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Database for the OSIPI challenge on DCE-MRI (TF6.2)

Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive and life-limiting condition of unknown cause with no curative treatment. The impact of IPF on a patient’s quality of life is devastating and palliative treatment such as pulmonary rehabilitation programmes are used to improve quality of life among these individuals, yet relatively little attention has been made to access the effectiveness of rehabilitation programs aimed designed for these patients. There are large gaps in our knowledge on the cardiorespiratory response to exercise and rehabilitation among IPF patients and this study aims to fill this gap in a physiological prospective. We quantified the effects of an eight-week pulmonary rehabilitation program for IPF patients, conducted at Morriston Hospital, Swansea. Fifteen individuals (13 with Idiopathic Pulmonary Fibrosis and two with Pulmonary Fibrosis associated with Rheumatoid Disease) underwent physical and physiological assessments during a three-day testing protocol: 1) On Day 1, physical function (six-minute walk test) and ventilatory function (spirometry) were measured; 2) On Day 2, patients’ cardio-respiratory responses to slowly-increasing, wide-ranging metabolic challenge (using a protocol consisting of periods of rest, incremental bicycle exercise to maximal effort, and post-exercise recovery) were assessed via respiratory gas analysis and ECG recording; 3) On Day 3, patients’ cardio-respiratory responses to rapid-onset, high-workload metabolic challenge were assessed (using a protocol including a rapid-onset, constant workload bicycle exercise) by modelling dynamic respiratory oxygen and heart rate responses. Respiratory gas analysis was used to measure the rate of oxygen uptake ( VO2 ) and oxygen uptake efficiency (OUES). All assessments were performed before and after participants completed the pulmonary rehabilitation programme. A Holter ECG recorder (Pathfinder/Lifecard Digital CF system; Spacelabs Medical Ltd., UK) provided continuous ECG data throughout each exercise test, from which heart rate was derived. Following the rehabilitation programme, heart rate was elevated by 11% - 18% during exercise and recovery states. Post-rehabilitation VO2 was significantly increased (p = 0.01 - 0.03) during the first two minutes of heavy-intensity exercise, whilst HR was reduced (p = 0.04) during this period. OUES and standard measures of respiratory performance (minute ventilation, peak VO2) were unchanged following rehabilitation, whilst peak HR and work rates were significantly reduced during incremental exercise only (p < 10-3). Pulmonary rehabilitation improved the rate of oxygen uptake during heavy-intensity exercise, despite substantially lower heart rates. This suggests that the rehabilitation programme increased systemic arterial-tissue oxygen exchange and/or influenced cardiovascular function to improve systemic oxygen delivery. We might therefore expect that individuals with IPF would find it easier to perform the activities of daily life, including those requiring substantial metabolic demands, following rehabilitation.

The food industry has long been searching for an efficient replacement for saturated-fatty-acid-rich fats for baking applications. Although oleogels have been considered a potential alternative for saturated and trans fats, their success in food application has been poor. The present study explored the use of oleofoams obtained by whipping the pulse protein foam-templated oleogels for cake baking. Oleogels were prepared at room temperature by adding canola oil containing high-melting monoglyceride (MAG) or candelilla wax (CW) to the freeze-dried pea or faba bean protein-stabilized foams. Oleogels were then whipped to create the oleofoams; however, only the oleogels containing MAG could form oleofoams. CW-oleogel could not form any oleofoam. The most stable oleofoams with the highest overrun, stability, and storage modulus were obtained from 3% MAG+pulse protein foam-templated oleogels. The MAG plus protein foam-templated oleogels showed smaller and more packed air bubbles than MAG-only oleofoam, which was ascribed to the protein’s ability to stabilize air bubbles and provide a network in the continuous oil phase to restrict air bubble movement. A novel batter preparation method for oleofoam was developed to increase air bubble incorporation. The X-ray microtomography images of the cakes showed a non-homogeneous distribution of larger air bubbles in the oleofoam cake compared to the shortening cake although their total porosity was not much different. The oleofoam cakes made with the new method yielded similar hardness and chewiness compared to the shortening cakes. By improving rheology and increasing air incorporation in the batter, high-quality cakes can be obtained with MAG-containing oleofoams made from pulse protein foam-templated oleogels.

