Strategies for improved targeting of therapeutic cells: implications for tissue repair

Multipotent mesenchymal stem cells (MSCs) have been suggested as a suitable cell source for cell-based treatments for diseases such as osteoarthritis due to their ability to differentiate towards chondrogenic and osteogenic lineages. MSCs can be obtained from a variety of tissue sources, are scalable for mass-production and immuno-privileged enabling their use for allogeneic cell therapy. However, recent pre-clinical studies and clinical trials point to the necessity of increasing engraftment and efficacy of MSCs. This review explores how cell surface modification of the cells can improve homing of MSCs and summarises the use of nanoparticles to enable gene delivery by stem cells as well as facilitate in vivo imaging. The use of advanced biomaterials and how they can be applied to reduce the overall dose of MSCs during therapeutic interventions while achieving optimal targeting efficiency of cells to the diseased sites are addressed. Particular attention is paid to methods that improve engraftment of MSCs to cartilage and research describing combinatorial approaches of particle-based cell therapies for improved regeneration of this tissue is reviewed. The use of such approaches will add to the array of potential regenerative therapeutics for treatment of osteoarthritis.

Comparison in maternal body composition between Caucasian Irish and Indian women

The use of body mass index (BMI) for the diagnosis of obesity has limitations, especially when comparing ethnic groups with different body proportions. The aim of this prospective study was to compare maternal body composition in early pregnancy between Caucasian Irish and Indian women. A total of 81 Indian women and 81 Irish Caucasian women were matched for age, parity and BMI. Maternal weight and height were measured, and body composition analysed using bioelectrical impedance. The Irish women were taller and weighed more than the Indian women (p<0.001). At any given BMI, the Indian women had a higher total body fat percentage, visceral fat level and high fat percentage than the Irish women (p=0.024, 0.001 and 0.001, respectively). Our findings suggest that lower BMI cut-offs should be used for screening for gestational diabetes mellitus in Indian women attending our antenatal services.

Surveillance of verocytotoxigenic Escherichia coli in Irish bovine dairy herds

Verocytotoxigenic Escherichia coli (VTEC) are highly significant zoonotic threats to public health, and have been the causative agent implicated in numerous high-profile outbreaks affecting large numbers of people. Serovar O157 is most frequently linked with human illness; however, other serovars, such as O26, O103, O111 and O145, have also been implicated. This study aimed to characterize the prevalence and virulence determinants of these five serovars in Irish dairy farm herds, and their milk. Using real-time PCR (RTi-PCR), bovine rectal faecal swabs and raw milk samples, along with milk filters, were screened for the presence of vt genes. Positive samples were then screened for the five serovars using sero-specific PCR. Serovar-positive samples were subjected to immunomagnetic separation, to isolate viable VTEC strains. These isolates were subsequently screened for four virulence factors: vt1, vt2, eaeA and hlyA. Three hundred and eighty six of the 600 rectal faecal swabs, 85 of the 117 milk-filters and 43 of the 120 bulk-tank milk samples, were positive for vt genes. From these 514 total vt-positive samples, 58 O26, 162 O103, 1 O111, 324 O145 and 26 O157 positives were detected by sero-specific RTi-PCR. Immunomagnetic separation yielded 12 O26, 26 O103, 0 O111, 19 O145 and 10 O157 isolates. Ten of these isolates contained at least one of the four virulence determinants screened for (i.e. vt1, vt2, eaeA and hlyA). Of these 10 isolates, pulsed-field gel electrophoresis showed that two of the O26 isolates from different farms were indistinguishable. Two O157 isolates were also indistinguishable. This study found serovars O103 and O145 to be the most prevalent in samples tested. Apart from the occurrence of VTEC in dairy herds, this study shows a high occurrence of vt genes in the environment, creating the possibility of horizontal gene transfer and emergence of new VTEC strains.

Lateral polarity heterostructures by overgrowth of patterned AlxGa1-xN nucleation layers

In this study thin AlxGa1−xN nucleation layers on sapphire were patterned and overgrown by plasma-induced molecular beam epitaxy (PIMBE) and metalorganic chemical vapor deposition (MOCVD) to obtain adjacent regions of GaN and AlGaN/GaN heterostructures with different polarities. The role of polarity on the structural and electrical properties of epitaxial layers and AlGaN/GaN heterostructures was investigated for samples grown on patterned AlN or GaN nucleation layers. Epitaxial GaN and AlGaN/GaN heterostructures grown on Al-face AlN or N- face GaN nucleation layers were found to be Ga-face or N-face, respectively, independent of the technique used for the overgrowth.

Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial

BACKGROUND

Trial findings show cognitive behaviour therapy (CBT) and graded exercise therapy (GET) can be effective treatments for chronic fatigue syndrome, but patients' organisations have reported that these treatments can be harmful and favour pacing and specialist health care. We aimed to assess effectiveness and safety of all four treatments.

METHODS

In our parallel-group randomised trial, patients meeting Oxford criteria for chronic fatigue syndrome were recruited from six secondary-care clinics in the UK and randomly allocated by computer-generated sequence to receive specialist medical care (SMC) alone or with adaptive pacing therapy (APT), CBT, or GET. Primary outcomes were fatigue (measured by Chalder fatigue questionnaire score) and physical function (measured by short form-36 subscale score) up to 52 weeks after randomisation, and safety was assessed primarily by recording all serious adverse events, including serious adverse reactions to trial treatments. Primary outcomes were rated by participants, who were necessarily unmasked to treatment assignment; the statistician was masked to treatment assignment for the analysis of primary outcomes. We used longitudinal regression models to compare SMC alone with other treatments, APT with CBT, and APT with GET. The final analysis included all participants for whom we had data for primary outcomes. This trial is registered at http://isrctn.org, number ISRCTN54285094.

FINDINGS

We recruited 641 eligible patients, of whom 160 were assigned to the APT group, 161 to the CBT group, 160 to the GET group, and 160 to the SMC-alone group. Compared with SMC alone, mean fatigue scores at 52 weeks were 3·4 (95% CI 1·8 to 5·0) points lower for CBT (p = 0·0001) and 3·2 (1·7 to 4·8) points lower for GET (p = 0·0003), but did not differ for APT (0·7 [-0·9 to 2·3] points lower; p = 0·38). Compared with SMC alone, mean physical function scores were 7·1 (2·0 to 12·1) points higher for CBT (p = 0·0068) and 9·4 (4·4 to 14·4) points higher for GET (p = 0·0005), but did not differ for APT (3·4 [-1·6 to 8·4] points lower; p=0·18). Compared with APT, CBT and GET were associated with less fatigue (CBT p = 0·0027; GET p = 0·0059) and better physical function (CBT p=0·0002; GET p<0·0001). Subgroup analysis of 427 participants meeting international criteria for chronic fatigue syndrome and 329 participants meeting London criteria for myalgic encephalomyelitis yielded equivalent results. Serious adverse reactions were recorded in two (1%) of 159 participants in the APT group, three (2%) of 161 in the CBT group, two (1%) of 160 in the GET group, and two (1%) of 160 in the SMC-alone group.

INTERPRETATION

CBT and GET can safely be added to SMC to moderately improve outcomes for chronic fatigue syndrome, but APT is not an effective addition.

FUNDING

UK Medical Research Council, Department of Health for England, Scottish Chief Scientist Office, Department for Work and Pensions.

Sharing and borrowing prescription medication: a survey of Irish college students

BACKGROUND

Prescription medicine borrowing and sharing has received not much attention in the research literature, despite serious potential health risks. Although this behaviour is prevalent across all ages, it appears to be particularly high amongst young adults.

AIMS

To determine the prevalence and the characteristics of sharing and borrowing medicines amongst students in an Irish University.

METHOD

Web survey of University College Cork 18-25-year-old undergraduates.

RESULTS

A total of 343 completed the questionnaire. A quarter (26%) reported borrowing, 20% reported sharing and 12% reported both sharing and borrowing prescription drugs, primarily to avoid the cost (37%), the inconvenience of going to a doctor (22%) and not feeling sick enough to see a medical professional (14%). Participants borrowed medicines from family (51.2%) and friends (18.2%). Those who borrowed or shared prescription drugs believed they were at a lesser risk of side effects from taking other people's medicines (p < 0.0005, χ(2) test).

CONCLUSION

Sharing and borrowing prescription drugs appear to be a common practice amongst Irish college students, who may underestimate the risks associated with taking these medicines.

