Transparency as a Means to Analyse the Impact of Inertial Sensors on Users during the Occupational Ergonomic Assessment: A Systematic Review.

The literature has yielded promising data over the past decade regarding the use of inertial sensors for the analysis of occupational ergonomics. However, despite their significant advantages (e.g., portability, lightness, low cost, etc.), their widespread implementation in the actual workplace has not yet been realized, possibly due to their discomfort or potential alteration of the worker's behaviour. This systematic review has two main objectives: (i) to synthesize and evaluate studies that have employed inertial sensors in ergonomic analysis based on the RULA method; and (ii) to propose an evaluation system for the transparency of this technology to the user as a potential factor that could influence the behaviour and/or movements of the worker. A search was conducted on the Web of Science and Scopus databases. The studies were summarized and categorized based on the type of industry, objective, type and number of sensors used, body parts analysed, combination (or not) with other technologies, real or controlled environment, and transparency. A total of 17 studies were included in this review. The Xsens MVN system was the most widely used in this review, and the majority of studies were classified with a moderate level of transparency. It is noteworthy, however, that there is a limited and worrisome number of studies conducted in uncontrolled real environments.

Performance assessment of the integration of semitransparent solar cells with different geometry of greenhouses under different climate regions.

A lack of resources and suitable farming lands, climate change, and a rapidly growing population are some of the main concerns of the societies that pose security challenges to the governments. Creating controlled environments for cultivation, growing plants, and farming, such as greenhouses, may assist in overcoming these challenges. Greenhouses can significantly increase land use efficiency in agriculture by increasing crop yield and harvesting throughout the year, which has long been proven effective. The history of greenhouses for farming dates back to Roman times, and there are different barriers to their applications. An example is the provision of energy to control the cultivation conditions of plants in greenhouses, particularly for heating and cooling hot and cold climate areas. On the other hand, based on the global energy trend, decentralized energy production based on solar energy is highly regarded. In the same way, that households can harvest solar energy, greenhouses can also benefit from solar energy. However, because greenhouses need sunlight to cultivate plants, reducing sunlight using common photovoltaic panels is not logical. By incorporating semitransparent solar cells into these greenhouses, the issue of reduced sunlight could be addressed, and further efficiency gains could be achieved by reducing energy demand in these greenhouses. This research investigates the energy supply system's integration with greenhouses consumption. First, we assess different conventional types of greenhouses in terms of energy demand. Then, we investigate the energy demand with organic photovoltaic (OPV) integration for each type. Finally, the best design of the greenhouse for OPV integration is recommended. Results show that flat arch geometry is the best choice for dry and cold climates, while sawtooth geometry showed better improvements in tropical climates. In both temperate/mesothermal and continental/microthermal climates, A-frame geometry showed superiority in energy saving. Simulations revealed an annual electricity generation for a unit floor area of the greenhouses to be 173.7 kWh/m2 to 247.9 MWh/m2 for the optimum structural geometries that decrease the energy consumption of greenhouses. Additionally, the results show that the installation of the OPV can decrease energy consumption from 15 to 58% based on the greenhouse's location and structural geometry.

Comparative analysis of IoT-based controlled environment and uncontrolled environment plant growth monitoring system for hydroponic indoor vertical farm.

Agriculture is a very important economic sector that contributes to a nation's overall economic development. According to the UN Food and Agriculture Organization, with a rising population, the cereals demand will reach 3 billion tons by 2050. Also, the mission of Sustainable Development Goals (SDGs) is to provide zero hunger and sustainable agriculture by 2030. With a simultaneous decline in cultivable land and water scarcity, food production has to increase in order to achieve the above mission. Vertical farming is a current state of art agriculture technology to increase crop yield per unit area. This work focuses on designing and constructing an IoT-enabled smart vertical farming system with a controlled environment for plant growth. This system uses the hydroponic Deep Flow Technique (DFT), various sensors, and an auto pH and Total Dissolved Solids (TDS) balancing system. This paper provides a comparative analysis of IoT-based controlled environment vertical farming setup with the uncontrolled setup for Romaine lettuce in terms of plant growth parameters like plant height, maximum leaf length, maximum leaf width, and fresh and dry weight of the plant. The observed fresh weight of the aerial part for automated and unautomated setup is found to be 58.66 g and 48.81 g respectively. Also, the chemical analysis showed the plants possess the required optimum range of micro and macronutrients for both setups. The macronutrient results obtained for the controlled/automated (A setup), and uncontrolled/unautomated setup (U setup for Phosphorus (P), and Potassium (K) are (PA, PU) (5.91 g/Kg, 6.06 g/Kg), and (KA, KU) (67.03 g/Kg, 74.01 g/Kg) respectively.

