bluuebunny/crossref_metadata_2025 huggingface dataset:
Two-point discrimination responses in children with idiopathic toe walking: A feasibility fMRI study
Authors: Donne Jack , Farrell Michael J , Kolic Jessica , Powell Jennifer , Fahey Michael , Williams Cylie
Published: November 2022

Idiopathic toe walking (ITW) is a diagnosis given to children who walk with an absence or limitation of heel strike in the contact phase of the gait cycle, that are otherwise typically developing. There is emerging evidence that this gait pattern may occur in children who experience tactile sensory processing challenges. This feasibility study aimed to determine if children were able to respond to a sensory stimulus during a fMRI. Children aged between 8–16 years of age, with and without idiopathic toe walking were recruited from general public advertising. Participants were required to perform a two-point discrimination test (task block) and press a button without being tested (control block) during an fMRI using a standard block design. Activation differences were examined in the left frontal pole, left supramarginal gyrus, left parahippocampal gyrus, left paracingulate gyrus and the right superior temporal. Five children were in the typically developing (TD) group and three were in the ITW group. There were between-group activation differences in the decision-making block compared to the control block in the left frontal lobe, parahippocampal gyrus and the right superior temporal gyrus. There was greater variation in activation in the left supramarginal gyrus and the left paracingulate gyrus in the ITW group compared to the typically developing group. Based on this study a future sample size of 15 children per group will be required to detect an adequate effect across chosen regions of interest Conducting fMRI using two-point discrimination testing on this population is feasible. Further research is required with larger population sizes to determine if brain activation patterns during the sensory input decision-making process are different in this population.
COMMENTARY – THE PARADOX OF TWO WARS IN UKRAINE
Authors: Baranowski Mariusz
Published: November 2022

The central thesis of this commentary focuses on the paradox of two wars occurring in parallel with Russian aggression in Ukraine. It is not just that—in addition to military action—there is a geopolitical tsunami and its consequences in the form of a possible food crisis, mass migration, or an already open energy war. The paradox relates to the fact that a potential Ukrainian victory could have adverse effects on the welfare of European countries as a consequence of the embargo on Russian hydrocarbons and the need to replace them (assuming there is no return to the ancien régime before the Russian aggression of February 24, 2022). The defeat of the Ukrainians, on the other hand, could lead to a so-called “new opening” and a gradual return to the import of Russian energy resources (which, although they will not obtain the pre-war volume, will provide energy stability for Europe in a period of diversifying contracts and developing investments in renewable energy sources).
In-Egg-Quality: Teaching Perpetuation of Wealth Inequity Across the Lifespan Through a Hands-On Activity
Authors: Governale Amy
Published: November 2022

Introduction:

Poverty is a central concept in many fields of psychology, yet poorly designed activities regarding wealth inequality may backfire or cause students to become defensive.

Statement of the Problem:

Many students hold misperceptions about class mobility and lack an understanding of how systemic barriers perpetuate poverty across the lifespan. The activity described demonstrates how access to resources is often not sufficient to reduce wealth inequality over time.

Literature Review:

Wealth inequity in America has worsened since the 1970s. Subjective perceptions of income are often predictive of well-being above and beyond objective measures. Students’ misperceptions of social class mobility may be changed through activities that elucidate privilege and oppression across different groups.

Teaching Implications:

The activity included opportunities for hands-on learning as well as critical reflection in small groups and with the larger class. Students reported the activity was engaging, emotional, and connected to real-life contexts.

Conclusion:

Activities that ask students to confront their misperceptions about class mobility and personal understanding of privilege and oppression in a non-threatening way may facilitate greater understanding and empathy towards low-income groups.
Stigma Among Older Adults With Age-Related Vision Impairments
Authors: Kumar Priyanka , Campanile Jessica , Swenor Bonnielin K. , Varadaraj Varshini
Published: November 2022

Introduction: Limited research has examined the experience and psychosocial effect of vision impairment in older adults. We examine the relationship between vision impairment and stigma using guided interviews among older adults with age-related eye disease. Methods: Thirty-six participants with vision impairment were recruited from glaucoma ( n = 18) (better eye visual fields mean deviations: >5 and <15 decibels) or retina ( n = 18) (better eye visual acuity: <20/40 and >20/400) clinics of the Johns Hopkins Wilmer Eye Institute between 2015 and 2020. Participants completed interviews to examine stigma surrounding age-related vision impairment. Interviews were transcribed and analyzed using directed content analysis. Results: Content analyses of interview transcripts revealed underlying stigma within our cohort. Starting with categories of (1) interpersonal relationships and (2) evolving self-perception, specific domains of stigma were realized in this study. Although both enacted (external) stigma and perceived stigma were acknowledged by a subset of participants, few endorsed internalized stigma. In the face of stigma, participants demonstrated notable resiliency in adapting to and living with age-related vision impairment, captured in an additional category of (3) behavioral adaptations. Discussion: In-depth interviews revealed that older adults with vision impairment confront specific domains of stigma, including enacted and perceived stigma. Features protective against internalized stigma included older age, community support, and assistive technologies. Implications for Practitioners: A recognition of the subtypes of stigma that older adults with age-related vision impairment face is necessary to tailor support and target interventions.
Crowdfunding (as) disinformation: ‘Pitching’ 5G and election fraud campaigns on GoFundMe
Authors: Elmer Greg , Ward-Kimola Sabrina
Published: November 2022

