bluuebunny/crossref_metadata_2025 huggingface dataset:
Finding Futures: A Spatio-Visual Experiment In Participatory Engagement
Authors: Davies Sarah R , Selin Cynthia , Gano Gretchen , Pereira Ângela Guimarães
Published: September 2012

The Finding Futures Project explores innovative ways of deliberating the future of cities through an emphasis on embodied spatio-visual engagement with urban landscapes. The first instantiation of the project - which took place in Lisbon in 2011 - is reported through a discussion of the project's background, methods and outcomes.
From Gesture to Form: The Evolution of Expressive Freehand Spatial Interfaces
Authors: Keefe Daniel F.
Published: September 2012

This paper presents a series of insights from an ongoing investigation into refining custom spatial computer interfaces and graphical primitives for suggesting 3D form in immersive digital spaces. Technical innovations utilizing 3D gesture capture, force feedback, and stereoscopic presentation are described through reference to specific free-form digital sculptures created with the CavePainting and Drawing on Air interfaces. The role of the human hand in digital art practice and the potential of interfaces that tightly couple freehand movements with geometric algorithms are discussed.
The Serendiptichord: Reflections on the Collaborative Design Process between Artist and Researcher
Authors: Murray-Browne Tim , Mainstone Di , Bryan-Kinns Nick , Plumbley Mark D.
Published: September 2012

The Serendiptichord is a wearable instrument, resulting from a collaboration crossing fashion, technology, music and dance. This paper reflects on the collaborative process and how defining both creative and research roles for each party led to a successful creative partnership built on mutual respect and open communication. After a brief snapshot of the instrument in performance, the instrument is considered within the context of dance-driven interactive music systems followed by a discussion on the nature of the collaboration and its impact upon the design process and final piece.
Invisible Navigation (or Impossible?)
Authors: Özcan Oguzhan , O'Neil Mary Lou
Published: September 2012

This article introduces an experimental artwork on moving mobile interfaces. It aims to answer the question: Is it possible to navigate a part of a large image composition, moving a smaller interface of a mobile device in a certain direction such as left and right, back and forth or up and down? The article then outlines the new concept of “Invisible (or impossible) Navigation” and discusses the output of artistic practices which address the “Labyrinth of Art”.
Dynamics of Feature Categorization
Authors: Martí Daniel , Rinzel John
Published: September 2012

In visual and auditory scenes, we are able to identify shared features among sensory objects and group them according to their similarity. This grouping is preattentive and fast and is thought of as an elementary form of categorization by which objects sharing similar features are clustered in some abstract perceptual space. It is unclear what neuronal mechanisms underlie this fast categorization. Here we propose a neuromechanistic model of fast feature categorization based on the framework of continuous attractor networks. The mechanism for category formation does not rely on learning and is based on biologically plausible assumptions, for example, the existence of populations of neurons tuned to feature values, feature-specific interactions, and subthreshold-evoked responses upon the presentation of single objects. When the network is presented with a sequence of stimuli characterized by some feature, the network sums the evoked responses and provides a running estimate of the distribution of features in the input stream. If the distribution of features is structured into different components or peaks (i.e., is multimodal), recurrent excitation amplifies the response of activated neurons, and categories are singled out as emerging localized patterns of elevated neuronal activity (bumps), centered at the centroid of each cluster. The emergence of bump states through sequential, subthreshold activation and the dependence on input statistics is a novel application of attractor networks. We show that the extraction and representation of multiple categories are facilitated by the rich attractor structure of the network, which can sustain multiple stable activity patterns for a robust range of connectivity parameters compatible with cortical physiology.
Stochastic Hodgkin-Huxley Equations with Colored Noise Terms in the Conductances
Authors: Güler Marifi
Published: September 2012

The excitability of cells is facilitated by voltage-gated ion channels. These channels accommodate a multiple number of gates individually. The possible impact of that gate multiplicity on the cell's function, specifically when the membrane area is of limited size, was investigated in the author's prior work (Güler, 2011 ). There, it was found that a nontrivially persistent correlation takes place between the transmembrane voltage fluctuations (also between the fluctuations in the gating variables) and the component of open channel fluctuations attributed to the gate multiplicity. This nontrivial phenomenon was found to be playing a major augmentative role for the elevation of excitability and spontaneous firing in small cells. In addition, the same phenomenon was found to be enhancing spike coherence significantly. Here we extend Fox and Lu's ( 1994 ) stochastic Hodgkin-Huxley equations by incorporating colored noise terms into the conductances there to obtain a formalism capable of capturing the addressed cross-correlations. Statistics of spike generation, spike coherence, firing efficiency, latency, and jitter from the articulated set of equations are found to be highly accurate in comparison with the corresponding statistics from the exact microscopic Markov simulations. This way, it is demonstrated vividly that our formulation overcomes the inherent inadequacy of the Fox and Lu equations. Finally, a recently proposed diffusion approximation method (Linaro, Storace, & Giugliano, 2011 ) is taken into consideration, and a discussion on its character is pursued.
Multilayer Perceptron Classification of Unknown Volatile Chemicals from the Firing Rates of Insect Olfactory Sensory Neurons and Its Application to Biosensor Design
Authors: Bachtiar Luqman R. , Unsworth Charles P. , Newcomb Richard D. , Crampin Edmund J.
Published: September 2012

