bluuebunny/crossref_metadata_2025 huggingface dataset:
Variable selection for joint models of multivariate skew-normal longitudinal and survival data
Authors: Tang Jiarui , Tang An-Min , Tang Niansheng
Published: July 2023

Many joint models of multivariate skew-normal longitudinal and survival data have been presented to accommodate for the non-normality of longitudinal outcomes in recent years. But existing work did not consider variable selection. This article investigates simultaneous parameter estimation and variable selection in joint modeling of longitudinal and survival data. The penalized splines technique is used to estimate unknown log baseline hazard function, the rectangle integral method is adopted to approximate conditional survival function. Monte Carlo expectation-maximization algorithm is developed to estimate model parameters. Based on local linear approximations to conditional expectation of likelihood function and penalty function, a one-step sparse estimation procedure is proposed to circumvent the computationally challenge in optimizing the penalized conditional expectation of likelihood function, which is utilized to select significant covariates and trajectory functions, and identify the departure from normality of longitudinal data. The conditional expectation of likelihood function-based Bayesian information criterion is developed to select the optimal tuning parameter. Simulation studies and a real example from the clinical trial are used to illustrate the proposed methodologies.
Pyelonephritic end-stage kidney and ureterocutaneous fistula in a Shetland pony
Authors: Schinköthe Jan , Gerlach Kerstin , Ulrich Reiner G. , Brehm Walter
Published: July 2023

A 12-y-old Shetland Pony was presented with a mucus-secreting fistula in the right paralumbar fossa. Surgery was performed to unravel the origin of the fistula. The horse died under anesthesia and was forwarded to autopsy. The right kidney was markedly atrophic and fibrotic, consistent with unilateral end-stage kidney. The right ureter was markedly thickened, but with luminal continuity leading into the urinary bladder where a partial obstruction caused by nodular para-ureteral fat necrosis was evident. The lumen of the cutaneous fistula was continuous with the right ureter; therefore, we diagnosed the lesion as a ureterocutaneous fistula. Anomalies of the ureter are uncommon, and ureterocutaneous fistula formation in equids has not been reported previously to our knowledge.
Nonlinear free vibrations analysis of truncated conical shells made of bidirectional functionally graded materials
Authors: Shadmani Mahmoud , Afsari Ahmad , Jahedi Reza , Kazemzadeh-Parsi Mohammad J.
Published: July 2023

For the first time, present paper addresses the nonlinear vibrations analysis of a truncated conical shell made of bidirectional functionally graded (BDFG) materials whose mechanical properties varied continuously through the thickness and the length directions of the conical shell based on the power law distribution. Accordingly, the set of nonlinear equation of motions of the conical shell are derived based on first-order shear deformation theory (FSDT) and von Karman strain-displacement relations using Hamilton’s principle. System of partial differential equations of the BDFG conical shell are transformed into time-dependent ordinary differential equations using Galerkin approach. Afterward, the nonlinear equations are analytically solved by means of modified Poincaré–Lindstedt method, and the nonlinear frequency of the BDFG conical shell is obtained. For verification purpose, the present outcomes are compared with those available in previous researches. Eventually, the effect of longitudinal and transverse gradient indexes, vibration amplitude, and geometrical parameters on the nonlinear frequency of the BDFG conical shell is investigated. The present research may give benchmark solutions and some guidelines for designing BDFG truncated conical shells.
The evaluation of the adhesion defects in FRCM reinforcements for masonry constructions by Sideband Peak Count based nonlinear acoustic technique
Authors: Castellano Anna , Fraddosio Aguinaldo , Paparella Francesco , Piccioni Mario Daniele , Kundu Tribikram
Published: July 2023

Fabric-reinforced cementitious matrix (FRCM) composites have emerged as reliable strengthening materials especially for historical masonry constructions. Their strengthening effectiveness strongly depends on the bond at the matrix-fibers interface and at the matrix-substrate interface; thus, the analysis of FRCM bond behavior is of crucial relevance. The strong diffusion of the FRCM composites for the reinforcement of masonry and concrete constructions requires suitable experimental techniques for assessing possible defects in the adhesion between FRCM and masonry, and between FRCM layers. To this aim, in this paper, an innovative nonlinear ultrasonic approach based on the sideband peak count technique is proposed. This approach is discussed and validated through acoustic (sonic and ultrasonic) tests performed on masonry tuff substrates reinforced with FRCM mortars embedding a basalt fibers grid and having known artificial defects at the adhesion between masonry and the reinforcement as well as in the fiber grid.
Red wine processing-derived Brazilian Alicante bouschet grape skin as a promising ingredient for cereal bars production
Authors: Rosa Machado Allien Monique , Galdeano Melicia Cintia , Freitas de Sá Daniela de Grandi Castro , Fraga de Souza Erika , Alcantara Marcela de , Cordeiro de Freitas Sidinea , Tonon Renata Valeriano
Published: July 2023