RATIONALE: Structural changes to airway morphology such as increased bronchial wall thickness (BWT) and airway wall area are cardinal features of chronic obstructive pulmonary disease (COPD). Ferrets are a recently established animal model uniquely exhibiting similar clinical and pathological characteristics of COPD as humans, including chronic bronchitis. OBJECTIVES: Develop a µCT method for evaluating structural changes to the airways in ferrets, and assess whether the effects of smoking induce changes consistent with chronic bronchitis in humans. METHODS: Ferrets were exposed to mainstream cigarette smoke or air control twice daily for 6 months. µCT was conducted in vivo at 6 months; a longitudinal cohort was imaged monthly. Manual measurements of BWT, luminal diameter (LD), and BWT:LD ratio were conducted, and confirmed by a semi-automated algorithm. The square root of bronchial wall area (WA) vs. luminal perimeter was determined on an individual ferret basis. MEASUREMENTS AND MAIN RESULTS: Smoke exposed ferrets reproducibly demonstrated 34% increased BWT (P CONCLUSIONS: µCT-based airway measurements in ferrets are feasible and reproducible. Smoke exposed ferrets develop increased BWT and Pi4, changes similar to humans with chronic bronchitis. µCT can be used as a significant translational platform to measure dynamic airway morphological changes.

Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. It has a poor prognosis with a median survival of approximately 3 years, and whilst new therapies are finally beginning to offer hope of improved survival, most patients will require palliation of symptoms as their disease progresses. Whilst all patients with IPF complain of breathlessness, up to 80% develop a distressing cough, which is detrimental to their quality of life and difficult to treat. This article examines the possible causes of cough in the wider context of current theories of the pathogenesis of IPF and its associated comorbidities, which may also cause or exacerbate cough. We examine the evidence for increased cough sensitivity in patients with IPF and neuroplasticity in animal models of lung pathology. Finally, we discuss new therapies that are becoming available to treat cough in IPF and their possible mechanisms of action, and which highlight the need for further, appropriately powered studies that include objective measures of cough as an outcome.

Background Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive and life-limiting condition. From a healthcare perspective it is vital to establish effective methods of improving the quality of remaining life in these patients. This requires a detailed understanding of the multiple impacts of an IPF diagnosis on the individual. Methods We sought to understand how patients coped with their initial diagnosis, how they live with the disease day-to-day, and their experiences and opinions of the professional support they receive. A patient-centred approach was used to explore the social, psychological and physical impacts of IPF. Semi-structured interviews were conducted by an experienced academic. Interview questions were written by the researchers but guided by informal conversations with patients and clinicians. An inductive thematic approach was used to analyse the data, allowing us to identify common themes in the patients’ experiences. Results Of fifty invited participants, ten took part in the study (aged 53–81 years; 9 male). Inductive analysis of interviews identified seven second-order themes and eleven first-order themes, represented by two General Dimensions: ‘Patient experience with the condition’ and ‘Patient-led recommendations for practice’. The key message on ‘coping’ in these patients was that acceptance of their condition led to a sense of optimism. Participants reported using appraisal-focused coping strategies to change their perspectives (thinking positively) and emotion-focused strategies to overcome depression (the main opportunity for emotional expression being an IPF support group). The support group also facilitated problem-focused coping: individuals exchanged knowledge and experience and gave one another tips on how to live with their condition. Conclusions Health professionals should provide patients with information that focuses on living with IPF, encouraging them to make lifestyle changes and adaptations to improve quality of life. Family members should receive education about IPF so that they can support such changes. Patients should be encouraged to join a support group and to participate in physical activity (again preferably group-based). This study offers novel findings that will help inform much-needed changes in the practice of supporting IPF patients to cope with their diagnosis and disease progression.

SummaryVenous thromboembolism (VTE) is common in cancer patients, and is the second commonest cause of death associated with the disease. Patients with chronic inflammation, such as cancer, have been shown to have pathological clot structures with modulated mechanical properties. Fractal dimension (df) is a new technique which has been shown to act as a marker of the microstructure and mechanical properties of blood clots, and can be performed more readily than current methods such as scanning electron microscopy (SEM). We measured df in 87 consecutive patients with newly diagnosed lung cancer prior to treatment and 47 matched-controls. Mean group values were compared for all patients with lung cancer vs controls and for limited disease vs extensive disease. Results were compared with conventional markers of coagulation, fibrinolysis and SEM images. Significantly higher values of df were observed in lung cancer patients compared with controls and patients with extensive disease had higher values than those with limited disease (p< 0.05), whilst conventional markers failed to distinguish between these groups. The relationship between df of the incipient clot and mature clot microstructure was confirmed by SEM and computational modelling: higher df was associated with highly dense clots formed of smaller fibrin fibres in lung cancer patients compared to controls. This study demonstrates that df is a sensitive technique which quantifies the structure and mechanical properties of blood clots in patients with lung cancer. Our data suggests that df has the potential to identify patients with an abnormal clot micro-structure and greatest VTE risk.

