bluuebunny/crossref_metadata_2025 huggingface dataset:
Tactics in Support of the Strategy to Include Artistic Research as Evidence in Systematic Reviews
Authors: Hannes Karin
Published: May 2023

Artistic research studies produce a felt and often physically embodied type of knowledge initiated in an artistic experience and consolidated as an art form. The actual art work as the outcome of these studies, complements other types of knowledge and therefore requires attention from systematic review authors who synthesize evidence from primary studies. Working with artistic research evidence in a systematic review context requires a different approach to searching, appraising, analysing and integrating research findings than what is usually promoted by international review organisations. In this paper we outline how the different steps in a systematic review process can be adapted to include art work as as a multimodal type of research evidence in systematic reviews. We discuss useful tactics of identifying artistic research evidence, judging its value, analysing and synthesizing such evidence, hereby building on iconographic, thematic and/or art and design related analytical frameworks. In addition, we feature a gallery approach to present artistic research evidence to end-users and feature a multimodal type of evidence synthesis in which individual art works are comprehensively integrated in an audio visual production.
Assessing lexical ambiguity of simplified Chinese characters: Plurality and relatedness of character meanings
Authors: Chen Huilin , Xu Xu , Wang Tianqi
Published: May 2023

Lexical ambiguity is pervasive among Chinese characters as many of them are polysemantic, with one orthographic form carrying unrelated meanings, related meanings, or sometimes both unrelated and related meanings. A large-scale database with ambiguity measures for simplified Chinese characters has yet to be developed, which could greatly benefit psycholinguistic research on the Chinese language or cross-language comparisons. This article reports two sets of ratings by native speakers, the perceived number of meanings (pNoM) for 4,363 characters and the perceived relatedness of meanings (pRoM) for a subset of 1,053 characters. These rating-based ambiguity measures capture the representational nuance about a character’s meanings stored in average native speakers’ mental lexicon, which tends to be obscured by dictionary- and corpus-based ambiguity measures. Consequently, they each account for a reliable portion of variance in the efficiency of character processing, above and beyond the effects of character frequency, age of acquisition, and other types of ambiguity measures. Theoretical and empirical implications with regard to the plurality and the relatedness of character meanings, the two focal aspects of debate on lexical ambiguity, are discussed.
Feasibility of ‘Daughters and Dads Cricket’: A programme targeting fathers to improve daughters’ engagement and skills in cricket
Authors: Morgan Philip J , Pollock Emma R , Kennedy Stevie-Lee , Young Myles D , Eather Narelle , Ashton Lee M
Published: May 2023

Background

Utilising fathers to support their daughters and enhance their cricket skills may be an innovative approach to addressing traditional socio-cultural views of cricket relating to gender, by improving girls’ enjoyment, participation and long-term retention in in the sport.

Purpose

To assess the feasibility of the ‘Daughters and Dads Cricket’ programme.

Methods

In a single-arm, pre–post study, fathers (n  =  34, 43.1  ±  4.4 years) and daughters (n  =  34, 9.4  ±  1.5 years) from Newcastle, Australia were recruited. The 9-week programme was delivered by trained facilitators and included weekly educational and practical sessions, plus home-based tasks. A priori feasibility benchmarks targeted recruitment (20 dyads), fidelity (≥80%), attendance (≥70%), compliance (≥70%), satisfaction (mean: ≥ 4/5) and retention (≥85%). Preliminary efficacy outcomes included cricket skill proficiency, daughters’ enjoyment in cricket, intention to keep playing cricket and long-term retention in cricket.

Results

Feasibility benchmarks were exceeded for recruitment (n  =  34 dyads), fidelity (98% education, 100% practical), attendance (88%), satisfaction (fathers: 4.6 of 5, daughters: 4.8 of 5) and retention (97%). Home-programme compliance fell short of the benchmark (64%). Preliminary efficacy was confirmed with medium-to-large effect size changes in 11 of the 13 daughters’ cricket skill proficiency outcomes. Promising findings were identified for daughters’ enjoyment of cricket, intention to continue playing and long-term retention in cricket.

Conclusion

A cricket-focused programme targeting daughters and dads was feasible and led to medium-to-large improvements in cricket skill proficiency among the daughters. Additionally, daughters were engaged with cricket, as shown by high levels of enjoyment, intention to continue playing and their long-term retention. Examining future efficacy in a larger trial is warranted.
Reducing trauma theatre list delays through improved communication between orthopaedic teams and radiographers: A quality improvement project
Authors: Anazor Fitzgerald , Ekungba-Adewole Mutmainah , Dhinsa Baljinder , Mohammed Omar
Published: May 2023

Aims:

This quality improvement project was performed to improve delays in starting our trauma theatre lists by implementing measures to improve effective communication between the surgical team and the theatre radiographers.

Materials and Methods:

This was a quality improvement project performed prospectively for 30 orthopaedic trauma lists over two cycles. Only lists requiring fluoroscopy guidance (image intensifier) for the first case were included. Interventions included improvements in use of theatre booking forms with fluoroscopy request checkboxes, dedication of an allocated radiographer for the trauma lists, timely communication of the finalised theatre list order and radiographers participating in the team briefing.

