Computer-based lung sound simulation

An algorithm for the simulation of normal and pathological lung sounds is developed. The simulation algorithm is implemented on a personal computer as well as on a digital signal processor system in real time. Normal, bronchial and tracheal breathing sounds can be generated, and continuous and discontinuous adventitious lung sounds can be added. The attributes of the individual sound components, such as loudness, frequency, duration or number of occurrences within one breathing cycle, are controlled by the user. The quality of the simulations is evaluated by sending audio tapes to 15 experienced pulmonary physicians for a formal assessment. Each tape contains five simulated lung sounds and five real lung sounds from a commercially available teaching tape, presented in random order. Simulated lung sounds are slightly better rated in terms of realism and signal quality when compared to the recordings from the teaching tape. The differences are, however, not significant. 13 out of the 15 physicians feel that computer-based lung sound simulators would be a useful and desirable teaching tool for auscultation course

Testing the global capabilities of the Antelope software suite: fast location and Mb determination of teleseismic events using the ASAIN and GSN seismic networks

The Italian National Institute for Oceanography and Experimental Geophysics (Istituto Nazionale di Oceanografia e di Geofisica Sperimentale, OGS) is running the Antarctic Seismographic Argentinean Italian Network (ASAIN), made of 5 seismic stations located in the Scotia Sea region in Antarctica and in Argentina: data from these stations are transferred in real time to the OGS headquarters in Trieste (Italy) via satellite links. OGS is also running, in close cooperation with the Friuli-Venezia Giulia Civil Defense, the North East (NI) Italy seismic network, making use of the Antelope commercial software suite from BRTT as the main acquisition system. As a test to check the global capabilities of Antelope, we set up an instance of Antelope acquiring data in real time from both the regional ASAIN seismic network in Antarctica and a subset of the Global Seismic Network (GSN) funded by the Incorporated Research Institution for Seismology (IRIS). The facilities of the IRIS Data Management System, and specifically the IRIS Data Management Center, were used for real time access to waveform required in this study. Preliminary results over 1 month period indicated that about 82% of the earthquakes with magnitude M>5.0 listed in the PDE catalogue of the National Earthquake Information Center (NEIC) of the United States Geological Survey (USGS) were also correctly detected by Antelope, with an average location error of 0.05 degrees and average body wave magnitude Mb estimation error below 0.1. The average time difference between event origin time and the actual time of event determination by Antelope was of about 45’: the comparison with 20’, the IASPEI91 P-wave travel time for 180 degrees distance, and 25’, the estimate of our test system data latency, indicate that Antelope is a serious candidate for regional and global early warning systems. Updated figures calculated over a longer period of time will be presented and discussed

Genetic Variability of Lucerne Landraces from Central Italy Detected by RAPD Markers

With the aim to characterize six lucerne landraces (Medicago sativa L.), representing a sample of a collection from central Italy, sixty individuals per landrace were evaluated by screening for RAPD markers with three lucerne-specific primers. Twenty-one amplification products were scored as present or absent across all plants. The dendrogram from mean genetic similarity estimates displayed Casalina alone and the other landraces clustered into one distinct group, showing a single branch point with more than 73% of genetic similarity. The discriminant analysis grouped the landraces in a similar manner. The first function maximally separated the group Grosseto, Gubbio and C. Pieve from Latina and L’Aquila while the second function maximally separated Casalina from the rest of landraces. Overall 56% of individual plants were correctly reclassified into their own groups. Owing to their rather narrow geographic provenance, more primers are needed to increase precision in the estimate of the genetic variability

Using Serious Games for Learning British Sign Language Combining Video, Enhanced Interactivity, and VR Technology

One in every six persons in the UK suffers a hearing loss, either as a condition they have been born with or they disordered they acquired during their life. 900,000 people in the UK are severely or profoundly deaf and based on a study by Action On Hearing Loss UK in 2013 only 17 percent of this population, can use the British Sign Language (BSL). That leaves a massive proportion of people with a hearing impediment who do not use sign language struggling in social interaction and suffering from emotional distress, and an even larger proportion of Hearing people who cannot communicate with those of the deaf community. This paper presents a serious game (SG) that aims to close the communication gap between able hearing people and people with a hearing impediment by providing a tool that facilitates BSL learning targeting adult population. The paper presents the theoretical framework supporting adult learning based on which a SG game using Virtual Reality (VR) technology has been developed. It explains the experimental framework of the study and presents the creation of the research instruments to facilitate the study comprising of a SG that integrates video and conventional video based educational material. It reports and analyses the study results that demonstrate the advantage of the SG in effectively supporting users learning a set of BSL signs and it presents qualitative outcomes that inform the further development of the game to serve learning needs. The paper closes with conclusions, directions for further development of this educational resource and future studies