Grape skin is a wine by-product with a high fiber and phenolic compound content, with potential application as an ingredient in food products. This work aimed to study the hedonic and sensory perception of the consumer using the Check-all-that-apply about cereal bars made with grape skin flour (GSF) obtained from wine residue. Grape skin flour with different granulometric ranges (coarse and fine) was added to the cereal bars in different proportions (10, 15, and 20%) to replace the oat flakes present in the formulation. Sensory acceptance results showed that all bars had good acceptance scores (>6.42) and presented different sensory profiles. The cereal bar containing 15% of coarse GSF had good sensory acceptance with attributes “few dark spots,” “light color,” and “softer,” with desirable sensory characteristics and from the nutritional point of view with high fiber content and bioactive compounds and it was considered the best formulation. Therefore, the incorporation of wine by-products in cereal bars showed excellent acceptability and the possibility of insertion in the market.
Protein Quality, Glycemic and Metabolic Indices and Anthropometric Features Among Overweight and Obese Adults
Authors: Soleimani Ensiye , Abbasalizad Farhangi Mahdieh
Published: July 2023

Background:

Various studies have shown an inverse relationship between the quality of protein intake based on essential amino acids (EAAs) with obesity and its complications. We assumed that increasing EAAs-based protein intake quality improves glycemic and metabolic markers and anthropometric measurements in obese and overweight people.

Methods:

This cross-sectional study included 180 obese and overweight participants aged 18 to 35. Dietary information was obtained using an 80-item food frequency questionnaire. The total intake of EAAs was calculated using the United States department of agriculture (USDA) database. Quality protein was defined as the ratio of EAAs (gr) to total dietary protein (gr). Sociodemographic status, physical activity (PA), and anthropometric characteristics were evaluated using a valid and reliable method. Analysis of covariance (ANCOVA) tests adjusted for sex, PA, age, energy, and body mass index (BMI) were used to measure this association.

Results:

Protein quality intake was highest among the group with the lowest weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and fat mass (FM); and on the other hand, the fat-free mass (FFM) has increased; also Increasing the quality of protein intake improved the lipid profile and some glycemic indices and insulin sensitivity, although this association was not significant.

Conclusions:

Increasing the quality of protein intake significantly improved anthropometric measurements, and also improved some glycemic and metabolic indices although, their relationship was not significant.
Decoding Hypercalcemia and Renal Stones in a Young Adult: Could it be Dent’s Disease?
Authors: Hajji Meriam , Kaaroud Hayet , Ben Hamida Fethi , Abderrahim Ezzeddine
Published: July 2023

Dent’s disease is a rare genetic kidney disorder characterized by proximal tubular dysfunction, nephrocalcinosis, recurrent nephrolithiasis, and chronic kidney disease. Hypercalcemia is a rare finding in this disease. In this report, we present a case of possible Dent’s disease in a young adult male with hypercalcemia and chronic kidney disease. The diagnosis was evoked based on the presence of low-molecular-weight proteinuria, kidney stones, and renal failure. This case underscores the significance of considering Dent’s disease as a potential diagnosis, even in patients with chronic renal disease who exhibit hypercalcemia. It also emphasizes the importance of regular monitoring and management of patients with this condition to prevent further complications.
Dynamic characteristics analysis and the identification signal of the horizontal tail drive shaft system with the ballistic impact damage of a helicopter
Authors: Zhang Chao , Zhu Rupeng , Wang Dan , Cao Peng , Li Jian , Li Jian , Li Peng
Published: July 2023

The ballistic impact damage (BID) will change the dynamic characteristics of the horizontal tail drive shaft system (HTDSS) and will directly affect the flight safety of the helicopter. Aiming at the problem of how the BID affects the dynamic characteristics of the HTDSS and how to identify the BID in time, the dynamic characteristics of the HTDSS with the BID are studied in this paper. The BID is simplified as the ideal geometric damage, and the calculation method of the BID is given. The finite element dynamic equation of the HTDSS with the BID is established, and the effect mechanism of the ballistic impact parameters on the dynamic characteristics is revealed. The result shows: the BID causes the mass loss and the stiffness asymmetric of the ballistic impact position of the TDS; the eccentric excitation introduced by the BID leads to the obvious increase of the system response, and the stiffness asymmetry leads to the super-harmonic resonance of the system. The obvious increase of system response and the appearance of 2Ω frequency component can be used as the identification signal of the BID. Finally, the experiment was carried out, which verified the correctness of the established dynamic model, and explained the reliability of the proposed identification signal of the BID.
Climate Justice Is Environmental Justice: System Change for Promoting Planetary Health and a Just Transition From Extractive to Regenerative Action
Authors: Evans-Agnew Robin A. , Aguilera Juan
Published: July 2023

Our climate emergency is changing health promotion practice, and we need to increase our efforts. In the 20 years since our journal was published, we have witnessed the pressing challenges incurred by human-caused threats to planetary health. These threats are most profound in communities that are already unjustly under threat from structural factors such as poverty, toxic exposures, and inequitable allocation of resources for promoting their health. Those least responsible for contributing to this emergency, including all living environments in harm’s way, will unjustly experience the greatest burdens. This commentary calls for health promotion practice to engage in system change and action in the struggle for climate justice by adopting a planetary health perspective. There must be a just transition from extractive to regenerative economies and actions. We describe our own journey as researchers and health practitioners toward this call for action. We propose a series of system change actions in social, environmental, political, health systems, and health profession education within the scope and responsibility of health promotion practice.
Parallel simulation of high-speed trains controlled by radio block centers using Spark cloud
Authors: Tao Xin , Zhou Yonghua , Mei Yiduo , Fujita Hamido
Published: July 2023