Results:

Improvements in the timing of fluoroscopy requests and prompt arrival of the radiographer to the theatre were achieved. Furthermore, there was elimination of radiographer-related surgical start time delays following implementation of the interventions. Nevertheless, only minimal improvements were achieved in the participation of the radiographers for the trauma theatre team briefings.

Conclusion:

Although reasons for trauma theatre delays are multifactorial, this quality improvement project has demonstrated that these delays can be reduced through improved communication between radiographers and the orthopaedic team. This is especially important for theatre cases requiring the use of an image intensifier.
Molecular imaging as biomarker for treatment response and outcome in breast cancer
Authors: van Geel Jasper J. L. , de Vries Erik F. J. , van Kruchten Michel , Hospers Geke A. P. , Glaudemans Andor W. J. M. , Schröder Carolina P.
Published: May 2023

Molecular imaging, such as positron emission tomography (PET), is increasingly used as biomarker to predict and assess treatment response in breast cancer. The number of biomarkers is expanding with specific tracers for tumour characteristics throughout the body and this information can be used to aid the decision-making process. These measurements include metabolic activity using [18F]fluorodeoxyglucose PET ([18F]FDG-PET), oestrogen receptor (ER) expression using 16α-[18F]Fluoro-17β-oestradiol ([18F]FES)-PET and human epidermal growth factor receptor 2 (HER2) expression using PET with radiolabelled trastuzumab (HER2-PET). In early breast cancer, baseline [18F]FDG-PET is frequently used for staging, but limited subtype-specific data reduce its usefulness as biomarker for treatment response or outcome. Early metabolic change on serial [18F]FDG-PET is increasingly used in the neo-adjuvant setting as dynamic biomarker to predict pathological complete response to systemic therapy, potentially allowing de-intensification or step-up intensification of treatment. In the metastatic setting, baseline [18F]FDG-PET and [18F]FES-PET can be used as biomarker to predict treatment response, in triple-negative and ER-positive breast cancer, respectively. Metabolic progression on repeated [18F]FDG-PET appears to precede progressive disease on standard evaluation imaging; however, subtype-specific studies are limited and more prospective data are needed before implementation in clinical practice. Even though (repeated) [18F]FDG-PET, [18F]FES-PET and HER2-PEt all show promising results as biomarkers to predict therapy response and outcome, for eventual integration into clinical practice, future studies will have to clarify at what timepoint this integration has to optimally take place.
What is a Resource? Representing Eurasia’s Pastoral/nomadic Development History in the IPBES Framework for Reconceptualized Resource Meanings
Authors: Berman Callie
Published: May 2023

The purpose of this article is to update the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) framework to reflect resource understandings arising within historically non-sedentary societies. This article examines how Eurasia’s unique development history based on livestock cultivation beget modes of understanding predicated in mobile life strategies and pastoral/nomadic interactions with the Eurasian geography. In contrast, prevailing resource ideas emphasize land relation histories of sedentary peoples. Using the IPBES framework, this article takes a novel approach to show how food and food customs reflect embedded resource understandings relevant to non-sedentary peoples. Empirical findings from sturgeon aquaculture facilities in the Caspian states of Azerbaijan, Kazakhstan, and Turkmenistan demonstrates sturgeon meat in customary cuisine connects Eurasian peoples to land knowledge instilled with its own resource meanings. This article updates the IPBES framework to incorporate the livestock element as the integrative mechanism giving the method for land use and Eurasia’s own resource concept. Incorporating the livestock variable within the IPBES framework to express the value accorded to mobility better represents the diversity of resource meaning-making processes. It also makes possible a consideration for how food and food customs enabling narrative transmit land appreciations and knowledges not adequately captured by conventional resource analyses.
Chronic hippocampal subfield damage in transient global amnesia revealed by 7T MRI: All is not reversible?
Authors: Singh Rahul B , Ahmed Ahmed K , Vibhute Prasanna , Middlebrooks Erik H , Sandhu Sukhwinder JS
Published: May 2023

Transient global amnesia (TGA) is a neurological condition characterized by temporary memory loss and classically associated with a reversible unilateral punctate focus of restricted diffusion in the cornu ammonis 1 (CA1) region of the hippocampus. Historically, the lesions were considered to be transient in nature with no long-term imaging abnormality. However, more recent studies have challenged the concept that there are no long-term neurological sequelae. In line with this evidence, we explore the role of ultra-high-resolution imaging using 7 Tesla MRI to evaluate for long-term imaging abnormalities in a 63-year-old woman with a typical clinical course and acute TGA imaging findings. The 7 Tesla MRI revealed a residual lesion on susceptibility-weighted imaging (SWI) with evidence of gliosis and volume loss at the site of the acute lesion in CA1 eight months after the acute episode. This case challenges the traditional mantra of TGA as a fully reversible condition with no long-term imaging findings, suggesting the need for further research using ultra-high-field MRI to determine TGA's potential long-term imaging sequelae and any association with neurocognitive sequelae.
Left ventricular outflow tract cyst: What was it and where did it go?
Authors: Lone Hafeez U , Carr Cornelia S , Maghrabi Ahmed , Alkhulaifi Abdulaziz M
Published: May 2023

