Search

Aims: The epidemiologic Study of Women's Health Across the Nation (SWAN) includes urinary incontinence (UI) questionnaire items. We introduced an independently self-administered paper towel test (PTT-ISA; invention disclosure #2021-347) to objectively demonstrate UI. Aims were to determine: (1) PTT-ISA compliance and (2) relationship to questionnaire results., Methods: 276 community women were invited to complete both SWAN questionnaire and PTT-ISA. For PTT-ISA, a woman holds a trifold brown paper towel against her perineum while coughing hard three times. She checks the towel for wetness and compares it with pictorial showing wetted area gradations (dry towel through >6 ml/saturated). She then selects the best photo match for her towel. A newly conceptualized variable constructed as PTT-ISA plus questionnaire results was formed., Results: Of 276 women, noncompliance with PTT-ISA was 2.2% (6 women). Four others (1.5%) were missing questionnaires. For the remaining 266 women, conceptual cohesiveness between questionnaire-only and PTT-ISA + questionnaire was demonstrated in 165 (62.0%). Lack of cohesiveness occurred in 101 (38.9%), including 41 women who said "no" to the questionnaire item indicative of stress UI and had leakage on PTT-ISA; leakage degree varied across the full pictorial spectrum from drops to saturated., Conclusion: PTT-ISA demonstrates high compliance, with rate comparable to survey compliance. It is a novel measure for objective sign of urine loss when independently self-administered by community women outside of a clinic environment. Further research comparing PTT-ISA with clinician-observed cough test is warranted. As independently self-administered, PTT-ISA is simple, noninvasive, inexpensive, and an acceptable test that adds value to otherwise survey-dependent research., (© 2021 Wiley Periodicals LLC.)

Background: Cough is a common yet distressing symptom that results in significant health care costs from outpatient visits and related consultations., Objective: The understanding of the pathobiology of cough in recent times has undergone an evolution with Cough hypersensitivity syndrome (CHS) being suggested in most cases of dry cough. However, in the case of productive cough, ancillary mechanisms including impaired Mucociliary clearance, in addition to hypermucosecretory bronchospastic conditions of Smoker's cough, asthma-COPD overlap, bronchiectasis, and allergic bronchopulmonary aspergillosis, need to be critically addressed while optimizing patient care with symptomatic therapy in outpatient settings of India., Methods: In this review, evidence-based graded recommendations on use of antitussives - & protussives as a Position Paper were developed based on the Level and Quality of Scientific evidence as per Agency for Health Care and Quality (AHRQ) criteria listing and Expert opinions offered by a multidisciplinary EMA panel in India., Results: Management of acute or chronic cough involves addressing common issues of environmental exposures and patient concerns before instituting supportive therapy with antitussives or bronchodilatory cough formulations containing mucoactives, anti-inflammatory, or short-acting beta-2 agonist agents., Conclusion: The analyses provides a real world approach to the management of acute or chronic cough in various clinical conditions with pro- or antitussive agents while avoiding their misuse in empirical settings., Competing Interests: Declaration of competing interest The listed authors declare and report no conflict of interest for this work and received no honorarium for the development of this Position Paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Following the waning severity of COVID-19 due to vaccination and the development of immunity, the current variants of SARS-CoV-2 often lead to mild upper respiratory tract infections (MURTIs), suggesting it is an appropriate time to review the pathogenesis and treatment of such illnesses. The present article reviews the diverse causes of MURTIs and the mechanisms leading to symptomatic illness. Different symptoms of MURTIs develop in a staggered manner and require targeted symptomatic treatment. A wide variety of remedies for home treatment is available, including over-the-counter drugs and plant-derived substances. Recent pharmacological research has increased the understanding of molecular effects, and clinical studies have shown the efficacy of certain herbal remedies. However, the use of subjective endpoints in these clinical studies may suggest limited validity of the results. In this position paper, the importance of patient-centric outcomes, including a subjective perception of improved well-being, is emphasized. A best practice approach for the management of MURTIs, in which pharmacists and physicians create an improved multi-professional healthcare setting and provide healthcare education to patients, is proposed. Pharmacists act as first-line consultants and provide patients with remedies, considering the individual patient’s preferences towards chemical or plant-derived drugs and providing advice for self-monitoring. Physicians act as second-line consultants if symptoms worsen and subsequently initiate appropriate therapies. In conclusion, general awareness of MURTIs should be increased amongst medical professionals and patients, thus improving their management.