In this letter, we use the firing rates from an array of olfactory sensory neurons (OSNs) of the fruit fly, Drosophila melanogaster, to train an artificial neural network (ANN) to distinguish different chemical classes of volatile odorants. Bootstrapping is implemented for the optimized networks, providing an accurate estimate of a network's predicted values. Initially a simple linear predictor was used to assess the complexity of the data and was found to provide low prediction performance. A nonlinear ANN in the form of a single multilayer perceptron (MLP) was also used, providing a significant increase in prediction performance. The effect of the number of hidden layers and hidden neurons of the MLP was investigated and found to be effective in enhancing network performance with both a single and a double hidden layer investigated separately. A hybrid array of MLPs was investigated and compared against the single MLP architecture. The hybrid MLPs were found to classify all vectors of the validation set, presenting the highest degree of prediction accuracy. Adjustment of the number of hidden neurons was investigated, providing further performance gain. In addition, noise injection was investigated, proving successful for certain network designs. It was found that the best-performing MLP was that of the double-hidden-layer hybrid MLP network without the use of noise injection. Furthermore, the level of performance was examined when different numbers of OSNs used were varied from the maximum of 24 to only 5 OSNs. Finally, the ideal OSNs were identified that optimized network performance. The results obtained from this study provide strong evidence of the usefulness of ANNs in the field of olfaction for the future realization of a signal processing back end for an artificial olfactory biosensor.
A Spiking Neural Model for Stable Reinforcement of Synapses Based on Multiple Distal Rewards
Authors: O'Brien Michael J. , Srinivasa Narayan
Published: September 2012

In this letter, a novel critic-like algorithm was developed to extend the synaptic plasticity rule described in Florian ( 2007 ) and Izhikevich ( 2007 ) in order to solve the problem of learning multiple distal rewards simultaneously. The system is augmented with short-term plasticity (STP) to stabilize the learning dynamics, thereby increasing the system's learning capacity. A theoretical threshold is estimated for the number of distal rewards that this system can learn. The validity of the novel algorithm was verified by computer simulations.
Internal Waves and Turbulence in the Antarctic Circumpolar Current
Authors: Waterman Stephanie , Naveira Garabato Alberto C. , Polzin Kurt L.
Published: September 2012

This study reports on observations of turbulent dissipation and internal wave-scale flow properties in a standing meander of the Antarctic Circumpolar Current (ACC) north of the Kerguelen Plateau. The authors characterize the intensity and spatial distribution of the observed turbulent dissipation and the derived turbulent mixing, and consider underpinning mechanisms in the context of the internal wave field and the processes governing the waves’ generation and evolution.

The turbulent dissipation rate and the derived diapycnal diffusivity are highly variable with systematic depth dependence. The dissipation rate is generally enhanced in the upper 1000–1500 m of the water column, and both the dissipation rate and diapycnal diffusivity are enhanced in some places near the seafloor, commonly in regions of rough topography and in the vicinity of strong bottom flows associated with the ACC jets. Turbulent dissipation is high in regions where internal wave energy is high, consistent with the idea that interior dissipation is related to a breaking internal wave field. Elevated turbulence occurs in association with downward-propagating near-inertial waves within 1–2 km of the surface, as well as with upward-propagating, relatively high-frequency waves within 1–2 km of the seafloor. While an interpretation of these near-bottom waves as lee waves generated by ACC jets flowing over small-scale topographic roughness is supported by the qualitative match between the spatial patterns in predicted lee wave radiation and observed near-bottom dissipation, the observed dissipation is found to be only a small percentage of the energy flux predicted by theory. The mismatch suggests an alternative fate to local dissipation for a significant fraction of the radiated energy.
Effects of Remote Generation Sites on Model Estimates of M2 Internal Tides in the Philippine Sea*
Authors: Kerry Colette G. , Powell Brian S. , Carter Glenn S.
Published: September 2012

This study investigates the impact of remotely generated internal tides on model estimates of barotropic to baroclinic tidal conversion for two generation sites bounding the Philippine Sea: the Luzon Strait and the Mariana Island Arc. A primitive equation model is used to characterize the internal tides generated by the principal semidiurnal tide (M2) over a domain encompassing the two generation sites. Energetic internal tides are generated at the Luzon Strait where nearly 17 GW of barotropic tide energy is converted to baroclinic energy, of which 44% (4.78 GW) is radiated eastward into the Philippine Sea. From the Mariana Arc, baroclinic energy propagates westward into the Philippine Sea as a result of 3.82 GW of barotropic to baroclinic energy conversion. Simulations that focus on each generation site without influence of the other are performed, and comparisons show that remotely generated internal tides have a significant effect on local conversion at the two sites. Total conversion is greater in the absence of remotely generated internal tides at both sites: 11% greater at the Luzon Strait and 65% greater at the Mariana Arc. The first three modes of the remotely generated internal tides traverse the basin and alter the amplitude and phase of bottom pressure. The arrival of the remote internal tides varies significantly with changing stratification and mesoscale circulation. The results suggest that an important source of variability in local conversion around the globe is due to remotely generated internal tides.
In Situ CO2 and O2 Measurements on a Profiling Float
Authors: Fiedler Björn , Fietzek Peer , Vieira Nuno , Silva Péricles , Bittig Henry C. , Körtzinger Arne
Published: September 2012

