Diagnosis of asthma and chronic obstructive pulmonary disease in general practice

There may be an overlap between the clinical pictures of asthma and chronic obstructive pulmonary disease which hampers a clear distinction between the two diseases. Most symptoms presented by patients do not clearly belong exclusively to either asthma or chronic obstructive pulmonary disease. By the nature of their discipline and training, general practitioners focus mainly on symptoms presented, which do not give a decisive answer in the differential diagnosis between the two diseases. Therefore, general practitioners must rely on objective parameters, such as determining the presence and degree of reversibility of airway obstruction, diurnal peak flow variability, bronchial hyper-responsiveness and allergy. This paper puts forward a pragmatic, primary care definition of asthma and chronic obstructive pulmonary disease.     

A Study of The Moisture-Uptake Kinetics of a Hygroscopic Pharmaceutical Powder

The moisture-uptake kinetics of a hygroscopic powder, sodium heparin contained in a cylindrical container, was determined using a novel moisture-uptake measuring device under a constant convective air flow. The amount of moisture uptake increased with the increase in the relative humidity of the air. The effect of powder-bed height on the total amount of moisture uptake was found to be significant only at the highest relative humidity (75%) evaluated in this study. However, the percent of weight increase of the powder as a result of moisture uptake decreases as the height of the powder bed increases. The results of this study are explained by the dynamic nature of the moisture-uptake process associated with the instrument.     

Explicit Ziv-Zakai lower bound for bearing estimation

The extended Ziv-Zakai bound for vector parameters is used to develop a lower bound on the mean square error in estimating the 2-D bearing of a narrowband planewave signal using planar arrays of arbitrary geometry. The bound has a simple closed-form expression that is a function of the signal wavelength, the signal-to-noise ratio (SNR), the number of data snapshots, the number of sensors in the array, and the array configuration. Analysis of the bound suggests that there are several regions of operation, and expressions for the thresholds separating the regions are provided. In the asymptotic region where the number of snapshots and/or SNR are large, estimation errors are small, and the bound approaches the inverse Fisher information. This is the same as the asymptotic performance predicted by the local Cramer-Rao bound for each value of bearing. In the a priori performance region where the number of snapshots or SNR is small, estimation errors are distributed throughout the a priori parameter space and the bound approaches the a priori covariance. In the transition region, both small and large errors occur, and the bound varies smoothly between the two extremes. Simulations of the maximum likelihood estimator (MLE) demonstrate that the bound closely predicts the performance of the MLE in all regions     

Limited expansion of the (CAG)n repeat of the Huntington gene: a premutation (?)

Pantoprazole is a specific inhibitor of the H+/K(+)-ATPase of the gastric parietal cell. The dose-dependency of a range of pantoprazole pharmacokinetic characteristics was studied. Twelve healthy male subjects were given 10, 20, 40 and 80 mg pantoprazole intravenously according to a randomized, single blind, 4-period change-over scheme. The area under the concentration vs time curve (AUC) and the maximum serum concentration (Cmax) showed a linear increase in line with the dose. Apparent volume of distribution (Vd area), clearance (Cl) and terminal half-life (t1/2) were independent of the dose. The dose-independent elimination of pantoprazole was attributed to the lack of interaction of the drug with cytochrome P450. In clinical practice, a good predictable response, as well as a low potential for interaction with other drugs might be expected.     

Design for testability in hardware software systems

Clearly, in today's complex systems, hardware and software approaches to DFT must work together to achieve a successful overall solution. The authors investigate existing and new concepts that may lead to a single design for test strategy in the future     

Time-dependent differential changes of immune function in rats exposed to chronic intermittent noise

Noise is a highly relevant environmental and clinical stressor. Compared to most other experimental stressors, noise is a modest activator of neuroendocrine pathways that mimic the situation in human health where neuroendocrine activation by environmental stressors is often absent or difficult to establish. Little is known about the effects of noise exposure on the immune system. In the present work, the effects of a low-intensity chronic intermittent unpredictable noise regimen on various parameters of immune function was studied. Male wistar rats were exposed to a randomized noise protocol (white noise, 85 dB, 2-20 kHz) for 10 h per day, 15 min per h over a total period of 3 weeks. Control animals were exposed to ambient sound only. Immune function was monitored after 24 h, 7 days, and 21 days of noise exposure. Noise induced several significant changes in immune function in a time-dependent differential pattern involving both immunosuppression and immunoenhancement. After 24 h, serum IgM levels were increased and peripheral phagocytic activity was decreased. Splenic lymphocytic proliferation to mitogens was significantly decreased after 7 days, but slightly elevated after 3 weeks. The activity of splenic NK cells was increased significantly after 24 h and 7 days, but suppressed after 3 weeks. These results show that various parameters of immune function are affected differentially over time in a period of chronic mild noise stress, possibly due to sequential activation of different physiological mechanisms.     

Job demands and worker health: Three-dimensional reexamination of the relationship between person€nvironment fit and strain.

The most influential study of the person–environment (P–E) fit approach to stress was conducted by J. R. French et al (1982). Unfortunately, this study operationalized fit using various transformations of difference scores, thereby introducing numerous substantive and methodological problems. In the present study, the authors reanalyze data from French et al, using a procedure described by J. R. Edwards (in press) that avoids problems with difference scores and captures the underlying 3-dimensional relationship between environment, person, and strain. Results resolve ambiguities in the French et al findings and identify relationships between environment, person, and strain that, although consistent with P–E fit theory, cannot be adequately represented by fit measures such as those used by French et al. Implications for P–E fit research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of plasticizer on extruded thermoplastic starch

This paper describes the use of an extruder for the plastification process of potato starch with glycerol and water as plasticizers. The influence of both plasticizers is expressed in the water absorption index (WAI) and water solubility index (WSI). The amount of water added prior to extrusion is a tool to protect the starch polymers from degradation and to improve the extruder performance.     

Evaluation of the Short Parkinson's Evaluation Scale: a new friendly scale for the evaluation of Parkinson's disease in clinical drug trials

The extensive use of the Unified Parkinson's Disease Rating Scale (UPDRS) has revealed low interrater reliability in some items and redundancy in others. In view of these shortcomings, we have structured a new scale that includes a zero-to three-point scale for each item in the evaluation of PD. The mental axis includes memory, thought disorders, and depression. Activities of daily living (ADL) includes eight items: speech, eating, feeding, dressing, hygiene, handwriting, walking, and turning in bed. The motor examination includes eight items: speech, tremor, rest and posture, rigidity, finger tapping, arising from chair, gait, and postural stability. Complications of therapy were also included: dyskinesias, dystonia, motor fluctuations, and freezing episodes, collected by history. In addition, a global scoring for motor fluctuations that should complement the Hoehn and Yahr Scale was incorporated. In this report, we present a statistical analysis of the ADL, motor evaluation, and complications of therapy sections. Concerning the interrater reliability mean, Kendall's W values were >0.9 for most of the items in the Short Parkinson's Evaluation Scale (SPES). Kendall's W <0.8 (motor evaluation) was found for two items of the SPES and nine items of the UPDRS. The mean interrater reliability for both scales across all seven centers (seven Kendall's W for seven centers) (Mann-Whitney test) showed no statistical differences between the scales. Spearman's correlations between items of both scales were significant. Factor analysis of the SPES and UPDRS data revealed a four-factor solution that explained approximately 60% of the data. All participating centers found the SPES easier to apply and quicker to complete, when compared with the UPDRS. The results obtained strongly favor the introduction of SPES for clinical practice.