Lack of paradoxical bronchoconstriction after administration of tiotropium via Respimat® Soft Mist™ Inhaler in COPD

Bronchoconstriction has been reported in asthma and chronic obstructive pulmonary disease (COPD) patients after administration of some aqueous inhalation solutions. We investigated the incidence of this event during long-term clinical trials of tiotropium delivered via Respimat® Soft Mist™ Inhaler (SMI). We retrospectively analyzed pooled data from two identical Phase III clinical trials, in which 1990 patients with COPD received 48 weeks’ treatment with once-daily tiotropium (5 or 10 μg) or placebo inhaled via Respimat® SMI. We recorded the incidence of bronchospasm and of a range of respiratory events that could suggest bronchoconstriction during the first 30 minutes after inhalation of study treatment on each of the eight test days. No patients reported bronchospasm. Six patients (0.3%) reported a combination of at least two events suggestive of bronchoconstriction, and 21 (1.1%) reported either rescue medication use or a respiratory adverse event. Asymptomatic falls in forced expiratory volume in one second (FEV1) of ≥15% were recorded on all test days, with no change in incidence over time, and affected 8.2% of those in the tiotropium groups and 14.5% of those on placebo. In COPD patients receiving long-term treatment with tiotropium 5 or 10 μg via Respimat® SMI, no bronchospasm was recorded, and the number of events possibly indicative of paradoxical bronchoconstriction was very low

New advances in cystic fibrosis - implications for developing countries

No Abstract

No Admixture, Sustainable, Self-Consolidating Grout

The consolidation of grout in concrete masonry unit (CMU) walls is labor-intensive. Also, the grout’s Portland cement content has a high embodied energy demand – a non-sustainable characteristic. For the labor-intensive issue, chemical admixture self-consolidating grouts have been used in walls 12.67 ft. (3.86 m) tall, however the chemical additive can impose new limitations on the grout (non-robust characteristics). No admixture self-consolidating grout with high percentage Portland cement replacement have potential for robust and sustainable application. This paper reports on the consolidation of no admixture self-consolidating grout made by substituting high percentages of Portland cement with Type-F fly ash and/or GGBFS. The percent replacement ranged from 50% to 80% by volume. Single lift test CMU walls were 12.67 ft. (3.86 m) tall. The relative reinforcement consolidation was assessed by comparison to traditional mechanically consolidated grout and also compared to criteria of ACI technical notes for shotcrete. Cure time was 125 days

Nash or Stackelberg? -- A comparative study for game-theoretic AV decision-making

This paper studies game-theoretic decision-making for autonomous vehicles (AVs). A receding horizon multi-player game is formulated to model the AV decision-making problem. Two classes of games, including Nash game and Stackelber games, are developed respectively. For each of the two games, two solution settings, including pairwise games and multi-player games, are introduced, respectively, to solve the game in multi-agent scenarios. Comparative studies are conducted via statistical simulations to gain understandings of the performance of the two classes of games and of the two solution settings, respectively. The simulations are conducted in intersection-crossing scenarios, and the game performance is quantified by three metrics: safety, travel efficiency, and computational time.Comment: 8 pages, submitted to ECC2

Designing game-based myoelectric prosthesis training

A myoelectric prosthesis (myo) is a dexterous artificial limb controlled by muscle contractions. Learning to use a myo can be challenging, so extensive training is often required to use a myo prosthesis effectively. Signal visualizations and simple muscle-controlled games are currently used to help patients train their muscles, but are boring and frustrating. Furthermore, current training systems require expensive medical equipment and clinician oversight, restricting training to infrequent clinical visits. To address these limitations, we developed a new game that promotes fun and success, and shows the viability of a low-cost myoelectric input device. We adapted a user-centered design (UCD) process to receive feedback from patients, clinicians, and family members as we iteratively addressed challenges to improve our game. Through this work, we introduce a free and open myo training game, provide new information about the design of myo training games, and reflect on an adapted UCD process for the practical iterative development of therapeutic games

Lack of paradoxical bronchoconstriction after administration of tiotropium via Respimat® Soft Mist™ Inhaler in COPD

