bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel insights into modifiable risk factors for arteriovenous fistula failure and the importance of CKD lipid profile: A meta-analysis
Authors: Wei Shizhuo , Liu Naimeng , Fu Yingli , Sun Mindan
Published: March 2023

Background:

Arteriovenous fistula (AVF) failure can occur in patients undergoing hemodialysis (HD). In this study, we explored the correlation between hyperlipidemia and AVF failure in patients undergoing HD. Moreover, we compared the lipid profiles of patients with chronic kidney disease (CKD) with those of healthy people to provide a basis for lipid-lowering in patients undergoing HD.

Method and analysis:

We searched PubMed, Web of Science, Embase, the Cochrane library, CNKI, CBM, the China Science Periodical Database, and the China Science and Technology Journal Database. The final search was conducted on August 31, 2021, and the search period was restricted between 2000 and August 31, 2021, without publication restrictions. All studies met the inclusion criteria, and the influences of sex, age, geographical location, diagnosis method, and publication year were excluded. The data were analyzed using the random-effects model and the fixed-effects model.

Results:

Twenty-eight studies were included in the meta-analysis with 121,666 patients in the CKD group and 1714 patients in the AVF failure group. Triglyceride concentration in patients with CKD was higher than in healthy subjects (MD: −31.56, 95% CI: −41.23 to −21.90, p < 0.00001). A high total cholesterol (TC) concentration (MD: 6.97, 95% CI: 2.19–11.74, p = 0.004) and a high low-density lipoprotein cholesterol (LDL-C) concentration (MD: 23.83, 95% CI: 18.48–29.18, p < 0.00001) were associated with AVF failure. Furthermore, HDL-C was lower in the AVF failure group than in the AVF patency group (MD: −2.68, 95% CI: −4.60 to −0.76, p = 0.006).

Conclusion:

Our analysis indicates that the AVF failure may be related to the increase of TC/LDL-C and the decrease of HDL-C. Although current guidelines do not consider intensive lipid-lowering therapy as necessary in patients undergoing HD, our research indicates that patients with AVF undergoing HD may need regular TC/LDL-C-lowering therapy to prevent AVF failure. However, this issue still needs well designed prospective trials.
Granulomatosis With Polyangiitis Presenting as an Infratemporal Fossa Mass
Authors: Kim Sulgi , Johnson Steven M , Lopez Erin , Stack Taylor , Lamb Meredith M , Zeatoun Abdullah L , Mohammad Ibtisam , Alicea Delgado Daniel , Norris Meghan , Klatt-Cromwell Christine , Thorp Brian , Ebert Charles S , Senior Brent A , Kimple Adam J
Published: March 2023

Granulomatosis with polyangiitis is a rare autoimmune disease that affects small to medium-sized blood vessels throughout the body. Here, we present a case of an infratemporal mass that was the result of granulomatosis with polyangiitis. A 51-year-old male presented to the emergency department due to right cheek and facial pain that he had been experiencing for 2 to 3 months. An MRI revealed a mass within the right infratemporal and pterygopalatine fossae extending into the inferior right orbital fissure along the maxillary division of the trigeminal nerve (V2) and the vidian nerve causing concern for malignancy. Histology from an endoscopic biopsy demonstrated multiple arteries with luminal obliteration with non-necrotizing granulomas. The patient was started on steroids and immunosuppressive therapy, which improved his symptoms and decreased the size of the residual mass. This case illustrates the need for laboratory testing, imaging, and biopsy of the involved tissue in cases where GPA is suspected to prevent treatment delays that could lead to the destruction of vital organs.
On the Contesting Conceptualisation of the Human Body: Between ‘Homo-Microbis’ and ‘Homo-Algorithmicus’
Authors: Kotliar Dan M , Grosglik Rafi
Published: March 2023

Microbiome science has highlighted human and microbial interdependency, offering a radical epistemic shift from the individualistic view of the human body and self. Research has accordingly offered to see humans as ‘homo-microbis’ – complex biomolecular networks composed of humans and their associated microbes. While social scientists have begun to address microbiome science, the proliferation and commodification of the homo-microbial episteme have largely been overlooked. Based on an ethnographic account of a research project that offered microbiome-based personalised nutrition and the successful start-up that emerged from it, this article examines the emergence, proliferation, and commodification of the homo-microbial body. We show that this episteme necessarily depends on opaque machine learning algorithms; that the microbiome is paradoxically seen as a data-driven individuating marker; and that homo-microbis is, in fact, also a homo-algorithmicus – a being that can only access its non-human sub-parts by blindly following opaque algorithmic recommendations in an app.
Advice for autistic people considering a career in academia
Authors: Jones Sandra C
Published: March 2023

Academia is underpinned by an apprenticeship model, with increasing recognition of the need for a ‘cognitive apprenticeship’ model in which the methods and strategies of academic success are learnt through participation in a community of inquiry. Autistic people face systemic barriers in academia, as in other professions, and these may be exacerbated by a model based on learning by observing and modelling. This study sought to obtain specific practical advice for autistic people considering a career in academia, from the perspective of those already working within the academy. Thirty-seven autistic academics provided written reflections on the advice they would give a young person considering a career in academia. Five key themes were generated from these reflections: know the role, find the right people, know (and value) yourself, remember well-being and proceed with caution but with passion.

