Nocturnal CPAP improves walking capacity in COPD patients with obstructive sleep apnoea

BACKGROUND: Exercise limitation is an important issue in patients with chronic obstructive pulmonary disease (COPD), and it often co-exists with obstructive sleep apnoea (overlap syndrome). This study examined the effects of nocturnal continuous positive airway pressure (CPAP) treatment on walking capacity in COPD patients with or without obstructive sleep apnoea. METHODS: Forty-four stable moderate-to-severe COPD patients were recruited and completed this study. They all underwent polysomnography, CPAP titration, accommodation, and treatment with adequate pressure. The incremental shuttle walking test was used to measure walking capacity at baseline and after two nights of CPAP treatment. Urinary catecholamine and heart rate variability were measured before and after CPAP treatment. RESULTS: After two nights of CPAP treatment, the apnoea-hypopnoea index and oxygen desaturation index significantly improved in both overlap syndrome and COPD patients, however these changes were significantly greater in the overlap syndrome than in the COPD group. Sleep architecture and autonomic dysfunction significantly improved in the overlap syndrome group but not in the COPD group. CPAP treatment was associated with an increased walking capacity from baseline from 226.4 ± 95.3 m to 288.6 ± 94.6 m (P < 0.05), and decreased urinary catecholamine levels, pre-exercise heart rate, oxygenation, and Borg scale in the overlap syndrome group. An improvement in the apnoea-hypopnoea index was an independent factor associated with the increase in walking distance (r = 0.564). CONCLUSION: Nocturnal CPAP may improve walking capacity in COPD patients with overlap syndrome. TRIAL REGISTRATION: NCT0091426

Liquid biopsies come of age: towards implementation of circulating tumour DNA

Improvements in genomic and molecular methods are expanding the range of potential applications for circulating tumour DNA (ctDNA), both in a research setting and as a ‘liquid biopsy’ for cancer management. Proof-of-principle studies have demonstrated the translational potential of ctDNA for prognostication, molecular profiling and monitoring. The field is now in an exciting transitional period in which ctDNA analysis is beginning to be applied clinically, although there is still much to learn about the biology of cell-free DNA. This is an opportune time to appraise potential approaches to ctDNA analysis, and to consider their applications in personalized oncology and in cancer research.We would like to acknowledge the support of The University of Cambridge, Cancer Research UK (grant numbers A11906, A20240, A15601) (to N.R., J.D.B.), the European Research Council under the European Union's Seventh Framework Programme (FP/2007-2013)/ERC Grant Agreement n. 337905 (to N.R.), the Cambridge Experimental Cancer Medicine Centre, and Hutchison Whampoa Limited (to N.R.), AstraZeneca (to R.B., S.P.), the Cambridge Experimental Cancer Medicine Centre (ECMC) (to R.B., S.P.), and NIHR Biomedical Research Centre (BRC) (to R.B., S.P.). J.G.C. acknowledges clinical fellowship support from SEOM

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Experimental Investigation on the Performance of a Compressed-Air Driven Piston Engine

This study presents an experimental investigation of a piston engine driven by compressed air. The compressed air engine was a modified 100 cm3 internal combustion engine obtained from a motorcycle manufacturer. The experiments in this study used a test bench to examine the power performance and pressure/temperature variations of the compressed air engine at pressures ranging from 5 to 9 bar (absolute pressure). The engine was modified from a 4-stroke to a 2-stroke engine using a cam system driven by a crankshaft and the intake and exhaust valves have a small lift due to this modification. The highest power output of 0.95 kW was obtained at 9 bar and 1320 rpm. The highest torque of 9.99 N·m occurred at the same pressure, but at 465 rpm. The pressure-volume (P-V) diagram shows that cylinder pressure gradually increases after the intake valve opens because of the limited lift movement of the intake valve. Similar situations occurred during the exhaust process, restricting the power output of the compressed air engine. The pressure and temperature variation of the air at engine inlet and outlet were recorded during the experiment. The outlet pressure increased from 1.5 bar at 500 rpm to 2.25 bar at 2000 rpm, showing the potential of recycling the compressed air energy by attaching additional cylinders (split-cycle engine). A temperature decrease (from room temperature to 17 °C) inside the cylinder was observed. It should be noted that pressures higher than that currently employed can result in lower temperatures and this can cause poor lubrication and sealing issues. The current design of a compressed air engine, which uses a conventional cam mechanism for intake and exhaust, has limited lift movement during operation, and has a restricted flow rate and power output. Fast valve actuation and a large lift are essential for improving the performance of the current compressed air engine. This study presents a power output examination with the pressure and temperature measurements of a piston-type compressed air engine to be installed in compact vehicles as the main or auxiliary power system

Experimental Investigation on the Performance of a Compressed-Air Driven Piston Engine

This study presents an experimental investigation of a piston engine driven by compressed air. The compressed air engine was a modified 100 cm3 internal combustion engine obtained from a motorcycle manufacturer. The experiments in this study used a test bench to examine the power performance and pressure/temperature variations of the compressed air engine at pressures ranging from 5 to 9 bar (absolute pressure). The engine was modified from a 4-stroke to a 2-stroke engine using a cam system driven by a crankshaft and the intake and exhaust valves have a small lift due to this modification. The highest power output of 0.95 kW was obtained at 9 bar and 1320 rpm. The highest torque of 9.99 N·m occurred at the same pressure, but at 465 rpm. The pressure-volume (P-V) diagram shows that cylinder pressure gradually increases after the intake valve opens because of the limited lift movement of the intake valve. Similar situations occurred during the exhaust process, restricting the power output of the compressed air engine. The pressure and temperature variation of the air at engine inlet and outlet were recorded during the experiment. The outlet pressure increased from 1.5 bar at 500 rpm to 2.25 bar at 2000 rpm, showing the potential of recycling the compressed air energy by attaching additional cylinders (split-cycle engine). A temperature decrease (from room temperature to 17 °C) inside the cylinder was observed. It should be noted that pressures higher than that currently employed can result in lower temperatures and this can cause poor lubrication and sealing issues. The current design of a compressed air engine, which uses a conventional cam mechanism for intake and exhaust, has limited lift movement during operation, and has a restricted flow rate and power output. Fast valve actuation and a large lift are essential for improving the performance of the current compressed air engine. This study presents a power output examination with the pressure and temperature measurements of a piston-type compressed air engine to be installed in compact vehicles as the main or auxiliary power system