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INSERM

INSERM

Because of their size, making them comparable to a DNA molecule or a protein, one hundred to one thousand times smaller than a cell, the nanoparticles have different physical properties from those of common objects. Evolving to the same scale as the biological mechanisms of the body, they are able to cross natural barriers and enter cells. Their main therapeutic application, currently is to ensure the transport of drugs into the interior of the cell by wrapping in tiny structures, and to protect them from interactions with the surrounding environment. The hope is to bring more of the active ingredient to its molecule target, avoiding its degradation or distribution in healthy tissues.

NanoAthero FP7 NMP program with €9.8m over 5 years, is intended for the diagnosis of atherosclerotic plaque to prevent cardiovascular diseases including stroke. It also relates to therapeutic uses for delivering drug in target tissues.

INSERM coordinates the European NanoAthero program and here is their story…

AG 002 | May 2014

Welcome to the 2nd edition of AG. In this spring publication, we give thought to a number of topics that remain at the forefront of the government agenda.

Throughout Europe there is consistent agreement from country to country about the importance of sustainability in our cities. Ensuring that each nation becomes greener by reducing their carbon emissions is a key commitment of the European Commission. Each country has their own policies in how this will be established and we highlight a number of cities that are progressing with their campaigns.

An article by Kirsten Brosbel, The Danish Minister for Environment highlights how Denmark is focusing on creating a more sustainable city. Another piece by Glasgow City Council gives an overview on how they are reducing their carbon emissions to become one of the most sustainable cities in Europe.

We highlight Blood and Patient Safety with a special focus in this edition, where we include articles from the NHS Blood and Transplant group in the UK, and from Diana Agacy from Southampton University Hospital – NHS, which gives an overview of the importance of patient safety during blood transfusions.

Throughout the publication we aim to bring you the topics that are currently on the agenda, and that we feel need further debate. One of these topics is investment in rail and rail infrastructure. There are a number of major projects currently underway throughout Europe and the UK. In the transport section we highlight a couple of these projects including HS2, and SHIFT2Rail. Each article sheds light on how these projects will benefit communities, and the economy.

We hope that you find the articles in this spring edition of interest and thought provoking. As always we welcome comment from the readers, and should you wish to come forward with future feature ideas, please do get in touch.

Challenges remain for local economic growth

economic growth

Aileen Murphie, Director at the National Audit Office examines the government’s latest local economic growth initiatives and how they are performing.

The government’s plan for local economic growth was set out in the 2010 White Paper Local growth: realising every place’s potential. Its core objective was “to achieve strong, sustainable and balanced growth that is more evenly shared across the country and between industries”. A key part of this involved transferring decision-making to the local level.

As a result of this, Regional Development Agencies were closed and Local Enterprise Partnerships were introduced. Another of the main principles included focusing investment through the Regional Growth Fund, Growing Places Fund, Enterprise Zones and City Deals.

In our report on Funding and structures for local economic growth, the NAO examined whether departments were implementing the new local growth programmes in a way that would achieve the government’s objectives on growth. We looked at six case studies, including the Cornwall and Isles of Scilly Local Enterprise Partnership and North Eastern Local Enterprise Partnership, East Riding of Yorkshire Council and Southwark Council, and two cities with City Deals: Bristol and Nottingham.

We found that although the new local growth landscape is taking shape, a key government objective of ensuring an orderly transition has not been achieved. Although the Regional Development Agencies’ functions transferred to central government departments effectively, the new local programmes were introduced over a different time frame. Significant dips in funding and outputs over this period are consequences of this.

The local economic growth initiatives covered in the NAO’s report were also not designed as a coordinated national programme with a common strategy and set of objectives, although the Department of Communities and Local Government (DCLG) has made changes over time to help address this. The new initiatives covered in this report are each managed separately. Even though there is joint working on each initiative, the government lacks a clear plan to measure outcomes and evaluate performance, and therefore is unable to demonstrate value for money across the programme.

Local Enterprise Partnerships are allocating funding from the Growing Places Fund to local projects but evidence of outputs in terms of new jobs, houses and improved transport to date has been limited. Local Enterprise Partnerships allocated £599m of capital funds to 305 local infrastructure projects by mid-2013. However, in 2012-13, those projects spent only an estimated £56m and created just 112 jobs.

The 24 enterprise zones established by the government also face a challenge to create the expected number of jobs. Job creation forecasts have changed from an initial expectation of 54,000 additional jobs by 2015 to between 6,000 and 18,000.

The Regional Growth Fund began to create and safeguard jobs in 2011 12, but the slow start means that the Fund now faces a heavily back loaded spending profile. The Department for Business, Innovation & Skills reported that the fund created 32,000 jobs by the end of 2012-13 against a target of 31,500. However, 40 schemes (21% of currently operational schemes) achieved less than 25% of their annual jobs targets.

If value for money from both the existing schemes and the new £2bn Growth Deals is to be secured, central government needs to make sure that there is enough capacity centrally and locally to oversee initiatives, that timescales are realistic and that there is clear accountability.

In addition, departments need to manage the range of local growth initiatives as a programme and address how they intend to evaluate performance and monitor outcomes across the programme as a whole. Otherwise, departments will have no basis for matching resources against priorities across the portfolio of initiatives to achieve best overall value for money.

 

Aileen Murphie

Director

National Audit Office (NAO)

Tel: +44 (0)207 798 7700

aileen.murphie@nao.gsi.gov.uk

www.nao.org.uk

Challenging the stem cell convention

stem cell

Professor Alan Clarke, Director of the European Cancer Stem Cell Research Institute gives an overview of how cancer stem cells differ from the conventional stem cell.

Cancer remains one of the major challenges in terms of life expectancy and is recognised as the second largest cause of mortality within the EU, accounting for 28% of all deaths in 2010. Although we are slowly improving 5 year survival rates for many tumour types, we still do not have effective therapies for all tumours and we still do not properly understand the processes that underlie resistance to therapy and tumour relapse. Furthermore, for some tumours (such as those of the pancreas) our understanding of how to treat patients is so woeful that they are currently virtually untreatable. There is therefore a plethora of unmet clinical needs relating to better cancer diagnosis and treatment.

One concept that may aid in tackling these problems is that of the ‘cancer stem cell’. Normal stem cells have now been found in many different tissue types and these are responsible for the growth and subsequent maintenance of those tissues, and also for their repair following damage, such as exposure to toxins or irradiation. One way to view this is that the stem cells sit at the top of a hierarchy of cells which are required for correct tissue maintenance and that the stem cells are capable of generating all of that hierarchy. Our understanding of these normal stem cell populations is burgeoning and as it does it opens up radical new prospects for regenerative medicine in diseases such as neurodegeneration and arthritis.

The ‘Cancer Stem Cell’ notion is that, in a manner parallel to normal tissues, tumorous tissues actually possess a similar hierarchy of cells, with a small proportion of cancer stem cells capable of driving the growth and development of the entire tumour. However, this view clashes with the more conventional notion that all tumours are homogeneous – i.e., that all cells within a tumour have similar tumorigenic capacity. Evidence from many different laboratories is now challenging this conventional view, with clear examples of cancers that are driven by a small population of ‘cancer stem cells’ which we can identify by the unique profiles of proteins they express on the surface of these cells. The importance of the cancer stem cell concept may also extend beyond implications for the growth and relapse of the primary tumour, as these cells have also been implicated in the spreading of the tumour around the body – a process termed metastasis which is the stage of disease most closely associated with lethality. If the above is correct, it may be possible to treat cancer more effectively by concentrating on the stem cells alone, rather than all the cells in the tumour, as current treatments do.

