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Among patients with COPD, ventilatory inefficiency in response to exercise can be due to respiratory muscle dysfunction or expiratory flow limitation causing air-trapping and dynamic hyperinflation. We discuss a case of severe ventilatory limitation in response to exercise due to reduced respiratory muscle mass in the setting of gender-affirming hormone therapy (GAHT), and how the interpretation of pulmonary function testing (PFT) and respiratory symptoms among transgender and gender diverse (TGD) patients can be influenced by GAHT. [ABSTRACT FROM AUTHOR]

To investigate the action of the new drug benazepril hydrochloride in special populations, single or multiple doses between 5 and 20 mg were given, and the action of the drug was compared to the action of its naturally produced active metabolite, benazeprilat, in healthy males. In elderly patients and those with only mild or moderately inadequate blood supply to the kidneys, the action of both benazepril and benazeprilat remained unchanged. In patients with severe kidney impairment, however, the body's ability to eliminate benazeprilat was slowed down, resulting in accumulation after repeated doses. In patients with cirrhosis of the liver, the action of benazeprilat was not affected. The authors conclude that dose adjustment accordance either to the patient's age, mild or moderate kidney impairment, or cirrhosis, is unnecessary. Reduced dosage is required for patients with severely impaired kidneys.

With over 220,000 fatalities, the 26 December 2004 Indian Ocean tsunami was one of the deadliest natural hazard events ever, and represents a landmark in disaster risk reduction governance in several ways. The 2004 Indian Ocean tsunami led to a better understanding of the likelihood of tsunami occurrence and potential tsunami inundation. For example, the Hyogo Framework Agreement was a direct result of this event. Since December 2004, Indonesia, Samoa, Chile and Japan were hit by altogether six destructive tsunamis in 2006, 2007, 2009, 2010 and 2011. This article looks into the progress (or lack thereof) made in tsunami risk reduction at the local level during the past ten years, with focus on the densely populated coastal regions of Indonesia and Sri Lanka. The experience from other countries, as well as the progress made in the state of the art for assessment of tsunami hazard, vulnerability, exposure and risk are also summarized. In addition, extensive new warning systems enabling a rapid assessment of the potential coastal impact of a tsunami have been developed and implemented. However, the experience from the tsunami events in October 2010 in Indonesia and March 2011 in Japan clearly demonstrated that the tsunami risk mitigation measures implemented to date are far from adequate. The article also examines the progress in assessing and factoring in vulnerability aspects in tsunami risk reduction, highlighted through two case studies in Padang (Indonesia) and Galle (Sri Lanka). In this regard, societal awareness and behavioural response to tsunamis are addressed. Recommendations about how the improved knowledge about tsunami hazard, vulnerability and exposure assessment gained over the past decade could be better implemented into tsunami risk reduction measures are provided at the end of the article. [ABSTRACT FROM AUTHOR]