Cyst or thrombus formation in the left ventricular outflow tract of a normal heart is very rare. We present a case of a male who presented with a major stroke and was found to have a freely mobile cystic mass in the left ventricular outflow tract, with an otherwise completely normal heart. He had some risks factors for hypercoagulability (reduced protein C activity and raised fibrinogen), but only received aspirin therapy due to his stroke severity (haemorrhagic transformation). Once his brain imaging suggested it was safe to proceed, repeat imaging showed the mass had gone, so cardiac surgery was avoided. What was it and where did it go?
Evaluating digital competencies for allied health professionals in the United Kingdom
Authors: Lee Geraldine , Caton Emma , Knight Annemarie
Published: May 2023

The Covid-19 pandemic accelerated the move to virtual and remote consultations in clinical practice with digital technologies widely implemented. eHealth interventions and use of applications in a variety of conditions means that patients and their families, as well as healthcare professionals, can access and interpret data in real-time, as well as providing trends in various clinical parameters including blood pressure for instance. Despite the aim of digital transformation in the National Health Service in the United Kingdom, this has not been fully realised and there is no consensus on the skills and competencies required for allied health professionals (AHPs). This qualitative study undertook two focus groups with twelve AHPs to evaluate the AHP Digital Competency Framework in the UK. The participants recognised the importance of a digital technology in their clinical practice and perceived digital literacy as essential for AHPs. In relation to the AHP framework, participants agreed that competencies in digital technology were clinically relevant, and assessment of these competencies should be performed regularly in practice. However, the majority were unaware of the AHP digital competency framework and suggested improvements to optimise its use in practice and identified areas for improvement. Overall, the AHP Digital Competency Framework has the potential, with better dissemination and further refinement of the wording, to become a useful tool to support the enhancement of digital competency in AHPs and improve the delivery of patient care.
Adapting an Electronic STI Risk Assessment Program for Use in Pediatric Primary Care
Authors: Ahmad Fahd A. , Chan Pamela , McGovern Collin , Dickey Viani , Foraker Randi , McKay Virginia
Published: May 2023

Objectives:

Sexually transmitted infections (STIs) are an ongoing public health issue in adolescents. the Centers for Disease Control and Prevention and American Academy of Pediatrics have and continue to recommend STI screening in at-risk adolescents, however screening and testing continues to lag behind the need. We previously designed and implemented an electronic risk assessment tool to support STI testing in our pediatric emergency department. Pediatric primary care clinics may be better positioned for STI risk assessments, as they can offer greater privacy and confidentiality, a lower stress environment, and greater opportunity for longitudinal care. STI risk assessment and testing continues to be a challenge in this setting. The goal of this work was to evaluate the usability of our electronic tool to support adaptation and implementation in pediatric primary care practices.

Methods:

We conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews were (1) to understand contextual factors related to STI screening in primary care, which we have reported previously, and (2) to obtain feedback on our electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings, which we report here. We received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications. SUS scores range from a score of 0 to 100, with a score of 68 or higher indicating above average usability. We additionally obtained qualitative feedback via interviews and used inductive analysis to identify common themes.

Results:

We recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool highly using the SUS, with a median score of 92.5 (threshold for average usability is 68) and an interquartile range of 82.5 to 100. Thematically, all participants perceived a need for such a screening program and indicated the format would encourage more honest responses on the topic adolescents. We used these results to modify the questionnaire prior to implementing it into participating practices.

Conclusion:

We demonstrated that our electronic STI risk assessment tool had a high level of usability and could be adapted for use in pediatric primary care.
Expansion of Home Health Care: Experience of Nurses and General Duty Assistants: An Exploratory Study
Authors: Bawa Raman D. , Sinha Anil K.
Published: May 2023

Home health care services are an extension of the hospital services provided in the home of the patients. These services cover systematic nursing care and professional caregiving to chronically ill and bedridden patients. There are a substantial number of such patients who are immobile or suffer from chronic illnesses such as dementia, cancer, hypertension and similar ill-health conditions where constant care is necessary. The home care services, therefore, range from basic support for conducting the routine daily activities of dressing, grooming, ambulation and preparing prescribed meals to complex nursing services such as feeding through a nasogastric tube, catheter change, administering injections, medications and tending to tracheotomy. There is a growing need for the successful retention of people working in home care. This article provides vital insights into the job experiences of nurses and General Duty Assistants, which have been provided through qualitative findings of the study. Semi-structured interviews were conducted among 40 nurses and 40 General Duty Assistants. Open-ended questions were used to obtain the views of participants, and three primary relationships affecting their emotional state were identified. Relationship with the patient, family members of the patient and agency supervisor were studied. The participants were asked to describe the reasons why they do their jobs and the challenges they face while working in home care. Short-term and long-term recommendations were formulated based on the participant’s narratives.
Bibliometric Analysis of the Top 50 Most Cited Studies on Achilles Tendon Pathology
Authors: Moore M. Lane , Hawkins Ryan J. , Pollock Jordan R. , Makovicka Justin L. , Haglin Jack M. , Brinkman Joseph C. , Patel Karan A.
Published: May 2023

Background:

The development of Achilles tendon treatment modalities has been rapid, and it is increasingly difficult for clinicians to stay up to date with the most influential studies in this field. In order to fully understand the current state of the literature regarding Achilles tendon injury, it is invaluable to be familiar with the foundational articles and studies upon which the field is built.

