bluuebunny/crossref_metadata_2025 huggingface dataset:
Entre Madres y Comadres: Trans Latina Immigrants Empowering Women Beyond Marianismo
Authors: Alvarez-Hernandez Luis R. , Bermudez Judith Maria
Published: July 2023

When social workers discuss the lives of Latinx individuals, it is often in the context of cultural values such as marianismo. Marianismo is linked to Catholicism and patriarchal values that reinforce traditional gender scripts for women. Although Latina feminists have challenged these values for decades, it continues to be paramount that social workers deepen their understanding of the lives of Chicanas and Latinas through critical theories. From this perspective, mujeristas and Chicana feminists who emphasize liberative work often use the term comadres, or comothers, to explore Latinas’ roles and relationships. The distinction between the traditional motherly role of marianismo and the collaborative and empowering role of comadres was evident in our feminist-informed study about the lived experiences of trans Latina immigrants who are activists and agents of change in their Southern U.S. communities. Our goal as Latina feminists is to include these women in the theoretical conversation as their experiences allowed us to expand our knowledge of these concepts. By reconceptualizing the mutually supportive role of Latinas in their communities, trans Latina immigrants and Latina feminists encourage us to see Latinas beyond the traditional and stereotypical gender script of marianismo.
Trends of Single, Dual, and Polytobacco Use Among School-Based Students in the United States: An Analysis of the National Youth Tobacco Survey
Authors: Cook Steven , Ortiz Chavez Stephany , Zavala-Arciniega Luis , Hirschtick Jana L. , Fleischer Nancy L.
Published: July 2023

Purpose

To examine trends in single, dual, and polytobacco use between 2014-2020 for US youth and to identify disparities in these trends by grade level, sex, and race/ethnicity.

Design

A secondary analysis of the National Youth Tobacco Survey (NYTS).

Subjects

A total of 122 566 students.

Measures

Past 30-day exclusive use of cigarettes, e-cigarettes, other combustibles (cigars, little cigars, cigarillos, hookah, pipe tobacco, bidis) and smokeless tobacco (snus, smokeless, dissolvable); dual use of each product with e-cigarettes; polyuse with e-cigarettes; dual/polyuse without e-cigarettes.

Analysis

Multivariable modified Poisson regression.

Results

Compared to 2014, exclusive e-cigarette use (APR = 2.51, 95% CI: 1.96, 3.21) trended upward while exclusive cigarette (APR = .34, 95% CI: .23, .50), ‘other’ combustibles (APR = .47, 95% CI: .37, .58), and smokeless tobacco (APR = .40, 95% CI: .25, .65) use trended downward in 2020. Polytobacco use with and without e-cigarettes trended downward in 2020 compared to 2014. We also saw differences in trends across sociodemographic groups. Comparing 2020 to 2014, exclusive e-cigarette use was higher for females than males, ‘other’ combustible tobacco use remained stable for Non-Hispanic Black students but decreased for other racial/ethnic groups, and dual e-cigarette/cigarette use trended upward more for middle school students than high school students.

Conclusions

Despite decreased trends in tobacco product use without e-cigarettes between 2014-2020, differences in tobacco product use trends by grade level, sex, and race/ethnicity were identified. Prevention efforts targeting disparities in tobacco product use are needed.
Voting Power of Citizens in a Democracy
Authors: Gupta Aakash
Published: July 2023

Shapley and Shubik in 1954 proposed an index to measure the relative voting power of members of a decision-making body, given their weights in the said body. In this article, we have tried to investigate whether one can ensure equal voting power for all the citizens in a democracy through their respective representatives in the state legislature. The article shows that if the citizens realise their voting power through legislators and the number of constituencies in a democracy are at most four, then there does not exist any weighted voting rule such that the citizens enjoy equal voting power.

JEL: C71, D71, D72
Perspectives on Diversion in the Criminal Justice and Health care Systems
Authors: Stott Jerry M. , Giese Jordan T. , Gittner Lisaann S. , Forbis Robert E. , Dennis Jeff A.
Published: July 2023

This introduction offers a primer for this special edition of the Journal of Contemporary Criminal Justice. The purpose is to provide an interdisciplinary platform for scholars and practitioners to communicate perspectives of criminal justice, criminology, and law; public policy and administration, economics and political science; social work and sociology; behavioral health, counseling and psychology; public health, emergency medicine, and psychiatry around diversion. While disciplines share objectives of diversion as (1) rehabilitation, (2) efficient case processing, and (3) reducing resources, the defining and reporting of diversion differs. Justice-involved individuals with mental health issues making successful re-entry into the civil society, however, becomes convoluted. Diversion in practice has taken many shapes. Diversion in theory has taken many meanings. This special edition offers a variety of empirical and theoretical articles that attempt to provide clarity to an often implemented and understudied area of criminal justice and health care. Interviews with street-level officials, quantitative analyses of programs, and philosophical challenges to innate assumptions about individuals and systems are seen from a wide variety of scholars. The authors showcase their varied backgrounds with graduate students, university faculty, and practitioners, offering the fields of criminal justice and health care insight into diversion at all levels.
Uterine Leiomyoma-Like Inflammatory Myofibroblastic Tumor Without Myxoid Matrix or Inflammatory Cell Infiltration: A Case Report of a Potential Diagnostic Pitfall
Authors: Zhou Ning , Li Tao , Yang Li , Chen Liqiao , Fu Yangyan , Chen Ying
Published: July 2023