Train movement prediction simulation is an effective method of enhancing operation safety and efficiency of railway transportation. Train movement data generated by the trains running in a railway network are huge, and on the other hand, the data quantity generated from data processing is also explosively increased for the analysis and decision such as conflict recognition and scheduling optimization, which greatly increases the time cost of prediction simulation. This paper attempts to propose a train movement model driven by the movement authorities (MAs) issued from radio block centers (RBCs) and its parallel simulation algorithm realized on Spark cloud. This paper provides a solution of iterative computing of dynamic process simulation based on cloud. Different from the general big data processing of independent datasets, the resilient distributed datasets are expandable along iterative computing processes. The Dataframe of SparkSQL modules on Apache Spark is employed to handle the problems of usage interdependency of datasets. The parallel simulation is realized by Scala language that is used to build the Spark platform. The simulation results on a high-speed railway network demonstrates that the proposed train movement model and parallel algorithm can achieve theoretical rationality and decrease the time cost to satisfy real-time performance.
Stumbling Blocks in the Investigation of the Relationship Between Age-Related Hearing Loss and Cognitive Impairment
Authors: Asakawa Tetsuya , Yang Yunfeng , Xiao Zhenxu , Shi Yirong , Qin Wei , Hong Zhen , Ding Ding
Published: July 2023

The relationship between age-related hearing loss (ARHL) and cognitive impairment (CI) remains intricate. However, there is no robust evidence from experimental or clinical studies to elucidate their relationship. The key unaddressed questions are (a) whether there is a causal effect of ARHL on CI and (b) whether efficacious treatment of ARHL (such as hearing-aid use) ameliorates CI and dementia-related behavioral symptoms. Because of several methodological and systematic flaws/challenges, rigorous verification has not been conducted. Addressing these stumbling blocks is essential to unraveling the relationship between ARHL and CI, which motivated us to undertake this review. Here, we discuss the methodological problems from the perspectives of potential confounding bias, assessments of CI and ARHL, hearing-aid use, functional-imaging studies, and animal models based on the latest information and our experiences. We also identify potential solutions for each problem from the viewpoints of clinical epidemiology. We believe that “objectivity,” specifically the use of more objective behavioral assessments and new computerized technologies, may be the key to improving experimental designs for studying the relationship between ARHL and CI.
Wet bulb globe temperature variability and its implications on heat stress monitoring
Authors: Grundstein Andrew , Cooper Earl , Hosokawa Yuri
Published: July 2023

The wet bulb globe temperature (WBGT) is widely used in athletics for assessing heat stress. Sports governing bodies provide a wide variety of recommendations on how often to take WBGT measurements during activities like practices and competitions. This can leave coaching staff and other sports medicine personnel in a quandary as to what is the “best practice.” Our study is the first to use a large dataset to quantify the variability of WBGT within practice and competition sessions, and to identify the impact of using different measurement rates on the WBGT. The study leverages 6 years of data from thousands of American football practice and competition sessions from across Georgia, USA. We observed that, on average, WBGTs are coolest in the morning (26.67°C) and evening (24.84°C), and hottest in the midday (30.23°C) and afternoon (27.21°C). The variability within sessions tended to be greater for morning, midday, and afternoon than evenings, with session standard deviations of 0.96°C to 1.27°C and ranges of 2.67°C to 3.55°C when controlling for duration. WBGTs also tended to increase over time in morning sessions and decrease over time during afternoon and evening sessions. These changes are clinically important. We found that Georgia High School Association (GHSA) WBGT activity modification categories often changed during sessions, especially in the morning, midday, and afternoon where a change in GHSA category of ≥1 occurred in 57% to 76% of sessions. Considering this variability, our results indicate that more frequent measurements better capture maximum WBGT values over a session and reduce the likelihood of misclassifying activity modification.
Ectopic parathyroid adenoma causing hyperparathyroidism-induced psychosis: A case report
Authors: Corredor-Orlandelli David , Valenzuela-Vallejo Laura , Aguirre-Ruiz Juan Felipe , Valenzuela Rincon Alex
Published: July 2023

Primary hyperparathyroidism is a disease with multisystemic and heterogeneous manifestations, characterized by underlying high parathormone concentrations. Despite neuropsychiatric involvement being one of the manifestations, psychosis is rare. This is the case of a 68-year-old female with a 10-day clinical course of anorexia, mutism, dysphagia, constipation, and weight loss. The patient had disorganized speech associated with paranoid delusions. Prior to this visit, the patient was recently diagnosed with a mixed anxiety-depressive disorder. For this reason, treatment with antidepressants in combination with atypical antipsychotics was administered without a satisfactory response. Neuroimaging, infectious panel, and toxicology screening showed no abnormal findings. Hypercalcemia secondary to a retropharyngeal ectopic parathyroid adenoma was the causative etiology of her primary hyperparathyroidism, and hypercalcemia treatment resolved the psychotic episode. We highlight the importance of recognizing psychosis as a possible initial presentation of hyperparathyroidism and hypercalcemia. Ruling out organic etiologies prior to diagnosing a primary cause of psychosis is crucial, as their treatment can reverse the psychotic symptoms.
Lung cancer presenting with acute myocardial infarction and pulmonary embolism within 1 month
Authors: Jin Jiacheng , Qi Xin , Zhang Hongyu , Li Min , Li Shuangbin , Shen Guangyin
Published: July 2023

