Understanding COPD: A Vision on Phenotypes, Comorbidities and Treatment Approach

Chronic Obstructive Pulmonary Disease (COPD) phenotypes have become increasingly recognized as important for grouping patients with similar presentation and/or behavior, within the heterogeneity of the disease. The primary aim of identifying phenotypes is to provide patients with the best health care possible, tailoring the therapeutic approach to each patient. However, the identification of specific phenotypes has been hindered by several factors such as which specific attributes are relevant, which discriminant features should be used for assigning patients to specific phenotypes, and how relevant are they to the therapeutic approach, prognostic and clinical outcome. Moreover, the definition of phenotype is still not consensual. Comorbidities, risk factors, modifiable risk factors and disease severity, although not phenotypes, have impact across all COPD phenotypes. Although there are some identified phenotypes that are fairly consensual, many others have been proposed, but currently lack validation. The on-going debate about which instruments and tests should be used in the identification and definition of phenotypes has contributed to this uncertainty. In this paper, the authors review present knowledge regarding COPD phenotyping, discuss the role of phenotypes and comorbidities on the severity of COPD, propose new phenotypes and suggest a phenotype-based pharmacological therapeutic approach. The authors conclude that a patient-tailored treatment approach, which takes into account each patient's specific attributes and specificities, should be pursued.

Evaluation of Two Ultrasonic Systems for Analysis of Porosity in Ceramic

The Ultrasound Laboratory of the Nuclear Engineering Institute (LABUS / IEN) has developed an ultrasonic technique to measure porosity in nuclear fuel pellets (UO2). By difficulties related to the handling of UO2 pellets, Alumina (Al2O3) pellets have been used in preliminary tests, until a methodology for tests with pellets of UO2 could be defined. In a previous work, in which a contact ultrasonic technique was used, good results were obtained to measure the porosity of Alumina pellets. In the current studies, it was found that the frequency spectrum of an ultrasonic pulse is very sensitive to the porosity of the medium in which it propagates. In order to define the most appropriate experimental apparatus for using immersion technique in future tests, two ultrasonic systems, available in LABUS, which permit to work with the ultrasonic pulse in the frequency domain were evaluated . One system was the Explorer II (Matec INSTRUMENTS) and the other the ultrasonic pulse generator Epoch 4 Plus (Panametrics) coupled with an oscilloscope TDS 3032B (Tektronix). For this evaluation, several frequency spectra were obtained with the two equipment, by the passage of the ultrasonic wave in the same pellet of Alumina. This procedure was performed on four different days, on each day 12 ultrasonic signals were acquired, one signal every 10 minutes, with each apparatus. The results were compared and analyzed as regard the repeatability of the frequency spectra obtained.

The governance of adaptation: choices, reasons, and effects. Introduction to the Special Feature

The governance of climate adaptation involves the collective efforts of multiple societal actors to address problems, or to reap the benefits, associated with impacts of climate change. Governing involves the creation of institutions, rules and organizations, and the selection of normative principles to guide problem solution and institution building. We argue that actors involved in governing climate change adaptation, as climate change governance regimes evolve, inevitably must engage in making choices, for instance on problem definitions, jurisdictional levels, on modes of governance and policy instruments, and on the timing of interventions. Yet little is known about how and why these choices are made in practice, and how such choices affect the outcomes of our efforts to govern adaptation. In this introduction we review the current state of evidence and the specific contribution of the articles published in this Special Feature, which are aimed at bringing greater clarity in these matters, and thereby informing both governance theory and practice. Collectively, the contributing papers suggest that the way issues are defined has important consequences for the support for governance interventions, and their effectiveness. The articles suggest that currently the emphasis in adaptation governance is on the local and regional levels, while underscoring the benefits of interventions and governance at higher jurisdictional levels in terms of visioning and scaling-up effective approaches. The articles suggest that there is a central role of government agencies in leading governance interventions to address spillover effects, to provide public goods, and to promote the long-term perspectives for planning. They highlight the issue of justice in the governance of adaptation showing how governance measures have wide distributional consequences, including the potential to amplify existing inequalities, access to resources, or generating new injustices through distribution of risks. For several of these findings, future research directions are suggested.

