Dyspnea affective response: comparing COPD patients with healthy volunteers and laboratory model with activities of daily living

Background: Laboratory-induced dyspnea (breathing discomfort) in healthy subjects is widely used to study perceptual mechanisms, yet the relationship between laboratory-induced dyspnea in healthy volunteers and spontaneous dyspnea in patients with chronic lung disease is not well established. We compared affective responses to dyspnea 1) in COPD patients vs. healthy volunteers (HV) undergoing the same laboratory stimulus; 2) in COPD during laboratory dyspnea vs. during activities of daily living (ADL). Methods: We induced moderate and high dyspnea levels in 13 COPD patients and 12 HV by increasing end-tidal CO2 (PETCO2) during restricted ventilation, evoking air hunger. We used the multidimensional dyspnea profile (MDP) to measure intensity of sensory qualities (e.g., air hunger (AH) and work/effort (W/E)) as well as immediate discomfort (A1) and secondary emotions (A2). Ten of the COPD subjects also completed the MDP outside the laboratory following dyspnea evoked by ADL. Results: COPD patients and HV reported similar levels of immediate discomfort relative to sensory intensity. COPD patients and HV reported anxiety and frustration during laboratory-induced dyspnea; variation among individuals far outweighed the small differences between subject groups. COPD patients reported similar intensities of sensory qualities, discomfort, and emotions during ADL vs. during moderate laboratory dyspnea. Patients with COPD described limiting ADL to avoid greater dyspnea. Conclusions: In this pilot study, we found no evidence that a history of COPD alters the affective response to laboratory-induced dyspnea, and no difference in affective response between dyspnea evoked by this laboratory model and dyspnea evoked by ADL

Fluoride-containing bioactive glasses: Effect of glass design and structure on degradation, pH and apatite formation in simulated body fluid

NOTICE: this is the author’s version of a work that was accepted for publication in Acta Biomaterialia. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Acta Biomaterialia, [VOL 6, ISSUE 8, (2010)] DOI: 10.1016/j.actbio.2010.01.04

A “Novel” Approach to the Design of an IS Management Course

We report on the design and implementation of an unusual course in Information Systems (IS) management built around an extended case series: a fictitious but reality-based story about the trials and tribulations of a newly appointed but not-technically-trained Chief Information Officer (CIO) in his first year on the job. Together the cases constitute a true-to-life “novel” about IS management (published, in fact, as a novel, as well as individual cases). Four principles guided development of the series and its associated pedagogy: 1) Emphasis on integrative, soft-skill, and business-oriented aspects of IS, independent of underlying technologies; 2) Student derivation and ongoing refinement of cumulative theoretical frameworks arrived at via in-class discussion; 3) Identification of a set of core issues vital to practice that collectively approximate IS management as a business discipline; and 4) Design for student engagement, in particular by basing the case “story” on the monomyth, a literary pattern common to important narratives around the world. A supporting website facilitates sharing of teaching materials and experiences by faculty using the case series. We report results from using this curriculum with undergraduate and graduate students in two universities in different countries, and with executives at a multinational corporation and in an executive program at Harvard Business School. Our results suggest that a “novel-based” approach holds considerable promise for use at undergraduate, graduate, and executive levels, and that it might have advantages in addressing the so-called “enrollment crisis” in IS education, especially with the generation of “digital natives” who have come of age in an environment crowded with engaging approaches to communication and entertainment that compete for their attention

Extensively Drug-Resistant Tuberculosis in Women, KwaZulu-Natal, South Africa

To determine whether women in KwaZulu-Natal, South Africa, with drug-resistant tuberculosis (TB) were more likely than men to have extensively drug-resistant TB, we reviewed 4,514 adults admitted during 2003–2008 for drug-resistant TB. Female sex independently predicted extensively drug-resistant TB, even after we controlled for HIV infection. This association needs further study

Early clinical outcomes after small incision lenticule extraction surgery (SMILE)

Purpose Dry eye is known to impact on clinical outcomes after laser vision correction and the use of a newer ‘all femtosecond laser’ surgical approach may be associated with less impact on the ocular surface post-operatively. The purpose of this study was to evaluate the early clinical outcomes and tear instability after the first small incision lenticule extraction (SMILE) cases undertaken by three surgeons at a single site in the UK. Methods Retrospective audit. Seventy-one eyes of 37 patients underwent SMILE surgery using the Zeiss VisuMax laser system (Carl Zeiss Meditec, Germany). Uncorrected and corrected distance visual acuity, spherical equivalent refraction, fluorescein enhanced tear break up time, simulated keratometry and complications were evaluated pre- and post-operatively where applicable. Results The study population consisted of 21 males and 16 females. The mean ± standard deviation age was 33 ± 8 years. The results showed that 100% of eyes achieved 20/40 or better and 88% achieved 20/20 or better uncorrected distance visual acuity. The spherical equivalent refraction after surgery was within ±0.50D in 82% of eyes at three months. There was no significant difference in tear break up time from pre-operative levels at three months. Complications were infrequent. Conclusions This early data from surgeons’ first SMILE procedures suggest SMILE provides good outcomes in terms of refractive predictability and visual acuity with minimal impact on the tear film. Longitudinal research will further improve our understanding of the longer-term impact of SMILE on clinical outcomes, ocular surface metrics and patient reported outcomes

