The role of fractional exhaled nitric oxide in the assessment of athletes reporting exertional dyspnoea

Background: Exercise-induced bronchoconstriction (EIB) is a common cause of breathing difficulty in athletes. Fractional exhaled nitric oxide (FeNO) is an indirect marker of airway inflammation, recommended for the assessment and management of asthma; however, the role of FeNO in detecting and monitoring EIB has yet to be fully established. The aim of this study was therefore to evaluate the predictive value of FeNO to confirm or refute EIB in athletes presenting with exertional dyspnoea. Method: Seventy athletes (male: n = 45) (age: 35 ± 11 years) reporting respiratory symptoms (i.e. wheeze, cough and dyspnoea) during exercise attended the laboratory on a single occasion. All athletes performed resting FeNO and spirometry pre-and-post a eucapnic voluntary hyperpnoea challenge (EVH) in accordance with international guidelines. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for established FeNO thresholds: (intermediate [≥25ppb] and high [>50ppb]) and evaluated against objective evidence of EIB: (EVH diagnostic cut-off [-10% ΔFEV1 at two consecutive time-points] and [-15% ΔFEV1 at one time-point]). The diagnostic accuracy of FeNO was calculated using receiver operating characteristics area under the curve (ROC-AUC). Results: All had normal resting lung function (>80% FEV1 pred). The prevalence of EIB was 33% (-10% ΔFEV1) and 23% (-15% ΔFEV1) (median (IQR) ΔFEV1 = -7% (10.02)). FeNO values ≥25ppb and >50ppb were observed in 49% and 23% of the cohort, respectively. ROC-AUC for FeNO was 75% (-10% ΔFEV1) and 86% (-15% ΔFEV1). Sensitivity, specificity, PPV and NPV are presented in Table 1. Conclusion: Our findings indicate that FeNO >50ppb provides good specificity for a positive EVH test; however, should not replace indirect bronchoprovocation for diagnostic purposes. The high proportion of athletes reporting breathing difficulty in the absence of EIB highlights the requirement to consider alternative causes of exertional dyspnoea during clinical work-up

Polymeric rapid prototyping for inexpensive and portable medical diagnostics

Tianchi Ma, Victoria Northrup, Andrew O. Fung, D. Moira Glerum, Christopher J. Backhouse, "Polymeric rapid prototyping for inexpensive and portable medical diagnostics", Proc. SPIE 8412, Photonics North 2012, 84120B (24 October 2012); doi: 10.1117/12.2001470. Copyright 2012, Society of Photo Optical Instrumentation Engineers. One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited. https://doi.org/10.1117/12.2001470The advent of inexpensive CO2 laser systems has led to a wide range of demonstrations of microfabricated lab on chip systems built of acrylic. However, there has been little application of these systems to building microfluidics for DNA analysis. In this work we explore the use of CO2 laser systems for building microfluidics for DNA analysis and relate the artifacts of the fabrication technology to the performance of the system. We show that surface roughness that leads to significant constrictions in the separation channel provides an upper limit of the size of DNA that can be analysed. Below that upper limit, the resolution of the chip is strongly affected by the degree to which the separation channel is exposed to redeposited by-products of the ablation process. We show that by controlling these effects we are reliably able to discern two types of PCR product as a test representative of a real application. By being able to do this is in microfluidic devices the size of a postage stamp we have shown that we can now use CO2 laser systems for the development of extremely inexpensive diagnostic systems using a rapid prototyping approach.Natural Sciences and Engineering Research Council of CanadaTeledyne-DALS

Plasma density profile reconstruction of a gas cell for Ionization Induced Laser Wakefield Acceleration

Laser-driven plasma wakefields can provide hundreds of MeV electron beam in mm-range distances potentially shrinking the dimension of the actual particle accelerators. The plasma density plays a fundamental role in the control and stability of the acceleration process, which is a key development for the future electron injector proposed by EuPRAXIA. A gas cell was designed by LPGP and LIDYL teams, with variable length and backing pressure, to confine the gas and tailor the gas density profile before the arrival of the laser. This cell was used during an experimental campaign with the multi TW-class laser at the Lund Laser Centre. Ionization assisted injection in a tailored density profile is used to tune the electron beam properties. During the experiment, we filled the gas cell with hydrogen mixed with different concentration of nitrogen. We also varied the backing pressure of the gas and the geometrical length of the gas cell. We used a transverse probe to acquire shadowgraphic images of the plasma and to measure the plasma electron density. Methods and results of the analysis with comparisons between shadowgraphic and interferometric images will be discussed

Provision of foot health services for people with rheumatoid arthritis in New South Wales: a web-based survey of local podiatrists

Background: It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists' perceptions of the nature of podiatric foot care provision for people who have RA in NSW.Methods: An anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices.Results: 86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self-referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents.Conclusions: The results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms. © 2013 Hendry et al.; licensee BioMed Central Ltd

Mutations in FRMD7, a newly identified member of the FERM family, cause X-linked idiopathic congenital nystagmus.

Idiopathic congenital nystagmus is characterized by involuntary, periodic, predominantly horizontal oscillations of both eyes. We identified 22 mutations in FRMD7 in 26 families with X-linked idiopathic congenital nystagmus. Screening of 42 singleton cases of idiopathic congenital nystagmus (28 male, 14 females) yielded three mutations (7%). We found restricted expression of FRMD7 in human embryonic brain and developing neural retina, suggesting a specific role in the control of eye movement and gaze stability

Variety of Methodological Approach in Economics

It has been argued by some that the distinction between orthodox economics and heterodox economics does not fit the growing variety in economic theory, unified by a common methodological approach. On the other hand, it remains a central characteristic of heterodox economics that it does not share this methodological approach, but rather represents a range of alternative methodological approaches. The paper explores the evidence, and arguments, for variety in economics at different levels, and a range of issues which arise. This requires in turn a discussion of the meaning of variety in economics at the different levels of reality, methodology, method and theory. It is concluded that there is scope for more, rather than less, variety in economic methodologies, as well as within methodologies. Further, if variety is not to take the form of “anything goes”, then critical discussion by economists of different approaches to economics, and of variety itself, is required

A design theory for e-service environments: The interoperability challenge

The delivery of e-services across organizational boundaries poses a number of issues in terms of design of inter-organizational systems that support service delivery effectively. In this context interoperability emerges as a mandatory requirement for the design of Information Technology (IT) platforms supporting collaborative e-service environments. In this paper we address this issue by presenting a design theory for IT platforms supporting e-services based on both a deep understanding of the interoperability concept and a design research approach. Through the analysis of a cooperation framework developed in the context of an EU funded project, we instantiate the theory by providing the concrete example of a solution addressing this design problem. © 2012 Springer-Verlag GmbH Berlin Heidelberg.The delivery of e-services across organizational boundaries poses a number of issues in terms of design of inter-organizational systems that support service delivery effectively. In this context interoperability emerges as a mandatory requirement for the design of Information Technology (IT) platforms supporting collaborative e-service environments. In this paper we address this issue by presenting a design theory for IT platforms supporting e-services based on both a deep understanding of the interoperability concept and a design research approach. Through the analysis of a cooperation framework developed in the context of an EU funded project, we instantiate the theory by providing the concrete example of a solution addressing this design problem. © 2012 Springer-Verlag GmbH Berlin Heidelberg.Monograph's chapter