Design of the Endobronchial Valve for Emphysema Palliation Trial (VENT): a non-surgical method of lung volume reduction

Background

Lung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently, less invasive bronchoscopic approaches have been designed to utilize these principles while avoiding the associated perioperative risks. The Endobronchial Valve for Emphysema PalliatioN Trial (VENT) posits that occlusion of a single pulmonary lobe through bronchoscopically placed Zephyr^® endobronchial valves will effect significant improvements in lung function and exercise tolerance with an acceptable risk profile in advanced emphysema.

Methods

The trial design posted on Clinical trials.gov, on August 10, 2005 proposed an enrollment of 270 subjects. Inclusion criteria included: diagnosis of emphysema with forced expiratory volume in one second (FEV₁) < 45% of predicted, hyperinflation (total lung capacity measured by body plethysmography > 100%; residual volume > 150% predicted), and heterogeneous emphysema defined using a quantitative chest computed tomography algorithm. Following standardized pulmonary rehabilitation, patients were randomized 2:1 to receive unilateral lobar placement of endobronchial valves plus optimal medical management or optimal medical management alone. The co-primary endpoint was the mean percent change in FEV₁ and six minute walk distance at 180 days. Secondary end-points included mean percent change in St. George's Respiratory Questionnaire score and the mean absolute changes in the maximal work load measured by cycle ergometry, dyspnea (mMRC) score, and total oxygen use per day. Per patient response rates in clinically significant improvement/maintenance of FEV₁ and six minute walk distance and technical success rates of valve placement were recorded. Apriori response predictors based on quantitative CT and lung physiology were defined.

Conclusion

If endobronchial valves improve FEV₁ and health status with an acceptable safety profile in advanced emphysema, they would offer a novel intervention for this progressive and debilitating disease.

Trial Registration

ClinicalTrials.gov: NCT00129584     

The effect of direct supplementary feeding of nestlings on weight loss in female Great Tits Parus major

Experimentally hand-feeding nestlings of enlarged (+3 nestlings) broods reduced female weight loss during the nestling period in a single-brooded Great Tit Parus major population in Scotland but did not affect nestling size. The result is consistent with the existence of a trade-off in parental care between reproductive costs and benefits.     

Extreme differences in rates of molecular evolution of foraminifera revealed by comparison of ribosomal DNA sequences and the fossil record

Foraminifera have one of the best known fossil records among the unicellular eukaryotes. However, the origin and phylogenetic relationships of the extant foraminiferal lineages are poorly understood. To test the current paleontological hypotheses on evolution of foraminifera, we sequenced about 1,000 base pairs from the 3' end of the small subunit rRNA gene (SSU rDNA) in 22 species representing all major taxonomic groups. Phylogenies were derived using neighbor- joining, maximum-parsimony, and maximum-likelihood methods. All analyses confirm the monophyletic origin of foraminifera. Evolutionary relationships within foraminifera inferred from rDNA sequences, however, depend on the method of tree building and on the choice of analyzed sites. In particular, the position of planktonic foraminifera shows important variations. We have shown that these changes result from the extremely high rate of rDNA evolution in this group. By comparing the number of substitutions with the divergence times inferred from the fossil record, we have estimated that the rate of rDNA evolution in planktonic foraminifera is 50 to 100 times faster than in some benthic foraminifera. The use of the maximum-likelihood method and limitation of analyzed sites to the most conserved parts of the SSU rRNA molecule render molecular and paleontological data generally congruent.      

Mutant dn Influences Dry Matter Distribution, Assimilate Partitioning and Flowering in Lathyrus odoratus L.

The flowering mutant dn in sweet pea was used as a tool to study¹⁴C-assimilate and dry matter partitioning with respect to nutrientdiversion theories on the control of flower initiation. Wildtype plants (Dn^h) are photoperiodic and exhibit late floweringand profuse basal branching in short days while mutant plants(dn) are day neutral, early flowering and devoid of basal laterals.In short days, dn plants exported a significantly greater proportionof assimilate acropetally than (Dn^h) plants and the upper portionof dn plants had a greater dry weight. These differences werereduced dramatically when basal laterals were excised regularlyfrom the (Dn^h) plants although the difference in flowering remained.However, the effect of dn on resource allocation within theapical region may be more important in regard to flowering thanthe effect on acropetal versus basipetal movement. In shortdays, the dn plants partitioned significantly more resourcesinto their internodes and petioles, and less into their leaflets,than Dn^h plants as shown by dry weight and ¹⁴C-assimilate measurements.These differences were apparent from as early as node 7 up tothe node of flower initiation in dn plants (node 30) and theywere not eliminated by removal of basal laterals from Dn^h plants.Differences between dn and Dn^h plants in partitioning and floweringwere largely eliminated under long days. The fact that in thisspecies a single gene influences both resource allocation andflower initiation lends further support to nutrient diversionhypotheses on the control of flowering. Key words: Assimilate partitioning, branching, flowering, mutant, sweet pea     