This paper argues that the current disinformation studies literature lacks any sustained analysis of a crucial element in any communication campaign – its sources of funding. The paper argues that crowdfunding platforms are arguably better networked and ‘cross platform enabled’ than most social media sites to spread disinformation. And that disinformation actors have weaponized crowdfunding to amplify and sustain the spread of their grievances and forms of disinformation. The paper offers a rich qualitative study of a set of election fraud and 5G themed campaigns on the GoFundMe crowdfunding platform. The study questions how networked content and financial appeals in the crowdfunding pitch can contribute to the disinformation literature and potential solutions.
Native American Dis/possessions: Postcolonial Trauma in Hitchcock’s Vertigo
Authors: Ecks Stefan
Published: November 2022

The Ohlone, the original settlers of the San Francisco region, were violently dispossessed by successive colonial regimes, first Spanish, then US American. The colonial trauma was written out of history, and by the 20th century anthropologists pronounced the Ohlone to be ‘extinct’. In this article, I explore how the dispossession of the Ohlone haunt one of the greatest movies of all time: Alfred Hitchcock’s Vertigo (1958). Although Vertigo is one of the most-analysed films ever, no one has noticed that Carlotta Valdes – the dispossessed woman who comes back from the dead to take possession of the living – would have been Native American. A hauntological reading reveals Vertigo as an unwitting witness of colonial dispossession.
The complexing of cationic copolymer MPC30-DEA70 with TGF-β1 antisense oligodeoxynucleotide and transfection into cardiomyocytes in vitro
Authors: Agyekum Godfred Amfo , Zhang Min , Li Fei , Sun Min , Zhang Fengyun , Yang Yu , Lu Yuan , Chen Minmin , Zhang Zhuoqi
Published: November 2022

Although gene therapy is an attractive option for the treatment of cardiovascular diseases, the ideal gene delivery systems are still under investigation and must meet the following criteria: safety, adequate gene transfer efficiency, and stable expression of the transgene for a duration appropriate for treating the disease. In this study, we developed a cationic phosphorylcholine-containing diblock copolymer, namely MPC30-DEA70, as carrier systems to deliver a chemically synthesized transforming growth factor-beta 1(TGF-β1) antisense oligonucleotide (AS-ODN) into cardiomyocytes (CMs) to observe the cell transfection efficiency of MPC30-DEA70 and the inhibition effect on the expression of TGF-β1. MPC30-DEA70/TGF-β1 AS-ODN complexes were formed through complexation between copolymer MPC30-DEA70 (N) and AS-ODN (P) at different N/P ratios and were characterized by DNA electrophoresis. Notably, the cytotoxicity and cell growth inhibition assay showed that the MPC30-DEA70 had low cytotoxicity to CMs within the effective transfection dosage range (<20 μL/mL). CLSM/TEM images displayed that most of the AS-ODN molecules engulfed by cells were located around the cell nuclei, and a few entered into the cell nuclei without harming the organelles in the cell. Transfection studies from CMs indicated a steady increase of transfection efficiency with increasing N/P ratios. The expression levels of TGF-β1 mRNA and protein in CMs were significantly inhibited at high N/P ratios. This study shows that MPC30-DEA70 can function as an effective transgenic vector into CMs and that TGF-β1 AS-ODN delivered by MPC30-DEA70 can silence the expression of the TGF-β1 gene efficiently and specifically and thereafter antagonize TGF-β1-mediated biological function in cardiomyocytes.
The Tribal Games: Tribalist Foundations of Trump Supporters
Authors: McKenna Bernard , Brienza Justin P. , Intezari Ali
Published: November 2022

This paper builds on Smith and Hanley’s finding that Trump’s supporters were not solely driven by demographics and economic distress, but predominantly by prejudices and preference for an overt authoritarian leadership. Our longitudinal study of the 2020 US Presidential election extended their study to test additional propositions about tribalism by considering two intergroup factors: an orientation to protestors and minorities and conservative vs liberal ingroups. While there was a strong negative correlation between attitude to protestors and to minorities, the strength of correlation between liberal and conservative ingroup ‘membership’ and support/vote for Trump/Biden was more telling. Essentially, because tribalism factors overpowered almost every variable including political orientation, we conclude that identity-based tribalism is now the primary basis of political allegiance.
Development of high strength and high electrical conductive Cu and Cu–W composite by friction stir processing: Effect of traverse speed
Authors: Naik Ramavath Bheekya , Reddy Koppula Venkateswara , Reddy Gankidi Madhusudhan , Arockia Kumar R
Published: November 2022

In this work, pure copper and copper-tungsten (Cu-W) surface composite is produced using a single pass friction stir processing (FSP) with an intention to enhance the hardness and wear resistance without impairing electrical conductivity. FSP is performed by changing the traverse speed from 50 to 200 mm/min and at a constant tool rotational speed of 600 rpm. The samples extracted from the stir zone are characterized for their microstructure, hardness, wear behaviour and electrical conductivity. The average grain size, at the stir zones, was significantly reduced (from 40 to 3 µm) after FSP. In the case of pure copper, the grain size decreased from 9 to 3 µm with an increase in traverse speed, however, grain size increased from 4 to 6 µm in the case of Cu-W composite. The hardness of FSP’ed Cu and FSP’ed Cu-W surface composite was increased in the order of 52% and 130% compared to the unprocessed copper. The wear rate significantly reduced after FSP also with an addition of W particles. A negligible reduction (1.83% IACS) in electrical conductivity was noticed for both Cu and Cu-W after FSP. This study demonstrates that the FSP is an effective approach to improve the surface mechanical properties of Cu without much impairing the electrical conductivity.
Modal properties investigation of a carbon/glass fiber-reinforced polymer composite sandwich structure with lozenge-like core: An experimental and finite element simulation
Authors: Eratbeni Mehdi Gholizadeh , Rostamiyan Yasser
Published: November 2022

