The long haul: Caring for bone marrow transplant patients in regional Australia

Objective To evaluate the experience of, and services to, patients from rural and regional Australia referred to a large urban tertiary referral hospital for allogeneic haematopoietic cell transplantation (allo‑HCT) and to compare their quality of life with similar populations. Design and setting A cross‑sectional survey of allo‑HCT recipients referred from the Calvary Mater Newcastle to Westmead Hospital, Sydney, NSW. Subjects Thirty‑seven of forty adult survivors of allo‑HCT (92.5%) who underwent transplant between 1999 and 2008 and were at least three months post transplant. Intervention All subjects completed a validated measure of quality‑of‑life (QoL) in bone marrow transplant recipients ( FACT‑BMT Version 4) and the Regional/Rural BMT Needs Assessment Survey. Results Most patients (79%) were between one and five years post transplant. Almost all reported having been sufficiently prepared for transplant and received most information and support from the Nurse Coordinator. Despite the fact that 89% of patients reported significant adverse effects of allo‑HCT, >60% still reported an acceptable quality of life. Importantly, however, about a third of patients experienced financial difficulties associated with transplantation and felt pressure to return to work. Conclusion Patients referred for allo‑HCT should be advised about the arduousness of transplant but also reassured that most survivors will experience acceptable levels of functioning and QoL one to two years after transplant. With sufficient local support and with appropriate nursing care and coordination the experiences of regional/rural patients is comparable with other allo‑HCT patient populations. Further investigation into vocational rehabilitation is warranted due to the significant financial and occupational pressures reported by survivors of allo‑HC

The long haul: Caring for bone marrow transplant patients in regional Australia

Objective To evaluate the experience of, and services to, patients from rural and regional Australia referred to a large urban tertiary referral hospital for allogeneic haematopoietic cell transplantation (allo‑HCT) and to compare their quality of life with similar populations. Design and setting A cross‑sectional survey of allo‑HCT recipients referred from the Calvary Mater Newcastle to Westmead Hospital, Sydney, NSW. Subjects Thirty‑seven of forty adult survivors of allo‑HCT (92.5%) who underwent transplant between 1999 and 2008 and were at least three months post transplant. Intervention All subjects completed a validated measure of quality‑of‑life (QoL) in bone marrow transplant recipients ( FACT‑BMT Version 4) and the Regional/Rural BMT Needs Assessment Survey. Results Most patients (79%) were between one and five years post transplant. Almost all reported having been sufficiently prepared for transplant and received most information and support from the Nurse Coordinator. Despite the fact that 89% of patients reported significant adverse effects of allo‑HCT, >60% still reported an acceptable quality of life. Importantly, however, about a third of patients experienced financial difficulties associated with transplantation and felt pressure to return to work. Conclusion Patients referred for allo‑HCT should be advised about the arduousness of transplant but also reassured that most survivors will experience acceptable levels of functioning and QoL one to two years after transplant. With sufficient local support and with appropriate nursing care and coordination the experiences of regional/rural patients is comparable with other allo‑HCT patient populations. Further investigation into vocational rehabilitation is warranted due to the significant financial and occupational pressures reported by survivors of allo‑HC

Prediction of the probability of large fires in the Sydney region of south-eastern Australia using components of fire weather.

The probability of large-fire (\u3e= 1000 ha) ignition days, in the Sydney region, was examined using historical records. Relative influences of the ambient and drought components of the Forest Fire Danger Index (FFDI) on large fire ignition probability were explored using Bayesian logistic regression. The preferred models for two areas (Blue Mountains and Central Coast) were composed of the sum of FFDI (Drought Factor, DF = 1) (ambient component) and DF as predictors. Both drought and ambient weather positively affected the chance of large fire ignitions, with large fires more probable on the Central Coast than in the Blue Mountains. The preferred, additive combination of drought and ambient weather had a marked threshold effect on large-fire ignition and total area burned in both localities. This may be due to a landscape-scale increase in the connectivity of available fuel at high values of the index. Higher probability of large fires on the Central Coast may be due to more subdued terrain or higher population density and ignitions. Climate scenarios for 2050 yielded predictions of a 20-84% increase in potential large-fire ignitions days, using the preferred model

How old is the Tasmanian cultural landscape? a test of landscape openness using quantitative land-cover reconstructions

