bluuebunny/crossref_metadata_2025 huggingface dataset:
The rise of paedophile hunters: To what extent are cyber-vigilante groups a productive form of policing, retribution and justice?
Authors: Tippett Anna
Published: November 2022

There are an increasing number of cyber-vigilante groups in the United Kingdom who use the Internet as a tool for regulation and retributive justice. The policing of child sexual predators by citizen groups outside of law enforcement, commonly termed ‘paedophile hunters’, has evoked a range of responses among media commentators and the general public. This article explores public perceptions of vigilante justice in the United Kingdom via an online survey to assess the extent to which they are considered retributive. It focusses on the moral justice imposed by such groups and interrogates the relationship between retribution and doxing (the ‘naming and shaming’ tactics which are commonly actioned by paedophile hunting groups). The findings highlight three dominant responses to cyber-vigilantism: (1) public support for cyber-vigilantism; (2) doxing as a human rights issue; and (3) a lack of faith in the criminal justice system. This article is consequently concerned with the merits and drawbacks of retributive justice when led at a community level and critically examines perceptions of this form of citizen-policing.
Intravenous anti-P. aeruginosa IgY-antibodies do not decrease pulmonary bacterial concentrations in a porcine model of ventilator-associated pneumonia
Authors: Otterbeck A. , Skorup P. , Hanslin K. , Larsson A. , Stålberg J. , Hjelmqvist H. , Lipcsey M.
Published: November 2022

Ventilator associated pneumonia (VAP) caused by P. aeruginosa is a cause of morbidity and mortality in critically ill patients. The spread of pathogens with anti-microbial resistance mandates the investigation of novel therapies. Specific polyclonal anti- P. aeruginosa IgY-antibodies ( Pa-IgY) might be effective for VAP caused by P. aeruginosa. The objective of this study was to investigate if intravenous Pa-IgY decreases the lower airway concentration of P. aeruginosa in VAP. We used a double blind randomized placebo controlled porcine model of VAP caused by P. aeruginosa. Eighteen pigs were randomized to either receive intravenous Pa-IgY or placebo. Repeated registration of physiological parameters and sampling was performed for 27 h. Concentration of P. aeruginosa in BAL-cultures was similar in both groups with 104.97 ± 102.09 CFU/mL in the intervention group vs 104.37 ± 102.62 CFU/mL in the control group at the end of the experiment. The intervention group had higher heart rate, cardiac index, oxygen delivery and arterial oxygen tension/fraction of inspired oxygen-ratio, but lower plasma lactate and blood hemoglobin levels than the control group. In summary, in an anesthetized and mechanically ventilated porcine model of VAP, Pa-IgY at the dose used did not decrease concentrations of P. aeruginosa in the lower airways.
Akathisia and oculogyric crisis in hyperemesis gravidarum
Authors: Morton Adam , Mackle Conor , Pavey Julian
Published: November 2022

Hyperemesis gravidarum complicates 0.5–2% of pregnancies. HG is associated with insomnia, significantly increased risks of anxiety and depression, and may be associated with feelings of guilt, social isolation and thoughts of suicidal ideation or termination of pregnancy. Anti-emetic therapy may be complicated by akathisia and dystonic reactions, which may affect the ongoing management of nausea and vomiting. A case of akathisia and oculogyric crisis following the addition of parenteral prochlorperazine to ondansetron and metoclopramide is presented. The treatment options for extrapyramidal side effects with anti-emetics in pregnancy and for ongoing treatment of nausea and vomiting are discussed.
Moving Upstream to Address Health Inequity: A Middle School Program to Introduce Students to a Career in Nursing
Authors: Randolph Alexandra , Mattey Beth
Published: November 2022

To promote health equity and address an increasing need for nurses, educational pathways and mentorship programs for students who want to pursue a nursing career should be considered during the earlier stages of secondary education. Several school nurses in the Brandywine School District in Delaware piloted a program to introduce middle school students to a career in nursing. Recognizing the racial, ethnic, and gender disparity in the nursing workforce, nurses sought out Black/African-American, Hispanic, and male students, populations who are underrepresented in nursing. Nurses informed students about a career in nursing and offered information on pathways to pursue an education in nursing. The program is intended to give a realistic perspective on the duties of nurses and to provide a level of educational and collaborative support from parents and faculty to assist students to transition into postsecondary nursing education programs. The current nursing shortage is a multifaceted issue creating an extreme need for nurses, particularly baccalaureate-prepared nurses who provide culturally competent and safe patient care. The BSD Lifesavers program aims to create programs and policies to promote a more diverse nursing workforce that will provide equitable health care for all communities.
ANCA-associated vasculitis following the CoronaVac vaccination
Authors: Ma Yaohui , Huang Tianlun , Xu Gaosi
Published: November 2022