The critical distinction between these views (homogeneous versus driving cancer stem cells) means that, if the cancer stem cell concept is correct, current cancer therapies being developed and used may not be being targeted at the correct cell type within the tumour. At the present time, this traditional view could mean an “apparently” successful therapy or treatment in a cancer patient that results in reducing tumour ‘bulk’ is, in fact, a poor or failed treatment because it still allows the driving cancer stem cell population to survive and therefore the tumour is still able to re-grow. It could also mean that potential cancer treatments and therapies which successfully target the cancer stem cell are currently being disregarded. These are the cuttingedge scientific issues that now need to be addressed. If we can now confirm that the cancer stem cells concept is correct, it offers the possibility of transformingour progress in the fight against cancer.

The cancer stem cell concept has always been vigorously debated, with the field split into two camps – those advocating the existence of cancer stem cells and those opposed to this concept. However, there have been significant changes over the last 12-24 months in that a series of high impact scientific papers have been published that are seen to prove the notion of the cancer stem cell, or at least confirmation of the existence of hierarchy within tumours. Furthermore, there has been rapid technological development in our capacity to extract and indefinitely grow cancer stem cells in a laboratory setting which is revolutionising the utility of these cells. For example, this is now opening up possibilities for the development of tailored therapy per patient (known as ‘stratified’ or ‘personalised’ medicine) which is predicted to change the landscape of both research and therapy over the coming years.

The study of cancer stem cells remains in its infancy. There are a number of key objectives within the field that need to be met. The most basic of these is to improve our understanding of cancer stem cells and the roles they play in a range of cancers. For example, we are still unsure if the concept is relevant to all cancers or just to a subset. We also need to identify robust markers of disease that reflect the presence of cancer stem cells; and further we need to use this approach to identify new therapeutic targets. Perhaps most excitingly, it may be possible to repurpose existing drugs against cancer stem cells that have previously not been shown to be effective against bulk cancer cells. This latter approach carries the great twin benefits of reduced cost and reduced time in development. We will also need to develop new platforms based around cancer stem cells which will allow mid-to-high throughput drug screening of both existing and novel agents (including natural agents) to assess their capacity to target the cancer stem cell.

The cancer stem cell concept offers a new approach to the treatment of cancer that has wide ranging implications. From our improved basic knowledge, the aim will be to develop new therapies which can be shown to make a real difference in the clinic. Ultimately, the objective will be to transform the survival rates for patients suffering from a range of cancer types. All of the above of course requires substantial investment from both industrial and academic partners. Currently this is derived from a range of funding streams, none of which is wholly devoted to the cancer stem cell concept. However some institutions do exist, such as the European Cancer Stem Cell Research Institute, based at Cardiff University, which is wholly focussed on this problem. The key challenge must be to coalesce efforts across the EU to truly ascertain the value and usefulness of the cancer stem cell notion.

 

Prof Alan Clarke

Director

European Cancer Stem Cell Research Institute

Tel: +44(0) 2920 874829

EuropeanCancerStemCell@cardiff.ac.uk

http://www.cardiff.ac.uk/research/cancer-stem-cell

 

The birth of blood cells

Unravelling the mechanisms leading to the formation of blood progenitor and stem cells.

The continuous generation of blood cells throughout life relies on the existence of haematopoietic stem cells (HSC) generated during embryogenesis. They have the ability to self-renew and to generate all types of blood cells. Any pathology affecting these cells could lead to the development of serious diseases such as leukaemia and anaemia. That is why understanding how HSC and haemato-poietic progenitors are produced during embryonic life is important.

The cellular origin of blood stem and progenitor cells has been the subject of an intense scientific debate during the last decade. However, in the last few years, several studies, including ours, have allowed to single out one particular cell type as the source of HSC. It is a rare type of endothelial cells, the building block of blood vessels, endowed with haemat -poietic potential. They form the haemogenic endothelium and can be only detected during embryonic life. The process of the generation of blood cells from haemogenic endothelium is evolutionary conserved since it takes place in many different organisms including the human, the mouse, and the fish species.

Future projects and goals

Recently, the generation of the Embryonic Stem Cell (ESC)-like induced Pluripotent Stem Cells (iPSC) by reprogramming of fully differentiated cell type such as skin cells, provided a major breakthrough for the field of regenerative medicine. However, to fulfill the therapeutic potential of iPSC, essential basic research has to be done to find the way to differentiate them efficiently toward blood progenitor and stem cells.

Consequently, in order to better understand the development of the haematopoietic system, the focus of our research is to unravel the mechanisms underlying the generation of blood stem and progenitor cells from haemogenic endothelium using mouse embryos and the mouse ESC in vitro differentiation system, an ideal setting to define the key molecules involved in haematopoiesis.

Our group is part of the European Molecular Biology Laboratory (EMBL), one of the highest ranked scientific research organisations in the world. At the EMBL Monterotondo unit (Italy), we have access to a state-of-the-art transgenesis facility allowing us to perform advanced mouse biology experiments. Through the other EMBL units in Germany (Heidelberg and Hamburg), France (Grenoble) and United Kingdom (Hinxton) we have access to a very strong set of experts in various fields: structural biology, proteomics, bioinformatics, genomics, cell biology, development biology and advanced imaging. This unique environment allows us to combine different methodological and innovative approaches to address key questions about the mechanisms of cell fate decisions leading to the production of the first haematopoietic cells. It will give us the opportunity to develop new strategies to improve methods of blood cells generation from ESC or iPSC for regenerative medicine.

 

Christophe Lancrin

Group Leader

The Lancrin Group, European Molecular Biology Laboratory (EMBL)– Monterotondo

Tel: +39 06 90091 218

christophe.lancrin@embl.it

www.lancrinlaboratory.com/

LinkedIn: http://it.linkedin.com/in/christophelancrin

 

Stem cells and immunity

stem cells

From stem cell biology to tissue mending

In the last 25 years, tremendous advances have been made in the identification and generation of stem cells (SC) from diverse organisms, generating a wealth of knowledge in various fields from embryology to development. SC not only have the ability to differentiate into several cell types, but are also capable of prolonged self-renewal in an undifferentiated state. SC can be classified according to the range of cell types into which they can differentiate. This property, termed potency, is dictated by progressive hierarchical differentiation; totipotent SC can differentiate into embryonic and extra-embryonic tissues, pluripotent cells can form embryonic tissues (ectoderm, mesoderm and endoderm), and multipotent SC become only a reduced number of cell types. In addition to potency, SC ontogeny is important. Embryonic SC (ESC) are harvested from the inner cell mass of the blastocyst of 5-day-old preimplantation embryos and are pluripotent. Fetal stem cells (from different tissues) are considered multipotent. Most, if not all, organs and adult functional structures harbor adult stem cells (ASC). Finally, umbilical cord tissue is an important, practical source of multipotent stem cells that can be stored for long periods in tissue banks.

Therapeutic application of stem cells is based on a variety of strategies, of which cell replacement therapy is the best-known. The predominant alternative method relies on paracrine effects, in which the transplanted stem cells secrete trophic factors that induce or promote self-repair. There is no universal method, and a specific SC source or determined procedures must be prioritised depending on the pathology or the patient’s medical condition.

Despite the expectations that stem cell biology generates, current SC research is driven mainly by regenerative/reparative medicine, which tries to identify conditions useful for replacement of malfunctioning organs in the body. To consolidate the efficiency and safety of new SC therapies, however, a sustained effort that encompasses trial and error will be necessary, as was the case for gene therapy1. SC approaches are also being used to generate interesting models for human disease and are currently producing a revolution in the understanding of several human diseases and the creation of physiological testing platforms (even personalised) for screening chemical and molecular drugs and for toxicology.