Aim: To test competing hypotheses about the timing and extent of Holocene landscape opening using pollen-based quantitative land-cover estimates. Location: Dove Lake, Tasmanian Wilderness World Heritage Area, Australia. Methods: Fossil pollen data were incorporated into pollen dispersal models and corrected for differences in pollen productivity among key plant taxa. Mechanistic models (REVEALS-Regional Estimates of VEgetation Abundance from Large Sites) employing different models for pollen dispersal (Gaussian plume and Lagrangian stochastic models) were evaluated and applied in the Southern Hemisphere for the first time. Results: Validation of the REVEALS model with vegetation cover data suggests an overall better performance of the Lagrangian stochastic model. Regional land-cover estimates for forest and non-forest plant taxa show persistent landscape openness throughout the Holocene (average landscape openness similar to 50%). Gymnoschoenus sphaerocephalus, an indicator of moorland vegetation, shows higher values during the early Holocene (11.7-9 ka) and declines slightly through the mid-Holocene (9-4.5 ka) during a phase of partial landscape afforestation. Rain forest cover reduced (from similar to 40% to similar to 20%) during the period between 4.2-3.5 ka. Main conclusions: Pollen percentages severely under-represent landscape openness in western Tasmania and this bias has fostered an over-estimation of Holocene forest cover from pollen data. Treeless vegetation dominated Holocene landscapes of the Dove Lake area, allowing us to reject models of landscape evolution that invoke late-Holocene replacement of a rain forest-dominated landscape by moorland. Instead, we confirm a model of Late Pleistocene inheritance of open vegetation. Rapid forest decline occurred after c.4 ka, likely in response to regional moisture decline.Australian Research Council; AINSE AWARD [ALNGRA16024]; AINSE PGRA scholarship [12039]info:eu-repo/semantics/publishedVersio

Long-term in vitro maintenance of clonal abundance and leukaemia-initiating potential in acute lymphoblastic leukaemia

Lack of suitable in vitro culture conditions for primary acute lymphoblastic leukaemia (ALL) cells severely impairs their experimental accessibility and the testing of new drugs on cell material reflecting clonal heterogeneity in patients. We show that Nestin-positive human mesenchymal stem cells (MSCs) support expansion of a range of biologically and clinically distinct patient-derived ALL samples. Adherent ALL cells showed an increased accumulation in the S phase of the cell cycle and diminished apoptosis when compared with cells in the suspension fraction. Moreover, surface expression of adhesion molecules CD34, CDH2 and CD10 increased several fold. Approximately 20% of the ALL cells were in G0 phase of the cell cycle, suggesting that MSCs may support quiescent ALL cells. Cellular barcoding demonstrated long-term preservation of clonal abundance. Expansion of ALL cells for >3 months compromised neither feeder dependence nor cancer initiating ability as judged by their engraftment potential in immunocompromised mice. Finally, we demonstrate the suitability of this co-culture approach for the investigation of drug combinations with luciferase-expressing primograft ALL cells. Taken together, we have developed a preclinical platform with patient-derived material that will facilitate the development of clinically effective combination therapies for ALL

Biological and geophysical feedbacks with fire in the Earth System

Roughly 3% of the Earth’s land surface burns annually, representing a critical exchange of energy and matter between the land and atmosphere via combustion. Fires range from slow smouldering peat fires, to low-intensity surface fires, to intense crown fires, depending on vegetation structure, fuel moisture, prevailing climate, and weather conditions. While the links between biogeochemistry, climate and fire are widely studied within Earth system science, these relationships are also mediated by fuels – namely plants and their litter – which are the product of evolutionary and ecological processes. Fire is a powerful selective force and, over their evolutionary history, plants across diverse clades have evolved numerous traits that either tolerate or promote fire. Here we outline a conceptual framework of how plant traits determine the flammability of ecosystems and interact with climate and weather to influence fire regimes. We explore how these evolutionary and ecological processes scale to impact biogeochemistry and Earth system processes. Finally, we outline several research challenges that, when resolved, will improve our understanding of the role of plant evolution in mediating the fire feedbacks driving Earth system processes. Understanding current patterns of fire and vegetation, as well as patterns of fire over geological time, requires research that incorporates evolutionary biology, ecology, biogeography, and the biogeosciences

Ecological implications of fine-scale fire patchiness and severity in tropical savannas of northern Australia