With the coronavirus disease 2019 (COVID-19) pandemic, vaccination has become one of the cornerstones to contain the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Large clinical trials have shown high efficacy and safety of SARS-CoV-2 vaccination against COVID-19. However, with the widespread use of SARS-CoV-2 vaccines worldwide, an increasing number of reports describe the onset of glomerular disease. Here, we report a case of a 70-year-old Chinese woman who developed new antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis within 4 h post the first dose of CoronaVac. CoronaVac is an inactivated SARS-CoV-2 vaccine developed by Sinovac Life Sciences (Beijing, China). Her clinical symptoms were nausea, fatigue, acute kidney injury, and proteinuria. Laboratory tests showed markedly elevated serum myeloperoxidase titers, and the renal biopsy showed microcellular fibrous crescent formation. Renal function of the patient responded favorably after treatment with steroids and cyclophosphamide. Although there is no direct evidence of a link between vasculitis and vaccination, similar complications should be monitored as potential adverse events with widespread vaccination globally.
Implementing configure, price, quote in the supply chain: The case of Essemtec AG
Authors: Blumentritt Ariane , Ehrenthal Joachim , Haueter Benjamin , Hitz Nadine , Sufian Muhammad
Published: November 2022

Essemtec AG develops, manufactures, and sells machinery and equipment to the electronics industry. This teaching case presents Essemtec AG’s experience with implementing a configure, price, quote (CPQ) system in its supply chain from the perspective of Tim, the Product Manager, who led the implementation project. This case helps students understand the value and organizational impact of a CPQ system on companies like Essemtec AG.
Use of mobile app to monitoring growth outcome of children: A systematic literature review
Authors: Kustiawan Theresia Chrisanthy , Nadhiroh Siti Rahayu , Ramli Roziana , Butryee Chaniphun
Published: November 2022

Advances in knowledge and technology have created opportunities to help monitor child growth. Thus, we conducted a systematic review to determine if the use of mobile apps resulted in improved growth outcomes for children. We include articles published related to children's growth with poor nutritional status. The relevant articles were searched from PubMed, ScienceDirect, Scopus, ProQuest, and Google Scholar. Twelve studies were identified, which is the use of the mobile app to monitor growth in undernutrition and obesity in children. Six studies found that the use of mobile apps improved undernutrition child growth and improved parents’ and/or front health workers’ knowledge to prevent, treat, and monitor children with undernutrition. Six studies stated that the use of mobile app helps overweight/obese children lose weight and motivate them to achieve ideal body weight. Mobile apps for monitoring the growth of children with various standards are likely a promising means for early detection of growth failure and guiding overweight/obese children in gaining normal weight. Studies with large sample sizes and long-term interventions and follow-ups are needed to help assess the effectiveness of mobile app intervention programs and their impact on multiple growth outcomes more comprehensively and accurately.
Formative Exploration of the Feasibility of Embedding Community Assets Into Primary Health Care: Barbershop and Place of Worship Readiness in Guyana
Authors: Goberdhan Sharlene , Gobin Reeta , Perreira Olly , Sharma Manoj , Ramdeen Melissa , Harding Seeromanie
Published: November 2022

Introduction:

Community engagement is key to improving the quality of primary health care (PHC), with asset-based interventions shown to have a positive impact on equity and health outcomes. However, there tends to be a disconnect between community-based interventions and PHC, with a lack of evidence on how to develop sustainable community—primary care partnerships. This paper reports on the formative phases of 2 studies exploring the feasibility of embedding community assets, namely places of worship and barbershops, into the PHC pathway for the prevention and control of NCDs in deprived settings. It describes the participatory approach used to map and gather contextual readiness information, including the enablers and constrainers for collaborative partnerships with PHC.

Methods:

Grounded in community-based participatory research, we used elements of ground-truthing and participatory mapping to locate and gather contextual information on places of worship and barbershops in urban and rural communities. Local knowledge, gathered from community dialogs, led to the creation of sampling frames of these community assets. Selected places of worship were administered a 66-item readiness questionnaire, which included domains on governance and financing, congregation profile, and existing health programs and collaborations. Participating barbershops were administered a 40-item readiness questionnaire, which covered barbers’ demographic information, previous training in health promotion, and barbers’ willingness to deliver health promotion activities.

Results:

Fourteen barbershops were identified, of which 10 participated in the readiness survey, while 240 places of worship were identified, of which 14 were selected and assessed for readiness. Contextual differences were found within and between these assets regarding governance, accessibility, and reach. Key enablers for both include training in health promotion, an overwhelming enthusiasm for participation and recognition of the potential benefits of a community—primary care partnership. Lack of previous collaborations with the formal health system was common to both.

Conclusion:

The participatory approach extended reach within underserved communities, while the readiness data informed intervention design and identified opportunities for partnership development. Contextual differences between community assets require comprehensive readiness investigations to develop suitably tailored interventions that promote reach, acceptance, and sustainability.
Looking Hateworthy: An Investigation of the Relationship Between Chinese Phenotypicality and COVID-19-Related Prejudice and Discrimination
Authors: Choi Samuel , Burd Kayla A. , Choi Alice
Published: November 2022

Throughout the COVID-19 pandemic, there have been an increasing number of hate crimes perpetrated against Chinese and non-Chinese Asian Americans. Some hate incidents suggest that Chinese Asian Americans have been mainly targeted followed by non-Chinese Asian Americans. The present study examined the influence of victim Chinese phenotypicality (CP) and participant individual differences on COVID-19-related prejudice and discrimination. Participants were presented with a mock news story detailing a restaurant employee (varying in CP) who tested positive for COVID-19 but went to work despite warnings to quarantine and allegedly spread COVID-19 to other employees and customers. CP was manipulated through photographs embedded within the mock news story of the employee (White (control) vs. Low CP vs. High CP). After reading the news story, participants completed measures of prejudice and discrimination endorsement along with measures of individual differences. Results revealed that CP influenced prejudice and support for discrimination, but only for individuals with certain characteristics (e.g., low income). The findings highlight individual difference characteristics among perpetrators of prejudice and discrimination against Asian Americans, in addition to phenotypic variations among those who may be victims of hate related to the COVID-19 pandemic.
Technology Adoption and Usage by the Public During the COVID-19 Pandemic
Authors: Mishra Ram , Sainy Monica
Published: November 2022