Double bass and electric bass: the case study of John Patitucci

The electric bass and double bass are two different instruments sharing a common function: they link harmony with rhythm, especially when talking about jazz music. The capacity of a bassist to fully support an ensemble is something that can be achieved individually playing electric or double bass. However there are some bassists who, despite of the technical differences between these two instruments, choose to play both. Some of these performers are true masters using and switching electric and double bass according to the different musical settings. It is possible to define similarities and differences between the electric and double bass, but is it viable to use similar approaches too? In order to investigate this field, I focus my research on one exemplar player who combines all the qualities needed to both play electric than double bass: John Patitucci, an inspiration for bassists of all generations and a musician who synthesizes all the fundamental characteristics of an ideal bass player. This dissertation is inspired by Patitucci’s example and by the urge to fill a gap in the specialized literature concerning the history and application of different left and right hand techniques on the electric and double bass. The main purpose of this study is to create the backbone of a bass program for teaching both instruments using John Patitucci as example. His technical approach on both instruments and his soloing vocabulary are points of departure of this dissertation. I begin my study with the historical origins of Patitucci’s techniques ending with the development of exercises created in order to teach his techniques and vocabulary to those who aspire to play electric and double bass; RESUMO: Baixo elétrico e contrabaixo, dois instrumentos distintos que partilham uma função comum: a possibilidade de produzir um conjunto de notas capazes de interligar uma grelha harmonia a uma base rítmica, criando uma coesão estética e musical, sobretudo na música jazz. A capacidade de um baixista de conseguir alcançar de forma eficiente esta ligação como sólido suporte para um “ensemble” musical está na base de uma sua eventual afirmação profissional. Há músicos que apesar das diferencias técnicas entre estes dois instrumentos, decidiram tocar ambos; alguns deles conseguiram destacarse, usando e trocando o baixo elétrico e o contrabaixo para servir melhor diferentes situações musicais. O contrabaixo e baixo elétrico têm características em comum mas ao mesmo tempo diferem por apresentar algumas diferenças técnica substanciais; será por isso possível abordar, explorar e aprender ambos utilizando uma mesma base metodológica? Com o intuito de explorar esta possibilidade direcionei a minha pesquisa para o estudo de um músico que no curso da sua longa carreira consegui grande destaque em quanto baixista elétrico e contrabaixista. John Patitucci é a síntese desta tipologia de músico, sendo uma fonte de inspiração para baixistas de todas as gerações. Esta dissertação é inspirada no seu exemplo e no desejo de colmatar o vazio presente na literatura musical comum aos dois instrumentos sobre a história e aplicação das técnicas da mão esquerda e direita. O foco principal é a criação de uma base sólida para o futuro desenvolvimento de um programa de ensino comum para o baixo eléctrico e o contrabaixo, utilizando o vocabulário técnico e improvisativo de Patitucci como ponto de partida. A dissertação aborda as origens históricas das técnicas utilizadas por Patitucci desenvolvendo, numa fase sucessiva, exercícios criados com a função de ensinar as suas técnicas aos que desejarem aprofundar a prática do baixo elétrico e do contrabaixo.

A PRELIMINARY SURVEY OF ANIMAL HANDLING AND CULTURAL SLAUGHTER PRACTICES AMONG KENYAN COMMUNITIES: POTENTIAL INFLUENCE ON MEAT QUALITY

Kenya is composed of over 40 ethnic communities who practice varied methods of animal handling and slaughter. Socio-cultural and religious traditions have the potential to influence animal handling and slaughter practices. These influences have, however, not been documented in the literature as far as the author is aware. Also, the literature has documented the connection between the manner of animal treatment and meat quality, but this is rarely discussed in the literature in Kenya; this connection is important as it informs modern meat trade practices by Kenyans as they trade in the global arena. This survey aimed to mainly establish and document the animal slaughter practices among Kenyan communities, and, to also highlight any current provisions related to meeting modern animal welfare requirements, animal handling procedures in the meat trade and discuss their potential influence on meat quality available in commerce in Kenya. This preliminary study surveyed the slaughter practices among 10 different Kenyan communities through a semi-structured questionnaire, focus group discussions and individual interviews. The survey demonstrated that different Kenyan communities practice varied methods of animal slaughter depending on whether the animal being slaughtered is for public feasting, domestic consumption or commercial merchandizing. The Kenyan communities surveyed in this study depend mainly on males to slaughter livestock for females preparing it for domestic use using a number of instruments and methods. For small stock for domestic consumption, females may slaughter the animal except for Muslims whose males have to slaughter the animal with a special knife (a Khalef) according to Muslim rites to render it Halal. Large stock is invariably slaughtered by males irrespective of the community, and the manner of use of the carcass. Gender, age, religion, community and the size of the animal were the major determinants of the method of animal slaughter. The animal welfare issues highlighted in the survey and related to the handling and slaughter of livestock have important implications for meat quality during commercial merchandizing. There is an apparent need to provide education to herders, livestock handlers, employees and management in the livestock industry in Kenya on the relationship between animal welfare requirements, animal handling procedures and meat quality. Such awareness can potentially improve the quality and economic value of the meat available in commerce.

