bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental Forcing of Upper-Tropospheric Cold Low on Tropical Cyclone Intensity and Structural Change
Authors: Chen Yu-An , Wu Chun-Chieh
Published: January 2023

The interaction between Typhoon Nepartak (2016) and the upper-tropospheric cold low (UTCL) is simulated to better understand the impact of UTCL on the structural and intensity change of tropical cyclones (TCs). An experiment without UTCL is also performed to highlight the quantitative impacts of UTCL. Furthermore, idealized sensitivity experiments are carried out to further investigate the specific TC–UTCL configurations leading to different interactions. It is shown that a TC interacting with the UTCL is associated with a more axisymmetric inner-core structure and an earlier rapid intensification. Three plausible mechanisms related to the causality between a UTCL and the intensity change of TC are addressed. First, the lower energy expenditure on outflow expansion leads to higher net heat energy and intensification rate. Second, the external eddy forcing reinforces the secondary circulation and promotes further TC development. Ultimately, the shear-induced downward and radial ventilation of the low-entropy air is unexpectedly reduced despite the presence of UTCL, leading to stronger inner-core convections in the upshear quadrants. In general, the TC–UTCL interaction process of Nepartak is favorable for TC intensification owing to the additional positive effect and the reduced negative effect. In addition, results from sensitivity experiments indicate that the most favorable interaction would occur when the UTCL is located to the north or northwest of the TC at a stable and proper distance of about one Rossby radius of deformation of the UTCL.
Insights in Hailstorm Dynamics through Polarimetric High-Resolution X-Band and Operational C-Band Radar: A Case Study for Vienna, Austria
Authors: Klaus Vinzent , Rieder Harald , Kaltenböck Rudolf
Published: January 2023

Data from a dual-polarized, solid-state X-band radar and an operational C-band weather radar are used for high-resolution analyses of two hailstorms in the Vienna, Austria, region. The combination of both radars provides rapid-update (1 min) polarimetric data paired with wind field data of a dual-Doppler analysis. This is the first time that such an advanced setup is used to examine severe storm dynamics at the eastern Alpine fringe, where the influence of local topography is particularly challenging for thunderstorm prediction. We investigate two storms transitioning from the pre-Alps into the Vienna basin with different characteristics: 1) A rapidly evolving multicell storm producing large hail (5 cm), with observations of an intense ZDR column preceding hail formation and the rapid development of multiple pulses of hail; and 2) a cold pool–driven squall line with small hail, for which we find that the updraft location inhibited the formation of larger hailstones. For both cases, we analyzed the evolution of different ZDR column metrics as well as updraft speed and size and found that (i) the 90th percentile of ZDR within the ZDR column was highest for the cell later producing large hail, (ii) the peak 90th percentile of ZDR preceded large hailfall by 20 min and highest updraft size and speed by 10 min, and (iii) sudden drops of the 90th percentile of ZH within the ZDR column indicated imminent hailfall.

Significance Statement

Thunderstorm evolution on the transition from complex terrain into the Vienna basin in northeastern Austria varies strongly. In some instances, thunderstorm cells intensify once they reach flat terrain, while in most cases there is a weakening tendency. To improve our process understanding and short-term forecasting methods, we analyze two representative cases of hail-bearing storms transitioning into the Vienna basin. We mainly build our study on data from a new, cost-efficient weather radar, complemented by an operational radar, lightning observations, and ground reports. Our results show which radar variables could be well suited for early detection of intensification, and how they relate to thunderstorm updraft speeds and lightning activity.
Use of psychotropic medications in adults with intellectual disability: A systematic review and meta-analysis
Authors: Song Menghuan , Rubin Bryn S , Ha Justin WT , Ware Robert S , Doan Tan N , Harley David
Published: January 2023

Objective:

This study presents the proportion of adults with intellectual disability using psychotropic medications including antipsychotics, antidepressants, anxiolytics, hypnotics and sedatives, and psychostimulants.

Methods:

A search was performed in PubMed, Embase, PsycINFO, Web of Science, and Scopus up to 31 December 2021. Articles were included if they reported the proportion of adults with intellectual disability using psychotropic medications. Frequency of use was estimated using a random effects meta-analysis. Meta-regression analysis was used to assess the association between study-level characteristics and variability in estimates, when heterogeneity was considerable.

Results:

Twenty-four articles were included in pooled analysis. The pooled prevalence of psychotropic medications was 41% (95% confidence interval: 35–46%). Pooled prevalences of subclasses were as follows: antipsychotics 31% (27–35%), antidepressants 14% (9–19%), anxiolytics 9% (4–15%), hypnotics/sedatives 5% (2–8%), and psychostimulants 1% (1–2%). Heterogeneity was considerable between studies, except for psychostimulants. There was no significant association between assessed characteristics and variability in prevalence estimates.

Conclusion:

Two-fifths of adults with intellectual disability were prescribed psychotropic medications. Antipsychotics and antidepressants were used by one-third and one-seventh of adults, respectively. There was considerable variability between studies, and further investigation is required to determine the source of variability. More studies are needed to better characterise prescribed psychotropic medications, including effectiveness and adverse effects, to ensure appropriate use of these drugs.
Ameliorative Potential of Betanin on Cigarette Smoke Extract-induced Respiratory Mucosal Inflammation and Oxidative Stress in the Adult Zebrafish Model
Authors: Alqasmi Ibrahim
Published: January 2023

Background

Betanin, a natural pigment and glycosidic bioactive compound, possesses anti-inflammatory antioxidant activity.