Evaluation of the Results of a Periodic Environmental Biosecurity Assessment Program on Air Quality in Controlled Environment Rooms of Hospitals.

AIM: Determine the utility of the Periodic Environmental Biosecurity Assessment Program (PEBAP) in achieving clean air as measured by the number of colony-forming units (CFU) of fungi and bacteria in the air. BACKGROUND: There is no international consensus on the sampling frequency, the recommended limits for microorganisms in the air nor on the usefulness of routine microbiological air monitoring of hospitals. METHODS: During the PEBAP, data were recollected between 2010 and 2017 in eight hospitals in southeast Spain. Air samples were collected in very high risk rooms (VHRRs) and high risk rooms (HRRs), unoccupied, using active sampling methods. Temperature, relative humidity, air changes per hour (ACH), and differential pressure were measured. When limits of CFU of opportunistic fungi and bacteria established in the PEBAP were exceeded, corrective measures were adopted. RESULTS: We found a reduction (p < .01) of percentage of air samples with fungi growth throughout the years of PEBAP in all rooms. Aspergillus was the most frequent opportunistic fungus. We found a high compliance of the standards of CFU of bacteria in HRR, and the percentage of compliance in VHRR was lower than in HRR in all years. Differences in environmental and design parameters were statistically significant (p < .05) between rooms, except for ACH. CONCLUSIONS: PEBAP resulted in a useful tool to maintain and improve air quality in hospitals. The control of environmental biosecurity requires a multidisciplinary approach from preventive medicine, engineering, and cleaning services. Aspergillus is the most frequent opportunistic fungus in southeast Spain.

Assessment of Selected Commercially Available Seed Treatments on Suppressing the Effects of Red Crown Rot on Soybeans Under a Controlled Environment.

Calonectria ilicicola is a soilborne fungus responsible for red crown rot (RCR) in soybeans. Recently, this disease has been detected in new areas within the United States and Asia, where it has been reported to cause significant yield losses. To date, no data on the efficacy of fungicide seed treatments for suppressing RCR in soybeans are available. We screened three commercially available soybean seed treatments (Acceleron STANDARD; Acceleron STANDARD + IleVO; Cruiser MAXX + Saltro) for impacts on germination, seedling growth, and disease caused by C. ilicicola under controlled laboratory conditions. The Cruiser MAXX + Saltro treatment improved final plant dry mass to levels similar to noninoculated controls. Both Acceleron STANDARD + IleVO and Cruiser MAXX + Saltro reduced percent root rot. Acceleron STANDARD alone did not impact root rot, indicating that the IleVO component was efficacious on C. ilicicola. These data indicate that IleVO and Cruiser MAXX + Saltro have potential for reducing early season impacts of RCR in soybeans. Future work assessing these seed treatments in field-grown soybeans is needed to better understand the role of seed treatments as components of an integrated management program for RCR.

National Economic and Environmental Benefit of Reusable Textiles in Cleanroom Industry.

In cleanroom facilities, both disposable and reusable textile garments (coveralls, boots, hoods, and frocks) meet the particulate standards from the most rigorous to the most basic levels. However, the reusables clearly offer two other important benefits, lower annual cost and lower environmental impact. The objectives of this article are to now provide quantitative reusable product benefits on a U.S. national environmental and economic basis. This is the first quantitative, novel multi-user economic evaluation of selecting cleanroom reusables over disposables. For personal protection equipment (PPE), these cost and environmental benefits indicate there is also an improved environmental and economic aspect to the increased national demand for reusables related to coronavirus disease 2019 (COVID-19), while necessary cleaning with approved detergents is easily achieved. The current reusable cleanroom market (14.1 million packages) was estimated to be 60% nonsterile and 40% sterilized. The total market is about 50% reusable and 50% disposable. This research documents that there is an annual cost reduction of about 58% when selecting reusables over disposables, giving an economic savings to the U.S. cleanroom sector from reusables of about $1.2 billion in the next decade. This is also saving the total U.S. about 136 million MJ natural resource energy/year (38 million kWh) and about 8.4 million kg CO2eq annually (removal of about 1,650 cars/year). A maximum hypothetical case for reusables at 87.5% of the market (12.5% are mandatory Hazmat disposable) would yield a U.S. national savings of nearly $2.1 billion/decade to the cleanroom sector bottom line, as well as 2.4 billion MJ nre savings in energy or removal of about 29,000 cars/decade. These results indicate there are effective, verifiable, and easily obtained environmental and economic benefits by the basic transition by diverse cleanrooms in deciding to select reusable garments.

