bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung deposition of inhaled once-daily long-acting muscarinic antagonists via standard jet nebulizer or dry powder inhaler, measured using functional respiratory imaging, in patients with chronic obstructive pulmonary disease
Authors: Crater Glenn D. , Johnson Karmon , Ward Jonathan , Backer Jan De 
Published: March 2022

Background: Data for bronchodilator deposition via nebulizers and dry powder inhalers (DPIs) in the respiratory tract of patients with chronic obstructive pulmonary disease (COPD) are limited. We used functional respiratory imaging (FRI) to determine deposition patterns for revefenacin solution via a PARI LC® Sprint® nebulizer and tiotropium powder via HandiHaler® DPI. Methods: Ten patients with COPD, of whom 9 had severe airflow obstruction, were selected from FLUIDDA’s database. The study did not enroll patients. Drug deposition in the extrathoracic and intrathoracic regions, including the central and peripheral airways was simulated by FRI. The percentage of delivered dose and central-to-peripheral (C/P) deposition ratio for nebulizer and DPI were evaluated. Results: Mean ± standard deviation (SD) age was 64.7 ± 7.1 years, height was 168.8 ± 8.5 cm, and percent predicted forced expiratory volume in 1 s was 40.8 ± 12.3%; 50% of patients were men. At optimal inhalation flow, intrathoracic and peripheral deposition was three-fold higher for revefenacin via nebulizer than tiotropium via HandiHaler (mean ± SD 34.6 ± 8.53% versus 10.9 ± 5.67% and 18.2 ± 4.30% versus 5.8 ± 2.73% of delivered dose, respectively). Similar results were observed for suboptimal flow (mean ± SD percentage of revefenacin versus tiotropium: intrathoracic, 32.1 ± 8.3% versus 15.1 ± 5.9%; peripheral; 16.6 ± 4.1% versus 8.4 ± 2.9%). The C/P deposition ratio for nebulizer was similar to DPI (mean ± SD 0.915 ± 0.241 versus 0.812 ± 0.249 at optimal; 0.947 ± 0.253 versus 0.784 ± 0.219 at suboptimal flow), even though the mass median aerodynamic diameter of revefenacin was higher than tiotropium. C/P deposition ratio for revefenacin decreased after bronchodilation (0.915 ± 0.241 pre-bronchodilation versus 0.799 ± 0.192 post-bronchodilation), suggesting progressively better deposition in the peripheral region, assuming bronchodilation occurred during the nebulization process. Conclusions: These results demonstrate more efficient intrathoracic and peripheral deposition for revefenacin via standard jet nebulizer than tiotropium via HandiHaler, with similar C/P deposition ratio in patients with COPD. Nebulizers are an efficient alternative to DPIs for bronchodilator administration in patients with COPD.
Anatomic Monopolar Press-fit Radial Head Arthroplasty; High Rate of Loosening at Mid-Term Follow Up
Authors: Samra Inderpaul , Kwaees Tariq A , Mati Wael , Blundell Clare , Lane Suzanne , Harrison John WK , Charalambous Charalambos P 
Published: March 2022

Introduction Radial head arthroplasty (RHA) is used for the management of unstable or unreconstructable injuries of the radial head. Our aim was to investigate clinical and radiographic outcomes in patients treated with the Acumed anatomic radial head press-fit system for trauma. Methods Clinical and radiographic assessment of RHAs undertaken for trauma with minimum 2-year follow-up. Results 16 consecutive patients, mean age 53 (21–82) and 66 month ± 27 (26–122) clinical follow-up were included. There were marked radiographic changes with 11/16 showing periprosthetic lucent lines and 13/16 showing subcollar osteolysis. Radiographic changes occurred early post-surgery. Stem loosening was associated with larger cantilever quotients (0.47 vs 0.38, p  =  0.004). Overall survivability was 81.2%, with 3 RHAs removed. Clinical outcomes for the retained RHAs were acceptable with mean flexion 134°, extension deficit of 10°, pronation of 82°, and supination of 73°. Mean VAS scores were 8.5 ±  14.4, QuickDASH 13.8 ±  18.9, Mayo Elbow Performance Scores were 91.5 ±  12.5 with no poor scores. Conclusion Mid-term clinical functional outcomes following the Acumed anatomic RHA are acceptable in most cases. However, in view of the extensive periprosthetic lucencies and surgical removal due to loosening, patients should be cautioned when consented for implantation of the prosthesis, especially if a large collar is anticipated.
Prostate Disease Severity Score: In the management of benign enlargement of prostate
Authors: Sanman KN , Patil Santosh , Prabhu GG Laxman , Shetty Ranjit , Venugopal P 
Published: March 2022