Acute myocardial infarction and pulmonary embolism can have life-threatening consequences such as congestive heart and respiratory failure, respectively. Cancer patients are at great risk of both acute myocardial infarction and pulmonary embolism complications because the malignancy sparks the patient’s blood hypercoagulable state. Nevertheless, the literature currently offers only a few reports on acute myocardial infarction associated with pulmonary embolism, and two of them occurred in the same cancer patient. Here, we present a case of a 60-year-old woman who had been diagnosed with lung cancer. She was admitted to the emergency department twice. She was diagnosed with acute myocardial infarction at her first admission, when she experienced sudden-onset chest pain. Electrocardiography showed ST-segment elevation in leads V1–V3 with inverted T wave and pathological Q wave, suggesting an acute myocardial infarction. Coronary angiography revealed a thrombus in the left anterior descending coronary artery, and thrombus aspiration was performed. After 1 month, she had an attack of pulmonary embolism with syncope upon the second admission. A computed tomographic pulmonary angiography showed branches of right and left pulmonary embolism. Anticoagulation and antiplatelet measures were taken. In this article, we discuss the relationship between cancer and thrombosis with a special focus on the conservative management strategy regarding anticoagulant and antiplatelet therapy in our case.
Factors of effectiveness of green nudges for more eco-responsible behaviour – Systematic review and research directions
Authors: Carrel Clement , Gavard-Perret Marie-Laure , Caldara Cindy
Published: July 2023

Considering the rise of green nudges, our objective is to determine the factors of their effectiveness through a systematic review, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method, which analyses 28 articles and 73 pro-environmental nudges. Following a redefinition of the concept and a categorisation based on the construal-level theory of psychological distance (opposing the lever of the ‘how’ to that of the ‘why’ of choice), the effectiveness of green nudges is analysed. A relationship of dependence appears between the (in)effectiveness of nudges and (1) the levers, mechanisms and techniques mobilised; (2) the visibility of the behaviour by others; (3) the field of application; and (4) the geographical area. These analyses and the limitations of the work reviewed provide a basis to propose avenues for research. New theoretical insights and recommendations are provided in favour of more effective nudges for the adoption of ecological and responsible behaviours.
Configuring the Pattern of Sustainable Tourism Development as Affected by the Construction of a High-Speed Railway System
Authors: Li Yanan , Terason Sid
Published: July 2023

This study highlights the role of a high-speed railway system in driving the tourism industry, as the tourism market prepares to achieve sustainable development after the COVID-19 pandemic. Considering the example of southwestern China, this study summarizes the configuration patterns of sustainable tourism development based on the fuzzy-set qualitative comparative analysis method, and subsequently uses the gravity model to express its core factor based on the ArcGIS platform. The study found that the tourism development pattern in this area was not homogenous, but rather a combination of six equivalent patterns (namely configured pattern). Tourism Economic Connection was the core variable to promote tourism development. Therefore, based on the configurational theory, each city should determine its own pattern and accordingly develop strengths as well as complement weaknesses. Furthermore, determined by the complexity theory, cities should capitalize on the strength of the high-speed railway system and learn from the accomplishments realized in other cities.
Workplace Incivility and Its Demographic Characteristics: A Cross-Cultural Comparison Between Chinese and Vietnamese Working Adults
Authors: Hoang Nguyen Tran Quan
Published: July 2023

Workplace incivility (WI) is defined as low-intensity negative behaviors in the workplace. While this topic is common in a Western context, limited research has been conducted in the Asian context, particularly in China and Vietnam. This research aims to investigate a cross-cultural study about WI, to focus on the linkage between demographic variables and WI. The research sample comprised 598 voluntary working adults in China and Vietnam. The data were calculated using descriptive statistics and paired t-tests in SPSS. The result indicated that Chinese and Vietnamese experienced the same incivility behaviors at works. In addition, males experienced more WI than females. This research is a pioneer cross-cultural study about WI in the Asian context, which investigates the influence of demographic variables on WI in Chinese and Vietnamese working adults. Although this study attempts to conduct a cross-cultural study, its limitation is that the sample size is modest and random. This study also expresses some solutions to eliminate incivility behaviors in the workplace.
Exploration of understanding of integrated care from a public health perspective: A scoping review
Authors: Noor Fadumo , Gulis Gabriel , Karlsson Leena Eklund
Published: July 2023

Background:

Many health care systems attempt to develop an integrated care approach that is a whole population health-oriented system. However, knowledge of strategies to support this effort are scarce and fragmented. The aim of the current paper is to investigate existing concepts of integrated care and their elements from a public health perspective and to propose an elaborated approach that could be applied to explore the public health orientation of integrated care.

Design and methods:

We applied a scoping review approach. A literature search was conducted in Embase, Medline, CINAHL, Scopus and Web of Science for the period 2000–2020 yielding 16 studies for inclusion.