Inflammatory myofibroblastic tumors (IMTs) of the uterus are relatively rare. Although most IMTs exhibit indolent biological behaviors, local recurrence, and metastasis may occur. Such patients may benefit from targeted therapy; therefore, precise diagnosis is essential for clinical follow up and treatment. Here, we describe a 33-year-old woman with a uterine mass that was detected 4 years previously during pregnancy. The morphology of the tumor resembled that of a uterine leiomyoma, lacking myxoid matrix, and inflammation. Following immunohistochemical and molecular analyses, the tumor was definitively identified as a uterine IMT based on its morphological features. The uterine IMT described in this case had a rare morphology, which can be easily misdiagnosed based on histology alone. Hence, understanding the morphological changes of IMTs in greater detail is imperative to facilitate their accurate diagnosis.
The Hustle: How Struggling to Access Elites for Qualitative Interviews Alters Research and the Researcher
Authors: Collett Clementine
Published: July 2023

When conducting qualitative research on elites, researchers often face issues regarding time-constraints, power asymmetries, and rapport building. In this article, I outline the methodological concept of “the hustle” so that we might better understand how these issues intersect and how the difficulty to access elites for interviews alters research and researcher. The hustle is defined as the pushing or jostling of the qualitative researcher in the face of resistance to access research settings or participants. Inspired by my own hustle when researching elites who design AI recruitment technology (AI-rec-tech), I argue that the hustle has four major effects: first, it requires the researcher to act as networker; second, it influences how much data can be collected; third, it dictates research design; and fourth, it alters interview dynamics. The hustle is an important conceptual umbrella which draws together themes which have arisen in qualitative research on elites for decades.
Case report: Drug-induced vitiligo during treatment with BRAF/MEK inhibitors in a patient with metastatic conjunctival melanoma
Authors: Saray Seray , Hızlı Pelin
Published: July 2023

Introduction

Autoimmune side effects can be detected during the use of BRAF/MEK inhibitor. Although its frequency, mechanism and importance are not known exactly, there are cases reported in the literature.

Case Report

We report a case of drug-induced vitiligo in a patient with metastatic conjunctival malignant melanoma who was treated with BRAF/MEK inhibition therapy.

Management and Outcome

In the case, vitiligo was controlled with topical treatments. Follow-up process of the patient has been continuing with no progression on month 12 of the current treatment.

Discussion

Although ICI-related autoimmune side effects and vitiligo have been described more frequently, vitiligo may also occur secondary to BRAK/MEK inhibition. This case also points out that cutaneous toxicity is manageable with no delay in treatment thanks to collaboration of dermatologists and oncologists.
Novel chimeric antigen receptor targets and constructs for acute lymphoblastic leukemia: Moving beyond CD19
Authors: Acharya Luna , Garg Alpana , Rai Manoj , Kshetri Rupesh , Grewal Udhayvir S , Dhakal Prajwal
Published: July 2023

Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults with a poor prognosis with relapsed or refractory (R/R) B-cell lineage ALL (B-ALL). Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy has shown excellent response rates in RR B-ALL, but most patients relapse due to poor persistence of CAR T-cell therapy or other tumor-associated escape mechanisms. In addition, anti-CD19 CAR T-cell therapy causes several serious side effects such as cytokine release syndrome and neurotoxicity. In this review, we will discuss novel CAR targets, CAR constructs, and various strategies to boost CARs for the treatment of RR B-ALL. In addition, we discuss a few novel strategies developed to reduce the side effects of CAR.
Trends in Stimulant and Sedative/Hypnotic Dispensing: An Exploratory Study
Authors: Liou Harris , Gentry Melanie T. , Leung Jonathan G. , Mara Kristin C. , Staab Jeffrey P. , Rummans Teresa A.
Published: July 2023

Objective:

To investigate patterns and trends of co-prescriptions of stimulants and sedatives within the last 6 years at a tertiary care center.

Method:

Patients 18 years of age and older who were dispensed at least one stimulant prescription from an institutional pharmacy between 1/1/2015 and 7/1/2021 were included. Prescription data for any co-prescribed sedative/hypnotic were collected.

Results:

Both the number of stimulant dispenses and the number of patients with stimulant dispenses increased significantly with yearly incidence rate ratios of 1.115 (95% CI [1.110, 1.119]) and 1.090 (95% CI [1.084, 1.096]), respectively. The number of patients with a stimulant dispensed who also had a benzodiazepine or “Z-drug” sedative-hypnotic dispensed at any point in the search timeframe increased significantly with incidence rate ratios of 1.077 and 1.092, respectively. The number of stimulant dispenses, number of patients with stimulant dispenses, and number of patients with a stimulant dispensed who also had both a benzodiazepine and Z-drug dispensed at any point in the search timeframe increased significantly more in Non-White than in White patients.

