Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease from exposure to environmental antigens. Diagnosing HP could be challenging. The American College of Chest Physicians ...(CHEST) and American Thoracic Society/Japanese Respiratory Society/and Asociación Latinoamericana del Tórax (ATS/JRS/ALAT) have published diagnostic guidelines in 2021 and 2020 respectively. The CHEST guideline uses four grades of confidence: confident (>90%), provisional high (70-89%), provisional low (51-69%), and unlikely (≤50%). The ATS/JRS/ALAT guideline uses five grades of confidence: definite (>90%), high (80-89%), moderate (70-79%), low (51-69%) and not excluded (≤50%). In this study, we determined how these two guidelines could have affected the diagnosis of HP made before the guidelines.
Two hundred and fifty-nine adult patients from a previous cohort with HP (ICD-9:495) made between Jan. 1, 2008, and Dec. 31, 2013, at Duke University Medical Center were included. We simplified the diagnostic confidence into three categories so we could compare the guidelines: high (≥90%), intermediate (51-89%), and low (≤50%).
There were 156 female and 103 male. Mean age was 58 (range: 20-90). 68.8% of the patients had restrictive defects (FVC < 80% pred) and 48.6% had lung biopsy. The CHEST guideline classified 33.6% of the patients into high, 59.5% into intermediate and 6.9% into low confidence categories. The ATS/JRS/ALAT guideline classified 29.7% of the patients into high, 21.2% into intermediate and 49.0% into low confidence categories (
< 0.0001 vs. CHEST). Cohen's kappa was 0.331. In patients with identifiable inciting agents (IAs) (
= 168), the CHEST guideline classified 32.1% of the patients into high, 64.3% into intermediate and 3.6% into low confidence categories. The ATS/JRS/ALAT guideline classified 29.2% of the patients into high, 20.8% into intermediate, and 50.0% into low confidence categories. Cohen's kappa was 0.314.
In our HP cohort with two-thirds of the patients with restrictive defects, we found the two guidelines had fair agreement in diagnosing HP with or without identifiable IAs. They agreed more when the diagnostic confidence was high. When the diagnostic confidence was lower, however, the ATS/JRS/ALAT guideline was more stringent. Clinicians should be aware of the differences between the two guidelines when evaluating patients suspicious of HP.
Many prospective cohort studies have investigated the association between the consumption of alcohol and CKD risk and have revealed inconsistent results. In the present study, we aimed to perform a ...meta-analysis of these studies to assess this association.We searched the PubMed and Embase databases up to 2020 and reviewed the reference lists of relevant articles to identify appropriate studies. We calculated the pooled relative risks with 95% CIs using random effects models, and then performed subgroup and meta-regression analyses. Dose-response meta-analyses were performed by sex separately. We identified 25 eligible prospective cohort studies, including 514,148 participants and 35,585 incident CKD cases. Compared with the category of minimal alcohol intake, light (RR = 0.90, I2 = 49%), moderate (RR = 0.86, I2 = 40%), and heavy (RR = 0.85, I2 = 51%) alcohol intake were associated with a lower risk of CKD. Subgroup meta-analysis by sex indicated that light (RR = 0.92, I2 = 0%), moderate (RR = 0.83, I2 = 39%) and heavy (RR = 0.76, I2 = 40%), alcohol consumption were inversely associated with CKD risk in male. Dose-response meta-analyses detected a nonlinear inverse association between alcohol consumption and the risk of CKD in all participants and linear inverse association in female participants. This meta-analysis shows that light (<12 g/day), moderate (12-24 g/day), and heavy (>24 g/day) alcohol consumption are protective against chronic kidney disease in adult participants especially in males.
The desulfurization in metallurgical process is electrochemical reaction in nature. Desulfurization using the electrochemical method was proposed with the CaO-MgO-Al2O3 molten slag covering molten ...steel. Effect of an applied external DC voltage, which varied from 0 to 8V, was discussed. The results indicated that sulfur in molten steel could be removed effectively with applied external voltage. According to the mechanism analyses of the desulfurization under the applied external voltage, kinetics formulae were developed, and the model calculated results that were in agreement with the experimental values. The transfer coefficient of sulfur in molten slag under electromigration conditions was approximately 2.09?10-5 m?s-1?V-1. The desulfurization of molten steel with molten slag can be promoted by increasing the applied voltage, reducing the partial pressure of atmospheric oxygen, strengthening the stirring intensity of the reaction system, and optimizing the composition and properties of the slag.