Lay abstract

One of the recognised strengths of autistic people is their ability to absorb and retain large amounts of information; autistic children and adolescents are often described as ‘little professors’. So, is the life of a university researcher or teacher the ideal career for an autistic person? In this study, 37 autistic people working in universities and colleges provide advice to young people considering a future career as an academic. They emphasise the importance of understanding the complexities and requirements of the role, understanding and valuing yourself and your strengths, and finding the right people to work with and learn from. They also discuss the importance of maintaining a balance between work and well-being, and between caution and passion. The life of an academic can be ideally suited to an autistic person, but it can also be very challenging.
A history of New Year’s Eve, Sydney: From ‘the crowd’ to ‘crowded places’
Authors: Dibley Ben
Published: March 2023

This article presents a history of Sydney's New Year's Eve event. First established when a crowd gathered outside Sydney's General Post Office in 1897 to celebrate the inauguration of International Standard Time, in more recent years it has evolved into a signature event on the city's calendar, drawing in excess of 1 million people into the Central Business District in a spectacular celebration of the global city. For those authorities charged with managing the event an enduring problem concerns the question of security: how is the aggregate of human bodies that gather to be governed in ways that secure it from the risks it presents: be they risks to public order (riot), to the crowd itself (panic), or external to it (terror attack) or to the population (viral spread)? This article maps how crowds have been thought as objects of government in relation to the New Year’s Eve event.
Fatigue evaluation of the rib-deck weld in OSDs considering the effect of asphalt-steel interface bonding property
Authors: Wang Qiudong , Fu Zhongqiu , Wei Yang , Wang Yixun
Published: March 2023

The interface bonding layer is usually adopted to connect the asphalt surfacing and steel deck plate; however, the effect of interface bonding conditions on fatigue performance of rib-deck welds still remains unclear. In this study, comprehensive finite element analysis was carried out to clarify the effect of interface bonding conditions. Parametric analysis was conducted to investigate the effect of Poisson’s ratio and elastic modulus of asphalt surfacing, and the interface bonding condition on fatigue performance of rib-deck welds, so is the coupled effect of elastic modulus and interface bonding condition. Taking into account the time-variant temperature and traffic volume, the accumulated fatigue damages in rib-deck welds were compared and analysed. Results show that the simulation of the interface bonding condition is reliable, as convinced by bending tests. The interface bonding condition and the elastic modulus of asphalt surfacing, which are both sensitive to the temperature, considerably affect the fatigue performance of rib-deck welds. The fatigue damage of rib-deck welds is underestimated if the interface bonding behaviour is not considered.
Dementia-Friendly Communities: Exploring Terms used to Describe Dementia, Attitudes and Reactions Towards People with Dementia in Ilembe District, South Africa
Authors: Mfene Xoli P , Pillay Basil J
Published: March 2023

Background

People with dementia often experience stigma, abuse and social exclusion in their communities. Thus, developing dementia-friendly communities is a priority in the fight against dementia.

Objectives

This study investigated communities' attitudes towards people with dementia by exploring the colloquial terms referring to dementia and the social tolerance toward people with dementia.

Methods

A cross-sectional household study, using individual interviews, was conducted in the iLembe district, South Africa, with 300 participants aged ≥18 years. Data was collected between 2018 and 2019. Data was analysed using descriptive and reflexive thematic analyses.

Results

Two themes related to local dementia terms were identified: (i) There are no known local terms synonymous with the term dementia; (ii) Communities use inaccurate and stigmatizing terms to describe dementia. The terms identified did not accurately describe dementia, and others had negative connotations toward people with dementia. Although most participants reported being tolerant, neighbourly, and friendly towards people with dementia, their tolerance decreased when personal interaction was required with a person with dementia. Most participants reported a more agreeable attitude when considering being neighbours rather than family members of people with dementia, and 50.3% reported that their communities discriminate against older people with dementia.

Conclusion

The identified dementia terms did not promote dementia-friendly societies. Appropriate dementia terms are crucial for changing social intolerance and negative perceptions of people with dementia and promoting a dementia-friendly culture in South African communities. Terms that encourage and perpetuate stigma against people with dementia must be replaced with terms that promote inclusion and tolerance.
Resection of Extrapulmonary Lymphangiomyoma and Post-Operative Management Considerations
Authors: Abramov Roi , Rufizen Liel , Gilshtein Hayim
Published: March 2023

Background: Lymphangiomyomatosis is a rare disease involving the lymph vessels, causing obstruction and cystic formation with an incidence of 3-8 per million women. The disease might be sporadic or inherited. Lymphangiomyomatosis mostly affects the pulmonary system, whereas extrapulmonary Lymphangiomyomatosis may present in various site, occasionally as a localized abdominal mass. The diagnostic process might entail surgical resection to obtain a specimen for pathology that may also help to achieve a long-term control of the disease. Methods: Herein, we present a case of a 45 years old female, who suffered from pulmonary symptoms, and during her workup an abdominal mass was found. The patient underwent exploratory laparotomy with resection of a left retroperitoneal bilobar mass. Results: Histopathological report revealed Lymphangiomyoma. She had a complication of a lymphatic leakage that required a second laparotomy with satisfactory clinical outcome. Conclusions: Surgeons should be aware of the pathological lymphatics and manage post-operative complications by a trial of conservative.
Pivot Years. World War II in 20th-Century History
Authors: Eckel Jan
Published: March 2023