Developing European operational oceanography for Blue Growth, climate change adaptation and mitigation, and ecosystem-based management

Operational approaches have been more and more widely developed and used for providing marine data and information services for different socio-economic sectors of the Blue Growth and to advance knowledge about the marine environment. The objective of operational oceanographic research is to develop and improve the efficiency, timeliness, robustness and product quality of this approach. This white paper aims to address key scientific challenges and research priorities for the development of operational oceanography in Europe for the next 5-10 years. Knowledge gaps and deficiencies are identified in relation to common scientific challenges in four EuroGOOS knowledge areas: European Ocean Observations, Modelling and Forecasting Technology, Coastal Operational Oceanography and Operational Ecology. The areas "European Ocean Observations" and "Modelling and Forecasting Technology" focus on the further advancement of the basic instruments and capacities for European operational oceanography, while "Coastal Operational Oceanography" and "Operational Ecology" aim at developing new operational approaches for the corresponding knowledge areas.

Les instruments actuariels d'évaluation du risque de récidive : applicables aux auteurs d'infractions sexuelles ayant une déficience intellectuelle?

L’intérêt porté à l’évaluation du risque de récidive chez les délinquants ayant une déficience intellectuelle (DI) a notablement augmenté depuis les 10 dernières années. D’ailleurs, certains croient que les instruments utilisés pour mesurer le risque chez les auteurs d’infractions sexuelles neurotypiques peuvent s’appliquer aux auteurs d’infractions sexuelles ayant une DI tandis que d’autres appuient l’idée d’utiliser et de développer des mesures actuarielles propres à ces individus. Trois objectifs ont été posés pour tenter d’éclaircir ces deux visions, soit 1) Comparer les taux de récidive entre les deux groupes d’auteurs d’infractions sexuelles (ayant une DI et neurotypiques), en plus de déterminer lequel récidive plus rapidement sur une courte période de temps, 2) Analyser la validité prédictive de huit instruments actuariels (et de la PCL-R) auprès d’un échantillon d’auteurs d’infractions sexuelles ayant une DI et 3) Analyser la composition des instruments par domaines (Knight et Thornton, 2007). L’échantillon est composé de 550 auteurs d’infractions sexuelles dont 54 ont une DI. Les résultats suggèrent que les deux groupes d’auteurs d’infractions sexuelles (neurotypiques et ayant une DI) présentent des taux de récidive similaires. Un nombre restreint d’instruments semblent par contre efficaces chez les auteurs d’infractions sexuelles ayant une DI. De ce fait, le SVR-20 s’est révélé avoir une validité prédictive pour la récidive sexuelle, le RMC, le RMV et le MnSOST-R pour la récidive violente et le VRAG pour la récidive non violente. Il est toutefois justifié de se questionner sur la manière d’évaluer le risque chez cette clientèle particulière. L’analyse de la composition des instruments semble importante puisque certains domaines pourraient prédire différemment la récidive chez les auteurs d’infractions sexuelles ayant une DI. Une grande partie des facteurs pouvant être utiles dans la prédiction de la récidive ne semblent toujours pas avoir été identifiés, repoussant ainsi la création d’instruments propres aux délinquants ayant une DI.

Les instruments actuariels d'évaluation du risque de récidive : applicables aux auteurs d'infractions sexuelles ayant une déficience intellectuelle?