Objectives

In this study, we evaluated the potential effect of betanin on cigarette smoke extract (CSE)-induced pulmonary inflammation in the zebrafish model.

Materials and Methods

Zebrafish were randomly divided into five groups with control, CSE-exposed and betanin-treated after CSE exposure for 3 and 6 days. Oxidative stress-related parameters like reactive oxygen species (ROS), nitric oxide (NO) and myeloperoxidase (MPO) were analysed, histopathological studies were carried out and gene expression of proinflammatory tumour necrosis factor-alpha, inducible NO synthase and anti-inflammatory interleukin-10 cytokines was determined.

Results

Treatment with betanin reduced ROS, MPO and NO with histopathological improvement, alleviating CSE-induced pulmonary inflammation. Further, decreased expression of the proinflammatory gene and increased expression of the anti-inflammatory gene were observed after 6 days of treatment.

Conclusion

Betanin exhibits a protective effect against CSE exposure by inhibiting oxidative stress and inflammation.
Effect of Educational Intervention Based on Theory of Planned Behavior (TPB) on Doing Breast Self-examination in a Sample of Iranian Women
Authors: Khani Jeihooni Ali , Moayedi Zahra Sadat , Momenabadi Victoria , Ghalegolab Farzaneh , Afzali Harsini Pooyan
Published: January 2023

Background:

Breast self-examination (BSE) is an important part of health care for all women in every stage of life. This study aimed to investigate the effect of theory of planned behavior (TPB) on doing BSE in a sample of Iranian women.

Methods:

A cross-sectional study was carried out to examine the factors affecting the BSE in 400 women. Then, a quasi-experimental study was conducted on 200 subjects (100 in experimental group and 100 in control group). The educational intervention for the experimental group consisted of 8 training sessions. A questionnaire including demographic characteristics, knowledge, and constructs of TPB was used to measure BSE performance before and 6 months after the intervention. Constructs of attitude, subjective norms, and perceived behavioral control predicted the intention to do the BSE.

Results:

The mean age of the subjects was 31.65 ± 7.59 years. The studied variables predicted 38.7% of behavioral intention ( P < .001, odds ratio = 0.387). Six months after the intervention, the experimental group showed a significant increase in the knowledge, attitude, perceived behavioral control, subjective norms, intention, and BSE performance compared with the control group ( P < .001).

Conclusions:

This study showed that educational intervention based on the TPB was effective in promoting breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators and health care planners use educational texts based on these constructs of TPB to increase their influence on individuals via screening behavior for breast cancer.
Suicide and non-fatal self-injury-related emergency department visits among individuals with autism spectrum disorder
Authors: Giannouchos Theodoros V , Beverly Judith , Christodoulou Ilias , Callaghan Timothy
Published: January 2023

We analyzed the Healthcare Cost and Utilization State Emergency Department (ED) Databases and State Inpatient Databases for all individuals who were 2 years of age or older with at least one ED visit from 2011 to 2016 in New York to estimate the association between suicide and non-fatal injury-related ED visits and autism spectrum disorder (ASD). Our study included 14.4 million individuals with 43.5 million ED visits. Of those, 31,946 (0.2%) individuals had ASD accounting for 162,440 ED visits (0.4%). Compared to those without ASD, individuals with ASD had 2.1 more ED visits on average, higher shares of inpatient ED visits, more years of ED utilization, and higher prevalence of mental health-related comorbidities and diagnoses and self-injury-related ED visits. Among the ASD cohort, 6.1% had at least one self-injury-related ED visit compared to 2.2% among those without ASD. Using multivariable regressions adjusted for sociodemographic, clinical, contextual, and visit-level characteristics, we found that individuals with ASD were significantly more likely to have at least one self-injury-related ED visit compared to those without ASD. Our findings highlight the importance of raising awareness among caregivers and providers about the increased self-injury risk that individuals with ASD face and to tailor care delivery practices towards their needs.

Lay abstract

This study used data for 14.4 million individuals with 43.5 million emergency department visits from all hospitals in the state of New York to explore the association between suicide and non-fatal self-injury-related (self-injury) emergency department visits and autism spectrum disorder. Overall, we found that individuals with autism spectrum disorder had more emergency department visits and admissions through the emergency department, more years of emergency department utilization, and higher prevalence of mental health-related comorbidities. Individuals with autism spectrum disorder were also significantly more likely to have at least one self-injury-related emergency department visit compared to those without autism spectrum disorder. These results emphasize the need to raise awareness across both family caregivers and healthcare providers on the increased suicide and self-injury risks that individuals with autism spectrum disorder face and to improve care delivery practices. In addition, effort to promote and increase timely access to mental health care is an urgent priority for individuals with autism spectrum disorder.
Muslim charity in the United Kingdom: Between counter-terror and social integration
Authors: May Samantha
Published: January 2023