Assessing the value of complex refractive index and particle density for calibration of low-cost particle matter sensor for size-resolved particle count and PM2.5 measurements.

Low-cost optical scattering particulate matter (PM) sensors report total or size-specific particle counts and mass concentrations. The PM concentration and size are estimated by the original equipment manufacturer (OEM) proprietary algorithms, which have inherent limitations since particle scattering depends on particles' properties such as size, shape, and complex index of refraction (CRI) as well as environmental parameters such as temperature and relative humidity (RH). As low-cost PM sensors are not able to resolve individual particles, there is a need to characterize and calibrate sensors' performance under a controlled environment. Here, we present improved calibration algorithms for Plantower PMS A003 sensor for mass indices and size-resolved number concentration. An aerosol chamber experimental protocol was used to evaluate sensor-to-sensor data reproducibility. The calibration was performed using four polydisperse test aerosols. The particle size distribution OEM calibration for PMS A003 sensor did not agree with the reference single particle sizer measurements. For the number concentration calibration, the linear model without adjusting for the aerosol properties and environmental conditions yields an absolute error (NMAE) of ~ 4.0% compared to the reference instrument. The calibration models adjusted for particle CRI and density account for non-linearity in the OEM's mass concentrations estimates with NMAE within 5.0%. The calibration algorithms developed in this study can be used in indoor air quality monitoring, occupational/industrial exposure assessments, or near-source monitoring scenarios where field calibration might be challenging.

Step detection and energy expenditure at different speeds by three accelerometers in a controlled environment.

Physical activity (PA) is one of the most efficient ways to prevent obesity and its associated diseases worldwide. In the USA, less than 10% of the adult population were able to meet the PA recommendations when accelerometers were used to assess PA habituation. Accelerometers significantly differ from each other in step recognition and do not reveal raw data. The aim of our study was to compare a novel accelerometer, Sartorio Xelometer, which enables to gather raw data, with existing accelerometers ActiGraph GT3X+ and activPAL in terms of step detection and energy expenditure estimation accuracy. 53 healthy subjects were divided into 2 cohorts (cohort 1 optimization; cohort 2 validation) and wore 3 accelerometers and performed an exercise routine consisting of the following speeds: 1.5, 3, 4.5, 9 and 10.5 km/h (6 km/h for 2nd cohort included). Data from optimization cohort was used to optimize Sartorio step detection algorithm. Actual taken steps were recorded with a video camera and energy expenditure (EE) was measured. To observe the similarity between video and accelerometer step counts, paired samples t test and intraclass correlation were used separately for step counts in different speeds and for total counts as well as EE estimations. In speeds of 1.5, 3, 4.5, 6, 9 and 10.5 km/h mean absolute percentage error (MAPE) % were 8.1, 3.5, 4.3, 4.2, 3.1 and 7.8 for the Xelometer, respectively (after optimization). For ActiGraph GT3X+ the MAPE-% were 96.93 (87.4), 34.69 (23.1), 2.13 (2.3), 1.96 (2.6) and 2.99 (3.8), respectively and for activPAL 6.55 (5.6), 1.59 (0.6), 0.81 (1.1), 10.60 (10.3) and 15.76 (13.8), respectively. Significant intraclass correlations were observed with Xelometer estimates and actual steps in all speeds. Xelometer estimated the EE with a MAPE-% of 30.3, activPAL and ActiGraph GT3X+ with MAPE percentages of 20.5 and 24.3, respectively. The Xelometer is a valid device for assessing step counts at different gait speeds. MAPE is different at different speeds, which is of importance when assessing the PA in obese subjects and elderly. EE estimates of all three devices were found to be inaccurate when compared with indirect calorimetry.

Assessment of the effects of exposure to extremely low-frequency magnetic fields on MDCK epithelial cell lines under a controlled environment.