Embryonic stem cells

ESC are obtained from early stage embryos; they have indefinite selfrenewal capacity and can differentiate into cell types derivative of all three germ layers. They provide a powerful research tool for developmental biology, drug screening, disease modeling, and potentially in cell replacement therapy. The ESC concept was established in mice in 1987, and translated to humans2. Controlled, efficient differentiation protocols will lead to maximal exploitation of these cells. Their use has ethical considerations associated with the destruction of human embryos to obtain ESC cell lines, and research in the field is controlled in Europe by strict legislation3.

Yamanaka4 recently developed revolutionary procedures for obtaining ES-like cells from somatic cells, known as reprogramming. These cells are termed induced pluripotent stem cells (iPS) and show potency comparable to that of ESC. These iPS have immense potential and can be obtained from an adult patient in a reasonable period of time, eliminating most ethical concerns associated with ESC. Procedures to derive specific cell lineages are being developed and show promising results, yielding hematopoietic stem cells (HSC), mesenquimal stem cells (MSC), cardiomyocytes (CS), dendritic cells and dopaminergic neurons. These advances will boost research in replacement therapy, as well as physiological drug screening, toxicology and biosafety studies. Several clinical trials to test the clinical potential of iPS will soon be under way5.

Adult stem cells

The cradle of SC therapy was in bone marrow transplant research. This community established and developed central concepts that have since been shown to apply to most ASC systems. These contributions remain relevant more than 40 years after the first descriptions of hematopoietic stem cells (HSC) in the bone marrow, and intense research continues to decipher the laws of HSC regulation and its alteration in hematopoietic pathologies.

Adult stem cells (ASC) are central participants in the repair of most, if not all, host tissues in mature organisms, and the prevention of ASC senescence is critical for tissue homeostasis. Bmi1 expression is reported to have a crucial role in the self-renewal and maintenance of hematopoietic, neural, intestinal, bronchioalveolar, pancreatic, prostate, lung and epithelial SC, as well as in the tongue and in rodent incisors; Bmi1 thus seems to be a general marker for ASC. Bmi1 is one of the main regulators of INK4a/ARF, encoding p16, which in turn is associated with cell senescence and ageing. The effects of p16 activity include not only loss of ASC, but also triggering an unresponsive state.

The plausible involvement of altered stem cells in cancer is another important contribution of the SC field, which suggests the emergence of malignant clones that could evolve and progressively generate a tumor. This is the origin of an SC-centric view of some human diseases. In this line of thought, selective drugs able to cope with cancer stem cells and their metastasis could be a critical step in curing human cancer or rendering it a chronic illness.

Conclusions

The last 25 years have seen impressive advances in the identification and generation of SC from several organisms. Adult stem cells at first, and subsequently embryonic or induced pluripotent stem cells have been evaluated for their therapeutic potential. Although preliminary results are encouraging, especially with MSC, RPE and HSC, several central aspects of the therapeutic procedure must be optimised to improve the therapeutic index. Preserving the genomic stability of ASC and ESC, intrinsically and after the required expansion, seems particularly important. These observations underline the need for more complete understanding of each SC system. Finally, animal models must undergo critical re-evaluation for each specific intervention, combining previous results with the model’s realistic ability to predict SC behavior in man. Despite all these pending technical issues, however, a bright future is envisioned for SC-based therapies. We will see notable improvements and new applications in areas in which no cure is currently available. In addition, the extensive use of ES-derived cells as human disease models will reveal their relevance for drug and toxicology screening, especially in situations where an animal model cannot be substituted. Anti-cancer and immunomodulatory therapies are probably the two areas on which SCbased therapies will have the most direct impact.

REFERENCES

1 Wirth et al. (2013) Gene 525:162-9.

2 Amit et al. (2000) Dev Biol 227:271-8.

3 Birmingham (2003) J Clin Invest 112:458.

4 Takahashi et al. (2007) Cell 131:861-72.

5 www.clinicaltrials.gov

 

Professor Antonio Bernad

abernad@cnb.csic.es

Karel van Wely

kvanwely@cnb.csic.es

 

Professor Carlos Martinez-A

cmartineza@cnb.csic.es

Dept Immunology and Oncology National Center for Biotechnology

Tel: +34 91585 4537/4850

www.intranet.csic.es/web/stem-cellsand-immunity

 

Biobank Graz

biobank

The hub for biobanking in Europe.

Biobank Graz at Medical University of Graz, Austria, belongs to the largest repositories of human samples in Europe. It contains nearly six million samples from normal and pathological tissues, including formalinfixed, paraffin-embedded tissues (FFPE), fresh frozen tissue samples and frozen body fluids such as serum, plasma, urine and liquor.

Biobank Graz is characterised by a number of features, unique to be present in a single biobank.

Biobank Graz

  • is based in a university carrying the label “HR Excellence in Research”.
  •  is certified according to ISO 9001:2008.
  • runs a QM system with SOPs for all aspects of the biobanking process.
  •  fully protects personal rights and privacy of sample donors and handles their biological samples accordingly.
  • runs powerful logistics to offer highest sample qualities.
  • has set up new automated infrastructure for handling and storage of samples at room temperature, -80°C and below -130°C (liquid nitrogen).
  • enables prospective collections of samples and data based on the needs of the scientists.

At Medical University of Graz, Biobank Graz is a publicly owned non-profit organisation supported by public funds (BM.WFW, Zukunftsfond Steiermark).

Biobank Graz has developed into a central research facility and now matures to a biological resource center specifically designed to support scientific projects that foster medical research and personalised medicine. Biobank Graz is directly linked to cutting-edge technologies (all -omics) combined with sustainable high quality research services based at the Center of Medical Research (ZMF) of the Medical University of Graz. Biobank Graz is also directly linked to the highly renowned clinical expertise of the LKH-University Hospital Graz.

Using this perfect environment, Biobank Graz directly supports academic, industrial as well as cooperative research all over the world. In recent years, a large number of clinical projects and trials have been carried out using samples, data and/or logistic services of Biobank Graz. Thus, Biobank Graz contributes to scientific development and research results building the basis for medical benefits for the public and the health care system.

The collection strategy of Biobank Graz is represented by a double-tracked system. Therefore, Biobank Graz merges two different types of biobanks in one supra-regional biobank:

• A non-selected, cross sectional biobank, containing essentially all pathological samples and clinical data from the population of the Austrian state of Styria (1.2 million inhabitants). These samples with their respective clinical data are derived from a nonselected patient group characteristic of central Europe and have been collected and stored over the last 30 years.

• A disease-focused clinical biobank containing specific types of human biological samples of the highest quality and with detailed clinical follow-up data during the whole course of diseases. Samples and data include long term observations for specifically selected diseases and targeted disease groups. Such disease focused collections are based on the major research interests of cooperating institutions.

The strategic combination of both types of collections in Biobank Graz provides the ideal basis for epidemiological studies as well as allowing scientists to validate biomarkers for the identification of specific diseases and determine response to treatment. Hence, samples can be used for testing and validating strategies for personalised monitoring and treatment or any other research question.

Today, networking and cooperation become more and more important. Therefore, Biobank Graz is an active leading player in (inter) national networks and activities targeting improved interactions between biobanks and scientists to foster internationally successful research. Biobank Graz is member of the ESBB Biobanking Society (www.esbb.org) and ISBER (www.isber.org), the Austrian node of BBMRI (BBMRI.AT, www.bbmri.at) and thus is member of the European network of biobanks BBMRI-ERIC (www.bbmri-eric.eu). Just recently, the headquarters of BBMRI.AT as well as of the European network BBMRI-ERIC have been established in the same building where Biobank Graz is located.

As the largest biobank in Europe, Biobank Graz was one of the leading biobanks fostering the development of the European biobanking network BBMRI-ERIC.