Objective: Developing a simple, user-friendly objective severity scoring system for symptomatic benign enlargement of prostate (BEP) and comparing with International Prostate Symptom Score (IPSS). Subjects and Methods: In this prospective study, patients with BEP completed IPSS proforma. A grading system was developed for peak flow of urine ( Qmax), transitional zone index (TZI), detrusor wall thickness (DWT) and intravesical prostatic protrusion (IPP). Prostate Disease Severity Score (PDSS) was developed as sum of the variables. Results: Among 115 patients, obstructive voiding (70.43%) was predominant symptom followed by storage symptom (10.44%). Among predominant obstructive voiders, grades 1–3 TZI was common (97.53%), followed by IPP (64.19%) and DWT (62.96%) of varying grade. IPP, DWT, TZI and Qmax proved to be strong determinants of obstructive voiding ( p < 0.05). The components of PDSS correlated well with total score ( p < 0.05), positively correlated with IPP, DWT and TZI, and negatively with Qmax ( p < 0.05); correlation with IPSS was statistically significant ( p < 0.05). According to PDSS, 92.5% (37/40) patients with severe, 73.02% (46/63) with moderate, 8.33% (1/12) with mild degree of obstruction needed surgical intervention. Conclusion: The objective nature, comparable correlation with IPSS, potentiality to predict future need for surgical intervention, makes PDSS, a potential user-friendly assessment tool in management of BEP. Level of evidence: Not applicable
Safety, efficacy and functional outcomes of photoselective vaporisation of the prostate: A single-centre experience
Authors: Kumar Sanjay , Panaiyadiyan Sridhar , Singh Prashant , Dogra Premnath 
Published: March 2022

Objective: The objective of this study was to report the safety, efficacy and functional outcomes following photoselective vaporisation of prostate (PVP) with GreenLight laser for benign prostatic enlargement (BPE). Material and methods: We retrospectively analysed men who underwent PVP from April 2011 to August 2019 for BPE. Preoperative, intraoperative and postoperative details were retrieved from electronic data software. The perioperative and functional outcomes were analysed. Results: A total of 147 patients, with a mean age of 65.4 years, underwent PVP (51 patients – high performance system (HPS), 120 Watts; 96 patients – xcelerated performance system (XPS), 180 Watts). In 20 (13.6%) patients, antiplatelet or anticoagulant were continued in the perioperative period. The mean operative time, lasing time, catheterization time and hospital stay were 54.4 minutes, 38.0 minutes, 48.7 hours and 2.73 days, respectively. Postoperatively, all the functional outcomes IPSS (international prostate symptom score), QOL (quality of life), Qmax (maximum flow rate) and PVR (postvoid residue) were significantly improved from the baseline. The most common complication was dysuria (36.7%). There was no significant perioperative bleeding complications in high-risk men who were on antiplatelet or anticoagulant therapy. Conclusion: PVP is a safe, efficacious and durable surgical option in BPE including patients on antiplatelet or anticoagulant therapy. Level of evidence: Level 4
Autoimmune hepatitis in Egyptian children: A single center experience
Authors: Mogahed Engy , El-Karaksy Hanaa , Zaki Heba , Abdullatif Hala 
Published: March 2022