Results:

Across the papers, 14 frameworks were identified. Nine of these referred to the Chronic Care Model (CCM). Service delivery, person-centeredness, IT systems design and utilization and decision support were identified as the core elements of most of the included frameworks. The descriptions of these elements were mainly clinical-oriented focusing particularly on clinical care processes and treatment of diseases instead of wider determinants of population health.

Conclusions:

A synthesized model is proposed that emphasizes the importance of mapping the unique needs and characteristics of the population it aims to serve, leans on the social determinants approach with a commitment to individual and community empowerment, health literacy and suggests reorienting services to meet the expressed needs of the population.
Prevalence and Risk Factors of Glenoid Bone Loss in Combined Shoulder Instability in Young, Active-Duty Military Patients
Authors: Green Clare K. , Scanaliato John P. , Turner Robert C. , Sandler Alexis B. , Dunn John C. , Parnes Nata
Published: July 2023

Background:

US military servicemembers experience higher rates of posterior and combined-type instability as compared with their nonmilitary peers.

Purpose:

(1) To determine the prevalence of glenoid bone loss (GBL) in young, active-duty military patients with combined-type shoulder instability who underwent operative shoulder stabilization; (2) to evaluate whether GBL is associated with differences in postoperative outcomes; and (3) to identify factors associated with larger defects.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included active-duty military patients who underwent primary surgical shoulder stabilization for combined anterior and posterior capsulolabral tears between January 2012 and December 2018. Preoperative magnetic resonance arthrograms were used to calculate anterior, posterior, and total GBL using the “perfect circle” technique. We recorded patient characteristics, revisions, complications, return to duty, range of motion, and scores on multiple outcome measures (visual analog scale for pain, Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons, and Rowe). GBL prevalence was compared by time to surgery, glenoid version, history of trauma, and number of anchors used for labral repair. Outcome scores, return to active duty, and revision procedures were compared by degree of anterior or posterior GBL: <13.5% (mild) versus ≥13.5% (subcritical).

Results:

GBL was noted in 28 (77.8%) of the 36 patients. Nineteen (52.8%) patients had anterior GBL, 18 (50.0%) had posterior, and 9 (25.0%) had combined. Four (11.1%) patients had subcritical anterior or posterior GBL. Increased posterior GBL was associated with history of trauma ( P = .041), time to surgery >12 months ( P = .024), and glenoid retroversion ≥9° ( P = .010); increased total GBL was associated with longer time to surgery ( P = .023) and labral repair requiring >4 anchors ( P = .012); and increased anterior GBL was associated with labral repair requiring >4 anchors ( P = .011). There were statistically significant improvements on all outcome measures, with no changes in range of motion postoperatively. No significant difference on any outcome score was observed between patients with mild and subcritical GBL.

Conclusion:

In our analysis, 78% of patients had appreciable GBL, suggesting that GBL is highly prevalent in this patient population. Longer time to surgery, traumatic cause, significant glenoid retroversion, and large labral tears were identified as risk factors for increased GBL.
Preaching to Social Media: Turkey’s Friday Khutbas and Their Effects on Twitter
Authors: Aksoy Ozan
Published: July 2023

The author analyzes through unsupervised machine learning the content of all Friday khutbas (sermons) read to millions of citizens in thousands of mosques in Turkey between 2015 and 2021. The author focuses on six nonreligious and recurrent topics that feature in the sermons, namely, business, family, nationalism, health, trust, and patience. The author demonstrates that the content of the sermons responds strongly to events of national and political importance. The author then links the Friday sermons with about 4.8 million tweets on these topics. The author finds generally strong associations between the topics of the sermons and of the subsequent tweets, controlling for the tweets posted before the sermons. There is also heterogeneity by topic. The link between sermons and tweets is strongest for nationalism, patience, and health and weakest for business. Overall, these results suggest that religious institutions in Turkey are influential in shaping the public’s social media content on salient issues. More generally, these results show that mass offline religious activity can have strong effects on online social media behavior.
Destabilizing the science of soils: Geoscientists as spokespersons for land subsidence in Semarang, Indonesia
Authors: Belland Marie , Kooy Michelle , Zwarteveen Margreet
Published: July 2023

In this article, we explore how land subsidence is scientifically known in the coastal city of Semarang, Indonesia. We do so to ask questions about how the authority of this scientific knowledge is or not effective to help slow down land subsidence? We examine the scientific methods used to measure where, and at what rate, subsidence occurs, and we inventory the theories mobilized to interpret and explain them. Our analysis shows how land subsidence resists being fully or unambiguously known; its science remains somewhat speculative. We explore how, in Semarang, but also more broadly, this makes it difficult for subsidence scientists to act as effective ‘spokespersons’ for subsidence; their predictions lack certainty and confidence. As we follow the subsidence debates in Semarang we document how subsidence scientists need the authority of science to speak convincingly to powerful elite coalitions of government agencies and private companies, who have vested interests in ignoring or denying their role in causing or accelerating subsidence. We identify this as one reason why subsidence scientists deploy great efforts to present themselves, and their science, as separate from politics and society, as detached and therefore objective. Beyond contributing to emergent discussions in science and technology studies about how science shapes underground politics, our analysis opens up and sheds new light on the question of how scientific facts become entangled with politics in societal controversies.
Seismic performance assessment of medical equipment using experimentally validated rolling and toppling nonlinear models
Authors: Guamán-Cabrera Jaime , de la Llera Juan Carlos , Mery Domingo
Published: July 2023