Linear unselective CCR3 antagonist leads with IC(50) values in the 200 nM range were converted into low nM binding compounds selective at CCR3 by moving the piperidine nitrogen substituent to the carbon at the 2-position of the ring. Substitution of the piperidine nitrogen with simple alkyl and acyl groups was found to improve the selectivity of this new compound class. In particular, N-{3-[(2S, 4R)-1-(propyl)-4-(4-fluorobenzyl)piperidinyl]propyl}-N'-(3-acetylphenyl)urea exhibited single digit nanomolar IC(50) values for CCR3 with >100-fold selectivity against an extensive counter screen panel.

Formative research findings from 10 focus group interviews on botulism are described. Data were collected from a diverse sample of people throughout the United States in 2003, as part of a collaborative multisite initiative sponsored by the Centers for Disease Control and Prevention to improve communications materials on bioterrorism agents. Focus group guides included questions on knowledge, action, emotions, and information seeking in response to a series of scenarios on a hypothetical terrorist attack using botulinum toxin. Data were collected, transcribed, coded, and analyzed using content domains based on risk and health communications theories. Initial participant responses to scenarios were emotional, changing into immediate health and survival concerns conceptualized as information specific to the agent and event. Knowledge about botulism was low, and participants wanted clear, concise, and actionable messages. Broadcast media, the internet, and community-based sources were cited as sources of information. Findings have implications for botulism preparedness messages and for general public risk communications.

The singer-songwriter Renaud, whose work stretches from the mid-1970s to 2003, shows a constant awareness of the genre in which he is working and its place in popular cultural history. This article will concentrate on Renaud’s struggle to come to terms with his own place and status as a chanson artist, and with the place of the chanson artist generally in a commercialised and globalised music industry.Through an examination of his songs and interviews, it will briefly outline Renaud’s relationship with the music industry, exploring how his almost arrogant defiance of the industry, and the mass media generally, changes over his career as he has to come to terms with commercial success. It will explore Renaud’s reasons for the ongoing struggle with the industry and hypothesize that his distaste for commercialism is concomitant with his projection of himself as a chanson artist, which is equated as the binary other of the ‘pop’ or variétés singer. The second part of the article will focus on some of the ways in which Renaud distinguishes himself from more commercial pop singers and draws attention to himself as an auteur.It will argue that although Renaud’s own personal battles with the mass media have perhaps not been as victorious as he may have hoped, the fact that he has inspired a whole new generation of singer-songwriters working in the chanson tradition and looking to ways of mediating the genre’s roots and traditions with today’s more commercial industry, is a testament to Renaud’s own place and importance in chanson history, and reason to view his work as a valid area of academic investigation.

Background: Short courses of oral prednisolone are used as rescue therapy for severe asthma exacerbations. This study compares nebulised budesonide or oral prednisolone, both followed by budesonide Turbohaler®, as a treatment for severe asthma exacerbations, in the absence of life-threatening features. Patients and Methods: Thirteen adults admitted to hospital were randomised to receive either nebulised budesonide (4mg 8-hourly) for 48 to 72 hours followed by budesonide Turbohaler® (1600μg twice daily for 7 days, then 800μg twice daily for 21 days) for 28 days or prednisolone (40mg daily) for 9 to 11 days followed by budesonide Turbohaler® (800μg twice daily) for 21 days. The primary efficacy variable was the change from baseline at 48 hours in forced expiratory volume in 1 second (FEV1). Secondary efficacy variables included an assessment of symptom severity (0 = none, 1 = mild, 2 = moderate, 3 = severe). Results: Difficulties were experienced with patient recruitment in the emergency setting. The results presented are from an incomplete study. Change in FEV1 from baseline to 48 hours was not statistically significantly different between the groups (the study was underpowered to detect a difference in change in FEV1, as the power to detect a prespecified difference between groups was 18%). Nebulised budesonide significantly reduced the severity of wheeze after 24 hours compared with prednisolone [estimate of treatment effect = −0.95; 95% confidence intervals (CI) = −1.76 to −0.15; p = 0.0336 between groups] and 48 hours (estimate of treatment effect = −0.79; 95% CI = −1.42 to −0.15; p = 0.0326 between groups). Conclusion: While oral prednisolone or intravenous hydrocortisone, oxygen and bronchodilators are the mainstay of acute management in severe asthma, the results of this study suggest that nebulised budesonide may assist in regaining control of symptoms during exacerbations of asthma.

