bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stack Sorting with Increasing and Decreasing Stacks
Authors: Cerbai Giulio , Cioni Lapo , Ferrari Luca 
Published: January 2020

We introduce a sorting machine consisting of $k+1$ stacks in series: the first $k$ stacks can only contain elements in decreasing order from top to bottom, while the last one has the opposite restriction. This device generalizes the $\mathfrak{DI}$ machine introduced by Rebecca Smith, which studies the case $k=1$. Here we show that, for $k=2$, the set of sortable permutations is a class with infinite basis, by explicitly finding an antichain of minimal nonsortable permutations. This construction can easily be adapted to each $k\geqslant 3$. Next we describe an optimal sorting algorithm, again for the case $k=2$. We then analyze two types of left-greedy sorting procedures, obtaining complete results in one case and only some partial results in the other one. We close the paper by discussing a few open questions.
Sepsis in the Context of Nonventilator Hospital-Acquired Pneumonia
Authors: Giuliano Karen K. , Baker Dian 
Published: January 2020

Background
Sepsis is a leading cause of mortality among hospitalized patients and is the most expensive condition affecting the US health care system. Pneumonia is associated with about half of sepsis cases, yet limited research has described the incidence of sepsis in the context of nonventilator hospital-acquired pneumonia (NV-HAP). Persons with NV-HAP who are at risk for sepsis must be identified so that interventions to reduce the burden of NV-HAP and improve outcomes among patients with sepsis can be designed.

Objective
To determine the proportion of persons with NV-HAP in whom sepsis develops and to describe the demographic and clinical characteristics of persons with NV-HAP in whom sepsis develops.

Methods
In this retrospective, population-based study, data were extracted from the National Inpatient Sample from the 2012 Healthcare Cost and Utilization Project dataset. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify adult patients at least 18 years of age who had a stay of at least 48 hours, had no documented diagnosis of ventilator-associated pneumonia, and had secondary diagnoses of both NV-HAP and sepsis, neither of which was present on admission.

Results
In the 2012 calendar year, 119 075 adults had NV-HAP develop; sepsis developed in 36.3% of these cases. Male and black patients were overrepresented in the sample, and patients had a mean of 7 comorbid conditions (SD, 3.3).

Conclusions
Sepsis in the context of NV-HAP is a key concern. Additional research is needed to identify factors associated with the development of sepsis among patients with NV-HAP.
Cutting Edge: IL-6–Driven Immune Dysregulation Is Strictly Dependent on IL-6R α-Chain Expression
Authors: Mufazalov Ilgiz A. , Andruszewski David , Schelmbauer Carsten , Heink Sylvia , Blanfeld Michaela , Masri Joumana , Tang Yilang , Schüler Rebecca , Eich Christina , Wunderlich F. Thomas , Karbach Susanne H. , Bluestone Jeffrey A. , Korn Thomas , Waisman Ari 
Published: January 2020

Abstract
IL-6 binds to the IL-6R α-chain (IL-6Rα) and signals via the signal transducer gp130. Recently, IL-6 was found to also bind to the cell surface glycoprotein CD5, which would then engage gp130 in the absence of IL-6Rα. However, the biological relevance of this alternative pathway is under debate. In this study, we developed a mouse model, in which murine IL-6 is overexpressed in a CD11c-Cre–dependent manner. Transgenic mice developed a lethal immune dysregulation syndrome with increased numbers of Ly-6G+ neutrophils and Ly-6Chi monocytes/macrophages. IL-6 overexpression promoted activation of CD4+ T cells while suppressing CD5+ B-1a cell development. However, additional ablation of IL-6Rα protected IL-6–overexpressing mice from IL-6–triggered inflammation and fully phenocopied IL-6Rα–deficient mice without IL-6 overexpression. Mechanistically, IL-6Rα deficiency completely prevented downstream activation of STAT3 in response to IL-6. Altogether, our data clarify that IL-6Rα is the only biologically relevant receptor for IL-6 in mice.
CREER, EXPERIMENTAR, COMPRENDER: UNA REFLEXIÓN SOBRE LA INTERSUBJETIVIDAD A PROPÓSITO DE UNA EXPERIENCIA DE INTERVENCIÓN EN EL CAMPO DE LA CREENCIA
Authors: Aburto Héctor Zapata 
Published: January 2020