Even though the crucial importance of World War II has never been called into doubt by historians, it has not featured as a focal point for the interpretation of the 20th century in recent narratives. In most cases, historians have located the war's historical meaning within the dualistic framework of ‘catastrophe’ and ‘reconstruction’. For all its obvious plausibility, however, this approach tends to isolate the war from the wider historical context. This article develops and discusses three perspectives that may serve to embed World War II within broader historical trends. It highlights the global dimensions of the war, examines contemporaneous interpretations that proved influential for decades after the war's conclusion – most notably, the notion of an ‘international civil war’ – and explores the causal and perceptual cohesiveness of the ‘age of world wars’ between 1911/14 and 1945/53. By pursuing these avenues, the essay makes several claims. It argues that World War II must be understood as part of longer-term developments originating in the late 19th century and reaching far into the second half of the 20th century; that the era of the world wars gave rise to a coherent space of experience forming the core of this extended trajectory; that there was no monolithic ‘interwar’ period, while the intellectual history of these decades reveals a smooth transition from world war to ‘Cold War’; and, finally, that World War II acted as a catalyst for far-reaching changes on a global scale.
The Harraseeket Conference – Revisiting systems for ethics oversight of research with human participants
Authors: Rosenfeld Stephen J , Shaler George , Hickey Ross
Published: March 2023

The current system of ethical oversight in the United States is based on Institutional Review Board (IRB) review. The system was established in response to well-known and egregious mistreatment of subjects in both biomedical and social and behavioral research. In the decades since the research regulations were enacted, reaction to the burden of IRB oversight has led the system to focus on compliance and limit its active oversight disproportionately to studies that could present the risk of physical harm. At the same time, the characteristics of the research enterprise have changed and methodologies now present novel risks that were not envisioned in the regulations. We convened a group of IRB professionals, academic leaders, and others to discuss limitations of the current system, how that system could be changed to recognize evolving risks and an increasing focus on participant and community voice, and how it could better serve the needs of researchers and support the societal project of science as a public good. Recommendations included a call to reexamine the academic incentive structure, to develop a system to support consideration of ethical principles from the time of study design, and to explicitly provide different ethical support and oversight for high-risk interventional trials and lower risk biomedical and social behavioral research.
VIRT2UE: A European train-the-trainer programme for teaching research integrity
Authors: Evans Natalie , Schmolmueller Armin , Stolper Margreet , Inguaggiato Giulia , Hooghiemstra Astrid , Tokalic Ruzica , Pizzolato Daniel , Foeger Nicole , Marušić Ana , van Hoof Marc , Lanzerath Dirk , Molewijk Bert , Dierickx Kris , Widdershoven on Guy
Published: March 2023

Universities and other research institutions are increasingly providing additional training in research integrity to improve the quality and reliability of research. Various training courses have been developed, with diverse learning goals and content. Despite the importance of training that focuses on moral character and professional virtues, there remains a lack of training that adopts a virtue ethics approach. To address this, we, a European Commission-funded consortium, have designed a train-the-trainer programme for research integrity. The programme is based on (1) virtue ethics, (2) the ethos of science, (3) learning by doing and (4) learner-centred teaching. The blended learning programme combines e-learning modules with participatory group sessions. Trainers are taught how to guide researchers through a series of structured exercises for fostering reflection on scientific virtues, and how to promote understanding and application of the European Code of Conduct for Research Integrity. Trainers are provided with adaptable tools and resources that can be used and combined in different ways. The programme implementation began in Spring 2020 and 470 trainers have participated to date. When trainers were asked to grade – between 0 (very bad) and 10 (excellent) – the e-learning modules and the participatory exercises, 60% scored a grade 8 or higher (median = 8, IQR = 2) for the e-learning modules, whereas 80% scored a grade 8 or higher (median = 9, IQR = 1) for the participatory exercises. A majority felt that the training helped them as a trainer to learn about ways to organise and teach a research integrity course (82%) and would recommend the interactive exercises to others (92%). Trainers have educated over 3300 researchers in Europe using our virtue-based approach. The VIRT2UE train-the-trainer programme fosters research integrity by providing trainers with exercises and tools which enable them to stimulate the development of good researchers across Europe.
Analyzing continuous coach education courses in Portugal: Implications for youth development
Authors: Santos Fernando , Rathwell Scott , Sabino Bebiana , Camiré Martin , Strachan Leisha , MacDonald Dany J.
Published: March 2023