A challenge for solid organ transplantation in Germany is the shortage of organs. In an effort to increase donation rates, some federal states mandated hospitals to install transplantation officers to coordinate, evaluate, and enhance the donation and transplantation processes. In 2009 the German Foundation for Organ Transplantation (DSO) implemented the In-House Coordination Project, which includes retrospective, quarterly, information technology-based case analyses of all deceased patients with primary or secondary brain injury in regard to the organ donation process in maximum care hospitals. From 2006 to 2008 an analysis of potential organ donors was performed in our hospital using a time-consuming, complex method using questionnaires, hand-written patient files, and the hospital IT documentation system (standard method). Analyses in the In-House Coordination Project are instead carried out by a proprietary semiautomated IT tool called Transplant Check, which uses easily accessible standard data records of the hospital controlling and accounting unit. The aim of our study was to compare the results of the standard method and Transplant Check in detecting and evaluating potential donors. To do so, the same period of time (2006 to 2008) was re-evaluated using the IT tool. Transplant Check was able to record significantly more patients who fulfilled the criteria for inclusion than the standard method (641 vs 424). The methods displayed a wide overlap, apart from 22 patients who were only recorded by the standard method. In these cases, the accompanying brain injury diagnosis was not recorded in the controlling and accounting unit data records due to little relative clinical significance. None of the 22 patients fulfilled the criteria for brain death. In summary, Transplant Check is an easy-to-use, reliable, and valid tool for evaluating donor potential in a maximum care hospital. Therefore from 2010 on, analyses were performed exclusively with Transplant Check at our university hospital. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Macrophage colony stimulating factor (M-CSF) as well as vascular endothelial growth factor (VEGF) play an important role in bone homeostasis and in the process of fracture healing. To date, limited data regarding the influence of age, gender, diabetes, smoking, and alcohol consumption on the systemic expression of M-CSF and VEGF after long bone fracture exist. Methods: From a total of 113 patients with long bone fractures 51 patients met inclusion criteria and were finally enrolled in this study. Patient's serum was collected over a period of 6 months following a standardised time schedule. M-CSF and VEGF serum concentrations were measured. Patient's history with special focus on cigarette smoking, diabetes mellitus, and regular alcohol intake was recorded. All patients were followed up clinically and radiologically for at least 24 weeks after trauma. A total of 22 male and 29 female patients formed the study population. Results The present results show significantly elevated mean overall M-CSF serum concentration in women, older patients as well as in non-smoking individuals. The mean overall VEGF serum concentration was significantly higher in women, older patients, and diabetic individuals as well as in non-smokers. Statistically significant differences were not observed at any time point regarding alcohol consumption. Conclusion: These results suggest that age, gender, diabetes mellitus and cigarette smoking significantly influence the expression of M-CSF and VEGF after fracture of long bones in human. Of note, diabetic patients showed significantly elevated overall VEGF levels when compared to non-diabetic patients. Therefore, further studies with larger patient cohorts are needed to better understand the influence of these endogenous and exogenous factors on the expression of the osteogenic during human fracture healing. [Copyright &y& Elsevier]

Abstract: Monitoring vegetation dynamics is fundamental for improving Earth system models and for increasing our understanding of the terrestrial carbon cycle and the interactions between biosphere and climate. Medium spatial resolution sensors, like MERIS, exhibit a significant potential to study these dynamics over large areas because of their spatial, spectral and temporal resolution. However, the spatial resolution provided by MERIS (300 m in full resolution mode) is not appropriate to monitor heterogeneous landscapes, where typical length scales of these dynamics rarely reach 300 m. We, therefore, motivate the use of data fusion techniques to downscale medium spatial resolution data (MERIS full resolution, FR) to a Landsat-like spatial resolution (25 m). An unmixing-based data fusion approach was applied to a time series of MERIS FR images acquired over The Netherlands. The selected data fusion approach is based on the linear mixing model and uses a high spatial resolution land use database to produce images having the spectral and temporal resolution as provided by MERIS, but a Landsat-like spatial resolution. A quantitative assessment of the quality of the fused images was done in order to test the validity of the proposed method and to evaluate the radiometric characteristics of the MERIS fused images. The resulting series of fused images was subsequently used to compute two vegetation indices specifically designed for MERIS: the MERIS terrestrial chlorophyll index (MTCI) and the MERIS global vegetation index (MGVI). These indices represent continuous fields of canopy chlorophyll (MTCI) and of the fraction of photosynthetically active radiation absorbed by the canopy (MGVI). Results indicate that the selected data fusion approach can be successfully used to downscale MERIS data and, therefore, to monitor vegetation dynamics at Landsat-like spatial, and MERIS-like spectral and temporal resolution. [Copyright &y& Elsevier]