Background and aim Autoimmune hepatitis (AIH) has variable clinical manifestations and should be considered in the diagnostic work-up of any patient with cryptogenic liver disease. The aim of the study was to determine the clinical, biochemical, histopathological characteristics and treatment outcome of AIH in Egyptian children. Patients and methods This observational study was conducted at the Pediatric Hepatology Unit at Cairo University Pediatric Hospital, Egypt. All children (<18 years of age) presenting from 2009 to 2016 with established diagnosis of AIH were included. Medical history, clinical examination, and results of investigations were retrieved from patients’ files. The main outcome measures included the rate of remission, relapses, and mortality. Results The study included 34 children with AIH. Twenty patients (58%) presented with chronic liver disease. There was a history of concomitant autoimmune diseases in 5 patients. Transaminases were elevated in all patients. There was synthetic dysfunction in 58%. Twenty-four patients (70.5%) had AIH-1, while nine patients (26.4%) had AIH-2 and one patient (2.9%) had autoantibody negative AIH. Piecemeal necrosis was observed in the liver biopsy of 79% of our cohort. Approximately 80% achieved biochemical remission (88% received combined therapy of prednisolone and azathioprine). About half of the patients developed relapses. One patient died of liver cell failure. Conclusion In children with liver disease, a diagnosis of AIH should be considered. In those patients, AIH-1 is more common than AIH-2. Prednisolone monotherapy or combined with azathioprine could achieve remission, but relapse is still common. Treatment non-adherence is the main risk factor for relapse.
The Prevalence and Sociodemographic Correlates of Social Anxiety Disorder: A Focused National Survey
Authors: Ambusaidi Aamal , Al-Huseini Salim , Alshaqsi Hiba , AlGhafri Manal , Chan Moon-Fai , Al-Sibani Nasser , Al-Adawi Samir , Qoronfleh M. Walid 
Published: March 2022

Background Social Anxiety Disorder (SAD) is among the most common anxiety disorders worldwide with data largely emerging from the Euro-American and Pacific Rim populations. In contrast, there is a dearth of studies among the populations of Arabian Gulf countries including Oman. This study has two interrelated aims: (i) to explore the prevalence of SAD among Omani adults, and (ii) to tease out the links between socio-demographic factors and SAD in Oman. Methods A cross-sectional study via an online survey was conducted among 1019 adult Omani nationals residing in Oman. The presence of SAD was assessed using the Arabic version of the Liebowitz Social Anxiety Scale (LSAS). Results Nearly half the participants (45.9%, n = 468) exhibited “caseness” for SAD as defined by LSAS. In the multivariate logistic analysis, participants below 40 years of age were 1.6 times (OR = 1.568, p = .026) more likely to have caseness for SAD than those who were 40 and older. Women were 1.3 times (OR = 1.348, p = .038) more likely to exhibit caseness for SAD than men. Participants who had secondary or undergraduate education were respectively 1.5 times (OR = 1.45, p = .014) and 2.5 times (OR = 2.509, p < .001) to have caseness for SAD than those who were graduates. Conclusion The present data suggest that 45.9% of the participants reached the cut-off for caseness in LSAS, which is high compared to reports from other populations. The present accrued frequency is discussed within the context of the accrued response rate, socio-cultural factors as well as the tendency for self-reported measures to “produce” spurious results is also highlighted which, in turn, calls for studies that adopt more inclusive survey methods.
The interrelationship of chronic cough and depression: a prospective population-based study
Authors: Arinze Johnmary T. , Hofman Amy , de Roos Emmely W. , de Ridder Maria A.J. , Verhamme Katia M.C. , Stricker Bruno , Brusselle Guy G. , Luik Annemarie I. 
Published: March 2022

BackgroundChronic cough is a debilitating medical condition that is often complicated by psychomorbidities such as depressive symptoms. Nevertheless, little is known about the impact of chronic cough on the risk of developing depression. Therefore, we investigated the association between chronic cough and prevalent, incident and recurrent depression in a population-based sample of middle-aged and older persons.MethodsWithin the Rotterdam Study, a population-based cohort, we defined chronic cough as reporting daily coughing for ⩾3 months. Depression was assessed using the Center for Epidemiologic Studies Depression scale, clinical interviews and medical records. Associations between chronic cough and depression were determined with linear, logistic and Cox regression analyses.ResultsThe study included 5877 participants (mean±sdage 72±8 years, 59% female) who contributed 37 287 person-years of follow-up. At baseline, participants with chronic cough reported more depressive symptoms (adjusted standardised mean difference 0.15, 95% CI 0.07–0.22) compared to those without chronic cough. Over time, chronic cough was associated with an increased risk of depression in participants with a history of depression (hazard ratio (HR) 1.45, 95% CI 1.13–1.84), but not in those without a history of depression (HR 0.91, 95% CI 0.68–1.22).ConclusionsAdults with chronic cough have a disproportionate burden of depressive symptoms and an increased risk of recurrent depression. This highlights the importance of screening for depression in patients with chronic cough.
Self-help cognitive behavioural therapy for anxiety in pulmonary hypertension: pilot randomised controlled trial
Authors: Rawlings Gregg H. , Beail Nigel , Armstrong Iain , Thompson Andrew R. 
Published: March 2022