This research article determines the most adopted and used technology by common public and end consumers during the COVID-19 pandemic and tries to determine the technologies that will continue to see increased adoption rate beyond the COVID-19 pandemic. It examines examples of how digital technologies and services have been employed in daily lives of individuals and enterprises/businesses during the COVID-19 crisis. We have used responses to the survey built using Google Forms as the method for data collection. The study undertaken was exploratory in nature to identify the most adopted and used technology among common public during the COVID-19 pandemic. We used descriptive statistics, R-test, R-squared test, and ANOVA for the study. The results show that video-based collaboration technology-related services had the highest adoption and usage among respondents, followed by process automation, mobile/web-based services and microservices, and artificial intelligence (AI) and analytics. As an implication of the study, businesses can focus upon technologies such as video-based collaboration technology, process automation, mobile/web-based services and microservices, and AI and analytics—in that order—to roll out new services and models while dealing with their end customers and prospects, during and beyond the COVID-19 pandemic.
Qualitative and Quantitative Assessment of the Medial Patellar Retinaculum Anatomy: the Anteromedial Side of the Knee Revisited
Authors: Peez Christian , Wermers Jens , Glasbrenner Johannes , Briese Thorben , Raschke Michael J. , Herbst Elmar , Kittl Christoph
Published: November 2022

Background:

In the current literature, studies on the anatomy of the anteromedial region of the knee are scarce. However, the anteromedial structures, especially the longitudinal medial patellar retinaculum (MPR), may play an important role in restraining external tibial rotation.

Purpose:

To conduct a layer-by-layer dissection of the anteromedial side of the knee and describe qualitatively and quantitatively the MPR anatomy pertaining to surgically relevant landmarks.

Study Design:

Descriptive laboratory study.

Methods:

A total of 10 fresh-frozen human cadaveric knees (mean age 81 ± 16.3 years) without history of previous ligament injury were used in this study. A layer-by-layer dissection was performed, and measurements were obtained using a tactile 3-dimensional (3-D) measuring arm to define the anatomy of the MPR in relation to surgically relevant landmarks, such as the superficial medial collateral ligament (sMCL) and medial patellofemoral ligament (MPFL). The 3-D datasets were used for multiplanar reconstruction.

Results:

The tibial and femoral attachment of the MPR were identified in 100% of cases. Layer-by-layer dissection confirmed its close topography to the sMCL. The mean length of the MPR was 84.9 ± 9.1 mm. The average width of the tibial and femoral attachment was 23.8 ± 3.1 mm and 69.2 ± 8.2 mm, respectively. The distance from the midpoint of the MPR tibial attachment to the midpoint of the distal tibial attachment of the sMCL was 27.2 ± 5.8 mm. Femorally, the MPR attached at the anterior border of the MPFL over a mean distance of 52.3 ± 9.4 mm.

Conclusion:

The MPR is a distinct tibiofemoral structure with well-defined tibial and femoral attachments, which could be consistently identified. Layer-by-layer dissection confirmed its close topography to the sMCL and MPFL.

Clinical Relevance:

As injuries to the anteromedial side of the knee may contribute to anteromedial rotational rotatory instability (AMRI), precise knowledge of the underlying anatomy of the MPR may be necessary to perform an anatomic reconstruction of the anteromedial side of the knee.
Rebuilding From the Ground Up: Employer and Alumni Perspectives for Course Redesign
Authors: Dolechek Rachel , Lehenbauer Kruti
Published: November 2022

Institutions rely on career-ready competencies developed by the National Association of Colleges and Employers (NACE) to understand the nationwide job outlook and labor market trends. The purpose of this mixed-methods study is to inform a course redesign process in the business curriculum at a Midwestern university in the United States. Using an adapted NACE survey, we found that while Midwestern employers and alumni valued NACE core competencies and employability attributes similarly, there were certain elements that were overlooked in the previous curriculum. Thus, identification of the locally relevant top competencies and attributes was a leading factor in the course redesign process.
Developing Self-Efficacy in Public Speaking Using Video and Digital Oratory on YouTube
Authors: Sharma Daneshwar
Published: November 2022

Digital communication and digital oratory have become an integral part of today’s workplace. This research discusses an innovative assessment tool that uses digital oratory and digital video along with YouTube to create opportunities for the students to develop self-efficacy in digital oratory and public speaking. The measurement of the effectiveness through a survey questionnaire displays that the assessment tool met its learning objectives. The assessment tool fostered self-efficacy in digital oratory and improved digital communication knowledge and skills. The article also discusses the challenges and recommendations for implementing this assessment tool in various contexts.
Exploring the Motivational Drivers of Young Adults with Diabetes for Participation in Kidney Research
Authors: Mohini P , Palaganas M , Elia Y , Motran L , Sochett E , Curtis J , Scholey JW , McArthur L , Mahmud FH
Published: November 2022

