bluuebunny/crossref_metadata_2025_split huggingface dataset:
Definition of sinonasal and otological exacerbation in patients with primary ciliary dyskinesia: an expert consensus
Authors: Goutaki Myrofora , Lam Yin Ting , Anagiotos Andreas , Armengot Miguel , Burgess Andrea , Campbell Raewyn , Carlier Mathilde , Caversaccio Nathalie , Chadha Neil K. , Demir Berat , Dheyauldeen Sinan Ahmed D. , Gunaydin Onder , Harris Amanda , Hayn Isolde , Inal-Ince Deniz , Levi Eric , Fernandez Trini Lopez , Lucas Jane S. , Maitre Bernard , Poirrier Anne-Lise M.L. , Schofield Lynne , Takeuchi Kazuhiko , van Gogh Christine , Wolter Nikolaus E. , Papon Jean-François 
Published: August 2024

BackgroundRecurrent infections of the nose, sinuses and ears are common problems for people with primary ciliary dyskinesia. While pulmonary exacerbations in primary ciliary dyskinesia are defined, there is no definition for ear-nose-throat exacerbations, a potential outcome for research and clinical trials.MethodsWe set up an expert panel of 24 ear-nose-throat specialists, respiratory physicians, other healthcare professionals and patients to develop consensus definitions of sinonasal and otological exacerbations in children and adults with primary ciliary dyskinesia for research settings. We reviewed the literature and used a modified Delphi approach with four electronic surveys.ResultsDefinitions for both sinonasal and otological exacerbations are based on a combination of major and minor criteria, requiring three major or two major and at least two minor criteria each. Major criteria for a sinonasal exacerbation are 1) reported acute increase in nasal discharge or change in colour, 2) reported acute pain or sensitivity in the sinus regions and 3) mucopurulent discharge on examination. Minor criteria include reported symptoms, examination signs, doctor's decision to treat and improvement after at least 14 days. Major criteria for the otological exacerbation are 1) reported acute ear pain or sensitivity, 2) reported acute ear discharge, 3) ear discharge on examination and 4) signs of otitis media in otoscopy. Minor criteria are reported acute hearing problems, signs of acute complication, and doctor's decision to treat.ConclusionThese definitions might offer a useful outcome measure for primary ciliary dyskinesia research in different settings. They should be validated in future studies and trials together with other potential outcomes, to assess their usability.
Automated method of bronchus and artery dimension measurement in an adult bronchiectasis population
Authors: Pieters Angelina L.P. , Lv Qianting , Meerburg Jennifer J. , van der Veer Tjeerd , Andrinopoulou Eleni-Rosalina , Ciet Pierluigi , Chalmers James D. , Loebinger Michael R. , Haworth Charles S. , Elborn J. Stuart , Tiddens Harm A.W.M. 
Published: August 2024

AimBronchiectasis (BE) is a disease defined by irreversible dilatation of the airway. Computed tomography (CT) plays an important role in the detection and quantification of BE. The aim of this study was three-fold: 1) to assess bronchus–artery (BA) dimensions using fully automated software in a cohort of BE disease patients; 2) to compare BA dimensions with semi-quantitative BEST-CT (Bronchiectasis Scoring Technique for CT) scores for BE and bronchial wall thickening; and 3) to explore the structure–function relationship between BA-method lumen dimensions and spirometry outcomes.MethodsBaseline CTs of BE patients who participated in a clinical trial were collected retrospectively. CTs were analysed manually with the BEST-CT scoring system and automatically using LungQ (v.2.1.0.1, Thirona, The Netherlands), which measures the following BA dimensions: diameters of bronchial outer wall (Bout), bronchial inner wall (Bin) and artery (A), and bronchial wall thickness (Bwt) and computes BA ratios (Bout/A and Bin/A) to assess bronchial widening. To assess bronchial wall thickness, we used the Bwt/A ratio and the ratio between the bronchus wall area (Bwa) and the area defined by the outer airway (Boa) (Bwa/Boa).ResultsIn total, 65 patients and 16 900 BA pairs were analysed by the automated BA method. The median (range) percentage of BA pairs defined as widened was 69 (55–84)% per CT using a cut-off value of 1.5 for Bout/A, and 53 (42–65)% of bronchial wall were thickened using a cut-off value of 0.14 for Bwt/A. BA dimensions were correlated with comparable outcomes for the BEST-CT scoring method with a correlation coefficient varying between 0.21 to 0.51. The major CT BA determinants of airflow obstruction were bronchial wall thickness (p=0.001) and a narrower bronchial inner diameter (p=0.003).ConclusionThe automated BA method, which is an accurate and sensitive tool, demonstrates a stronger correlation between visual and automated assessment and lung function when using a higher cut-off value to define bronchiectasis.
Childhood lung function is associated with adolescent-onset and persistent asthma
Authors: Koefoed Hans Jacob L. , Ullah Anhar , Hallberg Jenny , Merid Simon Kebede , Kere Maura M. , Lowe Lesley , Simpson Angela , Murray Clare S. , Gehring Ulrike , Vermeulen Roel , Kull Inger , Bergström Anna , Vonk Judith M. , Custovic Adnan , Melén Erik , Koppelman Gerard H. 
Published: August 2024