During the last decades, several hospitals stopped service due to severe seismic damage to nonstructural components and medical equipment. This article investigates the dynamic behavior of medical equipment deployed in a full-scale, five-story building with two different support conditions, base isolated (BI) and fixed to the base (FB). Two nonlinear mathematical models, namely, rolling and toppling, are used to simulate the observed experimental responses using recorded data and the camera projection technique (CPT). CPT generated the possibility of measuring equipment horizontal displacements, slips, rotations, rocking, and toppling responses. The Euler–Lagrange formulation, along with the Stribeck friction model, was used to numerically model the rolling and in-plane rotation behavior of a four-wheel mobile cart (4WMC), which is considered to represent the trajectory of equipment supported on caster wheels. Besides, a simple two-dimensional (2D) rigid block model was used to describe the rocking and toppling behavior of locked and free-standing equipment. It was found that the 4WMC model was sensitive to the platform and wheels’ initial orientation angles, as well as the static and kinetic friction coefficients. As it should be, the toppling model was sensitive to the block dimensions and the intensity of the shaking. It was concluded that both numerical models successfully predicted the equipment rolling, in-plane rotation, rocking, and toppling behavior, as long as neither severe lateral impacts nor significant changes in the equipment mass occur during the motion.
European Respiratory Society statement on frailty in adults with chronic lung disease
Authors: Osadnik Christian R. , Brighton Lisa J. , Burtin Chris , Cesari Matteo , Lahousse Lies , Man Will D.C. , Marengoni Alessandra , Sajnic Andreja , Singer Jonathan P. , ter Beek Lies , Tsiligianni Ioanna , Varga Janos T. , Pavanello Stefano , Maddocks Matthew
Published: July 2023

Frailty is a complex, multidimensional syndrome characterised by a loss of physiological reserves that increases a person's susceptibility to adverse health outcomes. Most knowledge regarding frailty originates from geriatric medicine; however, awareness of its importance as a treatable trait for people with chronic respiratory disease (including asthma, COPD and interstitial lung disease) is emerging. A clearer understanding of frailty and its impact in chronic respiratory disease is a prerequisite to optimise clinical management in the future. This unmet need underpins the rationale for undertaking the present work. This European Respiratory Society statement synthesises current evidence and clinical insights from international experts and people affected by chronic respiratory conditions regarding frailty in adults with chronic respiratory disease. The scope includes coverage of frailty within international respiratory guidelines, prevalence and risk factors, review of clinical management options (including comprehensive geriatric care, rehabilitation, nutrition, pharmacological and psychological therapies) and identification of evidence gaps to inform future priority areas of research. Frailty is underrepresented in international respiratory guidelines, despite being common and related to increased hospitalisation and mortality. Validated screening instruments can detect frailty to prompt comprehensive assessment and personalised clinical management. Clinical trials targeting people with chronic respiratory disease and frailty are needed.
Longitudinal effects of elexacaftor/tezacaftor/ivacaftor on sputum viscoelastic properties, airway infection and inflammation in patients with cystic fibrosis
Authors: Schaupp Laura , Addante Annalisa , Völler Mirjam , Fentker Kerstin , Kuppe Aditi , Bardua Markus , Duerr Julia , Piehler Linus , Röhmel Jobst , Thee Stephanie , Kirchner Marieluise , Ziehm Matthias , Lauster Daniel , Haag Rainer , Gradzielski Michael , Stahl Mirjam , Mertins Philipp , Boutin Sébastien , Graeber Simon Y. , Mall Marcus A.
Published: July 2023

Background

Recent studies demonstrated that the triple combination cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy elexacaftor/tezacaftor/ivacaftor (ETI) improves lung function and reduces pulmonary exacerbations in cystic fibrosis (CF) patients with at least oneF508delallele. However, effects of ETI on downstream consequences of CFTR dysfunction,i.e.abnormal viscoelastic properties of airway mucus, chronic airway infection and inflammation have not been studied. The aim of this study was to determine the longitudinal effects of ETI on airway mucus rheology, microbiome and inflammation in CF patients with one or twoF508delalleles aged ≥12 years throughout the first 12 months of therapy.

Methods

In this prospective observational study, we assessed sputum rheology, the microbiome, inflammation markers and proteome before and 1, 3 and 12 months after initiation of ETI.

Results

In total, 79 patients with CF and at least oneF508delallele and 10 healthy controls were enrolled in this study. ETI improved the elastic modulus and viscous modulus of CF sputum at 3 and 12 months after initiation (all p<0.01). Furthermore, ETI decreased the relative abundance ofPseudomonas aeruginosain CF sputum at 3 months and increased the microbiome α-diversity at all time points.In addition, ETI reduced interleukin-8 at 3 months (p<0.05) and free neutrophil elastase activity at all time points (all p<0.001), and shifted the CF sputum proteome towards healthy.