Detecting sputum pyocyanin (PYO) with a competitive immunoassay is a promising approach for diagnosing Pseudomonas aeruginosa respiratory infections. However, it is not possible to perform a negative control to evaluate matrix-effects in competitive immunoassays, and the highly complex sputum matrix often interferes with target detection. Here, we show that these issues are alleviated by performing competitive immunoassays with a paper biosensor. The biosensing platform consists of a paper reservoir, which contains antibody-coated gold nanoparticles, and a substrate containing a competing recognition element, which is a piece of paper modified with an albumin-antigen conjugate. Detection of PYO with a limit of detection of 4.7·10−3 µM and a dynamic range between 4.7·10−1 µM and 47.6 µM is accomplished by adding the sample to the substrate with the competing element and pressing the reservoir against it for 5 min. When tested with patient samples, the biosensor was able to qualitatively differentiate spiked from non-spiked samples, whereas ELISA did not show a clear cut-off between them. Furthermore, the relative standard deviation was lower when determining sputum with the paper-based biosensor. These features, along with a mild liquefaction step that circumvents the use of harsh chemicals or instruments, make our biosensor a good candidate for diagnosing Pseudomonas infections at the bedside through the detection of sputum PYO. [ABSTRACT FROM AUTHOR]

Introduction: Literature is lacking on the safety of storing contaminated PPE in paper bags for reuse, potentially increasing exposure to frontline healthcare workers (HCW) and patients. The aim of this study is to evaluate the effectiveness of paper bags as a barrier for fomite transmission of SARS-CoV-2 by storing face masks, respirators, and face shields. Methods: This quasi-experimental study evaluated the presence of SARS-CoV-2 on the interior and exterior surfaces of paper bags containing PPE that had aerosolized exposures in clinical and simulated settings. Between May and October 2020, 30 unique PPE items were collected from COVID-19 units at two urban hospitals. Exposed PPE, worn by either an infected patient or HCW during a SARS-CoV-2 aerosolizing event, were placed into an unused paper bag. Samples were tested at 30-minute and 12-hour intervals. Results: A total of 177 swabs were processed from 30 PPE samples. We found a 6.8% positivity rate among all samples across both collection sites. Highest positivity rates were associated with ventilator disconnection and exposure to respiratory droplets from coughing. Positivity rates differed between hospital units. Total positivity rates were similar between 30-minute (6.7%) and 12-hour (6.9%) sample testing time intervals. Control samples exposed to inactivated SARS-CoV-2 droplets had higher total viral counts than samples exposed to nebulized aerosols. Conclusions: Data suggests paper bags are not a significant fomite risk for SARS-CoV-2 transmission. However, controls demonstrated a risk with droplet exposure. Data can inform guidelines for storing and re-using PPE in situations of limited supplies during future pandemics. [ABSTRACT FROM AUTHOR]

Cough is a nonspecific and relatively common symptom that can present difficulties in diagnosis and management, particularly when it is reported to be associated with the workplace. The present consensus document, prepared by a taskforce of the Interest Group on Occupational Allergy of the European Academy of Allergy and Clinical Immunology by means of a nonsystematic review of the current literature, is intended to provide a definition and classification of work-related chronic cough (WRCC) to assist the daily practice of physicians facing with this symptom. The review demonstrates that several upper and lower airway work-related diseases may present with chronic cough; hence, the possible link with the workplace should always be considered. Due to the broad spectrum of underlying diseases, a multidisciplinary approach is necessary to achieve a definite diagnosis. Nevertheless, more epidemiological studies are necessary to estimate the real prevalence and risk factors for WRCC, the role of exposure to environmental and occupational sensitizers and irritants in its pathogenesis and the interaction with both upper and lower airways. Finally, the best management option should be evaluated in order to achieve the best outcome without adverse social and financial consequences for the worker., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Most doctors can identify key papers that have influenced their approach to the management of a particular clinical problem, although sometimes the gestation period of this effect can be very prolonged. In this short review I discuss the effects of a seminal paper by Sheila Mackenzie from the early 1990s on my current approach to the diagnosis and management of chronic cough in children.

Objective: To develop and test a simple and rapid method for quantifying the urine loss resulting from three deep coughs using an ordinary brown paper towel., Methods: A brown paper towel is held lightly against the perineum during three single coughs performed in the upright stance. The resulting wetted area was calculated using simple geometry; if desired, leakage volume can be interpolated from a calibration curve, which demonstrates the relationship between wetted area (cm2) and volume (mL) of leakage. Four bench tests of the method were performed. In addition, the test-retest reliability of the method was evaluated in eight elderly women with mild stress urinary incontinence, a sample size adequate to detect a 1-mL difference with 80% power., Results: The smallest measurable quantity of fluid resulted in a wetted area of 0.04 cm2 (equivalent to 0.2 microl). For leakage volumes up to 6 mL, the regression showed that each 1 mL of fluid volume resulted in an average 25.4 cm2 increase in wetted area (coefficient of determination: 0.97). In eight women with stress incontinence 95% of within- and across-visit comparisons of urine loss were within 1 mL., Conclusion: The paper towel test is a simple and reliable measure providing immediate visual and quantitative feedback of cough-related urine loss typical of mild-to-moderate stress urinary incontinence.

