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AimsCONCERT-HF is an NHLBI-sponsored, double-blind, placebo-controlled, Phase II trial designed to determine whether treatment with autologous bone marrow-derived mesenchymal stromal cells (MSCs) and c-kit positive cardiac cells (CPCs), given alone or in combination, is feasible, safe, and beneficial in patients with heart failure (HF) caused by ischaemic cardiomyopathy.Methods and resultsPatients were randomized (1:1:1:1) to transendocardial injection of MSCs combined with CPCs, MSCs alone, CPCs alone, or placebo, and followed for 12 months. Seven centres enrolled 125 participants with left ventricular ejection fraction of 28.6 ± 6.1% and scar size 19.4 ± 5.8%, in New York Heart Association class II or III. The proportion of major adverse cardiac events (MACE) was significantly decreased by CPCs alone (-22% vs. placebo, P = 0.043). Quality of life (Minnesota Living with Heart Failure Questionnaire score) was significantly improved by MSCs alone (P = 0.050) and MSCs + CPCs (P = 0.023) vs. placebo. Left ventricular ejection fraction, left ventricular volumes, scar size, 6-min walking distance, and peak oxygen consumption did not differ significantly among groups.ConclusionsThis is the first multicentre trial assessing CPCs and a combination of two cell types from different tissues in HF patients. The results show that treatment is safe and feasible. Even with maximal guideline-directed therapy, both CPCs and MSCs were associated with improved clinical outcomes (MACE and quality of life, respectively) in ischaemic HF without affecting left ventricular function or structure, suggesting possible systemic or paracrine cellular mechanisms. Combining MSCs with CPCs was associated with improvement in both these outcomes. These results suggest potential important beneficial effects of CPCs and MSCs and support further investigation in HF patients.

BackgroundAnthracycline-induced cardiomyopathy (AIC) may be irreversible with a poor prognosis, disproportionately affecting women and young adults. Administration of allogeneic bone marrow-derived mesenchymal stromal cells (allo-MSCs) is a promising approach to heart failure (HF) treatment.ObjectivesSENECA (Stem Cell Injection in Cancer Survivors) was a phase 1 study of allo-MSCs in AIC.MethodsCancer survivors with chronic AIC (mean age 56.6 years; 68% women; NT-proBNP 1,426 pg/ml; 6 enrolled in an open-label, lead-in phase and 31 subjects randomized 1:1) received 1 × 108 allo-MSCs or vehicle transendocardially. Primary objectives were safety and feasibility. Secondary efficacy measures included cardiac function and structure measured by cardiac magnetic resonance imaging (CMR), functional capacity, quality of life (Minnesota Living with Heart Failure Questionnaire), and biomarkers.ResultsA total of 97% of subjects underwent successful study product injections; all allo-MSC-assigned subjects received the target dose of cells. Follow-up visits were well-attended (92%) with successful collection of endpoints in 94% at the 1-year visit. Although 58% of subjects had non-CMR compatible devices, CMR endpoints were successfully collected in 84% of subjects imaged at 1 year. No new tumors were reported. There were no significant differences between allo-MSC and vehicle groups with regard to clinical outcomes. Secondary measures included 6-min walk test (p = 0.056) and Minnesota Living with Heart Failure Questionnaire score (p = 0.048), which tended to favor the allo-MSC group.ConclusionsIn this first-in-human study of cell therapy in patients with AIC, transendocardial administration of allo-MSCs appears safe and feasible, and CMR was successfully performed in the majority of the HF patients with devices. This study lays the groundwork for phase 2 trials aimed at assessing efficacy of cell therapy in patients with AIC.

After the first large scale national sampling survey on handicapped persons in 1987, China conducted its second national sampling survey in 2006. Using the data from these two surveys and the national life tables, we computed and compared the expected years of life free of handicapped condition by the Sullivan method. The expected years of life lived with handicap for the Chinese population increased from 4.87 years for males and 5.81 years for females in 1987 to 5.55 years and 6.32 years in 2006, respectively. The same trend was observed for people in working ages (15-64) and old ages (65+). However, the expected years of life lived with handicap decreased for children (0-14). Our results also showed that the effect of skeletal handicap increased notably for both sexes. Healthy life expectancy is an important indicator in measuring quality of life of a population. Our study utilized this measurement to quantify one aspect of quality of life of the Chinese population.