Continuous coach education courses (CCEC) are considered a crucial vehicle for exposing coaches to topics (e.g., nutrition, mental health, positive youth development) not addressed in their initial coach training. CCEC can help coaches develop well-rounded coaching practices based on youth's physical, social, emotional, and psychological needs. The purpose of the study was to analyze the distribution of CCEC offered in Portugal between 2014 and 2020. Descriptive and inferential statistics were used to analyze (a) the number of CCEC offered; (b) hours devoted to each topic; (c) the types of organizations who delivered CCEC; (e) the format of CCEC (i.e., online or in-person); (f) the geographical distribution of CCEC throughout Portugal; (g) the number of coach participants per topic. The results indicate that courses addressing mental health, social justice, positive youth development, and sleep hygiene are seldomly delivered in Portugal, meaning that coaches have few opportunities to be exposed to and learn about these important topics. Thus, our results suggest CCEC in Portugal may not be extending coaches’ knowledge much beyond topics covered in their initial coach training. The lack of breadth in training may help perpetuate the emphasis on the technical, tactical, and physical development of youth with the Portuguese youth sport system. Based on the results, implications for youth development are offered.
Advanced Hybrid Closed Loop in Adult Population With Type 1 Diabetes: A Substudy From the ADAPT Randomized Controlled Trial in Users of Real-Time Continuous Glucose Monitoring
Authors: van den Heuvel Tim , Kolassa Ralf , Keuthage Winfried , Kroeger Jens , Ré Roseline , de Portu Simona , Vorrink Linda , Shin John , Castañeda Javier , Vigersky Robert , Cohen Ohad
Published: March 2023

Background:

This analysis reports the findings from a predefined exploratory cohort (cohort B) from the ADAPT (ADvanced Hybrid Closed Loop Study in Adult Population with Type 1 Diabetes) study. Adults with type 1 diabetes (T1D) with suboptimal glucose control were randomly allocated to an advanced hybrid closed-loop (AHCL) system or multiple daily injections of insulin (MDI) plus real-time continuous glucose monitoring (RT-CGM).

Methods:

In this prospective, multicenter, exploratory, open-label, randomized controlled trial, 13 participants using MDI + RT-CGM and with HbA1c ≥8.0% were randomized to switch to AHCL (n = 8) or continue with MDI + RT-CGM (n = 5) for six months. Prespecified endpoints included the between-group difference in mean change from baseline in HbA1c, CGM-derived measures of glycemic control, and safety.

Results:

The mean HbA1c level decreased by 1.70 percentage points in the AHCL group versus a 0.60 percentage point decrease in the MDI + RT-CGM group, with a model-based treatment effect of −1.08 percentage points (95% confidence interval [CI] = −2.17 to 0.00 percentage points; P = .0508) in favor of AHCL. The percentage of time spent with sensor glucose levels between 70 and 180 mg/dL in the study phase was 73.6% in the AHCL group and 46.4% in the MDI + RT-CGM group; model-based between-group difference of 28.8 percentage points (95% CI = 12.3 to 45.3 percentage points; P = .0035). No diabetic ketoacidosis or severe hypoglycemia occurred in either group.

Conclusions:

In people with T1D with HbA1c ≥8.0%, the use of AHCL resulted in improved glycemic control relative to MDI + RT-CGM. The scale of improvement suggests that AHCL should be considered as an option for people not achieving good glycemic control on MDI + RT-CGM.
Exploring the Active Constitutions of Peach Blossom for Amelioration of Loperamide-Induced Mice Constipation by Ultra-Performance Liquid Chromatography-Mass Spectrometry Combined with Network Pharmacology
Authors: Fu Yu , Zhang Xinya , Song Zhenguang , Wang Lili , Zhao Peng , Chen Suiqing
Published: March 2023

Constipation is a multifactorial health problem resulting from systemic or neurologic disorders including medication. Peach blossom, an edible flower, could promote defecation, urination, and improve abdominal pain. However, the active components and mechanisms of action remain unclear. In the present study, we established a loperamide-induced mice constipation model to validate the anti-constipation activity of peach blossom. Some classical biomarkers for constipation, including fecal water content, gastrointestinal transit ratio, and fecal pellet weight were used to evaluate the efficacy of peach blossom. Then, the chemical compounds present in peach blossom were screened out by Ultra-performance liquid chromatography (UPLC)-Orbitrap fusion mass spectrometer combined with diagnostic ions and database searching. Finally, the potential mechanism of peach blossom for the treatment of constipation was explored by network pharmacology on a system level. Peach blossom significantly reduced the fecal water content, gastrointestinal transit ratio, and fecal pellet weight, which were increased in the model group. Histological analysis showed that peach blossom could alleviate histological changes of the colon in constipated mice. In UPLC-MS analysis, 40 compounds, mainly flavonoids and phenolic acids, were identified. Network pharmacology analysis results indicate that 27 compounds exhibited anti-constipation activity by neurotransmitter receptor activity, carboxylic acid binding, flavin adenine dinucleotide binding, adrenergic receptor, and nuclear receptor activity. In this study, we found that peach blossom might alleviate the pathological process of constipation by regulating multi-targets. Our study serves as a theoretical basis for the utilization and further development of peach blossom as a promising health food for ameliorating constipation.
Paresthesia Is Predictive of Symptom Recurrence After Fasciotomy for Exertional Compartment Syndrome of the Leg
Authors: Shankar Dhruv S. , Blaeser Anna M. , Gillinov Lauren A. , Vasavada Kinjal D. , Fariyike Babatunde B. , Mojica Edward S. , Borowski Lauren E. , Jazrawi Laith M. , Cardone Dennis A.
Published: March 2023

Background:

Exertional compartment syndrome (ECS) is an underdiagnosed cause of lower extremity pain among athletes. The condition can be managed operatively by fasciotomy to relieve excess compartment pressure. However, symptom recurrence rates after fasciotomy are considerable, ranging from 3% to 17%.

