bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensitization to rodents (mouse/rat) in urban atopic populations without occupational exposure living in Campania district (Southern Italy): a multicenter study
Authors: Liccardi Gennaro , Baldi Gennaro , Ciccarelli Anna , Cutajar Marina , D’Amato Maria , Gargano Domenico , Giannattasio Domenico , Leone Gennaro , Lo Schiavo Mario , Madonna Francesco , Menna Giovanni , Montera Carmen , Pio Antonio , Russo Maria , Salzillo Antonello , Stanziola Anna , D’Amato Gennaro
Published: January 2020

Background: Up to now very few data on allergic sensitization to rodent allergens in Western Europe and Italy are available, and there are no information at district level. The aim of this report was to investigate clinical significance and characteristics of allergic sensitization to mouse/rat (M/ Rt) allergens in atopic subjects living in Campania district (Southern Italy). Methods: Allergists from the whole Campania district were required to report the results of skin prick tests of at least 100 consecutive subjects. In 1,477 consecutive outpatients, we selected all subjects with an immediate skin reaction to M/Rt dander. Clinical history including a careful evaluation of the modality of exposure and the results of skin-prick tests (SPTs) were recorded. Results: Fifty seven patients were sensitized to M/Rt dander (5.78%). Two patients were mono-sensitized. Fourteen patients reported indoor conditions suggesting presence of rodents allergens at home. All patients exhibited low-moderate degree of SPT positivity to M/Rt. High frequency of concomitant allergic sensitization to dust mites was found. Conclusions: Our results suggest that the role of allergic sensitization to rodents is not negligible in atopic subjects without occupational exposure living in Campania district area; these values are higher in comparison to those previously found in Naples area. Highly atopic individuals should be tested by SPTs/evaluation of serum specific IgE to rodents in the case they should begin an occupational exposure to M/Rt or keep these animals as pets.
Intensive care and non-invasive mechanical ventilation in kyphoscoliosis: are new perspectives still needed?
Authors: Esquinas Antonio M. , Matsuoka Yoshinori , Adıgüzel Nalan , Karakurt Zuhal
Published: January 2020

Non-invasive ventilation (NIV) assists breathing and thus improves oxygenation in patients with Kyphoscoliosis. The benefits of short- and long-term intermittent nocturnal in such patients have been reported previously (improvement of vital capacity, total lung capacity, muscle strength, daytime oxygenation, exercise capacity, and pulmonary hypertension). We review this important study reporting patients with kyphoscoliosis and acute respiratory failure along with their long-term outcomes. We believe that this letter may provide important information regarding the prognosis and efficacy of NIV.
Role of interleukin 4 and its receptor in clinical presentation of chronic extrinsic allergic alveolitis: a pilot study
Authors: Sterclova Martina , Matej Radoslav , Mandakova Petra , Skibova Jelena , Vasakova Martina
Published: January 2020

Background: Th-2 cytokine milieu including interleukin 4 (IL-4) was detected in fibrotic lung diseases. Chronic extrinsic allergic alveolitis (EAA) may be also accompanied by marked fibrogenesis. The aim of this study was to determine if IL-4 and its receptor (IL-4R-alpha) play any role in the clinical presentation and pathogenesis of chronic EAA. Methods: Twenty patients originally investigated for interstitial lung disease and finally diagnosed affected with chronic EAA and sarcoidosis were prospectively enrolled into the study. Concentrations of IL-4, IL-4R-aplha and total protein were assessed in the bronchoalveolar lavage fluid (BALF) of all enrolled subjects as well as high resolution computed tomography (HRCT) scores and pulmonary function tests. Results: BALF IL-4R-alpha and total protein concentrations were significantly higher in chronic EAA patients (p < 0.05). Concentrations of BALF IL-4R-alpha were significantly higher in men than in women (p < 0.05) in EAA group. Total protein BALF levels were significantly elevated in ex-smokers with EAA compared to nonsmokers (p < 0.05). A positive correlation (p < 0.01) between IL-4R-alpha BALF concentrations and HRCT interstitial scores were observed in chronic EAA group; the IL-4R-alpha/total protein ratio showed the same significant positive correlation. A negative correlation between lung function results and IL-4R-alpha, and IL-4R-alpha/total protein as well, was also found (p < 0.05). Conclusions: We suggest a clinical relevance for the IL-4/IL-4R axis in the etiopathogenesis of chronic EAA. IL-4R-alpha could serve as a potential biomarker of lung fibrogenesis.
Does drug compliance change in asthmatic patients during pregnancy?
Authors: Yilmaz Insu , Oner Erkekol Ferda , Celen Sevki , Zayifoglu Karaca Mujdegul , Aydin Omur , Celik Gulfem , Misirligil Zeynep , Mungan Dilsad
Published: January 2020

