Potential of a cyclone prototype spacer to improve in vitro dry powder delivery

Copyright The Author(s) 2013. This article is published with open access at Springerlink.com. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are creditedPurpose: Low inspiratory force in patients with lung disease is associated with poor deagglomeration and high throat deposition when using dry powder inhalers (DPIs). The potential of two reverse flow cyclone prototypes as spacers for commercial carrierbased DPIs was investigated. Methods: Cyclohaler®, Accuhaler® and Easyhaler® were tested with and without the spacers between 30-60 Lmin-1. Deposition of particles in the next generation impactor and within the devices was determined by high performance liquid chromatography. Results: Reduced induction port deposition of the emitted particles from the cyclones was observed due to the high retention of the drug within the spacers (e.g. salbutamol sulphate (SS): 67.89 ± 6.51 % at 30 Lmin-1 in Cheng 1). Fine particle fractions of aerosol as emitted from the cyclones were substantially higher than the DPIs alone. Moreover, the aerodynamic diameters of particles emitted from the cyclones were halved compared to the DPIs alone (e.g. SS from the Cyclohaler® at 4 kPa: 1.08 ± 0.05 μm vs. 3.00 ± 0.12 μm, with and without Cheng 2, respectively) and unaltered with increased flow rates. Conclusion: This work has shown the potential of employing a cyclone spacer for commercial carrier-based DPIs to improve inhaled drug delivery.Peer reviewe

Towards ensemble asteroseismology of the young open clusters Chi Persei and NGC 6910

As a result of the variability survey in Chi Persei and NGC6910, the number of Beta Cep stars that are members of these two open clusters is increased to twenty stars, nine in NGC6910 and eleven in Chi Persei. We compare pulsational properties, in particular the frequency spectra, of Beta Cep stars in both clusters and explain the differences in terms of the global parameters of the clusters. We also indicate that the more complicated pattern of the variability among B type stars in Chi Persei is very likely caused by higher rotational velocities of stars in this cluster. We conclude that the sample of pulsating stars in the two open clusters constitutes a very good starting point for the ensemble asteroseismology of Beta Cep-type stars and maybe also for other B-type pulsators.Comment: 4 pages, Astronomische Nachrichten, HELAS IV Conference, Arecife, Lanzarote, Feb 2010, submitte

Too close for comfort: cyber terrorism and information security across national policies and international diplomacy

This article analyses the evolution and interplay of national policies and international diplomacy on cyber terrorism within and across the UNSC’s permanent five members and the UN process on cyber norms (GGE and OEWG). First, it reveals how – through the extension of preemptive measures to low-impact cyber activities and online content – national policies progressively articulate cyber terrorism as an issue of information security. Second, it problematizes how – through the adoption of comprehensive and imprecise definitions – the diplomatic language on cyber terrorism might lend international support to those authoritarian regimes keen on leveraging counter-terrorism to persecute domestic oppositions and vulnerable groups. Third, it concludes that – with UN diplomatic efforts increasingly discussing countering (dis)information operations – combining normative debates on cyber terrorism with those on information security requires precision of language to safeguard human rights globally.Cybersecurity en cybergovernanc

Pushing Boundaries: An Empirical View on the Digital Sovereignty of Six Governments in the Midst of Geopolitical Tensions

In just a few years, the issue of “digital sovereignty” has emerged as an important security issue for governments across the globe, reflecting a growing unease about the security risks associated with government services that depend on foreign service providers for digital infrastructure and traffic routing. This work investigates to which extent government services and communication with citizens relies on infrastructure outside their own jurisdiction for six countries facing sensitive or sometimes even antagonistic relations with neighbors: India, the Netherlands, Pakistan, Taiwan, Ukraine, and the United Kingdom. By combining various methods (traceroute measurements, passive DNS data and geolocation), we determine where and how domains are hosted, as well as the network paths taken by citizens' traffic to them. We uncover different strategies and degrees of autonomy, as well as difficult tradeoffs between different risks to autonomy, some of which might be larger than the risks associated with the dependency on foreign providers. This includes transnational providers being used by all countries, with geopolitical rivals even being tenants on the same network and traffic between citizens and governments regularly traversing international borders. Furthermore, we compared our empirical findings to stated governmental policies and find that they are not always consistent.Organisation & GovernanceMulti Actor System

Feasibility of joystick guided colonoscopy

The flexible endoscope is increasingly used to perform minimal invasive interventions. A novel add-on platform allows single-person control of both endoscope and instrument at the site of intervention. The setup changes the current routine of handling the endoscope. This study aims to determine if the platform allows effective and efficient manipulation to position the endoscope at potential intervention sites throughout the bowel. Five experts in flexible endoscopy first performed three colonoscopies on a computer simulator using the conventional angulation wheels. Next they trained with the joystick interface to achieve their personal level of intubation time with low pain score. 14 PhD students (novices) without hands-on experience performed the same colonoscopy case using either the conventional angulation wheels or joystick interface. Both novice groups trained to gain the average expert level. The cecal intubation time, pain score and visualization performance (% of bowel wall) were recorded. All experts reached their personal intubation time in 6 ± 6 sessions. Three experts completed their learning curve with low pain score in 8 ± 6 sessions. The novices required 11 ± 6 sessions using conventional angulation wheels, and 12 ± 6 sessions using the joystick interface. There was no difference in the visualization performance between the novice and between the expert groups. This study shows that the add-on platform enables endoscope manipulation required to perform colonoscopy. Experts need only a relatively short training period. Novices are as effective and as efficient in endoscope manipulation when comparing the add-on platform with conventional endoscope contro

Observed and predicted risk of breast cancer death in randomized trials on breast cancer screening

BACKGROUND: The role of breast screening in breast cancer mortality declines is debated. Screening impacts cancer mortality through decreasing the number of advanced cancers with poor diagnosis, while cancer treatment works through decreasing the case-fatality rate. Hence, reductions in cancer death rates thanks to screening should directly reflect reductions in advanced cancer rates. We verified whether in breast screening trials, the observed reductions in the risk of breast cancer death could be predicted from reductions of advanced breast cancer rates. PATIENTS AND METHODS: The Greater New York Health Insurance Plan trial (HIP) is the only breast screening trial that reported stage-specific cancer fatality for the screening and for the control group separately. The Swedish Two-County trial (TCT)) reported size-specific fatalities for cancer patients in both screening and control groups. We computed predicted numbers of breast cancer deaths, from which we calculated predicted relative risks (RR) and (95% confidence intervals). The Age trial in England performed its own calculations of predicted relative risk. RESULTS: The observed and predicted RR of breast cancer death were 0.72 (0.56-0.94) and 0.98 (0.77-1.24) in the HIP trial, and 0.79 (0.78-1.01) and 0.90 (0.80-1.01) in the Age trial. In the TCT, the observed RR was 0.73 (0.62-0.87), while the predicted RR was 0.89 (0.75-1.05) if overdiagnosis was assumed to be negligible and 0.83 (0.70-0.97) if extra cancers were excluded. CONCLUSIONS: In breast screening trials, factors other than screening have contributed to reductions in the risk of breast cancer death most probably by reducing the fatality of advanced cancers in screening groups. These factors were the better management of breast cancer patients and the underreporting of breast cancer as the underlying cause of death. Breast screening trials should publish stage-specific fatalities observed in each group