Today, the greatest challenge for national and international biobanking networks is to set up standards and to achieve harmonisation regarding high level sample and data quality combined with an ethical, legally adjusted environment. Biobanks need to explore their economic justification, perform effective reporting and quantify economic and often non-profit performance. Common standards need to be defined on a high rather than low level and hence, only few biobanks may be able to join such high-standard networks. Supra-regional biobanks such as Biobank Graz mostly meet international standards and thus will add innovative implementations to the field of maintaining sample and data quality.

 

Professor Berthold Huppertz, PhD

Director and CEO

Biobank Graz

Medical University of Graz

Tel: +43 316 385 72716

berthold.huppertz@medunigraz.at

www.medunigraz.at/biobank

 

Smart Biobanking

research

Senior Research Analyst for Frost & Sullivan Divyaa Ravishankar discusses the growing need for innovative products in the realm of bio-storage applications.

The concept of biobanking has triggered massive interest in the area of long-term sample storage conditions but with a key challenge of maintaining sample integrity. In order to combat this, biobanks are adopting new storage methodologies and solutions that will guarantee better sample quality to the research community.

Globally, sample storage is an outsourced activity by many large pharmaceutical companies. Commercialisation of biobanking activity has forced the providers to adopt tools that are more sophisticated and facilitate sample tracking. Laboratory information management systems (LIMS) prove to be an essential component in facilitating various biorepository models and it is important to understand the workflow involved in each biobank set up; this will aid the adoption of automation at certain levels.

Market Insights

Researchers handling small quantities of samples are at the risk of getting contaminated. Further, maintaining consistency becomes a huge factor when large quantities of samples are processed. Therefore, automated protocols are replacing manual ones.

Interest in dry-state storing and eliminating freeze-thaw cycles causing unwanted intervention of sample quality has brought many patented automated biobanking storage platforms for -20°C and -80°C with a facility to store samples in both microplates and micro-tube format. Continuous monitoring of samples is ensured even during picking.

The cornerstone of every biorepository lies in the efficiency of its freezer inventory software or the LIMS employed. The key objective is to enable researchers to locate and use biospecimens. Besides tracking the location of the vial of a specific sample, it is important to retrieve the associated additional data such as consent information, demographic information and related regulatory data.

Challenges Associated with Clinical Sample Storage

Primitive methods of storing samples in cryotanks have reported instances of loss of samples, with them either being discarded, owing to the fact that they become unidentifiable, or due to ‘handling errors’. The sample retrieval process would be laborious if performed by humans, with the loss of an ID label leading to sample mix-up.

Given the fact that no 2 biobanks function in a similar way, it is tough to generalise a technology platform that is common for them. A lot of custom work is required to suit the workflow processes of a biobank, and at the same time, funding and financial maintenance of the biobanking infrastructure becomes tougher in the long run.

With time, samples demand more sophisticated methods of storage with clinical samples requiring a highly integrated set up that involves continuous monitoring of temperatures, along with the associated sample information.

An exponential increase in the volume of samples is leading to issues with store capacity and duration, with space to accommodate new samples in the given temperature and conditions posing a huge problem.

Today, the lack of high-quality and clinically annotated samples is seen as a major drawback. There is a need for standardising sample handling and storage protocols globally. Owing to very few standardised quality checking protocols for the pre-analytical phase, there arises a difficulty to compare and share samples, especially when specimen volumes are likely to be high. These issues need to be addressed, as they prove to be a barrier for the development of new treatments.

Many issues associated with the scientific use of biobanking samples are ethical in nature, such as consent, personal integrity, privacy protection, safety of samples and access to data and stored samples. The laws and regulations pertaining to ownership, intellectual property rights and commercialisation discourage the use of resource material. There are also issues pertaining to cross-border shipping of samples, which requires consent from donors. With the sole aim of safeguarding the donor information, biobanking acts in Norway and Sweden allow the analysis of samples but discourage their long-term storage.

Technology Innovations for Clinical Sample Storage

Biobanks seek solutions that are easy, efficient and are able to provide cost-effective sample management. Traditional methods of storage include storing samples in laboratory freezers at -20°C, -80°C and liquid nitrogen, and this process is being largely automated with the help of RFID and the MEMS technology.

On the other hand, the recent trend shows an increasing preference towards room temperature storage. There are firms developing reagents to stabilise the DNA and RNA in order to be able to last long under ambient temperature; this concept has allowed whole blood samples to be shipped and preserved under room temperature for about 3 months. Adapting to room temperature storage can yield benefits such as eliminating the need for freezer units and extra storage space.

Over time, it becomes tough for biobanks and biorepositories to track and retrieve samples when stored at ultra-low temperatures. Traditional methods of storage involve microplates with barcode readers. Retrieval of a single sample from a microplate meant thawing the entire plate, which affects the freeze-thaw cycles of other samples simultaneously. For this purpose, sample storage is being carried out in microtubes and individual vials. Earlier, equipment and robotic arms were designed to handle microplates; now, systems are flexible to cherry pick individual microtubes. Most of the storage systems today provide robotic interfaces inside a chilled atmosphere in order to prevent the disturbance of unused samples.

Conclusions

A totally integrated system of hardware, software and consumable tools would be the way to “smart biobanking”. With many new technologies, biobanks oriented towards the future can retain sample quality/integrity by employing smart and smooth sample handling systems available in the market today.

 

Divyaa Ravishankar

Senior Research Analyst, Life Sciences

Frost & Sullivan

divyaar@frost.com

www.frost.com

Combating mental health

mental health

Journalist Tony Hall gives an overview of how the Cognitive Behaviour Treatment (CBT) is used within the armed forces to combat mental health issues.

In recent years the UK government and Ministry of Defence (MoD) have acknowledged that service in the Armed Forces should be publicly recognised and not be a cause of any personal or social disadvantage. The Armed Forces Covenant that is the tangible result of that intent was introduced into law in 2011. It encompasses all levels of welfare support from the transition from service to civilian life to the rehabilitation of the physically injured.1 The Covenant also broadens the nation’s welfare commitments by bringing issues of psychological health to the forefront of policy. In doing so MoD and Government have acknowledged that mental health is an essential contributor to the social stability and individual wellbeing of service personnel, veterans, and their families.

This commitment was first introduced as an integral part of a welfare strategy set out in the UK’s first Strategic Defence and Security Review (SDSR) in 2010. The SDSR in seeking to promote a more active engagement in psychological health gave official endorsement to a new mental health programme for the Armed Forces and veterans proposed by Dr Andrew Murrison, MP in his report ‘Fighting Fit’, published the same year.2

Murrison’s report laid out a future for the provision of mental health care based on established models within the NHS, delivered against guidelines and standards set out by National Institute for Health and Clinical Excellence (NICE) guidelines and Care Quality Commission (CQC). It acknowledged that the long term psychological care of serving and former personnel represented special challenges, in that the clinical care pathways had to be established by the MoD’s Defence Medical Services (DMS) at the onset of an illness and then referred over to the Department of Health, NHS and private sector health providers, if these service-related illnesses persisted and led to a medical discharge.

Post Traumatic Stress Disorder (PTSD) was singled out as an example of a chronic service-related illness that would require this new breadth of focus. ‘Fighting Fit’ recommended that the MoD develop PTSD screening tools and “that a mental health systems enquiry is built into routine Service medical examinations, discharge medicals and the medical examinations conducted prior to invaliding from the Service on the grounds of physical or mental incapacity. This will employ a series of structured questions designed to highlight common mental health problems such as depression and anxiety together with alcohol misuse and PTSD.” 3

Responding to these recommendations, MoD through DMS has now established 15 military run Departments of Community Mental Health (DCMH) in the UK and 5 at overseas bases. The DCHM’s provide both out-patient and in-patient assessment and care. The individual services have also responded. The Army for example now acknowledges that mental illness is both serious and disabling. It has raised awareness within its ranks by establishing a peer-group Trauma Risk Management (TRiM) model that supports personnel following traumatic incidence. It is a method of risk assessment recommended in the ‘Fighting Fit’ as a means of making mental health interventions acceptable, and reducing the stigma of mental ill-health among service personnel which the report emphasises strongly is “accustomed to viewing itself as mentally and physically robust.”