Conclusions:

The results confirm previous findings of increases in dispensing of stimulants over the past 6 years and report increased polypharmacy of stimulants and sedative-hypnotics.
Advancing Understanding of Global Mass Murder: A Comparison of Public Mass Stabbings and Shootings
Authors: Silva Jason R.
Published: July 2023

Previous studies of global mass murder focus on public mass shootings, but there is little known about incidents involving other weapon types. To fill this gap in research, this study examines public mass stabbings and compares them with public mass shootings around the world (1999–2022). Findings identify significant differences in the geographic locations, target locations, offenders’ age and resolution, and number of victim casualties that illustrate these are unique forms of mass murder. This work provides the next step toward advancing knowledge of global mass murder and paves the way for future research aimed at understanding and addressing the phenomenon.
Multimodal resources in the ‘Get It Together’ reproductive health campaign in Nigeria
Authors: Oyebode Oluwabunmi O
Published: July 2023

This study analyses the use of multimodal semiotic resources in the Family Planning campaign materials of the Nigerian Urban Reproductive Health Initiative’s (NURHI) ‘Get It Together’ (GIT) campaign which aims to persuade individuals and families, families to adopt family planning and thus significantly reduce the country’s high fertility and maternal mortality rate. Using Kress and Van Leeuwen’s (2006) visual grammar in Reading Images and Van Leeuwen’s (2008) social actor framework in Discourse and Practice, combined with research in the Nigerian social and cultural context, the study finds that the campaign uses both visual and verbal means to create awareness of contraceptive methods and to counter misconceptions about them. The author also finds that the campaign primarily addresses married couples and includes people from different ethnoreligious backgrounds, but excludes young people, subtly affirming ‘sexual abstinence’ before marriage. Furthermore, the campaign uses a range of strategies for persuading Nigerians to adopt family planning, including linking the adoption of family planning to the benefits of a modern urban lifestyle, engaging religious and community leaders as supporters of the campaign and countering patriarchal traditions by promoting the participation of men in family planning.
Management of diabetic neuropathy with memantine: A randomized clinical trial
Authors: Jafarzadeh Elnaz , Beheshtirouy Samineh , Aghamohammadzadeh Nasser , Ghaffary Saba , Sarbakhsh Parvin , Shaseb Elnaz
Published: July 2023

Background

Diabetes patients frequently experience diabetic neuropathy (DN), a microvascular complication that significantly reduces patients’ quality of life. Memantine has demonstrated potential benefits for neuropathic pains in preclinical studies. This study aimed to assess the efficacy of memantine in the management of peripheral neuropathy in patients with type 2 diabetes mellitus (T2DM).

Method

This randomized clinical trial includes 143 diabetic patients (aged between 18 and 75 years) with a confirmed diagnosis of diabetic neuropathy. Patients were randomly assigned to receive memantine 5 mg twice daily for 1 week, followed by 10 mg twice daily plus gabapentin 300 mg daily ( n = 72) or just gabapentin 300 mg daily ( n = 71) for 8 weeks. The DN4 questionnaire, monofilament, tuning fork, and Tip-therm tests were used to measure neuropathy at baseline and after the 8-week intervention.

Results

The mean score of the DN4 questionnaire in the memantine group was significantly lower than the control group ( p. value: .001). The number of patients with diabetic neuropathy remarkably decreased in the memantine group at the end of the study based on the performed tests ( p. value: .001).

Conclusion

Memantine functions as a beneficial agent in the management of diabetic neuropathy, which would significantly improve the quality of life in diabetic patients.
Designing Men’s Health Programs: The 5C Framework
Authors: Galdas Paul M. , Seidler Zac E. , Oliffe John L.
Published: July 2023

Men are less likely than women to access or engage with a range of generic health programs across a diversity of settings. Designing health programs that mitigate barriers associated with normative ideals of masculinity has been widely viewed as a key factor in how health systems should respond, but strategies to engage men have often narrowly conceptualized male health behavior and risk inadvertently reinforcing negative and outdated gender stereotypes. Currently absent from the men’s health literature is practical guidance on gender-transformative approaches to men’s health program design—those which seek to quell harmful gender norms and purposefully promote health equity across wide-ranging issues, intervention types, and service contexts. In this article, we propose a novel conceptual model underpinned by gender-transformative goals to help guide researchers and practitioners tailor men’s health programs to improve accessibility and engagement. The “5C framework” offers key considerations and guiding principles on the application of masculinities in program design irrespective of intervention type or service context. By detailing five salient phases of program development, the framework is intended as a designate approach to the design of accessible and engaging men’s health programs that will foster progressive changes in the ways in which masculinity can be interpreted and expressed as a means to achieve health for all.
Increased Piezo1 expression in myofibroblasts in patients with symptomatic carotid atherosclerotic plaques undergoing carotid endarterectomy: A pilot study
Authors: Konishi Takao , Kamiyama Kenji , Osato Toshiaki , Yoshimoto Tetsuyuki , Aoki Takeshi , Anzai Toshihisa , Tanaka Shinya
Published: July 2023

Objectives

We aimed to investigate Piezo1 expression in myofibroblasts in symptomatic and asymptomatic patients undergoing carotid endarterectomy and its relationship with atherosclerotic plaque formation.

Methods

This cross-sectional study analyzed carotid plaques of 17 randomly selected patients who underwent carotid endarterectomy from May 2015 to August 2017. In total, 51 sections (the most stenotic lesion, and the sections 5-mm proximal and distal) stained with hematoxylin-eosin and elastica-Masson were examined. Immunohistochemistry was performed using antibodies to Piezo1. The Piezo1 score of a section was calculated semiquantitatively, averaged across 30 randomly selected myofibroblasts in the fibrous cap of the plaque.