Bronchoconstriction has been reported in asthma and chronic obstructive pulmonary disease (COPD) patients after administration of some aqueous inhalation solutions. We investigated the incidence of this event during long-term clinical trials of tiotropium delivered via Respimat® Soft Mist™ Inhaler (SMI). We retrospectively analyzed pooled data from two identical Phase III clinical trials, in which 1990 patients with COPD received 48 weeks’ treatment with once-daily tiotropium (5 or 10 μg) or placebo inhaled via Respimat® SMI. We recorded the incidence of bronchospasm and of a range of respiratory events that could suggest bronchoconstriction during the first 30 minutes after inhalation of study treatment on each of the eight test days. No patients reported bronchospasm. Six patients (0.3%) reported a combination of at least two events suggestive of bronchoconstriction, and 21 (1.1%) reported either rescue medication use or a respiratory adverse event. Asymptomatic falls in forced expiratory volume in one second (FEV1) of ≥15% were recorded on all test days, with no change in incidence over time, and affected 8.2% of those in the tiotropium groups and 14.5% of those on placebo. In COPD patients receiving long-term treatment with tiotropium 5 or 10 μg via Respimat® SMI, no bronchospasm was recorded, and the number of events possibly indicative of paradoxical bronchoconstriction was very low

Performance of no vibration / no admixture masonry grout containing high replacement of Portland cement with fly ash and ground granulated blast furnace slag

When hollow concrete masonry is used for construction in high seismic regions, structural designs typically require fully grouted walls. For a fully grouted 203x203x406 mm (8x8x16) concrete masonry unit (CMU), 52 percent of total volume is grout. Grouting process is labor-intensive, time consuming and has a high energy demand due to requirements of consolidation in each and subsequent grout lifts. Self-consolidating grout with admixtures has been successfully used without segregation in walls of up to 3.86 m (12.67 ft.) in height. Investigation of self-consolidating grout mixes without admixtures has potential for sustainability improvement. This paper reports on the compression strength and consolidation observations of self-consolidating characteristics of no vibration/no admixture grout made by substituting various proportions of Portland cement with Type F fly ash and/or ground granulated blast furnace slag (GGBFS). The percentages of Portland cement replacement were 0%, 50%, 60%, and 70% for Type F fly ash replacement. The percentages of Portland cement replacement were 0%, 60%, 70% and 80% for Type F fly ash and GGBFS. Compression test specimens were made from individual 203x203x406 mm (8x8x16) concrete masonry hollow core units, where the cells were filled with no vibration/ no admixture grout. The specimens were dry cured and compression testing performed at 7, 14, 28, 42, 56, and 130 days. Consolidation testing specimen walls were 3.86 m (12.67 ft.) tall by 1.22 m (4.0 ft.) long with 203x203x406 mm (8x8x16) CMU. The relative performance assessed by comparing to traditional grouted masonry and evaluating consolidation characteristics around mortar fins and reinforcement at 130 days as well as compressive strength of the grout at various wall heights

Spintronic properties of one-dimensional electron gas in graphene armchair ribbons

We have investigated, using effective mass approach (EMA), magnetic properties of a one-dimensional electron gas in graphene armchair ribbons when the electrons of occupy only the lowest conduction subband. We find that magnetic properties of the one-dimensional electron gas may depend sensitively on the width of the ribbon. For ribbon widths $L_x=3Ma_0$, a critical point separates ferromagnetic and paramagnetic states while for $L_x=(3M+1)a_0$ paramagnetic state is stable ($M$ is an integer and $a_{0}$ is the length of the unit cell). These width-dependent properties are a consequence of eigenstates that have a subtle width-dependent mixture of $\mathbf{K}$ and $\mathbf{K'}$ states, and can be understood by examining the wavefunction overlap that appears in the expression for the many-body exchange self-energy. Ferromagnetic and paramagnetic states may be used for spintronic purposes.Comment: 5 pages, 6 figure

Two-period linear mixed effects models to analyze clinical trials with run-in data when the primary outcome is continuous: Applications to Alzheimer\u27s disease.

Introduction: Study outcomes can be measured repeatedly based on the clinical trial protocol before randomization during what is known as the run-in period. However, it has not been established how best to incorporate run-in data into the primary analysis of the trial. Methods: We proposed two-period (run-in period and randomization period) linear mixed effects models to simultaneously model the run-in data and the postrandomization data. Results: Compared with the traditional models, the two-period linear mixed effects models can increase the power up to 15% and yield similar power for both unequal randomization and equal randomization. Discussion: Given that analysis of run-in data using the two-period linear mixed effects models allows more participants (unequal randomization) to be on the active treatment with similar power to that of the equal-randomization trials, it may reduce the dropout by assigning more participants to the active treatment and thus improve the efficiency of AD clinical trials