ObjectivePeople with pulmonary hypertension (PH) are at an increased risk of experiencing anxiety disorders. This study developed and tested the acceptability, feasibility and preliminary effectiveness of a cognitive behavioural self-help intervention for anxiety in adults with PH using a pilot randomised control trial design.MethodsIndividuals with PH recruited from pulmonary hypertension associations were randomised to either receive a newly developed self-help intervention (n=37) or a wait-list condition (n=40). Acceptability was explored using mixed-methods questionnaires. A 2×3 repeated-measures analysis of variance was used to explore anxiety (GAD-7), depression (PHQ-9), health-related quality of life (emPHAsis-10), dyspnoea (D-12), self-mastery (Self-Mastery Scale) and mood-related cognitions and behaviours (CBP-Q) at baseline, post-intervention and 1-month follow up. A mediation analysis was performed to examine potential mechanisms of change.ResultsDropout was low at 15.6%. All participants would recommend the intervention to another person with PH and felt it had helped with their anxiety. Participants in the intervention group reported a reduction in anxiety, depression and cognitive and behavioural processes linked with mood disorders, compared to the control group. Change in unhelpful cognitions and behaviours mediated the relationship between intervention condition and change in anxiety and depression.DiscussionThe intervention was found to be acceptable, feasible and safe. Anxiety at baseline was higher than previously observed, which could be associated with the additional burden caused by COVID-19 as the intervention was trialled during the pandemic. Findings add to the growing evidence supporting the use of psychological therapies, including cognitive behavioural therapy, in this clinical group.
An international survey on nasal nitric oxide measurement practices for the diagnosis of primary ciliary dyskinesia
Authors: Beydon Nicole , Ferkol Thomas , Harris Amanda Lea , Colas Murielle , Davis Stephanie D. , Haarman Eric , Hogg Claire , Kilbride Emma , Kouis Panayotis , Kuehni Claudia E. , Latzin Philipp , Marangu Diana , Marthin June , Nielsen Kim G. , Robinson Phil , Rumman Nisreen , Rutter Matthew , Walker Woolf , Lucas Jane S. 
Published: March 2022

Nasal nitric oxide (nNO) measurements are used in the assessment of patients suspected of having primary ciliary dyskinesia (PCD), but recommendations for performing such measurements have not focused on children and do not include all current practices. To guide the development of a European Respiratory Society-supported technical standard for nNO measurement in children, an international online survey was conducted to better understand current measurement practices among providers involved in PCD diagnostics.78 professionals responded, representing 65 centres across 18 countries, mainly in Europe and North America. Nearly all centres measured nNO in children and more than half performed measurements before 5 years of age. The test was often postponed in children with signs of acute airway infection. In Europe, the electrochemical technique was more frequently used than chemiluminescence. A similar proportion of centres performed measurements during exhalation against a resistance (49 out of 65) or during tidal breathing (50 out of 65); 15 centres used only exhalation against a resistance and 15 used only tidal breathing. The cut-off values used to discriminate PCD were consistent across centres using chemiluminescence analysers; these centres reported results as an output (nL·min−1). Cut-off values were highly variable across centres using electrochemical devices, and nNO concentrations were typically reported as ppb.This survey is the first to determine real-world use of nNO measurements globally and revealed remarkable variability in methodology, equipment and interpretation. These findings will help standardise methods and training.
First record of the brachiopod Erymnaria in the Chruteren Member (Euthal Formation) from a new Palaeogene site in the Brülisau Schuppenzone of northeastern Switzerland (Canton St. Gallen) with remarks on shell asymmetry
Authors: Sulser Heinz , Menkveld-Gfeller Ursula , Bolliger Thomas , Kürsteiner Peter , Tschanz Karl 
Published: March 2022