Understanding motivational drivers and barriers to patient participation in diabetes research are important to ensure research is relevant and valuable. Young adults with type 1 diabetes (T1D) completed a 31-question qualitative survey evaluating participant experience, understanding, and motivators and barriers to research involvement. A total of 35 participants, 19–28 years of age, 60% female, completed the survey. Motivating factors included personal benefit, relationship with the study team, curiosity, financial compensation, altruism, and nostalgia. Older participants (>22 years) reported higher levels of trust in the study team (p = 0.02) and their relationship with the study team positively influenced their decision to participate (p = 0.03). Financial compensation was a strong motivator for participants with higher education (p = 0.02). Age, sex, education level, and trust in the study team influenced participants’ understanding. Barriers included logistics and lack of familial support. Important motivational drivers and barriers to participation in research by young adults with T1D must be considered to increase research engagement and facilitate the discovery of new knowledge.
The effect of laser cutting on the Young’s modulus of Polydimethylsiloxane
Authors: Helgason Rick , Fathy Jino , Lai Yongjun
Published: November 2022

Laser cutting is often used in the fabrication of Polydimethylsiloxane (PDMS) substrates for novel microdevices such as wearable sensors and microfluidic devices. PDMS is a thermosetting polymer whose material properties are affected by the thermal conditions during the curing process. Since laser cutting exposes the cutting material to high temperatures, this might affect the heat-sensitive material properties. In this work, we examine how laser cutting affects the stiffness of PDMS by measuring the Young’s modulus of PDMS and comparing that to the Young’s modulus of laser-cut PDMS. We find an increase in the Young’s modulus from 0.34 to 0.37 MPa (9%) for PDMS mixed at a ratio of 20:1 base to curing agent. For 10:1 ratio PDMS, we find the increase in Young’s modulus is 31%, from 1.02 to 1.34 MPa.
Research-to-Resource: A Tripartite Model of Cultural Humility-Music (TMCH-Music) in Music Education
Authors: Yoo Hyesoo
Published: November 2022

A Tripartite Model of Cultural Humility-Music (TMCH-Music) includes three tenets, which are essential to forming a humble character: (a) commitment to lifelong, critical self-reflection; (b) recognition and mitigation of power imbalances; and (c) mutually beneficial partnerships with communities. In this model, I situate cultural humility as a mindset that necessitates careful consideration relating to educational context, content, and pedagogy in music education. Adopting a humble mindset, music teachers may acknowledge their own biases, stereotyping, and prejudices relating to educational context, content, and pedagogy. A commitment to lifelong introspection through self-reflection and critique may help teachers continue to investigate new ways to redress power imbalances inherent in music education, as well as build their relationships with communities bidirectionally. I describe each dimension of the model and provide suggestions for how music educators may use this humble mindset of TMCH-Music in practice.
Rurality and the Provision of Extended School Year Services
Authors: Barnard-Brak Lucy , Fearon-Drake Danielle , Mutua Kagendo
Published: November 2022

We examined differences in the receipt and delivery of extended school year (ESY) services in the United States by locale as being rural, urban, or suburban. We found that there were significant differences in the percentage of students receiving ESY services according to locale, with rural local education agencies (LEAs) having a significantly lower percentage of students receiving ESY services. Additionally, we found that special education directors perceived the number of students receiving ESY services as generally being “about right” for their LEA. We also found that urban special education directors were significantly more likely to report that there should be less students receiving ESY services while rural special education directors were less likely to report this. We then found that rural LEAs generally reported providing significantly fewer types of ESY services offered than urban or suburban LEAs. Finally, we found that urban LEAs reported significantly higher attendance rates of students who attended ESY services as compared with rural LEAs.
BTG1 inactivation drives lymphomagenesis and promotes lymphoma dissemination through activation of BCAR1
Authors: Delage Lorric , Lambert Mireille , Bardel Émilie , Kundlacz Cindy , Chartoire Dimitri , Conchon Axel , Peugnet Anne-Laure , Gorka Lucas , Auberger Patrick , Jacquel Arnaud , Soussain Carole , Destaing Olivier , Delecluse Henri-Jacques , Delecluse Susanne , Merabet Samir , Traverse-Glehen Alexandra , Salles Gilles , Bachy Emmanuel , Billaud Marc , Ghesquières Hervé , Genestier Laurent , Rouault Jean-Pierre , Sujobert Pierre
Published: November 2022

Understanding the functional role of mutated genes in cancer is required to translate the findings of cancer genomics into therapeutic improvement. BTG1 is recurrently mutated in the MCD/C5 subtype of diffuse large B-cell lymphoma (DLBCL), which is associated with extranodal dissemination. Here, we provide evidence that Btg1 knock out accelerates the development of a lethal lymphoproliferative disease driven by Bcl2 overexpression. Furthermore, we show that the scaffolding protein BCAR1 is a BTG1 partner. Moreover, after BTG1 deletion or expression of BTG1 mutations observed in patients with DLBCL, the overactivation of the BCAR1-RAC1 pathway confers increased migration ability in vitro and in vivo. These modifications are targetable with the SRC inhibitor dasatinib, which opens novel therapeutic opportunities in BTG1 mutated DLBCL.
Hydroxyurea treatment is associated with lower malaria incidence in children with sickle cell anemia in sub-Saharan Africa
Authors: Olupot-Olupot Peter , Tomlinson George , Williams Thomas N. , Tshilolo Léon , Santos Brígida , Smart Luke R. , McElhinney Kathryn , Howard Thad A. , Aygun Banu , Stuber Susan E. , Lane Adam , Latham Teresa S. , Ware Russell E.
Published: November 2022

