The incidence of hepatocellular carcinoma(HCC)in patients with human immunodeficiency virus(HIV) is rising.HCC in HIV almost invariably occurs in the context of hepatitis C virus(HCV)or hepatitis B virus (HBV)co-infec...The incidence of hepatocellular carcinoma(HCC)in patients with human immunodeficiency virus(HIV) is rising.HCC in HIV almost invariably occurs in the context of hepatitis C virus(HCV)or hepatitis B virus (HBV)co-infection and,on account of shared modes of transmission,this occurs in more than 33% and 10% of patients with HIV worldwide respectively.It has yet to be clearly established whether HIV directly accelerates HCC pathogenesis or whether the rising incidence is an epiphenomenon of the highly active antiretroviral therapy(HAART)era,wherein the increased longevity of patients with HIV allows long-term complications of viral hepatitis and cirrhosis to develop.Answering this question will have implications for HCC surveillance and the timing of HCV/HBV therapy,which in HIV co-infection presents unique challenges.Once HCC develops,there is growing evidence that HIV co-infection should not preclude conventional therapeutic strategies,including liver transplantation.展开更多
There is increasing recognition of the potential morbidity and mortality associated with HIV-1 and hepatitis C (HCV)co-infection. HIV appears to adversely affect HCV disease while the reciprocal effect of HCV on HIV r...There is increasing recognition of the potential morbidity and mortality associated with HIV-1 and hepatitis C (HCV)co-infection. HIV appears to adversely affect HCV disease while the reciprocal effect of HCV on HIV remains controversial.We therefore studied the effect of co-infection on dendritic cell function versus HIV infection alone, as previous work has shown that HCV impairs dendritic cell (DC) function. HIV-1 positive individuals with HCV were matched for CD4count, HIV- 1 RNA viral load and therapy, to HIV- 1 positive patients without HCV. Monocyte-derived DC were generated and mixed leukocyte reactions were performed. We assessed allostimulatory capacity with and without administration of exogenous Thl cytokines, using thymidine uptake and cell division analyses with the vital dye CFSE. We found that monocyte-derived DC from co-infected individuals showed no significant differences in allostimulatory capacity to ex vivo generated DC from HIV-1 infected individuals without HCV. Unlike the situation with HCV infection alone, this impairment was not reversed by increasing concentrations of either interleukin-2 or -12. Monocyte-derived DC from HIV-1 and HCV co-infected individuals have a similar allostimulatory capacity to DC from matched patients with HIV-1alone. These findings are compatible with results of prior clinical studies that found no evidence that HCV co-infection altered HIV disease progression and has implications for immunotherapeutic approaches in co-infected individuals.展开更多
Soil biofiltration, also known as soil bed reactor (SBR), technology was originally developed in Germany to take advantage of the diversity in microbial mechanisms to control gases producing malodor in industrial proc...Soil biofiltration, also known as soil bed reactor (SBR), technology was originally developed in Germany to take advantage of the diversity in microbial mechanisms to control gases producing malodor in industrial processes. The approach has since gained wider international acceptance and continues to see improvements to maximize microbial and process efficiency and extend the range of problematical gases for which the technology can be an effective control. We review the basic mechanisms which underlay microbial soil processes involved in air purification, advantages and limitations of the technology and the current research status of the approach. Soil biofiltration has lower capital and operating/energetic costs than conventional technologies and is well adapted to handle contaminants in moderate concentrations. The systems can be engineered to optimize efficiency though manipulation of temperature, pH, moisture content, soil organic matter and airflow rates. Soil air biofiltration technology was modified for application in the Biosphere 2 project, which demonstrated in preparatory research with a number of closed system testbeds that soil could also support crop plants while also serving as soil filters with airpumps to push air through the soil. This Biosphere 2 research demonstrated in several closed system testbeds that a number of important trace gases could be kept under control and led to the engineering of the entire agricultural soil of Biosphere 2 to serve as a soil filtration unit for the facility. Soil biofiltration, coupled with food crop production, as a component of bioregenerative space life support systems has the advantages of lower energy use and avoidance of the consumables required for other air purification approaches. Expanding use of soil biofiltration can aid a number of environmental applications, from the mitigation of indoor air pollution, as a method of reducing global warming impact of methane (biogas), improvement of industrial air emissions and prevention of accidental release of toxic gases.展开更多
Objective To determine the prevalence and associations of general practice registrars’performing absolute cardio-vascular risk(ACVR)assessment(ACVRa).Design A cross-sectional study employing data(2017–2018)from the ...Objective To determine the prevalence and associations of general practice registrars’performing absolute cardio-vascular risk(ACVR)assessment(ACVRa).Design A cross-sectional study employing data(2017–2018)from the Registrar Clinical Encounters in Training project,an ongoing inception cohort study of Australian GP registrars.The outcome measure was whether an ACVRa was performed.Analyses employed univariable and multivariable regression.Analysis was conducted for all patient problems/diagnoses,then for an‘at-risk’population(specific problems/diagnoses for which ACVRa is indicated).Setting Three GP regional training organisations(RTOs)across three Australian states.Participants GP registrars training within participating RTOs.Results 1003 registrars(response