Tobramycin Inhalation Powder™:a novel drug delivery system for treating chronic Pseudomonas aeruginosa infection in cystic fibrosis

Lung disease in cystic fibrosis (CF) is typified by the development of chronic airways infection culminating in bronchiectasis and progression to end-stage respiratory disease. Pseudomonas aeruginosa, a ubiquitous gram-negative bacteria, is the archetypical CF pathogen and is associated with an accelerated clinical decline. The development and widespread use of chronic suppressive aerosolized antibacterial therapies, in particular Tobramycin Inhalation Solution (TIS), in CF has contributed to reduced lung function decline and improved survival. However, the requirement for the aerosolization of these agents through nebulizers has been associated with increased treatment burden, reduced quality of life and remain a barrier to broader uptake. Tobramycin Inhalation Powder (TIP™) has been developed by Novartis with the express purpose of delivering the same benefits as TIS in a time-effective manner. Administered via the T-326™ (Novartis) Inhaler in four individual 28-mg capsules, TIP can be administered in a quarter of the time of traditional nebulizers and is inherently portable. In clinical studies, TIP has been shown to be safe, result in equivalent or superior reductions in P. aeruginosa sputum density and produce similar improvements in pulmonary function. TIP offers significant advantages in time saving, portability and convenience over traditional nebulized TIS with comparable clinical outcomes for individuals with CF.

The physical activity loyalty card scheme:Development and application of a novel system for incentivizing behaviour change

In the Public Health White Paper "Healthy Lives, Healthy People" (2010), the UK Government emphasised using incentives and "nudging" to encourage positive, healthy behaviour changes. However, there is little evidence that nudging is effective, in particular for increasing physical activity. We have created a platform to research the effectiveness of health-related behaviour change interventions and incentive schemes. The system consists of an outward-facing website, incorporating tools for incentivizing behaviour change, and a novel physical activity monitoring system. The monitoring system consists of the "Physical Activity Loyalty Card", which contains a passive RFID tag, and a contactless sensor network to detect the cards. This paper describes the application of this novel web-based system to investigate the effectiveness of non-cash incentives to "nudge" adults to undertake more physical activity. © 2012 ICST Institute for Computer Science, Social Informatics and Telecommunications Engineering.

Web-assisted first-year undergraduate teaching in engineering

A software system, recently developed by the authors for the efficient capturing, editing, and delivery of audio-visual web lectures, was used to create a series of lectures for a first-year undergraduate course in Dynamics. These web lectures were developed to serve as an extra study resource for students attending lectures and not as a replacement. A questionnaire was produced to obtain feedback from students. The overall response was very favorable and numerous requests were made for other lecturers to adopt this technology. Despite the students' approval of this added resource, there was no significant improvement in overall examination performance

TMAX – a Database System Integrating Tissue Biomarker & Genomic Data

Background: Popular approaches in human tissue-based biomarker discovery include tissue microarrays (TMAs) and DNA Microarrays (DMAs) for protein and gene expression profiling respectively. The data generated by these analytic platforms, together with associated image, clinical and pathological data currently reside on widely different information platforms, making searching and cross-platform analysis difficult. Consequently, there is a strong need to develop a single coherent database capable of correlating all available data types.

Method: This study presents TMAX, a database system to facilitate biomarker discovery tasks. TMAX organises a variety of biomarker discovery-related data into the database. Both TMA and DMA experimental data are integrated in TMAX and connected through common DNA/protein biomarkers. Patient clinical data (including tissue pathological data), computer assisted tissue image and associated analytic data are also included in TMAX to enable the truly high throughput processing of ultra-large digital slides for both TMAs and whole slide tissue digital slides. A comprehensive web front-end was built with embedded XML parser software and predefined SQL queries to enable rapid data exchange in the form of standard XML files.

Results & Conclusion: TMAX represents one of the first attempts to integrate TMA data with public gene expression experiment data. Experiments suggest that TMAX is robust in managing large quantities of data from different sources (clinical, TMA, DMA and image analysis). Its web front-end is user friendly, easy to use, and most importantly allows the rapid and easy data exchange of biomarker discovery related data. In conclusion, TMAX is a robust biomarker discovery data repository and research tool, which opens up the opportunities for biomarker discovery and further integromics research.

