Adoptive transfer of cytomegalovirus-specific CTL to stem cell transplant patients after selection by HLA–peptide tetramers

Stem cell transplantation is used widely in the management of a range of diseases of the hemopoietic system. Patients are immunosuppressed profoundly in the early posttransplant period, and reactivation of cytomegalovirus (CMV) remains a significant cause of morbidity and mortality. Adoptive transfer of donor-derived CMV-specific CD8(+) T cell clones has been shown to reduce the rate of viral reactivation; however, the complexity of this approach severely limits its clinical application. We have purified CMV-specific CD8(+) T cells from the blood of stem cell transplant donors using staining with HLA-peptide tetramers followed by selection with magnetic beads. CMV-specific CD8(+) cells were infused directly into nine patients within 4 h of selection. Median cell dosage was 8.6 x 10(3)/kg with a purity of 98% of all T cells. CMV-specific CD8(+) T cells became detectable in all patients within 10 d of infusion, and TCR clonotype analysis showed persistence of infused cells in two patients studied. CMV viremia was reduced in every case and eight patients cleared the infection, including one patient who had a prolonged history of CMV infection that was refractory to antiviral therapy. This novel approach to adoptive transfer has considerable potential for antigen-specific T cell therapy

Developing State and National Evaluation Infrastructures- Guidance for the Challenges and Opportunities of EM&V

Evaluating the impacts and effectiveness of energy efficiency programs is likely to become increasingly important for state policymakers and program administrators given legislative mandates and regulatory goals and increasing reliance on energy efficiency as a resource. In this paper, we summarize three activities that the authors have conducted that highlight the expanded role of evaluation, measurement and verification (EM&V): a study that identified and analyzed challenges in improving and scaling up EM&V activities; a scoping study that identified issues involved in developing a national efficiency EM&V standard; and lessons learned from providing technical assistance on EM&V issues to states that are ramping up energy efficiency programs. The lessons learned are summarized in 13 EM&V issues that policy makers should address in each jurisdiction and which are listed and briefly described. The paper also discusses how improving the effectiveness and reliability of EM&V will require additional capacity building, better access to existing EM&V resources, new methods to address emerging issues and technologies, and perhaps foundational documents and approaches to improving the credibility and cross jurisdictional comparability of efficiency investments. Two of the potential foundational documents discussed are a national EM&V standard or resource guide and regional deemed savings and algorithm databases

Demand responsive programs - an emerging resource for competitive electricity markets?

The restructuring of regional electricity markets in the U.S. has been accompanied by numerous problems, including generation capacity shortages, transmission congestion, wholesale price volatility, and reduced system reliability. These problems have created significant new opportunities for technologies and business approaches that allow load serving entities and other aggregators, to control and manage the load patterns of their wholesale or retail end-users. These technologies and business approaches for manipulating end-user load shapes are known as Load Management or, more recently, Demand Responsive programs. Lawrence Berkeley National Laboratory (LBNL) is conducting case studies on innovative demand responsive programs and presents preliminary results for five case studies in this paper. These case studies illustrate the diversity of market participants and range of technologies and business approaches and focus on key program elements such as target markets, market segmentation and participation results; pricing scheme; dispatch and coordination; measurement, verification, and settlement; and operational results where available

Collecting, analyzing and archiving of ground based infrared solar spectra obtained from several locations

The infrared solar spectrum as observed from the ground under high resolution contains thousands of absorption lines. The majority of these lines are due to compounds that are present in the Earth's atmosphere. Ground based infrared solar spectra contain information concerning the composition of the atmosphere at the time the spectra were obtained. The objective of this program is to record solar spectra from various ground locations, and to analyze and archive these spectra. The analysis consists of determining, for as many of the absorption lines as possible, the molecular species responsible for the absorption, and to verify that current models of infrared transmission match the observed spectra. Archiving is an important part of the program, since a number of the features in the spectra have not been identified. At some later time, when the features are identified, it will be possible to determine the amount of that compound that was present in the atmosphere at the time the spectrum was taken

The Challenges of First-in-Human Stem Cell Clinical Trials: What Does This Mean for Ethics and Institutional Review Boards?