Results

Of 17 patients (mean age: 74.2 ± 7.1 years), 15 were men, 9 had diabetes mellitus, and 13 had hypertension. Symptomatic patients had higher mean Piezo1 score than asymptomatic patients (1.78 ± 0.23 vs 1.34 ± 0.17, p < .001). Univariate linear regression analyses suggested an association between plaque rupture, thin-cap fibroatheroma and microcalcifications and the Piezo1 score ( p = .001, .008, and 0.003, respectively).

Conclusions

Increased Piezo1 expression of myofibroblasts may be associated with atherosclerotic carotid plaque instability. Further study is warranted to support this finding.
Defining institutional review board application quality: critical research gaps and future opportunities
Authors: Serpico Kimberley
Published: July 2023

The quality of a research study application sends a distinct signal to the institutional review board (IRB) about the skills, capacities, preparation, communication, experience, and resources of its authors. However, efforts to research and define IRB application quality have been insufficient. Inattention to the quality of an IRB application is consequential because the application precedes IRB review, and perceptions of quality between the two may be interrelated and interdependent. Without a clear understanding of quality, IRBs do not know how to define quality and researchers do not know how to achieve quality. This position has not been systematically studied to date, and future research could provide much-needed empirical validation. This paper lays the conceptual groundwork for future investigation into what constitutes quality in an IRB application. It includes a landscape review of multidisciplinary research on quality, as well as a discussion of quality frameworks analogous to research with human participants that exist in the published literature. It also examines the background and significance of federal research regulations, regulatory burdens, researchers’ regulatory literacy, and the roles and responsibilities of IRB professionals within this ecosystem.
Bystanders, protesters, journalists: A qualitative examination of different stakeholders’ motivations to participate in collective action
Authors: Gulliver Robyn E. , Chan Christian S. , Chan Wendy W. L. , Tam Katy Y. Y. , Louis Winnifred R.
Published: July 2023

Both bystanders and journalists can play important roles in mobilizing and supporting social movements. However, there are few empirical studies examining and contrasting their violent and nonviolent collective-action motivations or perspectives on social movement goals. This study presents a comparative analysis of motivations to engage or stand aside from social unrest comparing bystanders ( n = 9) and journalists ( n = 7) motivations against those of protesters ( n = 35). Thematic qualitative analysis of interview data using a Social Identity Model of Collective Action framework examined differences in motivations and goals across each group, as well as the influence of violent protest repertoires on participation behaviors. Identified barriers to participation include bystanders’ lack of issue consensus, low efficacy perceptions, and negative views of violent action. Our results also lend support to the predictive validity of collective identification, anger, and injustice in motivating participation in collective action. Journalists’ collective identity precluded overt protest participation. However, their emotional responses to injustice or violent actions generated tensions between their role obligations and desire to intervene. Implications for future research on collective-action responses to injustice are discussed.
Unleashing the algorithmic frontier: Navigating the impact of algo trading on investor portfolios
Authors: Dananjayan Madhava Priya , Gopakumar Sridevi , Narayanasamy Parthasarathi
Published: July 2023

In the ever-evolving landscape of financial markets, algo trading has emerged as a powerful force, revolutionizing the way investors execute trades. With the speed and precision of computer algorithms, algo trading offers advantages such as faster trade execution, reduced errors, and access to complex trading strategies. However, its impact on investors is not without its challenges and risks. This case explores the profound influence of algo trading on investors and their portfolios. It delves into the opportunities and pitfalls associated with this technological advancement, shedding light on its implications for market liquidity, volatility, and investor behavior. It explores the potential for improved portfolio diversification and efficient risk management, while also addressing concerns about market manipulation and unfair advantages. Furthermore, the case study investigates the regulatory environment surrounding algo trading, highlighting the measures implemented to ensure fair and transparent markets. By presenting a nuanced understanding of the impact of algo trading on investor portfolios, this case study equips readers with the knowledge and insights necessary to navigate the algorithmic frontier. It encourages critical thinking and strategic decision-making, empowering investors to harness the potential of algo trading while managing its inherent risks.
EdTech industry in India: Revolution and challenges in the Indian market: Teaching case study
Authors: Bargavi R , Shanmugam Kavitha
Published: July 2023

India's education sector is one of the largest in the world, with over 260 million students enrolled in more than a million schools and universities. The country's education system is facing several challenges, including low levels of learning outcomes, inadequate infrastructure, and a shortage of skilled teachers. In recent years, the EdTech industry has emerged as a potential solution to these challenges, providing students with access to quality education and personalized learning experiences. This case study explores the revolutionary growth and challenges faced by the EdTech industry in India.
Characterization of Ankle Injuries and Associated Risk Factors in the National Basketball Association: Minutes Per Game and Usage Rate Associated With Time Loss
Authors: Tummala Sailesh V. , Morikawa Landon , Brinkman Joseph C. , Crijns Tom J. , Vij Neeraj , Gill Vikram , Kile Todd A. , Patel Karan , Chhabra Anikar
Published: July 2023

Background:

Ankle injuries are more common in the National Basketball Association (NBA) compared with other professional sports.