Purpose:

To objectively determine the 50 most frequently cited studies in Achilles tendon pathology and to conduct a bibliometric analysis.

Study Design:

Cross-sectional study.

Methods:

The Clarivate Analytics Web of Knowledge database was used to gather data and metrics of Achilles tendon research. The 50 most cited articles were selected for analysis from an initial 17,244 identified articles. The information extracted for each article included author name, publication year, country of origin, journal name, study type, and level of evidence.

Results:

For these 50 studies, the total number of citations was calculated to be 13,159, with a mean of 263.2 citations per paper. The most cited article collected 657 citations. The publication dates of the 50 studies included in this analysis spanned 41 years (1972-2013). The largest number of articles were published by Swedish authors (n = 14); however, many other countries were represented, including Canada and Finland (n = 6 articles each). The most prevalent study designs were cohort studies (n = 13) with level 4 evidence studies being the most common (n = 14).

Conclusion:

Among the 50 most influential articles in Achilles tendon pathology, the study designs most commonly used were cohort studies and review articles. Sweden was the country of origin for the most studies included on this list, which reflects this country’s interest and commitment to researching Achilles tendon injuries and treatments.
Association of Medial Meniscal Volume With Decreased Joint Space Width After Medial Opening-Wedge High Tibial Osteotomy
Authors: Choe Jung-Su , Bin Seong-II , Kim Jong-Min , Lee Bum-Sik , Song Ju-Ho , Cho Hyung-Kwon , Kee Tae-Hong
Published: May 2023

Background:

Medial opening-wedge high tibial osteotomy (MOWHTO) reduces contact stress by altering the weightbearing axis from the medial to the lateral compartment, relieves knee pain, and slows the progression of osteoarthritis.

Purpose/Hypothesis:

To evaluate whether the volume of the medial meniscus affects outcomes after MOWHTO. It was hypothesized that reduced medial meniscal volume would be associated with worse midterm clinical and radiographic outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 59 patients who underwent MOWHTO and had ≥4 years of follow-up data. The mean follow-up period was 66.5 ± 15.1 months (range, 48-110 months). The cohort was classified into 3 groups according to the status of the medial meniscus on arthroscopic examination before osteotomy: no meniscal tear, degenerative tear leading to partial meniscectomy, and degenerative tear leading to subtotal meniscectomy. The Hospital for Special Surgery score and Knee Society objective and functional scores were compared among the groups at 2 time points (preoperative and latest follow-up), and the medial joint space width (JSW) was compared among the groups at 3 time points (preoperative, 1 year postoperative, and latest follow-up).

Results:

Overall, 9 patients had no meniscal tear, 20 patients underwent partial meniscectomy, and 30 patients underwent subtotal meniscectomy. The clinical scores improved significantly from preoperatively to the latest follow-up ( P ≤ .001 for all), with no significant difference among the groups. Post hoc analysis indicated that at the latest follow-up, JSW was significantly lower in the subtotal meniscectomy group compared with the no-tear group on both 45° of flexion posterior-anterior (2.5 ± 1.3 vs 3.9 ± 1.8 mm; P = .004) and anterior-posterior (3.4 ± 1.1 vs 4.5 ± 0.9 mm; P = .011) radiographs.

Conclusion:

Subtotal meniscectomy of the medial meniscus performed during arthroscopic examination with MOWHTO was associated with decreased JSW at midterm follow-up. Efforts should be made to preserve the medial meniscus as much as possible during MOWHTO.
Contribution of the Bony Bankart in Calculating Glenoid Bone Loss
Authors: Bozzo Isabella , Kooner Paul , Nelson Ralph , Marwan Yousef , Paruthikunnan Samir , Laverdière Carl , Boily Mathieu , Martineau Paul A.
Published: May 2023

Background:

Determining the magnitude of glenoid bone loss in patients with anterior shoulder instability is an important step in guiding management. Most calculations to estimate the bone loss do not include the bony Bankart fragment. However, if it can be reduced and adequately fixed, the estimation of bone loss may be decreased.

Purpose:

To derive a simple equation to calculate the surface area of the bony fragment in Bankart fractures.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 26 patients suspected of having clinically significant bone loss underwent computed tomography imaging preoperatively, and the percentage of glenoid bone loss (%BL) was approximated with imaging software using a freehand region of interest area measurement with and without the inclusion of the bony Bankart fragment. By assuming this bony fragment as a hemi-ellipse with height, H, and thickness, d, we represented the surface are of the bony piece ([Formula: see text]), and subtracted it from the overall %BL. They compared this value with the one found using imaging software.

Results:

Without the inclusion of the bony Bankart, the overall %BL by the standard true-fit circle measured using imaging software was 23.8% ± 9.7%. When including the bony Bankart, the glenoid %BL measured using imaging software was found to be 12.1% ± 8.5%. The %BL calculated by our equation with the bony Bankart included was 10% ± 11.1%. There was no statistically significant difference between the %BL values measured using the equation and the imaging software ( P = .46).

