Mesenchymal stromal cells transiently alter the inflammatory milieu post-transplant to delay graft-versus-host disease

Background: Multipotent mesenchymal stromal cells suppress T-cell function in vitro, a property that has underpinned their use in treating clinical steroid-refractory graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. However the potential of mesenchymal stromal cells to resolve graft-versus-host disease is confounded by a paucity of pre-clinical data delineating their immunomodulatory effects in vivo. Design and Methods: We examined the influence of timing and dose of donor-derived mesenchymal stromal cells on the kinetics of graft-versus-host disease in two murine models of graft-versus-host disease (major histocompatibility complex-mismatched: UBI-GFP/BL6 [H-2b]→BALB/c [H-2d] and the sibling transplant mimic, UBI-GFP/BL6 [H-2b]→BALB.B [H-2b]) using clinically relevant conditioning regimens. We also examined the effect of mesenchymal stromal cell infusion on bone marrow and spleen cellular composition and cytokine secretion in transplant recipients. Results: Despite T-cell suppression in vitro, mesenchymal stromal cells delayed but did not prevent graft-versus-host disease in the major histocompatibility complex-mismatched model. In the sibling transplant model, however, 30% of mesenchymal stromal cell-treated mice did not develop graft-versus-host disease. The timing of administration and dose of the mesenchymal stromal cells influenced their effectiveness in attenuating graft-versus-host disease, such that a low dose of mesenchymal stromal cells administered early was more effective than a high dose of mesenchymal stromal cells given late. Compared to control-treated mice, mesenchymal stromal cell-treated mice had significant reductions in serum and splenic interferon-γ, an important mediator of graft-versus-host disease. Conclusions: Mesenchymal stromal cells appear to delay death from graft-versus-host disease by transiently altering the inflammatory milieu and reducing levels of interferon-γ. Our data suggest that both the timing of infusion and the dose of mesenchymal stromal cells likely influence these cells’ effectiveness in attenuating graft-versus-host disease.

Reduced intensity conditioning for allogeneic hematopoietic stem cell transplant determines the kinetics of acute Graft-Versus-Host Disease

Background Preparative myeloablative conditioning regimens for allogeneic hematopoietic stem-cell transplantation (HSCT) may control malignancy and facilitate engraftment but also contribute to transplant related mortality, cytokine release, and acute graft-versus-host disease (GVHD). Reduced intensity conditioning (RIC) regimens have decreased transplant related mortality but the incidence of acute GVHD, while delayed, remains unchanged. There are currently no in vivo allogeneic models of RIC HSCT, limiting studies into the mechanism behind RIC-associated GVHD. Methods We developed two RIC HSCT models that result in delayed onset GVHD (major histocompatibility complex mismatched (UBI-GFP/BL6 [H-2b]→BALB/c [H-2d]) and major histocompatibility complex matched, minor histocompatibility mismatched (UBI-GFP/BL6 [H-2b]→BALB.B [H-2b])) enabling the effect of RIC on chimerism, dendritic cell (DC) chimerism, and GVHD to be investigated. Results In contrast with myeloablative conditioning, we observed that RIC-associated delayed-onset GVHD is characterized by low production of tumor necrosis factor-α, maintenance of host DC, phenotypic DC activation, increased T-regulatory cell numbers, and a delayed emergence of activated donor DC. Furthermore, changes to the peritransplant milieu in the recipient after RIC lead to the altered activation of DC and the induction of T-regulatory responses. Reduced intensity conditioning recipients suffer less early damage to GVHD target organs. However, as donor cells engraft, activated donor DC and rising levels of tumor necrosis factor-α are associated with a later onset of severe GVHD. Conclusions Delineating the mechanisms underlying delayed onset GVHD in RIC HSCT recipients is vital to improve the prediction of disease onset and allow more targeted interventions for acute GVHD.

Cube Jam (Engagement Innovation Project)

Cube Jam is a project developed in response to the new and rising marketing in large-scale interactive public screens - the Cube being a premier site. Cube Jam will be a crossbreeding ‘think-ubator’ that rides on the back of the already nationally recognised Game On program and its digital communities. Via a bottom-up, non-directive approach Cube Jam will facilitate a series of design provocations within co-located Jam Studios; studios that are focused on supporting adaptation and new ideation and concept design. These Studios will seek new combinations of skills and knowledges with the intention of discovering provotypes of possibilities in both working and production methodologies and product outcomes.