Waiting for child developmental and rehabilitation services: an overview of issues and needs

Concern about the length of time that children, young people, and families may have to wait to access assessment, diagnostic, interventional, therapeutic, and supportive child developmental and rehabilitation (CDR) services is widespread, but adequate data collection and research on this issue remain limited. We review key concepts and issues relevant to waiting for CDR services from the published literature, a national workshop devoted to this topic, and international experience. We conclude that gaps in data, evidence, and consensus challenge our ability to address the issue of waiting for CDR services in a systematic way. A program of research coupled with actions based on consensus-building is required. Research priorities include acquiring evidence of the appropriateness and effectiveness of different models of intervention and rehabilitation services, and documenting the experience and expectations of waiting families. Consensus-building processes are critical to identify, categorize, and prioritize \u27sentinel\u27 components of CDR service pathways: (1) to reduce the inherent complexity of the field; (2) to create benchmarks for waiting for these respective services; and (3) to develop definitions for wait-time subcomponents in CDR services. Collection of accurate and replicable data on wait times for CDR services can be used to document baseline realities, to monitor and improve system performance, and to conduct comparative and analytic research in the field of CDR services

Toward the development of the International Classification of Functioning Core Sets for children with cerebral palsy: a global expert survey

The goal of the International Classification of Functioning is to standardize the classification of health and function of children around the world. To facilitate the application of this classification, International Classification of Functioning-based tools like the Core Sets are being developed. We conducted an international survey of professional experts to identify the most relevant areas of functioning in children with cerebral palsy. The questionnaire covered each component of the classification. In total, 193 professionals completed the survey (response rate 78%). Overall, 9706 answers were linked to the classification (pediatric version) by 2 professionals. From the experts\u27 perspective, movement-related areas and social participation are the most relevant areas of functioning. Experts suggest a more comprehensive profile of functioning in particular in areas of personal capacity and social participation. The results of this survey will inform the development of the International Classification of Functioning Core Sets for children with cerebral palsy

A new avenue in the search for <i>CP</i> violation:Mössbauer spectroscopy of ²²⁷ Ac

This work proposes a new avenue in the search for CP-violating odd-electric and even-magnetic nuclear moments. A promising candidate to find such moments in the ground state is the quadrupole-deformed and octupole-correlated nucleus 227-actinium. In this nucleus, the 27.4-keV $E1$~transition that connects the $3/2^+$ parity-doublet partner and the $3/2^-$ ground state is perfectly suited to apply the sensitive technique of recoil-free selfabsorption, commonly known as M\"ossbauer spectroscopy. In this experimental approach, the lifetime of the $3/2^+$ upper parity-doublet partner allows an estimate of the lower limit of $\Delta E = 2\cdot \Gamma_{\gamma}$= $23.7(1) \times 10^{-9}$ eV for the achievable energy resolution to be made. This resolution must be exceeded by the interaction of a CP-violating moment and the corresponding multipole moment of the field distribution in the lattice. This work presents the first ideas for patterns caused by CP-violating moments on the expected quadrupole splitting and nuclear Zeeman effect.Comment: 9 pages, 4 figure

Mapping the human platelet lipidome reveals cytosolic phospholipase A2 as a regulator of mitochondrial bioenergetics during activation

Human platelets acutely increase mitochondrial energy generation following stimulation. Herein, a lipidomic circuit was uncovered whereby the substrates for this are exclusively provided by cPLA2, including multiple fatty acids and oxidized species that support energy generation via β-oxidation. This indicates that acute lipid membrane remodeling is required to support energetic demands during platelet activation. Phospholipase activity is linked to energy metabolism, revealing cPLA2 as a central regulator of both lipidomics and energy flux. Using a lipidomic approach (LipidArrays), we also estimated the total number of lipids in resting, thrombin-activated, and aspirinized platelets. Significant diversity between genetically unrelated individuals and a wealth of species was revealed. Resting platelets demonstrated ∼5,600 unique species, with only ∼50% being putatively identified. Thrombin elevated ∼900 lipids >2-fold with 86% newly appearing and 45% inhibited by aspirin supplementation, indicating COX-1 is required for major activation-dependent lipidomic fluxes. Many lipids were structurally identified. With ∼50% of the lipids being absent from databases, a major opportunity for mining lipids relevant to human health and disease is presente

The architecture of EMC reveals a path for membrane protein insertion

Approximately 25% of eukaryotic genes code for integral membrane proteins that are assembled at the endoplasmic reticulum. An abundant and widely conserved multi-protein complex termed EMC has been implicated in membrane protein biogenesis, but its mechanism of action is poorly understood. Here, we define the composition and architecture of human EMC using biochemical assays, crystallography of individual subunits, site-specific photocrosslinking, and cryo-EM reconstruction. Our results suggest that EMC’s cytosolic domain contains a large, moderately hydrophobic vestibule that can bind a substrate’s transmembrane domain (TMD). The cytosolic vestibule leads into a lumenally-sealed, lipid-exposed intramembrane groove large enough to accommodate a single substrate TMD. A gap between the cytosolic vestibule and intramembrane groove provides a potential path for substrate egress from EMC. These findings suggest how EMC facilitates energy-independent membrane insertion of TMDs, explain why only short lumenal domains are translocated by EMC, and constrain models of EMC’s proposed chaperone function