The vibration properties of a carbon fiber-reinforced polymer (CFRP) and glass fiber-reinforced polymer (GFRP) composite sandwich panels with lozenge-like core and free-free boundary conditions are experimentally determined in this research. The sandwich panels manufactured for this study are composed of CFRP, GFRP, and epoxy resin. A modal experiment is performed using a modal hammer with an acceleration sensor to obtain modal properties of the structure, including natural frequencies, damping ratio, mode shapes, and frequency responses. Eventually, the comparison of vibration characteristics of the CFRP sandwich panel with the GFRP sandwich panel with almost identical geometry is discussed in detail. Furthermore, a finite element simulation is developed to validate the precision of the experimental data. It is recognized that the finite element results are in remarkably good agreement with those obtained by modal experiments. Hence, the finite element analysis and experiment method could be utilized to predict the modal properties of the CFRP and GFRP composite sandwich panels.
Net Promoter and Revenue Growth: An Examination Across Three Industries
Authors: Dawes John G.
Published: November 2022

This study examines the claim that the Net Promoter Score (NPS) is an indicator of future revenue growth. It firstly reviews published work on this topic, then presents evidence from firms in three US industries: airlines, supermarkets and insurance companies. A distinctive feature of the analysis is that it uses longitudinal data for NPS and revenue for periods between 5 and 11 years for airlines and supermarkets. This contrasts to the predominant approach in past work, which has been to analyse cross-sectional data. In addition to that longitudinal analysis, the cross-sectional association between NPS and revenue growth is examined for a sample of 10 large insurance firms for an aggregated period 2017 to 2020. The overall conclusion from the analysis is that Net Promoter is not an indicator of future revenue growth.
Connecting the Portuguese system of evolutive housing with building information modeling: From analogical to digital methods
Authors: Lacroix Igor , Güzelci Orkan Zeynel , Lopes Gonçalo Furtado , Sousa José Pedro
Published: November 2022

In Portugal, in the 1960s and 1970s, there was research concerning a system of the architectural design of housing for economically less favored populations, which related sociological information with analogical computational methods and culminated with its application in the Local Ambulatory Support Service (SAAL). This article presents the digitization process of these methods for the development of an architectural design system for social housing. The main goal is to improve methodological procedures for the original research and, specifically, to adapt them to computational design and modeling processes. To this end, this research transposed the aforementioned methodology into an algorithmic model that matches sociological information acquired from an online form with a database of social housing floor plan images to generate a building information modeling (BIM) directly from the selected image source. The result is an algorithmic model informed by sociological data linked with a BIM model to enable further rationalization of architectural design.
Comparison of Diabetic and Non-Diabetic Individuals Outcomes Following Ankle ORIF Surgery Based on Physical Therapy Start Times
Authors: Jones Jared M. , Worts Phillip R. , Guyer Aaron J.
Published: November 2022

Category:

Ankle; Trauma

Introduction/Purpose:

The surgical correction of ankle fractures are one of the most common orthopedic procedures performed and about 13% of individuals undergoing these procedure are classified as diabetic. Diabetes, as a disease, impairs fracture healing due to decreased bone quality and cardiometabolic dysfunction. The use of early mobilization following ankle surSgery has improved post-operative outcomes in the 'healthy' populations; however, early mobilization or early physical therapy initiation in the diabetic populations has not been elucidated.

Methods:

Surgical correction CPT codes for ankle fracture were used to identify eligible patients followed by a retrospective chart review to confirm diagnosis and procedure(s) as well as collection of demographic information and pertinent medical history. Patient cases were examined over a two year period. Once the inclusion criteria was met, 209 unique patients were included in the analyses. Patients were grouped by diabetes status and early (i.e., <=8 weeks) or late mobilization (i.e., days post- op until physical therapy referral). Generalized linear models and a series Chi-squared tests, Fisher's Exact tests, one-way ANOVAs, and Mann Whitney U Tests were used to assess recovery duration, fracture healing, time to PT referral, medical history, and demographic information.

Results:

The diabetic group in our study was significantly older [60 (IQR:18) vs. 58 (26) years; p = 0.019] and had a higher BMI [34(8) vs. 29(10); p = 0.041] compared to our non-diabetic group but there were no differences in the proportions for sex or the fracture type by diabetic status. The non-diabetic group displayed a quicker fracture healing time [86(35) vs. 111(45) days; p = 0.04] but there were no differences in recovery duration or days until physical therapy was prescribed. The GLM analysis performed with recovery duration (i.e., time to medical clearance) found that late mobilization was a significant predictor (p < 0.001) of recovery duration but not diabetic diagnosis (p = 0.738).

