bluuebunny/crossref_metadata_2025 huggingface dataset:
Hearing functional harmony in jazz: A perceptual study of music-theoretical accounts of extended tonality
Authors: Cecchetti Gabriele , Herff Steffen A. , Finkensiep Christoph , Harasim Daniel , Rohrmeier Martin A.
Published: November 2022

Functional harmony is an integral part of many repertoires in the Western musical practices, including both diatonic and extended tonality. In the latter context, music-theoretical accounts suggest that the three octatonic equivalence classes (OECs) consisting of pitch-classes related by stacked minor-third intervals may be associated with tonic (T), dominant (D), and subdominant (S) functions. Whether this theoretical description of music is also relevant to the perception of music has not yet been tested empirically. In this study, 100 participants familiar with Western repertoires were presented with jazz chord progressions containing chord substitutions. When each stimulus had been played, participants predicted how many more chords they would have expected to hear before the progression could reach a plausible conclusion. We computed the similarity of responses for pairs of stimuli containing different harmonic substitutions and modeled such similarity values based on different measures of harmonic relatedness between substitutions. Data show that the OEC membership of substitutions strongly predicts the similarity of participants’ completion ratings. Bayesian mixed-effects modeling of similarity values further showed a categorical distinction between D and S as functional categories, on one hand, and T, on the other hand. The data also appear to reflect the prevalent influence of rock and pop repertoires on the participants, encouraging further research into the influence of stylistic diversity and musical expertise. Overall, results contribute to the characterization of listeners’ implicit knowledge of the principles of harmonic structure in extended tonality and support the relevance of OECs not only as descriptors of extended-tonal compositional practices but also parsimonious predictors of perceived functionality.
The effect of dichotic music presentation on ratings of emotional facial expressions
Authors: Hae Erika Y , Hatin Bianca DM
Published: November 2022

Music has a cross-modal influence on the emotional appraisal of pictures, probably due to a misattribution of emotion from music to the visually perceived images. Moreover, dichotic listening studies have demonstrated a left-ear (right-hemisphere) advantage for processing emotional and/or musical stimuli. The present study investigated the role of laterality in cross-modal affect misattribution: that is, whether visual judgments of emotion would be affected differently depending on which ear was presented with music via the dichotic listening task. Participants rated the emotionality of happy, sad, and neutral faces while listening to happy or sad music in one ear and white noise in the other. Baseline ratings without music were used as a comparison to see whether and how emotionality judgments shifted in the music conditions. As predicted, the results showed that happy music played to the left ear had a stronger cross-modal influence on ratings of sad faces than the same music played to the right ear. Furthermore, sad music affected the ratings of all faces regardless of whether it was played to the left or right ear. These results do not fully align with any given lateralized model of emotion processing, suggesting that other factors such as negativity bias may play a role.
Cognitive remediation therapy: is it a feasible and acceptable psychological treatment for borderline personality disorder?
Authors: Dinu Bianca , Dark Frances
Published: November 2022

Objective

Cognitive remediation (CR) is increasingly being used to address the cognitive impairment that can occur in people diagnosed with borderline personality disorder (BPD). This study aimed to understand attitudes towards CR in this service user group from the perspective of the person with the diagnosis and clinicians involved in their care.

Method

Anonymous online surveys were made available to people with a diagnosis of BPD in a public mental health service and clinicians of the same service.

Results

Thirty-three percent of service users with a diagnosis of BPD responded to the survey. Most respondents (93%) expressed a desire to improve their cognition and were interested in cognitive remediation therapy (83%). Most staff (88%) recognised cognitive impairment can occur in people with a diagnosis of BPD and the same proportion believed cognitive skills impact on patient’s emotional and mental health. Seventy percent of respondents believed CR would be useful for this service user group.

Conclusions

It is important that interventions to address the cognitive impairment associated with BPD are made available and that they are well integrated into the person’s overall care plan.
Comparison of the context provision and imagination elicitation approaches to learning emotional vocabulary
Authors: Sánchez María Jesús , Fernández María , Pérez-García Elisa
Published: November 2022

The purpose of this study is to examine which teaching methodology – context provision or imagination elicitation – is more efficient to learn emotional vocabulary in the English as a foreign language (EFL) classroom. A pre-test / post-test design was used to test the benefit of the two types of instruction, compared to a traditional teaching method. A total of 60 EFL students at a B2 level (Council of Europe, 2001, 2018) participated in the research. A set of 40 emotional words was selected according to the following criteria: to be emotional and mid-frequency vocabulary in English, and rather unknown words by B2-level students in order to allow room for learning. Statistical analyses showed that the instruction phase was successful, since the groups significantly differed in the post-test. Although the two experimental treatments were effective, the imagination elicitation approach turned out to be better than the context provision method. The conclusion has relevant pedagogical implications for the EFL classroom.
Immediate and delayed effects of everyday racial discrimination on mental health among Black college students: A mixed-methods approach
Authors: Volpert-Esmond Hannah I. , Landor Antoinette M. , Bartholow Bruce D.
Published: November 2022