To assess the effects of exposure to extremely low-frequency magnetic fields (ELF-MFs) on MDCK cell lines, experiments were performed in a chamber under controlled conditions (temperature, humidity and CO2). Therefore, the measured physicochemical and electrical changes in the cells are due solely to the magnetic field exposure and not to external factors. A developed sinusoidal magnetic field generator produced the ELF-MFs with a uniform magnetic field and adjustable intensity and frequency. Three experimental indicators were used: (i) transepithelial electrical impedance (TEEI); (ii) cell migration and proliferation; and (iii) expression of the proteins of the tight junctions, and changes in the area and shape of the cell nuclei. No significant effects on TEEI values were observed when 10 and 50 G 60 Hz magnetic fields were applied to confluent cell monolayers. There were no significant differences in migration and proliferation of the cell monolayer exposed to 60 Hz magnetic fields10 and 50 G , but a contact inhibition factor was observed. The expression of the CLDN-1 protein decreased by 90% compared with the control, while ZO-1 protein expression increased by 120%. No significant effects were observed in the area and shape of the cell nuclei. Experimentation in a controlled environment, under physiological conditions, ensures that the observed effects were strictly due to exposure to magnetic fields. Different exposure conditions are necessary to determine the impact on TEEI and cell migration-proliferation indicators.

Health technology assessment: Choice between a cytotoxic safety cabinet and an isolator for oncology drug reconstitution in Tunisia.

INTRODUCTION: In order to implement a centralized cytotoxic reconstitution unit (CCRU), a study was conducted to compare the implementation costs of a CCRU equipped with a cytotoxic safety cabinet (CSC) and one equipped with an isolator with negative pressure. MATERIALS AND METHODS: This study compares items such as infrastructure, air treatment and CCRU qualification costs, equipment's purchase and qualifications costs, as well as staff dressing costs. Two plans were elaborated according to the international recommendations in a way that they respond to the necessary requirements in both cases. Requests for quotes for the compared items were sent to different suppliers. RESULTS: The implementations' cost of a CCRU equipped with a CSC is cheaper than the one equipped with an isolator. The price of an isolator is much higher than a CSC; its qualification is also more expensive. However, the requirements and the costs for the air treatment and the dressing of the staff are less in the case of an isolator. The overall cost of the CCRU's implementation is approximately 1.3 times higher in the case of an isolator. However, by excluding the equipment purchase cost, the overall cost of a CSC's implementation becomes higher. CONCLUSION: For Tunisia, it seems that the CSC is the most adapted. However, this work should be completed by the comparison of the CCRU's operating costs in order to optimize the resources and figure out the cheapest system.

Pediatric lung function testing during a pandemic: An international perspective.

The COVID pandemic has passed its first peak for now in many countries while some are still on the rise, with some facing a second wave of cases. Precautions and infection control measures for both pediatric and adult pulmonary function testing (PFT) have been a topic of debate during the pandemic. Many centers had to close their PFT laboratories during the initial periods of the pandemic and are reopening as the numbers of new cases are decreasing. This review aims to summarize different practices of PFT laboratory management in different countries, including patient appointments, personal protective equipment, testing room requirements and telemedicine during and immediately following the COVID pandemic.

Wheat yield potential in controlled-environment vertical farms.

Scaling current cereal production to a growing global population will be a challenge. Wheat supplies approximately one-fifth of the calories and protein for human diets. Vertical farming is a possible promising option for increasing future wheat production. Here we show that wheat grown on a single hectare of land in a 10-layer indoor vertical facility could produce from 700 ± 40 t/ha (measured) to a maximum of 1,940 ± 230 t/ha (estimated) of grain annually under optimized temperature, intensive artificial light, high CO2 levels, and a maximum attainable harvest index. Such yields would be 220 to 600 times the current world average annual wheat yield of 3.2 t/ha. Independent of climate, season, and region, indoor wheat farming could be environmentally superior, as less land area is needed along with reuse of most water, minimal use of pesticides and herbicides, and no nutrient losses. Although it is unlikely that indoor wheat farming will be economically competitive with current market prices in the near future, it could play an essential role in hedging against future climate or other unexpected disruptions to the food system. Nevertheless, maximum production potential remains to be confirmed experimentally, and further technological innovations are needed to reduce capital and energy costs in such facilities.

Risk Assessment for Use of a Porcine Circovirus-Contaminated Reagent in a Barrier Maintained Rodent Colony.