In recent years, profiling floats, which form the basis of the successful international Argo observatory, are also being considered as platforms for marine biogeochemical research. This study showcases the utility of floats as a novel tool for combined gas measurements of CO2 partial pressure (pCO2) and O2. These float prototypes were equipped with a small-sized and submersible pCO2 sensor and an optode O2 sensor for high-resolution measurements in the surface ocean layer. Four consecutive deployments were carried out during November 2010 and June 2011 near the Cape Verde Ocean Observatory (CVOO) in the eastern tropical North Atlantic. The profiling float performed upcasts every 31 h while measuring pCO2, O2, salinity, temperature, and hydrostatic pressure in the upper 200 m of the water column. To maintain accuracy, regular pCO2 sensor zeroings at depth and surface, as well as optode measurements in air, were performed for each profile. Through the application of data processing procedures (e.g., time-lag correction), accuracies of floatborne pCO2 measurements were greatly improved (10–15 μatm for the water column and 5 μatm for surface measurements). O2 measurements yielded an accuracy of 2 μmol kg−1. First results of this pilot study show the possibility of using profiling floats as a platform for detailed and unattended observations of the marine carbon and oxygen cycle dynamics.
The Multiple Altimeter Beam Experimental Lidar (MABEL): An Airborne Simulator for the ICESat-2 Mission
Authors: McGill Matthew , Markus Thorsten , Scott V. Stanley , Neumann Thomas
Published: September 2012

This paper presents the motivation for, and initial results from, the Multiple Altimeter Beam Experimental lidar (MABEL) instrument. The MABEL instrument provides a new capability for airborne altimetry measurements and serves as a prototype and simulator for the upcoming NASA second-generation Ice, Cloud, and Land Elevation Satellite (ICESat-2) mission. Designed to be highly flexible in measurement capability, MABEL serves as both a demonstration of measurement capability and a science tool for cryospheric and biospheric remote sensing. It is important to document the instrument specifications and essential background information to provide a suitable reference for the detailed MABEL results and science investigation publications that will be forthcoming.
Home Parenteral Nutrition Tutorial
Authors: Kirby Donald F. , Corrigan Mandy L. , Speerhas Rex A. , Emery Dorothy M.
Published: September 2012

The nutrition support practitioner may be called upon to help coordinate care at home for a patient who requires prolonged intravenous nutrition after he or she becomes stable enough to leave the hospital. This tutorial reviews the many concepts that must be considered to manage this type of care successfully.
Increased plasma levels of pentraxin 3 in patients with multiple sclerosis and neuromyelitis optica
Authors: Wang Honghao , Wang Kai , Wang Conghui , Zhong Xiaonan , Qiu Wei , Hu Xueqiang
Published: September 2012

Background:

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are immune-mediated inflammatory diseases of the central nervous system. In the acute phase of these diseases, secondary ischemia due to inflammation-induced endothelial dysfunction may be an important pathological change. Pentraxin 3 (PTX3) is a pro-inflammatory protein and a novel biomarker of inflammatory vascular diseases.

Objective:

We aimed to determine whether PTX3 levels are elevated in MS and NMO patients.

Methods:

The concentrations of plasma PTX3 were measured using an enzyme-linked immunosorbent assay in 22 MS patients, 26 NMO patients, 15 acute cerebral infarction (CI) patients, 11 mild headache patients, and 14 volunteer controls.

Results:

During relapse, plasma PTX3 levels were higher in MS patients than in headache patients ( p=0.003) and controls ( p<0.001). Plasma PTX3 levels were also increased in NMO patients compared with CI patients ( p=0.011), headache patients ( p<0.001) and controls ( p<0.001). CI patients showed elevated PTX3 levels compared with controls ( p=0.008). MS and NMO patients showed a trend toward an increased disease disability with higher plasma PTX3 during relapse (MS: p=0.005; NMO: p<0.001). Plasma PTX3 levels were remarkably lower in remission than in the relapse stage (MS: p<0.001; NMO: p<0.001).

Conclusion:

Plasma PTX3 level is associated with inflammatory responses in MS and NMO.
Expanded functional coupling of subcortical nuclei with the motor resting-state network in multiple sclerosis
Authors: Dogonowski Anne-Marie , Siebner Hartwig R , Sørensen Per Soelberg , Wu Xingchen , Biswal Bharat , Paulson Olaf B , Dyrby Tim B , Skimminge Arnold , Blinkenberg Morten , Madsen Kristoffer H
Published: September 2012

Background:

Multiple sclerosis (MS) impairs signal transmission along cortico-cortical and cortico-subcortical connections, affecting functional integration within the motor network. Functional magnetic resonance imaging (fMRI) during motor tasks has revealed altered functional connectivity in MS, but it is unclear how much motor disability contributed to these abnormal functional interaction patterns.

Objective:

To avoid any influence of impaired task performance, we examined disease-related changes in functional motor connectivity in MS at rest.

Methods:

A total of 42 patients with MS and 30 matched controls underwent a 20-minute resting-state fMRI session at 3 Tesla. Independent component analysis was applied to the fMRI data to identify disease-related changes in motor resting-state connectivity.