Purpose/Hypothesis:

The purpose of this study was to report the incidence and associated risk factors of ankle injuries in NBA athletes. It was hypothesized that factors associated with an increased physiologic burden, such as minutes per game (MPG), usage rate, and associated lower extremity injury, would be associated with increased ankle injury risk and time loss.

Study Design:

Descriptive epidemiology study.

Methods:

Ankle injury data from the 2015-2016 through 2020-2021 NBA seasons were evaluated. The truncated 2019-2020 season due to the COVID-19 pandemic was omitted. The primary outcome was the incidence of ankle injuries, reported per 1000 game-exposures (GEs). Secondary analysis was performed to identify risk factors for ankle injuries through bivariate analysis and multivariable logistic regression of player demographic characteristics, performance statistics, injury characteristics, and previous lower extremity injuries. Factors influencing the time loss after injury were assessed via a negative binomial regression analysis.

Results:

A total of 554 ankle injuries (4.06 injuries per 1000 GEs) were sustained by NBA players over 5 NBA seasons, with sprain/strain the most common injury type (3.71 injuries per 1000 GEs). The majority of ankle injury events (55%) resulted in 2 to 10 game absences. The likelihood of sustaining an ankle injury was significantly associated with a greater number of games played ( P = .029) and previous injury to the hip, hamstring, or quadriceps ( P = .004). Increased length of absence due to ankle injury was associated with greater height ( P = .019), MPG ( P < .001), usage rate ( P = .025), points per game ( P = .011), and a prior history of foot ( P = .003), ankle ( P < .001), and knee injuries ( P < .001).

Conclusion:

The incidence of ankle injuries was 4.06 per 1000 GEs in professional basketball players. Games played and prior history of hip, hamstring, or quadriceps injuries were found to be risk factors for ankle injuries. Factors associated with physiologic burden such as MPG and usage rate were associated with an increased time loss after injury.
Quantifying the pedestrian access potential of suburban street network retrofits
Authors: Aras Rohan L , Ouellette Nicholas T , Jain Rishee K
Published: July 2023

The United States largely depends on the automobile for personal transportation. This dominance has significant consequences for society over a range of issues, including the environment, public safety, public health, and equity. The issues associated with the dominance of the automobile are most pressing in the suburbs due to their size and curvilinear street network patterns. Thus, any effort to address the negative consequences of automobile dependency in the US needs to consider retrofitting the suburbs and their street networks. We attempt to better understand the potential for street network retrofits to increase suburban pedestrian access. We consider a class of planar graph augmentation problems that attempt to increase pedestrian access to points of interest (POIs) within the study area by adding new pedestrian paths to the street network that follow existing property lines. Our methodology builds on past work on graph dilation and route directness, from the planar graph and street network communities, respectively, to score the pedestrian access disruption of individual blocks. We apply this methodology to a case study of suburban Seattle. We find that, both in the limit of all possible interventions and with a limited number of untargeted interventions, retrofits can meaningfully increase pedestrian access to POIs. Given this promise, the methods we outline present a useful starting point for discussing the potential of street network retrofits to serve non-automobile mobility in suburban communities across the US.
Humility. Listen. Respect: Three values underpinning Indigenous (environmental) education sovereignty
Authors: Bishop Michelle
Published: July 2023

This article looks beneath Indigenous (environmental) education sovereignty to uncover the underpinning values of Humility; Listen; and Respect. These values are invoked by education practices that have existed in the so-called Australia forever and have the potential to change the way we live and interact; restoring health and relationships with Country, each other and more-than-human kin. These are not pretty concepts to “do,” they comprise of deeper axiological ways to “be.” It is imperative Indigenous knowledges are centered when talking about “the environment,” as colonialism continues to cause severe and irreversible damage across the globe. These values encompass a shift toward Indigenous Education Sovereignty, that is, education grounded in Indigenous knowledge, for our grandchildren's grandchildren.
European Respiratory Society/American Thoracic Society technical statement: standardisation of the measurement of lung volumes, 2023 update
Authors: Bhakta Nirav R. , McGowan Aisling , Ramsey Kathryn A. , Borg Brigitte , Kivastik Jana , Knight Shandra Lee , Sylvester Karl , Burgos Felip , Swenson Erik R. , McCarthy Kevin , Cooper Brendan G. , García-Río Francisco , Skloot Gwen , McCormack Meredith , Mottram Carl , Irvin Charles G. , Steenbruggen Irene , Coates Allan L. , Kaminsky David A.
Published: July 2023

This document updates the 2005 European Respiratory Society (ERS) and American Thoracic Society (ATS) technical standard for the measurement of lung volumes. The 2005 document integrated the recommendations of an ATS/ERS task force with those from an earlier National Heart, Lung, and Blood Institute workshop that led to the publication of background papers between 1995 and 1999 and a consensus workshop report with more in-depth descriptions and discussion. Advancements in hardware and software, new research and emerging approaches have necessitated an update to the 2005 technical standard to guide laboratory directors, physiologists, operators, pulmonologists and manufacturers. Key updates include standardisation of linked spirometry, new equipment quality control and validation recommendations, generalisation of the multiple breath washout concept beyond nitrogen, a new acceptability and grading system with addition of example tracings, and a brief review of imaging and other new techniques to measure lung volumes. Future directions and key research questions are also noted.
The impact of respiratory infections and probiotic use on the nasal microbiota of frail residents in long-term care homes
Authors: Bowdish Dawn M.E. , Rossi Laura , Loeb Mark , Johnstone Jennie , Schenck Louis P. , Fontes Michelle , Surette Michael G. , Whelan Fiona J.
Published: July 2023