rate 96.8%)recorded details of 69105 problems either with Aboriginal and/or Torres Strait patients aged 35 years and older or with non-Indigenous patients aged 45 years and older.Of these problems/diagnoses,1721(2.5%(95%CI 2.4%to 2.6%))involved an ACVRa.An ACVRa was‘plausibly indicated’in 10384 problems/diagnoses.Of these,1228(11.8%(95%CI 11.2%to 12.4%))involved ACVRa.For‘all problems/diagnoses’,on multivariable analysis female gender was associated with reduced odds of ACVRa(OR 0.61(95%CI 0.54 to 0.68)).There was some evidence for Aboriginal and/or Torres Strait Islander people being more likely to receive ACVRa(OR 1.40(95%CI 0.94 to 2.08),p=0.10).There were associations with variables related to continuity of care,with reduced odds of ACVRa:if the patient was new to the registrar(OR 0.65(95%CI 0.57 to 0.75)),new to the practice(OR 0.24(95%CI 0.15 to 0.38))or the problem was new(OR 0.68(95%CI 0.59 to 0.78));and increased odds if personal follow-up was organised(OR 1.43(95%CI 1.24 to 1.66)).For‘ACVRa indicated’problems/diagnoses,findings were similar to those for‘all problems/diagnoses’.Association with Aboriginal and/or Torres Strait Islander status,however,was significant at p<0.05(OR 1.60(95%CI 1.04 to 2.46))and association with female gender was attenuated(OR 0.88(95%CI 0.77 to 1.01)).Conclusion Continuity of care is associated with registrars assessing ACVR,reinforcing the importance of care continuity in general practice.Registrars’assessment of an individual patient’s ACVR is targeted to patients with individual risk factors,but this may entail ACVRa underutilisation in female patients and younger age groups.展开更多
Biosphere 2,the largest and most biodiverse closed ecological system facility yet created,has contributed vital lessons for living with our planetary biosphere and for long-term habitation in space.From the space life...Biosphere 2,the largest and most biodiverse closed ecological system facility yet created,has contributed vital lessons for living with our planetary biosphere and for long-term habitation in space.From the space life support perspective,Biosphere 2 contrasted with previous BLSS work by including areas based on Earth wilderness biomes in addition to its provision for human life support and by using a soil-based intensive agricultural system producing a complete human diet.No previous BLSS system had included domestic farm animals.All human and domestic animal wastes were also recycled and returned to the crop soils.Biosphere 2 was important as a first step towards learning how to miniaturize natural ecosystems and develop technological support systems compatible with life.Biosphere 2’s mostly successful operation for three years(1991-1994)changed thinking among space life support scientists and the public at large about the need for minibiospheres for long-term habitation in space.As an Earth systems laboratory,Biosphere 2 was one of the first attempts to make ecology an experimental science at a scale relevant to planetary issues such as climate change,regenerative agriculture,nutrient and water recycling,loss of biodiversity,and understanding of the roles wilderness biomes play in the Earth’s biosphere.Biosphere 2 aroused controversy because of narrow definitions and expectations of how science is to be conducted.The cooperation between engineers and ecologists and the requirement to design a technosphere that supported the life inside without harming it have enormous relevance to what is required in our global home.Applications of bioregenerative life support systems for near-term space applications such as initial Moon and/or Mars bases,will be severely limited by high costs of transport to space and so will rely on lighter weight,hydroponic systems of growing plants which will focus first on water and air regeneration and gradually increase its production of food required by astronauts or inhabitants.The conversion of these systems to more robust and sustainable systems will require advanced technologies,e.g.,to capture sunlight for plant growth or process usable materials from the lunar or Martian atmosphere and regolith,leading to greater utilization of in situ space resources and less on transport from Earth.There are many approaches to the accomplishment of space life support.Significant progress has been made especially by two research efforts in China and the MELiSSA project of the European Space Agency.These approaches use cybernetic controls and the integration of intensive modules to accomplish food production,waste treatment and recycling,atmospheric regeneration,and in some systems,high-protein production from insects and larvae.Biosphere 2 employed a mix of ecological self-organization and human intervention to protect biodiversity for wilderness biomes with a tighter management of food crops in its agriculture.Biosphere 2’s aims were different than bioregenerative life support systems(BLSS)which have focused exclusively on human life support.Much more needs to be learned from both smaller,efficient ground-based BLSS for nearer-term habitation and from minibiospheric systems for long-term space application to transform humanity and Earth-life into truly multiplanet species.展开更多
文摘The incidence of hepatocellular carcinoma(HCC)in patients with human immunodeficiency virus(HIV) is rising.HCC in HIV almost invariably occurs in the context of hepatitis C virus(HCV)or hepatitis B virus (HBV)co-infection and,on account of shared modes of transmission,this occurs in more than 33% and 10% of patients with HIV worldwide respectively.It has yet to be clearly established whether HIV directly accelerates HCC pathogenesis or whether the rising incidence is an epiphenomenon of the highly active antiretroviral therapy(HAART)era,wherein the increased longevity of patients with HIV allows long-term complications of viral hepatitis and cirrhosis to develop.Answering this question will have implications for HCC surveillance and the timing of HCV/HBV therapy,which in HIV co-infection presents unique challenges.Once HCC develops,there is growing evidence that HIV co-infection should not preclude conventional therapeutic strategies,including liver transplantation.
