Problematic Activities of Daily Life are Weakly Associated With Clinical Characteristics in COPD

BACKGROUND: Problematic activities of daily life (ADLs) can be the main reason to refer patients with chronic obstructive pulmonary disease (COPD) for pulmonary rehabilitation. To date, information on problematic ADLs and their clinical correlates in COPD remain scarce. This retrospective chart review aimed to identify the most prevalent self-reported problematic ADLs in COPD patients, determine performance and satisfaction scores of these problematic ADLs, and explore the association between 13 clinical determinants and 4 problematic ADL domains. METHODS: A total of 820 COPD patients entering pulmonary rehabilitation assessment were included in this retrospective study. Self-reported problematic ADLs were assessed using the Canadian Occupational Performance Measure, administered by occupational therapists in the form of a semistructured interview. RESULTS: COPD patients (59% male, age 63.6 +/- 9.3 years, FEV1 (%pred): 46.4 +/- 18.4) reported 2999 problematic ADLs. The most prevalent problematic ADLs were walking (68%), stair climbing (35%), and cycling (30%). Moreover, 30% of the patients reported "not able to do any of the scored problematic ADL" and 44% were "not satisfied at all with the performance of any of the scored problematic ADL." Significant but weak associations were found between clinical determinants (eg, physical and psychosocial) and problematic ADLs. CONCLUSIONS: The lack of a strong association between problematic ADLs and clinical determinants emphasizes the need for individualized assessment of these ADLs to allow tailored intervention

Comparison of genotyping using pooled DNA samples (allelotyping) and individual genotyping using the affymetrix genome-wide human SNP array 6.0

Background: Genome-wide association studies (GWAS) using array-based genotyping technology are widely used to identify genetic loci associated with complex diseases or other phenotypes. The costs of GWAS projects based on individual genotyping are still comparatively high and increase with the size of study populations. Genotyping using pooled DNA samples, as also being referred as to allelotyping approach, offers an alternative at affordable costs. In the

What is the Oxygen Isotope Composition of Venus? The Scientific Case for Sample Return from Earth’s “Sister” Planet

Venus is Earth’s closest planetary neighbour and both bodies are of similar size and mass. As a consequence, Venus is often described as Earth’s sister planet. But the two worlds have followed very different evolutionary paths, with Earth having benign surface conditions, whereas Venus has a surface temperature of 464 °C and a surface pressure of 92 bar. These inhospitable surface conditions may partially explain why there has been such a dearth of space missions to Venus in recent years.The oxygen isotope composition of Venus is currently unknown. However, this single measurement (Δ17O) would have first order implications for our understanding of how large terrestrial planets are built. Recent isotopic studies indicate that the Solar System is bimodal in composition, divided into a carbonaceous chondrite (CC) group and a non-carbonaceous (NC) group. The CC group probably originated in the outer Solar System and the NC group in the inner Solar System. Venus comprises 41% by mass of the inner Solar System compared to 50% for Earth and only 5% for Mars. Models for building large terrestrial planets, such as Earth and Venus, would be significantly improved by a determination of the Δ17O composition of a returned sample from Venus. This measurement would help constrain the extent of early inner Solar System isotopic homogenisation and help to identify whether the feeding zones of the terrestrial planets were narrow or wide.Determining the Δ17O composition of Venus would also have significant implications for our understanding of how the Moon formed. Recent lunar formation models invoke a high energy impact between the proto-Earth and an inner Solar System-derived impactor body, Theia. The close isotopic similarity between the Earth and Moon is explained by these models as being a consequence of high-temperature, post-impact mixing. However, if Earth and Venus proved to be isotopic clones with respect to Δ17O, this would favour the classic, lower energy, giant impact scenario.We review the surface geology of Venus with the aim of identifying potential terrains that could be targeted by a robotic sample return mission. While the potentially ancient tessera terrains would be of great scientific interest, the need to minimise the influence of venusian weathering favours the sampling of young basaltic plains. In terms of a nominal sample mass, 10 g would be sufficient to undertake a full range of geochemical, isotopic and dating studies. However, it is important that additional material is collected as a legacy sample. As a consequence, a returned sample mass of at least 100 g should be recovered.Two scenarios for robotic sample return missions from Venus are presented, based on previous mission proposals. The most cost effective approach involves a “Grab and Go” strategy, either using a lander and separate orbiter, or possibly just a stand-alone lander. Sample return could also be achieved as part of a more ambitious, extended mission to study the venusian atmosphere. In both scenarios it is critical to obtain a surface atmospheric sample to define the extent of atmosphere-lithosphere oxygen isotopic disequilibrium. Surface sampling would be carried out by multiple techniques (drill, scoop, “vacuum-cleaner” device) to ensure success. Surface operations would take no longer than one hour.Analysis of returned samples would provide a firm basis for assessing similarities and differences between the evolution of Venus, Earth, Mars and smaller bodies such as Vesta. The Solar System provides an important case study in how two almost identical bodies, Earth and Venus, could have had such a divergent evolution. Finally, Venus, with its runaway greenhouse atmosphere, may provide data relevant to the understanding of similar less extreme processes on Earth. Venus is Earth’s planetary twin and deserves to be better studied and understood. In a wider context, analysis of returned samples from Venus would provide data relevant to the study of exoplanetary systems