Background

Residents in long-term care homes, who tend to be of advanced age and frail, are at increased risk of respiratory infections. The respiratory microbiota is known to change with age, but whether these changes contribute to the risk of infection is not known. Our goal was to determine how the nasal microbiota of frail older adults changes during symptoms of influenza-like illness (ILI) and how this may be impacted by enrolment in a placebo-controlled trial testing the feasibility of administering aLactobacillus rhamnosusGG probiotic to prevent respiratory infection (2014–2017).

Methods

The microbiome of the nasal (mid-turbinate) of 150 residents of long-term care homes was interrogated using 16S rRNA gene sequencing.

Results

We identified a diverse and individualised microbiota which could be separated into nine distinct clusters based on Bray–Curtis distances. Samples collected during symptoms of ILI differed statistically from those collected pre- and post-cold and influenza season, and we observed decreased temporal stability (as measured by movement between clusters) in individuals who experienced ILI compared to those who did not.

Conclusions

The use of probiotics decreased ILI-induced changes to the microbiota; however, it is not clear whether this decrease is sufficient to prevent respiratory illness.
Machine learning to differentiate pulmonary hypertension due to left heart disease from pulmonary arterial hypertension
Authors: Swinnen Katleen , Verstraete Kenneth , Baratto Claudia , Hardy Laura , De Vos Maarten , Topalovic Marko , Claessen Guido , Quarck Rozenn , Belge Catharina , Vachiery Jean-Luc , Janssens Wim , Delcroix Marion
Published: July 2023

Background and aims

Pulmonary hypertension due to left heart disease (PH-LHD) is the most frequent form of PH. As differential diagnosis with pulmonary arterial hypertension (PAH) has therapeutic implications, it is important to accurately and noninvasively differentiate PH-LHD from PAH before referral to PH centres. The aim was to develop and validate a machine learning (ML) model to improve prediction of PH-LHD in a population of PAH and PH-LHD patients.

Methods

Noninvasive PH-LHD predictors from 172 PAH and 172 PH-LHD patients from the PH centre database at the University Hospitals of Leuven (Leuven, Belgium) were used to develop an ML model. The Jacobs score was used as performance benchmark. The dataset was split into a training and test set (70:30) and the best model was selected after 10-fold cross-validation on the training dataset (n=240). The final model was externally validated using 165 patients (91 PAH, 74 PH-LHD) from Erasme Hospital (Brussels, Belgium).

Results

In the internal test dataset (n=104), a random forest-based model correctly diagnosed 70% of PH-LHD patients (sensitivity: n=35/50), with 100% positive predicted value, 78% negative predicted value and 100% specificity. The model outperformed the Jacobs score, which identified 18% (n=9/50) of the patients with PH-LHD without false positives. In external validation, the model had 64% sensitivity at 100% specificity, while the Jacobs score had a sensitivity of 3% for no false positives.

Conclusions

ML significantly improves the sensitivity of PH-LHD prediction at 100% specificity. Such a model may substantially reduce the number of patients referred for invasive diagnostics without missing PAH diagnoses.
Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India
Authors: Oduro Michael Safo , Peprah Prince , Morgan Anthony Kwame , Agyemang-Duah Williams
Published: July 2023

Background

Although evidence on healthcare utilization avoidance during COVID-19 pandemic is emerging, such knowledge is limited in rural settings. An effective policy to the COVID-19 shocks and stresses in rural settings require empirical evidence to inform the design of health policies and programmes. To help overcome this evidence gap and also contribute to policy decisions, this study aimed at examining COVID-19-induced healthcare utilization avoidance and associated factors in rural India.

Methods

This study used the third-round data from the COVID-19-Related Shocks in Rural India survey conducted between 20-24 September, 2020 across six states. The outcome variable considered in this study was COVID-19-induced healthcare utilization avoidance. Multivariable Binary Logistic Regression Model via Multiple Imputation was used to assess the factors influencing COVID-19-induced healthcare utilization avoidance.

Results

Data on 4,682 respondents were used in the study. Of this, the prevalence of COVID-19-induced healthcare utilization avoidance was 15.5% in rural India across the six states. After adjusting for relevant covariates, participants from the Bihar State have significantly higher likelihood of COVID-19-induced healthcare utilization avoidance compared to those from the Andhra Pradesh. Also, participants whose educational level exceeds high school, those who use government hospital/clinic, engage in daily wage labour in agriculture have significantly higher odds of COVID-19-induced healthcare utilization avoidance compared to their counterparts.