Purpose: Cough is a prevalent symptom driving patients to seek medical attention in general practice. Despite its widespread use, the clinical efficacy of oxomemazine, the second most reimbursed molecule in France for symptomatic cough treatment, remains uncertain. This study aims to systematically evaluate the clinical efficacy of oxomemazine in cough., Methods: A systematic literature review with meta-analysis of randomized controlled trials (RCTs) was conducted according to the Rebuild the Evidence Base (REB) protocol. Clinical trials comparing the efficacy of oxomemazine versus placebo or active comparator in cough were searched for. Trials with insufficient data were excluded. Searches were conducted across major databases (Medline, Cochrane Central Register of Controlled Trials, and Embase) and trial registries (World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov). RCTs comparing oxomemazine versus placebo or active comparators in cough were sought. Risk of bias was assessed using the Cochrane Collaboration's RoB2 tool. The protocol was preregistered on PROSPERO under the number CRD42022345496 (15). This study received no funding., Results: No RCTs were at low risk of bias. Therefore, no meta-analysis was conducted, in accordance to the pre-specified protocol., Conclusions: This systematic review highlights the lack of evidence regarding the efficacy of oxomemazine in cough treatment and underscores the need for further well-designed clinical trials to inform its clinical utility in primary care settings., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Allergic asthma (AA) is a common asthma phenotype, and its diagnosis requires both the demonstration of IgE‐sensitization to aeroallergens and the causative role of this sensitization as a major driver of asthma symptoms. Therefore, a bronchial allergen challenge (BAC) would be occasionally required to identify AA patients among atopic asthmatics. Nevertheless, BAC is usually considered a research tool only, with existing protocols being tailored to mild asthmatics and research needs (eg long washout period for inhaled corticosteroids). Consequently, existing BAC protocols are not designed to be performed in moderate‐to‐severe asthmatics or in clinical practice. The correct diagnosis of AA might help select patients for immunomodulatory therapies. Allergen sublingual immunotherapy is now registered and recommended for controlled or partially controlled patients with house dust mite‐driven AA and with FEV1 ≥ 70%. Allergen avoidance is costly and difficult to implement for the management of AA, so the proper selection of patients is also beneficial. In this position paper, the EAACI Task Force proposes a methodology for clinical BAC that would need to be validated in future studies. The clinical implementation of BAC could ultimately translate into a better phenotyping of asthmatics in real life, and into a more accurate selection of patients for long‐term and costly management pathways. [ABSTRACT FROM AUTHOR]

Piper longum (family Piperaceae), commonly known as "long-pepper" or "Pippali" grows as a perennial shrub or as an herbaceous vine. It is native to the Indo-Malaya region and widely distributed in the tropical and subtropical world including the Indian subcontinent, Sri Lanka, Middle-East, and America. The fruits are mostly used as culinary spice and preservatives and are also a potent remedy in various traditional medicinal systems against bronchitis, cough, cold, snakebite, and scorpion-sting and are also used as a contraceptive. Various bioactive-phytochemicals including alkaloids, flavonoids, esters, and steroids were identified from the plant extracts and essential oils from the roots and fruits were reported as antimicrobial, antiparasitic, anthelminthic, mosquito-larvicidal, antiinflammatory, analgesic, antioxidant, anticancer, neuro-pharmacological, antihyperglycaemic, hepato-protective, antihyperlipidaemic, antiangiogenic, immunomodulatory, antiarthritic, antiulcer, antiasthmatic, cardioprotective, and anti-snake-venom agents. Many of its pharmacological properties were attributed to its antioxidative and antiinflammatory effects and its ability to modulate a number of signalling pathways and enzymes. This review comprehensively encompasses information on habit, distribution, ethnobotany, phytochemistry, and pharmacology of P. longum in relation to its medicinal importance and health benefits to validate the traditional claims supported by specific scientific experiments. In addition, it also discusses the safety and toxicity studies, application of green synthesis and nanotechnology as well as clinical trials performed with the plant also elucidating research gaps and future perspectives of its multifaceted uses., (© 2022 John Wiley & Sons Ltd.)