Hypothesis:

Leg paresthesia and its distribution during ECS episodes would be a significant predictor of outcomes after fasciotomy.

Study Design:

Retrospective cohort study.

Level of Evidence:

Level 4.

Methods:

We conducted a retrospective chart review of patients who underwent fasciotomy for ECS at our center from 2010 to 2020 (institutional review board no. 21-00107). We measured postoperative outcomes including pain frequency and severity, Tegner activity level, and return to sport. Significant predictors of outcomes were identified using multivariable linear and logistic regression. P values <0.05 were considered significant.

Results:

A total of 78 legs (from 42 male and 36 female participants) were included in the study with average follow-up of 52 months (range, 3-126 months); 33 participants (42.3%) presented with paresthesia. Paresthesia was an independent predictor of worse outcomes, including more severe pain at rest ( P = 0.05) and with daily activity ( P = 0.04), reduced postoperative improvement in Tegner scores ( P = 0.04), and lower odds of return to sport ( P = 0.05). Those with paresthesia symptoms in the tibial nerve distribution had worse outcomes than those without paresthesia in terms of preoperative-to-present improvement in pain frequency ( P < 0.01), pain severity at rest ( P < 0.01) and with daily activity ( P = 0.04), and return to sport ( P = 0.04).

Conclusion:

ECS patients who present with paresthesia have worse pain and activity outcomes after first-time fasciotomy, but prognosis is worst among those with tibial nerve paresthesia.

Clinical Relevance:

Paresthesia among ECS patients is broadly predictive of more severe recurrent leg pain, reduced activity level, and decreased odds of return to sport after fasciotomy.
Government Expenditures and Tax Revenues in the United States of America
Authors: Kirikkaleli Dervis , Ozbeser Bugra
Published: March 2023

This study explores the time-frequency dependency between government expenditures and tax revenues by employing the wavelet coherence approach using data from the United States of America (USA) for the period of 1960Q2 to 2019Q3. The four leading concepts regarding the correlation between government expenditures and tax revenues are the tax-and-spend, spend-and-tax, fiscal synchronization and institutional separation hypotheses. Our results indicate that government expenditures lead to tax revenues in both the short and long run for specific time intervals as proposed by the spend-and-tax hypothesis.
Prevalence of Presenteeism in Agricultural Workers: Systematic Review
Authors: Siqueira Vitória de Barros , Rocha Alaine de Souza Lima , Schwingel Paulo Adriano , Carvalho Fernando Martins
Published: March 2023

Background:

Presenteeism, the act of showing up to work when one is ill, is a prevailing global phenomenon, at rates varying from 30% to 90%. Presenteeism results in consequences to the worker’s health, like pain, depression, and poor work ability, as well as consequences to the organization like productivity loss, negative feelings and engagement of coworkers, and risk of accidents. Agriculture is an important sector for the global economy, providing employment for 27% of the global workforce. This study aimed to estimate the prevalence of presenteeism and its associated factors among agricultural workers.

Methods:

A systematic review was performed through searches at PubMed, Web of Science, LILACS, SciELO, EMBASE, PsycINFO, and Scopus databases. Observational studies (cross-sectional, cohort or case-control) that reported the prevalence of presenteeism in agricultural workers were eligible.

Findings:

A total of 139 studies were found but only two met the inclusion criteria. The selected studies reported prevalence rates of presenteeism of 5.0% and 58.2%. Poor work safety climate, female workers, workers dissatisfied with management, and sunscreen not available at the workplace were strongly associated with the prevalence of presenteeism.

Conclusions/Applications to Practice:

We concluded that the scientific literature about the prevalence of presenteeism among agricultural workers is scarce. Future studies about presenteeism among agricultural workers should measure the prevalence and/or incidence of presenteeism by using the epidemiological approach and, furthermore, should integrate these measures with the work productivity approach.
Contextualizing Bicultural Competence Across Youths’ Adaptation From High School to College: Prospective Associations With Mental Health and Substance Use
Authors: Gusman Michaela S. , Safa M. Dalal , Grimm Kevin J. , Doane Leah D.
Published: March 2023

Bicultural competence, the ability to navigate bicultural demands, is a salient developmental competency for youths of color linked with positive adjustment. In this study, we investigated how discrimination experiences informed developmental trajectories of behavioral and affective bicultural competence across youths’ adaptation from high school to college and how these biculturalism trajectories predicted later adjustment (i.e., internalizing symptoms and binge drinking). Data were collected between 2016 and 2020 and included 206 U.S. Latino youths (mean age = 17.59 years, 64% female, 85% Mexican origin, 11% first-generation immigrants, and 62% second-generation immigrants). Linear latent growth analyses revealed that youths who experienced greater time-varying discrimination demonstrated lower concurrent behavioral and affective bicultural competence. Higher behavioral bicultural competence intercepts were associated with fewer internalizing symptoms in the third college year. No other significant associations emerged for internalizing symptoms or binge drinking. These findings have implications for mental-health equity among Latino youths during a critical period of psychopathology onset.
Empirical research and proposed planning methodology for the greening of urban buildings to achieve low-carbon effects
Authors: Hong Wuyang , Guo Renzhong
Published: March 2023