Conclusions

Our data demonstrate that restoration of CFTR function by ETI improves sputum viscoelastic properties, chronic airway infection and inflammation in CF patients with at least oneF508delallele over the first 12 months of therapy; however, levels close to healthy were not reached.
Hyperpolarised xenon-129 diffusion-weighted magnetic resonance imaging for assessing lung microstructure in idiopathic pulmonary fibrosis
Authors: Eaden James A. , Weatherley Nicholas D. , Chan Ho-Fung , Collier Guilhem , Norquay Graham , Swift Andrew J. , Rajaram Smitha , Smith Laurie J. , Bartholmai Brian J. , Bianchi Stephen M. , Wild Jim M.
Published: July 2023

Background

Hyperpolarised 129-xenon (129Xe) magnetic resonance imaging (MRI) shows promise in monitoring the progression of idiopathic pulmonary fibrosis (IPF) due to the lack of ionising radiation and the ability to quantify functional impairment. Diffusion-weighted (DW)-MRI with hyperpolarised gases can provide information about lung microstructure. The aims were to compare129Xe DW-MRI measurements with pulmonary function tests (PFTs), and to assess whether they can detect early signs of disease progression in patients with newly diagnosed IPF.

Methods

This is a prospective, single-centre, observational imaging study of patients presenting with IPF to Northern General Hospital (Sheffield, UK). Hyperpolarised129Xe DW-MRI was performed at 1.5 T on a whole-body General Electric HDx scanner and PFTs were performed on the same day as the MRI scan.

Results

There was an increase in global129Xe apparent diffusion coefficient (ADC) between the baseline and 12-month visits (mean 0.043 cm2·s−1, 95% CI 0.040–0.047 cm2·s−1versusmean 0.045 cm2·s−1, 95% CI 0.040–0.049 cm2·s−1; p=0.044; n=20), with no significant change in PFTs over the same time period. There was also an increase in129Xe ADC in the lower zone (p=0.027), and an increase in129Xe mean acinar dimension in the lower zone (p=0.033) between the baseline and 12-month visits.129Xe DW-MRI measurements correlated strongly with diffusing capacity of the lung for carbon monoxide (% predicted), transfer coefficient of the lung for carbon monoxide (KCO) andKCO(% predicted).

Conclusions

129Xe DW-MRI measurements appear to be sensitive to early changes of microstructural disease that are consistent with progression in IPF at 12 months. As new drug treatments are developed, the ability to quantify subtle changes using129Xe DW-MRI could be particularly valuable.
Antibiotics in pregnancy influence nasal microbiome and respiratory morbidity in infancy
Authors: Rüttimann Céline , Nissen-Kratzert Annika , Mostacci Nadja , Künstle Noëmi , Marten Andrea , Gisler Amanda , Bacher Katharina , Yammine Sophie , Steinberg Ruth , Schulzke Sven , Röösli Martin , Latzin Philipp , Hilty Markus , Frey Urs , Gorlanova Olga
Published: July 2023

Background

The effects of prenatal antibiotic exposure on respiratory morbidity in infancy and the involved mechanisms are still poorly understood. We aimed to examine whether prenatal antibiotic exposure in the third trimester is associated with nasal microbiome and respiratory morbidity in infancy and at school age, and whether this association with respiratory morbidity is mediated by the nasal microbiome.

Methods

We performed 16S ribosomal RNA gene sequencing (regions V3–V4) on nasal swabs obtained from 296 healthy term infants from the prospective Basel–Bern birth cohort (BILD) at age 4–6 weeks. Information about antibiotic exposure was derived from birth records and standardised interviews. Respiratory symptoms were assessed by weekly telephone interviews in the first year of life and a clinical visit at age 6 years. Structural equation modelling was used to test direct and indirect associations accounting for known risk factors.

Results

α-Diversity indices were lower in infants with antibiotic exposure compared to nonexposed infants (e.g.Shannon index p-value 0.006). Prenatal antibiotic exposure was also associated with a higher risk of any, as well as severe, respiratory symptoms in the first year of life (risk ratio 1.38, 95% CI 1.03–1.84; adjusted p-value (padj)=0.032 and risk ratio 1.75, 95% CI 1.02–2.97; padj=0.041, respectively), but not with wheeze or atopy in childhood. However, we found no indirect mediating effect of nasal microbiome explaining these clinical symptoms.

Conclusion

Prenatal antibiotic exposure was associated with lower diversity of nasal microbiome in infancy and, independently of microbiome, with respiratory morbidity in infancy, but not with symptoms later in life.
The impact of emphysema heterogeneity on treatment response after endobronchial valve treatment
Authors: Roodenburg Sharyn A. , Klooster Karin , Slebos Dirk-Jan , Hartman Jorine E.
Published: July 2023

Background

Lung volume reduction with endobronchial valves can significantly improve functional outcomes in patients with advanced emphysema. The extent and spatial distribution pattern of emphysema shows considerable heterogeneity, which might affect response to endobronchial valve treatment. Our aim was to study the effect of emphysema heterogeneity on change in clinical outcomes after endobronchial valve treatment.

Methods

Data were collected from our national registry of patients who received endobronchial valve treatment between 2016 and 2020. We assessed the association between the heterogeneity index, absolute difference in destruction between the target and ipsilateral lobe, and relative change in forced expiratory volume in 1 s (FEV1), residual volume (RV), St George's Respiratory Questionnaire (SGRQ) and 6-min walk distance (6MWD) at 6-week, 6-month and 12-month follow-up.