Background: Pregnant women with asthma are recommended to maintain optimal therapeutic management during pregnancy. Uncontrolled, symptomatic asthma may increase the risk of adverse peri-natal outcomes; thus adequate regular anti-asthmatic treatment must be given to provide optimal asthma control during pregnancy. However, doubts about the safety of asthmatic drugs can affect pregnant asthmatic patients’ drug compliance. The aim of this study was to assess behavioral differences in drug compliance among pregnant asthmatic patients. Methods: Thirty two asthmatic and 121 healthy pregnant women were enrolled in the study. Structured face-to-face interviews were conducted after delivery. The interviews included disease characteristics, drug compliance and patients’ own perspective for asthma status prior to and during pregnancy. In addition, medical and pregnancy history, pregnancy complications and outcomes, and newborn characteristics were recorded. Results: In our study group the rates of hospitalization, emergency room visits and systemic steroid use in the year before pregnancy were 13%, 46.9% and 18.8%, respectively. The rate of regular asthma medication use was only 32% at that period and increased to 44% during pregnancy. However, hospitalization, emergency room visits, systemic steroid usage rates remained unchanged and according to patients’ own evaluations, 44% of asthmatics pointed out that their asthma had worsened during pregnancy. No statistically significant difference was detected in terms of pregnancy/labour complication between asthmatic and non-asthmatics. Conclusions: Contrary to some previous studies, in our study regular use of asthma drugs increased during pregnancy. The uncontrolled condition of their asthma before and during pregnancy and the idea that their asthma worsened during pregnancy might force the patients to use medication more regularly.
Can we use influencing factors to predict aspiration pneumonia in the United Kingdom?
Authors: Hibberd Judi , Fraser Jenni , Chapman Claire , McQueen Hannah , Wilson Adrian
Published: January 2020

Background: The current study builds upon the work of others in looking at influencing factors of aspiration pneumonia in people with a swallowing problem. This study differs from previous researches on this topic, focusing on the United Kingdom (UK) population and involving more recently defined influencing factors of aspiration pneumonia. The study aims to explore the multifactorial nature of aspiration pneumonia in a UKdysphagic client group, as well as different disease specific variables. Methods: Speech and Language Therapists collected data on 33 influencing factors over a period of 6 months during routine bedside swallowing assessment of 687 patients. All subjects were adults referred with suspected dysphagia and included acute inpatients, head and neck cancer patients and adults with learning disabilities. The study population included 400 males and 287 females and ages ranged from 17 to 102 giving a mean age of 72.9 years. The influence of the different variables included in the study was evaluated using multivariate logistic regression analysis. Results: The results show that 13 statistically significant influencing factors were implicated in the development of aspiration pneumonia for this group. Out of these, nine correlate with the previous work undertaken in the United States. These were poor mobility, nil by mouth status, age, dependency for feeding, number of medications, Chronic Obstructive Pulmonary Disease (COPD), number of medical conditions, stroke and alcohol abuse. Four further influencing factors were shown to be significant in the UK population, these were dysphagia, only oral intake, bedfast, and male gender. Conclusions: This study confirms that in the UK there are influencing factors in the development of an aspiration pneumonia. It would be prudent to remember that a direct link is yet to be established when applying this knowledge to inform clinical management.
Clinical significance in COPD patients followed in a real practice
Authors: Mendes de Oliveira Júlio César , De Carvalho Aguiar Isabella , Negrinho de Oliveira Beloto Ana Carolina , Reis Santos Israel , Studart Leitão Filho Fernando Sergio , Malosa Sampaio Luciana M. , Donner Claudio F. , De Oliveira Luís Vicente Franco
Published: January 2020

Background: Chronic obstructive pulmonary disease (COPD) is an important public health issue in many countries which is estimated to become the fifth cause of disability and the third cause of mortality in the world within 2020. The objective of this study was to identify the clinical characteristics in the real clinical practice of a sample of patients with COPD followed in a pulmonology clinic. Methods: The initial sample contained 207 subjects with respiratory claims that searched for specialized treatment and initiated regular monitoring between 2004 and 2009 in a private clinic localized in Cascavel, in the state of Parana, Brazil. Demographic data (weight, height, body mass index - BMI), history of comorbidities, use of respiratory and non respiratory drugs were also registered. Results: The main cause related to the development of COPD was current or prior smoking (92.0%); the most frequently reported symptom was dyspnea (95.0%), followed by cough (86.1%), wheezing (69.4%) and sputum production (40.0%). During the follow up, 51 patients developed the need for oxygen therapy (28.3%). In 96 patients, there were periods of acute exacerbation, resulting in 37 hospitalizations. In addition to COPD, a significant number of comorbidities were identified, being cardiovascular disease and neurological disorders the most prevalent ones. Conclusions: Based on the data collected, we could outline the profile of patients with COPD, showing characteristics of an elderly population, with multiple comorbidities, suggesting a health related quality of life lower than expected.
Expiratory CT scan in patients with normal inspiratory CT scan: a finding of obliterative bronchiolitis and other causes of bronchiolar obstruction
Authors: Gaeta Michele , Minutoli Fabio , Girbino Giuseppe , Murabito Alessandra , Benedetto Caterina , Contiguglia Rosario , Ruggeri Paolo , Privitera Salvatore
Published: January 2020

Expiratory CT scan is usually obtained as supplement to normal inspiratory CT scan to recognize air-trapping, which is expression of small airways obstruction. In some patients the air-trapping may be the only sign of an early-stage small airways disease in an otherwise normal lung. The purpose of this article is to illustrate pathologic conditions, namely obliterative bronchiolitis, in which expiratory CT scan can be abnormal despite normal inspiratory CT examination, and to highlight indications for this technique in patients with clinical and functional suspect of bronchiolar obstruction.
Functional maturation of nasal mucosa: role of secretory immunoglobulin A (SIgA)
Authors: Bellussi Luisa , Cambi Jacopo , Passali Desiderio
Published: January 2020