Building coverage in urban areas is gradually increasing, inducing a lack of green spaces—a common problem for sustainable urban development. Greenery on buildings has significant low-carbon effects and it becomes an innovative approach to reduce loss of urban green spaces. This paper focused on the planning methodology for urban building greening and established the content framework including the investigation and analysis, planning proposal, and management policies. In addition, the key issues that affect planning scientificity and implementation were discussed. Quantitative models on greening potential were developed, and a combined policy system comprising incentives and mandatory measures was established. Shenzhen is a typical Chinese city densely built-up with a shortage of green spaces. The city was taken as the empirical research object to analyze the current scale and compositional, and the distributional characteristics of building greening planning. Method of estimating the low-carbon effects of building greening was proposed. The results indicate that the carbon reduction effect of existing building greening was 1.96%, which reached 5.55% under the planning scenario. Finally, the paper emphasized the need for a planning methodology to realize the large-scale refurbishment of existing buildings, and discussed the issue of planning implementation being highly dependent on public policies.
Anxiety and Depression in Spouses of Cardiac Patients
Authors: Pushkarna Megha
Published: March 2023

It is becoming increasingly apparent that although anxiety and depression are separate concerns, there is considerable overlap of clinical symptoms and pathophysiological processes. Research shows that comorbidities, anxiety, and depression are most common than either disorder alone. Coronary heart disease and mental illness are among the leading causes of morbidity and mortality worldwide. Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience challenging and demanding situations when their partner becomes critically ill.

In the present research, spouses showed normal anxiety levels, but when assessed separately, women’s anxiety scores were significantly higher compared to men. There was no significant difference between male and female spouses’ depression scores. Correlation analysis showed a positive relationship between anxiety and depression scores explaining that with rise in anxiety scores, there was an increase in depression scores in female spouses. Spouses who were unemployed felt overwhelmed with not being financially competent to manage expenses incurred for surgery and pre- and postoperative care. Lastly, a lack of social support led to anxiety in nuclear families.
The Clinical Picture of the ERCC6L2 Disease - from Bone Marrow Failure to Acute Leukemia
Authors: Hakkarainen Marja , Kaaja Ilse , Douglas Suvi P. M. , Vulliamy Thomas J , Dokal Inderjeet , Soulier Jean , Larcher Lise , Peffault de Latour Régis , Leblanc Thierry M , Sicre de Fontbrune Flore , Siitonen Timo , Lohi Olli , Hellström-Lindberg Eva , Barbany Gisela , Tesi Bianca , Shimamura Akiko , Beier Fabian , Jackson Sharon Rosalie , Kuperman Amir , Falik Zaccai Tzipora C. , Tamary Hannah , Mecucci Cristina , Capolsini Ilaria , Jahnukainen Kirsi , Salmenniemi Urpu , Niinimäki Riitta , Varilo Teppo , Kilpivaara Outi , Wartiovaara-Kautto Ulla
Published: March 2023

Biallelic germline ERCC6L2 variants strongly predispose to bone marrow failure (BMF) and myeloid malignancies characterized by somatic TP53-mutated clones and erythroid predominance. We present a series of 52 subjects (35 families) with ERCC6L2 biallelic germline variants collected retrospectively in 11 centers globally, including follow-up of 1165 person-years. At initial investigations, 32 individuals were diagnosed with BMF and 15 with a hematological malignancy (HM). Subjects presented with 19 different variants across ERCC6L2, and we identified a founder mutation c.1424delT in the Finnish patients. The median age of subjects at baseline was 18 years (range 2-65). Changes in complete blood count (CBC) were mild despite severe bone marrow hypoplasia and somatic TP53 mutations, with no significant difference between subjects with or without (HM). Signs of a progressive disease were increasing TP53 variant allele frequency, dysplasia in megakaryocytes and/or erythroid lineage, and erythroid predominance in bone marrow morphology. The median age at onset of HM was 37.0 years (95% CI: 31.5-42.5; range 12-65). Overall survival (OS) at 3 years was 95% (95% CI: 85-100) and 19% (95% CI: 0-39) for patients with BMF and HM, respectively. Patients with myelodysplastic syndrome or acute myeloid leukemia with mutated TP53 undergoing hematopoietic stem cell transplantation had a poor outcome: 3-year OS is 28% (95% CI: 0-61). Our results demonstrate the importance of early recognition and active surveillance of patients with biallelic germline ERCC6L2 variants.
Cardiopulmonary exercise testing during follow-up after acute pulmonary embolism
Authors: Farmakis Ioannis T. , Valerio Luca , Barco Stefano , Alsheimer Eva , Ewert Ralf , Giannakoulas George , Hobohm Lukas , Keller Karsten , Mavromanoli Anna C. , Rosenkranz Stephan , Morris Timothy A. , Konstantinides Stavros V. , Held Matthias , Dumitrescu Daniel
Published: March 2023

Background

Cardiopulmonary exercise testing (CPET) may provide prognostically valuable information during follow-up after pulmonary embolism (PE). Our objective was to investigate the association of patterns and degree of exercise limitation, as assessed by CPET, with clinical, echocardiographic and laboratory abnormalities and quality of life (QoL) after PE.