Realizing Effectiveness Across Continents with Hydroxyurea (REACH, NCT01966731) provides hydroxyurea at maximum tolerated dose (MTD) for children with sickle cell anemia (SCA) in sub-Saharan Africa. Beyond reducing SCA-related clinical events, documented treatment benefits include ∼50% reduction in malaria incidence. To identify associations and propose mechanisms by which hydroxyurea could be associated with lower malaria rates, infections were recorded across all clinical sites (Angola, Democratic Republic of Congo, Kenya, and Uganda). Hazard ratios (HR) with 95% confidence intervals (CIs) for baseline demographics, and time-varying laboratory and clinical parameters were estimated in a modified Cox gap-time model for repeated events. Over 3387 patient-years of hydroxyurea treatment, 717 clinical malaria episodes occurred in 336 of 606 study participants; over half were confirmed by blood smear and/or rapid diagnostic testing with 97.8% Plasmodium falciparum. In univariate analysis limited to 4 confirmed infections per child, malaria risk was significantly associated with absolute neutrophil count (ANC), splenomegaly, hemoglobin, and achieving MTD; age, malaria season, MTD dose, fetal hemoglobin, α-thalassemia, and glucose-6-phosphate dehydrogenase deficiency had no effect. In multivariable regression of confirmed infections, ANC was significant (HR, 1.37 per doubled value; 95% CI, 1.10-1.70; P = .0052), and ANC values <3.0 × 109/L were associated with lower malaria incidence. Compared with nonpalpable spleen, 1- to 4-cm splenomegaly also was associated with higher malaria risk (HR, 2.01; 95% CI, 1.41-2.85; P = .0001). Hydroxyurea at MTD is associated with lower malaria incidence in SCA through incompletely defined mechanisms, but treatment-associated mild myelosuppression with ANC <3.0 × 109/L is salutary. Splenomegaly is an unexplained risk factor for malaria infections among children with SCA in Africa.
Measurement of pharmacological antagonism produced by atropine in bronchi of normal and asthmatic subjects
Authors: Gillett MK , Snashall PD
Published: November 2022

The bronchial response of six normal and six asthmatic subjects to increasing concentrations of methacholine aerosol was measured by serial measurements of specific airways conductance (sGaw) in a body plethysmograph. On separate days, the subjects were premedicated with 0.9% NaCl, inhaled atropine at four different doses, or intravenous atropine at two different doses. Cumulative log dose-response curves were constructed. The provocative dose of methacholine needed to cause a 35% fall in sGaw was measured from each curve (PD35). The antagonism produced by a given atropine dose was quantified as the dose ratio, which was defined as the ratio of PD35 after atropine to PD35 after saline. In normal subjects, approximately equal amounts of atropine given by the inhaled or intravenous routes produced mean dose ratios of almost identical value. However, in asthmatic subjects inhaled atropine (1.28 mg, 4.4 mumol) produced a mean dose ratio 7.5 times greater than the mean value seen with intravenous atropine (1.0 mg, 3.46 mumol). Intravenous atropine (1.0 mg, 3.46 mumol) produced a mean dose ratio of 18.3 for all subjects, compared to a value of 26 predicted from in vitro experiments. The slope of the regression line for the relationship of log (dose ratio -1) vs -log atropine dose (Schild plot) for all subjects was -0.99. The actions we have observed are compatible with the main actions of atropine being that of a competitive antagonist at the muscarinic receptor. The greater blocking effect of inhaled atropine in some asthmatics suggests that a higher concentration of atropine is achieved at the muscarinic receptor by the inhaled route in these subjects.
Influence of exercise and CO2 on breathing pattern in patients with chronic obstructive lung disease (COLD)
Authors: Scano G , Gigliotti F , van Meerhaeghe A , De Coster A , Sergysels R
Published: November 2022

In ten eucapnic patients with chronic obstructive lung disease (COLD) we evaluated the breathing pattern during induced progressive hypercapnia (CO2 rebreathing) and progressive exercise on an ergometric bicycle (30 W/3 min). The time and volume components of the respiratory cycle were measured breath by breath. When compared to hypercapnia, the increase in ventilation (VE) during exercise was associated with a smaller increase in tidal volume (VT) and a greater increase in respiratory frequency (fR). Plots of tidal volume (VT) against both inspiratory time (TI) and expiratory time (TE) showed a greater decrease in both TI and TE during exercise than with hypercapnia. Analysis of VE in terms of flow (VT/TI) and timing (TI/TT) showed VE to increase by a similar increase to that in VT/TI during both exercise and hypercapnia, while TI/TT did not change significantly. When the patients were matched for a given VE (28 l.min-1), exercise induced a smaller increase in VT (p less than 0.05), a greater increase in fR (p less than 0.025); TI (p less than 0.025) and TE (p less than 0.01) were found to be smaller during exercise than hypercapnia. The change in the off-switch mechanism during exercise and hypercapnia could account for our results.
Prevention and reversal of endotoxin-induced pulmonary hypertension by a leukotriene antagonist
Authors: Ahmed T , Weichman B , Wasserman MA , Muccitelli R , Tucker S , Marchette B
Published: November 2022