基金Project supported by the National Natural Science Foundation of China(61403346,61233001)Finnish TEKES's project “SoMa 2020:Social Manufacturing”(2015-2017,211560)Chinese Guangdong's S&T project(2014B010118001)
文摘There is increasing recognition of the potential morbidity and mortality associated with HIV-1 and hepatitis C (HCV)co-infection. HIV appears to adversely affect HCV disease while the reciprocal effect of HCV on HIV remains controversial.We therefore studied the effect of co-infection on dendritic cell function versus HIV infection alone, as previous work has shown that HCV impairs dendritic cell (DC) function. HIV-1 positive individuals with HCV were matched for CD4count, HIV- 1 RNA viral load and therapy, to HIV- 1 positive patients without HCV. Monocyte-derived DC were generated and mixed leukocyte reactions were performed. We assessed allostimulatory capacity with and without administration of exogenous Thl cytokines, using thymidine uptake and cell division analyses with the vital dye CFSE. We found that monocyte-derived DC from co-infected individuals showed no significant differences in allostimulatory capacity to ex vivo generated DC from HIV-1 infected individuals without HCV. Unlike the situation with HCV infection alone, this impairment was not reversed by increasing concentrations of either interleukin-2 or -12. Monocyte-derived DC from HIV-1 and HCV co-infected individuals have a similar allostimulatory capacity to DC from matched patients with HIV-1alone. These findings are compatible with results of prior clinical studies that found no evidence that HCV co-infection altered HIV disease progression and has implications for immunotherapeutic approaches in co-infected individuals.
文摘Soil biofiltration, also known as soil bed reactor (SBR), technology was originally developed in Germany to take advantage of the diversity in microbial mechanisms to control gases producing malodor in industrial processes. The approach has since gained wider international acceptance and continues to see improvements to maximize microbial and process efficiency and extend the range of problematical gases for which the technology can be an effective control. We review the basic mechanisms which underlay microbial soil processes involved in air purification, advantages and limitations of the technology and the current research status of the approach. Soil biofiltration has lower capital and operating/energetic costs than conventional technologies and is well adapted to handle contaminants in moderate concentrations. The systems can be engineered to optimize efficiency though manipulation of temperature, pH, moisture content, soil organic matter and airflow rates. Soil air biofiltration technology was modified for application in the Biosphere 2 project, which demonstrated in preparatory research with a number of closed system testbeds that soil could also support crop plants while also serving as soil filters with airpumps to push air through the soil. This Biosphere 2 research demonstrated in several closed system testbeds that a number of important trace gases could be kept under control and led to the engineering of the entire agricultural soil of Biosphere 2 to serve as a soil filtration unit for the facility. Soil biofiltration, coupled with food crop production, as a component of bioregenerative space life support systems has the advantages of lower energy use and avoidance of the consumables required for other air purification approaches. Expanding use of soil biofiltration can aid a number of environmental applications, from the mitigation of indoor air pollution, as a method of reducing global warming impact of methane (biogas), improvement of industrial air emissions and prevention of accidental release of toxic gases.
基金The ReCEnT project was funded from 2016 to 2019 by an Australian Department of Health-commissioned research grantsupported by the GP Synergy Regional Training Organisation.