Conclusion:

Using a simple equation that approximates the bony Bankart fragment as a hemiellipse allowed for estimation of the glenoid bone loss, assuming that the fragment can be reduced and adequately fixed. This method may serve as a helpful tool in preoperative planning when there are considerations for incorporating the bony fragment in the repair.
Return-to-Sport Rate, Type of Sport, Frequency of Participation, and Patient Satisfaction After Elective Spinal Surgery in the Elderly Population
Authors: Goto Kazumi , Kawasaki Yosuke , Hirota Jinso , Yamamoto Naoya , Seichi Atsushi
Published: May 2023

Background:

The number of elderly sports participants is increasing, and the possibility of return to sport (RTS) has become an important part of surgical decision making in this population.

Purpose:

To investigate RTS after elective spinal surgery in elderly patients.

Study Design:

Case series; Level of evidence, 4.

Methods:

We enrolled patients aged ≥65 years with a history of preoperative or preinjury sports participation who underwent elective spinal surgery at a single institution between 2019 and 2021. At minimum 12-month follow-up, a questionnaire was administered to each participant to assess postoperative RTS, timing of return, frequency and type of pre- and postoperative activities, and satisfaction (scored 1-10). Descriptive statistical analyses were performed, and regression models were developed to examine the influence of age and sex, as well as surgical site, on RTS.

Results:

A total of 53 patients (mean ± SD age, 73.8 ± 5.2 years; 24 women) were included, and 23 (43.4%) returned to sports at a median 6 months (interquartile range, IQR, 2-6 months). The RTS rate by surgical site was 17 of 34 (50%) for the lumbar spine and 6 of 17 (35.3%) for the cervical spine. There were no statistically significant differences in RTS rate by surgical site, age, or sex. Overall, 6 of 17 patients returned to golf, 4 of 6 to dance, 2 of 5 to swimming, and 1 of 5 to tennis. Of patients who returned, 34.8% participated in sports 5 times per week and 26.1% participated 3 times per week. The median satisfaction score after RTS was 8 (IQR, 6-9).

Conclusion:

RTS after spinal surgery was achieved in 43% patients at 1-year minimum follow-up, with high satisfaction scores. More than half of the returning patients participated in sports activities ≥3 times per week.
Improving the Prevention, Detection, and Management of Delirium in Adult Inpatients; an Interprofessional Consultative Team Pilot Project
Authors: Monaghan Caitlin , Kerr Jason , Ali Amna , Amer Samia , Ma Julia , Abraham Cynthia , Simpson Karen , Marcucci Michelle , Carter Audrey , Rizvi Zainab , Jones-Lim Lilibeth , Peters Mary Lynn , Versloot Judith
Published: May 2023

Delirium is a common, often preventable fluctuating state of cognition associated with increased morbidity and mortality. This report describes the implementation of an interprofessional consultative Delirium Team formed to improve the prevention, detection, and management of delirium in a community hospital. Team members consulted refered inpatients with delirium to establish a care plan and provide recommendations for pharmacological and non-pharmacological management. The team also offered delirium-related education to unit staff, patients, and caregivers. Consultations were initially completed by the team Nurse Practitioner or Occupational Therapist, and complex patients were discussed with the team Geriatrician and Psychiatrist at rounds to optimize specialist input. Of the 160 patients managed by the team over the 8-month study period, two-thirds of referred patients did not require specialist consultation for their delirium management. Strategies most often recommended by experts for managing delirium were related to medical management, social/cognitive engagement, and functional mobility. Two-thirds of all recommendations made by the team were implemented. Barriers and facilitators to implementation and improving unit staff adherence are further described. The consultative Delirium Team is a promising model that should be further explored for managing an aging population in a capacity-limited medical system.
Nasolabial Flap in Traumatic Nasal Alar Rim Defect
Authors: Rajpoot Ravina , Singh Akhilesh Kumar , Hirani Mehul Shashikant , M Sharanya
Published: May 2023

Reconstruction of post traumatic facial soft tissue defect remains a challenge. The reconstruction of nasal substructures with the locoregional flap is been practiced since the times of Sushruta. But still the quest for ideal reconstructive option is in pipeline. We present a case of posttraumatic nasal alar defect with superiorly based interpolated nasolabial flap. The postoperative outcomes were very encouraging.
Developing a pan-European technical standard for a comprehensive high-quality lung cancer computed tomography screening programme: an ERS technical standard
Authors: Baldwin David R. , O'Dowd Emma L. , Tietzova Ilona , Kerpel-Fronius Anna , Heuvelmans Marjolein A. , Snoeckx Annemiek , Ashraf Haseem , Kauczor Hans-Ulrich , Nagavci Blin , Oudkerk Matthijs , Putora Paul Martin , Ryzman Witold , Veronesi Giulia , Borondy-Kitts Andrea , Rosell Gratacos Antoni , van Meerbeeck Jan , Blum Torsten G.
Published: May 2023

Background

Screening for lung cancer with low radiation dose computed tomography (LDCT) has a strong evidence base. The European Council adopted a recommendation in November 2022 that lung cancer screening (LCS) be implemented using a stepwise approach. The imperative now is to ensure that implementation follows an evidence-based process that delivers clinical and cost-effectiveness. This European Respiratory Society (ERS) Task Force was formed to provide a technical standard for a high-quality LCS programme.