Research ArticleUnderstanding fine-scale fire patchiness has significant implications for ecological processes and biodiversity conservation. It can affect local extinction of and recolonisation by relatively immobile fauna and poorly seed-dispersed flora in fire-affected areas. This study assesses fine-scale fire patchiness and severity, and associated implications for biodiversity, in north Australian tropical savanna systems. We used line transects to sample burning patterns of ground layer vegetation in different seasons and vegetation structure types, within the perimeter of 35 fires that occurred between 2009 and 2011. We evaluated two main fire characteristics: patchiness (patch density and mean patch length) and severity (inferred from char and scorch heights, and char and ash proportions). The mean burned area of ground vegetation was 83 % in the early dry season (EDS: May to July) and 93 % in the late dry season (LDS: August to November). LDS fires were less patchy (smaller and fewer unburned patches), and had higher fire severity (higher mean char and scorch heights, and twice the proportion of ash) than EDS fires. Fire patchiness varied among vegetation types, declining under more open canopy structure. The relationship between burned area and fire severity depended on season, being strongly correlated in the EDS and uncorrelated in the LDS. Simulations performed to understand the implications of patchiness on the population dynamics of fire-interval sensitive plant species showed that small amounts of patchiness substantially enhance survival. Our results indicate that the ecological impacts of high frequency fires on firesensitive regional biodiversity elements are likely to be lower than has been predicted from remotely sensed studies that are based on assumptions of homogeneous burninginfo:eu-repo/semantics/publishedVersio

Savanna burning methodology for fire management and emissions reduction: a critical review of influencing factors

Savanna fire is a major source of global greenhouse gas (GHG) emissions. In Australia, savanna fire contributes about 3% of annual GHG emissions reportable to the Kyoto Protocol. In order to reduce GHG emissions from savanna burning, the Australian government has developed and approved a Kyoto compliant savanna controlled burning methodology—the first legal instrument of this kind at a global level—under its Emission Reduction Fund. However, this approved methodology is currently only applicable to nine vegetation fuel types across northern parts of Australia in areas which receive on average over 600 mm rainfall annually, covering only 15.4% of the total land area in Australia.Savanna ecosystems extend across a large proportion of mainland Australia. This paper provides a critical review often key factors that need to be considered in developing a savanna burning methodology applicable to the other parts of Australia. It will also inform discussion in other countries intent on developing similar emissions reduction strategies

Activating killer-cell immunoglobulin-like receptor haplotype influences clinical outcome following HLA-matched sibling haematopoietic stem cell transplantation

Natural killer cells are thought to influence the outcome of hematopoietic stem cell transplant (HSCT), impacting on relapse, overall survival, graft versus host disease and the control of infection, in part through the complex interplay between the large and genetically diverse killer immunoglobulin-like receptor (KIR) family and their ligands. This study examined the relationship between KIR gene content and clinical outcomes including the control of opportunistic infections such as cytomegalovirus in the setting of human leucocyte antigen (HLA)-matched sibling HSCT in an Australian cohort. The presence of the KIR B haplotype which contain more activating receptors in the donor, in particular centromeric B haplotype genes (Cen-B), was associated with improved overall survival of patients with acute myeloid leukemia (AML) undergoing sibling HSCT and receiving myeloablative conditioning. Donor Cen-B haplotype was also associated with reduced acute graft versus host disease grades II-IV whereas donor telomeric-B haplotype was associated with decreased incidence of CMV reactivation. In contrast, we were not able to demonstrate a reduced rate of relapse when the donor had KIR Cen-B, however relapse with a donor Cen-A haplotype was a competing risk factor to poor overall survival. Here we show that the presence of donor activating KIR led to improved outcome for the patient, potentially through reduced relapse rates and decreased incidence of acute GvHD translating to improved overall survival. This article is protected by copyright. All rights reserved

Biological and geophysical feedbacks with fire in the Earth system

Roughly 3% of the Earth’s land surface burns annually, representing a critical exchange of energy and matter between the land and atmosphere via combustion. Fires range from slow smouldering peat fires, to low-intensity surface fires, to intense crown fires, depending on vegetation structure, fuel moisture, prevailing climate, and weather conditions. While the links between biogeochemistry, climate and fire are widely studied within Earth system science, these relationships are also mediated by fuels—namely plants and their litter—that are the product of evolutionary and ecological processes. Fire is a powerful selective force and, over their evolutionary history, plants have evolved traits that both tolerate and promote fire numerous times and across diverse clades. Here we outline a conceptual framework of how plant traits determine the flammability of ecosystems and interact with climate and weather to influence fire regimes. We explore how these evolutionary and ecological processes scale to impact biogeochemical and Earth system processes. Finally, we outline several research challenges that, when resolved, will improve our understanding of the role of plant evolution in mediating the fire feedbacks driving Earth system processes. Understanding current patterns of fire and vegetation, as well as patterns of fire over geological time, requires research that incorporates evolutionary biology, ecology, biogeography, and the biogeosciences