The Effects of a "New" Walking Aid on Exercise Performance in Patients With COPD: A Randomized Crossover Trial

ABSTRACTBackgroundGenerally, the use of a rollator improves mobility in patients with COPD. Nevertheless, not all patients benefit from its use and many patients feel embarrassed about its use. Therefore, other walking aids are worthwhile to consider. We compared the direct effects of a 'new' ambulation aid (a modern draisine) to a rollator on six-minute walk distance (6MWD) in COPD.Methods21 patients with COPD performed two 6-minute walk tests (6MWTs) during pre-rehabilitation assessment (best 6MWD: 369+/-88 m). Additionally, two extra 6MWTs were performed on two consecutive days in random order: 1x with rollator and 1x with modern draisine. Walking pattern (n=21) was determined using an accelerometer and metabolic requirements (n=10) were assessed using a mobile oxycon.ResultsWalking with the modern draisine resulted in a higher 6MWD compared to the rollator (466+/-189 vs. 383+/-85 m). Moreover, patients had fewer strides (245+/-61 vs. 300+/-49) and a greater stride length (1.89+/-0.73 vs. 1.27+/-0.14 m) using the modern draisine compared to the rollator (all: p</=0.001). Oxygen uptake, ventilation, heart rate, oxygen saturation and Borg symptom scores were comparable between both walking aids. Ten percent of the patients felt embarrassed using the modern draisine compared to 19% for rollator; while a significantly smaller proportion of patients would use the modern draisine in daily life.ConclusionThe mean difference in 6MWD between modern draisine and rollator seems clinically relevant, with the same metabolic requirements and symptom Borg scores. Therefore, this 'new' ambulation aid could be a good alternative for the rollator to improve functional exercise performance in patients with COPD

Efficacy of walking aids on self-paced outdoor walking in individuals with COPD: A randomized cross-over trial

BACKGROUND AND OBJECTIVE: Walking aids, such as rollator or draisine, improve mobility and functional exercise performance in individuals with chronic obstructive pulmonary disease (COPD) during an indoor 6-min walk test. However, this test does not reflect everyday walking, which is the most frequently reported problematic activity of daily life in individuals with COPD. To date, efficacy of walking aids during self-paced outdoor walking remains unknown. Therefore, we aimed to determine the efficacy of a rollator and draisine on self-paced outdoor walking in individuals with COPD. METHODS: Fifteen individuals with COPD (68% men; age: 63 +/- 8 years; forced expiratory volume in 1 s: 40 +/- 14% predicted) performed three self-paced outdoor walking tests on two consecutive days: test 1 unaided, and tests 2 and 3 with rollator or draisine in random order. Participants had to walk as long as possible at their own pace. The test ended when participants needed to stop, with a maximum duration of 30 min. RESULTS: The use of rollator resulted in the highest walk distance and time (P < 0.05 vs unaided and draisine). Furthermore, individuals with COPD walked significantly further and longer during an unaided test compared with a draisine aided test (P < 0.05). Moreover, use of draisine resulted in a significantly higher walking speed, fewer strides, greater stride length, and higher step and stride variability (P < 0.05 vs unaided and rollator). CONCLUSION: To conclude, a rollator improves the self-paced outdoor walk distance and time in individuals with moderate and advanced COPD and a poor functional exercise capacity, whereas the use of a draisine had a detrimental effect compared with unaided walking