Secretory IgA (SIgA) plays an important role in defending the mucous membranes of the upper respiratory airways from common infection. Studying and comparing the values and the daily variation of SIgA in nasal secretion could explain the largest number of upper respiratory infection, especially in children. Moreover, the ELISA dosage of SIgA in nasal secretion, sampled by cotton swabs positioned between septum and middle turbinate for 20 minutes every 4 hours 5 times in a day, can be easily performed and shows significant differences between the healthy child and the healthy adult. Nasal secretion SIgA mean value is lower in the healthy child than in the healthy adult. Circadian variation for healthy child showed the highest value at 7.00 a.m., while in adult the highest value was at 4.00 a.m. These knowledge on SIgA may help to explain the highest number of upper airway infection during childhood and clarify the physiological cycle of production. Thus, in performing a SIgA dosage the time of sample must be considered and preferably it should be made at a standardized time of the day.
Diagnostic usefulness of pregnancy-associated plasma protein-A in suspected pulmonary embolism
Authors: Berk Serdar , Tamer Dogan Omer , Itir Aydemir Eylem , Bingol Asli , Levent Ozsahin Sefa , Akkurt Ibrahim
Published: January 2020

Background: The role of biomarkers for prognostication and diagnosis of pulmonary embolism (PE) is increasing. It has been reported that pregnancy-associated plasma protein-A (PAPP-A) can be used as a proatherosclerotic marker. The present study was aimed to evaluate whether PAPP-A levels are helpful in the differential diagnosis of patients presenting with suspected PE. Methods: 53 consecutive patients evaluated for suspected PE were prospectively enrolled in the study. Serum PAPP-A levels were measured in the blood samples which were taken at admission. Multi-slice computed tomographic angiography was used to verify the diagnosis of PE. Results: PE was detected in 24 out of the 53 patients, while it was excluded in 29 patients by thorax multi-detector computerized tomography scan. No significant difference was detected in mean serum PAPP-A level between groups (5.72 ± 0.31 mg/L vs. 5.67 ± 0.06 mg/L, respectively). Conclusions: Serum PAPP-A level has no role in the evaluation for PE.
The value of FeNO measurement in childhood asthma: uncertainties and perspectives
Authors: Ferrante Giuliana , Malizia Velia , Antona Roberta , Corsello Giovanni , La Grutta Stefania
Published: January 2020

Asthma is considered an heterogeneous disease, requiring multiple biomarkers for diagnosis and management. Fractional exhaled nitric oxide in exhaled breath (FeNO) was the first useful non-invasive marker of airway inflammation in asthma and still is the most widely used. The non-invasive nature and the relatively easy use of FeNO technique make it an interesting tool to monitor airway inflammation and rationalize corticosteroid therapy in asthmatic patients, together with the traditional clinical tools (history, physical examination and lung function tests), even if some controversies have been published regarding the use of FeNO to support the management of asthma in children. The problem of multiple confounding factors and overlap between healthy and asthmatic populations preclude the routine application of FeNO reference values in clinical practice and suggest that it would be better to consider an individual “best”, taking into account the context in which the measurement is obtained and the clinical history of the patient. Besides, there is still disagreement about the role of FeNO as a marker of asthma control, due to the complexity of balance among the different items involved in its determination and the lack of homogeneity in the population groups studied in the few studies conducted so far. Heterogeneity of problematic severe asthma greatly limits utility of FeNO alone as a biomarker of inflammation to optimize the disease management on an individual basis. None of the studies conducted so far demonstrated that the use of FeNO was better than current asthma guidelines in controlling asthma exacerbations. In summary, there is a large variation in FeNO levels between individuals, which may reflect the natural heterogeneity in baseline epithelial nitric oxide synthase activity and/or the contribution of other noneosinophilic factors to epithelial nitric oxide synthase activity. FeNO is a promising biomarker, but at present some limits are highlighted. We would recommend that further research can be carried out by organizing studies aimed to obtain reliable reference values of FeNO and in order to better interpret FeNO measurements in clinical settings, taking also into account the influence of genetic and environmental factors.
A retrospective study on acute health effects due to volcanic ash exposure during the eruption of Mount Etna (Sicily) in 2002
Authors: Lombardo Daniele , Ciancio Nicola , Campisi Raffaele , Di Maria Annalisa , Bivona Laura , Poletti Venerino , Mistretta Antonio , Biggeri Annibale , Di Maria Giuseppe
Published: January 2020

Background: Mount Etna, located in the eastern part of Sicily (Italy), is the highest and most active volcano in Europe. During the sustained eruption that occurred in October-November 2002 huge amounts of volcanic ash fell on a densely populated area south-east of Mount Etna in Catania province. The volcanic ash fall caused extensive damage to infrastructure utilities and distress in the exposed population. This retrospective study evaluates whether or not there was an association between ash fall and acute health effects in exposed local communities. Methods: We collected the number and type of visits to the emergency department (ED) for diseases that could be related to volcanic ash exposure in public hospitals of the Province of Catania between October 20 and November 7, 2002. We compared the magnitude of differences in ED visits between the ash exposure period in 2002 and the same period of the previous year 2001. Results: We observed a significant increase of ED visits for acute respiratory and cardiovascular diseases, and ocular disturbances during the ash exposure time period. Conclusions: There was a positive association between exposure to volcanic ash from the 2002 eruption of Mount Etna and acute health effects in the Catania residents. This study documents the need for public health preparedness and response initiatives to protect nearby populations from exposure to ash fall from future eruptions of Mount Etna.
The role of chest ultrasonography in the management of respiratory diseases: document I
Authors: Zanforlin Alessandro , Giannuzzi Rosangela , Nardini Stefano , Testa Americo , Soldati Gino , Copetti Roberto , Marchetti Giampietro , Valente Salvatore , Inchingolo Riccardo , Smargiassi Andrea
Published: January 2020

