bluuebunny/crossref_metadata_2025_split huggingface dataset:
Translating Cultural Safety to the UK
Authors: Lokugamage Amali U , Rix Elizabeth(Liz) , Fleming Tania , Khetan Tanvi , Meredith Alice , Hastie Carolyn Ruth 
Published: July 2021

Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The ‘Black Lives Matter’ movement has exposed structural racism’s contribution to these health inequities. ‘Cultural Safety’, an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.This paper explores what it means to be ‘culturally safe’. The ways in which New Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the ‘nuts and bolts’ of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation.
Occupation and subcategories of asthma: a population-based incident case–control study
Authors: Jaakkola Maritta S , Lajunen Taina K , Heibati Behzad , Wang Ying-Chuan , Lai Ching-Huang , Jaakkola Jouni J K 
Published: July 2021

BackgroundWe hypothesised that occupational exposures differently affect subtypes of adult-onset asthma.ObjectiveWe investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma–COPD overlap syndrome (ACOS).MethodsThis is a population-based case–control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking.ResultsThe following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97).ConclusionsOur results show that different occupations are associated with different subtypes of adult-onset asthma.
Dendritic cells in the mucosa of the human trachea are not regularly found in the first year of life
Authors: Tschernig T , Debertin A S , Paulsen F , Kleemann W J , Pabst R 
Published: July 2021

BACKGROUNDDendritic cells (DCs) in the mucosa of the respiratory tract might be involved in the early development of pulmonary allergy or tolerance. To date, little is known about when the first DCs occur in human airways.METHODSSpecimens of the distal trachea from patients who had died from sudden death in the first year of life (n=29) and in older age groups (n=59) as well as from those who had died from respiratory tract infections in the first year of life (n=8) were examined by immunohistochemistry. Transmission electron microscopy was performed in additional samples from two adults.RESULTSIn the sudden death subgroup DCs were absent in 76% of those who died in the first year of life but were present in 53 of the 59 older cases. All infants who had died of respiratory infectious diseases had DCs in the tracheal mucosa.CONCLUSIONSMature DCs are not constitutively present in the human tracheobronchial mucosa in the first year of life, but their occurrence seems to be triggered by infectious stimuli. These data support the hypothesis that DCs play a crucial role in immunoregulation in early childhood.
Intracellular cytokine repertoire in different T cell subsets from patients with sarcoidosis
Authors: Möllers M , Aries S P , Drömann D , Mascher B , Braun J , Dalhoff K 
Published: July 2021

BACKGROUNDPulmonary sarcoidosis is characterised by a mononuclear alveolitis with a predominance of CD4+ T cells and macrophages. We determined the intracellular expression of interferon (IFN)γ, interleukin (IL)-2, tumour necrosis factor (TNF)α, IL-4, IL-5 and IL-10 in CD4+ and CD8+, naive and memory lymphocytes from blood and bronchoalveolar lavage (BAL) fluid using three colour flow cytometry.METHODSEighteen untreated patients with pulmonary sarcoidosis were evaluated and stratified according to whether they had acute or chronic disease.RESULTSSignificantly more T cells expressed Th1 than Th2 type cytokines in both BAL fluid and peripheral blood samples, regardless of clinical presentation. Significantly greater proportions of T cells secreted Th1 type cytokines in BAL fluid than in peripheral blood. Th1 type cytokines were more frequently expressed by peripheral and alveolar T cells in acute disease than in chronic disease. There were no significant differences between CD4+ and CD8+ T cells. Concerning naive and memory lymphocytes, significantly higher CD45RO:CD45RA ratios were found in BAL fluid than in blood, and increased expression of Th2 type cytokines was found in peripheral compared with alveolar memory T cells.CONCLUSIONSOur data support the immunopathogenetic concept of Th1/Th2 imbalance and compartmentalisation in pulmonary sarcoidosis and suggest that the cytokine patterns change during the course of disease. Expression of Th2 type cytokines in memory lymphocytes is decreased in the alveolar compartment compared with peripheral blood.
Asthma in preschool children: prevalence and risk factors
Authors: Haby M M , Peat J K , Marks G B , Woolcock A J , Leeder S R 
Published: July 2021