AbstractA small, smooth-shelled rhynchonellid brachiopod, Erymnaria Cooper, 1959 was discovered in a previously unknown locality in the so-called Brülisau Schuppenzone (imbricate zone) of the South Helvetic region of northeastern Switzerland. It is the first record of this genus in this region and in Switzerland in general. It is comparable to the type species of Erymnaria, E. polymorpha (Massalongo, 1850). Its specific identity is currently undetermined, and the species is referred to Erymnaria sp. 1. The main characteristic of Erymnaria sp.1 is its asymmetric shell. This prompted a comparison of E. sp. 1 with other known asymmetric brachiopods. Questions of asymmetry and variability within the same genus and with brachiopods in general are discussed. Another, larger brachiopod species found at the new site is tentatively named Erymnaria? sp. 2. The site can be assigned to the Chruteren Member (Euthal Formation) of Early Ypresian age, dated by large Foraminifera. Thus, the previous distribution area of the Chruteren Member can be extended.
Peptidylarginine deiminase 2 promotes T helper 17-like T cell activation and activated T cell-autonomous death (ACAD) through an endoplasmic reticulum stress and autophagy coupling mechanism
Authors: Yang Yi-Fang , Wang Chuang-Ming , Hsiao I.-Hsin , Liu Yi-Liang , Lin Wen-Hao , Lin Chih-Li , Hung Hui-Chih , Liu Guang-Yaw 
Published: March 2022

AbstractPeptididylarginine deiminase type 2 (PADI2) catalyzes the conversion of arginine residues to citrulline residues on proteins. We demonstrate that PADI2 induces T cell activation and investigate how PADI2 promotes activated T cell autonomous death (ACAD). In activated Jurkat T cells, overexpression of PADI2 significantly increases citrullinated proteins and induces endoplasmic reticulum (ER) stress and unfolded protein response (UPR) signaling, ultimately resulting in the expression of autophagy-related proteins and autophagy. PADI2 promoted autophagy and resulted in the early degradation of p62 and the light chain 3B (LC3B)-II accumulation. In Jurkat T cells, silencing the autophagy-related gene (Atg) 12 protein inhibits PADI2-mediated autophagy and promotes ER stress and apoptosis, whereas overexpression of Atg12 decreased ER stress and prolonged autophagy to promote cell survival. Additionally, PADI2 regulates T cell activation and the production of Th17 cytokines in Jurkat T cells (interleukins 6, IL-17A, IL-17F, IL-21, and IL-22). In Jurkat T cells, silencing IL-6 promotes autophagy mediated by PADI2 and inhibits PADI2-induced apoptosis, whereas silencing Beclin-1 increases the activation and survival of Th17-like T cells while decreasing autophagy and apoptosis. PADI2 silencing alleviates ER stress caused by PADI2 and decreases cytokine expression associated with Th17-like T cell activation and ACAD. We propose that PADI2 was involved in Th17 lymphocyte ACAD via a mechanism involving ER stress and autophagy that was tightly regulated by PADI2-mediated citrullination. These findings suggest that inhibiting Th17 T cell activation and the development of severe autoimmune diseases may be possible through the use of novel antagonists that specifically target PADI2.
Unraveling the development behind unisexual flowers in Cylindropuntia wolfii (Cactaceae)
Authors: Ramadoss Niveditha , Orduño-Baez Amy , Portillo Carlos , Steele Scarlet , Rebman Jon , Flores-Rentería Lluvia 
Published: March 2022

Abstract
Background
In certain unisexual flowers, non-functional sexual organs remain vestigial and unisexuality can be overlooked leading to the ambiguous description of the sexual systems. Therefore, to accurately describe the sexual system, detailed morphological and developmental analyses along with experimental crosses must be performed. Cylindropuntia wolfii is a rare cactus endemic to the Sonoran Desert in southern California and northern Baja California that was described as gynodioecious by morphological analysis. The aims of our project include accurately identifying the sexual system of C. wolfii using histological and functional studies and characterizing the developmental mechanisms that underlie its floral development.

Methods
Histological analyses were carried out on different stages of C. wolfii flowers and controlled crosses were performed in the field.

Result
Our results identified C. wolfii to be functionally dioecious. The ovule and anther development differed between staminate and pistillate flowers. In vivo pollen germination tests showed that the pollen of staminate and pistillate flowers were viable and the stigma and style of both staminate and pistillate flowers were receptive. This suggests that there are no genetic or developmental barriers in the earlier stages of pollen recognition and pollen germination.

Conclusions
Despite being functionally dioecious, we observed that functionally pistillate individuals produced fruits with a large number of aborted seeds. This implies that not only does this species have low reproductive success, but its small population sizes may lead to low genetic diversity.