A global review of seed enhancement technology use to inform improved applications in restoration.

Seed-based restoration often experiences poor success due to a range of edaphic and biotic issues. Seed enhancement technologies (SETs) are a novel approach that can alleviate these pressures and improve restoration success. Broadly, SETs have been reviewed for agricultural and horticultural purposes, for specific types of SETs such as coating or priming, or for focal ecosystems. However, information is lacking for SETs within a restoration focused context, and how they are being used to alleviate certain barriers. This review aimed to synthesise the current literature on SETs to understand what SETs are being tested, in which sectors and locations they are being tested, what issues are faced within restoration using SETs, and how SETs are being used to approach these issues. Priming was highlighted as the main SET investigated. Inoculation, pesticide application and magnetic fields were also commonly tested (SETs we termed 'prospective techniques'). SET research mainly occurred in the agricultural sector. More recently, other sectors, such as restoration and rangeland management, have increased efforts into SET research. The restoration sector has focused on extruded pelleting and coating (with activated carbon), in combination with herbicide application, to overcome invasive species, and coating with certain additives to alleviate edaphic issues. Other sectors outside restoration were largely focused on evaluating priming for overcoming these barriers. The majority of priming research has been completed on crop species and differences between these species and ecosystems must be considered in future restoration efforts that focus on native seed use. Generally, SETs require further refinement, including identifying ideal additives and their optimum concentrations to target certain issues, refining formulations for coating and extruded pelleting and developing flash flaming. A bet-hedging approach using multiple SETs and/or combinations of SETs may be advantageous in overcoming a wide range of barriers in seed-based restoration.

The two-week rule in colorectal cancer. Can it deliver its promise?

Despite recent advances in technology, a high percentage of patients with colorectal cancer present with disease that is already advanced, leading to an overall 5-year survival rate of 49.6% in men and 50.8% in women. In order to facilitate access to specialist cancer units, across specialities, the Department of Health formulated the NHS Cancer Plan in 2000 which consisted, in part, of the 'two-week rule' (TWR). The TWR was launched to ensure that all patients meeting specific referral criteria for suspected colorectal cancer were seen by a hospital specialist within 14 days of referral. The TWR referral system was set up with the intention of identifying 90% of patients with bowel cancer for prompt treatment. This study was conducted to investigate the difference in presentation between patients referred via the TWR pathway compared to those referred via an elective (non-TWR) route and to examine the impact of these referral routes on the time to treatment and clinical outcome.

A randomized, controlled trial comparing ganciclovir to ganciclovir plus foscarnet (each at half dose) for preemptive therapy of cytomegalovirus infection in transplant recipients.

Forty-eight patients who provided 2 consecutive blood samples that tested positive for cytomegalovirus DNA by polymerase chain reaction (PCR) were randomized to receive either full-dose ganciclovir (5 mg/kg intravenously [iv] twice daily) or half-dose ganciclovir (5 mg/kg iv once daily) plus half-dose foscarnet (90 mg/kg iv once daily) for 14 days. In the ganciclovir arm, 17 (71%) of 24 patients reached the primary end point of being CMV negative by PCR within 14 days of initiation of therapy, compared with 12 (50%) of 24 patients in the ganciclovir-plus-foscarnet arm (P = .12). Toxicity was greater in the combination-therapy arm. In patients who failed to reach the primary end point, baseline virus load was 0.77 log10 higher, the replication rate before therapy was faster (1.5 vs. 2.7 days), and the viral decay rate was slower (2.9 vs. 1.1 days) after therapy. Bivariable logistic regression models identified baseline virus load, bone-marrow transplantation, and doubling time and half-life of decay as the major factors affecting response to therapy within 14 days. This study did not support a synergistic effect of ganciclovir plus foscarnet in vivo.