Methods

In a prospective cohort study of unselected consecutive all-comers with PE, survivors of the index acute event underwent 3- and 12-month follow-ups, including CPET. We defined cardiopulmonary limitation as ventilatory inefficiency or insufficient cardiocirculatory reserve. Deconditioning was defined as peak O2uptake (V′O2) <80% with no other abnormality.

Results

Overall, 396 patients were included. At 3 months, prevalence of cardiopulmonary limitation and deconditioning was 50.1% (34.7% mild/moderate; 15.4% severe) and 12.1%, respectively; at 12 months, it was 44.8% (29.1% mild/moderate; 15.7% severe) and 14.9%, respectively. Cardiopulmonary limitation and its severity were associated with age (OR per decade 2.05, 95% CI 1.65–2.55), history of chronic lung disease (OR 2.72, 95% CI 1.06–6.97), smoking (OR 5.87, 95% CI 2.44–14.15) and intermediate- or high-risk acute PE (OR 4.36, 95% CI 1.92–9.94). Severe cardiopulmonary limitation at 3 months was associated with the prospectively defined, combined clinical-haemodynamic end-point of “post-PE impairment” (OR 6.40, 95% CI 2.35–18.45) and with poor disease-specific and generic health-related QoL.

Conclusions

Abnormal exercise capacity of cardiopulmonary origin is frequent after PE, being associated with clinical and haemodynamic impairment as well as long-term QoL reduction. CPET can be considered for selected patients with persisting symptoms after acute PE to identify candidates for closer follow-up and possible therapeutic interventions.
Air pollution and COPD: GOLD 2023 committee report
Authors: Sin Don D. , Doiron Dany , Agusti Alvar , Anzueto Antonio , Barnes Peter J. , Celli Bartolome R. , Criner Gerard J. , Halpin David , Han MeiLan K. , Martinez Fernando J. , Montes de Oca Maria , Papi Alberto , Pavord Ian , Roche Nicolas , Singh Dave , Stockley Robert , Lopez Varlera M. Victorina , Wedzicha Jadwiga , Vogelmeier Claus , Bourbeau Jean
Published: March 2023

Exposure to air pollution is a major contributor to the pathogenesis of COPD worldwide. Indeed, most recent estimates suggest that 50% of the total attributable risk of COPD may be related to air pollution. In response, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Scientific Committee performed a comprehensive review on this topic, qualitatively synthesised the evidence to date and proffered recommendations to mitigate the risk. The review found that both gaseous and particulate components of air pollution are likely contributors to COPD. There are no absolutely safe levels of ambient air pollution and the relationship between air pollution levels and respiratory events is supra-linear. Wildfires and extreme weather events such as heat waves, which are becoming more common owing to climate change, are major threats to COPD patients and acutely increase their risk of morbidity and mortality. Exposure to air pollution also impairs lung growth in children and as such may lead to developmental COPD. GOLD recommends strong public health policies around the world to reduce ambient air pollution and for implementation of public warning systems and advisories, including where possible the use of personalised apps, to alert patients when ambient air pollution levels exceed acceptable minimal thresholds. When household particulate content exceeds acceptable thresholds, patients should consider using air cleaners and filters where feasible. Air pollution is a major health threat to patients living with COPD and actions are urgently required to reduce the morbidity and mortality related to poor air quality around the world.
ERS International Congress 2022: highlights from the Allied Respiratory Professionals Assembly
Authors: Price Oliver J. , Paixão Cátia , Poddighe Diego , Miranda Sabina , Silva Rui , Silva Liliana , Volpato Eleonora , Sylvester Karl , Nyberg André , Šajnić Andreja , Cruz Joana
Published: March 2023

In this article, we provide a brief overview of some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2022 European Respiratory Society International Congress, which was held in a hybrid format. Early Career Members from Assembly 9 summarised the content of the sessions, with the support of the Officers from the four Assembly groups: Respiratory Function Technologists and Scientists (Group 9.01); Physiotherapists (Group 9.02); Nurses (Group 9.03); and Psychologists and Behavioural Scientists (Group 9.04). The sessions covered the following topics: recent advances in cardiopulmonary exercise and challenge testing; the role and new trends in physiotherapy, exercise and physical activity promotion interventions in chronic respiratory diseases; development of the international curriculum for respiratory nurses and nursing aspects in disease management; and treatment adherence, e-health interventions and post-coronavirus disease 2019 challenges. This Highlights article targets delegates who attended the Congress sessions, as well as those who were unable to attend, and provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.
Application of the Rome severity classification of COPD exacerbations in a real-world cohort of hospitalised patients
Authors: Reumkens Carmen , Endres Adrian , Simons Sami O. , Savelkoul Paul H.M. , Sprooten Roy T.M. , Franssen Frits M.E.
Published: March 2023

Background

Recently, the Rome classification was proposed in which objective and readily measurable variables were integrated to mark exacerbations of COPD (ECOPD) severity. The aim of this study is to investigate the distribution of a real-world patient population with hospitalised ECOPD according to the current classification across the newly proposed severity classification. We assume that a significant proportion of hospitalised patients will have a mild or moderate event.