Carbon monoxide (CO) is considered as a new emerging cell signal molecule which is involved in plant growth, development, and acquisition of stress tolerance. In recent years, hydrogen sulfide (H
2
...S) has been found to have similar functions, but crosstalk between CO and H
2
S in the acquisition of heat tolerance in plants is not clear. In this study, pretreatment of tobacco (
Nicotiana tabaccum
L.) cells cultured in a suspension with a CO donor hematin significantly increased survival percentage of cells under a heat stress and regrowth ability after the heat stress, alleviated a decrease in cell vitality, and accumulation of malondialdehyde. In addition, treatment with hematin enhanced the activity of L-cysteine desulfhydrase, a key enzyme in H
2
S biosynthesis, which in turn induced accumulation of endogenous H
2
S in tobacco cells. Interestingly, hematin-induced heat tolerance was enhanced by addition of NaHS, a H
2
S donor, but weakened by specific inhibitors of H
2
S biosynthesis DL-propargylglycine or its scavenger hypotaurine. Furthermore, pretreatment with hemoglobin (a CO scavenger) and zinc protoporphyrin IX (a CO specific synthetic inhibitor) had no significant effect on NaHS-induced heat tolerance of tobacco cells. These results suggest that CO pretreatment could improve the heat tolerance of tobacco suspension cultured cells, and H
2
S might exert its signal role downstream to CO-induced heat tolerance.
In this study, melatonin (MEL)‐mediated plant resistance to tobacco mosaic virus (TMV) was examined to study local infection in Nicotiana glutinosa and systemic infection in Solanum lycopersicum. ...Exogenous application of 100 µm MEL increased anti‐virus infection activity to 37.4% in virus‐infected N. glutinosa plants. The same treatment significantly reduced relative levels of virus RNA analysed by qRT‐PCR and virus titres measured by dot‐ELISA, and increased the relative expression levels of the PR1 and PR5 genes analysed by qRT‐PCR, in virus‐infected S. lycopersicum. MEL treatment induced considerable accumulations of salicylic acid (SA) and nitric oxide (NO) but did not significantly affect production of hydrogen peroxide (H2O2) in the virus‐infected S. lycopersicum plants. Transgenic nahG N. tabacum was used to determine whether MEL‐induced TMV resistance was dependent on the SA pathway. The results showed that the relative RNA level of the TMV analysed by qRT‐PCR and virus titres analysed by dot‐ELISA were not reduced by the MEL treatment in the nahG transgenic N. tabacum seedlings treated twice with 100 µm MEL. The increased relative expression levels of PR1 and PR5 were greatly reduced when cPTIO, an NO scavenger, was included in the MEL treatment. A working model of MEL‐mediated plant resistance to TMV is proposed. MEL‐mediated plant resistance to viruses provides a new avenue to control plant viral diseases.
Restaurants and vehicles are important urban sources of particulate matter (PM). Due to the ubiquitous presence of these sources within cities, large variabilities in PM concentrations occur in ...source-rich environments (e.g. downtown), especially during times of peak activity such as meal times and rush hour. Due to intracity variations in factors such as racial-ethnic composition and economic status, we hypothesized that certain socio-economic groups living closer to sources are exposed to higher PM concentrations. To test this hypothesis, we coupled mobile PM measurements with census data in two midsize US cities: Oakland, CA, and Pittsburgh, PA. A novel aspect of our study is that our measurements are performed at a high (block-level) spatial resolution, which enables us to assess the direct relationship between PM concentrations and socio-economic metrics across different neighborhoods of these two cities. We find that restaurants cause long-term average PM enhancements of 0.1 to 0.3 µg m−3 over length scales between 50 and 450 m. We also find that this PM pollution from restaurants is unevenly distributed amongst different socio-economic groups. On average, areas near restaurant emissions have about 1.5× people of color (African American, Hispanic, Asian, etc), 2.5× poverty, and 0.8× household income, compared to areas far from restaurant emissions. Our findings imply that there are socio-economic disparities in long-term exposure to PM emissions from restaurants. Further, these socio-economic groups also frequently experience acutely high levels of cooking PM (tens to hundreds of µg m−3 in mass concentrations) and co-emitted pollutants. While there are large variations in socio-economic metrics with respect to restaurant proximity, we find that these metrics are spatially invariant with respect to highway proximity. Thus, any socio-economic disparities in exposure to highway emissions are, at most, mild, and certainly small compared to disparities in exposure to restaurant emissions.