Because the phenomenon of dissociation has been difficult to define and disentangle from other constructs, further study of the nature of dissociative experiences and the validity of instruments measuring dissociation was conducted. In this study, multiple measures of dissociative experiences were compared with instruments measuring a variety of theoretically related constructs in a sample of 225 college students. The results supported the convergent validity of the measures of dissociative experiences, but they demonstrated relatively poor discriminant validity. However, poor discriminant validity was not specific to dissociation measures and was found for almost all of the constructs studied. This suggests that dissociation can be seen as a distinct, valid, and reliable phenomenon, and that available instruments measure the phenomenon with similar precision as instruments measuring depression, anxiety, borderline, antisocial, and posttraumatic symptoms.

B cells are important in the development of autoimmune disorders by mechanisms involving dysregulated polyclonal B-cell activation, production of pathogenic antibodies, and co-stimulation of autoreactive T cells. zTNF4 (BLyS, BAFF, TALL-1, THANK) is a member of the tumour necrosis factor (TNF) ligand family that is a potent co-activator of B cells in vitro and in vivo. Here we identify two receptors for zTNF4 and demonstrate a relationship between zTNF4 and autoimmune disease. Transgenic animals overexpressing zTNF4 in lymphoid cells develop symptoms characteristic of systemic lupus erythaematosus (SLE) and expand a rare population of splenic B-Ia lymphocytes. In addition, circulating zTNF4 is more abundant in NZBWF1 and MRL-lpr/lpr mice during the onset and progression of SLE. We have identified two TNF receptor family members, TACI and BCMA, that bind zTNF4. Treatment of NZBWF1 mice with soluble TACI-Ig fusion protein inhibits the development of proteinuria and prolongs survival of the animals. These findings demonstrate the involvement of zTNF4 and its receptors in the development of SLE and identify TACI-Ig as a promising treatment of autoimmune disease in humans.

Introduction Idiopathic pulmonary fibrosis (IPF) is a progressive, life-threatening illness of unknown aetiology, with no proven pharmacological treatments. There is a limited evidence base indicating that the disease negatively affects quality of life, leading to increased dependence, restrictions on daily activities and fatigue. However, there is a paucity of in-depth information on disease impact across its trajectory, particularly in relation to unmet needs, outcomes of importance to patients and the experiences of carers. Furthermore, little is known about the support and information needs of individuals and their carers, or at what point individual need should trigger a referral to palliative care services. Methods and analysis A mixed-methods study is proposed recruiting individuals with IPF at different stages of the disease and their carers from three respiratory centres in England and Wales. In-depth interviews will be undertaken with participants, adopting an Interpretative Phenomenological Analysis approach. The study will also use validated questionnaires to explore quality of life (EQ-5D), depression (Hospital Anxiety and Depression Scale), breathlessness (Borg dyspnoea scale) and cough (Leicester Cough Questionnaire, Cough Symptom Score). Ethics and dissemination Ethical approvals were gained in April 2012. Palliative care research is a developing field, but there has been limited focus on IPF. We anticipate that the results of the study will enable healthcare professionals to provide appropriate palliative care across the trajectory for individuals with the disease, and their carers, and we therefore aim to disseminate via relevant respiratory and palliative care journals and conferences. We will also support the lay representative involved in the project to disseminate the findings to patient groups.

We describe the case of a 29-year-old farmer who developed upper limb radiculopathy followed by myelopathy in his lower limbs. MRI findings suggested cervical disc prolapse with cord changes. Despite a successful anterior cervical decompression and fusion his symptoms rapidly returned. Further investigations ultimately diagnosed underlying neurosarcoidosis.