Treatment following diagnoses is now centred on community-based care and is delivered by the MoD in partnership with the Department of Health, and service charities including Combat Stress. This broadening out of care provision is necessary because there is currently no organised network of military mental health care across the UK, with the Government admitting that the NHS alone no longer has access to the type of specialist care that is required. 4

This shortfall has at least been acknowledged, and in response Government has begun a Community Veterans Mental Health Pilot project which is now established across six UK sites, while MoD has provided Combat Stress with £2m of new funding in support of its own Treatment Centres. Charities themselves are also collaborating. These efforts include the training of over 6,000 Armed Forces Community Mental Health First Aiders, through the MFHA for the Armed Forces Community project, now being undertaken by MFHA (Mental First Aid England) in conjunction with SSAFA (the Soldiers, Sailors, Airmen, and Families Association), The Royal British Legion and Combat Stress. 5

MoD is also taking practical steps to improve the skills of those engaged in mental health care and has recently awarded contracts for DMS personnel to train in the treatment of PTSD. According to DCMH figures for serving personnel, the last quarter of 2013 rates of PTSD in serving currently stand at 0.6 per 1,000, “and there was no significant change in the rate of PTSD compared to previous quarters.” 6 However, this particular anxiety disorder has proven itself to be chronic and capable of revealing psychological and physical problems, such as emotional withdrawal, insomnia, and anger, years after traumatic events took place. Its impact on the long term mental health of veterans has been recognised for that reason.

But while PTSD has proven itself a persistent cause of mental ill health and distress, it is treatable. NICE guidelines recognise the benefit of treatments such as Cognitive Behaviour Therapy (CBT); a ‘talking therapy’ that addresses a patient’s current difficulties through discussions with the therapist, to consciously change state of mind and ways of thinking.

CBT is a therapy that engages the patient to face mental problems, and in understanding them better. It stands as a symbol of the moves being undertaken now on many fronts to help and support personnel, veterans and their families to break the stigma of mental health and change for good our suffering in silence culture.

1 For progress in Covenant pledges 2013/14 see www.gov.uk/government/publications/armed-forces-covenant-annual-report

www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/documents/digitalasset/dg_191634.pdf

2 www.gov.uk/government/uploads/system/uploads/attachment_data/file/27375/20101006_mental_health_Report.pdf

3 Ibid Page 3

4 See www.veterans-uk.info/mental_health/faq.html#vets11

5 See http://mhfaengland.org/instructor-training/instructor-armedforces/

6 Quarterly UK Armed Forces Mental Health: Presenting complaints at MOD Departments of Community Mental Health October 2012/13 -December 2013/14 www.gov.uk/government/uploads/system/uploads/attachment_data/file/300067/20131224-Mental_Health_Report_Q3_2013-2014_amended-U.pdf

 

Tony Hall

Journalist

editorial@adjacentopenaccess.org

www.adjacentgovernment.co.uk

Post Traumatic Stress Disorder and Acute Stress Disorder

ptsd

What is the difference?

Post Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) are rising in prevalence.

PTSD is a pervasive and devastating anxiety disorder, affecting millions of people, caused by experiencing or witnessing any event that is perceived to be life-threatening to ourselves or others and beyond our control such as rape, physical assault, natural and industrial disasters, being diagnosed with a life-threatening illness, or traffic accidents. It can result from enduring years of domestic violence to a single violent attack that lasts but a few seconds. Military personel are far more likely to be exposed to traumatic events, and with recent turns in the relationships between East and West together with the high rates of PTSD in returning military from Operation Iraqi Freedom/Operation Enduring Freedom, the urgency of providing timely and effective treatment options for ASD and PTSD is imperative.

What are PTSD and ASD?

How do ASD and PTSD differ from a natural response to a traumatic event? ASD is a natural response to an event that undermines our sense that life is fair, reasonably safe and that we are secure, making us feel griefstricken, depressed, anxious, guilty and angry. Characteristics that mark out an individual as suffering from ASD or PTSD are emotional numbness, restlessness (the need to be ‘on guard’ at all times), anxiety, uncharacteristic irritability, problems focusing or concentrating, flashbacks, sleep disturbance and physical reactions such as irregular heartbeats, feelings of panic and fear, and depression.

There are two important distinctions between ASD and PTSD.

One is that ASD is more associated with dissociative symptoms, which may include extreme emotional disconnection, manifesting as extreme withdrawal and unsociableness, or exhibiting as a mental or emotional ‘distance’ between the individual and their violent experience. They may seem “spaced out” and appear to refuse to acknowledge their trauma.

The other is that ASD is considered a more immediate, short-term response to trauma that lasts between two days and twelve weeks. When ASD symptoms persist for longer than that or if the symptoms surface much later, then PTSD may be diagnosed.

Individuals with untreated ASD are at a substantially higher risk for developing PTSD.

Why do these responses happen?

There are several possible psychological and physical reasons. Psychologically, the act of ‘reliving’ the event, including flashbacks, force the individual to decide what to do if the event should happen again; conversely, avoidance and numbing blocks the exhaustion and stress of reliving the trauma; and being ‘on guard’ means that the individual can react quickly should another crisis present itself.

From a physical perspective, vivid memories of what happened keep adrenaline levels high creating anxiety and irritability, and these same adrenaline levels may stop the hippocampus in the brain from processing memories, so causing continuing flashbacks and nightmares.

Stigma

Many sufferers remain reluctant to seek help because of the stigma of being diagnosed with a “mental health condition” or “mental illness”. It is important to understand that PTSD and ASD are potentially serious conditions that afflict a great number of trauma victims, and that experiencing them in no way reflects a “weakness” or “deficiency” on the part of the survivor.

PTSD in the military – the role of modifiable occupational factors

The mental health of any fighting force influences their occupational effectiveness. It has been shown to be an essential factor in the retention and productivity of military personnel, as well as affecting their chance of social inclusion when they leave the Armed Forces (Iversen at el, 2009). Therefore, understanding the factors which increase the risk of PTSD for military personnel is important.

While unsurprisingly, personal appraisal of threat to life and perceived loss of control during the trauma have emerged as the strongest predictors of symptoms. Research also suggests that there are some modifiable occupational factors which may influence an individual’s risk of PTSD including low morale, poor social support within the unit and non-receipt of a homecoming (Iversen et al, 1999).

Cognitive Behavioural Therapy is the most effective treatment

Three decades of research have revealed that cognitive behavioural therapy (CBT), particularly exposure based therapies, are the most effective in the treatment of ASD and PTSD (Bryant et al, 1999).

CBT is an umbrella term that covers a number of different psychological interventions. In essence, CBT helps individuals think differently about their memories to make them less distressing and more manageable. It is intended to be short-term therapy, with most studies on PTSD providing between 9 to 12 sessions, each typically lasting 90 to 120 minutes, which are administered once or twice weekly.

In between sessions, patients are usually assigned homework that involves practicing the specific interventions being used. The interventions most frequently used in the treatment of PTSD are exposure therapy, anxiety management training, and cognitive restructuring. A fourth treatment for PTSD, eye movement desensitisation and reprocessing (EMDR), incorporates elements of all three interventions and adds the use of therapist-directed rapid eye movements.

Our Trauma Management Workshops centre on the use of proven cognitive behavioural techniques to assist participants to manage Acute Stress Disorder, return to ‘normal’ productive life quickly and prevent the development of PTSD.