Experiences of racial discrimination significantly contribute to both mental and physical health outcomes. In this mixed-methods study, we examine both the immediate and delayed effect of discrimination experienced in daily life. Black students at a predominantly White university reported instances of racial discrimination, affect, anxiety, and depression several times per day over 4 weeks ( N = 114); this was followed by qualitative focus groups ( N = 25). Reporting an instance of discrimination corresponded with an acute decline in psychological wellbeing (higher negative affect, anxiety, and depression), consistent with previous work. However, this effect did not carry forward to later assessments during the same day or the following day as expected. Instead, positive affect temporarily increased in the hours following experiences of discrimination. Qualitative focus groups revealed social support, emotional reflection and processing, and feelings of taking action as important factors contributing to this bump in positive affect.
From asymmetric to symmetric consumption opportunities: Extractions from common resources by privileged and underprivileged group members
Authors: Nockur Laila , Pfattheicher Stefan , Keller Johannes
Published: November 2022

In social dilemmas, asymmetric opportunities among actors can aggravate the conflict between individual and collective interests. We examine if and under what conditions redistributing extraction opportunities symmetrically fosters sustainable resource consumption. Participants in two studies (total n=640) completed a common resource game, first under asymmetric distribution of extraction opportunities (i.e., two advantaged group members could extract more than two disadvantaged group members) and then under symmetric distribution (i.e., all group members could extract the same amount). Advantaged (vs. disadvantaged) individuals took more from the resource in the asymmetric game and voted more often for the maintenance of the asymmetric system. Consumption was overall not more sustainable under symmetric (vs. asymmetric) distribution. We did not find evidence that these effects depend on the legitimacy of status positions. Of note, the symmetric game elicited higher satisfaction and fairness ratings in both status groups. The findings demonstrate how unequal access to resources fosters unequal consumption despite broad support for symmetry as the fairer system.
In-train particulate matter (PM10 and PM2.5) concentrations: Level, source, composition, mitigation measures and health risk effect – A systematic literature review
Authors: Otuyo Muhsin K , Mohd Nadzir Mohd Shahrul , Latif Mohd Talib , Saw Lip Huat
Published: November 2022

Exposure of commuters to pollutants on trains has been an essential topic of discussion in recent years due to its health implications. This review summarizes literature that measures particulate matter (PM) in trains to understand the concentration levels and health effects caused due to exposure. The databases searched were Scopus, Web of Science (WOS) and Google Scholar. Articles, conference papers and textbooks written in English, measuring PM in train carriages and published between 1998 and 2022 were selected for this review. Out of the 3247 articles identified, only 73 were included in this study. 15/20 articles agreed that concentration is significant at the underground segment by a factor of 7 than the counterpart above/ground levels. The review observed that 80% of the publication of in-train concentrations of PM10 and PM2.5 were above the WHO standard. In-train PM2.5 concentration ranges from 2 μgm−3 to 563 μgm−3, and in-train PM10 concentration ranges from 6 μgm−3 to 997 μgm−3. People’s activities, mechanical movement of train parts, train operation conditions and local emissions were the primary source of PM. Future research should focus on health damage due to PM exposure and the effect of the filtration system on PM levels in trains.
A uniform front?: Power and front-line worker variation in Kakuma refugee camp, Kenya
Authors: Sackett Blair
Published: November 2022

Front-line workers, or street-level bureaucrats, who interact directly with clients, have significant discretion over clients’ lives. Drawing upon ethnographic observation in Kakuma refugee camp in Kenya and interviews with aid workers, I argue that front-line workers are not a uniform group. I examine three types of front-line aid workers (international, national, and refugee), who work directly with refugee clients. Workers use day-to-day work practices to structure where, when, and how they interact with refugee clients. Yet, workers at the bottom of the organizational hierarchy are less equipped to use these practices. As a result, they are vulnerable to increased criticism and accusations of corruption from co-workers and are uniquely affected by criticism from the refugee client community. By examining their day-to-day work practices, this paper illuminates how inequalities in power among workers contribute to differences in work practices and vulnerability in workplace interactions.
Effects of excess air ratio and spark timing on performance and gaseous pollutant emissions of fuel reforming natural gas engine
Authors: Zheng Jian , Zhou Rui , Zheng Zuwei , Zhang Yiran , Lin He
Published: November 2022

The combustion and emission characteristics as well as the economic performance of partial oxidation fuel reforming (POFR) natural gas engines were investigated by adjusting the fuel reforming ratios and the engine load. The performance of the POFR engine with a 12% fuel reforming ratio was compared with that of the original engine. The results showed that the fuel-partial-reforming was effective in reducing the cycle-to-cycle variations over the whole range of the operating conditions. The THC and NOX emissions decreased at almost all operating conditions, but showed different decreasing trends at different loads and equivalence ratios, while the CO emissions increased at all operating conditions. It was found that reducing the advancement of ignition timing of the POFR-engine can further reduce the gaseous pollutant emissions without reducing the economic performance of the engine. In conclusion, blending reforming gas improved the overall performance of the natural gas engine at low to medium load conditions.
Glycaemic variability and risk of adverse cardiovascular events in acute coronary syndrome
Authors: Zhang Lei , Li Feng , Liu Huan-Huan , Zhang Zhi-Yuan , Yang Fan , Qian Ling-Ling , Wang Ru-Xing
Published: November 2022

Objective

The relationship between different glycaemic variability (GV) indexes and adverse cardiovascular outcomes is not well understood. This study aims to determine whether GV is related to the occurrence of adverse cardiovascular events in patients with acute coronary syndrome (ACS).