We investigated the role of leukotrienes in endotoxin-induced changes in pulmonary circulation. In six conscious sheep, haemodynamic measurements were obtained for the calculation of pulmonary vascular resistance (PVR), along with measurements of arterial oxygen tension (PaO2), leucocyte count (WBC), thromboxane B2 (TxB2), 6-Keto-PgF1 alpha and PgF2 alpha, before and at predetermined intervals after a 10-min infusion of E. coli endotoxin (0.3 microgram/kg), with and without treatment with the leukotriene receptor antagonist, FPL-57231. Endotoxin caused a biphasic response (i.e., phase I = 0-1 h, phase II = 1.5-4 h), with a mean +/- SE increase in PVR to 415 +/- 112% of baseline during phase I and a lesser increase of 175% (range = 153-199%) of baseline during phase II. Mean +/- SE PaO2 decreased from 86 +/- 4 to 67 +/- 6 mmHg and WBC count decreased from 8.6 +/- 0.6 to 2.8 +/- 0.7 thousand/mm3 during phase I, whereas TxB2 increased from 145 +/- 28 to 3164 +/- 1082 pg/ml, 6-Keto-PgF1 alpha from 129 +/- 14 to 438 +/- 114 pg/ml and PgF2 alpha from 122 +/- 7 to 242 +/- 43 pg/ml. One hour infusion of FPL-57231 (1 mg/kg/min) administered prior to and throughout phase I attenuated the phase I increases in PVR without preventing the increases in TxB2; however, it partly attenuated 6-Keto-PgF1 alpha and enhanced generation of PgF2 alpha during phase I. Discontinuation of FPL-57231 was followed by an exaggerated response of PVR during phase II to an average of 209% of baseline (range = 186-235%).(ABSTRACT TRUNCATED AT 250 WORDS)
The clinical effect and the effect on the ciliary motility of oral N-acetylcysteine in patients with cystic fibrosis and primary ciliary dyskinesia
Authors: Stafanger G , Garne S , Howitz P , Morkassel E , Koch C
Published: November 2022

The effect of peroral N-acetylcysteine (NAC) in patients with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) was investigated. 41 CF patients and 13 PCD patients completed the study which was a double-blind, placebo-controlled, cross-over trial. The patients received either NAC or placebo for two periods of three months followed by a three month follow-up period. Active treatment consisted of NAC, either 200 mg x 3 daily (patients weighing less than 30 kg) or 400 mg x 2 daily (greater than 30 kg). The effect was evaluated in terms of a subjective clinical score, weight, sputum bacteriology, blood leucocyte count, sedimentation rate, titres of specific antimicrobial antibodies, lung function parameters and measurement of the ciliary function. No effect was seen in PCD patients, but in CF patients an improved lung function was seen in the period when the patients suffer most from lower airway infections.
Respiratory response to histamine- and methylcholine-induced bronchospasm in nonsmokers and asymptomatic smokers
Authors: Savoy J , Louis M , Kryger MH , Forster A
Published: November 2022

The respiratory response to bronchospasms of the same magnitude induced by inhalation of histamine or methylcholine was measured non-invasively, using bellow pneumographs, in nonsmokers and asymptomatic smokers. In each subject, tidal volume (VT), breathing frequency (f) and inspiratory time (TI) were obtained on two different days, in a randomized crossover fashion, with the following sequence: basal conditions, after inhalation of buffered saline as a control and after histamine or methylcholine inhalation. Basal and control conditions did not differ from each other and were the same for both groups. The respiratory responses to both bronchoconstrictors did not differ from each other and were also the same in both groups: VT increased, f and TI remained unchanged. Thus, VT/TI, an index of respiratory drive, also increased. In nonsmokers the increased VT/TI and the associated increase in minute ventilation were both correlated to the decrease in FEV1. These correlations were not found in smokers. Although they have different effects on airway irritant receptors, inhaled histamine and methylcholine induce the same respiratory response in nonsmokers and smokers. Thus, the presumed smoking-related changes in airway mucosa permeability do not seem to influence the direct stimulating effect of histamine on these endings. The absence of correlation between FEV1 and VT/TI changes in smokers suggest that smoking might affect the respiratory drive in acute drug-induced bronchospasm.
Effects of diffuse pleural thickening on respiratory mechanics
Authors: Corris PA , Best JJ , Gibson GJ
Published: November 2022

Five patients with radiographic and computed tomography (CT) evidence of extensive pleural thickening were studied. All had a restrictive ventilatory defect. The single breath carbon monoxide transfer factor (TLCO) was reduced in each case (mean 76% predicted) but in four patients the transfer coefficient (KCO) was increased (mean 116% predicted), which is consistent with lung 'en cuirasse'. Static pressure-volume curves of the lungs showed that the maximum transpulmonary pressure was greater than normal and pulmonary compliance was reduced; the curves were therefore indistinguishable from those obtained in patients with pulmonary fibrosis. Transdiaphragmatic pressures during maximal inspiratory efforts were moderately impaired and the proportions of each tidal breath contributed by anterposterior (AP) motion of rib cage and abdomen were similar to normal in both erect and supine postures, suggesting that diaphragmatic mobility was well preserved.
Orientation of human respiratory cilia
Authors: Rautiainen ME
Published: November 2022

