Novel study design to assess the utility of the copd assessment test in a primary care setting

The quality of a consultation provided by a physician can have a profound impact on the quality of care and patient engagement in treatment decisions. When the COPD Assessment Test (CAT) was developed, one of its aims was to aid the communication between physician and patient about the impact of COPD. We developed a novel study design to assess this in a primary care consultation. Primary care physicians across five countries in Europe conducted videoed consultations with six standardised COPD patients (played by trained actors) which had patient-specific issues that the physician needed to identify through questioning. Half the physicians saw the patients with the completed CAT, and half without. Independent assessors scored the physicians on their ability to identify and address the patient-specific issues, review standard COPD aspects, their understanding of the case and their overall performance. This novel study design presented many challenges which needed to be addressed to achieve an acceptable level of robustness to assess the utility of the CAT. This paper discusses these challenges and the measures adopted to eliminate or minimise their impact on the study results

A Metasystem of Framework Model Organisms to Study Emergence of New Host-Microbe Adaptations

An unintended consequence of global industrialization and associated societal rearrangements is new interactions of microbes and potential hosts (especially mammals and plants), providing an opportunity for the rapid emergence of host-microbe adaptation and eventual establishment of new microbe-related diseases. We describe a new model system comprising the model plant Arabidopsis thaliana and several microbes, each representing different modes of interaction, to study such “maladaptations”. The model microbes include human and agricultural pathogens and microbes that are commonly considered innocuous. The system has a large knowledge base corresponding to each component organism and is amenable to high-throughput automation assisted perturbation screens for identifying components that modulate host-pathogen interactions. This would aid in the study of emergence and progression of host-microbe maladaptations in a controlled environment

Interactions between the night time valley-wind system and a developing cold-air pool

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Boundary-Layer Meteorology following peer review. The version of record [Arduini, G., Staquet, C & Chemel, C., ‘Interactions between the night time valley-wind system and a developing cold-air pool’, Boundary-Layer Meteorol (2016) 161:1 (49-72), first published online June 2, 2016, is available at Springer online at doi: 10.1007/s10546-016-0155-8The Weather Research and Forecast (WRF) numerical model is used to characterize the influence of a thermally-driven down-valley flow on a developing cold-air pool in an idealized alpine valley decoupled from the atmosphere above. Results for a three-dimensional (3D) valley, which allows for the formation of a down-valley flow, and for a two-dimensional (2D) valley, where the formation of a down-valley flow is inhibited, are analyzed and compared. A key result is that advection leads to a net cooling in the 2D valley and to a warming in the 3D valley, once the down-valley flow is fully developed. This difference stems from the suppression of the slope-flow induced upward motions over the valley centre in the 3D valley. As a result, the downslope flows develop a cross-valley circulation within the cold-air pool, the growth of the cold-air pool is reduced and the valley atmosphere is generally warmer than in the 2D valley. A quasi-steady state is reached for which the divergence of the down-valley flow along the valley is balanced by the convergence of the downslope flows at the top of the cold-air pool, with no net contribution of subsiding motions far from the slope layer. More precisely, the inflow of air at the top of the cold-air pool is found to be driven by an interplay between the return flow from the plain region and subsidence over the plateaux. Finally, the mechanisms that control the structure of the cold-air pool and its evolution are found to be independent of the valley length as soon as the quasi-steady state is reached and the down-valley flow is fully developed.Peer reviewedFinal Accepted Versio