Method

A collaborative group was convened to include members of multiple European societies. Topics were identified during a scoping review and a systematic review of the literature was conducted. Full text was provided to members of the group for each topic. The final document was approved by all members and the ERS Scientific Advisory Committee.

Results

Topics were identified representing key components of a screening programme. The actions on findings from the LDCT were not included as they are addressed by separate international guidelines (nodule management and clinical management of lung cancer) and by a linked ERS Task Force (incidental findings). Other than smoking cessation, other interventions that are not part of the core screening process were not included (e.g.pulmonary function measurement). 56 statements were produced and areas for further research identified.

Conclusions

This European collaborative group has produced a technical standard that is a timely contribution to implementation of LCS. It will serve as a standard that can be used, as recommended by the European Council, to ensure a high-quality and effective programme.
Association between the use of statins and risk of interstitial lung disease/idiopathic pulmonary fibrosis: time-dependent analysis of population-based nationwide data
Authors: Jang Hye Jin , Lee Dong Yoon , Loloci Gjustina , Jeong Jihyeon , Choi Won-Il
Published: May 2023

Background

We aimed to study whether statin use is associated with lowering the development of interstitial lung disease (ILD) and idiopathic pulmonary fibrosis (IPF).

Methods

The study population was the Korean National Health Insurance Service-Health Screening Cohort. ILD and IPF cases were identified using diagnosis codes (J84.1 for ILD and J84.1A as a special code for IPF) based on the International Classification of Diseases, 10th Revision. The study participants were followed up from 1 January 2004 to 31 December 2015. Statin use was defined by the cumulative defined daily dose (cDDD) per 2-year interval and participants were categorised into never-users, <182.5, 182.5–365.0, 365.0–547.5 and ≥547.5 by cDDD. A Cox regression was used to fit models with time-dependent variables of statin use.

Results

Incidence rates for ILD with and without statin use were 20.0 and 44.8 per 100 000 person-years, respectively, and those for IPF were 15.6 and 19.3 per 100 000 person-years, respectively. The use of statins was independently associated with a lower incidence of ILD and IPF in a dose–response manner (p-values for trend <0.001). ILD showed respective adjusted hazard ratios (aHRs) of 1.02 (95% CI 0.87–1.20), 0.60 (95% CI 0.47–0.77), 0.27 (95% CI 0.16–0.45) and 0.24 (95% CI 0.13–0.42) according to the increasing category of statin use compared with never-users. IPF showed respective aHRs of 1.29 (95% CI 1.07–1.57), 0.74 (95% CI 0.57–0.96), 0.40 (95% CI 0.25–0.64) and 0.21 (95% CI 0.11–0.41).

Conclusion

A population-based cohort analysis found that statin use is independently associated with a decreased risk of ILD and IPF in a dose–response manner.
Incidence of interstitial lung abnormalities: the MESA Lung Study
Authors: McGroder Claire F. , Hansen Spencer , Hinckley Stukovsky Karen , Zhang David , Nath P. Hrudaya , Salvatore Mary M. , Sonavane Sushilkumar K. , Terry Nina , Stowell Justin T. , D'Souza Belinda M. , Leb Jay S. , Dumeer Shifali , Aziz Muhammad U. , Batra Kiran , Hoffman Eric A. , Bernstein Elana J. , Kim John S. , Podolanczuk Anna J. , Rotter Jerome I. , Manichaikul Ani W. , Rich Stephen S. , Lederer David J. , Barr R. Graham , McClelland Robyn L. , Garcia Christine Kim
Published: May 2023

Background

The incidence of newly developed interstitial lung abnormalities (ILA) and fibrotic ILA has not been previously reported.

Methods

Trained thoracic radiologists evaluated 13 944 cardiac computed tomography scans for the presence of ILA in 6197 Multi-Ethnic Study of Atherosclerosis (MESA) longitudinal cohort study participants >45 years of age from 2000 to 2012. Five percent of the scans were re-read by the same or a different observer in a blinded fashion. After exclusion of participants with ILA at baseline, incidence rates and incidence rate ratios for ILA and fibrotic ILA were calculated.

Results

The intra-reader agreement of ILA was 92.0% (Gwet's AC1 0.912, intraclass correlation coefficient (ICC) 0.982) and the inter-reader agreement of ILA was 83.5% (Gwet's AC1 0.814, ICC 0.969). Incidence of ILA and fibrotic ILA was estimated to be 13.1 and 3.5 cases per 1000 person-years, respectively. In multivariable analyses, age (hazard ratio (HR) 1.06 (95% CI 1.05–1.08); p<0.001 and HR 1.08 (95% CI 1.06–1.11); p<0.001), high attenuation area at baseline (HR 1.05 (95% CI 1.03–1.07); p<0.001 and HR 1.06 (95% CI 1.02–1.10); p=0.002) and theMUC5Bpromoter single nucleotide polymorphism (HR 1.73 (95% CI 1.17–2.56); p=0.01 and HR 4.96 (95% CI 2.68–9.15); p<0.001) were associated with incident ILA and fibrotic ILA, respectively. Ever-smoking (HR 2.31 (95% CI 1.34–3.96); p=0.002) and an idiopathic pulmonary fibrosis polygenic risk score (HR 2.09 (95% CI 1.61–2.71); p<0.001) were associated only with incident fibrotic ILA.