Differences in composition of symptom clusters between older and younger oncology patients

Context Older oncology patients have unique needs associated with the many physical, psychological,and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences. Objectives The purposes of this study were to identify and compare symptom clusters in younger (<60 years) and older ($60 years) patients undergoing cancer treatment. Methods. Symptom data from one Australian study and two U.S. studies were combined to conduct this analysis. A total of 593 patients receiving active treatment were dichotomized into younger (<60 years) and older ($60 years) groups. Separate exploratory factor analyses (EFAs) were undertaken within each group to identify symptom clusters from occurrence ratings of the 32 symptoms assessed by the Memorial Symptom Assessment Scale. Results In both groups, a seven-factor solution was selected. Four partially concordant symptom clusters emerged in both groups (i.e., mood/cognitive, malaise, body image, and genitourinary). In the older patients, the three unique clusters reflected physiological changes associated with aging, whereas in the younger group the three unique clusters reflected treatment-related effects. Conclusion The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.

Heathcote’s practice-led teaching: Pioneering research as well as pioneering pedagogy

It is widely recognized that Dorothy Heathcote was a dynamic and radical teacher who transformed and continually reinvented drama teaching. She did this by allowing her emerging thinking and understandings to flow from, and be tested by, regular and intensive ‘practicing’ in the classroom. In this way theoretical claims were grounded and evidenced in authentic classroom practice. And yet, for all her impact, it is rare to hear the claim that Heathcote’s pedagogic breakthroughs resulted from a legitimate research methodology. Clever and charismatic teaching yes; research no. One of the world’s best teachers certainly, but not a researcher; even though every lesson was experimental and every classroom was a site for discovery. This paper investigates that conundrum firstly by acknowledging that Heathcote’s practice-led teaching approach to discovery did not map comfortably on to the established educational research traditions of the day. It argues that traditional research methodologies, with their well-established protocols and methods, could not understand or embrace a research process which does its work by creating ‘fictional realities’ of openness, allegory and uncertainty. In recent years however it can be seen that Heathcote’s practice led-teaching, so essential for advancing the field, closely aligns with what many contemporary researchers are now calling practice-led research or practice as research or, in many Nordic countries, artistic research. A form of performative research, practice-led research has not emerged from the field of education but rather from the creative arts. Seeking to develop ways of researching creative practice which is deeply sympathetic and respectful of that practice, artist-researchers have developed practice-led research “which is initiated in practice, where questions, problems, challenges are identified and formed by the needs of practice and practitioners” (Grey, 1996). This sits comfortably with Heathcote’s classroom priority of “discovering by trial, error and testing; using available materials with respect for their nature, and being guided by this appreciation of their potential” (Heathcote, 1967). The paper will conclude by testing the dynamics of Heathcote’s practice-led teaching against the six conditions of practice-led research (Haseman&Mafe, 2011), a testing which will allow for a re-interpretation and re-housing of Dorothy Heathcote’s classroom-based teaching methodology as a form of performative research in its own right.

Art and science as creative catalysts

Science, Art and Science Art collaborations are generally presented and understood in terms of their products. We argue that the process of Science art can be a significant, even principal benefit of these collaborations, even though it may be largely invisible to anyone other than the collaborators. Hosting the Centenary of Canberra Science Art Commission at the Commonwealth Scientific and Industrial Research Organisation (CSIRO) has shown us that while Science and Art pursue orthogonal dimensions of creativity and innovation, collaborators can combine these directions to access new areas of imagination and ideas.

Simulating droplet motion on virtual leaf surfaces

A curvilinear thin film model is used to simulate the motion of droplets on a virtual leaf surface, with a view to better understand the retention of agricultural sprays on plants. The governing model, adapted from Roy et al. (2002 J. Fluid Mech. 454, 235–261) with the addition of a disjoining pressure term, describes the gravity- and curvature driven flow of a small droplet on a complex substrate: a cotton leaf reconstructed from digitized scan data. Coalescence is the key mechanism behind spray coating of foliage, and our simulations demonstrate that various experimentally observed coalescence behaviours can be reproduced qualitatively. By varying the contact angle over the domain, we also demonstrate that the presence of a chemical defect can act as an obstacle to the droplet’s path, causing break-up. In simulations on the virtual leaf, it is found that the movement of a typical spray size droplet is driven almost exclusively by substrate curvature gradients. It is not until droplet mass is sufficiently increased via coalescence that gravity becomes the dominating force.