Regulation of Internodal Extension in Avena Shoots by the Inflorescence, Nodes, Leaves, and Intercalary Meristem

It has been found in recent studies that the inflorescence and nodes (node-pulvini) are the primary sources for native gibberellins in the Avena shoot, and that GA₃ is the predominant gibberellin in the inflorescence. In the present work, linear growth of next-to-last internode is drastically reduced by removal of the inflorescence and last leaf. This growth is completely abolished when the nodes are also excised. It is restored fully by the addition of GA₃ when the nodes are present, and restored only partially when the nodes are deleted. Internodal growth in Avena stem segments with basal node present is also restored by native GA₃-like substances extracted from Avena inflorescences and partially purified by silica gel partition column chromatography. Evidence from these studies, taken in toto, indicates that the inflorescence, nodes, and leaves supply gibberellins, leaves supply substrate, and nodes modulate the gibberellin growth response in next-to-last Avena internodes.     

Successful immunotherapy with matrix metalloproteinase-derived peptides in adjuvant arthritis depends on the timing of peptide administration

We have recently found that matrix metalloproteinases (MMPs) are targets for T-cell and B-cell reactivity in experimental arthritis. In the present article, we investigate whether modulation of MMP-specific T-cell responses could influence the course of adjuvant arthritis (AA). Lewis rats were treated nasally with MMP peptides prior to or after AA induction. Administration of the MMP-10 or the MMP-16 peptide prior to AA induction reduced the arthritic symptoms. In contrast, administration of the MMP-10 peptide after AA induction aggravated the arthritic symptoms. The present study shows the possible usefulness of MMP peptides for immunotherapy. However, a clear understanding of proper timing of peptide administration is crucial for the development of such therapies.     

Habitat selection at multiple spatial scales by foraging Glossy Black‐cockatoos

Abstract: Habitat selection among vertebrates entails decision making at a number of spatial scales. An understanding of factors influencing decisions at each of these scales is required for the effective management of wildlife populations. This study investigates the foraging ecology of a population of Glossy Black‐cockatoos in central New South Wales. We took advantage of the characteristic feeding sign produced by Glossy Black‐cockatoos to examine factors influencing habitat selection at multiple spatial scales. Birds preferred to forage at sites where food was abundant and avoided open sites where the predation risk may be greater. Their two food species, Allocasuarina diminuta and Allocasuarina gymnanthera, differed in profitability (kernel intake rate as measured by the ratio of seed weight to total seed and cone weight), as did trees within a species. Both species were utilized extensively, although foraging intensity was greater at sites where the more profitable species was present. In order to maximize their food intake, birds selected individual trees on the basis of cone abundance and profitability. Cones produced in the previous year were preferred.     

Do pollinators influence seed-set in Banksia paludosa Sm. and Banksia spinulosa R. Br.?

The consequences of observed variations in pollinator activity for plant reproduction depend on the breeding system of the plant and also on whether pollination is a resource in short supply. These factors are frequently assumed rather than tested. In bagging experiments with Banksia paludosa in heath and B. spinulosa var. spinulosa in woodland, the present study demonstrated that seed-set does not occur by autogamy and that pollinators are indeed necessary. Experimental addition of outcrossed pollen to inflorescences failed to produce any increase in the mean number of seeds per inflorescence, measured for non-barren inflorescences, for either species. However, in B. paludosa, the addition of pollen increased the numbers of inflorescences that set seed from 20% (controls) to 45% (pollen-added treatment). This suggests either unusual patterns of pollen movement among and within plants or control of the pattern of seed-set within a plant. Pollen additions failed to alter seed-set in B. spinulosa. It is possible that a greater abundance of pollinators in the woodland ensures adequate pollination for these plants