In this article, we report statistical properties of two classes of generalized Gini coefficients (G1 and G2). The theoretical results were assessed via Monte Carlo simulations. Further, we used G1 and G2 on life expectancy to measure health inequalities among the provinces of China and the states of the United States. For China, the results indicated that there was statistically significant health inequality by both G1 and G2. However, for the US, the results showed that there was significant health inequality by G1 but no statistical significance was found in health inequality by G2. Overall, from our study, China has higher health inequality than the United States.

Utilizing data from the Census of India, this study compared child sex ratio in rural and urban regions of India and analyzed whether the child sex ratio was associated with mother's education level. The child sex ratios in the rural and urban regions throughout India were analyzed using the two-sample and paired Student's t-test. Further, the Chi-square test for trend in binomial proportions was used to assess the association between child sex ratios and mother's education levels in rural and urban areas. Analysis of the data showed that there was a significant difference between the child sex ratios in rural areas versus urban areas. In addition, the Chi-square test for trend showed that there was a significant association of the child sex ratio and the educational levels of their mothers. This trend occurred in both rural and urban areas.

Based on the recent three population censuses of China, in this article, we used life table technique to compute the expected years of working life for the Chinese labor force in the primary, secondary and tertiary industries in 1982, 1990 and 2000. We found, after two decades of economic reform, the expected years of working life in the primary industry decreased from 32.04 and 26.74 years for males and females in 1982 to 27.07 and 26.12 years, respectively, in 2000. For the tertiary industry, the expected years of working life increased from 5.70 and 2.94 years for males and females in 1982 to 8.05 and 5.66 years in 2000, respectively. For the secondary industry, there was virtually no change in terms of the expected years of working life.

A simple, yet mathematically precise and rigorous, feedback control design procedure is suggested in this paper, which can rearrange all the Lyapunov exponents of the controlled system according to the user's desire, namely, to make them positive, zero, and/or negative in any desired order, for any given n-dimensional discrete-time smooth nonlinear dynamical system that could be originally nonchaotic or even asymptotically stable. The argument used is purely algebraic and the design procedure is completely schematic, without using any approximations throughout the derivation. A numerical example is included to visualize the anticontrol. Index Terms - Chaos, control, Lyapunov exponent, time series.

Abstract Background There is increasing concern regarding the potential adverse health effects of air pollution, particularly hazardous air pollutants (HAPs). However, quantifying exposure to these pollutants is problematic. Objective Our goal was to explore the utility of kriging, a spatial interpolation method, for exposure assessment in epidemiologic studies of HAPs. We used benzene as an example and compared census tract-level kriged predictions to estimates obtained from the 1999 U.S. EPA National Air Toxics Assessment (NATA), Assessment System for Population Exposure Nationwide (ASPEN) model. Methods Kriged predictions were generated for 649 census tracts in Harris County, Texas using estimates of annual benzene air concentrations from 17 monitoring sites operating in Harris and surrounding counties from 1998 to 2000. Year 1999 ASPEN modeled estimates were also obtained for each census tract. Spearman rank correlation analyses were performed on the modeled and kriged benzene levels. Weighted kappa statistics were computed to assess agreement between discretized kriged and modeled estimates of ambient air levels of benzene. Results There was modest correlation between the predicted and modeled values across census tracts. Overall, 56.2%, 40.7%, 31.5% and 28.2% of census tracts were classified as having 'low', 'medium-low', 'medium-high' and 'high' ambient air levels of benzene, respectively, comparing predicted and modeled benzene levels. The weighted kappa statistic was 0.26 (95% confidence interval (CI) = 0.20, 0.31), indicating poor agreement between the two methods. Conclusions There was a lack of concordance between predicted and modeled ambient air levels of benzene. Applying methods of spatial interpolation for assessing exposure to ambient air pollutants in health effect studies is hindered by the placement and number of existing stationary monitors collecting HAP data. Routine monitoring needs to be expanded if we are to use these data to better assess environmental health risks in the future.