Conclusion:

There appears to be a different demographic profile for diabetic patients experiencing an ankle fracture when compared to non-diabetic patients. The delay in physical therapy referral and presumably early mobilization appears to be the strongest predictor of recovery duration. Future research should utilize randomized controlled trials to determine if early mobilization is safe and effective at facilitating quicker fracture healing and recovery following the surgical correction of an ankle fracture in diabetic patients.
Carfilzomib combined with rituximab, ifosfamide, carboplatin, and etoposide for relapsed or refractory DLBCL
Authors: Torka Pallawi , Groman Adrienne , Wong Jerry , Nichols Jenna , Kader Angela , Mavis Cory , Anampa-Guzmán Andrea , Sait Sheila Jani , Block AnneMarie , Przespolewski Eugene , Mohr Alice , Lund Ian , McWhite Kenneth , Kostrewa Jessica , DeMarco Joseph , Johnson Michael , Darrall Andrea , Thomas Roshneke , Sundaram Suchitra , Ghione Paola , Hutson Alan , Hernandez-Ilizaliturri Francisco J.
Published: November 2022

The CORAL study highlighted the need to develop novel salvage regimens in relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) previously treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. Carfilzomib (CFZ) can overcome rituximab chemotherapy resistance in lymphoma preclinical models by targeting the ubiquitin-proteasome system. We conducted an investigator initiated, single-center, open-label, prospective phase 1 study evaluating the safety and efficacy of CFZ in combination with rituximab, ifosfamide, carboplatin, and etoposide (C-R-ICE) in high-dose chemotherapy with autologous stem cell transplant (HDC-ASCT) eligible patients with R/R DLBCL (NCT01959698). In the dose-escalation phase, 18 patients were enrolled at 6 dose levels with no dose-limiting toxicities noted. CFZ 45 mg/m2 was selected as the recommended dose for expansion. Eleven additional patients were enrolled in the dose-expansion phase. Overall response rate (ORR) was 66% (48% CR; 17% PR); 52% patients underwent HDC-ASCT. An ORR of 85% was observed in patients with nongerminal center B-cell–like (non-GCB) DLBCL compared with only 13% in those with GCB DLBCL. Median progression-free survival (PFS) was 15.2 months (5.1 months, not reached [NR]), and median overall survival (OS) was 22.6 months (6.8 months, NR). Patients with non-GCB subtype had a significantly longer PFS (NR vs 6.6 months; P = .0001) and OS (NR vs 6.6 months; P = .001) than those with GCB subtype. C-R-ICE is well tolerated in patients with R/R DLBCL with toxicities comparable to rituximab, ifosfamide, carboplatin, and etoposide therapy. Our data show that patients with non-GCB DLBCL benefit significantly from incorporating CFZ into second-line therapy and HDC-ASCT.
The combined effects of histamine and methacholine on the maximal degree of airway narrowing in normal humans in vivo
Authors: Sterk PJ , Timmers MC , Bel EH , Dijkman JH
Published: November 2022

In normal subjects in vivo the dose-response curve to inhaled nonsensitizing stimuli reaches a plateau at mild degrees of airway narrowing. We investigated whether the limitation of the response is due to non-optimal smooth muscle activation, by administering high doses of histamine and methacholine together. In fifteen normal subjects a complete dose-response curve to methacholine was recorded by a tidal breathing method on three randomized days. On a separate day a complete histamine inhalation test was carried out. Each methacholine test was directly followed by double blind inhalation of the highest dose of either histamine or methacholine, or a dose of saline. The response was measured by flows from partial flow-volume curves (V 40p), and was expressed in % fall from baseline. Twelve subjects reached a maximal response plateau to methacholine which was reproducible. The addition of saline or extra methacholine did not change the response from its methacholine plateau value. Histamine caused a small increase in the response on top of the methacholine plateau (+ 9.0% fall; p less than 0.001). However, the response to the combined histamine and methacholine was not significantly larger than the maximal response to histamine alone. We conclude that there is no interaction between histamine and methacholine on the maximal degree of airway narrowing. This suggests that the plateau of the dose-response curve in normal subjects in vivo is due to other factors than limited smooth muscle activation.
Respiratory symptoms and the maximum expiratory flow-volume curve; a multivariate approach
Authors: Van Pelt W , Quanjer PH , Borsboom GJ , Van der Lende R
Published: November 2022

Information on the size and shape of about 8500 maximum expiratory flow-volume (MEFV) curves was related multivariately to respiratory symptoms to construct a sensitive measure of airflow limitation. The data were obtained in an epidemiological follow-up study of a normal population in The Netherlands. Using non-linear canonical correlation analysis, thirteen variables from each curve yielded two uncorrelated variates which were optimally related to two variates simultaneously derived from all respiratory data. Curves with different size and shape may yield the same probability for respiratory symptoms. In this context the scores of individuals on the scales of the two curve-derived variates do not have to be corrected for body or lung size. Using FEV1 and standing height about half as much of the variability in respiratory symptoms is explained as when using the whole MEFV-curve. Moreover, the distribution of the scores for the MEFV-curves allows the differentiation between three patterns of airflow limitation graphically. These three types suggest different pathophysiological mechanisms related to airways resistance and lung elastic recoil and may be used to characterize individual curves. One type relates to subjects with symptoms of 'asthma', one to airflow limitation as found among people with dyspnoea and elderly subjects and another to bronchitic symptoms. In females, the association of the MEFV-curve with 'asthma' is stronger than in males but much weaker with bronchitic symptoms. Curves found to be more related to 'asthma' or bronchitic symptoms, but not to dyspnoea, are more prevalent among current than among never smokers in males.
Assisted ventilation using cuirass respirators
Authors: Kinnear W , Petch M , Taylor G , Shneerson J
Published: November 2022