BackgroundAsthma is associated with impaired lung function; however, it is uncertain if a lower childhood lung function is associated with asthma onset and persistence during adolescence. The aims of the present study were to investigate the association between childhood lung function and onset and persistence of asthma during adolescence.MethodsIn the population-based BAMSE (Sweden), PIAMA (Netherlands) and MAAS (UK) birth cohorts, we analysed the association of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and forced expiratory volume at 75% of FVC at age 8 years with asthma onset and persistence in adolescence (age 12–16 years) using cohort-specific logistic regression analysis followed by meta-analysis.ResultsIn the BAMSE, PIAMA and MAAS cohorts, asthma incidence in adolescence was 6.1% (112/1824), 3.4% (36/1050) and 5.0% (39/779), respectively. Persistent asthma from childhood to adolescence was observed in 8.2%, 6.4% and 7.7% of all subjects within the respective cohorts. A higher FEV1% predicted and FEV1/FVC at age 8 years was associated with a lower odds for adolescent-onset asthma: OR 0.98 (95% CI 0.97–1.00) and 0.97 (0.94–0.99). These associations remained significant also when restricting the analyses to subjects with no wheezing or asthma treatment in childhood. A higher FEV1/FVC at age 8 years was associated with a lower odds for asthma persistence in adolescence (0.96 (0.93–0.99)). Sex by lung function interaction analysis was not significant.ConclusionsA higher lung function at school age was associated with a lower risk of adolescent-onset asthma, predominantly in males. This indicates that a lower lung function in childhood may precede and or potentially contribute to asthma incidence and persistence.
Physiological effects of high-flow nasal cannula during sustained high-intensity exercise in healthy volunteers: a randomised crossover trial
Authors: Moya-Gallardo Eduardo , Garcia-Valdés Patricio , Marambio-Coloma Consuelo , Gutierrez-Escobar Constanza , Hernández-Vargas Betsabeth , Muñoz-Castro Carolina , Riquelme-Sánchez Santiago , Moo-Millan Joel , Basoalto Roque , Bruhn Alejandro , Diaz Orlando , Damiani L. Felipe 
Published: August 2024

IntroductionHigh-flow nasal cannula (HFNC) has increased exercise capacity in patients with chronic respiratory diseases. However, it remains unknown whether HFNC impacts respiratory physiological variables during exercise. This study aimed to evaluate the effect of HFNC on respiratory physiological variables during sustained high-intensity exercise in healthy volunteers.MethodsWe performed a single-centre, open-label, randomised crossover trial to compare HFNC (60 L·min−1) and Sham-HFNC (2 L·min−1) interventions during a constant work rate exercise (CWRET) through randomised order. The primary outcome was change in oesophageal pressure (ΔPoes), and the secondary outcomes were other variables of inspiratory effort, ventilation distribution, ventilatory variables and clinical assessment. We evaluated volunteers at seven time points (baseline=T0; CWRET=T1-T2-T3 (1, 4 and 6 min); cooldown period=T4-T5-T6 (1, 6 and 10 min)) in both interventions.Results14 healthy volunteers (50% women; age: 22 (21–27) years) were enrolled. Mean differences in ΔPoesdecreased to favour the HFNC intervention compared to Sham-HFNC at T2 (−2.8 cmH2O; 95% CI −5.3 to −0.3), as well as the simplified oesophageal pressure–time product (sPTP) per minute at T2 (−86.1 cmH2O·s·min−1; 95% CI −146.2 to −26.1) and T3 (−79.9 cmH2O·s·min−1; 95% CI −142.3 to −17.6). The standard deviation of the Regional Ventilation Delay index was also lower with HFNC compared to Sham-HFNC (T1: −1.38; 95% CI −1.93 to −0.83; T2: −0.71; 95% CI −1.27 to −0.16). There was decreased dyspnoea to favour the HFNC, but sPTP per breath, spatial distribution ventilation indexes, ventilatory variables and clinical assessments were nonsignificant between interventions.ConclusionHFNC intervention reduces respiratory effort and dyspnoea and improves temporal ventilation distribution in healthy volunteers during CWRET.
The effect of triple CFTR modulator therapy and azithromycin on ion channels and inflammation in cystic fibrosis
Authors: Bani Melhim Suhad , Douglas Lisa E.J. , Reihill James A. , Downey Damian G. , Martin S. Lorraine 
Published: August 2024