Methods

PubMed, EMBASE, and Web of Science were comprehensively searched from the establishment of databases to 29 June 2022. The relationship between two important GV indexes, including the mean amplitude of glycemic excursion (MAGE) and standard deviation (SD), and the adverse cardiovascular events in ACS patients were evaluated, respectively.

Results

A total of 11 studies with 3709 ACS patients were included. Pooled results showed that patients with higher GV had significantly increased risk of adverse cardiovascular events, including MAGE (relative risk [RR] = 1.76, 95% CI: 1.40 to 2.22, p < 0.001, I2 = 25%) and SD (RR = 2.14, 95% CI: 1.73 to 2.66, p < 0.001, I2 = 0%).

Conclusions

Increased GV is related to the poor prognosis in patients with ACS. Additionally, more well-designed studies comparing different indicators of GV with adverse cardiovascular events in ACS patients are still warranted.
Preparation and properties of electrospun chitosan/polybutylenes succinate nanofiber membrane for wound hemostatic dressing
Authors: Wu Hongyan , Yan Shuang , Wang Yang , Zhang Changhuan
Published: November 2022

In order to make full use of the advantages of Chitosan in the process of wound repair and overcome the difficulty that Chitosan can not be electrospinned alone, Chitosan/Polybutylenes succinate nanofiber membrane was prepared by electrospinning, and its properties were tested and analysed. The results show that the content of Chitosan will affect the properties of composite fiber membrane, such as liquid absorption and hemostatic properties. When the content of Chitosan is 90%, the comprehensive performance of Chitosan/Polybutylenes succinate fiber membrane is the best and is most suitable for wound hemostatic dressing.
Infection Rate in Type I Open Distal Radius Fractures Surgically Treated >24 Hours Post-Injury: A Comparison Study
Authors: Colello Michael J. , Long Edward , Zimmerman Parker , Tanner Stephanie L. , Faucher Gregory
Published: November 2022

Purpose:

To determine how time to surgical debridement and fixation affects infection and complication rate in type I open distal radius fractures by comparing patients treated within 24 hours with those treated >24 hours post-injury.

Methods:

A retrospective review identified 62 patients who sustained a type I open distal radius fracture that was treated surgically. Patients were stratified into groups based on time to surgical intervention. An additional analysis was performed on patients with an isolated type I open distal radius fracture treated as an inpatient or outpatient. The primary outcome measure was infection rate. Secondary outcome measures were complications, reoperations, and readmissions.

Results:

Thirty-eight patients underwent surgery ≤24 hours post-injury at an average of 14 hours. Twenty-four patients underwent surgery >24 hours post-injury at an average of 72 hours. There were a total of 9 complications in 8 patients (14.5%). The overall infection rate was 1.6%, with only 1 deep infection occurring in the group treated ≤24 hours post-injury. There were 7 reoperations (11.3%) and 1 readmission (1.6%). No differences were found between groups in any outcome measure. In the 27 patients with an isolated fracture, there were no differences in any outcome measure when treated as an inpatient or outpatient.

Conclusions:

We suggest that type I open distal radius fractures could be safely treated surgically >24 hours post-injury without increased risk of infection.
Multi-objective optimization design of two-dimensional proportional valve with magnetic coupling
Authors: Xu Hao , Meng Bin , Zhu Chenhang , Heng Yaozhen , Ruan Jian
Published: November 2022

As a hydro-mechanical servo system, the whole performance of the two-dimensional proportional valve with magnetic coupling (2D-MC-PV) highly depend on certain structural parameters. To tradeoff good static/dynamic characteristics, good working stability and low leakage pilot stage, a multi-objective optimization is inevitable for preliminary design stage. Therefore, this paper proposes a multi-objective optimization method based on AMESim and Matlab/Simulink co-simulation model, which optimizes key structural parameters by adjusting weight coefficients (balancing static, dynamic, and pilot leakage performance). Considering that magnetic coupling (MC) is the key component for 2D-MC-PV to realize spool position feedback and translational motion conversion, the analytical equation of MC is derived based on the Coulomb’s law and the law of equivalent magnetic charge, and the Monte Carlo method is used to calculate. Finally, the prototype of 2D-MC-PV is designed and manufactured, and a special experimental platform is built to test the static/dynamic characteristics. The experimental results show that 2D-MC-PV has good working stability: under working pressure of 20 MPa, the maximum no-load flow rate is 108.8 L/min with the hysteresis of 3.36%, and the amplitude and phase frequency width is 27.8 and 36.6 Hz. It shows that the multi-objective optimization method proposed in this paper can be used as an optimization method for 2D-MC-PV.
Strategies to facilitate adolescent access to medicines: Improving regulatory guidance
Authors: Bucci-Rechtweg Christina , Siapkara Angeliki , An Haack Bonnet Kristina , Corriol Rohou Solange , Haf Davies Elin , Dehlinger Kremer Martine , Gamalo Margaret , Moreno Carmen , Nelson Robert M , Thomas Turner Rhian
Published: November 2022

Background:

Historically, pediatric medicines are developed after adult trials are completed, even when identical drug targets and disease similarities exist across the populations. This has resulted in significant delays in the authorization of medicines for adolescent use, limiting access to beneficial drugs. This study sought to understand how adolescent inclusion in adult trials is positioned in regulatory guidance documents as they set critical expectations for trial design and regulatory decision-making.