The effects of cuirass-assisted ventilation have been studied in 25 subjects with chest wall disease. Cuirass respirators increase ventilation in proportion to the peak negative pressure within the cuirass shell and the respiratory rate. Positive pressure applied during expiration produces little additional ventilation. During cuirass-assisted ventilation end-expiratory volume increases, arterial carbon dioxide tension (PaCO2) falls and arterial oxygen tension (PaO2) rises. Cardiac output is unchanged. Paradoxical chest wall motion is corrected by cuirass-assisted ventilation and restriction of chest wall expansion by the cuirass shell is minimal. Jacket-type respirators can produce larger tidal volumes than the cuirass at the same peak negative pressure, but are associated with greater air leakage.
Comparison between a new once-daily, bronchodilating drug, bambuterol, and terbutaline sustained-release, twice daily
Authors: Persson G , Gnosspelius Y , Anehus S
Published: November 2022

Bambuterol is a prodrug, from which terbutaline is slowly generated. The objectives of the study were to evaluate whether bambuterol, given once daily, can control symptoms in asthmatic patients and to compare the bronchodilating effect and the side effects with those of terbutaline sustained-release (SR) tablets given twice daily. Twenty-five out-patients with bronchial asthma were treated during two consecutive 14-day periods with either 30 mg bambuterol tablets once every evening or 2 x 5 mg terbutaline SR tablets morning and evening. The study had a double-blind, cross-over and randomized design. The mean evening peak expiratory flow rate (PEFR) (i.e. 24 h after intake of bambuterol and 12 h after intake of terbutaline SR) was significantly (p less than 0.001) higher during bambuterol than during terbutaline treatment (432 vs 415 l/min). The need for beta-adrenoceptor agonist aerosol in the daytime was significantly (p less than 0.05) lower during treatment with bambuterol once daily (0.70 puffs) than with terbutaline SR b.i.d. (1.04 puffs). The type and intensity of the side effects were the same during both treatments.
Cardiac function and central haemodynamics in severe chronic obstructive lung disease. Acute and long-term effects of felodipine
Authors: Bratel T , Hedenstierna G , Lundquist H , Nyquist O , Ripe E
Published: November 2022

Eleven patients, with advanced chronic obstructive lung disease (COLD), received an infusion of the calcium antagonist felodipine at a rate of 0.9 mg/h. Pulmonary and systemic vascular resistances (PVR and SVR) at rest were reduced by 18% (p less than 0.05) and 33% (p less than 0.001), respectively. Cardiac output increased by 33%. The right ventricular and left ventricular ejection fractions (RVEF and LVEF), measured by equilibrium gated radionuclide ventriculography, increased by 32% (p less than 0.01) and 25% (p less than 0.01), respectively. During exercise both PVR and SVR fell by a mean of 30% (p less than 0.01). RVEF and LVEF both increased by about 14% (p less than 0.05 and p less than 0.01). After three months of oral felodipine treatment, a dose-related decrease in PVR was noted at rest (r = -0.83) compared with pretreatment values. There was an increase in RVEF which correlated to a reduction in PVR (r = -0.76). Three patients discontinued the trial due to side effects. It is concluded that the reduction of PVR induced by felodipine is accompanied by an improvement in right heart function as measured by ejection fraction measurements.
Nocturnal asthma: slow-release terbutaline versus slow-release theophylline therapy
Authors: Heins M , Kurtin L , Oellerich M , Maes R , Sybrecht GW
Published: November 2022

In a double-blind cross-over study, the effects of slow release (S-R) terbutaline tablets (b.i.d. 0.25 mg/kg per day) and S-R theophylline (5.31 mg/kg morning and 10.62 mg/kg evening) were compared in eleven patients with nocturnal asthma. On day seven of each treatment period, drug serum concentrations and peak expiratory flow (PEF) were measured every 2h over a 24-h period. During daytime, terbutaline concentrations ranged from 1.6-14.1 (median 4.5) microgram/l and during the night from 2.1-18.7 (median 4.9) micron/l. Theophylline concentrations ranged from 3.9-24.3 (median 11.5) mg/l during the day and from 3.3-20.9 (median 10.4) mg/l at night. Nocturnal wheezing occurred during theophylline treatment in four patients 7 times and during terbutaline treatment in six patients 22 times. Daytime PEF values were 472 +/- 161 l/min during theophylline therapy versus 445 +/- 169 l/min during terbutaline therapy (p less than 0.05). In the night and early morning there was no significant difference between PEF values with the two treatment forms. During theophylline treatment, fewer inhalations of beta 2-sympathomimetics were used, and there were fewer side effects. One patient experienced severe asthmatic attacks during the terbutaline treatment period. The patients preferred theophylline for the treatment of nocturnal asthma.
Clinical diagnosis of pneumococcal, adenoviral, mycoplasmal and mixed pneumonias in young men
Authors: Lehtomaki K
Published: November 2022

