Microbial biofilms in nature: unlocking their potential for agricultural applications

Soil environments are dynamic and the plant rhizosphere harbours a phenomenal diversity of micro-organisms which exchange signals and beneficial nutrients. Bipartite beneficial or symbiotic interactions with host roots, such as mycorrhizae and various bacteria, are relatively well characterized. In addition, a tripartite interaction also exists between plant roots, arbuscular mycorrhizal fungi (AMF) and associated bacteria. Bacterial biofilms exist as a sheet of bacterial cells in association with AMF structures, embedded within a self-produced exopolysaccharide matrix. Such biofilms may play important functional roles within these tripartite interactions. However, the details about such interactions in the rhizosphere and their relevant functional relationships have not been elucidated. This review explores the current understanding of naturally occurring microbial biofilms, and their interaction with biotic surfaces, especially AMF. The possible roles played by bacterial biofilms and the potential for their application for a more productive and sustainable agriculture is discussed in this review.

Abstract T MP102: Hotline Use for Recruitment Support in Acute Stroke Trials: Lessons learned To Date in Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-II

Background: Use of hotline services for clinical support and safe operation of a research trial is common and important. The value of such services has not been objectively assessed within the context of a large acute stroke clinical trial.

Methods: The use of three different hotline services have been tested, and cell and Email- options have also been explored for their advantages. US and Non-US sites are provided access to central hotline services, but for efficiency a local network for managing calls is established in each region. All sites may access both data management and the trial PI via hotline services when needed and this is supported by other technologies in addition. A means for supporting overall trial communications in light of these interactions has been developed and valuable insights are gained.

Results: Data gathered from 211 calls logged at the Clinical Coordinating Center through the course of the ATACH-II trial have been summarized: Total Calls Reviewed: 211; Year 2 of trial: 92 calls, Year 3 of trial: 100 calls. Calls received midnight to 8 AM: 19 (9.0%), 8 AM - 5 PM 130 (61.6 %) 5 PM - 12:00 PM 65 (30.8%). Issues Resolved in < 5 min 143/211 (67.8%) Taking > 30 min to resolution 51/211 (24.2%). Purpose of calls: Eligibility 89 (42.2%). protocol compliance including drug management: 77 (36.5%%), randomization/emergency randomization: 16 (7.6%), protocol deviation:13 (6.2%), technological difficulties: 12 (5.7%), AE/SAE: 9 (4.3%), Subject enrollments directly associated with calls: 57 (20.8% of domestic subjects); excluded candidates directly associated with calls: 46 (% not available).

Conclusions: In an international trial requiring rapid enrollment of subjects with intracerebral hemorrhage, the role of direct support via a hotline and other immediate communications means has proven to be instrumental in maintaining good protocol compliance and supporting enrollment by site team members .

Enrollment of research subjects through telemedicine networks in a multicenter acute intracerebral hemorrhage clinical trial: design and methods

BACKGROUND

Enrollment of subjects in acute stroke trials is often hindered by narrow timeframes, because a large proportion of patients arrive via transfers from outside facilities rather than primary arrival at the enrolling hospital.

RATIONALE

Telemedicine networks have been increasingly used for provision of care for acute stroke patients at facilities outside of major academic centers. Treatment decisions made through telemedicine networks in patients with acute ischemic stroke have been shown to be safe, reliable, and effective. With the expanding use of this technology and the impediments to enrolling subjects into clinical trials, this approach can be applied successfully to the field of clinical research.

METHODS AND CONCLUSIONS

The Antihypertensive Treatment of Acute Cerebral Hemorrhage II trial is a phase III randomized multicenter trial that has developed a protocol in collaboration with participating sites to implement the use of telemedicine networks for the enrollment of research subjects. The protocol describes the operating procedures and legal and Institutional Review Board perspectives for its implementation.

Enrollment of Research Subjects through Telemedicine Networks in a Multicenter Acute Intracerebral Hemorrhage Clinical Trial: Design and Methods

BACKGROUND

Enrollment of subjects in acute stroke trials is often hindered by narrow timeframes, because a large proportion of patients arrive via transfers from outside facilities rather than primary arrival at the enrolling hospital.

RATIONALE

Telemedicine networks have been increasingly utilized for provision of care for acute stroke patients at facilities outside of major academic centers. Treatment decisions made through Telemedicine networks in patients with acute ischemic stroke have been shown to be safe, reliable, and effective. With the expanding use of this technology and the impediments to enrolling subjects into clinical trials, this approach can be applied successfully to the field of clinical research.

METHODS AND CONCLUSIONS

The antihypertensive treatment of acute cerebral hemorrhage II trial is a phase III randomized multicenter trial that has developed a protocol in collaboration with participating sites to implement the use of Telemedicine networks for the enrollment of research subjects. The protocol describes the operating procedures and legal and Institutional Review Board perspectives for its implementation.