El siguiente articulo propone una reflexión sobre la dinámica intersubjetiva dada entre un investigador y su campo, teniendo como marco de estudio la creencia, en lo particular la que refiere a la espiritualidad New Age. La pregunta primordial que delinea tal reflexión y que surge a partir de una experiencia de campo es: ¿Qué lugar juega y a qué problematizaciones lleva la creencia de un investigador una vez que decide aventurarse a estudiar la creencia de otros? Así pues, mi punto de partida para responder esta pregunta, es una narrativa de campo que intercala apuntes teórico-metodológicos que a su vez intentan poner en discusión algunos de los postulados de autores pertenecientes a la antropología posmoderna (particularmente me centraré en Clifford Geertz y James Clifford) y de otros que intentaron pensar el campo de la creencia.
Fit for high altitude: are hypoxic challenge tests useful?
Authors: Matthys Heinrich 
Published: January 2020

Altitude travel results in acute variations of barometric pres- sure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax), sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pres- sure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symp- toms of emotional hyperventilation. In patients with pre- existing respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea) an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and sys- temic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient.
Instead of the hypoxia altitude simulation test (HAST), which is not without danger for patients with respiratory insuffi- ciency, we prefer primarily a hyperoxic challenge. The supple- mentation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduc- tion of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supple- mental O2-breathing remains the gold standard. The increas- ing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil) or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists) including mechanical aids to reduce periodical or insufficient ventilation during altitude exposure (added dead space, continuous or bilevel positive airway pressure, non-invasive ventilation) call for further randomized controlled trials of combined applications.
Trends in adult asthma hospitalization: gender-age effect
Authors: Gonzalez-Barcala Francisco J. , Aboal Jorge , Valdes Luis , Carreira José M. , Alvarez-Dobaño José M. , Puga Amalia , Garcia-Sanz María Teresa , Takkouche Bahi 
Published: January 2020

Background: Hospital admissions due to asthma are a reliable source of information on the morbidity of the disease which, after the increase observed in the last quarter of the last centu- ry, shows a declining trend in the last few years. The aim of this study was to look at hospital admission trends due to asthma in our community and analyze some of its associated factors.
Methods: Retrospective analysis of all hospital admissions involving adults aged 15 years and older with asthma as the primary or secondary diagnosis (if the first diagnosis was res- piratory failure or respiratory infection) in Public Health Service hospitals in the Galician region of Spain between the years 1995-2009 (total 24,766 admissions).
Results: The majority of patients admitted were female (71%), over 60 years of age (64%), and admission occurred predomi- nantly in the winter months. The hospitalization rate due to asthma tripled over the period studied, this being mainly accounted for by women aged over 60 years. Mean hospital stay was 9.2 days, longer in older patients or those admitted over the weekend.
Conclusions: A significant increase in hospital admissions due to asthma over the last few years has been observed in our community, mainly involving older women. The mean stay seems long, increasing with patients’ age and admission over the weekend.
Effects of volatile substance abuse on the respiratory system in adolescents
Authors: Büker Halime S.C. , Demir Esen , Yüncü Zeki , Gülen Figen , Midyat Levent , Tanaç Remziye 
Published: January 2020