Chest ultrasonography can be a useful diagnostic tool for respiratory physicians. It can be used to complete and widen the general objective examination also in emergency situations, at the patient’s bedside. The aim of this document is to promote better knowledge and more widespread use of thoracic ultrasound among respiratory physicians in Italy. This document I is focused on basic knowledge of chest ultrasonography technique, physical basis, aims and characteristics, fields of application. Document I shows how chest ultrasonography can be useful to detect and monitor pleural diseases, pleural effusions and pneumothorax and how it can assess diaphragmatic kinetics and pathologies.
The role of chest ultrasonography in the management of respiratory diseases: document II
Authors: Smargiassi Andrea , Inchingolo Riccardo , Soldati Gino , Copetti Roberto , Marchetti Giampietro , Zanforlin Alessandro , Giannuzzi Rosangela , Testa Americo , Nardini Stefano , Valente Salvatore
Published: January 2020

Chest ultrasonography can be a useful diagnostic tool for respiratory physicians. It can be used to complete and widen the general objective examination also in emergency situations, at the patient’s bedside. The aim of this document is to promote better knowledge and more widespread use of thoracic ultrasound among respiratory physicians in Italy. This document II is focused on advanced approaches to chest ultrasonography especially in diagnosing sonographic interstitial syndrome with physical hypotheses about the genesis of vertical artifacts, differential diagnosis of cardiogenic pulmonary edema and non-cardiogenic pulmonary edema, raising diagnostic suspicion of pulmonary embolism, ultrasound characterization of lung consolidations and the use of ultrasonography to guide procedural interventions in pulmonology. Finally, document II focuses on chest ultrasonography as useful diagnostic tool in neonatal and pediatric care.
Clinical significance of incidental thyroid nodules identified on low-dose CT for lung cancer screening
Authors: Hoo Lee Jong , Jeong Sun Young , Kim Yee Hyung
Published: January 2020

Background: Incidental thyroid nodules (ITNs) are defined as newly encountered nodules identified on imaging performed for an unrelated purpose. In practice, ITNs are often detected on chest computed tomography (CT). We investigated the prevalence and clinical significance of ITNs detected on low-dose chest CT (LDCT) for lung cancer screening. Methods: We retrospectively reviewed the electronic medical records of patients with no history of thyroid disease who underwent LDCT for lung cancer screening between March 2009 and February 2012 at Jeju National University Hospital (Korea). Results: Among 1,941 patients that underwent LDCT, 55(2.8%) were found to have ITNs. Seven (12.7%) of those cases were malignant. The positive and negative predictive values of chest LDCT for the detection of incidental malignant thyroid nodules were 26.9% and 73.4%, respectively. Factors considered to be predictive of malignancy on LDCT were a mean attenuation value of 55 HU or more (p = 0.036) and the presence of dense calcifications (p = 0.048). Sex, age, location of the nodule, longest diameter of the lesion, AP/T (anteroposterior/transverse dimension) ratio, margins, density, presence of punctate calcifications, and thyroid enlargement had no significant predictive value in discriminating benign and malignant nodules. On multivariate analyses, a mean attenuation value above 55 was the only statistically significant feature (p = 0.048). Conclusions: A mean attenuation value greater than 55 HU on LDCT may be a useful predictive factor for differentiating malignant from benign lesions. Therefore, a careful assessment of the thyroid gland is necessary for patients undergoing LDCT for lung cancer screening.
Predictors of cardiovascular disease in asthma and chronic obstructive pulmonary disease
Authors: Bellocchia Michela , Masoero Monica , Ciuffreda Antonio , Croce Silvia , Vaudano Arianna , Torchio Roberto , Boita Monica , Bucca Caterina
Published: January 2020