Adult Learning Sign Language by combining video, interactivity and play in a 3D game platform

One in every six persons in the UK suffers a hearing loss, either as a condition they have been born with or a disorder they acquired during their life. 900,000 people in the UK are severely or profoundly deaf and based on a study by Action On Hearing Loss UK in 2013 only 17 percent of this population, can use the British Sign Language (BSL). That leaves a massive proportion of people with a hearing impediment who do not use sign language struggling in social interaction and suffering from emotional distress, and an even larger proportion of Hearing people who cannot communicate with those of the deaf community. This paper presents a theoretical framework for the design of interactive games to support learning BSL supporting the entire learning cycle, instruction, practice and assessment. It then describes the proposed design of a game based on this framework aiming to close the communication gap between able hearing people and people with a hearing impediment, by providing a tool that facilitates BSL learning targeting adult population. The paper concludes with the planning of a large scale study and directions for further development of this educational resource

The Antarctic Seismographic Argentinean Italian Network - ASAIN Improving the instrumental coverage in Antarctica

Scientific investigations of the Scotia Sea region are crucial to understand the history of the Antarctic continent tectonic evolution and the influence of the aperture of the Drake passage in establishing the Circumpolar Antarctic Current, as stressed by many authors (e.g. Lodolo, 2008). The Scotia Sea occupies a roughly rectangular area of about 900.000 km . This area is limited on three sides by the Scotia Arc, formed by islands and oceanic ridges, which is a remnant of the mountain chain that joined the South American Andes to the Antarctic Peninsula. The western border is represented by the about 1000 km wide Drake passage, that separates today the Tierra del Fuego in South America from the Antarctic continent. A review of the tectonics and evolution of the Scotia Sea can be found in Barker, 2001. The start of the geophysical studies in this area dates back to several decades ago, but only after 1990 instrumental passive seismology started to be widely applied to investigate the crustal properties and the properties of the seismic sources responsible for the strong seismicity level observed along the Scotia plate boundaries. ASAIN started operation in 1992 when a temporary seismograph was installed at the Argentinean Base Esperanza. It grew quickly during the nineties and today five stations are operated in Antarctica and two in Tierra del Fuego. All the Antarctic stations transmit real-time data to the OGS and to the Instituto Antartico Argentino. Esperanza (ESPZ), Jubany (JUBA), San Martin (SMAI) and Orcadas(ORCD) stations also participate in the Virtual European Seismographic Broadband Network (VEBSN) transmitting real time data to the Orfeus Data Centre. On January 16 , 2009 BELA station was added to the network. It is operated at the southernmost Argentinean Base Belgrano II (77° 52' S, 34° 37' W ) located on a rocky outcrop (Nunatak Bertrab) on the Filchner barrier. Its inclusion in the VEBSN is also planned. ASAIN data real-time acquisition is performed using SCREAM software, but also Earthworm and Antelope software are being tested at the OGS Seismological Research Centre

Integration of social aspects in decision support, based on life cycle thinking

Recently increasing attention has been paid to complementing environmental Life Cycle Assessment (LCA) with social aspects. The paper discusses the selection of social impacts and indicators from existing frameworks like Social Life Cycle Assessment (SLCA) and Social Impact Assessment (SIA). Two ongoing case studies, addressing sustainability assessment within decision support, were considered: (1) Integrated Water Resources Management (IWRM) in Indonesia; and (2) Integrated Packaging Waste Management in Spain and Portugal (FENIX). The focus was put on social impacts occurring due to decisions within these systems, such as choice of technologies, practices or suppliers. Thus, decision makers—here understood as intended users of the studies’ results—are not consumers that buy (or do not buy) a product, such as in recent SLCA case-studies, but mainly institutions that decide about the design of the water or packaging waste management system. Therefore, in the FENIX project, a list of social impacts identified from literature was sent to the intended users to be ranked according to their priorities. Finally, the paper discusses to what extent the entire life cycle is reflected in SLCA impact categories and indicators, and explains how both life-cycle and on-site-related social impacts were chosen to be assessed. However, not all indicators in the two projects will assess all stages of the life cycle, because of their varying relevance in the different stages, data availability and practical interest of decision makers

Lipoprotein glomerulopathy treated with LDL-apheresis (Heparin-induced Extracorporeal Lipoprotein Precipitation system): a case report.