Background: The African continent hosts many industrial mining projects, and many more are planned due to recent prospecting discoveries and increasing demand for various minerals to promote a low-carbon future. The extraction of natural resources in sub-Saharan Africa (SSA) represents an opportunity for economic development but also poses a threat to population health through rapid urbanisation and environmental degradation. Children could benefit from improved economic growth through various channels such as access to high-quality food, better sanitation, and clean water. However, mining can increase food insecurity and trigger local competition over safe drinking water. Child health can be threatened by exposure to mining-related air, noise, and water pollution. To assess the impact of mines on child health, we analyse socio-demographic, health, and mining data before and after several mining projects were commissioned in SSA., Results: Data of 90,951 children living around 81 mining sites in 23 countries in SSA were analysed for child mortality indicators, and 79,962 children from 59 mining areas in 18 SSA countries were analysed for diarrhoea, cough, and anthropometric indicators. No effects of the launch of new mining projects on overall under-five mortality were found (adjusted Odds Ratio (aOR): 0.88; 95% Confidence Interval (CI): 0.68-1.14). However, activation of mining projects reduced the mortality risk among neonates (0-30 days) by 45% (aOR: 0.55; 95% CI: 0.37-0.83) and risk for a child to develop diarrhoeal diseases by 32% (aOR: 0.68; 95% CI: 0,51-0.90). The timing analysis of observed changes showed that there is a significant decline in the risk for childhood diarrhoea (aOR: 0.69; 95% CI: 0.49-0.97), and the mean height-for-age z-scores by 28 percentage points, during the prospection and construction phase; i.e., within four years to the initiation of extraction activity. No effects were found for cough and weight-for-height., Conclusion: The results presented suggest that the impacts of mining on child health vary throughout the mine's life cycle. Mining development likely contributes positively to the income and livelihoods of the impacted communities in the initial years of mining operations, particularly the prospection and construction phase; these potential benefits are likely to be at least partially offset by food insecurity and environmental pollution during early and later mining stages, respectively. Further research is warranted to better understand these health impacts and to identify policies that can help sustain the positive initial health impacts of mining projects in the long term., (© 2022. The Author(s).)

Head orientations directly determine movement directions of exhaled pathogen-laden droplets, while there is a lack of research about the effect of the infected person's head orientations on respiratory disease transmission during close contact. This work experimentally investigated the effect of different head orientations of an infected person (IP) on the bioaerosol deposition on a healthy person (HP) during close contact. Also, the effectiveness of PV flow in reducing bioaerosol deposition on the HP under the IP's different head orientations was investigated. Bacteriophage T3 was employed to represent viruses inside the cough-generated aerosols. The bioaerosol depositions on different locations of the HP's upper body (chest, shoulder, and neck) and face (chin, mucous membranes, cheek, and forehead) were characterized by a cultivation method. Results showed that the IP's different head orientations resulted in significantly different deposition density on the HP. PV flow could reduce the bioaerosol deposition remarkably for most cases investigated. The effectiveness of PV flow in reducing deposition on the HP was significantly affected by the IP's head orientations. Findings suggest that changing head orientations can be a control measure to reduce the bioaerosol deposition. Personalized ventilation can be a potential method to reduce the bioaerosol deposition on the HP., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The article discusses patients with chronic obstructive pulmonary disease, and mentions the addition of oscillatory positive expiratory pressure to usual care improves cough-specific and general quality of life.

Background: Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different specialists would be highly recommended, but its implementation in clinical practice suffers from the lack of shared protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues., Aims: To develop evidence-based recommendations for the management of adults with CC., Methods: A 12-member expert task force of general practitioners, geriatricians, pneumologists, allergologists, otorhynolaringologists and gastroenterologists was established to develop evidence-based recommendations for the diagnostic and therapeutic approach to subjects with CC. A modified Delphi approach was used to achieve consensus, and the US Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence., Results: A total of 56 recommendations were proposed, covering 28 topics and concerning definitions and epidemiology, pathogenesis and etiology, diagnostic and therapeutic approach along with the consideration of specific care settings., Conclusion: These recommendations should ease the management of subjects with CC by coordinating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The post-viral acute cough is the most common symptom in childhood. Consequently, the use of cough relievers is frequent. Many products for treating cough contain natural components. An ancient tradition has always established herbal medicine and honey as effective and safe means to relieve cough. Nevertheless, very few studies adequately investigated the real effectiveness and safety of natural products in treating acute cough. There is some evidence, provided by pediatric randomized controlled trials, about honey, one multicomponent product (containing Plantagolanceolata, Grindelia robusta, Helichrysum italicum , and honey), and Pelargonium sidoides . Other group of substances, including glycerol and isolated natural compounds, can help manage cough but robust evidence still lacks in children. There is an urgent need to perform rigorous studies that confirm the natural products' efficacy and safety for relieving post-viral acute cough. Key points : Acute post-viral cough is prevalent in childhood and adolescence. There is a growing interest concerning the use of natural remedies for post-viral cough. Many herbal medicines could be used satisfactorily for this issue., Competing Interests: The authors declare that they have no competing interests.