Background: Cardiovascular disease (CVD) is a common comorbidity in patients with chronic airway obstruction, and is associated with systemic inflammation and airway obstruction. The aim of this study was to evaluate the predictors of CVD in two different conditions causing chronic airway obstruction, asthma and COPD. Methods: Lung function tests, clinical and echocardiographic data were assessed in 229 consecutive patients, 100 with asthma and 129 with COPD. CVD was classified into: pressure overload (PO) and volume overload (VO). Sub-analysis of patients with ischemic heart disease (IHD) and pulmonary hypertension (PH) was also performed. Results: CVD was found in 185 patients (81%: 51% COPD and 30% asthmatics) and consisted of PO in 42% and of VO in 38% patients. COPD patients, as compared to asthmatics, had older age, more severe airway obstruction, higher prevalence of males, of smokers, and of CVD (91% vs 68%), either PO (46% vs 38%) or VO (45% vs 30%). CVD was associated with older age and more severe airway obstruction both in asthma and COPD. In the overall patients the predictive factors of CVD were age, COPD, and male sex; those of PO were COPD, BMI, VC, FEV1 and MEF50 and those of VO were age, VC and MEF50. In asthma, the predictors of CVD were VC, FEV1, FEV1 /VC%, and PaO2, those of PO were VC, FEV1 and FEV1 /VC%, while for VO there was no predictor. In COPD the predictors of CVD were age, GOLD class and sex, those of VO age, VC and MEF50, and that of PO was BMI. Sub-analysis showed that IHD was predicted by COPD, age, BMI and FEV1, while PH (found only in 25 COPD patients), was predicted by VO (present in 80% of the patients) and FEV1. In subjects aged 65 years or more the prevalence of CVD, PO and VO was similar in asthmatic and COPD patients, but COPD patients had higher prevalence of males, smokers, IHD, PH, lower FEV1 and higher CRP. Conclusions: The results of this study indicate that cardiovascular diseases are frequent in patients with chronic obstructive disorders, particularly in COPD patients. The strongest predictors of CVD are age and airway obstruction. COPD patients have higher prevalence of ischemic heart disease and pulmonary hypertension. In the elderly the prevalence of PO and VO in asthma and COPD patients is similar.
Obesity can influence children’s and adolescents’ airway hyperresponsiveness differently
Authors: Sposato Bruno , Scalese Marco , Migliorini Maria Giovanna , Riccardi Maria Piera , Tosti Balducci Massimo , Petruzzelli Luigi , Scala Raffaele
Published: January 2020

Background: Literature is still arguing about a possible relationship between airway hyperresponsiveness (AHR) and body mass index (BMI). This study aimed at evaluating the influence of BMI on AHR and pulmonary function in children and adolescents that performed a methacholine test for suggestive asthma symptoms. Methods: 799 consecutive children/adolescents (535 M; mean age: 15 ± 3 yrs; median FEV1% predicted: 101.94% [93.46-111.95] and FEV1/FVC predicted: 91.07 [86.17-95.38]), were considered and divided into underweight, normal, overweight and obese. Different AHR levels were considered as moderate/severe (PD20 ≤ 400 μg) and borderline (PD20 > 400 μg). Results: 536 children/adolescents resulted hyperreactive with a median PD20 of 366 μg [IQR:168–1010.5]; 317 patients were affected by moderate/severe AHR, whereas 219 showed borderline hyperresponsiveness. Obese subjects aged > 13 years showed a lower (p = 0.026) median PD20 (187μg [IQR:110–519]) compared to overweight (377 μg [IQR:204–774]) and normal-weight individuals’ values (370.5 μg [IQR:189–877]). On the contrary, median PD20 observed in obese children aged ≤ 13 years (761 μg [IQR:731–1212]) was higher (p = 0.052) compared to normal-weight children’s PD20 (193 μg [IQR:81–542]) and to obese adolescents’ values (aged > 13 years) (p = 0.019). Obesity was a significant AHR risk factor (OR:2.853[1.037-7.855]; p = 0.042) in moderate/severe AHR adolescents. Females showed a higher AHR risk (OR:1.696[1.046-2.751] p = 0.032) compared to males. A significant relationship was found between BMI and functional parameters (FEV1, FVC, FEV1/FVC) only in hyperreactive females. Conclusions: Obesity seems to influence AHR negatively in female but not in male adolescents and children. In fact, AHR is higher in obese teenagers, in particular in those with moderate/severe hyperresponsiveness, and may be mediated by obesity-associated changes in baseline lung function.
Metabolic syndrome and carotid intima-media thickness in chronic obstructive pulmonary disease
Authors: Alpaydin Aylin Ozgen , Arslan Isin Konyar , Serter Selim , Coskun Aysin Sakar , Celik Pinar , Taneli Fatma , Yorgancioglu Arzu
Published: January 2020

Background: The aim of this study is to investigate the prevalence of metabolic syndrome (MetS), carotid intima media thickness (IMT), and serum C-reactive protein (CRP) levels in patients with chronic obstructive pulmonary disease (COPD), and the possible relationships among them. Methods: Fifty stable COPD patients and 40 healthy controls were included in the study. The participants were further divided into four groups according to their smoking status. Pulmonary function tests were performed in COPD patients. Anthropometric measurements and blood chemistry analysis, serum CRP levels and carotid intimamedia thickness (IMT) measurements were performed in all the study population. Results: Prevalence of metabolic syndrome was 43% in COPD patients and 30% in the control group (p = 0.173). FEV1% and FEV1/FVC were higher in COPD patients with MetS (p = 0.001 and p = 0.014, respectively) compared to those without MetS. Prevalence of MetS was significantly different among the COPD patients with different stages (p = 0.017) with the highest value in stage 2 (59%). Carotid IMT was significantly higher in COPD patients than in control group (1.07 ± 0.25 mm and 0.86 ± 0.18 mm, respectively; p < 0.001). Serum CRP levels were not different in COPD patients and controls, however they were higher in individuals with MetS compared to those without MetS regardless of COPD presence (p = 0.02). Conclusions: Early markers of atherogenesis, in terms of carotid IMT, were found to be higher in COPD patients than in healthy controls. MetS prevalence was observed to decrease as the severity of airflow obstruction increased. Therefore, screening COPD patients for these cardiovascular risk factors would be a novel approach even in absence of symptoms.
Effect of thyroid function on COPD exacerbation frequency: a preliminary study
Authors: Ulasli Sevinc Sarinc , Bozbas Serife Savas , Ozen Zeynep Erayman , Ozyurek Berna Akinci , Ulubay Gaye
Published: January 2020