Our CBT expertise

We have over 12 years’ experience of providing CBT services – including CBT training – to major UK organisations, both within the public and private sectors. Our services include initial assessments, treatment delivery and recommendations, and cover a hugely broad range from PTSD through to stress, anxiety, depression and obsessive- compulsive disorders.

Our highly skilled and experienced psychologists and CBT psychotherapists are all fully accredited members of the British Association of Behavioural and Cognitive Psychotherapies, many of whom are also employed as CBT Clinical Specialists, Clinical Psychologists and Psychiatrists within the NHS – and who are located throughout the UK. We do not employ CBT therapists who are trainees or newly-trained.

Our dedicated Case Managers manage individual cases, ensuring that treatment plans are running according to schedule, that regular progress reports are provided and that recommendations are clear and tailored not just to the individual’s needs but also to those of the employer.

For an informal chat about how we may be able to help your employees regain and maintain mental wellness, or our CBT training services, please call us on 0845 2600 126, e-mail us at talk@arcadiaalive.com or visit us at arcadiaalive.com.

 

Richard Madders

Managing Director

Arcadia Alive Ltd

Tel: 0845 2600 126

talk@arcadiaalive.com

www.arcadiaalive.com

Counterweight

The leaders in evidence based weight management

Counterweight Ltd. offers proven solutions (Counterweight Programme and The Counterweight Plus Programme) for weight loss and weight loss maintenance with published evidence demonstrating successful long term outcomes at 12 months.

The CounterweightProgramme

  • Lifestyle Programme • underpinned by behaviour change for individuals with BMI>25kg/m2. 1, 2
  • Aims for moderate weight loss of 5-10% followed by maintenance for at least 12 months.
  •  Delivered in 9 sessions over 12 months.1, 2
  • 1:1 or group delivery supported by comprehensive educational materials.

The Counterweight ProgrammeEvidence

  • Mean weight loss of 3.0 kg at 12 months.3, 4
  • 30% of patients attending follow up at 12 months achieve ≥5% weight loss.3, 4
  • 70% of individuals who attend at 12 months weigh less than at baseline.4

The Counterweight Plus Programme

  • Tier between lifestyle programme and bariatric surgery (and for some can provide alternative to bariatric surgery).
  • Non-surgical intervention to manage weight in those with BMI ≥30kg/m2 with type 2 diabetes or BMI ≥35kg/m2 .
  • Aims for a weight loss of at least 15kg/15% (2 stones or more) and then focuses on the skills needed to keep weight at this new lower level for 2 years or more.
  • Structured programme with 4 stages: Screening, Total Diet Replacement, Food Reintroduction, Weight Loss Maintenance with comprehensive educational materials for each stage.
  • Delivered in 20 one to one consultations over 12 months.
  • Total Diet Replacement product used is Pro800, manufactured by Cambridge Weight Plan. Some NHS providers pay for the product as part of contracts and others pass part or all the cost of product to the patients.

The Counterweight Plus Programme Evidence

  • Mean weight loss of 14.7 at 12 months in programme compliant patient.5
  • Mean weight loss of 12.4kg at 12 months in all followed up.5
  • 33% of those entering the programme achieve ≥15 kg weight loss at 12 months.5
  • 52% of individuals who complete all stages of the programme achieve the >15kg at 12months.5

 References

1 The Counterweight Project Team. A new evidence-based model for weight management in primary care: the Counterweight Programme. J Hum Nutr Diet 2004; 17: 191-208.

2 Counterweight Project Team. Empowering Primary Care to tackle the obesity epidemic: The Counterweight Programme. European Journal of Clinical Nutrition 2005; 59: Supplement 1, S93-101.

3 Counterweight Project Team. Evaluation of the Counterweight Programme for obesity management in primary care: a starting point for continuous improvement. Br J Gen Pract 2008; 58: 548-54.

4 Counterweight Project Team. The implementation of the Counterweight Programme in Scotland, UK. Family Practice 2012; 29:i139- i144.

5 Lean et al. Feasibility and indicative results from a 12-month low-energy liquid diet treatment and maintenance programme for severe obesity. Br J Gen Pract 2013; e115-124.

 

Hazel Ross

Counterweight Ltd

Tel: 07803 726604

hazel.ross@counterweight.org

www.counterweight.org

Asset management in the rail industry

rail

Benefits of adopting the new ISO 55000 standard

For many years the Rail Industry has been relatively stable with progressive evolution and development, however more recently significant changes have been seen. The recent development and technological advancements have resulted in numerous efficiencies with more transportation being undertaken on the rail network. Passenger traffic and freight movement is increasing due to convenience, comfort and value for money, thus making Rail an attractive means of transportation. If this progress is to be sustained focus must be on the Rail Assets.

The Rail Industry is not directly comparable to any other industry regarding Asset Management. One primary factor being, that we have two very different Asset Classes, Infrastructure Assets (Infra Assets) and Rolling Stock; each with their own specific requirements regarding Asset Management.

Asset Management activities enable Assets to deliver planned/expected results against planned/expected costs. Results not only from a financial perspective but also from other perspectives, like availability, safety, etc.

Now let us look at the infrastructure (termed as Linear Asset). The tracks must cope with the various types of loads transmitted by freight traffic, normal passenger trains and high speed trains. However Rolling Stock is being developed to carry more and heavier freight and more passengers at higher speeds. As a consequence wheel, axle and bogie maintenance/ management are critical. However the bottom line is that a train can still only operate within the limitations of the infrastructure.

The new ISO 55.000 standard, which was launched in January, professionally lays out the principles of Asset Management. Essentially this standard has been accepted within the Utility Industry, primarily by Power Generation and Transmission and Distribution, the expectations is that ISO 55000 will be adopted by the majority of industries. The Rail Industry will no doubt benefit by adopting this standard.

What is the basic principle of PAS55 & ISO 55000?

Asset Management is systematic and coordinated activities and practices through which an organisation optimally and sustainably manages its assets and asset systems, their associated performance, risks and expenditures over their life cycles for the purpose of achieving its Organisational Strategic Plan.

What are the comparisons between the Utility industry, especially T&D and the Rail industry?

Both industries are heavily regulated, often owned by the government, both industries having to deliver in accordance with their contractual requirements, unlike much of the “Commercial/Private Sector” who can basically decide to cease to produce/ deliver a certain product overnight. From a cost and risk management perspective both T&D and the Rail industries have aging Assets that are now displaying new failure modes. Knowledge of these failures is limited, let alone the experience re. detection/ prevention. Another aspect is the ageing workforce. Limited funding available for Asset Maintenance is another problem. This lack of funding is in effect building up a huge debt over the asset base, decreasing asset efficiency and increasing the risk of assets failure.

How can we implement and comply with the Management part of ISO 55000?

There are three main systems that deal with Asset Management. The most well known is the Enterprise Asset Management system. IBM’s MAXIMO and SAP’s EAM are the leading systems in the market. Basically the function function of these systems is to register all the Assets, their individual relationship to each other and the activities to be performed to maintain the assets, either by corrective, preventive or predictive maintenance. The second system is Asset Performance Management, the system that defines the Asset Strategy for the maintenance activities and the Asset Condition. Many types of Condition Monitoring can be applied along with new technologies allowing us to learn more about our Assets Health, these being at affordable costs due to their ability to reduce maintenance costs.

Last but not least is Asset Investment Planning & Management, e.g. Copperleaf’s C55. This system identifies all the investments needed to:

  • Align the Asset Strategy with the Business Strategy,
  • Manage the lifetime costs and revenue of the Assets and the individual investments made regarding Assets,
  • And manage the risk portfolio of the Assets.

It is the combined support that these three systems give that supports the ISO 55000 concept and give organisations unparalleled capability to optimise their Asset Management.