L’intérêt porté à l’évaluation du risque de récidive chez les délinquants ayant une déficience intellectuelle (DI) a notablement augmenté depuis les 10 dernières années. D’ailleurs, certains croient que les instruments utilisés pour mesurer le risque chez les auteurs d’infractions sexuelles neurotypiques peuvent s’appliquer aux auteurs d’infractions sexuelles ayant une DI tandis que d’autres appuient l’idée d’utiliser et de développer des mesures actuarielles propres à ces individus. Trois objectifs ont été posés pour tenter d’éclaircir ces deux visions, soit 1) Comparer les taux de récidive entre les deux groupes d’auteurs d’infractions sexuelles (ayant une DI et neurotypiques), en plus de déterminer lequel récidive plus rapidement sur une courte période de temps, 2) Analyser la validité prédictive de huit instruments actuariels (et de la PCL-R) auprès d’un échantillon d’auteurs d’infractions sexuelles ayant une DI et 3) Analyser la composition des instruments par domaines (Knight et Thornton, 2007). L’échantillon est composé de 550 auteurs d’infractions sexuelles dont 54 ont une DI. Les résultats suggèrent que les deux groupes d’auteurs d’infractions sexuelles (neurotypiques et ayant une DI) présentent des taux de récidive similaires. Un nombre restreint d’instruments semblent par contre efficaces chez les auteurs d’infractions sexuelles ayant une DI. De ce fait, le SVR-20 s’est révélé avoir une validité prédictive pour la récidive sexuelle, le RMC, le RMV et le MnSOST-R pour la récidive violente et le VRAG pour la récidive non violente. Il est toutefois justifié de se questionner sur la manière d’évaluer le risque chez cette clientèle particulière. L’analyse de la composition des instruments semble importante puisque certains domaines pourraient prédire différemment la récidive chez les auteurs d’infractions sexuelles ayant une DI. Une grande partie des facteurs pouvant être utiles dans la prédiction de la récidive ne semblent toujours pas avoir été identifiés, repoussant ainsi la création d’instruments propres aux délinquants ayant une DI.

IMPROVED SAMPLE INTRODUCTION SYSTEMS FOR INDUCTIVELY COUPLED PLASMA OPTICAL EMISSION SPECTROMETRY AND THEIR APPLICATION TO THE ANALYSIS OF SIMPLE AND COMPLEX MATRICES

The objective of this thesis is to explore new and improved methods for greater sample introduction efficiency and enhanced analytical performance with inductively coupled plasma optical emission spectrometry (ICP-OES). Three projects are discussed in which the capabilities and applications of ICP-OES are expanded: 1. In the first project, a conventional ultrasonic nebuliser was modified to replace the heater/condenser with an infrared heated pre-evaporation tube. In continuation from previous works with pre-evaporation, the current work investigated the effects of heating with infrared block and rope heaters on two different ICP-OES instruments. Comparisons were made between several methods and setups in which temperatures were varied. By monitoring changes to sensitivity, detection limit, precision, and robustness, and analyzing two certified reference materials, a method with improved sample introduction efficiency and comparable analytical performance to a previous method was established. 2. The second project involved improvements to a previous work in which a multimode sample introduction system (MSIS) was modified by inserting a pre-evaporation tube between the MSIS and torch. The new work focused on applying an infrared heated ceramic rope for pre-evaporation. This research was conducted in all three MSIS modes (nebulisation mode, hydride generation mode, and dual mode) and on two different ICP-OES instruments, and comparisons were made between conventional setups in terms of sensitivity, detection limit, precision, and robustness. By tracking both hydride-forming and non-hydride forming elements, the effects of heating in combination with hydride generation were probed. Finally, optimal methods were validated by analysis of two certified reference materials. 3. A final project was completed in collaboration with ZincNyx Energy Solutions. This project sought to develop a method for the overall analysis of a 12 M KOH zincate fuel, which is used in green energy backup systems. By employing various techniques including flow injection analysis and standard additions, a final procedure was formulated for the verification of K concentration, as well as the measurement of additives (Al, Fe, Mg, In, Si), corrosion products (such C from CO₃²¯), and Zn particles both in and filtered from solution. Furthermore, the effects of exposing the potassium zincate electrolyte fuel to air were assessed.