Clinical characteristics and course of disease of 19 pneumococcal, 11 adenoviral, 15 mycoplasmal and 10 mixed pneumonias, diagnosed in 55 military conscripts, were compared. Controls consisted of 104 conscripts with upper respiratory infections (URI). The triad: productive cough, blood stained sputum, and chest pain aggravated by breathing (pneumococcal score) distinguished pneumococcal and mixed pneumonias but not adenoviral and mycoplasmal pneumonias from URI. Higher C-reactive protein (CRP) and white blood cell (WBC) count distinguished the pneumococcal pneumonias, but not the other pneumonias, from URI. The pneumococcal scores and simple laboratory tests on admission were compared. The score effectively separated pneumococcal from adenoviral and mycoplasmal pneumonias, and patients with mixed infections from mycoplasmal infections. Higher CRP values and WBC counts distinguished pneumococcal pneumonia from other pneumonias. Auscultation revealed crackles in 27% of adenoviral and in 60-70% of mycoplasmal, pneumococcal and mixed pneumonias. Maxillary sinusitis was more common in pneumococcal (56%) than in mycoplasmal (7%) or mixed pneumonia (10%) or URI (14%). Pneumococcal pneumonias differed in most respects from the other groups. It is difficult to distinguish between adenoviral, mycoplasmal and mixed pneumonia and also URI.
Kinetics of the recovery from bronchial obstruction due to hyperventilation of cold air in asthmatic subjects
Authors: Malo JL , Cartier A , L'Archeveque J , Ghezzo H , Martin RR
Published: November 2022

The timecourse of recovery from bronchial obstruction due to inhaled cold air was studied in eight adult asthmatic subjects. On the first visit, bronchial responsiveness to inhaled histamine was assessed. On the other two visits, after assessment of baseline lung resistance (RL) and spirometry, dry cold (-20 degrees C) air was inhaled for three minutes. RL was monitored continuously until its return to baseline +/- 20%. The baseline concentration of histamine causing a 20% fall in FEV1 (PC20) varied from 0.03 to 5.9 mg.ml-1. The mean maximum increase in RL was 2-fold (2.03 +/- 0.41) and was reached 2-11 min after the challenge. RL values were linearly correlated to time (r2 values greater than 0.80 in 14/16 instances). The two slopes of recovery were not significantly different. Slopes of recovery and total time of recovery (14-55 min) varied greatly between subjects. No relationship was found between baseline airway calibre, bronchial hyperresponsiveness and maximal increase in baseline RL on the one hand and the slopes of recovery on the other.
Pulmonary hyalinizing granuloma
Authors: Gans SJ , van der Elst AM , Straks W
Published: November 2022

A patient with pulmonary hyalinizing granuloma (PHG) is presented. PHG is a rare disease with very specific histological characteristics. Roentgenograms display multiple bilateral pulmonary nodules which may be cavitated. Evidence exists that the nodules are the result of an exaggerated chronic immune response. The course of the disease is generally favourable. PHG should be considered in patients showing multiple bilateral pulmonary nodules.
The epidemiology of respiratory tract pathogens in southern Netherlands
Authors: Davies BI , Maesen FP
Published: November 2022

Results of sputum cultures and susceptibility tests have been reviewed for the years 1977-1986, with approximately 1,700 positive cultures per year. Haemophilus influenzae always occupied the first place, being grown in 65% of positive specimens in 1977 and 37% in 1986. Streptococcus pneumoniae occupied the second place, rising from 17 to 27% in the same period, during which Branhamella catarrhalis rose from 5 to 26%. Based on the frequency of occurrence of individual bacterial species in the sputum cultures and on the percentage of strains resistant to ampicillin, cotrimoxazole, doxycycline, erythromycin and ofloxacin, theoretical chances of failure of blind therapy were calculated and found to be most advantageous for ofloxacin and cotrimoxazole. No explanation could be given for the increase in beta-lactamase production by B. catarrhalis, but the disappearance of Haemophilus parainfluenzae may have been due to improvements in the identification procedure.
Acquired progressive asthma in a fire-fighter
Authors: Bergstrom CE , Tornling G , Unge G
Published: November 2022

A fire-fighter, who developed chronic severe asthma after exposure to decomposition products of plastics during routine fire-fighting, is described. The outcome was fatal 25 months after onset of the disease.
Different patterns of gas exchange response to exercise in asbestosis and idiopathic pulmonary fibrosis
Authors: Agusti AG , Roca J , Rodriguez-Roisin R , Xaubet A , Agusti-Vidal A
Published: November 2022

To analyse the pattern of pulmonary gas exchange during maximal exercise (Emax) in asbestosis, we compared nine subjects with this disease (1 female/8 male), aged 54 +/- 11 yrs (mean +/- SD), to nine patients (1 female/8 male) with idiopathic pulmonary fibrosis (IPF) of a similar age, height, weight and smoking history, both at rest and during Emax. No differences were observed in dynamic and static lung volumes between the groups. However, patients with IPF had a lower DLCOsb and KCO (p less than 0.005 and 0.05, respectively). At rest, both groups showed mild arterial hypoxaemia (76 +/- 11, asbestosis, vs 77 +/- 11 mmHg, IPF), widened AaPO2 (32 +/- 14 vs 31 +/- 13 mmHg) and slight increases in VD/VT (47 +/- 12 vs 46 +/- 11%), respectively. During Emax, PaO2 fell to 51 +/- 7 mmHg in patients with IPF whereas those with asbestosis had PaO2 of 73 +/- 21 mmHg (p less than 0.05). Conversely, those with asbestosis were able to reduce VD/VT (from 47 +/- 12 to 39 +/- 10%, p = 0.01) as opposed to those with IPF (from 46 +/- 11 to 47 +/- 13%). Furthermore, DLCOsb and AaPO2 during Emax were highly correlated only in IPF (r: -0.84, p less than 0.01). Despite the finding that both diseases represent a diffuse pulmonary fibrosis with a similar degree of resting ventilatory impairment, the pattern of gas exchange during exercise is different in each. These differences may be related to the underlying morphology of each process, which probably includes more airway disease and less pulmonary vascular involvement and/or a different degree of interstitial fibrotic change in asbestosis.
Dietary vitamin E supplement does not inhibit changes in lung pressure-volume characteristics produced by bleomycin in hamsters
Authors: Sato S , Nakamura H , Takada K , Takahashi K
Published: November 2022