Methods:

This study utilized a qualitative analysis approach. Guidance documents were identified via Food and Drug Administration and European Medicines Agency websites. Utilizing a blinded adjudication process, the documents were classified as permissive, exclusionary, or silent regarding recommendations about adolescent inclusion in adult clinical trials. A post hoc analysis of similarities and differences between the Food and Drug Administration and European Medicines Agency guidance documents was conducted to assess the possible role of regional pediatric research laws on age-inclusive trial methodologies as well as emergent themes by therapeutic area.

Results:

In total, 96 Food and Drug Administration (1977 to 2019) and 106 European Medicines Agency (1987 to 2019) guidance documents were identified for analysis. The guidance contained explicit or implicit recommendations supporting adolescent inclusion in adult trials in 32% of Food and Drug Administration and 15% of European Medicines Agency documents, while 14% and 21%, respectively, were found to be exclusionary. A large number of guidance documents were silent regarding the applicability of adolescent-inclusive trial designs (53% and 64%, Food and Drug Administration and European Medicines Agency, respectively). Analysis by therapeutic area revealed the most permissive of adolescent inclusion in Food and Drug Administration guidance for infectious diseases and conditions requiring blood products in European Medicines Agency guidance. A more holistic approach to age-inclusive trial design was identified in disease guidance published by the Food and Drug Administration Oncology Center of Excellence.

Discussion:

There are many influences on the development and/or revision of regulatory guidance documents. Substantial scientific knowledge and regulatory precedence for the inclusion of adolescents within adult trials are available to inform research approaches. Our study has identified important opportunities for the enhancement of guidance. For example, contextualization of developmental factors influencing adolescent disease progression provides insights into the role of adolescent inclusion. If addressed, guidance documents can facilitate broader acceptance of age-inclusive trial methodologies and accelerate adolescent access to medicines.
A composite learning approach for multiple fault diagnosis in gears
Authors: Inyang Udeme Ibanga , Petrunin Ivan , Jennions Ian
Published: November 2022

A major part of Prognostic and Health Management of rotating machines is dedicated to diagnosis operations. This makes early and accurate diagnosis of single and multiple faults an economically important requirement of many industries. With the well-known challenges of multiple faults, this paper proposes a new Blended Ensemble Convolutional Neural Network – Support Vector Machine (BECNN-SVM) model for multiple and single faults diagnosis of gears. The proposed approach is obtained by preprocessing the acquired signals using complementary signal processing techniques. This form inputs to 2D Convolutional Neural Network base learners which are fused through a blended ensemble model for fault detection in gears. Discriminative properties of the complementary features ensure the high capabilities of the approach to give good results under different load, speed, and fault conditions of the gear system. The experimental results show that the proposed method can accurately detect rotating machine faults. The proposed approach compared with other state-of-the-art methods indicates improved overall effectiveness for gear faults diagnosis.
Interstitial Institutions
Authors: Egholm Liv
Published: November 2022

Lately, cultural sociologists have been engaged in theorizing the complexity and ambiguities of border-crossing translations from a variety of research strings. This article contributes to this theorizing by developing the concept of interstitial institutions as ongoing sites of translations. Building on the history of gift-giving practices of Danish philanthropic organizations from the enactment of the Danish constitution in 1849 till today, the article broadens and expands on civil sphere theory (CST) in three ways. First, it shows how interstitial institutions are an important site of translation because they work as a lock on the border between the non-civil and civil spheres, and this dual membership inevitably leads to ongoing boundary tensions. Second, the study of interstitial institutions provides insights into how civil repair is molded by cultural-historical contexts and narratives and consequently fertilizes particular ways of mobilizing cultural codes. Third, studying interstitial institutions and their translation practices emphasizes and strengthens CST’s processual ground.
‘Smash this sissy boy’s mouth, Cuiguo!’: Framing and humor in gay Taiwanese YouTubers’ self-disclosures about being bullied
Authors: Chen Li-Chi
Published: November 2022