Results:

Patients with MS showed a spatial expansion of motor resting-state connectivity in deep subcortical nuclei but not at the cortical level. The anterior and middle parts of the putamen, adjacent globus pallidus, anterior and posterior thalamus and the subthalamic region showed stronger functional connectivity with the motor network in the MS group compared with controls.

Conclusion:

MS is characterised by more widespread motor connectivity in the basal ganglia while cortical motor resting-state connectivity is preserved. The expansion of subcortical motor resting-state connectivity in MS indicates less efficient funnelling of neural processing in the executive motor cortico-basal ganglia-thalamo-cortical loops.
Scoring treatment response in patients with relapsing multiple sclerosis
Authors: Sormani MP , Rio J , Tintorè M , Signori A , Li D , Cornelisse P , Stubinski B , Stromillo ML , Montalban X , De Stefano N
Published: September 2012

Background:

We employed clinical and magnetic resonance imaging (MRI) measures in combination, to assess patient responses to interferon in multiple sclerosis.

Objective:

To optimize and validate a scoring system able to discriminate responses to interferon treatment in patients with relapsing–remitting multiple sclerosis (RRMS).

Methods:

Our analysis included two large, independent datasets of RRMS patients who were treated with interferons that included 4-year follow-up data. The first dataset (“training set”) comprised of 373 RRMS patients from a randomized clinical trial of subcutaneous interferon beta-1a. The second (“validation set”) included an observational cohort of 222 RRMS patients treated with different interferons. The new scoring system, a modified version of that previously proposed by Rio et al., was first tested on the training set, then validated using the validation set. The association between disability progression and risk group, as defined by the score, was evaluated by Kaplan Meier survival curves and Cox regression, and quantified by hazard ratios (HRs).

Results:

The score (0–3) was based on the number of new T2 lesions (>5) and clinical relapses (0,1 or 2) during the first year of therapy. The risk of disability progression increased with higher scores. In the validation set, patients with score of 0 showed a 3-year progression probability of 24%, while those with a score of 1 increased to 33% (HR = 1.56; p = 0.13), and those with score greater than or equal to 2 increased to 65% (HR = 4.60; p < 0.001).

Conclusions:

We report development of a simple, quantitative and complementary tool for predicting responses in interferon-treated patients that could help clinicians make treatment decisions.
Improved ability to work after one year of natalizumab treatment in multiple sclerosis. Analysis of disease-specific and work-related factors that influence the effect of treatment
Authors: Wickström Anne , Nyström Josefina , Svenningsson Anders
Published: September 2012

Background:

Multiple sclerosis (MS) constitutes one of the major diseases that leads to neurological impairment and as a consequence also reduces ability to work.

Objectives:

The purpose of this study was to analyze possible effects on work ability resulting from highly active anti-inflammatory treatment in MS.

Methods:

We analyzed the effects of introducing an anti-inflammatory treatment, natalizumab, in MS, on factors related to work ability. This was done through a comprehensive questionnaire distributed to all patients in Sweden starting on natalizumab treatment between June 2007 and May 2008, identified via the Swedish National MS registry.

Results:

MS patients who were receiving sickness benefit and were treated with natalizumab approximately doubled their working ability in relation to their total employment rate. We also documented a significant improvement of their ability to cope with work-related requirements after one year of natalizumab treatment, an improvement which was independent of the previous level of employment. Predictors of a positive effect on work ability were short disease duration, younger age and lower Expanded Disability Status Scale (EDSS) grade at treatment onset.

Conclusions:

Our data support the notion that early inflammatory control in MS is essential to preserve a healthy state in MS that counteracts the negative consequences of the disease both at a personal and at a societal level.
Dismantling the guitar hero? A case of prodused parody and disarmed subversion
Authors: Skågeby Jörgen
Published: September 2012

A ‘shreds’ video combines existing live music concert footage, predominantly including a famous male rock guitarist or guitar based rock group, with a self-produced overdubbed soundtrack. The result is a musical parody that exists in an intersection between production and consumption and works as a within-genre evolution. The shred is controversial and its most popular instalments have been pulled from YouTube on claims of copyright infringement. This paper examines shreds as a form of multimodal intertextual critique by engaging with the videos themselves, as well as audience responses to them. As such, the applied method is genre analysis and multimodal semiotics geared towards the analysis of intertextual elements. The paper shows how prodused parody exists as a co-dependence between: (1) production and consumption; (2) homage and subversion; (3) comprehension and miscomprehension; and (4) media synchronicity and socioeconomic dis/harmony. The paper also discusses how shreds can be interpreted as tampered-with gender performances. In conclusion, it becomes clear that the produsage of shred videos is part of ‘piracy culture’ because it so carefully balances between the mainstream and counter-culture, between the legal and the illegal, and between the commoditized artefact and networked production.
New media idiocy
Authors: Goriunova Olga
Published: September 2012

