affect forage and animal production, and ecosystem functioning. The major known uncertainties in quantifying climate change impacts are: (i) carbon dioxide effects on forage production, quality, nutrient cycling and competition between life forms (e.g. grass, shrubs and trees); and (ii) the future role of woody plants including effects of. re, climatic extremes and management for carbon storage. In a simple example of simulating climate change impacts on forage production, we found that increased temperature (3 degrees C) was likely to result in a decrease in forage production for most rangeland locations (e. g. -21% calculated as an unweighted average across 90 locations). The increase in temperature exacerbated or reduced the effects of a 10% decrease/increase in rainfall respectively (-33% or -9%). Estimates of the beneficial effects of increased CO2 (from 350 to 650 ppm) on forage production and water use efficiency indicated enhanced forage production (+26%). The increase was approximately equivalent to the decline in forage production associated with a 3 degrees C temperature increase. The large magnitude of these opposing effects emphasised the importance of the uncertainties in quantifying the impacts of these components of climate change. We anticipate decreases in LCC given that the 'best estimate' of climate change across the rangelands is for a decline (or little change) in rainfall and an increase in temperature. As a consequence, we suggest that public policy have regard for: the implications for livestock enterprises, regional communities, potential resource damage, animal welfare and human distress. However, the capability to quantify these warnings is yet to be developed and this important task remains as a challenge for rangeland and climate systems science.

Improving the agent selection, release and evaluation process: the role of bioclimatic modelling

The value of CLIMEX models to inform biocontrol programs was assessed, including predicting the potential distribution of biocontrol agents and their subsequent population dynamics, using bioclimatic models for the weed Parkinsonia aculeata, two Lantana camara biocontrol agents, and five Mimosa pigra biocontrol agents. The results showed the contribution of data types to CLIMEX models and the capacity of these models to inform and improve the selection, release and post release evaluation of biocontrol agents. Foremost among these was the quality of spatial and temporal information as well as the extent to which overseas range data samples the species’ climatic envelope. Post hoc evaluation and refinement of these models requires improved long-term monitoring of introduced agents and their dynamics at well selected study sites. The authors described the findings of these case studies, highlighted their implications, and considered how to incorporate models effectively into biocontrol programs.

The Victorian 260 cc Legislation. Evaluation Report Using Accident Data to December, 1982.

Learner and first year probationary motorcyclists are over-represented in traffic accidents, being involved about four times as often as full motorcycle licence holders in relation to their numbers. In an attempt to reduce this over-involvement, the Victorian Government amended the law in 1979 to restrict learner and first year probationary motorcyclists to motorcycles with engine capacities of less than 260 cc. This paper reports an evaluation which showed that casualty rates for learner and first year probationers began to decrease from mid 1979 and continued to do so until the end of 1980. A further analysis indicated that compared to full licence holder casualties, learner permit casualties were about 40% less than expected while first year probationary casualties were about 39% lower.

Objective `Safe' Grazing Capacities for South-West Queensland Australia: Model Application and Evaluation

This paper describes the employment of two experienced graziers as consultants to apply and evaluate a model for calculating 'safe' long-term grazing capacities of individual properties. The model was based on ecological principles and entailed estimates of average annual forage grown (kglha) on the different land systems on each property and the calculation of the number of livestock (dry sheep equivalents, DSE) required to 'safely' utilise this forage. The grazier consultants applied and evaluated the 'safe' grazing capacity model on 20 properties of their choosing. For evaluation, model results were compared with; (a) the Department of Lands rated carrying capacities for those properties and (b) the grazing capacity assessed independently by the owners of those properties. For the 20 properties, the average 'safe' grazing capacity calculated by the model (21.0 DSE/kmZ) was 8% lighter than the average of the owner assessed capacities (22.7 DSE/kmZ), which in tum was 37% lighter than the average of the pre-1989 Department of Lands rated carrying capacity (31.0 DSE/kmZ). The grazing land management and administrative implications of these results and the role graziers played as consultants are discussed.

Evaluation of super-heated steam vacuum drying viability and development of a predictive drying model for four Australian hardwood species.

The results of drying trials show that vacuum drying produces material of the same or better quality than is currently being produced by conventional methods within 41 to 66 % of the drying time, depending on the species. Economic analysis indicates positive or negative results depending on the species and the size of drying operation. Definite economic benefits exist by vacuum drying over conventional drying for all operation sizes, in terms of drying quality, time and economic viability, for E. marginata and E. pilularis. The same applies for vacuum drying C. citriodora and E. obliqua in larger drying operations (kiln capacity 50 m3 or above), but not for smaller operations at this stage. Further schedule refinement has the ability to reduce drying times further and may improve the vacuum drying viability of the latter species in smaller operations.

A multisite managed environment facility for targeted trait and germplasm phenotyping

Field evaluation of germplasm for performance under water and heat stress is challenging. Field environments are variable and unpredictable, and genotype x environment interactions are difficult to interpret if environments are not well characterised. Numerous traits, genes and quantitative trait loci have been proposed for improving performance but few have been used in variety development. This reflects the limited capacity of commercial breeding companies to screen for these traits and the absence of validation in field environments relevant to breeding companies, and because little is known about the economic benefit of selecting one particular trait over another. The value of the proposed traits or genes is commonly not demonstrated in genetic backgrounds of value to breeding companies. To overcome this disconnection between physiological trait breeding and uptake by breeding companies, three field sites representing the main environment types encountered across the Australian wheatbelt were selected to form a set of managed environment facilities (MEFs). Each MEF manages soil moisture stress through irrigation, and the effects of heat stress through variable sowing dates. Field trials are monitored continuously for weather variables and changes in soil water and canopy temperature in selected probe genotypes, which aids in decisions guiding irrigation scheduling and sampling times. Protocols have been standardised for an essential core set of measurements so that phenotyping yield and other traits are consistent across sites and seasons. MEFs enable assessment of a large number of traits across multiple genetic backgrounds in relevant environments, determine relative trait value, and facilitate delivery of promising germplasm and high value traits into commercial breeding programs.