Sharing one’s past experience of being bullied is expected to be painful, but gay Taiwanese YouTubers’ self-disclosures about how they became victims of homophobic bullying are frequently accompanied by humor and shared laughter. Their interactions are also presented multimodally with other visual and audible semiotic resources. Adopting a multimodal social semiotic approach and a framing approach, this study analyzes three YouTube videos about homophobic bullying. Findings suggest that the gay Taiwanese YouTubers frequently shifted between the sociable frame and the audience-targeted frame when interacting with their interactants and audience. They also assumed different narrative roles, serving as the story-teller, the commentator, and the fictionist. How these gay influencers articulate their opinions on behalf of the LGBTQ community also helps them to assert themselves as eloquent, knowledgeable, and humorous sexual moderns.
Shoe wear test machine: What exists versus innovations and promising concepts. A scoping review
Authors: Polomé Elliot , Théveniau Nicolas , Vigier Cédric , Dumas Raphaël , Robert Thomas
Published: November 2022

The aim of this study is to provide a comprehensive review of the current literature on test techniques that imitate the contact phase between the shoe and the ground to study shoe wear over time. Scoping review. Peer-reviewed studies were identified from electronic databases using a structured keyword search and a screening process. Relevant characteristics have been classified into three fields: the control of the test machines, the characteristics of the foot-ankle complex machine control and the outputs of the mechanical tests. Eight peer-reviewed studies were retrieved after screening and further analyzed. They described seven different machines and testing arrangements presenting different mechanical designs and controls. The most advanced machines not only controlled the kinematic of shod passive prosthesis, but also included a form of control of the vertical ground reaction forces and the use of an active foot system with two joints. Still, the resulting foot kinematics and ground reaction forces remained far from those of a real human when the machines simulate walking or running at a realistic speed. Moreover, none of the reviewed studies presented results of wear tests for a long period of time. This review summarizes the different mechanical approaches described in existing shoe wear study literature. Although none of the reviewed studies proposed a fully satisfying mechanical solution, they presented encouraging results. The most promising concepts and the remaining research tracks have been identified.
The Collapse of State in Afghanistan: A Repeat of History?
Authors: Andisha Nasir A.
Published: November 2022

The sudden and stunning fall of Kabul on 15 August 2021 to the Taliban raised many questions about the immediate and underlying causes of the state’s collapse, the consequences of the US/NATO’s retreat, and what the Taliban’s military victory meant for Afghanistan, the region and beyond. This article focuses on the main causes of the collapse and attempts to offer an uncomplicated yet inclusive picture first by explaining the immediate overriding security and political triggers and then by examining the underlying strategic, structural and historical factors. A ground-level assessment of the situation indicated that the resumption of the Doha talks in late 2018 and its subsequent political, diplomatic and military repercussions building over months contributed to the precipitous collapse. However, a bird’s eye-view analysis revealed that structural flaws in the design, process and implementation of the post 9/11 state-building efforts in Afghanistan such as a top-down, highly centralised and winner takes all system, and a weak public participation and accountability mechanism were among the underlying failure factors.
Russia’s Views on and Initial Responses to the 2021 Strategic Retake of Afghanistan by the Taliban
Authors: Muraviev Alexey D.
Published: November 2022

The Taliban’s return to power in Afghanistan in mid-2021 has not taken the Russian authorities by surprise. For over 20 years, Moscow was observing the strategic rise of the fundamentalist militant movement with concern, which was largely triggered by domestic security considerations as well as potential challenges to security and stability across the former Soviet Central Asia. However, since the re-establishment of the Taliban’s rule in Kabul, Moscow’s approach underwent a gradual change, from being negative and alarmist to a more cautiously pragmatic one. This article will review the evolution of Russia’s perceptions of the Taliban, highlight Moscow’s principal concerns, identify the initial set of response measures following the country’s takeover in 2021 and entertain several scenarios of the Kremlin’s future approaches vis-a-vis the new rulers in Kabul.
Hypoxia potentiates nitric oxide synthesis and transiently increases cytosolic calcium levels in pulmonary artery endothelial cells
Authors: Hampl V , Cornfield DN , Cowan NJ , Archer SL
Published: November 2022

There is indirect, contradictory evidence both for increased and reduced synthesis of the endothelium-derived vasodilator, nitric oxide, in the pulmonary circulation during acute hypoxia. Therefore, we decided to directly measure the effect of acute hypoxia on nitric oxide production by cultured pulmonary endothelium. Because increases in the intracellular free calcium concentration are known to initiate nitric oxide synthesis, we also studied cytosolic calcium levels. We measured the accumulation of the stable nitric oxide metabolite, nitrite, in the fluid used to superfuse the cultured bovine pulmonary artery endothelial cells at an oxygen tension (PO2) of either 20.3 (normoxia) or 4.9 kPa (hypoxia) (152 or 37 mmHg). Intracellular calcium levels were measured with dual-excitation microfluorimetry after loading the cells with the fluorescent calcium indicator, fura 2. Basal NO synthesis, measured as nitrite accumulation over 10 min, was significantly higher under hypoxic than normoxic conditions (8.3 +/- 2.2 versus 4.6 +/- 0.8 nM). Hypoxia transiently increased cytosolic calcium concentration (from 113 +/- 10 to 231 +/- 45 nM). Ryanodine and thapsigargin (which deplete intracellular calcium stores), but not the removal of extracellular calcium, inhibited the hypoxic increase in cytosolic calcium, indicating that it resulted primarily from release of intracellular calcium. Bradykinin-elicited NO synthesis was potentiated by hypoxia. Bradykinin-induced increase in cytosolic calcium was not inhibited by hypoxia. We conclude that hypoxia acutely increases cytosolic calcium levels and basal and bradykinin-stimulated nitric oxide synthesis in pulmonary artery endothelium.
Pathogenesis of high-altitude pulmonary oedema: direct evidence of stress failure of pulmonary capillaries
Authors: West JB , Colice GL , Lee YJ , Namba Y , Kurdak SS , Fu Z , Ou LC , Mathieu-Costello O
Published: November 2022