BACKGROUNDThe prevalence of asthma in children has increased in many countries over recent years. To plan effective interventions to reverse this trend we need a better understanding of the risk factors for asthma in early life. This study was undertaken to measure the prevalence of, and risk factors for, asthma in preschool children.METHODSParents of children aged 3–5 years living in two cities (Lismore, n=383; Wagga Wagga, n=591) in New South Wales, Australia were surveyed by questionnaire to ascertain the presence of asthma and various proposed risk factors for asthma in their children. Recent asthma was defined as ever having been diagnosed with asthma andhaving cough or wheeze in the last 12 monthsand having used an asthma medication in the last 12 months. Atopy was measured by skin prick tests to six common allergens.RESULTSThe prevalence of recent asthma was 22% in Lismore and 18% in Wagga Wagga. Factors which increased the risk of recent asthma were: atopy (odds ratio (OR) 2.35, 95% CI 1.49 to 3.72), having a parent with a history of asthma (OR 2.05, 95% CI 1.34 to 3.16), having had a serious respiratory infection in the first 2 years of life (OR 1.93, 95% CI 1.25 to 2.99), and a high dietary intake of polyunsaturated fats (OR 2.03, 95% CI 1.15 to 3.60). Breast feeding (OR 0.41, 95% CI 0.22 to 0.74) and having three or more older siblings (OR 0.16, 95% CI 0.04 to 0.71) decreased the risk of recent asthma.CONCLUSIONSOf the factors tested, those that have the greatest potential to be modified to reduce the risk of asthma are breast feeding and consumption of polyunsaturated fats.
Exogenous female sex steroid hormones and risk of asthma and asthma-like symptoms: a cross sectional study of the general population
Authors: Lange P , Parner J , Prescott E , Ulrik C Suppli , Vestbo J 
Published: July 2021

BACKGROUNDRecent evidence suggests a role for hormonal factors in the aetiology of asthma.METHODSData from a large study of women selected from the general population were used to relate treatment with oral hormonal contraceptives (OCP) and postmenopausal hormone replacement therapy (HRT) to the following asthma indicators: self-reported asthma, wheezing, cough at exertion, and use of medication for asthma. The study sample comprised 1536 premenopausal and 3016 postmenopausal women who participated in the third round of the Copenhagen City Heart Study in 1991–4. A total of 377 women were taking OCP (24.5% of premenopausal women) and 458 were on HRT (15.2% of postmenopausal women).RESULTSIn premenopausal women 4.8% reported having asthma. The prevalence of self-reported asthma, wheeze, use of asthma medication, and cough at exertion was not significantly related to use of OCP. In postmenopausal women the prevalence of self-reported asthma was 6.2%. A weak but consistent association was observed between HRT and self-reported asthma (OR 1.42 (95% CI 0.95 to 2.12)), wheeze (OR 1.29 (95% CI 1.02 to 1.64)), cough at exertion (OR 1.34 (95% CI 1.01 to 1.77)), and use of asthma medication (OR 1.45 (95% CI 0.97 to 2.18)).CONCLUSIONSIn this study of the general population no relationship was found between the use of OCP and asthma. Although an association was observed between HRT and asthma and asthma-like symptoms, this was relatively weak and it is concluded that there is no necessity to change present prescription practice.
Airway function at one year: association with premorbid airway function, wheezing, and maternal smoking
Authors: Dezateux C , Stocks J , Wade A M , Dundas I , Fletcher M E 
Published: July 2021

BACKGROUNDImpaired growth and development of the respiratory system during fetal and early postnatal life may have important implications for lung development and later lung health. The aim of this study was to examine the association of diminished premorbid airway function, prior wheezing, and maternal smoking with airway function at 1 year of age.METHODSRespiratory function was measured at the end of the first year in 100 of 108 healthy term infants (93%) in whom similar measurements had been undertaken prior to any respiratory illness at 8 weeks. Physician diagnosed wheezing episodes were identified retrospectively from medical records.RESULTSAt 1 year specific airway conductance during end expiration (sGawee; /s/kPa) was significantly diminished in those infants with prior wheezing (95% CI wheeze/no wheeze –0.76 to –0.14), mothers who smoked (95% CI smoke/no smoke –0.81 to –0.27), a family history of asthma (95% CI family history/no family history –0.62 to 0.00), or diminished premorbid sGawee (95% CI –0.13 to –0.43/s/kPa per unit reduction sGawee at 8 weeks). In a multivariate model only maternal smoking and diminished premorbid sGaweewere independently associated with diminished sGawee at 1 year.CONCLUSIONSDiminished airway function at the end of the first year appears to be mediated by impaired airway development during early life as well as by exposure to maternal smoking. These findings are consistent with the hypothesis that, at a population level, diminished premorbid airway function provides the link between wheezing lower respiratory illness and diminished airway function at 1 year. Maternal smoking remains an important and avoidable cause of impaired airway development and function in infancy.
Changing patterns of hospital admission for asthma, 1981–97
Authors: Morrison D S , McLoone P 
Published: July 2021