Conclusion

Our study revealed that state of residence, type of health facility used, primary work activity and educational level were associated with COVID-19-induced healthcare utilization avoidance in rural India. The findings suggest that policy makers and public health authorities need to formulate policies and design interventions that acknowledge socioeconomic and demographic factors that influence healthcare use avoidance.
Serum IL-23 significantly decreased in obese patients with psoriatic arthritis six months after a structured weight loss intervention
Authors: Landgren A. J. , Jonsson C. A. , Bilberg A. , Eliasson B. , Torres L. , Dehlin M. , Jacobsson L. T. H. , Gjertsson I. , Larsson I. , Klingberg E.
Published: July 2023

Introduction

Patients with psoriatic arthritis (PsA) are frequently obese. We have previously shown decreased disease activity in patients with PsA with a body mass index (BMI) ≥ 33 kg/m2 following weight loss treatment with Very Low Energy Diet (VLED), resulting in a median weight loss of 18.6% at six months (M6) after baseline (BL). In this study we assessed the effects of VLED on cytokines and adipokines at M6 in the same patients with PsA and controls (matched on sex, age and weight).

Methods

VLED (640 kcal/day) during 12 or 16 weeks, depending on BL BMI < 40 or ≥ 40 kg/m2, was taken and followed by an energy-restricted diet. Cytokines and adipokines were measured with Magnetic Luminex Assays at BL and M6.

Results

Serum interleukin (IL)-23, (median (interquartile range) 0.40 (0.17–0.54) ng/mL vs. 0.18 (0.10–0.30) ng/mL, p < 0.001) and leptin (26.28 (14.35–48.73) ng/mL vs. 9.25 (4.40–16.24) ng/mL, p < 0.001) was significantly decreased in patients with PsA. Serum total (tot)-adiponectin and high molecular weight (HMW) adiponectin increased significantly. Similar findings were found in controls. Also, in patients with PsA, ∆BMI was positively correlated with ∆IL-23 (rS = 0.671, p < 0.001). In addition, significant positive correlations were found between ΔBMI and ΔDisease Activity Score (DAS28CRP), ΔCRP, Δtumor necrosis factor (TNF)-α, ΔIL-13, ∆IL-17 and Δleptin, and negative correlations between ΔBMI and Δtot-adiponectin.

Conclusions

Weight loss was associated with decreased levels of leptin and cytokines, in particular IL-23. These findings may partly explain the anti-inflammatory effect of weight reduction in PsA.

Trial registration

ClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016, retrospectively registered.
Machine learning for predicting diabetes risk in western China adults
Authors: Li Lin , Cheng Yinlin , Ji Weidong , Liu Mimi , Hu Zhensheng , Yang Yining , Wang Yushan , Zhou Yi
Published: July 2023

Objective

Diabetes mellitus is a global epidemic disease. Long-time exposure of patients to hyperglycemia can lead to various type of chronic tissue damage. Early diagnosis of and screening for diabetes are crucial to population health.

Methods

We collected the national physical examination data in Xinjiang, China, in 2020 (a total of more than 4 million people). Three types of physical examination indices were analyzed: questionnaire, routine physical examination and laboratory values. Integrated learning, deep learning and logistic regression methods were used to establish a risk model for type-2 diabetes mellitus. In addition, to improve the convenience and flexibility of the model, a diabetes risk score card was established based on logistic regression to assess the risk of the population.

Results

An XGBoost-based risk prediction model outperformed the other five risk assessment algorithms. The AUC of the model was 0.9122. Based on the feature importance ranking map, we found that hypertension, fasting blood glucose, age, coronary heart disease, ethnicity, parental diabetes mellitus, triglycerides, waist circumference, total cholesterol, and body mass index were the most important features of the risk prediction model for type-2 diabetes.

Conclusions

This study established a diabetes risk assessment model based on multiple ethnicities, a large sample and many indices, and classified the diabetes risk of the population, thus providing a new forecast tool for the screening of patients and providing information on diabetes prevention for healthy populations.
The efficacy of prophylactic metoclopramide in preventing nausea and vomiting in patients with acute pain treated with intravenous tramadol: a randomized double-blinded, placebo-controlled trial
Authors: Sriwiset Haruethai , Lokeskrawee Thanin , Patumanond Jayanton , Wongyikul Pakpoom , Phinyo Phichayut
Published: July 2023

Objective

To examine the clinical efficacy of prophylactic metoclopramide in reducing the incidence of nausea and vomiting in emergency department (ED) patients with acute pain who were treated with intravenous tramadol.

Results

We conducted a single-center randomized, double-blinded, placebo-controlled trial. A total of 99 ED patients presented with acute pain were recruited. Sixty-four patients were randomized, 31 patients in the treatment arm and 33 in the control arm. Overall, there were no significant differences in baseline characteristics between treatment arm and control arm. Only one patient within each arm reported having nausea symptom. No patients reported vomiting episode. There was no statistically significant difference in the proportion of patients with nausea or vomiting symptoms between the two groups (3.2% in the treatment arm vs. 3.0% in the control arm, p = 1.000). The administration of prophylactic metoclopramide may not provide additional benefit in reducing the occurrence of nausea and/or vomiting episode in ED patients with acute pain treated with intravenous tramadol.

Trial registration Randomized clinical trial TCTR20220525001; registration date: 21 October 2021. Retrospectively registered.
Acquired SERPINC1/antithrombin deficiency during oral contraceptive consumption: a case report
Authors: Denora D. , Di Rosa M. V. , Altamura N. , Pellicori F. , Vinci P. , Sisto U. G. , Spanò F. , Di Girolamo F. G. , Fiotti N. , Biolo G.
Published: July 2023

Background

SERPINC1 is a glycoprotein that regulates blood coagulation. SERPINC1 congenital or acquired deficiencies represent a significant risk factor for thromboembolic disease. SERPINC1 acquired defects are observed in very few cases and can occur in many clinical conditions such as treatment with l-asparaginase or oral contraceptive (particularly estrogen derivatives), but these conditions are not routinely investigated.