The pathogenesis of high-altitude pulmonary oedema (HAPE) is disputed. Recent reports show a strong correlation between the occurrence of HAPE and pulmonary artery pressure, and it is known that the oedema is of the high-permeability type. We have, therefore, proposed that HAPE is caused by ultrastructural damage to pulmonary capillaries as a result of stress failure of their walls. However, no satisfactory electron microscopy studies are available in patients with HAPE, and animal models are difficult to find. Madison strain Sprague-Dawley rats show a brisk pulmonary pressure response to acute hypoxia and are susceptible to HAPE. We exposed 13 Madison rats to a pressure of 294 torr for up to 12.5 h, or 4 rats to 236 torr for up to 8 h. Pulmonary arterial or right ventricular systolic pressures measured with a catheter increased from 30.5 +/- 0.5 (SEM) in controls (n = 4) to 48 +/- 2 torr (n = 11). The lungs were fixed for electron microscopy with intravascular glutaraldehyde. Frothy bloodstained fluid was seen in the trachea of three animals. Ultrastructural examination showed evidence of stress failure of pulmonary capillaries, including disruption of the capillary endothelial layer, or all layers of the wall, swelling of the alveolar epithelial layer, red blood cells (RBCs) and oedematous fluid in the alveolar wall interstitium, proteinaceous fluid and RBCs in the alveolar spaces, and fluid-filled protrusions of the endothelium into the capillary lumen.(ABSTRACT TRUNCATED AT 250 WORDS)
Frequency of voice problems and cough in patients using pressurized aerosol inhaled steroid preparations
Authors: Williamson IJ , Matusiewicz SP , Brown PH , Greening AP , Crompton GK
Published: November 2022

The aim of the study was to assess the prevalence of throat and voice symptoms in asthma patients using pressurized aerosol, metered-dose, inhaled corticosteroid preparations. A questionnaire was administered to hospital out-patients in an asthma clinic and to a control group attending a diabetic clinic. Two hundred and fifty five consecutive out-patients using pressurized aerosol inhaled corticosteroids and 100 controls were surveyed. One hundred and forty seven (58%) patients taking inhaled steroids reported voice dysphonia or throat symptoms compared with 13% of control patients. Women admitted to symptoms more frequently than men. Throat symptoms were more prevalent in patients using higher doses of inhaled steroid. Aerosol inhaler-induced cough was reported by 87 (34%) patients. Local side-effects were equally prevalent both with beclomethasone dipropionate and budesonide aerosol inhalers. The use of a large volume spacing device with either steroid aerosol did not appear to protect against these symptoms. Local side-effects are common in asthmatics taking pressurized aerosol, metered-dose, inhaled steroids.
Changes in phrenic, hypoglossal and recurrent laryngeal nerve activities after intravenous infusions of aminophylline in cats
Authors: Chiang CH , Tang YC , Wang SE , Hwang JC
Published: November 2022

Aminophylline is known to have respiratory stimulant properties, and it has been suggested that it may also be effective in sleep apnoea. However, its role in this disorder remains uncertain. Theoretically, increasing upper airway motoneural activity in order to maintain airway patency might alleviate obstructive sleep apnoea. On the other hand, increasing the respiratory drive may also prove beneficial in treating central sleep apnoea. In these studies, we attempted to determine the effect of aminophylline on neural activities of the upper airway and diaphragm. We administered intravenously either a low dose (4 mg.kg-1) or a high dose (16 mg.kg-1) of aminophylline to decerebrated, vagotomized and paralysed cats, and continuously recorded the phrenic hypoglossal and recurrent laryngeal nerve activities for 3 h. Results showed that a high dose of aminophylline induced a marked increase in phrenic nerve activity, but not hypoglossal or recurrent laryngeal nerve activity. In a group treated with a low dosage of aminophylline, a significant increase of activity was found in all three nerves. Furthermore, phrenic nerve activity increased more with a high dose than with a low dose. We confirmed that aminophylline has dose-dependent and selective effects on respiratory neural activity. A low dose acts on the upper airway and diaphragm, but a high dose induces a marked increase in central respiratory drive. According to our results, low dose aminophylline might be beneficial in obstructive sleep apnoea, whereas, a high or low dose might improve some cases of central sleep apnoea.
Theophylline and selective PDE inhibitors as bronchodilators and smooth muscle relaxants
Authors: Rabe KF , Magnussen H , Dent G
Published: November 2022