A Generic Reference Software Architecture for Load Balancing over Mirrored Web Servers: NaSr Case Study

With the rapid expansion of the internet and the increasing demand on Web servers, many techniques were developed to overcome the servers' hardware performance limitation. Mirrored Web Servers is one of the techniques used where a number of servers carrying the same "mirrored" set of services are deployed. Client access requests are then distributed over the set of mirrored servers to even up the load. In this paper we present a generic reference software architecture for load balancing over mirrored web servers. The architecture was designed adopting the latest NaSr architectural style [1] and described using the ADLARS [2] architecture description language. With minimal effort, different tailored product architectures can be generated from the reference architecture to serve different network protocols and server operating systems. An example product system is described and a sample Java implementation is presented.

The Influence of the User in Body-Centric Antennas and Propagation at 3–6 GHz—A Rician K-Factor Approach

We investigate whether the presence of a human body in wearable communications should be considered as part of the radiating structure or as part of the local radio environment. The Rician $K$ -factor was employed as a quantitative measure of the effect of the user's body for five environments and two mounting locations. Presented empirical results indicated that the environment had a greater impact on the $K$-factor values than the position of the transmit antenna for the ultrawideband signals used, confirming that the human body should be considered primarily as part of the overall radiating system when the antenna is worn on the body. Furthermore, independent variations also existed in the $K$-factor values for the differing antenna-body mounting positions, indicating that as the position changed, then the radiating effects and the contribution from the body changed. This is significant for ensuring body-antenna systems are accurately modeled in system-level simulations.

A review of radio channel models for body centric communications

The human body is an extremely challenging environment for the operation of wireless communications systems, not least because of the complex antenna-body electromagnetic interaction effects which can occur. This is further compounded by the impact of movement and the propagation characteristics of the local environment which all have an effect upon body centric communications channels. As the successful design of body area networks (BANs) and other types of body centric system is inextricably linked to a thorough understanding of these factors, the aim of this paper is to conduct a survey of the current state of the art in relation to propagation and channel models primarily for BANs but also considering other types of body centric communications. We initially discuss some of the standardization efforts performed by the Institute of Electrical and Electronics Engineers 802.15.6 task group before focusing on the two most popular types of technologies currently being considered for BANs, namely narrowband and Ultrawideband (UWB) communications. For narrowband communications the applicability of a generic path loss model is contended, before presenting some of the scenario specific models which have proven successful. The impacts of human body shadowing and small-scale fading are also presented alongside some of the most recent research into the Doppler and time dependencies of BANs. For UWB BAN communications, we again consider the path loss as well as empirical tap delay line models developed from a number of extensive channel measurement campaigns conducted by research institutions around the world. Ongoing efforts within collaborative projects such as Committee on Science and Technology Action IC1004 are also described. Finally, recent years have also seen significant developments in other areas of body centric communications such as off-body and body-to-body communications. We highlight some of the newest relevant research in these areas as well as discussing some of the advanced topics which are currently being addressed in the field of body centric communications. Key Points Channel models for body centric comms ©2014. The Authors.

The development of the PROMPT (PRescribing Optimally in Middle-aged People’s Treatments) criteria

BACKGROUND: Whilst multimorbidity is more prevalent with increasing age, approximately 30% of middle-aged adults (45-64 years) are also affected. Several prescribing criteria have been developed to optimise medication use in older people (≥65 years) with little focus on potentially inappropriate prescribing (PIP) in middle-aged adults. We have developed a set of explicit prescribing criteria called PROMPT (PRescribing Optimally in Middle-aged People's Treatments) which may be applied to prescribing datasets to determine the prevalence of PIP in this age-group.

METHODS: A literature search was conducted to identify published prescribing criteria for all age groups, with the Project Steering Group (convened for this study) adding further criteria for consideration, all of which were reviewed for relevance to middle-aged adults. These criteria underwent a two-round Delphi process, using an expert panel consisting of general practitioners, pharmacists and clinical pharmacologists from the United Kingdom and Republic of Ireland. Using web-based questionnaires, 17 panellists were asked to indicate their level of agreement with each criterion via a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree) to assess the applicability to middle-aged adults in the absence of clinical information. Criteria were accepted/rejected/revised dependent on the panel's level of agreement using the median response/interquartile range and additional comments.

RESULTS: Thirty-four criteria were rated in the first round of this exercise and consensus was achieved on 17 criteria which were accepted into the PROMPT criteria. Consensus was not reached on the remaining 17, and six criteria were removed following a review of the additional comments. The second round of this exercise focused on the remaining 11 criteria, some of which were revised following the first exercise. Five criteria were accepted from the second round, providing a final list of 22 criteria [gastro-intestinal system (n = 3), cardiovascular system (n = 4), respiratory system (n = 4), central nervous system (n = 6), infections (n = 1), endocrine system (n = 1), musculoskeletal system (n = 2), duplicates (n = 1)].