Conclusions

Incident ILA and fibrotic ILA were estimated by review of cardiac imaging studies. These findings may lead to wider application of a screening tool for atherosclerosis to identify pre-clinical lung disease.
Previous tuberculosis infection associated with increased frequency of asthma and respiratory symptoms in a Nordic–Baltic multicentre population study
Authors: Gyawali Sanjay , López-Cervantes Juan Pablo , Jõgi Nils Oskar , Mustafa Tehmina , Johannessen Ane , Janson Christer , Holm Mathias , Modig Lars , Cramer Christine , Gislason Thorarinn , Svanes Cecilie , Shigdel Rajesh
Published: May 2023

Background

Tuberculosis (TB) infection induces profound local and systemic, immunological and inflammatory changes that could influence the development of other respiratory diseases; however, the association between TB and asthma is only partly understood. Our objective was to study the association of TB with asthma and respiratory symptoms in a Nordic–Baltic population-based study.

Methods

We included data from the Respiratory Health in Northern Europe (RHINE) study, in which information on general characteristics, TB infection, asthma and asthma-like symptoms were collected using standardised postal questionnaires. Asthma was defined based on asthma medication usage and/or asthma attacks 12 months prior to the study, and/or by a report of ≥three out of five respiratory symptoms in the last 12 months. Allergic/nonallergic asthma were defined as asthma with/without nasal allergy. The associations of TB with asthma outcomes were analysed using logistic regressions with adjustments for age, sex, smoking, body mass index and parental education.

Results

We included 8379 study participants aged 50–75 years, 61 of whom reported having had TB. In adjusted analyses, participants with a history of TB had higher odds of asthma (OR 1.99, 95% CI 1.13–3.47). The associations were consistent for nonallergic asthma (OR 2.17, 95% CI 1.16–4.07), but not for allergic asthma (OR 1.20, 95% CI 0.53–2.71).

Conclusion

We found that in a large Northern European population-based cohort, persons with a history of TB infection more frequently had asthma and asthma symptoms. We speculate that this may reflect long-term effects of TB, including direct damage to the airways and lungs, as well as inflammatory responses.
Interleukin-11 disrupts alveolar epithelial progenitor function
Authors: Kortekaas Rosa K. , Geillinger-Kästle Kerstin E. , Borghuis Theo , Belharch Kaoutar , Webster Megan , Timens Wim , Burgess Janette K. , Gosens Reinoud
Published: May 2023

Background

Interleukin-11 (IL-11) is linked to the pathogenesis of idiopathic pulmonary fibrosis (IPF), since IL-11 induces myofibroblast differentiation and stimulates their excessive collagen deposition in the lung. In IPF there is disrupted alveolar structural architecture, yet the effect of IL-11 on the dysregulated alveolar repair remains to be elucidated.

Methods

We hypothesised that epithelial-fibroblast communication associated with lung repair is disrupted by IL-11. Thus, we studied whether IL-11 affects the repair responses of alveolar lung epithelium using mouse lung organoids and precision-cut lung slices (PCLS). Additionally, we assessed the anatomical distribution of IL-11 and IL-11 receptor (IL-11R) in human control and IPF lungs using immunohistochemistry.

Results

IL-11 protein was observed in airway epithelium, macrophages and in IPF lungs, also in areas of alveolar type 2 (AT2) cell hyperplasia. IL-11R staining was predominantly present in smooth muscle and macrophages. In mouse organoid co-cultures of epithelial cells with lung fibroblasts, IL-11 decreased organoid number and reduced the fraction of Prosurfactant Protein C-expressing organoids, indicating dysfunctional regeneration initiated by epithelial progenitors. In mouse PCLS exposed to IL-11, ciliated cell markers were increased. The response of primary human fibroblasts to IL-11 on gene expression level was minimal, though bulk RNA-sequencing revealed IL-11 modulated various processes which are associated with IPF, including unfolded protein response, glycolysis and Notch signalling.

Conclusions

IL-11 disrupts alveolar epithelial regeneration by inhibiting progenitor activation and suppressing the formation of mature alveolar epithelial cells. Evidence for a contribution of dysregulated fibroblast–epithelial communication to this process is limited.
Amplicon-based metagenomic association analysis of gut microbiota in relation to egg-laying period and breeds of hens
Authors: Wang Xiang-Yu , Meng Jin-Xin , Ren Wei-Xin , Ma He , Liu Gang , Liu Rui , Geng Hong-Li , Zhao Quan , Zhang Xiao-Xuan , Ni Hong-Bo
Published: May 2023

Background

The gut microbiota plays an essential role in maintaining gut homeostasis and improving performance, with the composition of microbial communities visibly differing across different laying stages in hens and significantly correlating with egg production. To gain further insights into the association between microbial community characteristics and laying periods in Hy-Line variety brown and Isa brown laying hens, we conducted a 16S rRNA amplicon sequencing survey.