Background: Frequent exacerbations of chronic obstructive pulmonary disease (COPD) have negative effects on quality of life and survival. Thus, factors related to exacerbations should be determined. We aimed to evaluate the effects of thyroid function on quality of life and exacerbation frequency in COPD patients. Methods: The study population (n = 128) was divided into 3 groups (Group 1: COPD patients with hypothyroidism (n = 44); Group 2: COPD patients with normal thyroid function tests (n = 44); Group 3: Healthy subjects (n = 40)). Pulmonary function tests, maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) measurements were performed. Quality of life questionnaire (Short Form 36, SF-36) was carried out. Patients were followed up for one year and number of exacerbations was recorded. Results: FVC, FEV1/FVC, and FEF 25–75% measurements were statistically different between group 1 and 2 (p = 0.041, p = 0.001, p = 0.009 respectively). Although MEP values were significantly different between group 1 and 2 (p = 0.006), there was no significant difference in MIP values between groups (p = 0.77). Quality of life scores in group 1 and 2 were significantly lower than control group. Exacerbation frequency was significantly higher in group 1 than in group 2 (p = 0.017). TSH values and exacerbation frequency had positive correlation (p < 0.0001; r = 0.82). Conclusions: The results of the present study suggest that thyroid function has an effect in exacerbation frequency of COPD. Decrease in exacerbation numbers with early detection of impairment in thyroid function will have positive contribution on quality of life in COPD patients.
Predictors of seasonal influenza vaccination in chronic asthma
Authors: Asciak Rachelle , Balzan Martin , Buttigieg Jesmar
Published: January 2020

Background: Guidelines advise annual influenza vaccination in chronic asthma. The aim of this study was to determine uptake of the influenza vaccine in a group of patients (n = 146) with moderate to severe chronic asthma and establish the main predictors of vaccination. Method: Patients attending a hospital asthma clinic were asked to complete a questionnaire in February 2012 (n = 146). These same patients were contacted a year later via telephone (n = 109 responded), and they were asked to complete the same questionnaire. Results: Vaccination rate was 50.3% in winter 2011/12, and 57.8% in 2012/13. Using binary logistic regression, the predictors for vaccination in 2012 were patient advice (Odds ratio [OR] 15.37 p = 0.001), female gender (OR 2.75, p = 0.028), past side effects (OR 0.21, p = 0.001) and comorbidity (OR 0.39, p = 0.013). Stepwise regression resulted in age as predictor (T value = 3.99, p = 0.001). On analyzing the responses from the second questionnaire at one year after attendance to asthma clinic, predictors changed to compliance to medication (OR 9.52, p= 0.001) and previous exacerbations (OR 4.19, p = 0.026). Out of the 56 patients vaccinated in 2011/12, 33 reported asthma exacerbations before 2012, and 29 reported asthma exacerbations after receiving the influenza vaccine. Out of the 46 unvaccinated patients in 2012, 27 had asthma exacerbations before 2012 and 19 patients had exacerbations in 2013. Patients vaccinated in 2011/12 needed 0.59 courses of steroid/patient/year, and 1.23 visits for nebulizer/ patient/year while non-vaccinated patients needed 0.18 courses of steroids/patient/year (p = 0.048), and 0.65 visits for nebulized/patient/year (p = 0.012). Patients’ subjective statements broadly confirmed the predictors. 16/69 (23.1%) received the vaccine in winter 2012/13 despite reporting previous side effects. Conclusions: Advice to patient, female gender and patients’ age predicted vaccination, while past side effects to the influenza vaccine, and presence of comorbidities predicted non vaccination. Symptomatic asthma patients are more likely to be vaccinated. One year after the first contact, treatment compliance and previous asthma exacerbations gained statistical significance as predictors of vaccination.
Clinical variability of respiratory pulmonary hypertension: implications for diagnosis and management
Authors: Casali Lucio , Carratù Pierluigi , Sofia Matteo
Published: January 2020

Pulmonary Hypertension (PH) associated to chronic respiratory diseases is currently classified in the 3rd group, as a mild to moderate form of pre-capillary PH that progressively complicates the prognosis of associated pulmonary disease. In clinical practice, however, some unresolved issues in the respiratory PH should be considered: 1) the PH heterogeneity in some respiratory diseases, such as Chronic Obstructive Pulmonary Disease (COPD), where the prevalence of unrecognized left heart disease, or chronic pulmonary thromboembolism may change the clinical classification; 2) the combining form of severe PH which often is not correlated to chronic ventilator impairment, while outcome is strictly related to pulmonary haemodynamics. The recognition of out of proportion respiratory PH in several chronic respiratory diseases which include COPD, Idiopathic Pulmonary Fibrosis (IPF), Combined Pulmonary Fibrosis and Emphysema, Obstructive Sleep Apnea (OSA), Obesity Hypoventilation Syndrome (OHS) may be important for a comprehensive clinical classification of severe respiratory PH, as well as, for the inclusion of these patients in randomized clinical trials on PH targeted therapy.
Comparison of reducing effect on lung injury of dexamethasone and bosentan in acute lung injury: an experimental study
Authors: Araz Omer , Demirci Elif , Yilmazel Ucar Elif , Calik Muhammet , Pulur Didem , Karaman Adem , Yayla Muhammed , Altun Eren , Halici Zekai , Akgun Metin
Published: January 2020