Results

In total, 236 patients were included. Heterogeneity index was significantly associated with improvements in FEV1, RV and 6MWD at all follow-up visits, and in SGRQ at the 6- and 12-month follow-up visits. The majority of patients, independent of heterogeneity index, showed clinically meaningful improvements based on minimal important difference thresholds.

Conclusions

Heterogeneity index influences the degree of clinical improvement after endobronchial valve treatment where in general a more heterogeneous distribution translates to larger improvements. However, patients with a more homogeneous distribution also showed clinically meaningful improvements. Therefore, we believe emphysema heterogeneity alone should not be used as a decisive patient selection criterion, but should be weighed in the context of all other relevant patient and target lobe characteristics when deciding on a patient's treatment eligibility.
Development of a risk score to increase detection of severe alpha-1 antitrypsin deficiency
Authors: Riley E. Leonard , Brunson J. Cory , Eydgahi Soroush , Brantly Mark L. , Lascano Jorge E.
Published: July 2023

Background

Alpha-1 antitrypsin deficiency (AATD) is an under-recognised genetic cause of chronic obstructive lung disease, and many fewer cases than estimated have been identified. Can a reported respiratory and hepatic disease history from a large AATD testing database be used to stratify a person's risk of severe AATD?

Methods

We analysed data extracted from the AATD National Detection Program. Demographics and medical history were evaluated to predict AATD PI*ZZ genotype. Logistic regression and integer programming models identified predictors and obtained risk scores. These were internally validated on a subset of the data.

Results

Out of 301 343 subjects, 1529 (0.5%) had PI*ZZ genotype. Predictors of severe AATD were asthma, bronchitis, emphysema, allergies, bronchiectasis, family history of AATD, cirrhosis, hepatitis and history of abnormal liver function tests. The derived model establishes a subject's risk of severe AATD, and scores ≥0 had an estimated risk of 0.41%, sensitivity 84.62% and specificity 24.32%. A model simulating guideline recommendations had an estimated risk of 0.51% with a sensitivity of 37.98% and specificity 46.60%. By recommending screening for scores ≥0, we estimate that more subjects would be screened (75.7%versus53.4%) and detected (84.6%versus58.2%) compared to a guideline-simulated model.

Conclusion

This medical history risk model is a useful predictive tool to detect subjects at greater risk of having severe AATD and improves sensitivity of detection. Scores <0 are at lower risk and may need not be screened; testing is recommended for scores ≥0 and consistent with current guidelines.
Roles of protein post-translational modifications in glucose and lipid metabolism: mechanisms and perspectives
Authors: Yang Yu-Hang , Wen Ri , Yang Ni , Zhang Tie-Ning , Liu Chun-Feng
Published: July 2023

The metabolism of glucose and lipids is essential for energy production in the body, and dysregulation of the metabolic pathways of these molecules is implicated in various acute and chronic diseases, such as type 2 diabetes, Alzheimer’s disease, atherosclerosis (AS), obesity, tumor, and sepsis. Post-translational modifications (PTMs) of proteins, which involve the addition or removal of covalent functional groups, play a crucial role in regulating protein structure, localization function, and activity. Common PTMs include phosphorylation, acetylation, ubiquitination, methylation, and glycosylation. Emerging evidence indicates that PTMs are significant in modulating glucose and lipid metabolism by modifying key enzymes or proteins. In this review, we summarize the current understanding of the role and regulatory mechanisms of PTMs in glucose and lipid metabolism, with a focus on their involvement in disease progression associated with aberrant metabolism. Furthermore, we discuss the future prospects of PTMs, highlighting their potential for gaining deeper insights into glucose and lipid metabolism and related diseases.
CKM and TERT dual promoters drive CRISPR–dCas9 to specifically inhibit the malignant behavior of osteosarcoma cells
Authors: Hu Yawei , Zhang Hao , Guo Zengfeng , Zhou Jianhua , Zhang Wang , Gong Ming , Wu Jiawen
Published: July 2023

Improvements in treatment and chemotherapy have increased the survival rate of osteosarcoma, but overall efficacy remains low, highlighting the need for new gene therapy methods. Clustered regularly interspaced short palindromic repeats–deactivated Cas9 (CRISPR–dCas9) technology offers a promising strategy, but targeting osteosarcoma cells precisely is a challenge. We designed a system to achieve specific expression of CRISPR–dCas9–KRAB in osteosarcoma cells by using the creatine kinase muscle (CKM) promoter to drive dCas9–KRAB and the telomerase reverse transcriptase (TERT) promoter to drive single guide (sg)RNA expression. We inhibited the MDM2 proto-oncogene using this system in vitro, which efficiently inhibited the malignant behavior of osteosarcoma cells and induced apoptosis without affecting normal cells. In vivo experiments demonstrated that this system effectively inhibited the growth of subcutaneously transplanted tumors in nude mice. These findings provide a new method for precise identification and intervention of osteosarcoma with significant implications for the development of gene therapy methods for other cancers. Future research should focus on optimizing this system for clinical translation.