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This paper explores the conditions for embedding a new fully customized technology in the usage context in terms of the necessary adaptations (e.g., to other customers' needs) as well as the trade-offs necessary to spread the solution on the market. To achieve this purpose the paper employs a single case study design and analyzes the embedding of a bespoke innovative solution (called Mexus) in the market through the interactions between the developing firm (Loccioni), the major customer that was first to order it (Continental) and a major supplier (National Instruments), as well as other players such as a competitor (Innov8) and other customers. Our theoretical tools are the ARA (activities, resources, and actors) model and the 4R (fourresources) model, which we apply to identify both the specific adaptations between resources and the trade-offs faced by the involved actors. Our findings suggest firstly that embedding technology in networks requires not only that the involved actors gain something from an innovation, but also that they accept sacrifices and face trade-offs in relation to it; and secondly that both gains and trade-offs emerge from the resource interfaces that must be created in order to adapt resources to each other as a way to sustain the development and further marketing of new technical solutions. [ABSTRACT FROM AUTHOR]

RATIONALE: Asthma treatment might improve when inhaled steroids are titrated on airway inflammation. Fractional exhaled nitric oxide (FeNO0.05), a marker of eosinophilic airway inflammation, can be measured at home. OBJECTIVES: We assessed daily FeNO0.05 telemonitoring in the management of childhood asthma. METHODS: Children with atopic asthma (n = 151) were randomly assigned to two groups: FeNO0.05 plus symptom monitoring, or monitoring of symptoms only. All patients scored asthma symptoms in an electronic diary over 30 weeks; 77 received a portable nitric oxide (NO) analyzer. Data were transmitted daily to the coordinating centers. Patients were phoned every 3 weeks and their steroid dose was adapted according to FeNO0.05 and symptoms, or according to symptoms. Children were seen at 3, 12, 21, and 30 weeks for examination and lung function testing. The primary end point was the proportion of symptom-free days in the last 12 study weeks. MEASUREMENTS AND MAIN RESULTS: Telemonitoring was feasible with reliable FeNO0.05 data for 86% of days, and valid diary entries for 79% of days. Both groups showed an increase in symptom-free days, improvement of FEV1 and quality of life, and a reduction in steroid dose. None of the changes from baseline differed between groups. The difference in symptom-free days over the last 12 weeks was 0.3% (P = 0.95; 95% confidence interval, -10 to 11%). There was a trend for fewer exacerbations in the FeNO0.05 group. CONCLUSIONS: Thirty weeks of daily FeNO0.05 and symptom telemonitoring was associated with improved asthma control and a lower steroid dose. We found no added value of daily FeNO0.05 monitoring compared with daily symptom monitoring only. [ABSTRACT FROM AUTHOR]

Rationale: Metabolomic analysis provides biochemical profiles of low-molecular-weight endogenous metabolites in biological fluids. Objectives: The aim of this study was to assess the feasibility of nuclear magnetic resonance (NMR)-based metabolomic analysis applied to exhaled breath condensate ('breathomics'). Information coming from NMR spectra was analyzed with a view to establish the NMR variables that best discriminate between children with asthma and healthy children. Methods: Twenty-five children with asthma (17 with persistent asthma treated with inhaled corticosteroids, 8 with intermittent asthma inhaled corticosteroid naive; age, 7-15 yr) and 11 healthy age-matched control subjects were enrolled. Every child performed exhaled nitric oxide measurement, spirometry, and condensate collection. Condensate samples were analyzed by means of NMR spectroscopy. Linear and partial least squares discriminant analyses were applied to data obtained from the NMR spectra. Measurements and Main Results: The combination of exhaled nitric oxide and FEV(1) discriminates children with asthma and healthy children with a success rate of approximately 81%, whereas selected signals from NMR spectra offer a slightly better discrimination ( approximately 86%). The selected NMR variables derive from the region of 3.2 to 3.4 ppm, indicative of oxidized compounds, and from the region of 1.7 to 2.2 ppm, indicative of acetylated compounds. Conclusions: Metabolomics can be applied to exhaled breath condensate, leading to the characterization of airway biochemical fingerprints. The presence of acetylated compounds suggests new metabolic pathways that may have a role in asthma pathophysiology. [ABSTRACT FROM AUTHOR]