We tested the hypothesis that a dietary supplement of vitamin E (VE) may lessen changes in pulmonary pressure-volume characteristics induced by intratracheal instillation of bleomycin. Ninety-nine male hamsters were separated into a control group (C), a VE supplement group (E), a control plus bleomycin group (CB) and a VE supplement plus bleomycin group (EB). Animals were killed at 30, 40, 55, 70 and 90 days and the pressure-volume curves of their lungs, both air-filled and saline-filled, were determined. Bleomycin was instilled on the thirtieth day. Lung volumes, compliance and curve-fitting data were compared. The mean serum VE concentration was 17.5 micrograms.ml-1 in groups E and EB as compared to 5.7 micrograms.ml-1 in groups C and CB. Despite the remarkably high VE content, no significant difference was found between groups CB and EB for the parameters compared.
Effect of three different bronchodilators during an exacerbation of chronic obstructive pulmonary disease
Authors: Lloberes P , Ramis L , Montserrat JM , Serra J , Campistol J , Picado C , Agusti-Vidal A
Published: November 2022

This study evaluates the effect of three different bronchodilators (beta 2-adrenergic, anticholinergic and methylxanthine) alone and in randomized sequence, during an exacerbation in thirteen patients with chronic obstructive pulmonary disease. Dose-response curves were obtained for inhaled salbutamol and inhaled ipratropium bromide. The bronchodilator effect of a perfusion of aminophylline was also assessed. When a plateau of bronchodilatation was achieved with one agent, one dose of a second bronchodilator was administered to see whether additional bronchodilation could be achieved. The increments in FEV1 and FVC were similar with the three agents. The addition of a second bronchodilator did not result in significant increments in most of the patients. In at least half of the patients the doses of salbutamol and ipratropium that produced the maximal bronchodilatation were twice that currently employed.
Acute exposure to sawdust does not alter airway calibre and responsiveness to histamine in asthmatic subjects
Authors: De Luca S , Caire N , Cloutier Y , Cartier A , Ghezzo H , Malo JL
Published: November 2022

We investigated the effects of particles of sawdust delivered through a special device at known concentrations (close to the threshold limit value-short term exposure limit (TLV-STEL) of 10 mg.m-3) on FEV1 and PC20 in 12 asthmatic subjects free of clinical sensitization to this product. Subjects were studied over two days (day 1: exposure to sawdust; day 2: sham exposure) in random order with a maximum interval of 1 week. On each day, after the assessment of spirometry and PC20, subjects underwent exposure to sawdust or sham exposure. Sawdust was inhaled for a total of 30 min at average concentrations varying from 8.0 to 19.3 mg.m-3 (mean = 11.5 mg.m-3). Twenty-five to 39.7% (mean = 34.6%) of inhaled particles had a diameter less than 10 mu (diameter allowing deposition in the trachea and lower respiratory tract). At the end of each period of exposure, FEV1 was assessed. After recovery, the second PC20 was obtained. Serial measurements of FEV1 were carried out every hour for up to 6 h after the end of exposure. At that time, PC20 was reassessed. Only one subject showed an acute bronchoconstriction immediately after exposure to sawdust (maximum fall of 14% in FEV1) with complete recovery 10 min later. Overall, inhalation of sawdust did not modify PC20 by comparing the mean result of the first test with the second and the third assessments. Also, the mean changes in PC20 at each interval after exposure to sawdust were not significantly different from the variations in PC20 on the sham day.(ABSTRACT TRUNCATED AT 250 WORDS)
Particle size study of nine metered dose inhalers, and their deposition probabilities in the airways
Authors: Bouchikhi A , Becquemin MH , Bignon J , Roy M , Teillac A
Published: November 2022

This study deals with the particle size measurement of nine aerosol metered dose inhalers. Calibration was made possible by the use of a laser particle velocimeter (aerodynamic Particle Sizer from TSI). The count median aerodynamic diameters (CMAD) show little variation, from 0.63 to 0.73 micron, with standard deviations (sigma g) between 1.2 and 1.8. Aerodynamic diameter aerosol diagram analysis showed multimodal mass distribution for all the tested dose inhalers. Calculations for the airway deposition probabilities (extrathoracic, tracheobronchial and alveolar) refer to the studies made by W. Stahlhofen and co-workers. As most aerosol metered dose inhalers have a predominantly bronchial therapeutic destination, the deposition at the bronchial level could be enhanced with the following parameters: inspired volume of 1500 ml, inspiratory time of 2 sec, aerosol mass median aerodynamic diameter (MMAD) of 7.5 microns, with a monodispersed distribution. The respective influences of the excipients and propellents used for the aerosolization of these dose metered inhalers are also discussed.
Assessment of thoracic gas volume by low-frequency ambient pressure changes in children
Authors: Peslin R , Marchal F , Gallina C , Oswald M , Crance JP
Published: November 2022