Methods

The Rome classification was applied to a cohort of 364 COPD patients hospitalised at the Department of Respiratory Medicine of Maastricht University Medical Center (MUMC) with a severe ECOPD. Differences in in-hospital, 30- and 90-day mortality were compared between mild, moderate and severe ECOPD according to the new classification. Moreover, data were stratified by the different severity classes and compared regarding general disease characteristics and clinical parameters.

Results

According to the Rome proposal, 52 (14.3%) patients had a mild ECOPD, 204 (56.0%) a moderate and 108 (29.7%) a severe ECOPD. In-hospital mortality in mild, moderate and severe events was 3.8%, 6.9% and 13.9%, respectively. Most clinical parameters indicated a significantly worse condition in patients classified in the severe group, compared to those in mild or moderate groups.

Conclusion

Most of the events, traditionally all classified as severe because of the hospitalisation, were classified as moderate, while almost 15% were mild. The results of this study provide insight into the heterogeneity of hospitalised ECOPD and show that the newly proposed Rome criteria can differentiate between events with different short-term mortality rates.
The Bronchiectasis Exacerbation Diary: a novel patient-reported outcome for non-cystic fibrosis bronchiectasis
Authors: Shih Vivian H. , Jison Maria , Bark Erik , Venerus Meredith , Meyers Oren , Chalmers James D.
Published: March 2023

Bronchiectasis is a chronic, progressive lung disease believed to result from a vicious cycle of infection and inflammation, with symptoms of chronic cough with sputum production, chronic fatigue, rhinosinusitis, chest pain, breathlessness and haemoptysis. There are currently no established instruments to monitor daily symptoms and exacerbations for use in clinical trials. Following a literature review and three expert clinician interviews, we conducted concept elicitation interviews with 20 patients with bronchiectasis to understand their personal disease experience. Findings from literature and clinician feedback were used to develop a draft version of the Bronchiectasis Exacerbation Diary (BED), which was designed to monitor key symptoms on a daily basis and during exacerbations. Patients were eligible to be interviewed if they were US residents aged ≥18 years, had a computed tomography scan–confirmed diagnosis of bronchiectasis with ≥two exacerbations in the previous 2 years and had no other uncontrolled respiratory conditions. Four waves of five patient interviews each were conducted. Patients (n=20) had a mean±SDage of 53.9±12.8 years, and most were female (85%) and white (85%). A total of 33 symptoms and 23 impacts arose from the patient concept elicitation interviews. The BED was revised and finalised based upon patient feedback. The final BED is a novel, eight-item patient-reported outcome (PRO) instrument for monitoring key exacerbation symptoms on a daily basis with content validity established through comprehensive qualitative research and direct patient insight. The BED PRO development framework will be completed following psychometric evaluations of the data from a phase 3 bronchiectasis clinical trial.
The Palestinian primary ciliary dyskinesia population: first results of the diagnostic and genetic spectrum
Authors: Rumman Nisreen , Fassad Mahmoud R. , Driessens Corine , Goggin Patricia , Abdelrahman Nader , Adwan Adel , Albakri Mutaz , Chopra Jagrati , Doherty Regan , Fashho Bishara , Freke Grace M. , Hasaballah Abdallah , Jackson Claire L. , Mohamed Mai A. , Abu Nema Reda , Patel Mitali P. , Pengelly Reuben J. , Qaaqour Ahmad , Rubbo Bruna , Thomas N. Simon , Thompson James , Walker Woolf T. , Wheway Gabrielle , Mitchison Hannah M. , Lucas Jane S.
Published: March 2023

Background

Diagnostic testing for primary ciliary dyskinesia (PCD) started in 2013 in Palestine. We aimed to describe the diagnostic, genetic and clinical spectrum of the Palestinian PCD population.

Methods

Individuals with symptoms suggestive of PCD were opportunistically considered for diagnostic testing: nasal nitric oxide (nNO) measurement, transmission electron microscopy (TEM) and/or PCD genetic panel or whole-exome testing. Clinical characteristics of those with a positive diagnosis were collected close to testing including forced expiratory volume in 1 s (FEV1) Global Lung Index z-scores and body mass index z-scores.

Results

68 individuals had a definite positive PCD diagnosis, 31 confirmed by genetic and TEM results, 23 by TEM results alone, and 14 by genetic variants alone. 45 individuals from 40 families had 17 clinically actionable variants and four had variants of unknown significance in 14 PCD genes. CCDC39,DNAH11andDNAAF11were the most commonly mutated genes. 100% of variants were homozygous. Patients had a median age of 10.0 years at diagnosis, were highly consanguineous (93%) and 100% were of Arabic descent. Clinical features included persistent wet cough (99%), neonatal respiratory distress (84%) and situs inversus (43%). Lung function at diagnosis was already impaired (FEV1z-score median −1.90 (−5.0–1.32)) and growth was mostly within the normal range (z-score mean −0.36 (−3.03–2.57). 19% individuals had finger clubbing.

Conclusions

Despite limited local resources in Palestine, detailed geno- and phenotyping forms the basis of one of the largest national PCD populations globally. There was notable familial homozygosity within the context of significant population heterogeneity.