Background: Different medical therapies are employed in acute lung injury (ALI) but there is still a debate about the efficacy of these drugs. Among these therapies steroids are clinically applied and bosentan is experimentally studied. The aim of this study was to evaluate the efficacy of these two drugs to treat inflammation in ALI by histopathological comparison. Methods: The five experimental groups (n = 5 per group) were: saline control (Group I); lipopolysaccharide (LPS) + saline (Group II); LPS + dexamethasone (Group III); LPS + 50 mg/kg bosentan (Group IV); and LPS + 100 mg/kg bosentan (Group V). Bosentan was administered orally one hour before and 12 hours after LPS treatment. Dexamethasone was administered intraperitoneally in three doses of 1 mg/kg; one dose was co-administered with LPS and the other two doses were given respectively 30 minutes before and after LPS treatment. Vasodilation-congestion, hemorrhage, polymorphonuclear leukocyte (PMN) infiltration, mononuclear leukocyte (MNL) infiltration, alveolar wall thickening, alveolar destruction/emphysematous appearance, and focal organization were the parameters used as criteria for evaluating inflammation and efficacy of treatment. Results: Compared to the LPS-only group (Group II), dexamethasone treatment (Group III) resulted in significant improvements in vasodilation-congestion, hemorrhage, PMN and MNL infiltration, alveolar wall thickening and emphysematous areas. Treatment with 50 mg/kg dose of bosentan (Group IV) also resulted in significant improvements in hemorrhage, PMN and MNL infiltration, alveolar wall thickening and alveolar destruction. Reducing lung injury and reparative effects of 100 mg/kg bosentan were significant in all parameters. Conclusions: Bosentan is as effective as dexamethasone for treating lung injury in ALI. Bosentan at 100 mg/kg can be recommended as a first treatment choice based on its significant reducing lung injury and reparative effects.
معوقات التخطيط الاستراتيجي في الجامعات السعودية
Authors: سليمان بن عبدالرحمن سليمان بن عبدالرحمن
Published: January 2020

هدفت هذه الدراسة للتعرف على معوقات التخطيط الاستراتيجي بالجامعات السعودية والوقوف على مدى توافق أو تباين آراء القيادات الجامعية نحو تلك المعوقات. وتنبع أهميتها من أهمية الموضوع الذي تتناوله في ظل اهتمام الجامعات السعودية ووزارة التعليم العالي بعملية التخطيط الاستراتيجي.
Ouverture de ‘CSR and Multi-Stakeholder Management’
Authors: Brondoni Silvio M. , Bosetti Luisa , Civera Chiara
Published: January 2020

For a long time, boardroom decision-making focused almost exclusively on economic expectations of major shareholders.  During the last thirty years, this approach to corporate governance progressively changed and now responsible companies strive to meet all relevant stakeholders’ expectations, and this requires acknowledging the close links among economic, social and environmental performance for the creation of shared value and lasting prosperity.  More and more, in the ‘oversize economy’, robust corporate governance is based on the awareness that long-term value creation for shareholders cannot exist without a multi-stakeholder management approach. On the contrary, multistakeholder satisfaction generates positive effects on the relationships with employees, customers, suppliers and financiers.
The Interaction of Learning Style on Measures of Successful Intelligence in Secondary Agriculture Students Exposed to Experiential and Direct Instruction
Authors: Baker Marshall A. , Robinson J. Shane
Published: January 2020

Understanding the teaching and learning paradigm is a relentless search for educators. Because individual students bring their own learning style preferences to the learning environment, teachers are asked to consider and even adjust their teaching to these preferences to improve student learning. In Kolb’s (1984) experiential learning theory, learners have preferences for how they grasp and transform information. These considerations have implications for students’ success, or lack thereof, in the classroom. This study determined the interactions that existed between learning style and successful intelligence of secondary agricultural education students. No statistically significant differences were found regarding teaching approaches and students’ preferred method of grasping information. However, statistically significant interactions were identified related to students’ preferences for transforming information and performance on an analytical assessment. Recommendations point to infusing variability in the classroom, especially in how students are asked to transform the information they have grasped previously. Further research should focus on the motivational outcomes resulting from experiential instruction delivered to students of varying learning styles.
Identifying Challenges Pre-service Teachers Encountered When Teaching Curriculum for Agricultural Science Education (CASE) Coursework during Student Teaching
Authors: Wells Trent , Hainline Mark S. , Smalley Scott W.
Published: January 2020