In this paper, a microchannel-based cryocooler consisting of a compressor, a recuperator and a cold heat exchanger has been developed to study the feasibility of cryogenic cooling by the use of Joule–Thomson effect and Bernoulli effect. A set of governing equations including Bernoulli equations and energy equations are introduced and the performance of the cooler is calculated. The influences of some working conditions and structure parameters on the performance of coolers are discussed in details. [Copyright &y& Elsevier]

While our understanding of cystic fibrosis genetics has expanded in recent decades, the genetics and clinical manifestations of the disease remains highly heterogeneous. Diagnosis of CF in non-classical mutations remains a clinical challenge. We describe the clinical presentation of two patients with chronic cough found to have normal sweat chlorides. We discuss the subsequent evaluation that lead to the diagnosis of two rare CF mutations. We briefly discuss the use of the expanded 106-panel of CF mutations (homozygous 3849 + 10 kb C > T), and the role of whole CFTR gene sequencing (heterozygous c.2752-26 A > G/5T). [ABSTRACT FROM AUTHOR]

Introduction: The current organ donor shortage in Germany results in the death of 1000 patients on the transplant waiting list every year. In response, a recent amendment to the German Transplant Act aiming to increase donor rates was passed. Among a number of other measures, Germans are asked to decide whether they choose to donate organs or not in the event of a brain death or whether they would like to designate someone who should decide for them in this situation. The objective of this study was to collect and evaluate data on the public's attitude toward organ donation before the expected amendment. Methods: A survey on the subject of organ donation was conducted in 2011 among clients of a public pharmacy in a major city in the federal state North Rhine-Westphalia, Germany. Data regarding sex, age, health behavior, and attitude toward the amendment were collected and association organ donor card possession was analyzed. Results: A total of 1485 questionnaires were evaluated. Of those surveyed, only 14.1% had an organ donor card. No statistically significant associations between sex (P value .3045), age (P value .1453) and the possession of a donor card were observed. We found that 72.5% of respondents stated that they appreciated the expected amendment, and in the case of implementation, the majority would obtain an organ donor card. Discussion: The future success of transplantation medicine relies on an increase in the public's overall willingness to donate organs. Educating the public and ensuring transparency in transplantation medicine are vital to achieving higher donation rates. The new German transplantation act may be an important step to increase society's awareness and participation in organ donation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate our experience with patients who presented with chronic cough and how exhaled nitric oxide predicted response to inhaled corticosteroid (ICS) therapy. PATIENTS AND METHODS: This retrospective observational study of 114 patients evaluated for chronic cough with measured exhaled nitric oxide and methacholine challenge testing was conducted from December 1, 2004, through November 30, 2005. Clinical records were extracted. Patients with no documented follow-up were contacted by telephone and administered a questionnaire. RESULTS: In 64 patients, ICS therapy was started or the current ICS dose increased. Forty-one patients had elevated exhaled nitric oxide levels (defined as ⩾35 ppb), 36 (88%) of whom had significant improvement in their chronic cough (likelihood ratio of a positive response, 4.9; 95% confidence interval, 2.2-10.9). Twenty-three patients with exhaled nitric oxide levels in the reference range were also prescribed ICS, and only 2 had cough improvement (likelihood ratio of a negative response, 0.07; 95% confidence interval, 0.02-0.25). Patients had documented follow- up that ranged from 4 weeks to 16 months. A cutoff of 38 ppb was found to best differentiate ICS responders and nonresponders. CONCLUSION: Measurement of exhaled nitric oxide accurately predicted response to ICS therapy for chronic cough. Patients with a positive exhaled nitric oxide test result had a strong likelihood of response to ICS, whereas a negative exhaled nitric oxide test result indicated an unlikely response to ICS. This finding may potentially have an impact on how patients with chronic cough are evaluated and treated. [ABSTRACT FROM AUTHOR]