Aim: Inhalant abuse is a prevalent and often overlooked form of substance abuse in adolescents. Chronic inhalant abuse can damage respiratory, cardiac, renal, hepatic, and neurolog- ic systems. This study aims to determine the physiologic effects of inhaling solvents on the respiratory functions.
Methods: The general health status of the subjects was assessed by history taking, physical examination and a questionnaire which was designed to show the severity of respiratory symp- toms. Spirometry, ventilation/perfusion scintigraphy, and high resolution computed tomography (HRCT) were performed to assess pulmonary functions and anatomy.
Results: Thirty-one male volatile substance abusers and 19 control subjects were included in the study. The mean age of onset of inhalant use was 14.6 ± 2.2 (9-18) years and dura- tion of drug use was 3.7 ± 1.7 years. The most common respi- ratory symptoms in volatile substance abusers were nasal congestion (45.2%), sputum (38.7%), exercise intolerance (32.3%) and cough (22.6%). Results of spirometric studies showed 12 (41.4%) subjects with low FVC values < 80% of predicted, indicative of restrictive ventilatory pattern in the study group. Although the difference was not statistically sig- nificant, restrictive ventilatory pattern was higher in the study group. There was no statistically significant correlation between restrictive ventilatory pattern and the age of onset/duration/frequency of inhalant abuse, respiratory symptoms and scintigraphic abnormalities. Subjects who had restrictive pattern in their pulmonary function tests were more likely to have abnormal findings at HRCT (p < 0.01).
Conclusion: This study has shown a positive correlation between volatile substance abuse and the development of restrictive ventilatory pattern, but more comprehensive stud- ies are needed for more precise conclusions.
Clinical analysis of 68 patients with pulmonary mycosis in China
Authors: Luo Bai-ling , Zhang Le-meng , Hu Cheng-ping , Xiong Zeng 
Published: January 2020

Background: Due to the lack of specific clinical manifestations and imaging features, the diagnosis of pulmonary mycosis is difficult. This study aimed to investigate the pathogens, clinical manifestations, imaging features, diagnosis and management of pulmonary mycosis.
Methods: Data on 68 patients diagnosed as pulmonary mycosis in Xiang Ya hospital from January 2001 to December 2010 were collected and their clinical manifestations, radiographic characterization, diagnostic methods and management were analyzed.
Results: All patients were diagnosed by pathological examination. Of the 68 cases, 38 (55.9%) had pulmonary aspergillosis and 19 (27.9%) pulmonary cryptococcosis. Open-lung surgery was performed in 38 patients (55.9%), transbronchial biopsy in 15 (22.0%), and computerized tomography (CT)-guided percutaneous needle biopsy in 11 (16.2%). Main symptoms were as follows: cough in 51 cases (75.0%), expectoration in 38 (55.9%), hemoptysis in 25 (37.8%), fever in 20 (29.4%), while 6 cases (11.1%) were asymptomatic. X-ray and chest CT showed masses or nodular lesions in 52 cases (76.5%), patchy lesions in 10 (14.7%), cavity formation in 15 (22.0%), and diffuse miliary nodules in 1 case. In 51 cases (75.0%) misdiagnosis before pathological examination occurred. Surgical resection was performed in 38 patients (55.9%). In 25 patients (36.7%) systemic antifungal therapy was administered, and 20 patients (29.4%) experienced complete responses or partial responses.
Conclusion: The main pathogens of pulmonary mycosis are Aspergillus, followed by cryptococcosis. Final diagnosis of pulmonary mycosis mainly depends on pathological examination. The clinical manifestations, imaging features, diagnostic methods and management differ depending on the pathogens. Satisfactory therapy can be obtained by both antifungal and surgical treatment.
Effect of radiological extent and severity of bronchiectasis on pulmonary function
Authors: Habesoglu Mehmet A. , Tercan Fahri , Ozkan Ugur , Eyuboglu Fusun O. 
Published: January 2020

Background: The aim of this study was to ascertain the effect of the extent and severity of bronchiectasis as determined with high-resolution computed tomography (HRCT) on lung function in patients with pure bronchiectasis, bronchiectasis and asthma, and bronchiectasis and chronic obstructive pulmonary disease (COPD).
Methods: One hundred nineteen patients (71 with pure bronchiectasis, 25 asthmatic patients with bronchiectasis, and 23 COPD patients with bronchiectasis) underwent HRCT and pulmonary function tests. Computed tomography features were scored by the consensus of 2 radiologists.
Results: There were no statistically significant differences among the 3 patient groups regarding the extent of bronchiectasis, bronchial dilatation degree, bronchial wall thickening, decreased attenuation in the lung parenchyma, or presence of mucus in the large and small airways. In the pure bronchiectasis group, a negative correlation was found between forced vital capacity (FVC) % of predicted, forced expiratory volume in 1 sec (FEV1) % of predicted, the FEV1/FVC ratio and the extent of bronchiectasis, bronchial wall thickening, bronchial wall dilatation, and decreased attenuation. At multivariate analysis the main morphologic changes associated with impairment of FVC and FEV1 were the extent of bronchiectasis and a decreased attenuation in the lung parenchyma. The decrease in the FEV1/FVC ratio was associated with bronchial wall dilatation. No correlation was found between morphologic changes and indices of pulmonary function in the asthma and COPD patients.
Conclusions: Morphologic changes associated with bronchiectasis do not influence lung function in patients with asthma and COPD directly, although they do play a role in impairing pulmonary function in patients with bronchiectasis alone.
A combination of predispositions and exposures as responsible for acute eosinophilic pneumonia
Authors: Amiconi Simona , Hirl Bertrand 
Published: January 2020