THE use of technology has become increasingly widespread across the globe. Findings from a feasibility study for the proposed device suggests that a population of 45-65 year olds are experienced using technology. Therefore this experience will be carried through to old age facilitating the use of emerging technologies, such as a technology driven reminiscence device. Furthermore a case study revealed that stimulation may aid communication amongst elderly people. A technology based reminiscence device is proposed as a means of facilitating communication creating bonds among elderly people. This reminiscence device in turn should alleviate loneliness by initiating conversation between elderly people. The proposed device is targeted at elderly people living in a nursing home, elderly people living alone and as a tool for care workers.

Little is known about the mechanisms which generate cough in patients with diffuse parenchymal lung disease. This article outlines some of the possible mechanisms which cause cough in patients with idiopathic pulmonary fibrosis (IPF). It goes on to discuss what is currently known about the enhanced cough reflex which afflicts patients with this condition, and describes recent evidence for enhanced expression of neurotrophins in the lungs of these patients. Preliminary data indicating that corticosteroids can reduce the cough reflex response to capsaicin and substance P in IPF offer hope that more specific therapies may be developed in the future.

The effects of parent education programs on the parenting attitudes and abilities of 30 U.S. male inmates and on the self-perceptions of their children (aged 8-17 years) were examined. Inmates were pre- and post-tested with the Adult-Adolescent Parenting Inventory and the Index of Self-Esteem. The children were administered the Self-Perception Profile for Children or the Self-Perception Profile for Adolescents. Participants in the experimental group completed a 6-week program including parental training and behavior-management training. The control group's 6-week program consisted of viewing family-related videotapes, answering questions, and discussing the contents of the videotapes. Parent education improved the attitudes of inmates toward appropriate parenting but did not significantly change their children's self-perceptions.

Introduction: Idiopathic pulmonary fibrosis (IPF) is a progressive, life-threatening illness of unknown aetiology, with no proven pharmacological treatments. There is a limited evidence base indicating that the disease negatively affects quality of life, leading to increased dependence, restrictions on daily activities and fatigue. However, there is a paucity of in-depth information on disease impact across its trajectory, particularly in relation to unmet needs, outcomes of importance to patients and the experiences of carers. Furthermore, little is known about the support and information needs of individuals and their carers, or at what point individual need should trigger a referral to palliative care services. Methods and analysis: A mixed-methods study is proposed recruiting individuals with IPF at different stages of the disease and their carers from three respiratory centres in England and Wales. In-depth interviews will be undertaken with participants, adopting an Interpretative Phenomenological Analysis approach. The study will also use validated questionnaires to explore quality of life (EQ-5D), depression (Hospital Anxiety and Depression Scale), breathlessness (Borg dyspnoea scale) and cough (Leicester Cough Questionnaire, Cough Symptom Score). Ethics and dissemination: Ethical approvals were gained in April 2012. Palliative care research is a developing field, but there has been limited focus on IPF. We anticipate that the results of the study will enable healthcare professionals to provide appropriate palliative care across the trajectory for individuals with the disease, and their carers, and we therefore aim to disseminate via relevant respiratory and palliative care journals and conferences. We will also support the lay representative involved in the project to disseminate the findings to patient groups.

Engineering Design research relies on quantitative and qualitative data to describe design-related phenomena and prescribe improvements for design practice. Given data availability, privacy requirements and other constraints, most empirical data used in Engineering Design research can bedescribed as “closed”. Keeping such data closed is in many cases necessary and justifiable. However, this closedness also hinders replicability, and thus, may limit our possibilities to test the validity and reliability of research results in the field. This paper discusses implications and applications of using the already available and continuously growing body of open data sources to create opportunities for research in Engineering Design. Insights are illustrated by an examination of two examples: a study of open source software repositories and an analysis of open business registries in the cleantech industry. We conclude with a discussion about the limitations, challenges and risks of using open data in Engineering Design research and practice.

The use of colour is an integral component in visual interface design for creating separation between objects and for conveying meaning. It has previously been established that colours can be separated in a hierarchy of primary colours and secondary colours, and that colours are consistently associated with specific mood tones. However, it has thus far not been investigated whether these two factors, which we refer to as the perception-primacy and emotion-conveyance, are associated with attentional capture in a congruent manner. To investigate this, we conducted a visual search task study in a controlled environment, in which 11 participants scanned a 20 item display for a coloured target amongst coloured distractors. We found evidence to support that primary colours capture attention significantly more than secondary colours, and inconclusive evidence that colours convey their meaning at a sufficiently early level of processing to influence attention. We end by discussing implications of our results for design practice and research in psychology.