Writing ahead of the next ‘Independent Review’ of the United Kingdom’s counter-terror strategy, this article presents two inter-related arguments. First, that the current counter-terror legislation is counter-productive, according to its own logic, in achieving social integration. Second, that Islamic practices and conceptualisations associated with charitable giving hold potentials to offer a more inclusive understanding of social integration than that currently utilised in the United Kingdom. The actions of Muslim charities and practitioners within Britain (exemplified by service provisions during Covid restrictions) serve as an important tool for social integration. Thus, by exploring the potentials of Muslim charitable giving, an alternative solution to social integration in the United Kingdom is presented. Drawing from participant interviews with a range of Muslim charitable practitioners, this article argues that supporting British Muslim charities would assist social integration and the construction of ‘shared values’ assumed by UK counter-terror strategies to be a tool in combating ‘extremist’ narratives.
Evaluation of Age-related Differences in Foot Anthropometry among Women
Authors: Li Pui-Ling , Yick Kit-Lun , Zhang Li-Ying , Keung Yin-Ching
Published: January 2023

Foot morphological changes induced by degenerative processes are commonly found in old people. Such changes in foot anthropometry may adversely affect foot health and footwear comfort, and prolonged use of ill-fitting footwear may even cause foot deformation. This study compares foot anthropometric measurements between young and old women to determine key foot measurements, which can also act as indicators for developing footwear appropriate for the elderly. Using a three-dimensional handheld scanner, 11 foot anthropometric measurements are captured and used to characterize the dimensions and foot shape between young and old women. Eighty-two women between the ages of 20 and 95 years—that is, 41 young women (mean = 24.0; standard deviation = 3.5) and 41 old women (mean = 82.1; standard deviation = 7.2)—were recruited for this study. The results indicate that old women have a significantly longer and wider heel than young women as well as significantly larger ball and instep circumferences after normalization for foot length. Old women also exhibit larger deformity in the degree of hallux valgus and more pronated feet than young women do. A discriminant analysis linear equation has also been established to classify their foot type based on heel length and heel width with reference to their age group.
Plasma sphingolipids, lung function and COPD: the Cardiovascular Health Study
Authors: Gharib Arya R. , Jensen Paul N. , Psaty Bruce M. , Hoofnagle Andrew N. , Siscovick David , Gharib Sina A. , Sitlani Colleen M. , Sotoodehnia Nona , Lemaitre Rozenn N.
Published: January 2023

Rationale

COPD is the third leading cause of death in the United States. Sphingolipids, structural membrane constituents that play a role in cellular stress and apoptosis signalling, may be involved in lung function.

Methods

In the Cardiovascular Health Study, a prospective cohort of older adults, we cross-sectionally examined the association of plasma levels of 17 sphingolipid species with lung function and COPD. Multivariable linear regression and logistic regression were used to evaluate associations of sphingolipid concentrations with forced expiratory volume in 1 s (FEV1) and odds of COPD, respectively.

Results

Of the 17 sphingolipids evaluated, ceramide-18 (Cer-18) and sphingomyelin-18 (SM-18) were associated with lower FEV1values (–0.061 L per two-fold higher Cer-18, p=0.001; −0.092 L per two-fold higher SM-18, p=0.002) after correction for multiple testing. Several other associations were significant at a 0.05 level, but did not reach statistical significance after correction for multiple testing. Specifically, Cer-18 and SM-18 were associated with higher odds of COPD (odds ratio per two-fold higher Cer-18 1.29, p=0.03 and SM-18 1.73, p=0.008). Additionally, Cer-16 and SM-16 were associated with lower FEV1values, and Cer-14, SM-14 and SM-16 with a higher odds of COPD.

Conclusion

In this large cross-sectional study, specific ceramides and sphingomyelins were associated with reduced lung function in a population-based study. Future studies are needed to examine whether these biomarkers are associated with longitudinal change in FEV1within individuals or with incident COPD.
Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: safety, feasibility and diagnostic yield – experience in 50 cases
Authors: Ariza-Prota Miguel , Pérez-Pallarés Javier , Fernández-Fernández Alejandro , García-Alfonso Lucía , Cascón Juan A. , Torres-Rivas Héctor , Fernández-Fernández Luis , Sánchez Inmaculada , Gil Maria , García-Clemente Marta , López-González Francisco
Published: January 2023

Background

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the technique of choice in the study of mediastinal and hilar lesions; however, it can be affected by the insufficiency of intact biopsy samples, which might decrease its diagnostic yield for certain conditions, thus requiring re-biopsies or additional diagnostic procedures such as mediastinoscopy when the probability of malignancy remains high. Our objectives were to 1) attempt to reproduce this technique in the same conditions that we performed EBUS-TBNA,i.e.in the bronchoscopy suite and under moderate sedation; 2) describe the method used for its execution; 3) determine its feasibility by accessing different lymph node stations applying our method; and 4) analyse the diagnostic yield and its complications.

Methods

This was a prospective study of 50 patients who underwent EBUS-TBNA and EBUS-guided transbronchial mediastinal cryobiopsy (TMC) in a single procedure using a 22-G TBNA needle and a 1.1-mm cryoprobe subsequently between January and August 2022. Patients with mediastinal lesions >1 cm were recruited, and EBUS-TBNA and TMC were performed in the same lymph node station.