Comparative acaricidal efficacy of the topically applied combinations fipronil/(S)-methoprene, permethrin/imidacloprid and metaflumizone/ amitraz against Dermacentor reticulatus, the European dog tick (ornate dog tick, Fabricius, 1794) in dogs

The acaricidal efficacy against Dermacentor reticulatus in dogs of the commercial topical combinations fipronil/(S)-methoprene (FRONTLINE Combo spot-on dog), imidacloprid/permethrin (Advantix) and metaflumizone/amitraz (ProMeris Duo) was evaluated and compared. Three treatment groups and one untreated control group of six adult Beagle dogs each were randomly formed. Each treatment was administered topically once on Day-0, according to the recommended label dose and instructions for use. All dogs were infested weekly with approximately 50 adult unfed D. reticulatus over a period of seven weeks. Ticks were removed and counted approximately 48 hours after each infestation. The percent reduction in numbers of ticks for fipronil/(S)-methoprene was > or = 97% compared to untreated controls for all seven weekly infestations. The percent reductions for imidacloprid/permethrin and metaflumizone/amitraz were satisfactory initially but fell and stayed below 90 % after three weeks. From the third week onwards, fipronil/(S)-methoprene treated dogs had significantly fewer ticks than imidacloprid/permethrin or metaflumizone/amitraz treated dogs (p < 0.05).

Quantifying the lag time to detect barriers in landscape genetics

Understanding how spatial genetic patterns respond to landscape change is crucial for advancing the emerging field of landscape genetics. We quantified the number of generations for new landscape barrier signatures to become detectable and for old signatures to disappear after barrier removal. We used spatially explicit, individual-based simulations to examine the ability of an individual-based statistic [Mantel's r using the proportion of shared alleles' statistic (Dps)] and population-based statistic (FST ) to detect barriers. We simulated a range of movement strategies including nearest neighbour dispersal, long-distance dispersal and panmixia. The lag time for the signal of a new barrier to become established is short using Mantel's r (1-15 generations). FST required approximately 200 generations to reach 50% of its equilibrium maximum, although G'ST performed much like Mantel's r. In strong contrast, FST and Mantel's r perform similarly following the removal of a barrier formerly dividing a population. Also, given neighbour mating and very short-distance dispersal strategies, historical discontinuities from more than 100 generations ago might still be detectable with either method. This suggests that historical events and landscapes could have long-term effects that confound inferences about the impacts of current landscape features on gene flow for species with very little long-distance dispersal. Nonetheless, populations of organisms with relatively large dispersal distances will lose the signal of a former barrier within less than 15 generations, suggesting that individual-based landscape genetic approaches can improve our ability to measure effects of existing landscape features on genetic structure and connectivity.

Short-days induce weight loss in Siberian hamsters despite overexpression of the agouti-related peptide gene

Many vertebrates express profound annual cycles of body fattening, although it is not clear whether these represent differential activity of the central pathways known to mediate homeostatic control of food intake and energy expenditure, or whether the recent discovery of a major role for pars tuberalis-ependymal signalling points towards novel mechanisms. We examined this in the Siberian hamster (Phodopus sungorus) by using gene transfection to up-regulate a major orexigenic peptide, agouti-related peptide (AgRP), and then determined whether this increased anabolic drive could prevent the short-day induced winter catabolic state. Infusions of a recombinant adeno-associated virus encoding an AgRP construct into the hypothalamus of hamsters in the long-day obese phase of their seasonal cycle produced a 20% gain in body weight over 6 weeks compared to hamsters receiving a control reporter construct, reflecting a significant increase in food intake and a significant decrease in energy expenditure. However, all hamsters showed a significant, prolonged decrease in body weight when exposed to short photoperiods, despite the hamsters expressing the AgRP construct maintaining a higher food intake and lower energy expenditure relative to the control hamsters. Visualisation of the green fluorescent protein reporter and analysis of AgRP-immunoreactivity confirmed widespread expression of the construct in the hypothalamus, which was maintained for the 21-week duration of the study. In conclusion, the over-expression of AgRP in the hypothalamus produced a profoundly obese state but did not block the seasonal catabolic response, suggesting a separation of rheostatic mechanisms in seasonality from those maintaining homeostasis of energy metabolism.

A pseudoinverse deformation vector field generator and its applications

PURPOSE

To present, implement, and test a self-consistent pseudoinverse displacement vector field (PIDVF) generator, which preserves the location of information mapped back-and-forth between image sets.