The article explores the concept of new media idiocy – both a new kind of idiocy and an idiocy performed in new media networks. The paper argues that instead of being neglected, idiocy needs to be appreciated if we are to enquire into the current forms of techno-human subjectification. Idiocy, following Deleuze, is interpreted as distinct from stupidity (a base mode of thinking); it is a mode of living that explores the true through the false. In new media, idiocy acquires a performative character; it is crafted, practiced and re-enacted collectively. Many forms of aesthetic expression, and especially those produced and circulated through social networks, such as memes and viral videos, have such performance of idiocy at their core. Moreover, it is through such expressive creation and performance of the idiot that the new forms of subjectification take place. Network culture’s allowance for participatory creativity enables new media idiocy to establish new forms of visibility and availability in relation to digital networks. The process of becoming an individual or the formulation of political discontent are dynamically expressed and documented online as they happen. Such order of visibility problematizes the processes of subjectification and the emergence of the cultural as well as the political on the Internet. The article uses YouTube videos and subcultures of webpage production as its case studies.
Integral Control of Health Hazards in Hospital Environment
Authors: Dovjak Mateja , Kukec Andreja , Kristl Živa , Košir Mitja , Bilban Marjan , Shukuya Masanori , Krainer Aleš
Published: September 2012

Hospitals present complex indoor environment with various users, health hazards and specific activities. This paper classifies health hazards specific to the hospital environment (HE), defines their interactions and possible impacts on human health and summarizes recommendations for biological and chemical hazards. A detailed literature review clearly shows that there is no developed system or method for integral control of health hazards in HE. There is no appropriate technology available that would allow development of optimal thermal comfort conditions for individual users in HE. For integral control of physical hazards, an innovative low exergy (LowEx) system was designed and tested. The system enables individual control of thermal comfort parameters to meet the needs of various users in the same room. It enables the design of optional conditions for healthcare and treatment considering the different requirements of individual patients and thermally neutral zones for other users. The system application is presented in a model room for burns patient. The measured energy use was lower by 11–27% for space heating and by 32–73% for cooling, when using LowEx system as compared to the conventional system. Owning to its flexibility, the system can also be used for other potential users.
A Thermal Comfort Investigation of a Facility Department of a Hospital in Hot-Humid Climate: Correlation between Objective and Subjective Measurements
Authors: Azizpour F. , Moghimi S. , Lim C. H. , Mat S. , Salleh E. , Sopian K.
Published: September 2012

A field study on assessing thermal comfort has been performed on one of the large-scale hospitals in Malaysia, a country where the climate is classified as hot-humid. The main objective of this study was to examine the comfort criteria by American Society of Heating, Air conditioning & Refrigeration Engineers, US (ASHRAE) standards in hot-humid regions and also to find the correlation between predicted mean vote (PMV) according to Fanger’s theory and thermal sensation vote (TSV) according to occupant votes. Therefore, both objective and subjective data was collected in this hospital, and this study’s results have confirmed that the preferred temperature is not necessarily in compliance with a neutral temperature, and people in hot-humid areas would prefer cooler environment to neutral temperature. In addition, by analyzing linear regression, a strong correlation between PMV and TSV was found while R2 = 0.950, and also the neutral temperature point in this field study was around +0.75 on the seven-point ASHRAE thermal sensation scale.
Nocturnal Asthma and Domestic Exposure to Fungi
Authors: Terčelj Marjeta , Salobir Barbara , Narancsik Zoltan , Kriznar Kristina , Grzetic-Romcevic Tanja , Matos Tadeja , Rylander Ragnar
Published: September 2012

Fungal growth indoors is a common problem both in older and modern buildings. Numerous studies demonstrate a deterioration of asthma in environments with fungal growth but precise estimates of exposure levels have not been reported.

This study was carried out to investigate whether levels of airborne fungi were higher in homes of subjects with nocturnal asthma as compared to controls. Subjects with nocturnal asthma (n = 42) and non-nocturnal asthma (n = 14) were recruited from an outpatient department. Subjects without disease or respiratory symptoms (n = 24) served as controls. Among the asthmatics, determinations were made of pulmonary function before and after treatment with bronchodilatators. The subjects were equipped with a pump and a filter and instructed to sample air in their bedroom. The filters were analysed for the content of N-acetylhexosaminidase (NAHA) as a marker of fungal cell biomass. In some houses the number of colony forming units was also determined. Patients with asthma had significantly higher activities of NAHA in their bedrooms as compared to controls (31.2 vs. 12.5 U m−3, p = 0.004). When the material was divided according to the 2nd quartile of NAHA (14.0 U m−3), 29 out of 42 subjects with nocturnal asthma had high values compared to 5 out of 24 for the controls (p<0.0001). The results support the hypothesis that patients with nocturnal asthma have high levels of fungi in their homes. This provides a basis for treatment and exposure diminution. Whether that exposure is causative for their disease; or if it aggravates already existing airway symptoms remains to be elucidated.
Experimental and Numerical Analysis of the Relationship Between Indoor and Outdoor Airborne Particles in an Operating Room
Authors: Pereira Marcelo Luiz , Vilain Rogério , Galvão Flávio Henrique Ferreira , Tribess Arlindo , Morawska Lidia
Published: September 2012