Results

The diagnostic yield was 82% and 96% for TBNA and TMC, respectively. Diagnostic yields were similar for sarcoidosis, while cryobiopsy was more sensitive than TBNA in lymphomas and metastatic lymph nodes. As for complications, there was no pneumothorax and in no case was there significant bleeding. There were no complications during the procedure or in the follow-up of these patients.

Conclusions

TMC following our method is a minimally invasive, rapid and safe technique that can be performed in a bronchoscopy suite under moderate sedation, with a higher diagnostic yield than EBUS-TBNA, especially in cases of lymphoproliferative disorders and metastatic lymph nodes or when more biopsy sample is needed for molecular determinations.
Magnetic resonance imaging detects onset and association with lung disease severity of bronchial artery dilatation in cystic fibrosis
Authors: Leutz-Schmidt Patricia , Optazaite Daiva-Elzbieta , Sommerburg Olaf , Eichinger Monika , Wege Sabine , Steinke Eva , Graeber Simon Y. , Puderbach Michael U. , Schenk Jens-Peter , Alrajab Abdulsattar , Triphan Simon M.F. , Kauczor Hans-Ulrich , Stahl Mirjam , Mall Marcus A. , Wielpütz Mark O.
Published: January 2023

Background

Bronchial artery dilatation (BAD) is associated with haemoptysis in advanced cystic fibrosis (CF) lung disease. Our aim was to evaluate BAD onset and its association with disease severity by magnetic resonance imaging (MRI).

Methods

188 CF patients (mean±sdage 13.8±10.6 years, range 1.1–55.2 years) underwent annual chest MRI (median three exams, range one to six exams), contributing a total of 485 MRI exams including perfusion MRI. Presence of BAD was evaluated by two radiologists in consensus. Disease severity was assessed using the validated MRI scoring system and spirometry (forced expiratory volume in 1 s (FEV1) % pred).

Results

MRI demonstrated BAD in 71 (37.8%) CF patients consistently from the first available exam and a further 10 (5.3%) patients first developed BAD during surveillance. Mean MRI global score in patients with BAD was 24.5±8.3 compared with 11.8±7.0 in patients without BAD (p<0.001) and FEV1% pred was lower in patients with BAD compared with patients without BAD (60.8%versus82.0%; p<0.001). BAD was more prevalent in patients with chronicPseudomonas aeruginosainfectionversusin patients without infection (63.6%versus28.0%; p<0.001). In the 10 patients who newly developed BAD, the MRI global score increased from 15.1±7.8 before to 22.0±5.4 at first detection of BAD (p<0.05). Youden indices for the presence of BAD were 0.57 for age (cut-off 11.2 years), 0.65 for FEV1% pred (cut-off 74.2%) and 0.62 for MRI global score (cut-off 15.5) (p<0.001).

Conclusions

MRI detects BAD in patients with CF without radiation exposure. Onset of BAD is associated with increased MRI scores, worse lung function and chronicP. aeruginosainfection, and may serve as a marker of disease severity.
Hospitalisation outcomes in pneumococcal-vaccinatedversus-unvaccinated patients with exacerbation of COPD: results from the HOPE COPD Study
Authors: Venkitakrishnan Rajesh , Vijay Anand , Augustine Jolsana , Ramachandran Divya , Cleetus Melcy , Nirmal Aparna S. , John Susan
Published: January 2023

Background

Infectious exacerbations are crucial events that dictate the natural course of COPD patients. Pneumococcal vaccination has been shown to decrease incidence of community-acquired pneumonia in COPD patients. There is a paucity of data on outcomes of hospitalisation in pneumococcal-vaccinated COPD patients in comparison with unvaccinated subjects. The objectives of the present study were to evaluate the difference in hospitalisation outcomes in pneumococcal-vaccinatedversus-unvaccinated COPD subjects hospitalised with acute exacerbation.

Methods

This was a prospective analytical study on 120 subjects hospitalised with acute COPD exacerbation. 60 patients with prior pneumococcal vaccination and 60 unvaccinated patients were recruited. Outcomes of hospitalisation such as mortality rate, need for assisted ventilation, length of hospital stay, need for intensive care unit (ICU) care and length of ICU stay were collected and compared between two groups with appropriate statistical tools.

Results

60% of unvaccinated patients (36 out of 60) required assisted ventilation, whereas only 43.3% of vaccinated subjects (26 out of 60) needed assisted ventilation (p-value of 0.04). Most of the secondary outcomes were better in the vaccinated group. The mean±SDlength of ICU stay in the vaccinated group was 0.67±1.11 days compared to 1.77±1.89 days in the unvaccinated group. The mean±SDlength of hospital stay was 4.50±1.64 days and 5.47±2.03 days in the vaccinated and unvaccinated group, respectively (p-value of 0.005).