BACKGROUNDHospital admission rates for asthma have stopped rising in several countries. The aim of this study was to use linked hospital admission data to explore recent trends in asthma admissions in Scotland.METHODSLinked Scottish Morbidity Records (SMR1) for asthma (ICD-9 493 and ICD-10 J45–6) from 1981 to 1997 were used to describe rates of first admissions and readmissions by age and sex. As a measure of resource use, annual trends in bed days used were also explored by age and sex.RESULTSThere were 160 039 hospital admissions for asthma by 82 421 individuals in Scotland during the study period. The overall hospital admission rate increased by 122% (from 106.7 to 236.7 per 100 000 population) but this varied by sex, age, and admission type. First admissions rose by 70% from 73.2 per 100 000 in 1986 to 124.8 per 100 000 in 1997 while readmissions fell. Children (<15 years) experienced a decline in overall admissions after 1992 due to falls in both new admissions and readmissions. By 1997 the ratio of female to male admissions was 0.57 in children, but 1.50 above 14 years of age. Mean lengths of stay fell from 10.7 days to 3.7 days between 1981 and 1997 and bed days used showed little change except for a decline after 1992 in children.CONCLUSIONSAfter a period of increasing hospitalisation for asthma in Scotland, rates of admission among children have begun to fall but among adults admissions continue to rise.
Reference values of interrupter respiratory resistance in healthy preschool white children
Authors: Lombardi E , Sly P D , Concutelli G , Novembre E , Veneruso G , Frongia G , Bernardini R , Vierucci A 
Published: July 2021

BACKGROUNDInterrupter respiratory resistance (Rint) is reported to be useful in evaluating lung function in poorly collaborating patients. However, no reference values are available from large samples of preschool children using the standard interrupter method. The aim of this study was to define reference Rint values in a population of healthy preschool children.METHODSRint was assessed without supporting the cheeks in children with no history of wheeze from six kindergartens. To evaluate the effects of upper airway compliance on Rint in healthy children, an additional group of preschool children with either no history of wheeze or no respiratory symptoms at the time of testing underwent Rint measurements in our lung function laboratory with and without supporting the cheeks. Short term (about 1 minute apart) and long term (mean 2.5 months apart) repeatability of Rint measurements (2 SDs of the mean paired difference between measurements) was also assessed in children referred for cough or wheeze.RESULTSA total of 284 healthy white children (age range 3.0–6.4 years) were evaluated. Mean inspiratory and expiratory Rint (Rintiand Rinte) did not differ significantly in boys and girls. Age, height, and weight showed a significant inverse correlation with both Rintiand Rintein the univariate analysis with linear regression. Multiple regression with age, height, and weight as the independent variables showed that all three variables were significantly and independently correlated with Rinti, whereas only height was significantly and independently correlated with Rinte. Supporting the cheeks had no significant effect on Rinti(n=29, median 0.673v0.660 kPa/l.s, p=0.098) or Rinte(n=39, median 0.702v0.713 kPa/l.s, p=0.126). Short term repeatability was 0.202 kPa/l.s for Rinti(n=50) and 0.242 kPa/l.s for Rinte(n=69). Long term repeatability was 0.208 kPa/l.s for Rinte(n=26).CONCLUSIONSWe have reported reference Rint values in preschool white children and have demonstrated the usefulness of this technique in assessing lung function in this age group.
Continuous positive airway pressure for sleep apnoea/hypopnoea syndrome: usefulness of a 2 week trial to identify factors associated with long term use
Authors: Popescu G , Latham M , Allgar V , Elliott M W 
Published: July 2021