Many Rail companies struggle in defend-ing their Asset Management Policy/ Budget to the Regulators and therefore do not get the required or appropriate budget. This has resulted in budget reductions over the years, resulting in minimal maintenance being performed. Therefore early replacements of aging parts or condition monitoring to detect potential failures are not possible. ISO 55000 will assist Rail Companies in getting better visibility of the realistic requirements for Asset Maintenance and to subsequently justify the budget requirements to the regulators. It will support achieving the highest result with the given resources/funds and will identify the potential risks and related costs with insufficient maintenance. Note: Not performing the required maintenance will only increase costs and the Risks of Failure in the future.

Marcel van Velthoven is the managing director of ZNAPZ (www.znapz.com) an IBM partner that sells and supports Asset Management systems for Rail and other industries.

 

Marcel van Velthoven

Chief Executive Officer

Tel: +31 402 668 636

Marcel.van.velthoven@znapz.com

www.znapz.com

 

Rail infrastructure – a lasting legacy

rail

Stephen Hammond, Minister for Rail at the Department for Transport details how investment in rail is growing and its positive impact on the nation’s economy.

Rail travel in Britain is soaring. Over the past 20 years, passenger demand has doubled, and on intercity routes it has grown even faster. Although the network today is roughly the same size, we are running 4,000 extra services a day. But historic underinvestment over decades has left the ageing infrastructure in urgent need of modernisation – both to keep the country moving and to generate economic growth. This government has embarked on the biggest programme of improvements to the railway for generations to address this infrastructure deficit.

The investments are as diverse as they are ambitious. We are electrifying 850 miles of track, and spending £5.7bn on the Intercity Express Programme. We are building Crossrail and upgrading Thameslink, and we’re completing the Northern Hub connecting major cities in the north. And by 2017, we will be building HS2 to give us the capacity we need for long-term growth. All these investments will give Britain a world class railway – one that will create jobs and deliver a lasting skills legacy, providing the capacity and connectivity we need to secure the UK’s long-term economic growth, as well as allowing for a higher quality travel experience for passengers.

Crossrail is the largest infrastructure scheme in Europe. This £14.5bn scheme will create a 100km east-west rail route across London and beyond, from Reading in the west to Shenfield and Abbey Wood in the east, with 13 miles of new tunnels currently being built under central London.

More than 10,000 people are currently working on the new line, including more than 800 previously unemployed workers and nearly 300 new apprentices. Crossrail’s industry-leading Tunnelling and Underground Construction Academy (TUCA) has trained more than 5,000 people. The skills legacy of the programme will boost our construction and engineering industries for decades to come.

Crossrail will also deliver a lasting economic legacy. When the project is complete in 2018, it will bring an additional 1.5 million people within 45 minutes of London’s business centres, helping to create an extra 30,000 jobs in Central London by 2026. But the benefits will be felt far beyond the capital. Bombardier in Derby – Britain’s oldest surviving train manufacturer – will build the rolling stock in a deal with a capital value of around £1bn, but at least a quarter of the contract value will be channelled through small and medium sized suppliers – over 60% from outside London and the South East.

The £6.5bn Thameslink upgrade is another major initiative that will deliver big benefits. As well as improvements to stations, track and signalling, the rolling stock will be new, significantly increasing capacity and connectivity on the north-south rail route through London.

Thirty two previously unemployed residents of Southwark in London have found work on Thameslink, with many going on to gain construction qualifications that will help them find lasting employment. A further 38 people have secured apprenticeships across a range of roles, with many more planned over the next four years. Overall, the programme will generate more than 6,000 jobs while, outside London, the contract to build and maintain the new trains will create up to 2,000 jobs.

Other important projects include a massive electrification programme, the completion of the Northern Hub, which will allow an extra 700 trains to run each day, and the East-West Rail project, which will connect the South to the East Midlands and generate up to 12,000 new jobs across the region.

In a further boost to manufacturing in this country, the Intercity Express Programme will provide a new fleet of state-of-the-art trains and infrastructure improvements on the Great Western Main Line, and on the East Coast Main Line between London and Edinburgh. As well as improving connections between major cities, businesses from Gateshead to Cornwall have won contracts to make everything from safety switches to brake systems. The trains themselves will be assembled in a purpose-built factory in Newton Aycliffe, Co Durham, creating more than 700 local jobs.

Our expanding rail sector has also helped to attract international investment to the UK, creating new jobs and generating further growth. Earlier this year, Hitachi – the company building the new Intercity Express trains – announced it would be moving its global rail headquarters from Tokyo to London and expanding its workforce to 4,000 from the current 2,500 – a real vote of confidence in the industry.

On a more local level, improvements to individual stations are also having a major impact on local economies. In the West Midlands, the redevelopment of Birmingham New Street Station will have generated more than 1,000 jobs during construction, while a new John Lewis store being built as part of the project will produce many hundreds more.

Elsewhere, more than 1,300 stations across the country have benefited from a range of accessibility improvements. They include step-free access at more than 160 stations, with a further 42 on the way. These improvements not only create jobs during construction, but also open up opportunities for more passengers to access local work and leisure.

Rail is an engine for growth. Between 2014 and 2019, infrastructure operator Network Rail is planning to spend £38bn to run and expand the railway, and to give us the capacity we need to prosper. This massive commitment will help us overcome the infrastructure problems we inherited, and which have held Britain back for too long.

Stephen Hammond

Rail Minister

Department for Transport

www.gov.uk/government/organisations/department-for-transport

MVHR: new Standard and guidance

Paul Cribbens, Standards Manager at NHBC outlines the development of new standards and guidance for MVHR systems following research that suggests installations and design are under-performing.

The move towards higher levels of energy efficiency in new homes and improved airtightness has led to around a quarter of new homes built being fitted with Mechanical Ventilation with Heat Recovery (MVHR) systems, according to NHBC analysis.

The changes to Building Regulations have introduced a practical and regulatory need to ensure that the indoor air quality and ventilation provision in new homes are appropriate, as well as designing the home in such a way that reduces the amount of energy used for space heating. MVHR systems work by providing fresh air ventilation, while at the same time recovering heat from exhaust air that would have otherwise been lost.

With most people in developed countries spending an estimated 80% of the time indoors, good indoor air quality is vital for the comfort, health and wellbeing of occupants. Poor indoor air quality can be connected to a wide range of serious health effects, including allergic and asthma symptoms, lung cancer, chronic obstructive pulmonary disease and cardiovascular disease.

An increasing number of house-builders are using MVHR as a practical and cost effective way of meeting ventilation and energy efficiency requirements. It appears likely that the trend to install MVHR will continue, and could well become the dominant form of ventilation for new homes.

Designed and installed correctly, MVHR can offer a number of benefits. But there is a growing body of evidence, based on academic study and practical observations that indicate MVHR systems are all too often designed, installed or commissioned in such a way that the design performance is greatly reduced.

Research from the NHBC Foundation in 2009 Indoor air quality in highly energy efficient new homes – a review, followed by the publication this year of the Zero Carbon hub-led VIAQ Task Group report Mechanical Ventilation with Heat Recovery in new homes, both revealed a number of issues with MVHR systems.

However, with only limited evidence available that is based on monitoring the use of MVHR in practice, the NHBC Foundation has this month released primary research that studies 10 homes in Slough, built to level 6 of the Code for Sustainable Homes. As well as examining the design, commissioning, and installation of the systems, over the course of the 18 month monitoring, the occupants were also interviewed on 3 occasions to provide in-use feedback.

The earlier VIAQ Task Group final report did identify that when done correctly, MVHR systems can deliver good performance, but it is clear from this new research – ‘Assessment of MVHR systems and air quality in new homes’- that a number of lessons still need to be learned. Nine of the units had to be re-commissioned, and the remaining 1 completely replaced after approximately 1 year of occupation.