BackgroundInflammation in cystic fibrosis (CF) airways is difficult to treat with well-established regimens often including azithromycin (AZ) as an immunomodulatory drug. As AZ has been reported to require CF transmembrane conductance regulator (CFTR) to be able to reduce interleukin (IL)-8 and given the emergence of highly effective CFTR “triple” modulator therapy (elexacaftor/tezacaftor/ivacaftor; ETI), the aim of this study was to investigate the effect of AZ and ETI, singly and in combination, on ion channel activity and to assess the potential anti-inflammatory effects.MethodsElectrophysiological assessment of ETI and AZ was performed on three-dimensional cultures of primary CF human bronchial epithelial (HBE) cells using a Multi Trans-Epithelial Current Clamp. IL-8 from NuLi-1 (non-CF) and CuFi-1 (CF) cells treated with AZ was measured by ELISA. Inflammatory mediators from primary CF HBE cells exposed to tumour necrosis factor-α in the presence of AZ, ETI and their combination, were screened using the Proteome Profiler™ Human Cytokine Array Kit, with selected targets validated by ELISA.ResultsAZ did not alter CFTR chloride efflux, nor did it have any synergistic/antagonistic effect in combination with ETI. AZ reduced IL-8 in NuLi-1 but not CuFi-1 cells. The Proteome Profiler™ screen identified several disease-relevant cytokines that were modulated by treatment. Subsequent analysis by ELISA showed IL-8, IL-6, CXCL1 and granulocyte–macrophage colony-stimulating factor to be significantly reduced by treatment with ETI, but not by AZ.ConclusionsIncorporating ETI into the standard of CF care provides an opportunity to re-evaluate therapeutic regimens to reduce treatment burden and safely discontinue chronic treatments such as AZ, without loss of clinical benefit. Identification of redundant treatments in the era of CFTR modulation may improve medication adherence and overcome potential adverse effects associated with the chronic use AZ and other drugs.
Inhaled alpha-1 antitrypsin (AAT) restores lower respiratory tract protease–antiprotease homoeostasis and reduces inflammation in AAT-deficient individuals: a randomised phase 2 study
Authors: Brantly Mark , Stocks James , Lascano Jorge , Flagg Tammy , Jeffers Ann M. , Owens Shuzi Z. , Tucker Torry A. , Devine Megan , Alagem Noga , Tov Naveh 
Published: August 2024