Conclusions

COPD patients who have received prior pneumococcal vaccination have better outcomes when they are hospitalised for an acute exacerbation. Pneumococcal vaccination may be recommended for all patients with COPD who are at risk of hospitalisation with acute exacerbation.
The effect of d-cycloserine on brain processing of breathlessness over pulmonary rehabilitation: an experimental medicine study
Authors: Finnegan Sarah L. , Harrison Olivia K. , Booth Sara , Dennis Andrea , Ezra Martyn , Harmer Catherine J. , Herigstad Mari , Guillaume Bryan , Nichols Thomas E. , Rahman Najib M. , Reinecke Andrea , Renaud Olivier , Pattinson Kyle T.S.
Published: January 2023

Research question

Pulmonary rehabilitation is the best treatment for chronic breathlessness in COPD but there remains an unmet need to improve efficacy. Pulmonary rehabilitation has strong parallels with exposure-based cognitive behavioural therapies (CBT), both clinically and in terms of brain activity patterns. The partial N-methyl-d-aspartate (NMDA)-receptor agonistd-cycloserine has shown promising results in enhancing efficacy of CBT, thus we hypothesised that it would similarly augment the effects of pulmonary rehabilitation in the brain. Positive findings would support further development in phase 3 clinical trials.

Methods

72 participants with mild-to-moderate COPD were recruited to a double-blind pre-registered (ClinicalTrials.govidentifier:NCT01985750) experimental medicine study running parallel to a pulmonary rehabilitation course. Participants were randomised to 250 mgd-cycloserine or placebo, administered immediately prior to the first four sessions of pulmonary rehabilitation. Primary outcome measures were differences betweend-cycloserine and placebo in brain activity in the anterior insula, posterior insula, anterior cingulate cortices, amygdala and hippocampus following completion of pulmonary rehabilitation. Secondary outcomes included the same measures at an intermediate time point and voxel-wise difference across wider brain regions. An exploratory analysis determined the interaction with breathlessness anxiety.

Results

No difference betweend-cycloserine and placebo groups was observed across the primary or secondary outcome measures.d-cycloserine was shown instead to interact with changes in breathlessness anxiety to dampen reactivity to breathlessness cues. Questionnaire and measures of respiratory function showed no group difference. This is the first study testing brain-active drugs in pulmonary rehabilitation. Rigorous trial methodology and validated surrogate end-points maximised statistical power.

Conclusion

Although increasing evidence supports therapeutic modulation of NMDA pathways to treat symptoms, we conclude that a phase 3 clinical trial ofd-cycloserine would not be worthwhile.
Modifiable lifestyle risk factors for sarcoidosis: a nested case–control study
Authors: Dehara Marina , Sachs Michael C. , Grunewald Johan , Blomberg Anders , Arkema Elizabeth V.
Published: January 2023

Objective

We aimed to investigate whether obesity, tobacco use, alcohol consumption and physical inactivity are associated with sarcoidosis risk.

Methods

We conducted a matched case–control study nested within the Northern Sweden Health and Disease Study. Incident sarcoidosis cases (n=165) were identifiedviamedical records and matched to controls (n=660) on sub-cohort, sex, birth and questionnaire date (1:4). Data on lifestyle factors were obtained through questionnaires, and physical measurements of height, weight and waist were collected prior to sarcoidosis diagnosis. Conditional logistic regression estimated adjusted odds ratios with 95% confidence intervals (aOR; 95% CI).

Results

Compared with never-smoking, current smoking was associated with lower sarcoidosis odds (aOR 0.48; 95% CI 0.32–0.71), and former smoking with higher odds (aOR 1.33; 95% CI 0.98–1.81). Snus use was not associated with sarcoidosis. There was an increased odds of sarcoidosis associated with obesity (aOR 1.34; 95% CI 0.94–1.92) but not with overweight (aOR 0.99; 95% CI 0.76–1.30). Compared with those who were physically inactive, those who were active had a 25% higher odds of sarcoidosis (aOR 1.25; 95% CI 0.91–1.72). No association was found with moderate alcohol consumption (aOR 0.95; 95% CI 0.56–1.62). All results were similar when cases diagnosed within 5 years after exposure assessment were excluded, except the aOR for former smoking decreased to 1.1.

Conclusion

We observed a reduced sarcoidosis risk associated with smoking, which cannot be fully explained by early symptoms of sarcoidosis influencing smoking habits. Results indicate an increased risk associated with obesity, but not overweight, and being physically active.
ERS International Congress 2022: highlights from the Epidemiology and Environment Assembly
Authors: Parkin James G.H. , Delgado-Ortiz Laura , Delvert Rosalie , Ghosh Manosij , Korkontzelou Aliki , Patil Sarang , Savouré Marine , Jankowski Mateusz , Dumas Orianne
Published: January 2023

In this article, early career members of the Epidemiology and Environment Assembly of the European Respiratory Society summarise a selection of five sessions from the Society's 2022 International Congress, with a focus on areas of specific interest for the Assembly,i.e.epidemiology and risk factors of respiratory diseases in both children and adults. Topics covered include the characterisation of obstructive respiratory diseases, their comorbidities and their evolution, with novel insight from large cohorts. The importance of early-life factors in respiratory health was also emphasised, including maternal exposures and habits during pregnancy. As smoking behaviours have changed following the introduction of e-cigarettes and heated tobacco products, research remains very active to determine the health consequences and predictors of these novel uses, especially in teenagers. The impact of environmental and occupational exposures on respiratory health remained a major topic of the congress, with a focus on emerging risk factors such as landscape fire smoke, non-exhaust particles and nanoparticles. Regarding workplace exposures, old and novel causes of occupational asthma and rhinitis were discussed.
ERS International Congress 2022: highlights from the Respiratory Infections Assembly
Authors: Banka Radhika , Chichirelo-Konstantynovych Kiarina , Horton Katie L. , Konstantynovych Tetyana , Long Merete B. , McDonnell Melissa J. , Meldrum Oliver W. , Park Mirae , Perea Lidia , Viltsaniuk Oksana , Keir Holly R.
Published: January 2023