A proposal for the use of porcine pancreatic elastase (PPE) to develop a mouse model of pulmonary emphysema raised concerns about introducing contaminating porcine viruses into our barrier facility. Porcine Circovirus (PCV) is a known contaminant of vaccines and cell cultures that have been exposed to porcine-derived reagents. Endemic infection of PCV3 in laboratory mice has been reported, and some evidence supports natural PCV infection in wild mice. PPE samples from 2 different vendors tested positive for DNA from both PCV2 and 3. To allow model development with these reagents to proceed, we developed a protocol that would meet scientific objectives, minimize exposure of mice, and provide information on the potential for the virus to spread. Five d after BALB/c mice received intralaryngeal administration of PPE, lungs were harvested and analyzed for evidence of disease. Tissues from other major organs were submitted to test for disseminated PCV2 and 3 DNA. Similarly, tissues (including lungs) from direct contact nude sentinel mice were analyzed for the presence of the virus. To evaluate the possibility of endemic PCV2/3 infection, we also surveyed non-porcine reagent exposed mice on other studies. PCV2 and 3 was not detected in any of the tissues submitted. Although this study provided no evidence of infection and transmission of PCV2/3 from the contaminated PPE sample over the 5 d study, further work is needed to understand the risks and impact of introducing PCV contaminated cells or reagents into barrier maintained rodent colonies.

Good design practices for an integrated containment and production system for advanced therapies.

Advances in molecular biology and the possibility of differentiating stem cells have opened up new scenarios in therapies that use progenitor or variously differentiated cells. Regardless of the choice of the system, designing a plant for producing advanced therapies requires a clear understanding of the final objective (the product), taking into account all the regulatory, environment, process, risk assessment, asepsis, and validation aspects involved until its implementation. Good Manufacturing Practice (GMP) compliant procedures are a prerequisite for cell production in clinical application, and clean rooms are zones for producing cell therapies. Clean rooms for clinical application require high running and maintenance costs and need trained operators and strict procedures to prepare the rooms and the people involved in the processes. While today production mainly occurs in open systems (clean rooms), there is evidence of processes in closed systems (isolators). The isolator is a Grade A aseptic closed system that requires a controlled environment and at least a Grade D environment in the case of sterile productions (A in D closed system). The use of isolators can ensure a very high level of protection against the risk of product contamination and, at the same time, provide the operators with a very safe working environment. Furthermore, working with closed systems can optimize and facilitate the production of Advanced Therapy Medical Products in GMP environments, by providing an easily reproducible working tool even for large-scale production, with generally lower costs compared to a classical clean room approach. In conclusion, the isolator workstation as a possible alternative to the classic clean room, due to its small size and the simplification of the working and maintenance operational procedures, may represent an interesting solution in the perspective of the increasingly more stringent requests for cost reductions of GMP in clinical application.

Assessment of endoscope cleaning and disinfection efficacy, and the impact of endoscope storage on the microbiological safety level.

AIMS: The aim of the study was microbiological evaluation of the efficacy of cleaning and disinfection of endoscopes carried out with the use of endoscope washer-disinfector EndoCleaner and evaluation of the endoscope storage cabinet providing a controlled environment. METHODS AND RESULTS: The efficacy evaluation of endoscope cleaning and disinfection using the endoscope washer-disinfector EndoClener (AORT) was carried out in accordance with the PN-EN ISO 15883 standard, and the validity of endoscope storage cabinet (TRIBO LLC) was evaluated in accordance with the PN-EN 16442 standard. The micro-organism tested used in the study were as follows: Pseudomonas aeruginosa ATCC® 15442™, Enterococcus faecium ATCC® 12952™, Clostridium sporogenes ATCC® 19404™ (spores), Candida albicans ATCC® 90028™ and Aspergillus brasiliensis DSM® 1988™ (surrogate for Asperigllus niger ATCC® 16404™). It was demonstrated that the endoscope reprocessing carried out in the washer-disinfector EndoCleaner guaranteed the elimination of the micro-organism tested, and the tested endoscope storage cabinet met the microbiological criteria defined by the Polish standard PN-EN 16442 in the scope of tests. CONCLUSION: The obtained results showed that usage of washer-disinfector EndoCleaner and endoscope storage cabinet ensures the microbiological safety of using endoscopes. SIGNIFICANCE AND IMPACT OF STUDY: The increase in the frequency of procedures applying endoscopes contributes to the increased risk of transmission of potentially pathogenic micro-organisms remaining after insufficient cleaning and disinfection of these devices. Research allows assessing the effectiveness of antimicrobial cleaning and disinfection of endoscopes and the safety of storing this equipment in an endoscope cabinet. A particularly innovative aspect is equipping the cabinet with a module generating the phenomenon of radiant catalytic ionization, which is a unique solution on the market. This is one of the very few works involving the assessment of each stage, that is contamination, washing and disinfection, drying and storage of endoscopes.