BackgroundAlpha-1 antitrypsin (AAT)-deficient individuals have a greater risk for developing COPD than individuals with normal AAT levels.MethodsThis was a double-blind, randomised, parallel group, placebo-controlled trial to examine the safety and tolerability of “Kamada-AAT for Inhalation” (inhaled AAT) in subjects with AAT deficiency, and to explore its effect on AAT and biomarkers in the lung epithelial lining fluid (ELF). 36 patients with severe AAT deficiency were randomised 2:1 to receive 80 mg or 160 mg inhaled AAT or placebo once daily for 12 weeks. The primary outcomes were AAT and antineutrophil elastase capacity (ANEC) in bronchoalveolar lavage and plasma after treatment. Secondary outcomes included safety, levels of normal M-type AAT in the plasma and concentrations of AAT, neutrophil elastase (NE), AAT–NE complexes and neutrophil count in the ELF.Results12 weeks of active treatment significantly increased AAT, ANEC and AAT–NE complexes in the ELF. Mean antigenic AAT levels in the ELF were restored to 5.2±2.3 μM in the 80 mg arm and to 17.7±2 μM in the 160 mg arm. Both doses significantly restored AAT antiprotease activity within the lung and reduced NE levels. M-specific AAT levels in plasma increased in a dose-dependent manner. A clinically meaningful reduction in ELF neutrophil % was observed in the 80 mg arm. AAT for inhalation was well tolerated.ConclusionsInhaled AAT restores protease–antiprotease homoeostasis and may represent a safe and effective therapy.
Exploring social activity patterns among community-dwelling older adults in South Korea: a latent class analysis
Authors: Shin Jiyoung , Kang Hun , Choi Seongmi , Choi JiYeon 
Published: August 2024

AbstractBackgroundWith the trend of digitalization, social activities among the older population are becoming more diverse as they increasingly adopt technology-based alternatives. To gain a comprehensive understanding of social activities, this study aimed to identify the patterns of digital and in-person social activities among community-dwelling older adults in South Korea, examine the associated factors, and explore the difference in depressive symptoms by the identified latent social activity patterns.MethodsData were extracted from a nationwide survey conducted with 1,016 community-dwelling older adults (mean age 68.0 ± 6.5 years, 47.8% male). The main variables assessed were digital social activities (eight items), in-person social activities (six items), and depressive symptoms (20 items). Data were analyzed using latent class analysis, multinomial logistic regression, and multiple linear regression.ResultsWe identified four distinct social activity patterns: “minimal in both digital and in-person” (22.0%), “moderate in both digital and in-person” (46.7%), “moderate in digital & very high in in-person” (14.5%), and “high in both digital and in-person” (16.8%). Younger age, living in multi-generational households, and higher digital literacy were associated with a higher likelihood of being in the “moderate in both digital and in-person” than the “minimal in both digital and in-person” group. Younger age, male, living in multi-generational households, residing in metropolitan areas, no dependency on IADL items, doing daily physical exercise, and higher digital literacy were associated with a higher likelihood of being in the “moderate in digital & very high in in-person” than the “minimal in both digital and in-person” group. Younger age, living in multi-generational households, no dependency on IADL items, doing daily physical exercise, and higher digital literacy were associated with a higher likelihood of being in the “high in both digital and in-person” than the “minimal in both digital and in-person” group. Depressive symptoms were significantly higher in the group with minimal engagement in both digital and in-person activities, compared to other three groups.ConclusionsThis study highlights distinct patterns of social activities among Korean community-dwelling older adults. Since older adults with minimal social activity engagement can be more vulnerable to depressive symptoms, interventions that address modifiable attributes, such as supporting digital literacy and facilitating physical activity of older adults, could serve as potential strategies to enhance their social activity engagement and, consequently, their mental well-being.
The value of endocervical curettage during large loop excision of the transformation zone in combination with endocervical surgical margin in predicting persistent/recurrent dysplasia of the uterine cervix: a retrospective study
Authors: Scherer-Quenzer Anne Cathrine , Findeis Jelena , Herbert Saskia-Laureen , Yokendren Nithya , Reinhold Ann-Kristin , Schlaiss Tanja , Wöckel Achim , Diessner Joachim , Kiesel Matthias 
Published: August 2024

Abstract
Background
Cervical cancer often originates from cervical cell dysplasia. Previous studies mainly focused on surgical margins and high-risk human papillomavirus persistence as factors predicting recurrence. New research highlights the significance of positive findings from endocervical curettage (ECC) during excision treatment. However, the combined influence of surgical margin and ECC status on dysplasia recurrence risk has not been investigated.

Methods
In this retrospective study, data from 404 women with high-grade squamous intraepithelial lesions (HSIL) who underwent large loop excision of the transformation zone (LLETZ) were analyzed. Records were obtained retrospectively from the hospital’s patient database including information about histopathological finding from ECC, endocervical margin status with orientation of residual disease after LLETZ, recurrent/persistent dysplasia after surgical treatment and need for repeated surgery (LLETZ or hysterectomy).