The European Respiratory Society International Congress took place both in person, in Barcelona, Spain, and online in 2022. The congress welcomed over 19 000 attendees on this hybrid platform, bringing together exciting updates in respiratory science and medicine from around the world. In this article, Early Career Members of the Respiratory Infections Assembly (Assembly 10) summarise a selection of sessions across a broad range of topics, including presentations on bronchiectasis, nontuberculous mycobacteria, tuberculosis, cystic fibrosis and coronavirus disease 2019.
QTL mapping and candidate gene analysis for yield and grain weight/size in Tartary buckwheat
Authors: Li Ruiyuan , Chen Zhengfeng , Zheng Ran , Chen Qingfu , Deng Jiao , Li Hongyou , Huang Juan , Liang Chenggang , Shi Taoxiong
Published: January 2023

Background

Grain weight/size influences not only grain yield (GY) but also nutritional and appearance quality and consumer preference in Tartary buckwheat. The identification of quantitative trait loci (QTLs)/genes for grain weight/size is an important objective of Tartary buckwheat genetic research and breeding programs.

Results

Herein, we mapped the QTLs for GY, 1000-grain weight (TGW), grain length (GL), grain width (GW) and grain length–width ratio (L/W) in four environments using 221 recombinant inbred lines (XJ-RILs) derived from a cross of 'Xiaomiqiao × Jinqiaomai 2'. In total, 32 QTLs, including 7 for GY, 5 for TGW, 6 for GL, 11 for GW and 3 for L/W, were detected and distributed in 24 genomic regions. Two QTL clusters, qClu-1-3 and qClu-1-5, located on chromosome Ft1, were revealed to harbour 7 stable major QTLs for GY (qGY1.2), TGW (qTGW1.2), GL (qGL1.1 and qGL1.4), GW (qGW1.7 and qGW1.10) and L/W (qL/W1.2) repeatedly detected in three and above environments. A total of 59 homologues of 27 known plant grain weight/size genes were found within the physical intervals of qClu-1-3 and qClu-1-5. Six homologues, FtBRI1, FtAGB1, FtTGW6, FtMADS1, FtMKK4 and FtANT, were identified with both non-synonymous SNP/InDel variations and significantly differential expression levels between the two parents, which may play important roles in Tatary buckwheat grain weight/size control and were chosen as core candidate genes for further investigation.

Conclusions

Two stable major QTL clusters related to grain weight/size and six potential key candidate genes were identified by homology comparison, SNP/InDel variations and qRT‒qPCR analysis between the two parents. Our research provides valuable information for improving grain weight/size and yield in Tartary buckwheat breeding.
Fetal genetic findings by chromosomal microarray analysis and karyotyping for fetal growth restriction without structural malformations at a territory referral center: 10-year experience
Authors: Wu Xiaoqing , He Shuqiong , Li Ying , Guo Danhua , Chen Xuemei , Liang Bin , Wang Meiying , Huang Hailong , Xu Liangpu
Published: January 2023

Background

Prenatal invasive genetic testing is commonly recommended to pregnancies of early-onset FGR or FGR combined with a structural defect. Our study aimed to explore the genetic findings for FGR without structural malformations according to cytogenetic karyotyping and single nucleotide polymorphism array (SNP array) technology over a 10-year period.

Methods

A total of 488 pregnancies diagnosed with FGR without structural malformation were retrospectively reviewed. Cytogenetic karyotyping was performed on all the subjects, and SNP array was available from 272 of them. Based on the gestational age at onset, the cohort was classified into four groups: ≤ 24, 25–28, 29–32, and > 32 weeks of gestation. According to the ultrasound findings, they were grouped into isolated FGR, FGR with soft markers, and FGR with non-structural anomalies. In pregnancies of young maternal age, based on the results of maternal serum screening (MSS), they were categorized into high-risk and low-risk MSS groups.

Results

Nineteen (3.9%) cases of chromosomal abnormalities were detected by cytogenetic karyotyping, including 11 cases of numerical abnormalities, 5 cases of structural abnormalities, and 3 cases of mosaicism. Trisomy 21 was the most frequent abnormality. Abnormal karyotypes were more frequently observed in cases diagnosed at ≤ 24 weeks (7.2%) than those in any other group. Among pregnancies with normal karyotype, an incremental yield of 4.2% were revealed by SNP array technology regarding clinically relevant aberrations. The additional detection rates by SNP array in cases diagnosed at ≤ 24 weeks (6.5%), cases with soft markers (9.5%), and cases with high-risk MSS (12.0%) were higher than those in other groups within each classification. All the cases with abnormal karyotypes and 7 out of 11 pregnancies with clinically relevant anomalies revealed by SNP array alone resulted in pregnancy terminations.

