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BACKGROUND AND OBJECTIVE: Idiopathic pulmonary fibrosis (IPF) is a degenerative disease characterized by fibrosis following failed epithelial repair. Mesenchymal stromal cells (MSC), a key component of the stem cell niche in bone marrow and possibly other organs including lung, have been shown to enhance epithelial repair and are effective in preclinical models of inflammation-induced pulmonary fibrosis, but may be profibrotic in some circumstances. METHODS: In this single centre, non-randomized, dose escalation phase 1b trial, patients with moderately severe IPF (diffusing capacity for carbon monoxide (DLCO ) ≥ 25% and forced vital capacity (FVC) ≥ 50%) received either 1 × 10(6) (n = 4) or 2 × 10(6) (n = 4) unrelated-donor, placenta-derived MSC/kg via a peripheral vein and were followed for 6 months with lung function (FVC and DLCO ), 6-min walk distance (6MWD) and computed tomography (CT) chest. RESULTS: Eight patients (4 female, aged 63.5 (57-75) years) with median (interquartile range) FVC 60 (52.5-74.5)% and DLCO 34.5 (29.5-40)% predicted were treated. Both dose schedules were well tolerated with only minor and transient acute adverse effects. MSC infusion was associated with a transient (1% (0-2%)) fall in SaO2 after 15 min, but no changes in haemodynamics. At 6 months FVC, DLCO , 6MWD and CT fibrosis score were unchanged compared with baseline. There was no evidence of worsening fibrosis. CONCLUSIONS: Intravenous MSC administration is feasible and has a good short-term safety profile in patients with moderately severe IPF.

Exercise induced bronchoconstriction (EIB) is highly prevalent in elite athletes, especially in those training in cold dry environments. Dehydration of the airways plays a key role in this process. EIB has recently been linked to airway epithelial injury in asthmatic individuals. The aim of the study is to determine whether a short period of hyperpnoea of dry air causes airway epithelial disruption in winter and/or summer sport athletes. We hypothesise that urinary level of the Clara cell protein (CC16) – an indirect marker of permeability/cellular integrity of the lung epithelial barrier – will be increased after a eucapnic voluntary hyperpnoea (EVH) test and that this increase will be larger in winter compared to summer athletes. Forty two female athletes – 28 summer athletes (age 31.1+/-1.7yr (SEM), training volume 9+/-1.1h/wk) and 14 winter athletes (age 21.4+/-0.8yr, training volume 12.0 ± 1.10h/wk) – took part in this study. They all performed an 8-min EVH test at a target ventilation rate of 30 times their baseline forced expiratory volume in one second (FEV1). After the challenge, FEV1 was measured in duplicate at 2, 5, 10, 15, 20, 30, 60 and 90min. A sustained decrease in FEV1 of at least 10% from baseline was considered positive. Urine samples were collected at baseline and at 30, 60 and 90min recovery. CC16 concentration was measured by enzyme immunoassay. Ten summer athletes had a positive test (max FEV1 fall = 19.6+/-2.4%), whilst eighteen of the summer athletes and all the winter athletes were negative (max FEV1 fall = 5.7+/-0.7% and 5.3+/-0.7%, respectively). CC16 increased significantly after the challenge in all three groups (P<0.01) with no difference between groups: delta CC16 (max post-EVH minus baseline) in summer EVH negative athletes was 0.241+/-0.1 ng/μmol creatinine, 0.292+/-0.085 ng/μmol creatinine in summer EVH positive athletes, and 0.123+/-0.047ng/μmol creatinine in winter EVH negative athletes (P=0.415)In c

The Joint Vis-Eval is a follow-on effort to evaluate additional visual display devices and a multi-service effort including Air Force, Navy and Marine pilots. The objective of the initial Joint Vis-Eval was to identify the capability and limitations of the latest generation of Advance Fiber Optic Helmet Mounted Display (FOHMD) developed by CAE Electronics, Ltd. Purpose: (1) determine trainability of tactical mission tasks with available visual display technology, (2) demonstrate current visual simulation technology to users, (3) obtain feedback from those users to help define future visual requirements and (4) provide information and data to support future simulation acquisition decisions. A team of highly experienced F-15E, F-16C and FA-18C/D instructor pilots evaluated the Advanced FOHMD system using fighter tasks in a mission context. The United States Air Force Formal Training Unit (FTU) and United States Navy and United States Marine Corps Fleet Replacement Squadron (FRS) training levels were used as the benchmark for the evaluation. Each evaluator flew three missions: a familiarization and two evaluation missions. At the end of each mission, the pilot completed a questionnaire and debriefed the analysis team to document the task training capability of the display system. The Advanced FOHMD has several significant improvements over earlier versions of the FOHMD. These improvements include: (1) acceptable eye tracking, (2) improved resolution, (3) limited improvements in the area of in-cockpit viewing of instruments and controls, and (4) a more effective high resolution inset. The results and discussion indicate that the Advanced FOHMD provides training capability for selected fighter tasks. Human factors issue needs to be addressed to improve pilot acceptability.

This evaluation was a Joint Visual System Operational Evaluation (VIS-EVAL) to evaluate visual display devices. It was a multi-year effort including Air Force, Navy, and Marine pilots. This evaluation was the second of two visual evaluations. The first evaluation was conducted on the Advanced Fiberoptic Helmet Mounted Display (AFOHMD) developed by CAE Electronics, LTD and is reported in a separate report. This evaluation was conducted at the Site Number 2. Its purpose was to identify the capabilities and limitations of the Visual Integrated Display System (VIDS). Specifically, the purpose was to (1) determine trainability of tactical mission tasks with available visual display technology; (2) demonstrate current visual simulation technology to users; (3) obtain feedback from those users to help define future visual requirements; (provide information and data to support future simulation acquisition decisions), and (4) provide feedback to manufacturers for product improvement. This system was a multi-faceted, rear projected, real image screen display. A team of highly experienced F-15E, F-16C and FA-18C/D instructor pilots evaluated the VIDS using fighter tasks in a mission context. USAF Formal Training Unit (FTU) and USN/USMC Fleet Replacement Squadron (FRS) training levels were used as the benchmark for the evaluation. The VIDS that was evaluated provided a large Field of View (FOV) display of both background imagery and other aircraft imagery. The background imagery requires improvement for low level navigation, ground target identification and other low altitude tasks. Results and discussion indicate that the VIDS provides training capability for selected fighter tasks.