Objectives: In hospitalized and nonhospitalized children with asthma exacerbations, we evaluated the determinants of (a) prolonged cough on day-14 and (b) asthma quality of life (QoL) questionnaires for parents (PACQLQ) on day-21. We hypothesized that children with more severe acute asthma are more likely to have prolonged cough and/or poorer PACQLQ during the recovery phase., Design: Prospective cohort study performed during 2009-2011., Methodology: Two hundred and forty-four children aged 2-16 years presenting with acute asthma to the Emergency Departments of two hospitals were recruited. Clinical history, examination, baseline asthma severity, and acute asthma severity on presentation were documented. Validated daily cough diaries and weekly PACQLQ were recorded for 14 and 21 days, respectively., Results: 34.4% and 32.2% of children who returned the daytime and nighttime cough diaries respectively had a prolonged cough. Those on regular inhaled corticosteroids (ICS) were significantly more likely to have a daytime or nighttime cough score of ≥1 on day-14 (odds ratio [OR adjusted ] = 4.70, 95% confidence interval [CI] 1.65, 13.35, p = .004 and OR adjusted  = 2.65, 95% CI 1.05, 6.69, p = .040, respectively). PACQLQ on day-21 was significantly poorer in younger children (mean difference [MD] = -0.04 per year, 95% CI -0.08, -0.01, p = .016), those on ICS (MD = -0.31, 95% CI -0.52, -0.09, p = .005), leukotriene antagonists (MD = -0.42, 95% CI -0.83, -0.02, p = .040) and in those who had an unplanned visit for asthma on day-21 (MD = -1.20, 95% CI -1.61, -0.78, p = .0001)., Conclusions: Post an acute asthma exacerbation, children on regular ICS were more likely to have prolonged cough and poorer QoL. While this may be reflective of asthma severity or control, its association deserves further evaluation., (© 2020 Wiley Periodicals LLC.)

Cough and dyspnea are among the most common symptoms in primary medical care and potentially threatening diseases must be excluded in a timely manner, especially acute heart failure and its causes, pneumonia, pleural effusion, pulmonary embolism and pneumothorax. Anamnesis, inspection, physical examination and technical basic diagnostics are usually sufficient for an initial risk stratification. A reliable suspected diagnosis can often be made in this way; however, it is not uncommon for the findings to be ambiguous. Chest X‑ray diagnostics and laboratory diagnostics are established as the standard approach for these situations; however, a major limitation of these diagnostic techniques is the lack of immediate availability in the general practitioner's office and laboratory results are not available until the next day or the day after. Furthermore, the sensitivity and specificity of these diagnostic procedures are limited but often overestimated, especially in the case of mild to moderately pronounced alterations and in early stages of a disease. Thoracic sonography can be used in these situations as a direct extension of the physical examination. Its diagnostic value is undisputed. The most important pathological findings, such as pleural effusion and subpleural consolidations can be immediately visualized with sufficient certainty using miniaturized handheld ultrasound devices. The concept of the ultrasound stethoscope, which has been under discussion for more than 15 years, can also be implemented as point-of-care ultrasound (POCUS). The POCUS will become established as routine diagnostics in the future, for example in emergency outpatient diagnostics. It is time for pulmonary ultrasound to be added to the repertoire of primary care diagnostics.

Twenty six papers were presented as posters in the Seventh International Symposium on Cough; 12 papers were presented in the Basic Science of Cough session, and 14 papers presented in the Clinical Science of Cough session. These papers explored a wide spectrum of cough-related areas including pathophysiological mechanisms, treatment and detection of cough, and symptom assessment and perception, and were grouped into several general themes for facilitate the discussion. Studies presented in these posters have provided new information that should improve our knowledge on the basic physiology and pharmacology of cough, and the peripheral and central neural mechanisms involved in the generation of the cough motor pattern. In addition, in the clinical science section, studies reporting potential new anti-tussive agents and further characterisation of cough symptoms and perception have provided a base for the fruitful strategies for the development of novel anti-tussive therapies and cough management. [ABSTRACT FROM AUTHOR]

This paper introduces an innovative technique for creating a cough detection system that relies on speech recognition algorithms. The strategy utilizes the Kaldi platform, which is open source and incorporates a hybrid system of Gaussian Mixture Model-based Hidden Markov Models (GMM-HMM) through a straightforward monophone training model. Additionally, the study examines the effectiveness of two different feature extraction approaches, Mel Frequency Cepstral Coefficient (MFCC) and Perceptual Linear Prediction (PLP). The proposed system can function as a collection tool for gathering natural and spontaneous cough data from conversations or continuous speech. The paper also compares the Kaldi and CMU Sphinx4 toolkits, concluding that Kaldi's use of GMM-HMM outperforms CMU Sphinx4. [ABSTRACT FROM AUTHOR]