Impact history of the HED parent body(ies) clarified by new 40Ar/39Ar analyses of four HED meteorites and one anomalous basaltic achondrite

We investigate the thermal/impact histories of four HED meteorites: one cumulate eucrite (Lake Carnegie) two brecciated basaltic eucrites (Camel Donga, Millbillillie), one howardite (Old Homestead 003) and an anomalous basaltic achondrite (Deakin 010). We have measured eight convincing new 40Ar/39Ar ages for three HED meteorites. Laser incremental 40Ar/39Ar analyses of carefully separated small grains (3.66 Ga for the largest impact recorded. Cosmic ray exposure ages yielded apparent 38Arc ages ranging from 6 to >40 Ma.Two clusters of ages that represent significant impacts into the HED parent body may have been identified. The first high-temperature event is recorded by Lake Carnegie and other unbrecciated eucrites at ~4.5 Ga and is interpreted as a mega-impact, although it is also possible that this age is recording magmatic crystallisation due to the similarity of published Sm–Nd and Pb–Pb ages. Additionally, from statistically reliable isotopic ages, provided in this study, it appears that the age range of major impact heating events post 4.5 Ga might be more tightly restricted (~3.8–3.5 Ga) than previously suggested (~3.4–4.1 Ga), however a larger dataset is required before comparison with the range of the lunar heavy bombardment is justified. If HED are indeed from 4 Vesta, we raise the possibility that the impact at ~4.5 Ga might be associated with the formation of the south polar Veneneia basin, whereas an age at ~3.7 Ga may represent the formation age of either Veneneia, or the younger Rheasilvia impact structure

Clinical and molecular delineation of the 17q21.31 microdeletion syndrome.

The chromosome 17q21.31 microdeletion syndrome is a novel genomic disorder that has originally been identified using high-resolution genome analyses in patients with unexplained mental retardation. Here we report the molecular and/or clinical characterization of 22 individuals with the 17q21.31 microdeletion syndrome. We estimate the prevalence of the syndrome to be 1 in 16,000 and show that it is highly underdiagnosed. Extensive clinical examination, reveals that developmental delay, hypotonia, facial dysmorphisms including a long face, a tubular or pear-shaped nose and a bulbous nasal tip, and a friendly/amiable behavior are the most characteristic features. Other clinically important features include epilepsy, heart defects (ASD, VSD), and kidney/ urologic anomalies. Using high-resolution oligonucleotide arrays, we narrow the 17q21.31 critical region to a 424-kb genomic segment (chr17: 41046729-41470954, hg17), encompassing at least six genes, among which the gene encoding microtubule-associated protein tau (MAPT). Mutation screening of MAPT in 122 individuals with a phenotype suggestive of 17q21.31 deletion carriers, but who do not carry the recurrent deletion, failed to identify any disease-associated variants. In five deletion carriers, we identify a &lt;500-bp rearrangement hotspot at the proximal breakpoint contained within an L2 LINE motif and show that in every case examined, the parent originating the deletion carries a common 900-kb 17q21.31 inversion polymorphism, indicating that this inversion is a necessary factor for deletion to occur (p&lt;10-5). Our data establishes the 17q21.31 microdeletion syndrome as a clinically and molecularly well recognizable genomic disorder