文摘Objective To determine the prevalence and associations of general practice registrars’performing absolute cardio-vascular risk(ACVR)assessment(ACVRa).Design A cross-sectional study employing data(2017–2018)from the Registrar Clinical Encounters in Training project,an ongoing inception cohort study of Australian GP registrars.The outcome measure was whether an ACVRa was performed.Analyses employed univariable and multivariable regression.Analysis was conducted for all patient problems/diagnoses,then for an‘at-risk’population(specific problems/diagnoses for which ACVRa is indicated).Setting Three GP regional training organisations(RTOs)across three Australian states.Participants GP registrars training within participating RTOs.Results 1003 registrars(response rate 96.8%)recorded details of 69105 problems either with Aboriginal and/or Torres Strait patients aged 35 years and older or with non-Indigenous patients aged 45 years and older.Of these problems/diagnoses,1721(2.5%(95%CI 2.4%to 2.6%))involved an ACVRa.An ACVRa was‘plausibly indicated’in 10384 problems/diagnoses.Of these,1228(11.8%(95%CI 11.2%to 12.4%))involved ACVRa.For‘all problems/diagnoses’,on multivariable analysis female gender was associated with reduced odds of ACVRa(OR 0.61(95%CI 0.54 to 0.68)).There was some evidence for Aboriginal and/or Torres Strait Islander people being more likely to receive ACVRa(OR 1.40(95%CI 0.94 to 2.08),p=0.10).There were associations with variables related to continuity of care,with reduced odds of ACVRa:if the patient was new to the registrar(OR 0.65(95%CI 0.57 to 0.75)),new to the practice(OR 0.24(95%CI 0.15 to 0.38))or the problem was new(OR 0.68(95%CI 0.59 to 0.78));and increased odds if personal follow-up was organised(OR 1.43(95%CI 1.24 to 1.66)).For‘ACVRa indicated’problems/diagnoses,findings were similar to those for‘all problems/diagnoses’.Association with Aboriginal and/or Torres Strait Islander status,however,was significant at p<0.05(OR 1.60(95%CI 1.04 to 2.46))and association with female gender was attenuated(OR 0.88(95%CI 0.77 to 1.01)).Conclusion Continuity of care is associated with registrars assessing ACVR,reinforcing the importance of care continuity in general practice.Registrars’assessment of an individual patient’s ACVR is targeted to patients with individual risk factors,but this may entail ACVRa underutilisation in female patients and younger age groups.
文摘Biosphere 2,the largest and most biodiverse closed ecological system facility yet created,has contributed vital lessons for living with our planetary biosphere and for long-term habitation in space.From the space life support perspective,Biosphere 2 contrasted with previous BLSS work by including areas based on Earth wilderness biomes in addition to its provision for human life support and by using a soil-based intensive agricultural system producing a complete human diet.No previous BLSS system had included domestic farm animals.All human and domestic animal wastes were also recycled and returned to the crop soils.Biosphere 2 was important as a first step towards learning how to miniaturize natural ecosystems and develop technological support systems compatible with life.Biosphere 2’s mostly successful operation for three years(1991-1994)changed thinking among space life support scientists and the public at large about the need for minibiospheres for long-term habitation in space.As an Earth systems laboratory,Biosphere 2 was one of the first attempts to make ecology an experimental science at a scale relevant to planetary issues such as climate change,regenerative agriculture,nutrient and water recycling,loss of biodiversity,and understanding of the roles wilderness biomes play in the Earth’s biosphere.Biosphere 2 aroused controversy because of narrow definitions and expectations of how science is to be conducted.The cooperation between engineers and ecologists and the requirement to design a technosphere that supported the life inside without harming it have enormous relevance to what is required in our global home.Applications of bioregenerative life support systems for near-term space applications such as initial Moon and/or Mars bases,will be severely limited by high costs of transport to space and so will rely on lighter weight,hydroponic systems of growing plants which will focus first on water and air regeneration and gradually increase its production of food required by astronauts or inhabitants.The conversion of these systems to more robust and sustainable systems will require advanced technologies,e.g.,to capture sunlight for plant growth or process usable materials from the lunar or Martian atmosphere and regolith,leading to greater utilization of in situ space resources and less on transport from Earth.There are many approaches to the accomplishment of space life support.Significant progress has been made especially by two research efforts in China and the MELiSSA project of the European Space Agency.These approaches use cybernetic controls and the integration of intensive modules to accomplish food production,waste treatment and recycling,atmospheric regeneration,and in some systems,high-protein production from insects and larvae.Biosphere 2 employed a mix of ecological self-organization and human intervention to protect biodiversity for wilderness biomes with a tighter management of food crops in its agriculture.Biosphere 2’s aims were different than bioregenerative life support systems(BLSS)which have focused exclusively on human life support.Much more needs to be learned from both smaller,efficient ground-based BLSS for nearer-term habitation and from minibiospheric systems for long-term space application to transform humanity and Earth-life into truly multiplanet species.