Ethnopharmacological Relevance: Bronchitis is a respiratory disease characterized by a productive cough. Polygala tenuifolia Willd., commonly known as Yuan zhi, is a traditional Chinese herbal medicine used for relieving cough and removing phlegm. Despite its historical use, studies are lacking on the effectiveness of P. tenuifolia in treating bronchitis. Furthermore, the molecular mechanisms underlying the action of its bioactive compounds remain unknown., Aim of the Study: This study aims to identify the main bioactive compounds responsible for the effects of P. tenuifolia liquid extract (PLE) in treating bronchitis and to elucidate the associated molecular mechanisms., Materials and Methods: The main chemical compounds in PLE were identified and determined using ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The antitussive, expectorant and anti-inflammatory activities of PLE were evaluated in an ammonia-induced mouse cough model, a tracheal phenol red excretion mouse model, and a xylene-induced ear swelling mouse model, respectively. A network pharmacology analysis was conducted to investigate the associated gene targets, gene ontology, and KEGG pathways related to the main bioactives in PLE targeting bronchitis. PLE and its five bioactive compounds were assessed for their potential anti-inflammatory activities in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Western blot analysis was conducted to elucidate the associated molecular mechanisms., Results: Thirty-seven compounds in PLE were identified, and twelve main compounds were further quantified in PLE using UPLC-MS/MS. PLE oral gavage administrations (0.6 and 0.12 mg/kg) for 7 days markedly reduced cough frequency, prolonged latency period of cough, reduced phlegm and inflammation in mice. The network pharmacology analysis identified 57 gene targets of PLE against bronchitis. The PI3K/AKT and MAPK signalling pathways were the top two modulated pathways. In RAW264.7 cells, PLE (12.5-50 μg/mL) significantly reduced cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α. PLE downregulated LPS-elevated protein targets in both PI3K/AKT and MAPK signaling pathways. In PLE, tenuifolin, polygalaxanthone ⅠⅠⅠ, polygalasaponin ⅩⅩⅤⅢ, tenuifoliside B, and 3,6'-Disinapoyl sucrose, were identified as the top five core components responsible for treating bronchitis. These compounds were also found to modulate the protein targets in the PI3K/AKT and MAPK signalling pathways., Conclusions: This study demonstrated the potential therapeutic effects of PLE on bronchitis by reducing cough, phlegm and inflammation. The anti-inflammatory action and molecular mechanisms of the 5 main bioactive compounds in PLE were partly validated through the in vitro assays. The findings provide valuable insights into the mechanisms underlying the traditional use of PLE for bronchitis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Spirometry and peak cough flow testing (PCF) are commonly used in the respiratory assessment of children with a neuromuscular disorder (NMD). Testing uses two different machines, increases laboratory time, costs and resource utilisation. No studies have assessed the correlation between peak expiratory flow (PEF) obtained from spirometry and PCF in children with NMD using one device. An audit of children with a NMD managed at the Children's Hospital at Westmead in 2022-2024 aged < 20 years who performed spirometry and PCF testing on the same device (Vyaire Body Box TM , Ultrasonic flow meter-based, or Vyaire Pneumotachograph TM , Pneumotach flow meter-based; Germany) was conducted to assess the correlation between PCF and PEF. Fifty-one sets of testing were identified, and 40 subjects (9F) had reproducible testing and were included. Median (range) age was 14.95 (7.20-19.00) years. Median PEF (L/min) was 4.05 (1.22-10.26) and median PCF (L/min) was 4.29 (1.69-10.82). PEF and PCF had a strong Pearson's correlation coefficient, (R = 0.97, p = 0.03). The coefficient of determination was 0.93. If laboratory resources permit, spirometry should be the test of choice for children with NMD. On average, spirometry required multiple practices to achieve reproducibility to meet ATS/ERS standards. PCF testing can be utilised for children where performing technically acceptable spirometry is not possible., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: Chronic cough affects around 10 % of the general adult population, impairing all aspects of quality of life., Research Question: What are the Leicester Cough Questionnaire's psychometric properties?, Study Design and Methods: Electronic searches of PubMed, CINAHL, and ScienceDirect databases were conducted from inception until October 1rst 2022. All full-text articles, published in French or English, aimed at evaluating the LCQ's content validity or psychometric properties were included. The COSMIN Risk of Bias checklist was applied to assess their methodological quality and results. Results were qualitatively summarised and rated by a modified GRADE approach., Results: 40 studies were included accounting for 8731 adults, subject to cough or a respiratory condition. Chronic cough (>8 weeks) was the most represented. The LCQ's total score is relevant and comprehensible for the assessment of the impact of cough on QoL. The original 3-factor model showed a satisfactory model fit. Good convergent validity was found for the total and physical domain scores. These scores demonstrate good internal consistency and test retest reliability, with some variability noted and they are responsive to change. Recent estimates of MID thresholds were 1.7 and 0.4 for total and domain scores respectively. The quality of the studies is globally poor., Interpretation: The LCQ is a valid outcome to assess the intra-individual impact of cough on QoL and to detect large changes in quality of life mainly in a short-term clinical trial setting., Clinical Trial Registration: The protocol was registered with PROSPERO (CRD42022355191)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. A member of the review team is also an author of one of the included validation studies(1)., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Respiratory diseases are one of the major health problems worldwide. Early diagnosis of the disease types is of vital importance. As one of the main symptoms of many respiratory diseases, cough may contain information about different pathological changes in the respiratory system. Therefore, many researchers have used cough sounds to diagnose different diseases through artificial intelligence in recent years. The acoustic features and data augmentation methods commonly used in speech tasks are used to achieve better performance. Although these methods are applicable, previous studies have not considered the characteristics of cough sound signals. In this paper, we designed a cough-based respiratory disease classification system and proposed audio characteristic-dependent feature extraction and data augmentation methods. Firstly, according to the short durations and rapid transition of different cough stages, we proposed maximum overlapping mel-spectrogram to avoid missing inter-frame information caused by traditional framing methods. Secondly, we applied various data augmentation methods to mitigate the problem of limited labeled data. Based on the frequency energy distributions of different diseased cough audios, we proposed a parameter-independent self-energy-based augmentation method to enhance the differences between different frequency bands. Finally, in the model testing stage, we leveraged test-time augmentation to further improve the classification performance by fusing the test results of the original and multiple augmented audios. The proposed methods were validated on the Coswara dataset through stratified four-fold cross-validation. Compared to the baseline model using mel-spectrogram as input, the proposed methods achieved an average