In addition to its emerging immunodulatory properties, theophylline is a bronchodilator and also decreases mean pulmonary arterial pressure in vivo. The mechanism of action of this drug remains controversial; adenosine antagonism, phosphodiesterase (PDE) inhibition and other actions have been advanced to explain its effectiveness in asthma. Cyclic adenosine monophosphate (AMP) and cyclic guanosine monophosphate (GMP) are involved in the regulation of smooth muscle tone, and the breakdown of these nucleotides is catalysed by multiple PDE isoenzymes. The PDE isoenzymes present in human bronchus and pulmonary artery have been identified, and the pharmacological actions of inhibitors of these enzymes have been investigated. Human bronchus and pulmonary arteries are relaxed by theophylline and by selective inhibitors of PDE III, while PDE IV inhibitors also relax precontracted bronchus and PDE V/I inhibitors relax pulmonary artery. There appears to be some synergy between inhibitors of PDE III and PDE IV in relaxing bronchus, and a pronounced synergy between PDE III and PDE V inhibitors in relaxing pulmonary artery. In neither tissue does 8-phenyltheophylline, a xanthine exhibiting adenosine antagonism but not PDE inhibition, cause any significant relaxation, implying that theophylline does not exert its actions through adenosine antagonism. The close correspondence of theophylline concentrations inhibiting bronchus or pulmonary artery PDE and those causing relaxation points towards PDE inhibition as the major mechanism of action of theophylline in smooth muscle relaxation.
Swyer-James syndrome: bronchoalveolar lavage findings in two patients
Authors: Bernardi F , Cazzato S , Poletti V , Tassinari D , Burnaccini M , Zompatori M , Cacciari E
Published: November 2022

Swyer-James syndrome (SJS) is a rare constrictive bronchiolitis that appears to be the result of acute bronchiolitis in infancy or early childhood. In the present study the cytological and immunophenotypical profile of bronchoalveolar lavage (BAL) was studied in two patients with SJS who showed a different spectrum of clinical outcome. The total BAL yield was markedly increased in the patient with chronic cough and acute episodes of dyspnoea but not in the patient with decreased exercise tolerance and longer duration of disease. In the two patients, the differential cell counts in percentage were characterized by a significant increase of neutrophils and a slight increase of lymphocytes. The analysis of lymphocyte subsets showed a significant increase of CD8+ cells (T-suppressor-cytotoxic) in both cases, resulting in a decreased CD4/CD8 ratio. In addition, an increase of cells bearing a B-phenotype (CD19+ cells) was noted in the fluid recovered from the patient with chronic cough and acute episodes of dyspnoea. In conclusion, our data suggest that SJS is an active process with inflammatory characteristics. Further studies are needed to explain the mechanism leading to the expansion in situ of immunocompetent cells.
Pulmonary oedema in healthy persons during scuba-diving and swimming
Authors: Pons M , Blickenstorfer D , Oechslin E , Hold G , Greminger P , Franzeck UK , Russi EW
Published: November 2022

The prevalence of pulmonary oedema during scuba-diving is unknown. In our referral centre for diving accidents we have observed several episodes of pulmonary oedema in four previously healthy persons while scuba-diving or swimming. Four events were documented by physical findings, typical chest radiographic changes, and arterial hypoxaemia. Four additional episodes were identified in one of the individuals by a suggestive history. No technical problems with the diving equipment were detectable and none of the individuals reported aspiration of water. In order to gather information about the incidence of pulmonary oedema, we carried out a survey among 1,250 divers. To elucidate possible underlying mechanisms of this complication we investigated forearm vascular resistance, levels of vasoreactive hormones, and left ventricular function by Doppler echocardiography, at room temperature and during cold exposure, in four patients and in healthy control subjects. We found only one additional person with a history suggestive of pulmonary oedema among 460 responders to the survey. We found no differences in forearm vascular resistance, left ventricular systolic and diastolic function, and plasma levels of epinephrine, norepinephrine, cortisol, aldosterone, renin and atrial natriuretic peptide between the patients with a history of pulmonary oedema and the control subjects. We conclude that the occurrence of pulmonary oedema during scuba-diving or swimming is an extremely rare event in healthy individuals. The mechanisms responsible remain unclear.
The effects of theophylline on mucosal inflammation in asthmatic airways: biopsy results
Authors: Djukanovic R , Finnerty JP , Lee C , Wilson S , Madden J , Holgate ST
Published: November 2022

Theophylline, a nonspecific phosphodiesterase inhibitor, has only recently been reconsidered as a potential anti-inflammatory drug. Its ability to inhibit late asthmatic responses has pointed to possible inhibition of mechanisms regulating the influx and activity of inflammatory cells into the airways. Increasing evidence points to an anti-inflammatory action of theophylline at doses lower than those necessary for a bronchodilator effect. Withdrawal of theophylline from regular treatment results in an increase both in CD4+ and CD8+ T-cells in the bronchial mucosa and a concomitant decrease in the blood, suggesting that theophylline prevents T-cell trafficking from blood into the airways. Furthermore, pretreatment with theophylline significantly attenuates the influx of eosinophils into the airways associated with an allergen-induced late asthmatic response. In keeping with these observations, in a double-blind, placebo-controlled trial involving mild to moderately severe atopic asthmatics, treatment with theophylline resulted in a significant reduction in the numbers of epithelial CD8+ T-cells. In addition, the numbers of cells containing cytokines, interleukin 4 and 5 (IL-4 and IL-5), decreased in the theophylline-treated group and increased in the placebo-treated group, with the difference between the changes being significant. It would, therefore, appear that theophylline may contribute to asthma control due to its ability to reduce the suppressor/cytotoxic T-cells and cytokines which are relevant to allergic mucosal responses.
A metal aerosol holding chamber devised for young children with asthma
Authors: Bisgaard H
Published: November 2022

