Vulnerability is an emerging concept for climate science and policy. Over the past decade, effort... more Vulnerability is an emerging concept for climate science and policy. Over the past decade, efforts to assess vulnerability to climate change triggered a process of theory development and assessment practice, which is reflected in the reports of the Intergovernmental Panel on Climate Change (IPCC). This paper reviews the historical development of the conceptual ideas underpinning assessments of vulnerability to climate change. We distinguish climate impact assessment, first-and second-generation vulnerability assessment, and adaptation policy assessment. The different generations of assessments are described by means of a conceptual framework that defines key concepts of the assessment and their analytical relationships. The purpose of this conceptual framework is two-fold: first, to present a consistent visual glossary of the main concepts underlying the IPCC approach to vulnerability and its assessment; second, to show the evolution of vulnerability assessments. This evolution is characterized by the progressive inclusion of non-climatic determinants of vulnerability to climate change, including adaptive capacity, and the shift from estimating expected damages to attempting to reduce them. We hope that this paper improves the understanding of the main approaches to climate change vulnerability assessment and their evolution, not only within the climate change community but also among researchers from other scientific communities, who are sometimes puzzled by the unfamiliar use of technical terms in the context of climate change.
Prevention and treatment of infections with hepatitis C virus (HCV) remain a major challenge.1 Th... more Prevention and treatment of infections with hepatitis C virus (HCV) remain a major challenge.1 The main source of HCV infection in developed countries was formerly transfusion of contaminated blood and blood products but is now injection-drug use.2-4 In general, a ...
Recent studies provide increasing evidence that postnatal neovascularization involves bone marrow... more Recent studies provide increasing evidence that postnatal neovascularization involves bone marrow-derived circulating endothelial progenitor cells (EPCs). The regulation of EPCs in patients with coronary artery disease (CAD) is unclear at present. Therefore, we determined the number and functional activity of EPCs in 45 patients with CAD and 15 healthy volunteers. The numbers of isolated EPCs and circulating CD34/kinase insert domain receptor (KDR)positive precursor cells were significantly reduced in patients with CAD by Ϸ40% and 48%, respectively. To determine the influence of atherosclerotic risk factors, a risk factor score including age, sex, hypertension, diabetes, smoking, positive family history of CAD, and LDL cholesterol levels was used. The number of risk factors was significantly correlated with a reduction of EPC levels (RϭϪ0.394, Pϭ0.002) and CD34-/KDR-positive cells (RϭϪ0.537, PϽ0.001). Analysis of the individual risk factors demonstrated that smokers had significantly reduced levels of EPCs (PϽ0.001) and CD34-/KDR-positive cells (Pϭ0.003). Moreover, a positive family history of CAD was associated with reduced CD34-/KDR-positive cells (Pϭ0.011). Most importantly, EPCs isolated from patients with CAD also revealed an impaired migratory response, which was inversely correlated with the number of risk factors (RϭϪ0.484, Pϭ0.002). By multivariate analysis, hypertension was identified as a major independent predictor for impaired EPC migration (Pϭ0.043). The present study demonstrates that patients with CAD revealed reduced levels and functional impairment of EPCs, which correlated with risk factors for CAD. Given the important role of EPCs for neovascularization of ischemic tissue, the decrease of EPC numbers and activity may contribute to impaired vascularization in patients with CAD. The full text of this article is available at http://www.circresaha.org. (Circ Res. 2001;89:e1-e7.)
Background-Experimental studies suggest that transplantation of blood-derived or bone marrow-deri... more Background-Experimental studies suggest that transplantation of blood-derived or bone marrow-derived progenitor cells beneficially affects postinfarction remodeling. The safety and feasibility of autologous progenitor cell transplantation in patients with ischemic heart disease is unknown. Methods and Results-We randomly allocated 20 patients with reperfused acute myocardial infarction (AMI) to receive intracoronary infusion of either bone marrow-derived (nϭ9) or circulating blood-derived progenitor cells (nϭ11) into the infarct artery 4.3Ϯ1.5 days after AMI. Transplantation of progenitor cells was associated with a significant increase in global left ventricular ejection fraction from 51.6Ϯ9.6% to 60.1Ϯ8.6% (Pϭ0.003), improved regional wall motion in the infarct zone (Ϫ1.5Ϯ0.2 to Ϫ0.5Ϯ0.7 SD/chord; PϽ0.001), and profoundly reduced end-systolic left ventricular volumes (56.1Ϯ20 mL to 42.2Ϯ15.1 mL; Pϭ0.01) at 4-month follow-up. In contrast, in a nonrandomized matched reference group, left ventricular ejection fraction only slightly increased from 51Ϯ10% to 53.5Ϯ7.9%, and end-systolic volumes remained unchanged. Echocardiography revealed a profound enhancement of regional contractile function (wall motion score index 1.4Ϯ0.2 at baseline versus 1.19Ϯ0.2 at follow-up; PϽ0.001). At 4 months, coronary blood flow reserve was significantly (PϽ0.001) increased in the infarct artery. Quantitative F-18-fluorodeoxyglucose-positron emission tomography analysis revealed a significant (PϽ0.01) increase in myocardial viability in the infarct zone. There were no differences for any measured parameter between blood-derived or bone marrow-derived progenitor cells. No signs of an inflammatory response or malignant arrhythmias were observed. Conclusions-In patients with AMI, intracoronary infusion of autologous progenitor cells appears to be feasible and safe and may beneficially affect postinfarction remodeling processes. (Circulation. 2002;106:3009-3017.)