absolute performance improvement of 3.33% and 3.10% in macro Area Under the Receiver Operating Characteristic (macro AUC) and Unweighted Average Recall (UAR), respectively. The visualization results through Gradient-weighted Class Activation Mapping (Grad-CAM) showed the contributions of different features to model decisions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Radon decay products attach to particulate matter (referred to as particle radioactivity, PR) has been shown to be potential to promote airway damage after inhalation. In this study, we investigated associations between PR with respiratory symptoms and health-related quality of life (HRQL) in patients with COPD. 141 male patients with COPD, former smokers, completed the St. George's Respiratory Questionnaire (SGRQ) after up to four 1-week seasonal assessments (N=474) of indoor (home) and ambient (central site) particulate matter ≤ 2.5 µm in diameter (PM 2.5 ) and black carbon (BC). Indoor PR was measured as α-activity (radiation) on PM 2.5 filter samples. The ratio of indoor/ambient sulfur in PM 2.5 (a ventilation surrogate) was used to estimate α-PR from indoor radon decay. SGRQ responses assessed frequent cough, phlegm, shortness of breath, wheeze, and chest attacks in the past 3 months. Multivariable linear regression with generalized estimating equations accounting for repeated measures was used to explore associations, adjusting for potential confounders. Median (IQR) indoor α-PR was 1.22 (0.62) mBq/m 3 . We found that there were positive associations between α-PR with cough and phlegm. The strongest associations were with estimated α-PR of indoor origin for cough (31.1 % increase/IQR, 95 %CI: 8.8 %, 57.8 %), and was suggestive for phlegm (13.0 % increase/IQR, 95 %CI: -2.5 %, 31.0 %), similar adjusting for indoor BC or PM 2.5 . α-PR of indoor origin was positively associated with an increase in SGRQ Symptoms score [1.2 units/IQR; 95 %CI: -0.3, 2.6] that did not meet conventional levels of statistical significance. Our results suggested that exposure to indoor radon decay products measured as particle radioactivity, a common indoor exposure, is associated with cough, and suggestively associated with phlegm and worse HRQL symptoms score in patients with COPD., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Zhi-Ke-Bao pills (ZKB), a traditional Chinese medicine preparation composed of 13 herbs, is generally used to treat cough caused by external wind cold, phlegm, etc in clinical applications, and it plays a core role in relieving cough caused by COVID-19 and influenza in China. Till now, the understanding of its chemical constituents was dramatically limited due to its chemical complexity, restricting its clinical application or development. In this work, a developed ultra-high performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF MS) method, a targeted and non-targeted strategy and network pharmacology were used to comprehensively characterize the chemical compositions in ZKB and predict its mechanism against cough. A total of 164 compounds (148 targeted compounds and 16 non-targeted ones) were identified or tentatively characterized in ZKB, including 65 flavonoids, 25 alkaloids, 19 organic acids, 41 saponins, 9 coumarins, 2 phenylpropanoids, 2 anthraquinones, and 1 other types. Among them, 37 compounds were unambiguously identified by comparison to reference standards. Meanwhile, the fragmentation behaviors of five main chemical structure types were also summarized. 309 targets and two core signaling pathways of ZKB against cough were predicted by network pharmacology, including MAPK and PI3K-Akt signaling pathways. It was the first time to characterize the chemical compounds of ZKB and reveal its potential mechanism against cough, providing the material basis for further quality control or pharmacodynamic evaluation of ZKB., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Feng-Xiang Zhang reports financial support was provided by Teyi Pharmaceutical Group Co., Ltd. Qing-Min Zhang reports a relationship with Teyi Pharmaceutical Group Co., Ltd that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Decreased cough strength in myasthenia gravis (MG) leads to aspiration and increases the risk of MG crisis. The aim of this study was to clarify the reliability and validity of cough peak flow (CPF) measurements in MG. A total of 26 patients with MG who underwent CPF measurements using the peak flow meter by themselves were included. MG symptoms were evaluated by pulmonary function tests and clinical MG assessment scales before and after immune-treatments. The relationship between CPF and pulmonary function tests and MG comprehensive were assessed. The cut-off value of CPF for aspiration risk was determined and the area under the curve (AUC) was calculated. The intraclass correlation coefficient was more than 0.95 for pre-and post-treatment. Positive correlations were found between CPF and almost all spirometric values as well as between the differences of pre-and post-treatment in CPF and quantitative myasthenia gravis score. The CPF for identifying the aspiration risk was used to calculate the CPF cut-off value of 205 L/min with a sensitivity of 0.77, specificity of 0.90, and AUC of 0.85. The CPF, a convenient measure by patients themselves, has a high reliability in patients with MG, and is a useful biomarker reflecting MG symptoms., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background. The impact of SARS-CoV-2 infection alongside with influenza and RSV, the major viral agents in pediatric disordes, may be an important concern to the healthcare system. Clinical outcomes of the interaction are unknown. The aim of this systematic review is to contribute at establishing the prevalence of the co-infection, its clinical outcomes and potential risk factors. Methods. A systematical literature search was performed for papers published in PubMed, Scopus, Web of Science, Pedro and Cochrane Library, from January 2020 - the beginning of the COVID 19 pandemic - to June 2023. Our review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Studies were eligible for inclusion if they approached the co-infection COVID 19 and influenza or RSV, and were available in English. Due to the fact that studies conducted on pediatric population are scarce, we included patients of all ages. Results. Out of 159 articles found, 12 were eligible for inclusion. The prevalence of co-infection was between 5% and 12 % for influenza viruses and 10% for RSV. The most common symptoms were high-grade fever, cough, headache, and shortness of breath and the most frequent complications were pneumonia and respir-atory distress. In terms of laboratory findings, co-infected patients presented with signifi-cant lymphopenia and pronounced inflammatory response, as well as a progressive ten-dency towards pneumonia and respiratory distress. Regarding the clinical outcomes of co-infection, the majority of articles indicated that simultaneous infection with SARS-CoV-2 and influenza predisposes to a more severe course of the disease(s), with a longer length of hospital stay and an increased risk of death. Conclusion. Our study underlines that the frequency of such co-infections, although not very high, predisposes to more frequent hos-pitalisations and a longer length of stay, complications including admission to intensive care and more severe outcomes, including life-threatening events. It is therefore essential to determine the epidemiological impact of such an interaction nowadays, in order to in-form and adjust treatment and control and prevention strategies, for limiting co-infection between major respiratory viruses. Due to the lack of studies on children, we were unable to identify specific features of co-infections in this population. Therefore, more studies are needed to evaluate the paediatric population and consequently, our doctoral research en-deavour is warranted. [ABSTRACT FROM AUTHOR]