This work investigated the impact of the HVAC filtration system and indoor particle sources on the relationship between indoor and outdoor airborne particle size and concentrations in an operating room. Filters with efficiency between 65% and 99.97% were used in the investigation and indoor and outdoor particle size and concentrations were measured. A balance mass model was used for the simulation of the impact of the surgical team, deposition rate, HVAC exhaust and air change rates on indoor particle concentration. The experimental results showed that high efficiency filters would not be expected to decrease the risk associated with indoor particles larger than approximately 1 µm in size because normal filters are relatively efficient for these large particles. A good fraction of outdoor particles were removed by deposition on the HVAC system surfaces and this deposition increased with particle size. For particles of 0.3–0.5 µm in diameter, particle reduction was about 23%, while for particles >10 µm the loss was about 78%. The modelling results showed that depending on the type of filter used, the surgical team generated between 93% and 99% of total particles, while the outdoor air contributed only 1–6%.
Leader Political Skill, Relationship Quality, and Leadership Effectiveness
Authors: Brouer Robyn L. , Douglas Ceasar , Treadway Darren C. , Ferris Gerald R.
Published: September 2012

Grounded in leader–member exchange, social exchange, political skill and influence theories, the present two-study investigation tests the model that leader political skill is related to both leader and follower effectiveness through leader–follower relationship quality. It is hypothesized that leader political skill is associated with leader effectiveness (Study 1) and follower effectiveness (Study 2) through relationship quality. The results support the hypotheses and were constructively replicated in Study 2, contributing to theory that leader political skill enhances relationship quality, which then ultimately affects leader and follower effectiveness relationships. Strengths, limitations, directions for future research, and implications for practice are discussed.
Aclidinium inhibits cigarette smoke-induced lung fibroblast-to-myofibroblast transition
Authors: Milara Javier , Serrano Adela , Peiró Teresa , Artigues Enrique , Gavaldà Amadeu , Miralpeix Montse , Morcillo Esteban J. , Cortijo Julio
Published: September 2012

Cigarette smoking contributes to lung remodelling in chronic obstructive pulmonary disease (COPD). As part of this remodelling, peribronchiolar fibrosis is observed in the small airways of COPD patients and contributes to airway obstruction. Fibroblast-to-myofibroblast transition is a key step in peribronchiolar fibrosis formation.

Thisin vitrostudy examined the effect of cigarette smoke on bronchial fibroblast-to-myofibroblast transition, and whether aclidinium bromide inhibits this process. Human bronchial fibroblasts were incubated with aclidinium bromide (10−9–10−7M) and exposed to cigarette smoke extract. Collagen type I and α-smooth muscle actin (α-SMA) expression were measured by real-time PCR and Western blotting, as myofibroblast markers. Intracellular reactive oxygen species, cyclic AMP (cAMP), extracellular signal-regulated kinase (ERK)1/2 and choline acetyltransferase were measured as intracellular signalling mediators.

Cigarette smoke-induced collagen type I and α-SMA was mediated by the production of reactive oxygen species, the depletion of intracellular cAMP and the increase of ERK1/2 phosphorylation and choline acetyltransferase. These effects could be reversed by treatment with the anticholinergic aclidinium bromide, by silencing the mRNA of muscarinic receptors M1, M2 or M3, or by the depletion of extracellular acetylcholine by treatment with acetylcholinesterase.

A non-neuronal cholinergic system is implicated in cigarette smoke-induced bronchial fibroblast-to-myofibroblast transition, which is inhibited by aclidinium bromide.
Expression of the nuclear factor-κB inhibitor A20 is altered in the cystic fibrosis epithelium
Authors: Kelly Catriona , Williams Mark T. , Mitchell Kathryn , Elborn J. Stuart , Ennis Madeleine , Schock Bettina C.
Published: September 2012

A20 is a lipopolysaccharide (LPS)-inducible, cytoplasmic zinc finger protein, which inhibits Toll-like receptor-activated nuclear factor (NF)-κB signalling by deubiquitinating tumour necrosis factor receptor-associated factor (TRAF)-6. The action of A20 is facilitated by complex formation with ring finger protein (RNF)-11, Itch and TAX-1 binding protein-1 (TAX1BP1). This study investigated whether the expression of A20 is altered in the chronically inflamed cystic fibrosis (CF) airway epithelium.

Nasal epithelial cells from CF patients (F508del homozygous), non-CF controls and immortalised epithelial cells (16HBE14o- and CFBE41o-) were stimulated with LPS. Cytoplasmic expression of A20 and expression of NF-κB subunits were analysed. Formation of the A20 ubiquitin editing complex was also investigated.

In CFBE41o-, peak LPS-induced A20 expression was delayed compared with 16HBE14o- and fell significantly below basal levels 12–24 h after LPS stimulation. This was confirmed in primary CF airway cells. Additionally, a significant inverse relationship between A20 and p65 expression was observed. Inhibitor studies showed that A20 does not undergo proteasomal degradation in CFBE41o-. A20 interacted with TAX1BP1, RNF11 and TRAF6 in 16HBE14o- cells, but these interactions were not observed in CFBE41o-.

The expression of A20 is significantly altered in CF, and important interactions with complex members and target proteins are lost, which may contribute to the state of chronic NF-κB-driven inflammation.
Childhood tuberculosis in Israel: epidemiological trends and treatment outcomes, 1999–2010
Authors: Mor Zohar , Cedar Noa , Pinsker Galia , Bibi Haim , Grotto Itamar
Published: September 2012

Childhood tuberculosis (TB) poses a high risk for morbidity and death. This study describes the characteristics of childhood TB in Israel and examines treatment outcomes. Data sources were the National TB Registry and the National Civil Census.