Conclusion

Chromosome abnormality is an important etiology for FGR with no associated structural malformations, and plays a crucial role in pregnancies decision-making. SNP array improves the detection of genetic anomalies especially in FGR diagnosed at ≤ 24 weeks, FGR combined with soft makers, and FGR combined with high-risk MSS.
Exploring the relationships between hormone receptor, HER2 status, and bone involvement in the first distant metastases of in Chinese breast cancer patients who lacked HER2 targeted therapy
Authors: Jia Zhifeng , Dai Muwei , Shang Yuguang , Li Yue , Li Zhensheng
Published: January 2023

Background

This retrospective study explored the relationship between hormone receptor (HR), human epidermal growth factor receptor 2 (HER2) status, and bone involvement in the first distant metastases (DM) of Chinese breast cancer (BC) patients who lacked the HER2 targeted therapy. Such therapy was rarely received due to its lag approval or high cost in China compared with the developed countries.

Methods

All eligible women with primary unilateral stage I – III BC and first DM diagnosed in 2008—2018 at one cancer center were identified for enrollment. Based on chart records, a full or no/partial compliance status of endocrine therapy (ET) was assigned for HR-positive patients. Multivariate logistic regression was used to estimate the adjusted odd ratio (aOR), its 95%CI and p value.

Results

Four hundred eighteen patients had an average age of 50.7 years and median disease-free survival of 27.1 months at DM. Bone, lung, liver and brain metastasis rates in patients were 55.7%, 34.7%, 33.0% and 8.1%, respectively. Compared to HR-negative patients, HR-positive patients with the full and non/partial compliance of ET were significantly associated with higher risk of bone involvement with an aOR of 2.329 (1.316 – 1.741, p = 0.004) and 2.317 (1.330 – 4.036, p = 0.003), respectively. No difference of such risk was found between the two groups of ET compliance (p = 0.984) nor between HER2-negative and HER2-positive patients (aOR 0.827, p = 0.431). Stratified analyses further indicated that HR-positive was associated with bone involvement only in HER2-negative BC patients (p = 0.006—0.015).

Conclusions

HR-positive tumors are significantly associated with bone involvement in HER2-negative metastatic BC patients. ET does not appear to impact this association. HER2 status per se is not associated with such risk.
Spectral CT-based radiomics signature for distinguishing malignant pulmonary nodules from benign
Authors: Xu Hang , Zhu Na , Yue Yong , Guo Yan , Wen Qingyun , Gao Lu , Hou Yang , Shang Jin
Published: January 2023

Objectives

To evaluate the discriminatory capability of spectral CT-based radiomics to distinguish benign from malignant solitary pulmonary solid nodules (SPSNs).

Materials and methods

A retrospective study was performed including 242 patients with SPSNs who underwent contrast-enhanced dual-layer Spectral Detector CT (SDCT) examination within one month before surgery in our hospital, which were randomly divided into training and testing datasets with a ratio of 7:3. Regions of interest (ROIs) based on 40-65 keV images of arterial phase (AP), venous phases (VP), and 120kVp of SDCT were delineated, and radiomics features were extracted. Then the optimal radiomics-based score in identifying SPSNs was calculated and selected for building radiomics-based model. The conventional model was developed based on significant clinical characteristics and spectral quantitative parameters, subsequently, the integrated model combining radiomics-based model and conventional model was established. The performance of three models was evaluated with discrimination, calibration, and clinical application.

Results

The 65 keV radiomics-based scores of AP and VP had the optimal performance in distinguishing benign from malignant SPSNs (AUC65keV-AP = 0.92, AUC65keV-VP = 0.88). The diagnostic efficiency of radiomics-based model (AUC = 0.96) based on 65 keV images of AP and VP outperformed conventional model (AUC = 0.86) in the identification of SPSNs, and that of integrated model (AUC = 0.97) was slightly further improved. Evaluation of three models showed the potential for generalizability.

Conclusions

Among the 40-65 keV radiomics-based scores based on SDCT, 65 keV radiomics-based score had the optimal performance in distinguishing benign from malignant SPSNs. The integrated model combining radiomics-based model based on 65 keV images of AP and VP with Zeff-AP was significantly superior to conventional model in the discrimination of SPSNs.
Corneal thickness measurements with the RTVue, Casia-2, and Pentacam devices in patients with mild-to-moderate keratoconus: a comparative study
Authors: Sun Bingqing , Zhang Xiaoyu , Sun Ling , Huang Yangyi , Tian Mi , Shen Yang , Ding Lan , Zhou Xingtao
Published: January 2023

Background

To compare the characteristics of corneal thickness measurements among the RTVue, Casia-2, and Pentacam in patients with mild-to-moderate keratoconus.

Methods

We recruited 46 eyes of 46 patients diagnosed with mild-to-moderate keratoconus at our hospital between January and March 2022. The central corneal thickness (CCT) and thinnest corneal thickness (TCT) were measured using two optical coherence tomography (OCT) instruments (RTVue and Casia-2) and the more conventional Pentacam. Differences and correlations between the CCTs and TCTs, based on the device and influencing factors, were explored.