As a result of this body of research, and at the request of NHBC’s Standards Committee, it was agreed that new NHBC Standards for MVHR needed to be developed.

Following the proven method of engaging with stakeholders, a group of experts from the ventilation and house-building industries was assembled, including representatives from several manufacturers of MVHR systems, a range of house builders, academic and, industry bodies. This group assessed the use of MVHR in house building, identifying common problems and produced a set of technical standards to address them.

The outcome from this group is the new Chapter 3.2 Mechanical ventilation with heat recovery, which will be included in the 2014 edition of the NHBC Standards. It documents new technical guidance that will not only set the standard for MVHR, but significantly raise it, to the benefit of homeowners and the industry in general.

The NHBC Foundation research main findings in connection with the MVHR systems monitored in Slough are:

  • It is critical that the overall ventilation strategy is taken into consideration during the design stage when intending to use MVHR systems in home;
  • During the procurement process it is important to seek technical input from the supplier and installer of MVHR systems;
  • MVHR systems should be installed by trained and experienced ventilation system installers;
  • Commissioning of MVHR systems must be carried out with care and attention;
  • Factors likely to adversely affect the power consumption and thermal performance by MVHR fan units during operation must be considered, such as the size and location of the fan unit, the level of insulation provided and the commissioning.

Key technical issues covered by the new chapter include:

System design

Satisfactory performance is dependent on the design taking into account issues such as the location of the fan unit, the type and position of air valves and terminals, and the control of condensation, as even relatively minor variations from the design can result in under-performance.

Ductwork

The type of duct and its airflow resistance needs to be integral to the design. The main types of duct used in domestic ventilation systems are; rigid duct, semi-rigid duct with short, straight lengths of flexible duct acceptable only for final connections. Compatibility between the duct and other components such as bends, connectors and fixing brackets is essential. To achieve the correct ventilation rate, airflow has to be balanced against the resistance of the ductwork system and its constituent components.

Location of fan unit

MVHR systems require regular interaction from the occupants, which will involve ensuring that the system is maintained, such as regular cleaning/replacement of the filters, around twice a year. Filters are usually incorporated into the fan unit, which can be fairly large and difficult to locate. Because of the need to optimise space within the home, the fan unit is often located outside of the insulated envelope, typically in the roof void. While this may represent a good use of space, it does mean that additional measures need to be taken to ensure that the system performs as intended. Suitable access for maintenance should also be provided.

Prevention of condensation

Ductwork may be carrying air that is at a different temperature to the surrounding atmosphere and this can create favourable conditions for condensation to form either on, or in the ductwork. The new Chapter contains guidance for insulating ductwork that takes into account different types and functions of ducts, their location, and where condensation might occur.

It is critical that when considering MVHR as a ventilation system for new homes, that these new benchmark standards are complied with. A well-considered strategy during the design stage – before procurement and commissioning – is essential, as is ensuring that the design is followed through to the installation. ■

For more information on the NHBC Foundation research, please visit www.nhbcfoundation.org/MVHRsystems, and for more information on NHBC Standards please visit www.nhbc.co.uk/Builders/ProductsandServices/TechnicalStandards

Paul Cribbens

Standards Manager

NHBC

Tel: 0800 035 6422

cssupport@nhbc.co.uk

www.nhbc.co.uk

www.twitter.com/NHBC

 

University of Groningen – Math

Extreme weather events may cause severe damage to our society. Examples are hurricane Sandy in 2012 (the second costliest hurricane in United States history), European windstorms Lothar and Martin in 1999, and more recently, the exceptional sequence of floods in southern England in the winter of 2014. Insurance companies need to reserve sufficient capital to cover claims following an extreme weather event. Estimates of expected losses due to catastrophic events crucially depends on the tail width of the probability distribution describing the likelihood of extremes. Hence, understanding the typical tail behaviour of time series generated by climate models is a pressing challenge for the insurance industry and forecasting agencies.

The Johann Bernoulli Institute for Mathematics and Computer Science (JBI), based at University of Groningen, actively participates in current mathematical research on extreme events. The mission of the JBI is the cross-fertilisation by modelling of the disciplines mathematics and computer science both with other sciences and with the outside world. Here is their story…

Professor Shamala Devi Sekaran, Faculty of Medicine

Dengue, in recent decades has become one of the most uncontrolled neglected infectious diseases especially in the tropical and sub-tropical regions of the world. Dengue diagnosis is not only important for clinical management of patients, but also for epidemiological surveillance, outbreak intervention and vaccine development and monitoring. Due to the absence of pathognomonic clinical features that can distinguish dengue from other febrile illnesses, laboratory confirmation is an essential part of diagnosing dengue. Ideally, a dengue diagnostic test should be rapid, simple, with high sensitivity and specificity, able to serotype and differentiate primary and secondary infections. Despite the many efforts to create a single assay that could confirm dengue, that goal has not been reached. Nevertheless, dengue diagnostics have come a long way, with many researchers around the world attempting for a more efficient and reliable diagnostic method.

The University of Malaya has been actively involved in the development of diagnostic kits for dengue fever. Here is there story…

Prof. Bernd Fritzsch – Department Of Biology

Department Of Biology

Imagine that the sounds you hear become progressively attenuated every day and eventually you are cut off from music, laughter, and any other communication you enjoyed throughout your life. Words you hear may become ambiguous (for example, ‘someday’ and ‘Sunday’ may sound alike) and this word confusion confounds further your understanding of the little you are still able to hear. This will negatively impact the quality of life as we age and when proper communication with our carergivers becomes most essential to meet our increasing physical and mental needs associated with ageing. If unlucky, hearing loss might be combined with phantom sound or tinnitus, also bound to increase.

e-Storage Solutions

e-Storage Solutions

e-Storage Solutions Ltd. has discovered an alternative approach to designing and assembling pressure vessels with a significant cost advantage compared to conventional pressure vessels in order to store mass-energy in the form of compressing gas. e-Storage Solutions Limited was founded October 2011 in order to develop technologies that promise to enhance the reliability, accessibility and efficiency of energy through inexpensive, small to grid-scale energy-storage-systems.

Pfalzklinikum für Psychiatrie

Pfalzklinkum

In Germany the number of sick leave days due to mental disorders has risen continuously over the last few years. In 2012 mental disorders ranked third in causes for incapacity to work. There has also been a lot of discussion to what extent this is due to a general increase in this disease or to whether, a) on the one hand, successful public relations activities have led to a reduction of the stigmatisation, or, b) on the other hand, the general practitioners’ knowledge on the subject of depression could be improved. Against this background the following article outlines the implementation and the activities of a regional Alliance Against Depression in the region of LandauSüdliche Weinstraße. This is a region in south-western Germany which covers a surface area of about 640 km² where approximately 152,400 people live.

Rotherham praised for revival of high street

high streets

Rotherham has been praised by government as an example of how high streets can be rejuvenated.

High Streets Minister, Brandon Lewis and retail expert Mary Portas visited the City in Yorkshire to see first hand how it has gone from turned itself around in 2 years.

The high street has gone from struggling to thriving since receiving £100,000 of government funding through the Portas Pilot scheme in 2012.

The Minister said: “Rotherham is a prime example of how a struggling town centre can be turned around into a success story, and in the last 3 years 86 new businesses have opened their doors in the high street.

“The town has grabbed the opportunities offered to it and is a great example of how our high streets can become shopping destinations that serve the whole community. It’s an example to other town centres around the country.”

Rotherham has reopened 86 new shops, reduced the number of boarded up shops and signed up 100 shops to their local loyalty card scheme increasing footfall and shopper satisfaction.

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