Ciliary orientation was studied on the respiratory epithelium of the nasal cavity or the sphenoidal sinus of ten adult nonsmokers without respiratory disease. The ciliary orientation was evaluated from micrographs by measuring the angle between the plane defined by the central tubules and reference line (with a semiautomatic image analyser (IBAS I]. The standard deviation of the angles of cilia population was counted in every field. The standard deviation of the measurements described the ciliary alignment. It varied from 12.1-41.2 degrees. The mean standard deviation was 27.3 +/- 7.4 degrees. 58% of all measured cilia were within +/- 0-20 degrees of the mean and 85% of cilia were within +/- degrees. However, a few cilia or small groups of cilia were found in most fields which differed dramatically from the main orientation. The size of these groups was always less than ten cilia. On the normal respiratory epithelium the standard deviation of ciliary orientation varies between +/- 10-40 degrees (at about 97% probability). For diagnostic conclusions more than 60 cilia should be measured.
Respiratory muscle force and ventilatory function in adolescents
Authors: Schrader PC , Quanjer PH , Olievier IC
Published: November 2022

In 94 girls and 90 boys, aged 12.5-20.3 yr, the relationship of respiratory pressures or forces with lung volumes and ventilatory flows was studied. There was great variability in respiratory muscle performance, which helps to explain differences in lung volumes between individuals. Respiratory muscle force increases almost proportionally with thoracic dimensions, so that inspiratory and expiratory pressures generated at the level of residual volume (RV), functional residual capacity (FRC) and total lung capacity (TLC) are approximately constant with age. In the oldest boys there is evidence that the continued increase in lung volumes when they stop growing is due to a 'muscularity effect'. Boys generate larger pressures than girls at all lung volumes. Thus boys attain a larger TLC, and in spite of narrower airways, the same peak expiratory flow and a larger FIV1/FVC ratio than girls. Effort independent flows (FEV1 and MMEF), however, are larger in girls.
Breathing pattern and load compensatory responses in young scoliotic patients
Authors: Ramonatxo M , Milic-Emili J , Prefaut C
Published: November 2022

The breathing pattern and mouth occlusion pressure developed in 0.1 seconds (P0.1) were measured at rest in sixteen young scoliotic patients in whom the blood gases were within the normal limits. The patients exhibited rapid and shallow breathing. P0.1 was increased above normal, indicating a compensatory increase of neuromuscular inspiratory drive in the face of a stiffer respiratory system. P0.1 (% predicted) correlated positively with the angle of scoliosis. Both duration of inspiration and inspiratory duty cycle correlated negatively with angle of scoliosis and P0.1 (% predicted). On theoretical grounds we show that these changes in breathing pattern are beneficial, both in terms of reducing the energy cost of breathing and preventing the development of inspiratory muscle fatigue.
Urine cortisol excretion in children treated with high doses of inhaled corticosteroids: a comparison of budesonide and beclomethasone
Authors: Pedersen S , Fuglsang G
Published: November 2022

Thirty one children with asthma were treated with inhaled beclomethasone and budesonide in a randomized cross-over study of 2 x 6 weeks' duration. The excretion of free cortisol in two 24 hour urine samples, collected at the end of each treatment period, was significantly higher (mean = 76.3 nmol per day) during budesonide treatment than during beclomethasone treatment (mean = 53.7 nmol per day) (p less than 0.01). The difference between the two drugs was more pronounced in the eight children who received 1,000 and 1,200 micrograms per day than in the 22 children who received 800 micrograms per day. Four children had cortisol excretion below the normal range when treated with beclomethasone. This was seen in one child during budesonide treatment. The age of the child did not influence the result. The long term clinical significance of these findings has yet to be elucidated.
Endotracheal neurofibroma in a patient with von Recklinghausen's disease
Authors: Lossos IS , Breuer R , Lafair JS
Published: November 2022

Benign neurogenous tumours arising in the trachea are rare. We report on a patient with von Recklinghausen's disease who presented with shortness of breath caused by endotracheal neurofibroma.
Continuous intravenous therapy with theophylline in a patient with brittle bronchial asthma
Authors: Speelberg B , van den Brink WT
Published: November 2022

Ambulant continuous intravenous theophylline therapy was used in a patient with frequent and severe asthmatic attacks. The patient could not tolerate oral theophylline preparations. We demonstrated a reduction in complaints and prednisone therapy. Activities of daily life improved, as did theophylline levels, lung function and peak-flow.
Benign endobronchial tumours treated by neodymium-YAG laser
Authors: Eppinga P , van der Laan KT , Overbeek JJ , Meinesz AF , Postmus PE
Published: November 2022

We present two patients with benign endobronchial tumours: polypi and a chondroma. Both were treated by Neodymium-YAG laser photoresection. There have been no signs of recurrence in the four years since treatment. Endobronchial resection by Neodymium-YAG laser is an effective treatment for benign endobronchial tumours.
The humoral immune response after BCG vaccination in humans: consequences for the serodiagnosis of tuberculosis
Authors: Turneer M , Van Vooren JP , Nyabenda J , Legros F , Lecomte A , Thiriaux J , Serruys E , Yernault JC
Published: November 2022