Results

The CCTs were highly consistent among the groups (p = 0.434) and correlated with one another (p < 0.001). The TCTs measured by OCTs were thinner than those measured by the Pentacam (p < 0.001); however, all three devices were highly correlated (p < 0.001). The thinnest point location measurements with RTVue and Casia-2 differed significantly from the measurements with the Pentacam. Bland–Altman plots demonstrated a significant agreement between Pentacam and OCTs in TCT measurement (p < 0.001); the 95% limits of agreement were − 3.1 μm to + 33.1 μm for Pentacam and RTVue and − 8.6 μm to + 36.5 μm for Pentacam and Casia-2. RTVue and Casia-2 showed no difference in corneal thickness (p = 0.633) and thinnest point location measurement (p > 0.05). Multivariate analysis identified that the TCT measurement difference between the RTVue and Pentacam was related to the difference between the CCT and TCT (b = 0.490, 95% confidence interval [CI]: 0.033 to 0.948, p = 0.036), whereas the difference between the Casia-2 and Pentacam was related to the anterior radius for curvature (A) grade (b = 3.9, 95% CI: 1.753 to 6.074, p = 0.001), corneal pachymetry at the thinnest (C) grade (b = − 7.875, 95% CI: − 11.404 to − 4.346, p < 0.001), and the difference between the CCT and TCT (b = 0.425, 95% CI: 0.1 to 0.751, p = 0.012).

Conclusions

CCTs in patients with mild-to-moderate keratoconus were similar among all three devices, but the TCTs and the thinnest point locations were not. Furthermore, the TCT measurement differences between the OCT devices and the Pentacam were more pronounced in keratoconus cases with a steeper anterior surface, thicker TCTs, and a larger difference between the CCT and TCT.

Trial registration

Number: 2021118–1. Retrospectively registered: September 01, 2021.
Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder
Authors: Selaskowski Benjamin , Asché Laura Marie , Wiebe Annika , Kannen Kyra , Aslan Behrem , Gerding Thiago Morano , Sanchez Dario , Ettinger Ulrich , Kölle Markus , Lux Silke , Philipsen Alexandra , Braun Niclas
Published: January 2023

Background

Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task.

Methods

Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed.

Results

While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients.

Conclusions

Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD.

Trial registration

drks.de (identifier: DRKS00022370).
Involvement and burden of informal caregivers of patients with mental illness: the mediating role of affiliated stigma
Authors: Kaggwa Mark Mohan , Najjuka Sarah Maria , Mamun Mohammed A. , Griffiths Mark D. , Nyemara Novatus , Ashaba Scholastic
Published: January 2023

Background

The fear and lack of understanding of mental illness can lead to stigma. The stigma of mental illness affects not only individuals who suffer from it, but also the caregivers. Stigma among caregivers can lead to delay in seeking care, poor adherence to treatment and a high risk of relapse. Caregivers of patients with mental illness are at an increased risk of distress due to the burden to stigma and caregiving burden. An increase in caregivers’ burden can lead to a reduction in caregivers’ involvement. There is a relationship between caregivers’ involvement, burden, and affiliated stigma. The present study examined the mediating role of affiliated stigma in the relationship between caregivers’ burden and involvement among informal caregivers of hospital-admitted patients with mental illness in Uganda.

Methods

A cross-sectional study was conducted among 428 informal caregivers (mean age: 39.6 years [SD±14.6]; females = 62.1%). Information was collected regarding sociodemographic characteristics, affiliated stigma, and the involvement and burden of informal caregivers.

Results

The findings indicate that affiliated stigma serves as a full mediator between the caregiver’s roles and involvement (β=15.97, p<0.001). Being female increased the caregivers’ burden of caregiving (β= -0.23, p<0.001).

Conclusion

The findings in the present study suggest that intervention to address affiliated stigma among caregivers of patients with mental illness should be incorporated into mainstream mental health care to reduce the caregiving burden.
Clinical advantages of gradually reducing radius versus multi-radius total knee arthroplasty: a noninferiority randomized trial
Authors: Limmahakhun Sakkadech , Chaiamporn Anuchit , Klunklin Kasisin , Jingjit Warakorn
Published: January 2023

Background

The rationale for gradually reducing radius (GR) femoral component aims to prevent flexion instability by gradually change the center of femoral rotation, unlike a discrete change by the multi-radius (MR) which is more common for most of total knee arthroplasties (TKA). However, no strong evidence has been reported the clinical significance of the GR design.

Methods

This patient-blinded, parallel, non-inferiority trial conducted in September 2020. Patients with knee osteoarthritis consented for cruciate retaining TKA were randomly allocated to a GR or MR group. Primary outcome measures were knee functions at postoperative 6 and 12 months using the Knee injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures were performance-based tests (30-s chair stand test, 40-m fast paced walk test, and 3-m timed up and go test), and knee motions.

Results

Sixty patients were enrolled and randomized; GR (n = 30) and MR (n = 30) group. The changes of KOOS at 6 and 12 months from baseline showed clinical meaningful for both GR and MR group. At 6 and 12 months postoperatively, there was no significant difference between both groups in all KOOS subscales. The length of stay was not different between GR and MR group (5.93 ± 1.44 vs 6.17 ± 1.86 days, p = 0.59). Patients on both groups presented similar performance-based tests. However, the improvement in degrees of knee motion for the GR group was significantly greater than the MR group (34.67 ± 12.52 vs 23.67 ± 12.59, p = 0.001).

Conclusion

GR was noninferiority to MR for the functional outcomes and performances after TKA.

The GR femoral component gave more knee motions than did the MR prostheses.

Level of evidence

Level I, therapeutic study.