The low tidal volume and flow in preschool children may reduce the efficiency of aerosol delivery from a pressurized metered-dose inhaler (pMDI) through a traditional holding chamber. A prototype small-volume steel holding chamber with two one-way valves was devised to prolong aerosol availability in the chamber and to ensure unidirectional airflow. Dead space between the valves was minimized to less than 2 ml. The dose-delivery and rate of passive disappearance of a budesonide pMDI aerosol were compared between this prototype and the large-volume, single-valved plastic Nebuhaler, in 164 asthmatic children less than 8 yrs of age. In vitro, the half life of aerosol disappearance in the steel prototype and the plastic Nebuhaler was > 30 s and 9 s, respectively. In vivo, the prototype delivered an age-independent mean dose of 38% of the nominal dose, and the Nebuhaler delivered an age-dependent mean dose, ranging from 42% of the nominal dose in children > or = 4 yrs to 19% of the nominal dose in infants. We conclude that the use of plastic for holding chambers may influence dose-delivery, and single-valve control may cause age-dependent dose-delivery. Reproducible age-independent drug-delivery may be achieved by pMDI aerosol inhaled through a small-volume metal holding chamber with separate inlet and outlet valves and minimized dead space. This holding chamber would improve the possibilities of aerosol therapy for young children.
Ethambutol-induced pulmonary infiltrates with eosinophilia and skin involvement
Authors: Wong PC , Yew WW , Wong CF , Choi HY
Published: November 2022

A 67 year old woman presented with miliary tuberculosis. She was treated with streptomycin, isoniazid, rifampicin, ethambutol and pyrazinamide. However, she developed rifampicin-induced thrombocytopenia after 6 weeks of treatment, and skin rash, blood eosinophilia and pulmonary infiltrates after 8 weeks of therapy. The latter was found to be ethambutol related. Additional evidence, including blood and sputum eosinophilia and the rapidity of its response to corticosteroid, suggested that the pulmonary infiltrates might also be eosinophilic in nature. To the best of our knowledge, this constitutes the first report of such adverse drug reaction, induced by ethambutol.
CT-guided percutaneous drainage of an anterior mediastinal abscess with a 16 F catheter
Authors: Gevenois PA , Sergent G , De Myttenaere M , Beernaerts A , Rocmans P
Published: November 2022

We report a case of anterior mediastinal abscess treated by percutaneous drainage under computed tomography (CT) guidance. The relationships of the abscess to the adjacent organs were clearly delineated by an intravenous injection of contrast material, and the drain was inserted between the sternum and the vasa thoracica interna. Selection of this route and the choice of a large-bore catheter (16 F) are discussed.
Large lungs and growth hormone: an increased alveolar number?
Authors: Donnelly PM , Grunstein RR , Peat JK , Woolcock AJ , Bye PT
Published: November 2022

Previous physiological studies suggest that increased lung growth in patients with acromegaly is associated with either a normal or above normal pulmonary transfer factor. These findings can be interpreted to suggest either alveolar hypertrophy or hyperplasia as the mechanism for lung growth in this condition. Since the ventilated airspaces retain normal elastic properties, we wanted to determine whether the mechanism for lung growth in acromegaly is the result of an increased alveolar number rather than size. Measurements of pulmonary distensibility (K) (an index of alveolar size), elastic recoil, single-breath carbon monoxide transfer factor and carbon monoxide transfer coefficient (KCO), pulmonary capillary blood volume and alveolar membrane diffusing capacity, together with chest width, were compared in nonsmoking, acromegalic and normal men and women, with and without an increased lung size. Pulmonary transfer factor was normal for all groups studied, regardless of lung size. However, KCO was inversely related to total lung capacity (% predicted) for all subjects and KCO (% predicted) was inversely related to chest width in men. Pulmonary capillary blood volume (% predicted) was inversely related to total lung capacity (% predicted) for subjects with large lungs. Pulmonary distensibility (K), membrane diffusing capacity and elastic recoil were within the normal range. These findings suggest normal alveolar size, alveolar membrane surface area and mechanical function in subjects with large lungs. They also suggest that KCO may not be a reliable guide to the interpretation of the mechanism of lung growth in individuals with disproportionately large lungs, and may be reduced because not all the alveoli are perfused. The normal values for pulmonary distensibility found in all our individuals with large lungs, including acromegalics, suggest that lung growth has been achieved by an increased alveolar number rather than size. However, morphometric studies of the lungs of nonsmoking, acromegalic subjects without lung disease, are required to substantiate this finding.