The IgM and IgG response to BCG vaccination was investigated in 75 adults, tuberculin negative before vaccination, using an enzyme-linked immunosorbent assay with purified protein derivative (PPD) as antigen. The mean optical density (OD) increased significantly (p less than 0.001) in both immunoglobulin classes. Increase in at least one class was significant in 89% of the subjects. The observed increase in anti-PPD IgG was rather small but comparable to that seen in 17 newly diagnosed tuberculosis patients with negative direct smear [mean OD (SD): 0.59 (0.38) in vaccinated and 0.70 (0.48) in patients] but significantly lower (p less than 0.001) than that seen in 31 newly diagnosed patients with positive direct smear [mean OD (SD): 1.07 (0.67)]. With 55% of sera above the upper normal limit, smear positive patients differentiated (p less than 0.001) from vaccinated subjects (20% of positive sera) whilst smear negative patients (29% of positive sera) did not. We conclude that BCG vaccination induces a definite but small increase in anti-PPD serum IgM and IgG, which is likely to interfere when interpreting serological tests for the diagnosis of tuberculosis, especially in those patients who would most benefit from an early and fast diagnosis.
Primary endobronchial actinomycosis
Authors: Miracco C , Marino M , Lio R , Cornetti M , Luzi P
Published: November 2022

A male farmer referred for fever, cough and haemoptysis, presented, at bronchoscopic examination, a large mass occluding the middle lobe bronchus. No lung involvement was visible on chest X-ray. Histological examination showed an actinomycotic granule in the bronchial submucosa. The histological findings indicate that aspiration of contaminated material from the upper alimentary tract may have caused the disease.
Changes in neural drive (EMGd) and neuromuscular coupling during histamine-induced bronchoconstriction in patients with asthma
Authors: Gorini M , Spinelli A , Gigliotti F , Duranti R , Arcangeli P , Scano G
Published: November 2022

This study was undertaken in order to assess the neural drive to the respiratory muscles and the inspiratory neuromuscular coupling in patients with bronchial asthma during histamine-induced bronchoconstriction. Bronchoconstriction was produced in a graded fashion, with histamine phosphate aerosol of increasing dose, in twelve asymptomatic asthmatic patients and was measured by FEV1. Inspiratory drive was measured by electromyographic activity of the diaphragm (EMGd) and the coupling of the neural drive to the respiratory muscles was assessed by the relationship of mouth occlusion pressure (P0.1) to EMGd. During the test we also measured electromyographic activity of the inspiratory intercostal (EMGint), sternomastoid (EMGsm) and expiratory abdominal (EMGab) muscles. Histamine caused a significant decrease in FEV1, a significant increase in P0.1, EMGd, EMGint, and a relevant increase in EMGsm, with no substantial increase in EMGab. An inverse significant relationship between the change in FEV1 and changes in P0.1, EMGd and EMGint and a significant correlation between the change in FEV1 and in the P0.1/EMGd ratio were observed. We conclude that a progressive increase in bronchospasm is accompanied by a progressive increase in respiratory neural drive and decrease in neuromuscular coupling. This could be caused both by an increase in lung volume and a lack of abdominal expiratory muscle recruitment.
Release of thromboxane A2 by low-dose almitrine in the hypoxic dog
Authors: Chuma R , Tanaka O , Hoshino Y , Obara H , Iwai S
Published: November 2022

Potentiation of hypoxic pulmonary vasoconstriction by a low dose of almitrine bismesylate (1 microgram.kg-1.min-1) was evaluated in terms of blood chemical mediator concentrations. Time course changes in the blood concentrations of adrenaline, noradrenaline, serotonin, histamine, thromboxane TXB2 and 6-keto-PGF1 alpha were monitored after administration of almitrine bismesylate for 15 min at 1 microgram.kg-1.min-1) in hypoxic and normoxic beagles. The low almitrine dose significantly increased TXB2 levels in hypoxic beagles, but the levels remained virtually unchanged in the normoxic animals with almitrine bismesylate and in the hypoxic animals with solvent. TXB2 levels did not increase when the almitrine infusion was increased to 5 micrograms.kg-1.min-1 for 15 min in hypoxic conditions. These findings suggest that almitrine is involved in arachidonic acid metabolism at a low rate of infusion and that thromboxane release from hypoxic areas of the lung may cause local vasoconstriction.
Pulmonary artery pressure--flow plots in hyperoxic and in hypoxic dogs: effects of prostaglandin E1
Authors: Leeman M , Lejeune P , Melot C , Naeije R
Published: November 2022

The effects of prostaglandin E1 on mean pulmonary artery pressure (Ppa):cardiac index (Q) relationships were investigated in eight anaesthetized dogs, ventilated in hyperoxia (fraction of inspired oxygen (FiO2) 0.4) and in hypoxia (FiO2 0.1). Cardiac output was increased by opening an arterio-venous femoral bypass or reduced by stepwise inflations of a balloon in the inferior vena cava. Five-point Ppa:Q relationships were found to be linear in all experimental conditions. Hypoxia increased Ppa over the entire range of Q studied (1-5l.min-1.m-2). Prostaglandin E1 0.4 microgram.kg-1.min-1 intravenously decreased hyperoxic Ppa for Q ranging from 3-5 l.min-1.m-2, hypoxic Ppa for Q ranging from 2-5 l.min-1.m-2 and attenuated hypoxia-induced increases in Ppa. These results show that prostaglandin E1 is a pulmonary vasodilator in both hyperoxic and hypoxic conditions. At the dose of 0.4 microgram.kg-1, prostaglandin E1 partially inhibits hypoxic pulmonary vasoconstriction.