Between 1999 and 2010, 416 children (aged <18 years) had TB, averaging 1.5 per 100 000 children (range 0.6–3.2), demonstrating a declining trend. The average proportion of all TB cases reported annually that were in children was 8.4% (range 5.4–11.8%). Most (n=320, 79%) of the childhood TB cases were pulmonary. TB rates were highest for the 0–4-year age group and lowest for the 10–14-year age group.

Of all childhood TB cases, 236 (56.7%) were born in countries with high prevalence of TB: 214 were Israeli citizens who were Ethiopian-born and 22 were non-Israeli citizens. The overall childhood TB incidence in 2010 was 1.05 cases per 100 000 children. The incidence of TB for Israeli-born children, children whose parents were Ethiopian-born and children of migrant workers was 0.55 per 100 000, 7.5 per 100 000 and 50–100 per 100 000, respectively. Cultures were taken from 60% of all childhood TB cases. Most children (97.8%) achieved treatment success, while three children (0.7%) died.

Overall, rates of childhood TB rates in Israel are decreasing. However, children of parents born in countries with a high prevalence of TB are still at high risk of developing TB. Bacteriological confirmation should be encouraged to improve control of childhood TB.
Survival of lung adenocarcinoma patients with malignant pleural effusion
Authors: Wu Shang-Gin , Yu Chong-Jen , Tsai Meng-Feng , Liao Wei-Yu , Yang Chih-Hsin , Jan I-Shiow , Yang Pan-Chyr , Shih Jin-Yuan
Published: September 2012

In the era of targeted therapy, the association between lung adenocarcinoma patient survival and malignant pleural effusions (MPEs) remains unclear. This study investigated the clinical characteristics, survival and epidermal growth factor receptor (EGFR) gene (EGFR) mutation status of lung adenocarcinoma patients with MPE.

From June 2005 to December 2010, consecutive pleural effusions were collected prospectively. Patient clinical characteristics,EGFRmutation status, and overall survival were analysed.

We collected MPEs from 448 patients in stage IV lung adenocarcinoma at initial diagnosis. Median overall survival for patients with MPEs at initial diagnosis and following disease progression were 14.3 months and 21.4 months, respectively (p=0.001). There were 296 (66.1%) patients harbouringEGFRmutations, the mutation rates among patients with an MPE at initial diagnosis and one following disease progression were 68.2% and 56.6%, respectively (p=0.044); the L858R mutation rate was also higher among the former (32.6%versus18.1%; p=0.009). Multivariate analysis revealed that patients who: developed MPEs following disease progression, harbouredEGFRmutations, and received EGFR-tyrosine kinase inhibitor therapy, had longer overall survival. Patients in stage IV lung adenocarcinoma with MPEs at initial diagnosis have shorter overall survival and higherEGFRmutation rate, especially for L858R, than patients who develop MPEs following disease progression.
Ciprofloxacin dry powder for inhalation in non-cystic fibrosis bronchiectasis: a phase II randomised study
Authors: Wilson Robert , Welte Tobias , Polverino Eva , De Soyza Anthony , Greville Hugh , O'Donnell Anne , Alder Jeff , Reimnitz Peter , Hampel Barbara
Published: September 2012

This phase II, randomised, double-blind, multicentre study (NCT00930982) investigated the safety and efficacy of ciprofloxacin dry powder for inhalation (DPI) in patients with non-cystic fibrosis bronchiectasis.

Adults who were culture positive for pre-defined potential respiratory pathogens (includingPseudomonas aeruginosaandHaemophilus influenzae) were randomised to ciprofloxacin DPI 32.5 mg or placebo administered twice daily for 28 days (with 56 days of follow-up). Bacterial density in sputum (primary end-point), pulmonary function tests, health-related quality of life and safety were monitored throughout the study.

60 subjects received ciprofloxacin DPI 32.5 mg and 64 received placebo. Subjects on ciprofloxacin DPI had a significant reduction (p<0.001) in total sputum bacterial load at the end of treatment (-3.62 log10CFU·g−1(range -9.78–5.02 log10CFU·g−1)) compared with placebo (-0.27 log10CFU·g−1(range -7.96–5.25 log10CFU·g−1)); the counts increased thereafter. In the ciprofloxacin DPI group, 14 (35%) out of 40 subjects reported pathogen eradication at end of treatmentversusfour (8%) out of 49 in the placebo group (p=0.001). No abnormal safety results were reported and rates of bronchospasm were low.

Ciprofloxacin DPI 32.5 mg twice daily for 28 days was well tolerated and achieved significant reductions in total bacterial load compared with placebo in subjects with non-cystic fibrosis bronchiectasis.
Pulmonary hypertension in COPD: results from the ASPIRE registry
Authors: Hurdman Judith , Condliffe Robin , Elliot Charlie A. , Swift Andrew , Rajaram Smitha , Davies Christine , Hill Catherine , Hamilton Neil , Armstrong Iain J. , Billings Catherine , Pollard Lauren , Wild Jim M. , Lawrie Allan , Lawson Rod , Sabroe Ian , Kiely David G.
Published: September 2012

The phenotype and outcome of severe pulmonary hypertension in chronic obstructive pulmonary disease (COPD) is described in small numbers, and predictors of survival are unknown. Data was retrieved for 101 consecutive, treatment-naïve cases of pulmonary hypertension in COPD.