A cohort study spanning ten years was conducted to assess the health effects on toner manufacturing workers. A survey consisting of questions investigating subjective respiratory symptoms, current medical history, disease occurrence, dust exposure concentrations at the workplace, respiratory function tests, biochemical and immunological items in blood and urine, and a chest radiograph or chest computed tomography survey was conducted. The results of these surveys have been published in academic journals, and none of the surveys showed any findings suggesting significant health problems in the toner-worker group compared to the non-toner-worker group. The results suggest that the health risks associated with toner handling are not high when the work environment at the toner handling site is well controlled. [ABSTRACT FROM AUTHOR]

Background: As the global community begins recovering from the COVID-19 pandemic, the challenges due to its aftermath remain. This health crisis has highlighted challenges associated with airborne pathogens and their capacity for rapid transmission. While many solutions have emerged to tackle this challenge, very few devices exist that are inexpensive, easy to manufacture, and versatile enough for various settings., Methods: This paper presents a novel suction device designed to counteract the spread of aerosols and droplets and be cost-effective and adaptable to diverse environments. We also conducted an experimental study to evaluate the device's effectiveness using an artificial cough generator, a particle counter, and a mannequin in an isolated system. We measured droplet removal rates with simulated single and repeated cough incidents. Also, measurements were taken at four distinct areas to compare its effectiveness on direct plume versus indirect particle removal., Results: The device reduced airborne disease transmission risk, as evidenced by its capacity to decrease the half-life of aerosol volume from 23.6 minutes to 15.6 minutes, effectively capturing aerosol-sized droplets known for their extended airborne persistence. The suction device lessened the peak total droplet volume from peak counts. At 22 minutes post peak droplet count, the count had dropped 24% without the suction device and 43% with the suction device., Conclusions: The experiment's findings confirm the suction device's capability to effectively remove droplets from the environment, making it a vital tool in enhancing indoor air quality. Given the sustained performance of the suction device irrespective of single or multiple cough events, this demonstrates its potential utility in reducing the risk of airborne disease transmission. 3D printing for fabrication opens the possibility of a rapid iterative design process, flexibility for different configurations, and rapid global deployment for future pandemics., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lordly et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)