Antigen presentation safeguards the integrity of the hematopoietic stem cell pool

Hematopoietic stem and progenitor cells (HSPCs) are responsible for the production of blood and immune cells. Throughout life, HSPCs acquire oncogenic aberrations that can cause hematological cancers. Although molecular programs maintaining stem cell integrity have been identified, safety mechanisms eliminating malignant HSPCs from the stem cell pool remain poorly characterized. Here, we show that HSPCs constitutively present antigens via major histocompatibility complex class II. The presentation of immunogenic antigens, as occurring during malignant transformation, triggers bidirectional interactions between HSPCs and antigen-specific CD4(+4) T cells, causing stem cell proliferation, differentiation, and specific exhaustion of aberrant HSPCs. This immunosurveillance mechanism effectively eliminates transformed HSPCs from the hematopoietic system, thereby preventing leukemia onset. Together, our data reveal a bidirectional interaction between HSPCs and CD4(+4) T cells, demonstrating that HSPCs are not only passive receivers of immunological signals but also actively engage in adaptive immune responses to safeguard the integrity of the stem cell pool

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The role of commercial law in protecting consumers A comparative study between Kuwaiti, British, French and American law

SIGLEAvailable from British Library Document Supply Centre- DSC:DX184042 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

An application of TPB constructs on energy-saving behavioural intention among university office building occupants: a pilot study in Malaysian tropical climate

Buildings account for a vast amount of energy consumption in Malaysia. Occupant behaviour patterns are a major factor affecting the energy performance of buildings. Identifying energy waste due to occupant behaviour will allow stakeholders to develop effective strategies to curtail energy consumption in buildings. The purpose of this study was to investigate the effects of theory of planned behaviour constructs on energy-saving behavioural intention among university building occupants. Data from a survey questionnaire was collected from 292 occupants (students and staff) at one case study building at a public university in Malaysia. Data analysed using the structural equation model showed that attitude and perception significantly influence occupants’ energy-saving behaviour. Our results indicate that respondents showed moderate behaviour on three sub-constructs: duration of equipment use, frequency of equipment use, and energy saving practice. The current pilot study provides a basis for an improved theoretical framework that considers other variables to be applied in a larger scale study. The implications for behaviour models in terms of policy recommendations and suggestions for occupant engagement campaigns are discussed. © 2019, Springer Nature B.V