Changes in mood, depression and suicidal ideation after commencing pregabalin for neuropathic pain

Background Pregabalin is a treatment option for patients with persistent neuropathic pain. Its use has been associated with changes in mood and the development of depression and/or suicidal ideation. Objective Case presentations were reviewed of five patients reporting changes in mood, depression and suicidal ideation from the first 50 (approximately) patients commenced on pregabalin at the clinic. Discussion Although these patients had a history of depression, their mood had been stable before commencing pregabalin. Soon after commencement they reported changes in mood, and development of depression and/or suicidal ideation, which improved with dose reduction or cessation of pregabalin. Ultimately, all five patients ceased pregabalin treatment. Suicidal ideation is a recog-nised adverse effect of pregabalin. Patients should be warned of and monitored for deterioration in mood.

Guidelines for syringe driver management in palliative care

These guidelines are intended to provide clinicians and palliative care services with guidelines to inform practice, the development of policy and procedures, and associated training and education programs in relation to portable subcutaneous infusion device (syringe driver) management.

Developing guidelines for syringe driver management

The aim of this project was to develop clinical practice guidelines for the use and administration of pharmacological agents for symptom control via syringe drivers within Australia. By developing evidence-based clinical practice guidelines for the use of this common device, this project aimed to improve patient outcomes, reduce practice variation, minimize errors and encourage more efficient use of resources. A literature review identified current literature regarding syringe driver management and an expert panel was assembled to assist in the development of the guidelines. The development of these practice guidelines provides an example of how palliative care practitioners can use a framework of contemporary evidence to enhance clinical practice.

More than just audiences : Developing communitas and social inclusion through theatre participation for young people

In a Facebook conversation about theatre going by young people in Brisbane playwright Valerie Foley noted, “theatre in and of itself may not have the cultural value it once had”. This chapter explores how three Australian live theatre/performance events – World Theatre Festival (Brisbane 2011 and 2012), Backbone’s annual 2High Festival (Brisbane 2012) and Next Wave Festival (Melbourne 2012) - repositioned the value of live performing arts to develop social cohesion and wellbeing for young people. The chapter draws out how these performance events developed communitas (Turner 2012) for young audiences.

Numerical treatment of a two-dimensional variable-order fractional nonlinear reaction-diffusion model

A two-dimensional variable-order fractional nonlinear reaction-diffusion model is considered. A second-order spatial accurate semi-implicit alternating direction method for a two-dimensional variable-order fractional nonlinear reaction-diffusion model is proposed. Stability and convergence of the semi-implicit alternating direct method are established. Finally, some numerical examples are given to support our theoretical analysis. These numerical techniques can be used to simulate a two-dimensional variable order fractional FitzHugh-Nagumo model in a rectangular domain. This type of model can be used to describe how electrical currents flow through the heart, controlling its contractions, and are used to ascertain the effects of certain drugs designed to treat arrhythmia.

GPU accelerated algorithms for computing matrix function vector products with applications to exponential integrators and fractional diffusion

The efficient computation of matrix function vector products has become an important area of research in recent times, driven in particular by two important applications: the numerical solution of fractional partial differential equations and the integration of large systems of ordinary differential equations. In this work we consider a problem that combines these two applications, in the form of a numerical solution algorithm for fractional reaction diffusion equations that after spatial discretisation, is advanced in time using the exponential Euler method. We focus on the efficient implementation of the algorithm on Graphics Processing Units (GPU), as we wish to make use of the increased computational power available with this hardware. We compute the matrix function vector products using the contour integration method in [N. Hale, N. Higham, and L. Trefethen. Computing Aα, log(A), and related matrix functions by contour integrals. SIAM J. Numer. Anal., 46(5):2505–2523, 2008]. Multiple levels of preconditioning are applied to reduce the GPU memory footprint and to further accelerate convergence. We also derive an error bound for the convergence of the contour integral method that allows us to pre-determine the appropriate number of quadrature points. Results are presented that demonstrate the effectiveness of the method for large two-dimensional problems, showing a speedup of more than an order of magnitude compared to a CPU-only implementation.