Detection and Quantification of Exhaled Breath Condensate and Dyspnea Correlation in Stable COPD: A Proof-of-Concept Study.

BACKGROUND: The existing research data are still not able to provide an answer to the issue of the correlation between dyspnea and inflammation in stable chronic obstructive pulmonary disease (COPD). The purpose of this study was to assess the possible relationship between a noninvasive medium called the exhaled breath condensate (EBC) and dyspnea in stable COPD patients. METHODS: A group of ten patients (five with and five without COPD) participated. The exhaled breath condensate was analyzed for the first time with a high-resolution device, the Accusizer 780SIS. The particle concentration of the EBC was measured and correlated with tools used for dyspnea assessment and clinical picture (modified Research Council dyspnea scale, mMRC scale; modified Borg dyspnea scale; and COPD Assessment Test, CAT scale). Because of the very small sample size (Ν = 10), bootstrapping method (applying 5000 bootstrap resamples with 95% confidence intervals) was used to derive robust estimates of standard errors and confidence intervals for estimates of means and correlation coefficients. Bootstrap works well in small sample sizes by ensuring the correctness of tests. RESULTS: The bootstrap means of EBC, mMRC, Borg, and CAT scales were 223863.43 (95% CI, 151308.58-297603.04), 1.30 (95% CI, 0.70-1.90), 1.55 (95% CI, 0.55-2.80), and 6.70 (95% CI, 4.80-8.60), respectively. The bootstrap Pearson's correlation coefficient (r) of EBC, mMRC, Borg, and CAT scales were 0.889 (95% CI, 0.716-0.979), 0.641 (95% CI, -0.542-0.887), and 0.569 (95% CI, -0.184-0.912), respectively. CONCLUSIONS: The effect size of the correlations is significantly high at the 0.01 level (two-tailed) between the EBC and the mMRC scale, less high at the 0.05 level (two-tailed) between the EBC and the Borg dyspnea scale and marginally with the CAT scale, respectively. Studies with larger samples will be needed to obtain more reliable results.

Exhaled Breath Condensate and Dyspnea in COPD.

Chronic obstructive pulmonary disease (COPD) possesses a crucial position in the field of respiratory medicine as there are still unsolved issues in its whole spectrum. One promising tool that is believed to provide answers to various problems in COPD is the exhaled breath condensate (EBC). Its wealth due to its content mirrors the ongoing actions taking place in the lungs and especially the two processes blamed for the pathophysiology of COPD, the inflammation and the oxidative stress. Attempts to connect the products of the analysis of the EBC with the clinical manifestations of COPD such as dyspnea are scarce. Up to date research has shown a positive correlation between the elevated levels of some markers of EBC such as H2O2 and 8-isoprostane and dyspnea, while others present ambiguous results. The severity of COPD also seems to be connected with their increase. The purpose of this chapter is to highlight these findings and present potential correlations. Further research in EBC and its association with the clinical phenotypes of COPD and especially dyspnea is necessary.

Controlling the Chimera Form in the Leaky Integrate-and-Fire Model.

We study the influence of broken connectivity and frequency disorder in systems of coupled neuronal oscillators. Under nonlocal coupling, systems of nonlinear oscillators, such as Kuramoto, FitzHugh-Nagumo, or integrate-and-fire oscillators, demonstrate nontrivial synchronization patterns. One of these patterns is the "chimera state," which consists of coexisting coherent and incoherent domains. In networks of biological neurons, the connectivity is not always perfect, but might be locally broken or interrupted due to pathologies, neuron degenerative disorders, or accidents. Our simulations show that destructed connectivity drastically affects synchronization, driving the coherent parts of the chimera state to cover symmetrically the region where the anomaly is located. The network synchronization decreases with the size of the destructed region as evidenced by the Kuramoto synchronization index. To the contrary, when keeping the connectivity of all nodes intact, altering the frequency in a block of oscillators drives the incoherent part of the chimera state toward the anomaly. This work is in line with recent dynamical approaches aiming to locate anomalies in the structure of brain networks, in particular when the anomalies have small, difficult-to-detect sizes.