Results

Our result revealed the diversity of bacteria in the early laying period was commonly higher than peak, and in Hy-Line variety brown laying hens were generally higher than Isa brown. Principal coordinate analysis (PCoA) and permutational multivariate analysis of variance (PERMANOVA) revealed that the structure and composition of the gut microbiota of laying hens exhibited significant differences among different groups. Phylum Firmicutes, Bacteroidota, Proteobacteria, and Fusobacteriota were found that dominant in the host’s feces. Therein, the abundance of Fusobacteriota was higher in the peak period than in the early period, while the abundance of Cyanobacteria in the early period was higher in two breeds of hens. Furthermore, random forest based on machine learning showed that there were several distinctly abundant genera, which can be used as potential biomarkers to differentiate the different groups of laying periods and breeds. In addition, the prediction of biological function indicated the existing discrepancy in microbial function among the microbiota of four groups.

Conclusions

Our findings offer new insights into the bacterial diversity and intestinal flora composition of different strains of laying hens during various laying periods, contributing significantly to the improvement of production performance and the prevention of chicken diseases.
Association between short-term systemic use of glucocorticoids and prognosis of cardiogenic shock: a retrospective analysis
Authors: Fan Hua-Ping , Zhou Yan , Zhou Yu , Jin Jun , Hu Tian-Yang
Published: May 2023

Objective

To investigate the prescription rate of short-term systemic use of glucocorticoids during hospitalization in patients with cardiogenic shock (CS), and outcomes related with glucocorticoid use.

Methods

We extracted patients' information from the Medical Information Mart for Intensive Care IV version 2.0 (MIMIC-IV v2.0) database. The primary endpoint was 90-day all-cause mortality. Secondary safety endpoints were infection identified by bacterial culture and at least one episode of hyperglycemia after ICU admission. Propensity score matching (PSM) was used to balance baseline characteristics. The difference in cumulative mortality rate between these treated with and without glucocorticoids was assessed by Kaplan–Meier curve with log-rank test. Independent risk factors for endpoints were identified by Cox or Logistic regression analysis.

Results

A total of 1528 patients were enrolled, and one-sixth of these patients received short-term systemic therapy of glucocorticoids during hospitalization. These conditions, including rapid heart rate, the presence of rheumatic disease, chronic pulmonary disease and septic shock, high lactate level, the requirements of mechanical ventilation and continuous renal replacement therapy, were associated with an increase in glucocorticoid administration (all P ≤ 0.024). During a follow-up of 90 days, the cumulative mortality rate in patients treated with glucocorticoids was significantly higher than that in these untreated with glucocorticoids (log-rank test, P < 0.001). Multivariable Cox regression analysis showed that glucocorticoid use (hazard ratio 1.48, 95% confidence interval [CI] 1.22–1.81; P < 0.001) was independently associated with an increased risk for 90-day all-cause mortality. This result was consistent irrespective of age, gender, the presence of myocardial infarction, acute decompensated heart failure and septic shock, and inotrope therapy, but was more evident in low-risk patients as assessed by ICU scoring systems. Additionally, multivariable Logistic regression analysis showed that glucocorticoid exposure was an independent predictor of hyperglycemia (odds ratio 2.14, 95% CI 1.48–3.10; P < 0.001), but not infection (odds ratio 1.23, 95% CI 0.88–1.73; P = 0.221). After PSM, glucocorticoid therapy was also significantly related with increased risks of 90-day mortality and hyperglycemia.

Conclusions

Real-world data showed that short-term systemic use of glucocorticoids was common in CS patients. Importantly, these prescriptions were associated with increased risks of adverse events.
The contribution of lysophosphatidic acid receptors in the response of human lower esophageal sphincter under the electrical field stimulation
Authors: Feng Yong , Wei Wei , Chen Liang , Liu Jun-Feng
Published: May 2023

Background

This study aims to identify the impact on the reaction while the clasp and sling fibers of the human lower esophageal sphincter are under the electrical field stimulation, by adding lysophosphatidic acid receptor subtypes antagonist.

Methods

Between March 2018 to December 2018, muscle strips were isolated from 28 patients who underwent esophagectomy for mid-third esophageal carcinomas. Muscle tension measurement technique in vitro and electrical field stimulation were used to examine the effects of selective lysophosphatidic acid receptor antagonist on the clasp and sling fibers of human lower esophageal sphincter.

Results

The optimal frequency of frequency-dependent relaxation in clasp fibers and contraction in sling fibers induced by electrical field stimulation is 64 Hz and 128 Hz respectively. The selective lysophosphatidic acid 1 and 3 receptor antagonist produced no significant difference in the frequency-dependent relaxation in clasp fibers and contraction in sling fibers induced by the electrical field stimulation (P > 0.05).

Conclusion

The electrical field stimulation induced a frequency-dependent relaxation in clasp fibers and contraction in sling fibers. The lysophosphatidic acid 1 and 3 receptors are not involved in the response of clasp and sling fibers of the human lower esophageal sphincter induced by the electrical field stimulation.