Background: Acute eosinophilic pneumonia (AEP) is a rare febrile illness which is characterized by respiratory failure and often requires mechanical ventilation. The causes and sequence of events of this disease at a biochemical and histological level remain largely unknown. In this article we report the exceptional case, possibly unique, of a patient who developed AEP and three pneumothoraces within less than one month during her hospitalization.
Case presentation: A 39-year-old German woman was admitted to our hospital for a laparoscopy-assisted vaginal hysterectomy under general anaesthesia. The surgical intervention was followed by peritonitis in the early postoperative course. Following anaesthesia induction with propofol/midazolam and during the prolonged therapy with several broad-spectrum antibiotics, she developed AEP and three spontaneous (one left-sided and two right-sided) pneumothoraces, the latter ones observed in quick succession. Symptoms, laboratory markers, and chest radiology significantly improved after a one-day treatment with methylprednisolone.
Conclusions: On the whole, these pathological occurrences, together with similar cases reported in literature, can support the conclusion of possible predisposing genetic factors at the lung tissue level of AEP patients, a view that might shed new light on the pathogenesis of this disease. To provide a coherent pattern that explains the reported evidence for AEP and pneumothoraces, independently from the causative stimulus, the supposed molecular mutations could be localized in the connective tissue rather than in the epithelial cells. In order to interpret clinical and laboratory evidence, as well as to support the main conclusions, the important part of scientific research here presented can also assist physicians in making more informed decisions for the treatment of patients with pulmonary infiltrates.
Mean platelet volume as an inflammation marker in active pulmonary tuberculosis
Authors: Gunluoglu Gulsah , Yazar Esra Ertan , Veske Nurdan Simsek , Seyhan Ekrem Cengiz , Altin Sedat 
Published: January 2020

Background: The mean platelet volume (MPV) reflects the size of platelets. It has been shown to be inversely correlated with level of the inflammation in some chronic inflammatory diseases. This prospective study aims to show the usability of MPV as an inflammation marker in patients with active pulmonary tuberculosis (PTB) by comparison with healthy controls. In addition, its relationships with other inflammatory markers such as C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as well as with the radiological extent of disease were examined.
Methods: This study included 82 patients with active PTB and 95 healthy subjects (control group). Whole blood counts, CRP level, and ESR were compared between the two groups. In the PTB group, the relationships between the radiological extent of disease and the MPV and other inflammation markers were investigated.
Results: The MPV was 7.74 ± 1.33/μL in the PTB group and 8.20 ± 1.13/μL in the control group (p = 0.005). The blood platelet count, CRP level, and ESR were significantly higher in the active PTB group than in the control group (p < 0.0001). In the PTB group, CRP levels (r = 0.26, p = 0.003) and ESR (r = 0.39, p = 0.003), but not MPV (p = 0.80), were significantly correlated with the radiologic extent of the disease.
Conclusions: The MPV was lower in patients with PTB than in healthy controls, however, the difference was limited. The MPV does not reflect the severity of the disease. The use of MPV as an inflammation marker and a negative acute-phase reactant in PTB does not seem to be reliable.
Carrageenan nasal spray in virus confirmed common cold: individual patient data analysis of two randomized controlled trials
Authors: Koenighofer Martin , Lion Thomas , Bodenteich Angelika , Prieschl-Grassauer Eva , Grassauer Andreas , Unger Hermann , Mueller Christian A. , Fazekas Tamás 
Published: January 2020

