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Background The inverse relationship between BMI and lung cancer diagnosis is well defined. However, few studies have examined the racial differences in these relationships. The purpose of this paper is to explore the relationships amongst race, BMI, and lung cancer diagnosis using the National Lung Screening Trial (NLST) data. Methods Multivariate regression analysis was used to analyze the BMI, race, and lung cancer diagnosis relationships. Results Among 53,452 participants in the NLST cohort, 3.9% were diagnosed with lung cancer, 43% were overweight, and 28% were obese. BMI was inversely related to lung cancer diagnosis among Whites: those overweight (aOR = .83, 95%CI = .75-.93), obese (aOR = .64, 95%CI = .56-.73) were less likely to develop lung cancer, compared to those with normal weight. These relationships were not found among African-Americans. Conclusion Our findings indicate that the inverse relationship of BMI and lung cancer risk among Whites is consistent, whereas this relationship is not significant for African-Americans. In consideration of higher lung cancer incidence among African Americans, we need to explore other unknown mechanisms explaining this racial difference.

IntroductionErector spinae plane blocks have become popular for thoracic surgery. Despite a theoretically favorable safety profile, intercostal spread occurs and systemic toxicity is possible. Pharmacokinetic data are needed to guide safe dosing.MethodsFifteen patients undergoing thoracic surgery received continuous erector spinae plane blocks with ropivacaine 150 mg followed by subsequent boluses of 40 mg every 6 hours and infusion of 2 mg/hour. Arterial blood samples were obtained over 12 hours and analyzed using non-linear mixed effects modeling, which allowed for conducting simulations of clinically relevant dosing scenarios. The primary outcome was the Cmaxof ropivacaine in erector spinae plane blocks.ResultsThe mean age was 66 years, mean weight was 77.5 kg, and mean ideal body weight was 60 kg. The mean Cmaxwas 2.5 ±1.1 mg/L, which occurred at a median time of 10 (7–47) min after initial injection. Five patients developed potentially toxic ropivacaine levels but did not experience neurological symptoms. Another patient reported transient neurological toxicity symptoms. Our data suggested that using a maximum ropivacaine dose of 2.5 mg/kg based on ideal body weight would have prevented all toxicity events. Simulation predicted that reducing the initial dose to 75 mg with the same subsequent intermittent bolus dosing would decrease the risk of toxic levels to <1%.ConclusionLocal anesthetic systemic toxicity can occur with erector spinae plane blocks and administration of large, fixed doses of ropivacaine should be avoided, especially in patients with low ideal body weights. Weight-based ropivacaine dosing could reduce toxicity risk.Trial registration numberNCT04807504; clinicaltrials.gov.

Background and ObjectiveRacial disparities have been documented in care of many respiratory diseases but little is known about the impact of race on the treatment of interstitial lung diseases. The purpose of this study was to determine how race and ethnicity influence treatment of idiopathic pulmonary fibrosis.MethodsAdults with idiopathic pulmonary fibrosis (>18 years) were identified using TriNetX database and paired‐wised comparisons were performed for antifibrotic treatment among White, Black, Hispanic and Asian patients. Mortality of treated and untreated IPF patients was compared after propensity score matching for age, sex, nicotine dependence, oxygen dependence and predicted FVC. Additional comparisons were performed in subgroups of IPF patients older than 65 years of age and with lower lung function.ResultsOf 47,184 IPF patients identified, the majority were White (35,082), followed by Hispanic (6079), Black (5245) and Asian (1221). When subgroups were submitted to matched cohort pair‐wise comparisons, anti‐fibrotic usage was lower among Black patients compared to White (6.2% vs. 11.4%, p‐value <0.0001), Hispanic (10.8% vs. 20.2%, p‐value <0.0001) and Asian patients (9.6% vs. 14.7%, p‐value = 0.0006). Similar treatment differences were noted in Black individuals older than 65 years and those with lower lung function. Mortality among White patients, but not Hispanic, Black, or Asian patients, was lower in patients on antifibrotic therapy versus not on therapy.ConclusionThis study demonstrated that Black IPF patients had lower antifibrotic use compared to White, Hispanic and Asian patients. Our findings suggest that urgent action is needed to understand the reason why racial disparities exist in the treatment of IPF.

This paper seeks to investigate the sneaker trading industry through the analysis of the business model. Through a variety of ways of data collection, including both primary and secondary data, the mechanism of sneaker speculation was able to be found. The analysis of the profit model also helps to explain the reasons for the high-sky prices of sneakers. The buyers of sneakers are composed of two categories: enthusiasts and speculators, where speculators only take up a small proportion. The high prices of sneakers were achieved due to the Hunger Promotion by the suppliers, and the act of sneaker speculation has a lot of similarities to the stock market.