Our modern healthcare systems commonly face an important dilemma. While they depend on innovation to provide continuously greater healthcare value, they also struggle financially with the burden of adopting a continuous flow of new products and services. Although several disruptive healthcare models, i.e. decentralised, personalised, pervasive, connected, and stratified, promise to relieve some of this tension, they do not per se guarantee optimal value generation. We argue that systems thinking and engineering design can remedy this limitation. We support this claim by making the case of Design for Evolvability and by elaborating on two examples: MRI systems and Point-of-Care in-vitro diagnostics solutions. We specifically argue that Design for Evolvability can realign the agendas of various healthcare stakeholders, serving both individual and national interests. We finally acknowledge the limitations of current engineering design practices and call for new theoretical and empirical research initiatives taking a systems perspective on healthcare product and service design.

Presented research explores the nature of teamwork activity in the conceptual design phase with an aim to unfold the patterns of team behaviour during execution of a specific design task. Teamwork activity process is observed as a sequence of analysis, synthesis and evaluation design operations applied to the problem and solution spaces. Design operations are used to represent abstract and fine- granularity steps of exploring and modifying the problem- solution space. Protocol study was conducted to investigate if teamwork activity can be decomposed into patterns of design operations and problem-solution alternation. Brainstorming sessions of two design teams were coded by employing an operation-based coding scheme. Protocol segmentation revealed the distribution of design operations and problem-solution related discussion, as well as the distribution of transitions between design operations. The emphasis is placed on the cycles of synthesis and analysis that appear within both problem and solution space, but also in-between the two spaces, thus indicating the co-evolution of the problem-solution space. These findings support and complement what has been reported in the literature.

Understanding the role of iterations is a prevalent topic in both design research and design practice. Furthermore, the increasing amount of data produced and stored by companies leaves traces and enables the application of data science to learn from past design processes. In this article, we analyse a documentlog to show the temporal evolution of a real design process of a power plant by using exploratory data analysis and network analysis. We show how the iterative nature of the design process is reflected in archival data and how one might re-construct the design process, involving iterations between many parties, including the client, external consultants, suppliers, and designers. We also show how people use different representations during the design process and how this is associated with a design phasetransition in the process. Finally, we relate our findings with the literature on iterations and discuss implications for research and practice with application to project management and process modelling.

Product design presents an ethical dilemma. Despite increasing awareness of limited resources the majority of product design endeavours contribute to unsustainable over-consumption. Is the product design industry self-fulfilling; creating products in order to create more products and manufacturing demand to follow suit? Through complacency has product design become unintentionally harmful and morally questionable, has it become the greatest “evil” of our time? This paper intends to provoke thought and reflection over the role of the designer and their responsibilities. Literature on the subject of ethics, morality and responsibility in product design is reviewed and discussed, the key agents who possess responsibility in design are also explored. It is proposed that designers, while aware of sustainability concerns, possess a diminished sense of personal responsibility for these concerns. A study was conducted to assess the level of empathy possessed by product designers in this regard, it is concluded that while on the whole product designers are empathetic they are complacent with respect to environmental concerns to the extent that it may be considered harmful and damaging.

Design thinking has received an increasing amount of attention in both practice and academia. Previous research has successfully pointed out design thinking is vaguely and diversely defined, presenting eight different discourses. Although design thinking has been viewed from different perspectives with diverse results, much current research use the terms of design thinking without clarification of the relation to one another; this creates confusion. With this paper we clarify design thinking. Through a review of key literature and a conceptual synthesis, we show design thinking is not merely a process or either of eight suggested discourses-but all of them. Thinking like a designer is a paradigm, which may materialize in various forms. It is a way of seeing and interacting with the world. It is a world-view. By categorising central themes from key literature, we add to the current discussion with a coherent conceptual framework of design thinking. A taxonomy of the design thinking paradigm, which provide clarity of levels, since there in current literature are no clear distinction between the fundamental paradigm, methods and practical tools and techniques of design thinking.