The validity of a new method for measuring thoracic gas volume (TGV) was studied in 69 children, 4-16 yrs old, including twelve normal children and 57 children with an obstructive (n = 38) or restrictive (n = 19) respiratory disease. The method consisted of applying very slow (0.05 Hz) sinusoidal variations of ambient pressure around the body (delta Pam = 40 cmH2O peak to peak) and studying the relationship between delta Pam and the resulting gas displacement at the mouth (Vaw): TGVapc = PB.delta Vaw/delta Pam.cos phi, where PB is barometric minus alveolar water vapour pressure and phi the phase angle between Pam and Vaw. Functional residual capacities derived from TGVapc (FRCapc) were compared to the values obtained by plethysmography (FRCplet) and by helium dilution (FRCdil). FRCapc did not differ significantly from FRCplet in either the entire group (1.75 +/- 0.62 l vs 1.79 +/- 0.45 l) or in the patient subgroups. However, with the new method a trend to slightly lower FRCs was seen in patients with the most obstruction (p less than 0.05). FRCdil was significantly lower than both FRCapc and FRCplet (p less than 0.001), particularly in children with obstruction. Significant correlations were found between the three methods (p less than 0.001). On the other hand, the method investigated requires that the subject breathe very regularly for a period of several minutes. This was rarely achieved, so that the reproducibility of the measurements was unacceptably low. At present, the method cannot be recommended for routine use in 4-16 yr old children.
Ambient nitrogen dioxide concentrations increase bronchial responsiveness in subjects with mild asthma
Authors: Bylin G , Hedenstierna G , Lindvall T , Sundin B
Published: November 2022

Twenty subjects with mild asthma were exposed at rest in a body plethysmograph, to NO2 at 0, 260, 510 and 1,000 micrograms.m3, for 30 min on four separate days. Bronchial responsiveness (histamine inhalation test) was measured after each exposure session. Airway resistance (Raw), thoracic gas volume (TGV) and specific airway resistance (sRaw) were measured before, during and after exposure, and the breathing pattern was monitored during the whole session. Bronchial responsiveness increased significantly after 30 min exposure to 510 micrograms.m3 NO2 (p less than 0.01). There were also tendencies to an increased bronchial responsiveness after exposure to 260 and 1,000 micron.m3 NO2, but these changes were not statistically significant. Effects on airway resistance and breathing pattern were not demonstrated by exposure to 0-1,000 micrograms.m3 NO2. We conclude that short-term NO2 exposure at about 500 micrograms.m3 slightly affects human bronchial responsiveness in subjects with mild asthma.
Small cell lung cancer cell lines: pure and variant types can be distinguished by their extracellular matrix synthesis
Authors: Scarpa S , Morstyn G , Carney DN , Modesti A , Triche TJ
Published: November 2022

Variant subclasses of cell lines derived from small cell lung cancers have previously been characterized, having distinctive biochemical, morphological and growth properties compared to the classic lines. Both types of small cell lung cancer express features suggesting that they are derived from neuroectodermal cells. We compared the capacity of these two types of lung cancer cell lines to synthesize the extracellular matrix glycoproteins, fibronectin and laminin, and also analysed a few other non-small cell lung cancer lines, as controls. We found that the cell lines of the pure type did not produce laminin or fibronectin, whereas the cell lines of the variant type synthesized laminin, and the non-small cell lung cancer lines produced either laminin or fibronectin. These findings suggest that the variant form of small cell lung cancer may be derived from a primitive neuroectodermal cell, with both neural and epithelial features, whereas the classic type is derived from a more mature cell with predominantly neuronal features. The differences in extracellular matrix synthesis, and laminin in particular, may explain some of the in vitro and in vivo characteristics of the tumour.
Effects of oral N-acetylcysteine on cell content and macrophage function in bronchoalveolar lavage from healthy smokers
Authors: Linden M , Wieslander E , Eklund A , Larsson K , Brattsand R
Published: November 2022

Bronchoalveolar lavage (BAL) was performed in fourteen healthy non-smokers and eleven healthy smokers. In smokers BAL was performed before and after eight weeks' treatment with N-acetylcysteine (NAC; 200 mg t.i.d.). Cell number, composition and viability were determined in the BAL fluid. Alveolar macrophages (AMs) were cultured before examination of their phagocytic capacity and their ability to produce leukotriene B4 (LTB4). BAL fluid from smokers contained more cells than that from non-smokers (p less than 0.001). This was mainly attributable to increases in both proportion and absolute number of AMs (p less than 0.001) and to an increase in absolute number of neutrophils (p less than 0.05). However, there was a decrease in proportion of lymphocytes in BAL fluid from smokers (p less than 0.001). Phagocytic capacity of adherent cells and capacity of AMs to generate LTB4 after stimulation with opsonized zymosan (OZy) were decreased in smokers (p less than 0.05 and p less than 0.01 respectively). NAC treatment of smokers did not affect cell number but resulted in an increased proportion of lymphocytes in BAL fluid (p less than 0.05). The phagocytic capacity of AMs was not significantly altered but was improved in five of eleven smokers after NAC treatment. NAC also enhanced the decreased LTB4 secretion by smokers' AMs (p less than 0.05). We conclude that smoking leads to reduced phagocytic capacity and LTB4 secretion of AMs and that oral NAC treatment may improve the function of AMs.