INTRODUCTION: Lipoprotein glomerulopathy is a glomerulonephritis which was described for the first time by Saito in 1989 and is currently acknowledged as a separate nosological entity. It is histologically characterized by a marked dilatation of the glomerular capillaries and the presence of lipoprotein thrombi in the glomerular lumens. The dyslipidemic profile is similar to that of type III dyslipoproteinemia with Apolipoprotein E values that are often high; proteinuria and renal dysfunction are present. Proteinuria often does not respond to steroid and cytostatic treatments. The phenotypic expression of lipoprotein glomerulopathy is most probably correlated to a genetic alteration of the lipoprotein metabolism (mutation of the Apolipoprotein E coding gene). In literature, lipoprotein glomerulopathies have mainly been reported in Japanese and Chinese subjects, except for three cases in the Caucasian race, reported in France and the USA.CASE PRESENTATION: We describe the case of a 60-year-old female, Caucasian patient suffering from lipoprotein glomerulopathy, carrier of a new mutation on the Apolipoprotein E gene (Apolipoprotein E(MODENA)), and treated successfully with low density lipoprotein-apheresis with the Heparin induced extracorporeal lipoprotein precipitation system. After a first phase of therapeutic protocol with statins, the patient was admitted for nephrotic syndrome, renal failure and hypertension. Since conventional treatment alone was not able to control dyslipidemia, aphaeretic treatment with heparin-induced Extracorporeal Lipoprotein Precipitation - apheresis (HELP-apheresis) was started to maintain angiotensin converting enzyme inhibitor therapy for the treatment of hypertension. Treatment with HELP-apheresis led to a complete remission of the proteinuria in a very short time (four months), as well as control of hypercholesterolemia and renal function recovery.CONCLUSION: According to this case of lipoprotein glomerulopathy, we believe that renal damage expressed by proteinuria correlates to the levels of lipids and, furthermore, the treatment with HELP-apheresis, by lowering low-density lipoprotein cholesterol and triglycerides, may be considered as a therapeutic option in synergy with pharmacological treatment in the treatment of lipoprotein glomerulopathy

Low specificity of the bacterial index for the diagnosis of bacterial pneumonia by bronchoalveolar lavage

The bacterial index (BI) as defined by the sum of log10 colony-forming units (cfu) of microorganisms per milliliter of bronchoalveolar lavage (BAL) fluid, i.e., a multiplication of the single cfu/ml, has been used to distinguish between polymicrobial pneumonia (BI≥5) and colonization (BI<5). Since many false-positive results are to be expected using this parameter, the diagnostic value of the BI was studied prospectively by obtaining bacteriologic cultures of BAL fluid in 165 consecutive unselected patients. In 27 cases the diagnosis of bacterial pneumonia was established on clinical criteria. In 133 patients pneumonia could be excluded, and in five patients the diagnosis remained unclear. Using a cut-off of ≥105 cfu/ml BAL fluid, sensitivity and specificity for the diagnosis of pneumonia were 33% (9/27) and 99% (132/133), respectively. Sensitivity was mainly influenced by prior treatment with antibiotics, being 70% (7/10) in untreated and 12% (2/17) in treated patients. Applying the BI methodology at a cut-off of ≥ 5, however, resulted in an unacceptably high rate of 16 additional false-positive results, thus lowering the specificity to 87% (116/133;P<0.0001) while increasing the sensitivity to only 41% (11/27;P=0.77). In conclusion, given the high rate of false-positive results, the methodology of the BI is of doubtful value for the diagnosis of bacterial pneumonia by BAL in an unselected patient group. By applying the absolute number of cfu/ml BAL fluid, however, positive bacteriologic cultures of BAL fluid are highly specific for the diagnosis of pneumonia. Their sensitivity is limited by previous antibiotic therap