The matrix enhancement and matrix pencil (MEMP) has been used to reduce the number of array elements in the planar array with a shaped-beam pattern. This work extends the MEMP-based synthesis method ...to the synthesis of pattern reconfigurable sparse planar arrays in wide-angle scanning and wideband, which exploits a necessary restriction on finding the common element positions and individual element excitations for multiple patterns. Moreover, a unitary transformation is exploited in the multiple composite equivalent Hankel matrix, which converts the complex computations of singular value decomposition (SVD) and eigenvalue decomposition (EVD) courses into real ones and effectively reduces the computation complexity. A new tactic is also restricted on avoiding too small element spacing with the consideration of the size of array antenna element. A set of numerical experiments are provided to validate the effectiveness and advantages of the proposed method.
The influence of microstructure and strain rate on tensile behavior of AlxCrMnFeCoNi (x = 0, 0.4 and 0.6 in molar ratio) high-entropy alloys was investigated. The alloys with lower Al content ...exhibited microstructures of simple fcc solid solution whereas the Al0.6CrMnFeCoNi alloy consisted of fcc + bcc mixed solutions after thermomechanical processing. Al0.6CrMnFeCoNi showed higher tensile strength at quasi-static condition due to the combinative contributions from solution strengthening, grain-boundary strengthening and precipitation hardening. Under dynamic loading conditions, both the yield strength and work hardening increased remarkably with increasing strain rate for the two Al-containing alloys. However, the Al0.4CrMnFeCoNi alloy showed a larger strain-rate sensitivity than Al0.6CrMnFeCoNi alloy owing to the existence of abundant bcc phase and interphase boundaries. Johnson-Cook constitutive model can be utilized to describe the effects of strain rate and strain on the dynamic flow stress. Compared to quasi-static condition, the higher density dislocations and interaction were the main characteristics of microstructures for dynamic deformation, leading to the increased flow stress. High volume fraction of bcc phase and strain rate led to a transition from ductile to quasi-cleavage fracture.
To evaluate the diagnostic value and safety of ultrasound-guided core-needle biopsy for peripheral pulmonary lesions (PPLs).
PubMed, EMBASE, and the Cochrane Library for relevant were searched for ...studies published up to June 2022. The diagnostic accuracy of US-guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of PPLs was evaluated using pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and the area under the summary receiver operating characteristic curves value (SROC).
The search included 12 original studies (3,830 procedures). For US-guided PTNB, the pooled sensitivity and specificity for the diagnosis of PPLs were 0.93 (95% confidence interval CI: 0.91–0.94) and 0.99 (95% CI: 0.96–1.00), respectively. The pooled estimates of the PLR, NLR, and DOR were 134.88 (95% CI: 24.88–731.74), 0.07 (95% CI: 0.06–0.09), and 1,814.95 (95% CI: 333.62–9,873.76), respectively. The area under the SROC curve was 0.95 (95% CI: 0.93–0.97). The overall complication rate was 3.6% (136 of 3,830), including self-limited haemoptysis and asymptomatic pneumothorax, and only six cases of pneumothorax requiring chest tube drainage and one case of severe bleeding were reported.
US-guided core-needle biopsy is an excellent diagnostic tool for PPLs, with high accuracy and excellent technical performance and safety.
•Ultrasound-guided core needle biopsy shows high accuracy for PPLs.•Pooled sensitivity and specificity of ultrasound-guided PTNB for PPLs were high.•The procedure has a low overall complication rate of 3.6%.
We present a simplified model to study the orbital evolution of a young hot Jupiter inside the magnetospheric cavity of a proto-planetary disk. The model takes into account the disk locking of ...stellar spin as well as the tidal and magnetic interactions between the star and the planet. We focus on the orbital evolution starting from the orbit in 2:1 resonance with the inner edge of the disk, followed by the inward and then outward orbital migration driven by the tidal and magnetic torques as well as the Roche-lobe overflow of the tidally inflated planet. The goal in this paper is to study how the orbital evolution inside the magnetospheric cavity depends on the cavity size, planet mass, and orbital eccentricity. In the present work, we only target the mass range from 0.7 to 2 Jupiter masses. In the case of the large cavity corresponding to the rotational period 7 days, the planet of mass >1 Jupiter mass with moderate initial eccentricities (0.3) can move to the region <0.03 AU from its central star in 107 yr, while the planet of mass <1 Jupiter mass cannot. We estimate the critical eccentricity beyond which the planet of a given mass will overflow its Roche radius and finally lose all of its gas onto the star due to runaway mass loss. In the case of the small cavity corresponding to the rotational period 3 days, all of the simulated planets lose all of their gas even in circular orbits. Our results for the orbital evolution of young hot Jupiters may have the potential to explain the absence of low-mass giant planets inside ~0.03 AU from their dwarf stars revealed by transit surveys.
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