Autonomous formation flying: unified control and collision avoidance methods for close manoeuvring spacecraft

The idea of spacecraft formations, flying in tight configurations with maximum baselines of a few hundred meters in low-Earth orbits, has generated widespread interest over the last several years. Nevertheless, controlling the movement of spacecraft in formation poses difficulties, such as in-orbit high-computing demand and collision avoidance capabilities, which escalate as the number of units in the formation is increased and complicated nonlinear effects are imposed to the dynamics, together with uncertainty which may arise from the lack of knowledge of system parameters. These requirements have led to the need of reliable linear and nonlinear controllers in terms of relative and absolute dynamics. The objective of this thesis is, therefore, to introduce new control methods to allow spacecraft in formation, with circular/elliptical reference orbits, to efficiently execute safe autonomous manoeuvres. These controllers distinguish from the bulk of literature in that they merge guidance laws never applied before to spacecraft formation flying and collision avoidance capacities into a single control strategy. For this purpose, three control schemes are presented: linear optimal regulation, linear optimal estimation and adaptive nonlinear control. In general terms, the proposed control approaches command the dynamical performance of one or several followers with respect to a leader to asymptotically track a time-varying nominal trajectory (TVNT), while the threat of collision between the followers is reduced by repelling accelerations obtained from the collision avoidance scheme during the periods of closest proximity. Linear optimal regulation is achieved through a Riccati-based tracking controller. Within this control strategy, the controller provides guidance and tracking toward a desired TVNT, optimizing fuel consumption by Riccati procedure using a non-infinite cost function defined in terms of the desired TVNT, while repelling accelerations generated from the CAS will ensure evasive actions between the elements of the formation. The relative dynamics model, suitable for circular and eccentric low-Earth reference orbits, is based on the Tschauner and Hempel equations, and includes a control input and a nonlinear term corresponding to the CAS repelling accelerations. Linear optimal estimation is built on the forward-in-time separation principle. This controller encompasses two stages: regulation and estimation. The first stage requires the design of a full state feedback controller using the state vector reconstructed by means of the estimator. The second stage requires the design of an additional dynamical system, the estimator, to obtain the states which cannot be measured in order to approximately reconstruct the full state vector. Then, the separation principle states that an observer built for a known input can also be used to estimate the state of the system and to generate the control input. This allows the design of the observer and the feedback independently, by exploiting the advantages of linear quadratic regulator theory, in order to estimate the states of a dynamical system with model and sensor uncertainty. The relative dynamics is described with the linear system used in the previous controller, with a control input and nonlinearities entering via the repelling accelerations from the CAS during collision avoidance events. Moreover, sensor uncertainty is added to the control process by considering carrier-phase differential GPS (CDGPS) velocity measurement error. An adaptive control law capable of delivering superior closed-loop performance when compared to the certainty-equivalence (CE) adaptive controllers is finally presented. A novel noncertainty-equivalence controller based on the Immersion and Invariance paradigm for close-manoeuvring spacecraft formation flying in both circular and elliptical low-Earth reference orbits is introduced. The proposed control scheme achieves stabilization by immersing the plant dynamics into a target dynamical system (or manifold) that captures the desired dynamical behaviour. They key feature of this methodology is the addition of a new term to the classical certainty-equivalence control approach that, in conjunction with the parameter update law, is designed to achieve adaptive stabilization. This parameter has the ultimate task of shaping the manifold into which the adaptive system is immersed. The performance of the controller is proven stable via a Lyapunov-based analysis and Barbalat’s lemma. In order to evaluate the design of the controllers, test cases based on the physical and orbital features of the Prototype Research Instruments and Space Mission Technology Advancement (PRISMA) are implemented, extending the number of elements in the formation into scenarios with reconfigurations and on-orbit position switching in elliptical low-Earth reference orbits. An extensive analysis and comparison of the performance of the controllers in terms of total Δv and fuel consumption, with and without the effects of the CAS, is presented. These results show that the three proposed controllers allow the followers to asymptotically track the desired nominal trajectory and, additionally, those simulations including CAS show an effective decrease of collision risk during the performance of the manoeuvre.

X-ray your data with Rasch

By using the Rasch model, much detailed diagnostic information is available to developers of survey and assessment instruments and to the researchers who use them. We outline an approach to the analysis of data obtained from the administration of survey instruments that can enable researchers to recognise and diagnose difficulties with those instruments and then to suggest remedial actions that can improve the measurement properties of the scales included in questionnaires. We illustrate the approach using examples drawn from recent research and demonstrate how the approach can be used to generate figures that make the results of Rasch analyses accessible to non-specialists.

Prediction of adjacent vertebral fracture risk associated with vertebroplasty : a computer-based simulation study

Vertebrplasty involved injecting cement into a fractured vertebra to provide stabilisation. There is clinical evidence to suggest however that vertebroplasty may be assocated with a higher risk of adjacent vertebral fracture; which may be due to the change in material properties of the post-procedure vertebra modifying the transmission of mechanical stresses to adjacent vertebrae.