Diffusing capacity (DLCO) measurements are affected by hemoglobin. Two adjustment equations are used: Cotes (recommended by ATS/ERS) and Dinakara (used in the hematopoietic stem cell transplantation comorbidity index [HCT-CI]). It is unknown how these methods compare, and which is better from a prognostication standpoint. This is a retrospective cohort of 1273 adult patients who underwent allogeneic HCT, completed a pre-transplant DLCO and had a concurrent hemoglobin measurement. Non-relapse mortality was measured using competing risk analysis. Patients had normal spirometry (FEV 1 99.7% [IQR: 89.4–109.8%; FVC 100.1% [IQR: 91.0-109.6%] predicted), left ventricular ejection fraction (57.2[6.7]%) and right ventricular systolic pressure (30.1[7.0] mmHg). Cotes-DLCO was 85.6% (IQR: 76.5-95.7%) and Dinakara-DLCO was 103.6% (IQR: 90.7-117.2%) predicted. For anemic patients (Hb<10g/dL), Cotes-DLCO was 84.2% (IQR: 73.9–94.1%) while Dinakara-DLCO 111.0% (97.3–124.7%) predicted. Cotes-DLCO increased HCT-CI score for 323 (25.4%) and decreased for 4 (0.3%) patients. Cotes-DLCO was superior for predicting non-relapse mortality: for both mild (66-80% predicted, HR 1.55 [95%CI: 1.26-1.92, p < 0.001]) and moderate (<65% predicted, HR 2.11 [95%CI: 1.55-2.87, p<0.001]) impairment. In contrast, for Dinakara-DLCO, only mild impairment (HR 1.69 [95%CI 1.26-2.27, p < 0.001]) was associated with lower survival while moderate impairment was not (HR 1.44 [95%CI: 0.64-3.21, p = 0.4]). In multivariable analyses, after adjusting for demographics, hematologic variables, cardiac function and FEV 1 , Cotes-DLCO was predictive of overall survival at 1-year (OR 0.98 [95%CI: 0.97-1.00], p = 0.01), but Dinakara-DLCO was not (OR 1.00 [95%CI: 0.98-1.00], p = 0.20). The ERS/ATS recommended Cotes method likely underestimates DLCO in patients with anemia, whereas the Dinakara (used in the HCT-CI score) overestimates DLCO. The Cotes method is superior to the Dinakara method score in predicting overall survival and relapse-free survival in patients undergoing allogeneic HCT. [ABSTRACT FROM AUTHOR]

Temozolomide is an oral alkylating agent recently approved for the treatment of glioblastoma multiforme. It has a favorable side effect profile and is generally well tolerated. Although mild respiratory symptoms have been described, pulmonary toxicity that requires discontinuation of therapy is rare. To our knowledge, this is the first case of temozolomide-associated organizing pneumonitis. [ABSTRACT FROM AUTHOR]

Abstract: A new concept of a cold actuator chamber is realized to avoid using cumbersome high-pressure helium gas cylinders in space for the cold valves in AMS-2 project . A good repeatability was shown in the first experiment with the cold valve opened and closed. [Copyright &y& Elsevier]

Abstract: A comparative study of the corrosion properties of thermally sprayed ceramic coatings (Al2O3, Al2O3–TiO2 with different ratios, mullite, and ZrSiO4) and their sintered bulk ceramic counterparts was performed. The coatings were deposited on corrosion-resistant steel substrates using atmospheric plasma spraying (APS) and high velocity oxy-fuel (HVOF) spraying processes. The corrosion properties were investigated in 1N solutions of NaOH and H2SO4 at 85°C, respectively. The coating microstructures and phase compositions, as well as the corrosive environment were shown to have a strong effect on the corrosion resistance of the coatings. Al2O3–coatings were more sensitive to these factors than Al2O3–TiO2 coatings were. The corrosion resistance of the bulk ceramics was superior to that of the thermally sprayed coatings. This is mainly because the coatings exhibited specific microstructure and contained amorphous and/or metastable phases not appearing in the bulk ceramics. [Copyright &y& Elsevier]