METHODS

The algorithm is an iterative scheme based on nearest neighbor interpolation and a subsequent iterative search. Performance of the algorithm is benchmarked using a lung 4DCT data set with six CT images from different breathing phases and eight CT images for a single prostrate patient acquired on different days. A diffeomorphic deformable image registration is used to validate our PIDVFs. Additionally, the PIDVF is used to measure the self-consistency of two nondiffeomorphic algorithms which do not use a self-consistency constraint: The ITK Demons algorithm for the lung patient images and an in-house B-Spline algorithm for the prostate patient images. Both Demons and B-Spline have been QAed through contour comparison. Self-consistency is determined by using a DIR to generate a displacement vector field (DVF) between reference image R and study image S (DVF(R-S)). The same DIR is used to generate DVF(S-R). Additionally, our PIDVF generator is used to create PIDVF(S-R). Back-and-forth mapping of a set of points (used as surrogates of contours) using DVF(R-S) and DVF(S-R) is compared to back-and-forth mapping performed with DVF(R-S) and PIDVF(S-R). The Euclidean distances between the original unmapped points and the mapped points are used as a self-consistency measure.

RESULTS

Test results demonstrate that the consistency error observed in back-and-forth mappings can be reduced two to nine times in point mapping and 1.5 to three times in dose mapping when the PIDVF is used in place of the B-Spline algorithm. These self-consistency improvements are not affected by the exchanging of R and S. It is also demonstrated that differences between DVF(S-R) and PIDVF(S-R) can be used as a criteria to check the quality of the DVF.

CONCLUSIONS

Use of DVF and its PIDVF will improve the self-consistency of points, contour, and dose mappings in image guided adaptive therapy.

Bundles of fluid fibers formed by bent-core molecules

The internal structures, stability, and elastic properties of free-standing filament bundles of bent-core smectic liquid crystals are studied using polarizing microscopy, scanning electron microscopy, and a customized cantilever containing, temperature controlled heat stage for force measurements. We find that in bundles, the individual filaments fuse together to form semiseparable filaments with radii approximately two and three times larger than the individual fibers. We also find that the effective surface tension of wide bundles is about 10% smaller than a single filament. Finally, we describe the metastable coexistences of single fibers within the bundles that lead to bending of the bundles. All of these observations were explained with simple macroscopic models.

Laparoscopic nephrectomy: initial experience with 120 cases

Laparoscopic nephrectomy for both benign and malignant diseases of kidney is increasingly being performed. We report our experience with the first 120 consecutive laparoscopic nephrectomy performed in our hospital. It is the retrospective analysis of a prospectively maintained database of 4 years period. The parameters examined included age, gender, indications, operative time, blood loss, intraoperative and post operative complications. Mean age of surgery was 59 years (rang 19-84years). The indications for surgery included solid renal masses (71 patients), non-functioning kidneys (43), and collecting system tumours (6). The mean operating time was 132 minutes (range 75-270), average blood loss was 209 ml (range 0-1090) and average hospital stay was 4.7days (range 2-20). Bleeding, bowel injury and poor progression of laparoscopic procedure were the reasons in 7 (5.8%) cases converted to open surgery. There was 1 (0.8%) perioperative mortality. Eight (6.6%) patients developed post operative complications. Laparoscopic nephrectomy has inherent benefits and may be considered an alternate therapeutic option for kidney diseases with acceptable morbidity

Improved malignant melanoma prognosis at a consultant-delivered multidisciplinary pigmented lesion clinic in Cork

Early detection and excision is the only effective treatment for malignant melanoma. To assess the effect of a consultant-delivered, rapid-access pigmented lesion clinic (PLC) established at the South Infirmary-Victoria University Hospital (SIVUH), we analyzed melanoma tumour-stage prior to (1998-2002) and after (2003-2007) the advent of the PLC. Patients attending SIVUH had a greater proportion of early-stage tumours (65.3%) compared to the rest of Cork (51.2%), County Cork as a whole (56.7%) and all of Ireland (57.4%). The proportion of SIVUH males with early-stage tumours was statistically significantly higher than the rest of County Cork (chi2 = 11.23, P < 0.05). The proportion of patients > 50y with early-stage tumours was also statistically significantly higher than the rest of County Cork (chi2 = 18.88, P < 0.05), the whole of County Cork (chi2 = 7.84, P < 0.05) and all of Ireland (chi2 = 9.67, P < 0.05). We believe that the early detection and improved prognosis of Cork melanoma patients is at least partly due to the PLC.