Temple Lung Center

The primary aim of this study was to investigate the effects of Incisional Negative Pressure Wound Therapy (iNPWT) on surgical site complication rates for abdominal body contouring following bariatric surgery that resulted in massive weight loss. A large 15-hospital retrospective case-control study was conducted. Inclusion criteria consisted of nonsmokers who achieved massive weight loss, defined as >100 lb or >50% excess body weight, and had an abdominal body contouring surgery between January 2021 and June 2024. We conducted separate unadjusted analyses comparing the iNPWT cohort to the control cohort using separate chi-square or Fisher exact tests for categorical variables, and independent samples t tests or Mann-Whitney rank sums tests for normally distributed and skewed continuous variables, respectively. Statistical significance was set to P = 0.05. Basic demographics were similar for a majority of the variables between the iNPWT cohort and the standard cohort. Minor wound complications following abdominal body contouring surgery did not significantly differ between the standard and iNPWT (40.54% vs 36.36%, P = 0.070) cohorts. However, among major wound complications, rates of wound dehiscence (22.97% vs 2.27%, P = 0.003) and infection (21.62% vs 6.82%, P = 0.040) were significantly lower in the iNPWT cohort. There was no significant difference in hematoma or seroma formation between the 2 groups. Given the high volume of patients undergoing abdominal body contouring surgery following bariatric surgery, iNPWT dressings can provide plastic surgeons with an adjunct to further reduce the incidence of wound dehiscence and wound infection.

ABSTRACTPulmonary Langerhans cell histiocytosis (PLCH) frequently complicated by pulmonary hypertension (PH), which markedly worsens prognosis. We retrospectively reviewed three institutional PLCH‐PH cases treated with off‐label Sotatercept added to background triple therapy and performed a systematic review of published PLCH‐PH reports (PubMed/Embase through May 2025). Our three patients (ages 69, 62, 49; all female) had progressive vascular disease despite optimized vasodilator therapy. Following Sotatercept, all experienced ≥ 3‐fold increases in 6‐min walk distance and improved functional class. Hemodynamics improved substantially: right‐atrial pressure −78.6%, pulmonary vascular resistance −75.5%, pulmonary artery systolic pressure −58.5%, mean PAP − 56.0%, PA diastolic pressure −51.0%, PAWP − 47.1%; cardiac output and index rose +75.9% and +73.8%, respectively. BNP/NT‐proBNP normalized. Systematic review identified 34 published cases (2010–2025): mean age 37.2 ± 13.7 years, 44.1% female, 45.7% current/former smokers. Reported management strategies included targeted vasodilators, cytotoxic PLCH therapies (e.g., cladribine), smoking cessation, and selective surgery/transplant. In this small series, Sotatercept added to background therapy produced marked clinical and hemodynamic gains in refractory PLCH‐PH. These effects of Sotatercept in Group 5 PH—are encouraging but limited by sample size and retrospective design. Prospective, collaborative studies are needed to define safety, efficacy, and optimal patient selection.

BackgroundBlack and Latinx patients bear a disproportionate burden of asthma. Efforts to reduce the disproportionate morbidity have been mostly unsuccessful, and guideline recommendations have not been based on studies in these populations.MethodsIn this pragmatic, open-label trial, we randomly assigned Black and Latinx adults with moderate-to-severe asthma to use a patient-activated, reliever-triggered inhaled glucocorticoid strategy (beclomethasone dipropionate, 80 μg) plus usual care (intervention) or to continue usual care. Participants had one instructional visit followed by 15 monthly questionnaires. The primary end point was the annualized rate of severe asthma exacerbations. Secondary end points included monthly asthma control as measured with the Asthma Control Test (ACT; range, 5 [poor] to 25 [complete control]), quality of life as measured with the Asthma Symptom Utility Index (ASUI; range, 0 to 1, with lower scores indicating greater impairment), and participant-reported missed days of work, school, or usual activities. Safety was also assessed.ResultsOf 1201 adults (603 Black and 598 Latinx), 600 were assigned to the intervention group and 601 to the usual-care group. The annualized rate of severe asthma exacerbations was 0.69 (95% confidence interval [CI], 0.61 to 0.78) in the intervention group and 0.82 (95% CI, 0.73 to 0.92) in the usual-care group (hazard ratio, 0.85; 95% CI, 0.72 to 0.999; P=0.048). ACT scores increased by 3.4 points (95% CI, 3.1 to 3.6) in the intervention group and by 2.5 points (95% CI, 2.3 to 2.8) in the usual-care group (difference, 0.9; 95% CI, 0.5 to 1.2); ASUI scores increased by 0.12 points (95% CI, 0.11 to 0.13) and 0.08 points (95% CI, 0.07 to 0.09), respectively (difference, 0.04; 95% CI, 0.02 to 0.05). The annualized rate of missed days was 13.4 in the intervention group and 16.8 in the usual-care group (rate ratio, 0.80; 95% CI, 0.67 to 0.95). Serious adverse events occurred in 12.2% of the participants, with an even distribution between the groups.ConclusionsAmong Black and Latinx adults with moderate-to-severe asthma, provision of an inhaled glucocorticoid and one-time instruction on its use, added to usual care, led to a lower rate of severe asthma exacerbations. (Funded by the Patient-Centered Outcomes Research Institute and others; PREPARE ClinicalTrials.gov number, NCT02995733.)

ABSTRACTResearch on Chinese trade unions has privileged a state‐centred, structuralist approach, while the question of union agency has remained undertheorized. Seeking to overcome this limitation, this article examines the agency, the strategies and practice, and the limits and potentials of enterprise union reform in China's auto parts industry driven by worker activism since the wave of auto strikes in 2010. Drawing on in‐depth fieldwork conducted in Guangzhou and Chongqing between 2011 and 2017, the authors reveal variegated but constrained grassroots union agency and identify four key factors to explain the variations in the operation and reform of enterprise unions. Contrary to the common perception that Chinese trade unions are of no value to workers, the authors argue that, driven by worker activism and under specific circumstances, democratically elected enterprise unions are able to exploit certain operational space within the existing political and institutional constraints to carry out substantive collective bargaining and adaptive, incremental reforms, which have improved workers’ material well‐being and union representativeness and effectiveness. However, given the authoritarian regime and state‐controlled union structure, the space for grassroots union agency is severely restricted and contingent on broader political and economic environments. With growing state repression, the future of worker‐driven grassroots union reform is unclear.