Rationale: Acute exposure to chlorine gas results in respiratory impairment, but few data are available on the pathobiology of the underlying lung damage.Objectives: To assess lung function and potential lung damage pathways in the acute phase and longitudinally over a 15-mo follow-up after acute chlorine exposure.Methods: Ten previously healthy children were accidentally exposed to chlorine gas at a swimming pool because of an erroneous servicing procedure. The fraction of nitric oxide in exhaled air (Fe(NO)), exhaled breath condensate compounds, and serum Clara cell-specific protein CC16 were repeatedly measured.Main Results: In the acute phase, all patients had respiratory distress (one child required mechanical ventilation) and reduced lung function (median and interquartile range: FVC, 51 [43-60]% predicted; FEV(1), 51 [46-60]% predicted). This was accompanied by low Fe(NO) (4.7 [3.9-7.9] ppb), high exhaled breath condensate leukotriene B(4) (LTB(4)) levels (24.4 [22.5-24.9] pg/ml), and increased serum CC16 levels (mean +/- SEM, 23.4 +/- 2.5 microg/L). Lung function returned to normal in 15 d (FVC, 97% predicted [82-108], and FEV(1), 92% predicted [77-102]). Fe(NO) reached normal values after 2 mo (12.6 [11.4-15] ppb), whereas LTB(4) levels were still increased (12 [9.3-17.1] pg/ml).Conclusion: Children acutely exposed to chlorine in a swimming pool presented a substantial lung function impairment associated with biochemical exhaled breath alterations, represented mainly by an increase in LTB(4) and a reduction in Fe(NO). Although lung function and Fe(NO) improved within a few weeks, the increased levels of exhaled LTB(4) persisted for several months. [ABSTRACT FROM AUTHOR]

Bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity, may be associated with long-term airflow limitation. Survivors of BPD may develop asthma-like symptoms in childhood, with a variable response to ß[2]-agonists. However, the pathologic pathways underlying these respiratory manifestations are still unknown. The aim of this study was to measure exhaled nitric oxide (FE[NO]) and lung function in a group of 31 school-age survivors of BPD. They showed variable degrees of airflow obstruction (mean FEV[1] 77.8 +/- 2.3% predicted) unresponsive to ß[2]-agonists in 72% of the subjects. Their FE[NO] values (geometric mean [95% confidence interval]: 7.7 [+/- 1.1] ppb) were significantly lower than in a group of healthy matched control subjects born at term (10.7 [+/- 1.1] ppb, p < 0.05) and a group of preterm children without BPD (9.9 [+/- 1.1] ppb, p < 0.05). The children with BPD were also compared with a group of 31 patients with asthma with a comparable airflow limitation (FEV[1] 80.2 +/- 2.1% predicted) and showed FE[NO] values four times lower than in those with asthma (24.9 [+/- 1.2] ppb, p < 0.001). In conclusion, unlike children with asthma, school-age survivors of BPD have airflow limitation associated with low FE[NO] values and lack of reversibility to ß[2]-agonists, probably as a result of mechanisms related to early life structural changes in the airways. [ABSTRACT FROM AUTHOR]