Nesting box imager: Contact-free, real-time measurement of activity, surface body temperature, and respiratory rate applied to hibernating mouse models.

Noncontact methods to measure animal activity and physiology are necessary to monitor undisturbed states such as hibernation. Although some noncontact measurement systems are commercially available, they are often incompatible with realistic habitats, which feature freely moving animals in small, cluttered environments. A growing market of single-board computers, microcontrollers, and inexpensive sensors has made it possible to assemble bespoke integrated sensor systems at significantly lower price points. Herein, we describe a custom-built nesting box imager (NBI) that uses a single-board computer (Raspberry Pi) with a passive infrared (IR) motion sensor, silicon charge-coupled device (CCD), and IR camera CCD to monitor the activity, surface body temperature, and respiratory rate of the meadow jumping mouse during hibernation cycles. The data are logged up to 12 samples per minute and postprocessed using custom Matlab scripts. The entire unit can be built at a price point below US$400, which will be drastically reduced as IR (thermal) arrays are integrated into more consumer electronics and become less expensive.

Nocturnal temperature-controlled laminar airflow device for adults with severe allergic asthma: the LASER RCT.

BACKGROUND: Severe asthma exacerbations are costly to patients and the NHS, and occur frequently in severely allergic patients. OBJECTIVE: To ascertain whether or not nocturnal temperature-controlled laminar airflow (TLA) device usage over 12 months can reduce severe exacerbations and improve asthma control and quality of life compared with a placebo device, while being cost-effective and acceptable to adults with severe allergic asthma. DESIGN: A pragmatic, multicentre, randomised, double-blind, placebo-controlled, parallel-group, superiority trial with qualitative interviews. The trial included an internal pilot with qualitative focus groups. SETTING: Fourteen hospitals in the UK that manage patients with severe asthma. PARTICIPANTS: Adults (16-75 years) with severe, poorly controlled, exacerbation-prone asthma despite high-intensity treatment, and who are sensitised to a perennial indoor aeroallergen. INTERVENTION: Nocturnal, home-based TLA treatment using an Airsonett® (Airsonett AB, Ängelholm, Sweden) device. The comparator was a placebo device that was identical to the active device except that it did not deliver the laminar airflow. Participants were allocated 1 : 1 to TLA therapy or placebo, minimised by site, origin of case, baseline severe exacerbation frequency, maintenance oral corticosteroid use and pre-bronchodilator forced expiratory volume in 1 second. MAIN OUTCOME MEASURES: Primary outcome - frequency of severe asthma exacerbations occurring within the 12-month follow-up period, defined as worsening of asthma requiring systemic corticosteroids [≥ 30 mg of prednisolone or equivalent daily (or ≥ 50% increase in dose if on maintenance dose of ≥ 30 mg of prednisolone)] for ≥ 3 days. Secondary outcomes - changes in asthma control, lung function, asthma-specific and global quality of life for participants, adherence to the intervention, device acceptability, health-care resource use and cost-effectiveness. RESULTS: Between May 2014 and January 2016, 489 patients consented to participate in the trial, of whom 249 failed screening and 240 were randomised (n = 119 in the treatment group and n = 121 in the placebo group); all were analysed. In total, 202 participants (84%) reported use of the device for 9-12 months. Qualitative analyses showed high levels of acceptability. The mean [standard deviation (SD)] rate of severe exacerbations did not differ between groups [active 1.39 (1.57), placebo 1.48 (2.03); risk ratio 0.92, 95% CI 0.66 to 1.27; p = 0.616]. There were no significant differences in secondary outcomes for lung function, except for a reduction in mean daily peak expiratory flow [mean (SD) difference 14.7 l/minute (7.35 l/minute), 95% CI 0.32 to 29.1 l/minute; p = 0.045) for those in the active device group. There were no differences in asthma control or airway inflammation and no serious harms related to the device. No significant difference between the groups in quality-adjusted life-years gained over 1 year was observed. In addition, there was no difference in generic or disease-specific health-related quality of life overall, although statistically significant higher quality of life at month 6 was observed. Increases in quality of life were not sufficient to offset the annual costs associated with use of the TLA device. LIMITATIONS: Missing outcome data could have resulted in an underestimation of exacerbations and rendered the study inconclusive. CONCLUSIONS: Within the limits of the data, no consistent benefits of the active device were demonstrated, and the differences observed were not sufficient to make the device cost-effective. The types of patients who may benefit from the TLA device, and the reasons for large reductions in exacerbation frequency in severe asthma trials, which also incorporate other methods of recording exacerbations, need to be explored. TRIAL REGISTRATION: Current Controlled Trials ISRCTN46346208. FUNDING: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 29. See the NIHR Journals Library website for further project information.