Background: Clinical trials applying iota-carrageenan nasal spray have previously shown to reduce duration of virus-confirmed common cold. The present study pooled data of two similar clinical trials to provide further evidence for the antiviral effectiveness of carrageenan.
Methods: Individual patient data were analyzed from two randomized double blind placebo controlled trials assessing the therapeutic effectiveness of carrageenan nasal spray in acute common cold. Patients with virus-confirmed common cold (n = 254, verum 126, placebo 128) were included and the following parameters were appraised: duration of disease, number of patients with relapses, number of respiratory viruses and viral titers at inclusion (visit 1) compared to days 3–5 (visit 2).
Results: Carrageenan treated patients showed a significant reduction in duration of disease of almost 2 days (p < 0.05) as well as significantly fewer relapses during 21 days of observation period (p < 0.05). The virus clearance between visit 1 and visit 2 was significantly more pronounced in the carrageenan group (p < 0.05). In both studies, virus-confirmed common cold was caused by three main virus subtypes: human rhinovirus (46%), human coronavirus (25%) and influenza A (14%) virus. Carrageenan nasal spray showed significant antiviral efficacy in all three virus subgroups, the highest effectiveness was observed in human corona virus-infected patients. The reduced duration of disease was 3 days (p < 0.01) and the number of relapses was three times less (p < 0.01) in carrageenan treated corona-virus-infected patients compared to control patients.
Conclusions: Administration of carrageenan nasal spray in children as well as in adults suffering from virus-confirmed common cold reduced duration of disease, increased viral clearance and reduced relapses of symptoms. Carrageenan nasal spray appeared as an effective treatment of common cold in children and adults.
Trial registration: Pooled data from ISRCTN52519535 and ISRCTN80148028
Clinical efficacy and tolerability of an immune- stimulant* constituted by inactivated bacterial bodies in the prophylaxis of infectious episodes of airways: a double blind, placebo-controlled, randomized, multicentre study
Authors: Carlone Stefano , Minenna Michele , Morlino Peride , Mosca Luigi , Pasqua Franco , Pela Riccardo , Schino Pietro , Tubaldi Alberto , Tupputi Emmanuele , De Benedetto Fernando , Trial Group And the Buccalin 
Published: January 2020

Background: (Buccalin®) is a Bacterial Lysates (BL) that belongs to a family of immune-stimulators, developed more than 30 years ago and it still has a role in the prophylaxis of Recurrent Respiratory Tract Infections (RRTI). However, original studies were conducted with an approach that does not seem to be aligned with the present methodologies. In addition, concomitant therapies substantially improved in the last decades. These two reasons strongly suggested to update our knowledge on the capacity of this bacterial lysate (Buccalin®) to reduce the number of days with infectious episodes in patients with RRTI.
Methods: A double blind, placebo-controlled, randomized, multicentre study was programmed (EudraCT code: 2011-005187-25). The reduction of the number of days with infectious episodes (IE) was the primary endpoint. Secondary endpoints were the number of IE, the use of concomitant drugs, the efficacy on signs and symptoms of RRTI and the safety of the drug. Patients were treated according to the registered schedule and were followed up for a period of 6 months.
Results: From a cohort of 188 patients eligible for the study, 90 were included in the active group and 88 in the placebo group. The study was completed in 170 patients. A significant reduction of the number of days with IE was observed (6.57 days in the active group and 7.47 in the placebo group). Secondary endpoints were only partially achieved. No virtual adverse events related to the treatment were recorded.
Conclusion: The administration of Buccalin® in patients with RRTI had the capacity to significantly reduce the number of days with IE in a multicentre, randomized, placebo controlled, clinical study. The treatment was safe. Of note, all patients were free to be treated with the best concomitant therapies. In these conditions, the positive results observed demonstrated that this bacterial lysate has maintained its capacity of reducing the days with infections in patients with RRTI, also in association to the concomitant therapies available nowadays.