Student teaching is the capstone experience in an agricultural teacher preparation program (Edgar, Roberts, & Murphy, 2011). During student teaching, pre-service teachers work with cooperating teachers to learn to effectively deliver instruction (Feiman-Nemser & Buchmann, 1987) on topics such as agriscience, agricultural mechanics, horticultural science, and so forth, to secondary students. School-based agricultural education (SBAE) also includes instruction in applied academic content (Stubbs & Myers, 2015). Curriculum for Agricultural Science Education (CASE) has emerged in recent years to provide engaging, academically-reinforced coursework for SBAE teachers and students across the United States (CASE, n.d.a). Thus, it is reasonable to expect pre-service teachers may be responsible for teaching CASE coursework at their student teaching placement sites. We sought to identify challenges that pre-service teachers may encounter when teaching CASE coursework. Through two face-to-face focus group interviews conducted at both the mid-semester and end-of-semester student teacher meetings, we identified three primary themes: 1) accessibility to resources; 2) influence of cooperating teachers; and 3) applicability of coursework based on local needs. We concluded these pre-service teachers encountered both positive and negative experiences related to teaching CASE coursework and recommended that pre-service teachers be adequately prepared to engage in CASE coursework prior to student teaching.
Radiative forcing of climate change from the Copernicus reanalysis of atmospheric composition
Authors: Bellouin Nicolas , Davies Will , Shine Keith P. , Quaas Johannes , Mülmenstädt Johannes , Forster Piers M. , Smith Chris , Lee Lindsay , Regayre Leighton , Brasseur Guy , Sudarchikova Natalia , Bouarar Idir , Boucher Olivier , Myhre Gunnar
Published: January 2020

Abstract. Radiative forcing provides an important basis for understanding and predicting global climate changes, but its quantification has historically been done independently for different forcing agents, involved observations to varying degrees, and studies have not always included a detailed analysis of uncertainties. The Copernicus Atmosphere Monitoring Service reanalysis is an optimal combination of modelling and observations of atmospheric composition. It provides a unique opportunity to rely on observations to quantify the monthly- and spatially-resolved global distributions of radiative forcing consistently for six of the largest forcing agents: carbon dioxide, methane, tropospheric ozone, stratospheric ozone, aerosol-radiation interactions, and aerosol-cloud interactions. These radiative forcing estimates account for adjustments in stratospheric temperatures, but do not account for rapid adjustments in the troposphere. On a global average and over the period 2003–2016, stratospherically adjusted radiative forcing of carbon dioxide has averaged +1.84 W m−2 (5–95% confidence interval: 1.46 to 2.22 W m−2) relative to 1750 and increased at a rate of 17 % per decade. The corresponding values for methane are +0.45 (0.35 to 0.55) W m−2 and 3 % per decade, but with a clear acceleration since 2007. Ozone radiative forcing averages +0.32 (0 to 0.64) W m−2 and aerosol radiative forcing averages −1.37 (−2.17 to −0.57) W m−2. Both have been relatively stable since 2003. Taking the six forcing agents together, there no indication of a slowdown or acceleration in the rate of increase in anthropogenic radiative forcing over the period. These ongoing radiative forcing estimates will monitor the impact on the Earth’s energy budget of the dramatic emission reductions towards net-zero that are needed to limit surface temperature warming to the Paris Agreement temperature targets. Indeed, such impacts should be clearly manifested in radiative forcing before being clear in the temperature record. In addition, this radiative forcing dataset can provide the input distributions needed by researchers involved in monitoring of climate change, detection and attribution, interannual to decadal prediction, and integrated assessment modelling. The data generated by this work are available at https://doi.org/10.24380/ads.1hj3y896 (Bellouin et al., 2020).
Incorporating Political Engagement in General Education: An Examination of the Effects of Participation in a Political Research Action Project on Students' Perceived Relevance, Efficacy, Political Understanding, and Political Engagement Skills
Authors: Woolard Chad Everett , Hunt Stephen K.
Published: January 2020

The political disengagement of youth in this country is a serious concern for those in higher education. Although many initiatives have been launched in recent years to address this situation, many have missed the opportunity to equip students with the political skills necessary for meaningful participation in our democracy. This article details the results of a study designed to assess the effects of participation in a Social Issues Fair (SIF) on students' perceived relevance of the SIF, individual efficacy, political understanding, political deliberation skills, and strategic action skills. In addition, the study sought to explore differences in the dependent variables by participant sex. Findings demonstrated no significant differences between presenters and audience members who participated in the SIF; however, there were significant differences by sex. Specifically, women in the sample reported significantly higher means on the relevance, efficacy, and political deliberation skills measures. Finally, significant, positive correlations were found between perceived relevance of participation in the SIF and all of the political engagement learning outcomes. Overall, findings indicate that the pedagogy of political engagement can play a vital role in general education programs as a means of educating students for democracy.
Practicing What We Teach and Teaching What We Practice: A Town Hall Model as Curricular Component and Tool for Curricular Reform
Authors: Sarch Amy
Published: January 2020

Issues in society such as immigration and racial inequality threaten to derail classroom discussions. Likewise, issues in higher education such as general education (GE) reform threaten to obstruct faculty committee discussions. We want students to engage in classroom discussions through a comprehensive exploration of issues, ideas, and events before accepting or formulating opinions or conclusions. How can we expect this of students if we cannot expect this of ourselves? Shenandoah University (SU) adapted California State University-Chico's Town Hall Public Sphere Pedagogy model to incorporate role play and deliberative dialogue into its GE reform discussions and then adapted the model further to become a signature program in its revised GE curriculum. SU Town Hall classes require students to explore a social issue from the lens of their GE class and share that informed perspective with peers, faculty, and community consultants at a convening Town Hall event. While GE reform and issues such as immigration seemingly have little in common, discussions of both require participants to transcend individual biases, to find commonalties, and, one hopes, to discover new possibilities or solutions. This article describes how SU embedded civic engagement into GE curriculum after modeling the process in GE reform discussions.