Case presentation

A 50-year-old Caucasian woman who took gestodene 75 µg/ethinylestradiol 20 µg as oral contraceptive, was sent to our thrombophilia clinic because, on thrombophilia testing, a reduction of SERPINC1 (74%) and a slight increase in circulating D-dimer and homocysteine were found. We investigated triggers of such SERPINC1 reduction, and identified gestodene 75 µg/ethinylestradiol 20 µg use as the most likely candidate. Two months after the discontinuation of the oral contraceptive, SERPINC1 value returned to normal (92%) and D-dimer and homocysteine were normalized.

Conclusion

Each patient has a different sensitivity to contraceptive use. Genetic (or epigenetic) regulation of anticoagulant proteins might account for a different rate of consumption of anticoagulant proteins as oral contraceptives and probably determine the susceptibility to thrombotic events.
PPARγ-dependent hepatic macrophage switching acts as a central hub for hUCMSC-mediated alleviation of decompensated liver cirrhosis in rats
Authors: Yao Yunqi , Zhang Lin , Cheng Fuyi , Jiang Qingyuan , Ye Yixin , Ren Yushuang , He Yuting , Su Dongsheng , Cheng Lin , Shi Gang , Dai Lei , Deng Hongxin
Published: July 2023

Background

Decompensated liver cirrhosis (DLC), a terminal-stage complication of liver disease, is a major cause of morbidity and mortality in patients with hepatopathies. Human umbilical cord mesenchymal stem cell (hUCMSC) therapy has emerged as a novel treatment alternative for the treatment of DLC. However, optimized therapy protocols and the associated mechanisms are not entirely understood.

Methods

We constructed a DLC rat model consistent with the typical clinical characteristics combined use of PB and CCL4. Performing dynamic detection of liver morphology and function in rats for 11 weeks, various disease characteristics of DLC and the therapeutic effect of hUCMSCs on DLC in experimental rats were thoroughly investigated, according to ascites examination, histopathological, and related blood biochemical analyses. Flow cytometry analysis of rat liver, immunofluorescence, and RT-qPCR was performed to examine the changes in the liver immune microenvironment after hucMSCs treatment. We performed RNA-seq analysis of liver and primary macrophages and hUCMSCs co-culture system in vitro to explore possible signaling pathways. PPARγ antagonist, GW9662, and clodronate liposomes were used to inhibit PPAR activation and pre-exhaustion of macrophages in DLC rats’ livers, respectively.

Results

We found that changing the two key issues, the frequency and initial phase of hUCMSCs infusion, can affect the efficacy of hUCMSCs, and the optimal hUCMSCs treatment schedule is once every week for three weeks at the early stage of DLC progression, providing the best therapeutic effect in reducing mortality and ascites, and improving liver function in DLC rats. hUCMSCs treatment skewed the macrophage phenotype from M1-type to M2-type by activating the PPARγ signaling pathway in the liver, which was approved by primary macrophages and hUCMSCs co-culture system in vitro. Both inhibition of PPARγ activation with GW9662 and pre-exhaustion of macrophages in DLC rats’ liver abolished the regulation of hUCMSCs on macrophage polarization, thus attenuating the beneficial effect of hUCMSCs treatment in DLC rats.

Conclusions

These data demonstrated that the optimal hUCMSCs treatment effectively inhibits the ascites formation, prolongs survival and significantly improves liver structure and function in DLC rats through the activation of the PPARγ signaling pathway within liver macrophages. Our study compared the efficacy of different hUCMSCs infusion regimens for DLC, providing new insights on cell-based therapies for regenerative medicine.
The product quality inspection scheme based on software-defined edge intelligent controller in industrial internet of things
Authors: Hu Pengfei , He Chunming , Zhu Yiming , Li Tianhui
Published: July 2023

The Industrial Internet of Things (IIoT) enables the improvement of the productivity and intelligent level of factory. The procedure of product quality inspection has generally adopted machine intelligence algorithms instead of manual operation to improve efficiency. In this paper, we propose a product quality inspection system scheme based on software-defined edge intelligent controller (SD-EIC). By adopting the software definition and resource virtualization technologies, the hardware platform of SD-EIC is designed to support the real-time control tasks and non-real-time edge computing tasks at the same time. To this end, we propose the scheme and architecture of product quality inspection system based on SD-EIC. Multiple virtual controllers and virtual edge computing nodes are constructed on a set of SD-EIC hardware platform to realize the integrated deployment of the real-time control for terminal devices and the AI model reasoning of product defect recognition algorithm based on machine vision respectively. In addition, the management and control scheme of product quality inspection system based on industrial information model is proposed. By constructing the semantic-based digital twin information model of terminal device, the flexible adjustment and parameter configuration of terminal device are realized to meet the demands of flexible production and manufacturing. The proposed product quality inspection system solution can effectively improve the utilization of hardware resources and the efficiency of product quality inspection, and reduce the overall deployment cost of the system. It can flexibly adapt to product diversity and different industrial scenarios.