Stem cell-based clinical interventions are increasingly advancing through preclinical testing and approaching clinical trials. The complexity and diversity of these approaches, and the confusion created by unproven and untested stem cell-based "therapies," create a growing need for a more comprehensive review of these early-stage human trials to ensure they place the patients at minimal risk of adverse events but are also based on solid evidence of preclinical efficacy with a clear scientific rationale for that effect. To address this issue and supplement the independent review process, especially that of the ethics and institutional review boards who may not be experts in stem cell biology, the International Society for Stem Cell Research (ISSCR) has developed a set of practical questions to cover the major issues for which clear evidence-based answers need to be obtained before approving a stem cell-based trial

Interactions between Energy Efficiency Programs funded under the Recovery Act and Utility Customer-Funded Energy Efficiency Programs

Since the spring of 2009, billions of federal dollars have been allocated to state and local governments as grants for energy efficiency and renewable energy projects and programs. The scale of this American Reinvestment and Recovery Act (ARRA) funding, focused on 'shovel-ready' projects to create and retain jobs, is unprecedented. Thousands of newly funded players - cities, counties, states, and tribes - and thousands of programs and projects are entering the existing landscape of energy efficiency programs for the first time or expanding their reach. The nation's experience base with energy efficiency is growing enormously, fed by federal dollars and driven by broader objectives than saving energy alone. State and local officials made countless choices in developing portfolios of ARRA-funded energy efficiency programs and deciding how their programs would relate to existing efficiency programs funded by utility customers. Those choices are worth examining as bellwethers of a future world where there may be multiple program administrators and funding sources in many states. What are the opportunities and challenges of this new environment? What short- and long-term impacts will this large, infusion of funds have on utility customer-funded programs; for example, on infrastructure for delivering energy efficiency services or on customer willingness to invest in energy efficiency? To what extent has the attribution of energy savings been a critical issue, especially where administrators of utility customer-funded energy efficiency programs have performance or shareholder incentives? Do the new ARRA-funded energy efficiency programs provide insights on roles or activities that are particularly well-suited to state and local program administrators vs. administrators or implementers of utility customer-funded programs? The answers could have important implications for the future of U.S. energy efficiency. This report focuses on a selected set of ARRA-funded energy efficiency programs administered by state energy offices: the State Energy Program (SEP) formula grants, the portion of Energy Efficiency and Conservation Block Grant (EECBG) formula funds administered directly by states, and the State Energy Efficient Appliance Rebate Program (SEEARP). Since these ARRA programs devote significant monies to energy efficiency and serve similar markets as utility customer-funded programs, there are frequent interactions between programs. We exclude the DOE low-income weatherization program and EECBG funding awarded directly to the over 2,200 cities, counties and tribes from our study to keep its scope manageable. We summarize the energy efficiency program design and funding choices made by the 50 state energy offices, 5 territories and the District of Columbia. We then focus on the specific choices made in 12 case study states. These states were selected based on the level of utility customer program funding, diversity of program administrator models, and geographic diversity. Based on interviews with more than 80 energy efficiency actors in those 12 states, we draw observations about states strategies for use of Recovery Act funds. We examine interactions between ARRA programs and utility customer-funded energy efficiency programs in terms of program planning, program design and implementation, policy issues, and potential long-term impacts. We consider how the existing regulatory policy framework and energy efficiency programs in these 12 states may have impacted development of these selected ARRA programs. Finally, we summarize key trends and highlight issues that evaluators of these ARRA programs may want to examine in more depth in their process and impact evaluations

Mercury from chlor-alkali plants: measured concentrations in food product sugar

Mercury cell chlor-alkali products are used to produce thousands of other products including food ingredients such as citric acid, sodium benzoate, and high fructose corn syrup. High fructose corn syrup is used in food products to enhance shelf life. A pilot study was conducted to determine if high fructose corn syrup contains mercury, a toxic metal historically used as an anti-microbial. High fructose corn syrup samples were collected from three different manufacturers and analyzed for total mercury. The samples were found to contain levels of mercury ranging from below a detection limit of 0.005 to 0.570 micrograms mercury per gram of high fructose corn syrup. Average daily consumption of high fructose corn syrup is about 50 grams per person in the United States. With respect to total mercury exposure, it may be necessary to account for this source of mercury in the diet of children and sensitive populations

Treatment of Colorectal Peritoneal Carcinomatosis With Systemic Chemotherapy: A Pooled Analysis of North Central Cancer Treatment Group Phase III Trials N9741 and N9841

Symptoms and complications of metastatic colorectal cancer (mCRC) differ by metastatic sites. There is a paucity of prospective survival data for patients with peritoneal carcinomatosis colorectal cancer (pcCRC). We characterized outcomes of patients with pcCRC enrolled onto two prospective randomized trials of chemotherapy and contrasted that with other manifestations of mCRC (non-pcCRC)