Vulnerability is an emerging concept for climate science and policy. Over the past decade, effort... more Vulnerability is an emerging concept for climate science and policy. Over the past decade, efforts to assess vulnerability to climate change triggered a process of theory development and assessment practice, which is reflected in the reports of the Intergovernmental Panel on Climate Change (IPCC). This paper reviews the historical development of the conceptual ideas underpinning assessments of vulnerability to climate change. We distinguish climate impact assessment, first-and second-generation vulnerability assessment, and adaptation policy assessment. The different generations of assessments are described by means of a conceptual framework that defines key concepts of the assessment and their analytical relationships. The purpose of this conceptual framework is two-fold: first, to present a consistent visual glossary of the main concepts underlying the IPCC approach to vulnerability and its assessment; second, to show the evolution of vulnerability assessments. This evolution is characterized by the progressive inclusion of non-climatic determinants of vulnerability to climate change, including adaptive capacity, and the shift from estimating expected damages to attempting to reduce them. We hope that this paper improves the understanding of the main approaches to climate change vulnerability assessment and their evolution, not only within the climate change community but also among researchers from other scientific communities, who are sometimes puzzled by the unfamiliar use of technical terms in the context of climate change.
Prevention and treatment of infections with hepatitis C virus (HCV) remain a major challenge.1 Th... more Prevention and treatment of infections with hepatitis C virus (HCV) remain a major challenge.1 The main source of HCV infection in developed countries was formerly transfusion of contaminated blood and blood products but is now injection-drug use.2-4 In general, a ...
Recent studies provide increasing evidence that postnatal neovascularization involves bone marrow... more Recent studies provide increasing evidence that postnatal neovascularization involves bone marrow-derived circulating endothelial progenitor cells (EPCs). The regulation of EPCs in patients with coronary artery disease (CAD) is unclear at present. Therefore, we determined the number and functional activity of EPCs in 45 patients with CAD and 15 healthy volunteers. The numbers of isolated EPCs and circulating CD34/kinase insert domain receptor (KDR)positive precursor cells were significantly reduced in patients with CAD by Ϸ40% and 48%, respectively. To determine the influence of atherosclerotic risk factors, a risk factor score including age, sex, hypertension, diabetes, smoking, positive family history of CAD, and LDL cholesterol levels was used. The number of risk factors was significantly correlated with a reduction of EPC levels (RϭϪ0.394, Pϭ0.002) and CD34-/KDR-positive cells (RϭϪ0.537, PϽ0.001). Analysis of the individual risk factors demonstrated that smokers had significantly reduced levels of EPCs (PϽ0.001) and CD34-/KDR-positive cells (Pϭ0.003). Moreover, a positive family history of CAD was associated with reduced CD34-/KDR-positive cells (Pϭ0.011). Most importantly, EPCs isolated from patients with CAD also revealed an impaired migratory response, which was inversely correlated with the number of risk factors (RϭϪ0.484, Pϭ0.002). By multivariate analysis, hypertension was identified as a major independent predictor for impaired EPC migration (Pϭ0.043). The present study demonstrates that patients with CAD revealed reduced levels and functional impairment of EPCs, which correlated with risk factors for CAD. Given the important role of EPCs for neovascularization of ischemic tissue, the decrease of EPC numbers and activity may contribute to impaired vascularization in patients with CAD. The full text of this article is available at http://www.circresaha.org. (Circ Res. 2001;89:e1-e7.)
Background-Experimental studies suggest that transplantation of blood-derived or bone marrow-deri... more Background-Experimental studies suggest that transplantation of blood-derived or bone marrow-derived progenitor cells beneficially affects postinfarction remodeling. The safety and feasibility of autologous progenitor cell transplantation in patients with ischemic heart disease is unknown. Methods and Results-We randomly allocated 20 patients with reperfused acute myocardial infarction (AMI) to receive intracoronary infusion of either bone marrow-derived (nϭ9) or circulating blood-derived progenitor cells (nϭ11) into the infarct artery 4.3Ϯ1.5 days after AMI. Transplantation of progenitor cells was associated with a significant increase in global left ventricular ejection fraction from 51.6Ϯ9.6% to 60.1Ϯ8.6% (Pϭ0.003), improved regional wall motion in the infarct zone (Ϫ1.5Ϯ0.2 to Ϫ0.5Ϯ0.7 SD/chord; PϽ0.001), and profoundly reduced end-systolic left ventricular volumes (56.1Ϯ20 mL to 42.2Ϯ15.1 mL; Pϭ0.01) at 4-month follow-up. In contrast, in a nonrandomized matched reference group, left ventricular ejection fraction only slightly increased from 51Ϯ10% to 53.5Ϯ7.9%, and end-systolic volumes remained unchanged. Echocardiography revealed a profound enhancement of regional contractile function (wall motion score index 1.4Ϯ0.2 at baseline versus 1.19Ϯ0.2 at follow-up; PϽ0.001). At 4 months, coronary blood flow reserve was significantly (PϽ0.001) increased in the infarct artery. Quantitative F-18-fluorodeoxyglucose-positron emission tomography analysis revealed a significant (PϽ0.01) increase in myocardial viability in the infarct zone. There were no differences for any measured parameter between blood-derived or bone marrow-derived progenitor cells. No signs of an inflammatory response or malignant arrhythmias were observed. Conclusions-In patients with AMI, intracoronary infusion of autologous progenitor cells appears to be feasible and safe and may beneficially affect postinfarction remodeling processes. (Circulation. 2002;106:3009-3017.)
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