Abstract The effects on Botrytis cinerea of prolonged exposures to CO2 -enriched atmospheres were studied in vitro and in vivo at 0°C. Mycelial growth on potato dextrose agar decreased linearly with increasing CO2 concentrations from 5, 10, 15 and 20% CO2 . The growth reduction was greater after 30–40 days of incubation. A reduced production of sclerotia in air by the colonies formerly exposed to various CO2 concentrations was also detected. Conidial germination was delayed and the amount of germinated conidia decreased with increased CO2 and at 20% CO2 it was inhibited. Germ tube elongation was affected in the same way. In artificially inoculated red chicory, lesion area caused by B. cinerea decreased with increasing concentrations of CO2 up to 60 days storage, later only 10 and 15% CO2 were really effective, while in the final inspection after 120 days all the concentration tested showed a low efficacy. Similar results were obtained in naturally infected chicory where the severity of the disease decreased by increasing CO2 from 5 to 10%, higher values did not improve the suppressive effect or determined, after 150 days of storage, an increased vulnerability of the tissues to disease due to the phytotoxic effects of the gas. An atmosphere enriched with 10% CO2 is advised to suppress Botrytis rot during storage at 0°C of red chicory. [ABSTRACT FROM AUTHOR]

Oxidative stress is implicated in the pathogenesis of asthma, and clinical studies show an imbalance in the level of oxidants to the level of antioxidants in subjects with asthma. Aldehydes and glutathione are examples of biomarkers of oxidant-induced damage and antioxidant status in asthma, respectively. In the study, we applied analytical techniques based on liquid chromatography for the assessment of aldehydes and glutathione in the exhaled breath condensate of children with asthma and in control subjects without asthma. Twelve subjects with asthma were evaluated at exacerbation and after 5 days of therapy with prednisone. At exacerbation, malondialdehyde levels were higher in patients with asthma (30.2 +/- 2.4 nM) than in control subjects (19.4 +/- 1.9 nM, p = 0.002) and were reduced after steroid therapy (18.5 +/- 1.6 nM, p = 0.001). At exacerbation, glutathione levels were lower in subjects with asthma (5.96 +/- 0.6 nM) than in control subjects (14.1 +/- 0.8 nM, p < 0.0001) and were increased after the therapy (8.44 +/- 1.2 nM, p = 0.04). Malondialdehyde and glutathione both in subjects with asthma and control subjects were negatively correlated (r = -0.5, p = 0.001). The study shows that aldehydes and glutathione are detectable in the exhaled breath condensate of children with asthma and healthy children and that their levels are modified during asthma exacerbation and after a 5-day course of therapy with oral prednisone. [ABSTRACT FROM AUTHOR]

Background: Methylxanthines are often administered to preterm infants for the treatment of apnoea.Aims: To study the effects of theophylline on energy metabolism, physical activity, and lung mechanics in preterm infants.Methods: Indirect calorimetry was performed for six hours before and after administration of a bolus of theophylline (5 mg/kg) in 18 preterm infants while physical activity was recorded with a video camera. Lung mechanics measurements were performed at baseline and 12 and 24 hours after theophylline treatment.Results: Theophylline increased mean (SEM) energy expenditure by 15 (5) kJ/kg/day and augmented carbohydrate utilisation from 6.8 to 8.0 g/kg/day, but fat oxidation was unchanged. After theophylline treatment, preterm infants had faster respiration, lower transcutaneous CO2, and improved static respiratory compliance without increased physical activity.Conclusions: A bolus of 5 mg/kg theophylline increased energy expenditure independently of physical activity, increased carbohydrate utilisation, and improved respiratory compliance. The increased energy expenditure could be detrimental to the growth of the preterm infant. [ABSTRACT FROM AUTHOR]

In the May 1, 2001 issue of the journal "Thorax," researchers suggest that it is possible to distinguish different patterns of difficult childhood asthma by measuring exhaled nitrogen oxide (NO). The knowledge that severe asthma may have different phenotypes with different types of airway inflammation is not new and has been clearly shown by bronchoalveolar lavage and airway biopsy studies in adult patients. The potential importance of these data lies in the classification of different patterns by using a non-invasive instantaneous measurement such as NO. Exhaled NO levels are known to be increased in atopic asthma, to increase during an exacerbation, to decrease with anti-inflammatory therapy, and to rise as the dose of inhaled steroids is reduced.