Results
Patients with cranial (= endocervical) R1-resection together with cells of HSIL in the ECC experienced re-surgery 17 times. With statistical normal distribution, this would have been expected to happen 5 times (p < 0.001). The Fisher’s exact test confirmed a statistically significant connection between the resection status together with the result of the ECC and the reoccurrence of dysplasia after surgery (p < 0,001). 40,6% of the patients with re-dysplasia after primary LLETZ had shown cranial R1-resection together with cells of HSIL in the ECC. Investigating the risk for a future abnormal Pap smear, patients with cranial R1-resection together with dysplastic cells in the ECC showed the greatest deviation of statistical normal distribution with SR = 2.6.

Conclusion
Our results demonstrate that the future risk of re-dysplasia, re-surgery, and abnormal Pap smear for patients after LLETZ due to HSIL is highest within patients who were diagnosed with cranial (endocervical) R1-resection and with cells of HSIL in the ECC in their primary LLETZ. Consequently, the identification of patients, who could benefit of intensified observation or required intervention could be improved.
Medical management of post-sublobar resection pulmonary granulomatous lesion: a report of two cases
Authors: Endoh Hideki , Oura Nariaki , Yanagisawa Satoru , Morozumi Nobutoshi , Nishizawa Nobuhiro , Yamamoto Ryohei , Satoh Yukitoshi 
Published: August 2024

Abstract
Background
Automatic stapling devices are commonly utilized in pulmonary resections, including sublobar segmentectomy. Large tumors can develop around the staple line, posing challenges in distinguishing them from cancer recurrence or inflammatory changes. In this report, we present two cases of symptomatic staple granulomatous lesion effectively managed with medications.

Case presentation
A 74-year-old man presented with a persistent cough and sputum production six years post-segmentectomy for a hamartoma in the left upper lobe. Chest computed tomography (CT) revealed a large tumor around the staple line. Laboratory investigations and bronchoscopic examination revealed no malignancy. The patient received corticosteroids and a cyclooxygenase-2 inhibitor; despite experiencing adverse reactions to steroids, both tumor size and respiratory symptoms were significantly reduced. The second case involved a 78-year-old woman who underwent pulmonary resection for suspected lung cancer. Despite a non-malignant tumor diagnosis, she reported a cough six months post-surgery. Chest CT revealed extensive shadow around the surgical staple, which was diagnosed as mycobacterium granuloma. Low-dose erythromycin induced inflammatory changes but effectively reduced the lesion.

Conclusions
Granulomatous lesions around the staple can be effectively managed with medication, and monitoring the treatment response proves valuable in distinguishing them from tumor recurrence post-pulmonary resection.
The rise of bioelectronic medicine
Authors: Koutsouras Dimitrios A. , Malliaras George G. , Langereis Geert 
Published: August 2024

AbstractBioelectronic Medicine (BEM), which uses implantable electronic medical devices to interface with electrically active tissues, aspires to revolutionize the way we understand and fight disease. By leveraging knowledge from microelectronics, materials science, information technology, neuroscience and medicine, BEM promises to offer novel solutions that address unmet clinical needs and change the concept of therapeutics. This perspective communicates our vision for the future of BEM and presents the necessary steps that need to be taken and the challenges that need to be faced before this new technology can flourish.
Board expertise diversity and firm performance in sub-Saharan Africa: do firm age and size matter?
Authors: Danso Felix Kwabena , Adusei Michael , Sarpong-Danquah Beatrice , Prempeh Kwadwo Boateng 
Published: August 2024

AbstractOur study delved into an analysis of 128 public companies in Ghana, Kenya, and Nigeria to explore the influence of diversified board expertise on firm performance. We also investigated the impact of firm size and age on this relationship. Our results indicate that a varied blend of professional experts on corporate boards significantly boosts a company's ROA, although there is no significant effect when Tobin's Q measures firm performance. Nevertheless, we discovered that combining firm size and age negatively impacts the correlation between board expertise diversity and firm performance. Our findings support the significance of integrating agency, resource dependence, and convergence theories, implying that businesses can improve their financial performance by including an appropriate mix of expertise on their boards, especially for relatively younger small-sized firms. In contrast, more prominent and ageing firms may not see the same financial benefits. Consequently, we recommend that corporate executives and practitioners consider implementing board expertise diversity to enhance their firms' financial performance.