Allergies (along with viruses) are common triggers of asthma exacerbations or 'attacks', which can cause suffering and frequent visits to the general practitioner or hospital. A new machine known as a temperature-controlled laminar airflow device, which remains at the bedside and is switched on every night, filters out allergy particles in the air of a patient's breathing zone, allowing their lungs to rest in clean air overnight. We tested whether or not this machine could improve the lives of those with severe allergic asthma. We recruited 240 people across 14 centres that treat severe asthma across the UK; approximately half received the active device and the other half received a machine that looked exactly the same but did not remove the allergens (a 'placebo' machine). One in five participants was recruited using newer methods of social media such as Facebook (Facebook, Inc., Menlo Park, CA, USA) and Twitter (Twitter, Inc., San Francisco, CA, USA). Participants found the machine easy to use and to live with and there were no significant side effects. The number of attacks reduced a lot in both participants using the active device and those who used the placebo device ­ two participants in five did not suffer any attacks during the trial. However, there was no difference in the number of attacks between the two groups. This might have been because participants did not record everything that happened to them. There was no difference in measurements showing how well the lungs were working, nor in participants' quality of life after 1 year of participating in the trial. Those who were interviewed told us that the study visits and questionnaires could be burdensome, although it was helpful to think more about their asthma. An improvement was seen in one aspect of participants' breathing as well as in their quality of life after 6 months of using the machine, but these potential health benefits could not outweigh the cost of the machine.

Phenotypic plasticity influences the success of clonal propagation in industrial pharmaceutical Cannabis sativa.

The burgeoning cannabis market requires evidence-based science such that farmers can quickly and efficiently generate new plants. In part, horticultural operations are limited by the success of cloning procedures. Here, we measured the role of environmental conditions and cultivar identity on the success of generating long branch material with many meristems in planting stock (mothers) and in rooting success of stem-derived clones. To evaluate the influence of lighting treatments on the optimal production of branching mothers, four lighting conditions (Fluorescent High Output T5s [T5], Metal halide lamps [MH], Plasma lamps [PL], or Metal halide lamps augmented with far red LED lights [MH+FR]) were applied to two cultivars of container grown plants (Cannabis sativa L. 'Bubba Kush', 'Ghost Train Haze') grown in peat-based organic substrates in mylar grow tents. To evaluate the influence of lighting, cutting tool (secateurs or scalpels), and stem wounding (present/absent) on optimal rooting of stems, three lighting conditions (Fluorescent T8s, T5, PL) were applied to three cultivars of peat pellet grown plants (C. sativa L. 'Bubba Kush', 'Ghost Train Haze', 'Headband'). Mothers grown under T5 and MH (vs MH+FR) produced ~30% more meristems. However, growing mothers under MH+FR were 19% taller than mothers under T5, with ~25% longer internodes on dominant stems than plants under any other lighting condition. Canopies were denser under T5 because petiole length was ~30% shorter under T5 and fan leaves were longer and narrower under MH+FR and MH+FR and PL, respectively, than under other lighting conditions. Cultivar Ghost Train Haze stems rooted most frequently and most quickly. Wounded stems were 162% more likely to root than unwounded stems and rooted 1.5 days earlier. Our results will guide producers attempting to maximize the rate of clone production in licensed facilities; although results may differ among cultivars, where cultivars differed in their average phenotype as mother plants, and their propensity to root from cuttings, and the speed with which they produced those roots.