CONCLUSIONS: PROMPT is the first set of prescribing criteria developed for use in middle-aged adults. The utility of these criteria will be tested in future studies using prescribing datasets.

14C as a tool to trace terrestrial carbon in a complex lake system: implications for foodweb structure and carbon cycling

Carbon and nitrogen stable isotope analysis (SIA) has identified the terrestrial subsidy of freshwater food-webs but relies on different 13C fractionation in aquatic and terrestrial primary producers. However dissolved inorganic carbon (DIC) is partly comprised of 13C depleted respiration of terrestrial C and ‘old’ C derived from weathering of catchment geology. SIA thus fails to differentiate between the contribution of old and recently fixed terrestrial C. DIC in alkaline lakes is partially derived from weathering of 14C-free carbonaceous bedrock This
yields an artificial age offset leading samples to appear significantly older than their actual age. As such, 14C can be used as a biomarker to identify the proportion of autochthonous C in the food-web. With terrestrial C inputs likely to increase, the origin and utilisation of ‘old’ or ‘recent’ allochthonous C in the food-web can also be determined. Stable isotopes and 14C were measured for biota, particulate organic matter (POM), DIC and dissolved organic carbon (DOC) from Lough Erne, Northern Ireland, a humic but alkaline lake. High winter δ15N values in calanoid zooplankton (δ15N =24‰) relative to phytoplankton and POM (δ15N =6‰ and 12‰ respectively) may reflect several microbial trophic levels between terrestrial C and calanoids. Furthermore winter calanoid 14C ages are consistent with DOC from inflowing rivers (87 and 75 years BP respectively) but not phytoplankton (355 years BP). Summer calanoid δ13N, δ15N and 14C (312 years BP) indicate greater reliance on phytoplankton. There is also temporal and spatial variation in DIC, DOC and POM C isotopes.

The Fate of Terrestrial Carbon in a Complex Lake System: Lough Erne

Lake food webs were in the past viewed as being fuelled solely by primary production – i.e. by photosynthetic plants and algae. However this has changed as the exports of terrestrial areas into lakes have been taken into account. Previously, terrestrial carbon in lakes was thought to have been buried in sediments or exported to the atmosphere, however recent studies have indicated that terrestrial carbon can supplement primary production in some lakes, or in others be the dominant source of production for the lake food web. In this study radiocarbon has been used in conjunction with stable carbon and nitrogen isotopes to show the utilisation of terrestrial carbon in the food web. The fate of terrestrial carbon in the lake will be discussed as well as the possible mechanisms for the transfer of terrestrial carbon for utilisation in the lake.

Prioritisation of citizen centric information for disaster response

In the aftermath of a disaster event, and in the absence of trained professionals, many responsibilities are taken on by uninjured citizens who are willing and able to help, such as care of the injured or search and rescue. These citizens are constrained by communications and logistics problems but are less equipped to deal with them as most often they are cut off from any coordinated assistance. The method proposed in this study would increase the survivability of those injured or trapped by a disaster event by providing a facility to allow citizens to coordinate and share information among themselves. This is facilitated by the proposed deployment and the autonomous management of an ad hoc infrastructure that liaises (OK?) directly with survivors without central control. Furthermore, as energy concerns present critical constraints to these networks, this research proposes a system of categorising information elements within the network to ensure efficient information exchange.

Pet population management and public health:A web service based tool for the improvement of dog traceability

The risks associated with zoonotic infections transmitted by companion animals are a serious public health concern: the control of zoonoses incidence in domestic dogs, both owned and stray, is hence important to protect human health. Integrated dog population management (DPM) programs, based on the availability of information systems providing reliable data on the structure and composition of the existing dog population in a given area, are fundamental for making realistic plans for any disease surveillance and action system. Traceability systems, based on the compulsory electronic identification of dogs and their registration in a computerised database, are one of the most effective ways to ensure the usefulness of DPM programs. Even if this approach provides many advantages, several areas of improvement have emerged in countries where it has been applied. In Italy, every region hosts its own dog register but these are not compatible with one another. This paper shows the advantages of a web-based-application to improve data management of dog regional registers. The approach used for building this system was inspired by farm animal traceability schemes and it relies on a network of services that allows multi-channel access by different devices and data exchange via the web with other existing applications, without changing the pre-existing platforms. Today the system manages a database for over 300,000 dogs registered in three different Italian regions. By integrating multiple Web Services, this approach could be the solution to gather data at national and international levels at reasonable cost and creating a traceability system on a large scale and across borders that can be used for disease surveillance and development of population management plans. © 2012 Elsevier B.V.