BACKGROUNDThe sleep apnoea/hypopnoea syndrome (SAHS) is common and treatment with continuous positive airway pressure (CPAP) is effective. However, not all patients can cope with the demands of using mask positive pressure. Compliance can be improved with an intensive educational programme and patient support, but this is not practical in most centres given the large numbers of patients coming forward for treatment. Several studies have evaluated correlations between various parameters at diagnosis in order to anticipate patients' behaviour and to avoid the social and health implications of undertreated SAHS. We have evaluated the use of additional data derived during a 2 week home CPAP trial to identify factors associated with longer term use of CPAP and compliance.METHODSFollowing a diagnostic study, 209 patients were offered a CPAP machine for a 2 week home trial. After completing the trial, patients were reassessed and scored their overall satisfaction with CPAP treatment on a five point scale ranging from “much worse” to “much better” and an Epworth score relating to the loan period. Machine run time was recorded from the integral clock. These data were added to those available at diagnosis to construct models indicative of continuing CPAP and average nightly use at 1 year.RESULTS209 patients were offered the 2 week loan at least a year before June 1999 (90.9% men, mean (SD) age 51.0 (10.6) years, body mass index (BMI) 34.6 (7.7) kg/m2, Epworth score 15 (IQR 11–18), apnoea/hypopnoea index (AHI) 38.1 (22.9) events/h). 153 patients (73.2%) opted to continue CPAP and 56 declined. One year later data were available for 187 patients; 128 (68.5% on an intention to treat analysis) continued to use the machine with a mean use of 5.0 (2.4) hours/night. A logistic regression model indicated that mean CPAP use during the loan period and the overall satisfaction score accurately defined continuing CPAP and “satisfactory” CPAP use at 1 year. For patients with low machine use and no symptomatic improvement during the loan period, the addition of baseline AHI, baseline Epworth score, and the Epworth score at the end of the loan to the equation identifying factors associated with “satisfactory” CPAP use (mean >2 hours/night) improved the value of the model.CONCLUSIONData derived from a 2 week CPAP trial are useful in identifying patients who will comply with CPAP treatment to 1 year. It can be used to identify patients with significant symptomatic disease who will struggle with CPAP and may benefit from additional education and support. High mean hourly use and a high degree of overall satisfaction during the loan period identified patients likely to use CPAP and be compliant with it at 1 year.
Quark flavor physics and lattice QCD
Authors: Wingate Matthew 
Published: July 2021

AbstractFor a long time, investigation into the weak interactions of quarks has guided us toward understanding the Standard Model we know today. Now in the era of high precision, these studies are still one of the most promising avenues for peering beyond the Standard Model. This is a large-scale endeavour with many tales and many protagonists. In these pages I follow a few threads of a complex story, those passing through the realm of lattice gauge theory.
Matter production effects and interacting scenario within a reconstructed mimetic cosmology for late times
Authors: Cárdenas Víctor H. , Cruz Miguel , Lepe Samuel 
Published: July 2021

AbstractIn this work we explore two possible scenarios that can be considered to extend a recent proposed model by the authors known as reconstructed mimetic cosmology. This study is complemented with an statistical analysis for each case. The first scenario considers the inclusion of matter production as a possible source of cosmic expansion in the reconstructed mimetic model, at effective level was found that this construction can cross the phantom divide, the model evolves from quintessence to phantom dark energy. The second scenario corresponds to a construction of an interacting scheme for the dark sector which is described by the unified mimetic model. The resulting interaction term (not imposed by an Ansatz), Q, exhibits changes of sign leading to the violation of the second law along the cosmic evolution and non adiabaticity; the temperatures for the components of the dark sector are computed and such components are shown to be out of thermal equilibrium.
Explicit upper bound on the least primitive root modulo p2
Authors: Chen Bo 
Published: July 2021

In this paper, we give an explicit upper bound on [Formula: see text], the least primitive root modulo [Formula: see text]. Since a primitive root modulo [Formula: see text] is not primitive modulo [Formula: see text] if and only if it belongs to the set of integers less than [Formula: see text] which are [Formula: see text]th power residues modulo [Formula: see text], we seek the bounds for [Formula: see text] and [Formula: see text] to find [Formula: see text] which satisfies [Formula: see text], where, [Formula: see text] denotes the number of primitive roots modulo [Formula: see text] not exceeding [Formula: see text], and [Formula: see text] denotes the number of [Formula: see text]th powers modulo [Formula: see text] not exceeding [Formula: see text]. The method we mainly use is to estimate the character sums contained in the expressions of the [Formula: see text] and [Formula: see text] above. Finally, we show that [Formula: see text] for all primes [Formula: see text]. This improves the recent result of Kerr et al.