Mean±sdfollow-up was 2.3±1.9 years. 59 patients with COPD and severe pulmonary hypertension, defined by catheter mean pulmonary artery pressure ≥40 mmHg, had significantly lower carbon monoxide diffusion, less severe airflow obstruction but not significantly different emphysema scores on computed tomography compared to 42 patients with mild–moderate pulmonary hypertension. 1- and 3-year survival for severe pulmonary hypertension, at 70% and 33%, respectively, was inferior to 83% and 55%, respectively, for mild–moderate pulmonary hypertension. Mixed venous oxygen saturation, carbon monoxide diffusion, World Health Organization functional class and age, but not severity of airflow obstruction, were independent predictors of outcome. Compassionate treatment with targeted therapies in 43 patients with severe pulmonary hypertension was not associated with a survival benefit, although improvement in functional class and/or fall in pulmonary vascular resistance >20% following treatment identified patients with improved survival.

Standard prognostic markers in COPD have limited value in patients with pulmonary hypertension. This study identifies variables that predict outcome in this phenotype. Despite poor prognosis, our data suggest that further evaluation of targeted therapies is warranted.
Obstructive sleep apnoea: longer respiratory event lengths in patients with heart failure
Authors: Efken Christina , Bitter Thomas , Prib Natalie , Horstkotte Dieter , Oldenburg Olaf
Published: September 2012

This study investigated the effect of heart failure on respiratory patterns in patients with obstructive sleep apnoea (OSA).

39 patients with established OSA (apnoea/hypopnoea index (AHI) >10 events·h−1) and either with heart failure (New York Heart Association (NYHA) class II and III, left ventricular-ejection fraction (LVEF) ≤40%; n=26, age mean±sd67±9 years) or without heart failure (LVEF ≥50%, N-terminal pro-brain naturic peptide <400 pg·mL−1; n=13, age 73±6 years) underwent simultaneous right- and left-heart catheterisation within 12 h of cardiorespiratory polygraphy recording.

Respiratory patterns of OSA were significantly longer in OSA patients with heart failureversuswithout heart failure, including mean±sdcycle length (46.0±10.0versus37.8±10.6 s; p=0.024), ventilation length (25.4±6.3versus21.3±7.1 s; p=0.044), apnoea length (20.5±4.9versus16.5±3.9 s; p=0.013), time-to-peak ventilation (10.6±3.0versus8.3±2.5 sc; p=0.021) and circulatory delay (28.5±7.5versus22.6±3.7 s; p=0.005). Positive and robust correlations were found between some of these parameters and the degree of congestion in heart failure: cycle length (r=0.53; p=0.006), ventilation length (r=0.55; p=0.004) and time-to-peak ventilation (r=0.47; p=0.015) all increased with a rise in pulmonary capillary wedge pressure.

Respiratory patterns in OSA appear to be dependent on cardiac function, with an increase in event lengths as cardiac function decreases. In patients with heart failure, some of these events correlate with the degree of pulmonary congestion.
The Study to Understand Mortality and Morbidity in COPD (SUMMIT) study protocol
Authors: Vestbo Jørgen , Anderson Julie , Brook Robert D. , Calverley Peter M.A. , Celli Bartolome R. , Crim Courtney , Haumann Brett , Martinez Fernando J. , Yates Julie , Newby David E.
Published: September 2012

Chronic obstructive pulmonary disease (COPD) often coexists with other chronic diseases and comorbidities that can markedly influence patients' health status and prognosis. This is particularly true for cardiovascular disease (CVD). However, there have been no trials assessing the effect of COPD medications on CVD in patients with both diseases.

The “Study to Understand Mortality and Morbidity in COPD” (SUMMIT) aims at determining the impact of fluticasone furoate/vilanterol combination and the individual components on the survival of patients with moderate COPD and either a history of CVD or at increased risk for CVD.

SUMMIT is a multicentre, randomised, double-blind, parallel-group, placebo-controlled trial of 16 000 patients with moderate COPD randomly assigned to once daily treatment with fluticasone furoate/vilanterol (100/25 μg), fluticasone furoate (100 μg), vilanterol (25 μg) or matched placebo; mortality is the primary end-point. The study is an event-driven trial powered by the comparison of furoate/vilanterolversusplacebo. Secondary end-points are decline in forced expiratory volume in 1 s and effect on a composite cardiovascular end-point. This article describes the design of the SUMMIT study.
Imaging the inflammatory activity of sarcoidosis
Authors: Keijsers Ruth G.M. , van den Heuvel Daniel A.F. , Grutters Jan C.
Published: September 2012

Accurate assessment of pulmonary and extrapulmonary organ involvement in sarcoidosis is one of the great challenges for clinicians. This assessment includes the evaluation of symptoms and of sarcoidosis activity in a specific organ and its functional consequences.

In this review, radiological and nuclear techniques to image the inflammatory activity of sarcoidosis are described, in particular18F-FDG positron emission tomography/computed tomography. The current use of this technique in clinical practice is explained, particularly in patients with persistent symptoms, stage IV disease and cardiac sarcoidosis.