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Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by pulmonary and systemic inflammation. Inflammatory mediators show relationships with shortness of breath, exercise intolerance and health related quality of life. Pulmonary rehabilitation (PR), a comprehensive education and exercise training programme, is the most effective therapy for COPD and is associated with reduced exacerbation and hospitalization rates and increased survival. Exercise training, the primary physiological intervention within PR, is known to exert a beneficial anti‐inflammatory effect in health and chronic diseases. The question of this review article is whether exercise training can also make such a beneficial anti‐inflammatory effect in COPD. Experimental studies using smoke exposure mice models suggest that the response of the immune system to exercise training is favourably anti‐inflammatory. However, the evidence about the response of most known inflammatory mediators (C‐reactive protein, tumour necrosis factor α, interleukin 6, interleukin 10) to exercise training in COPD patients is inconsistent, making it difficult to conclude whether regular exercise training has an anti‐inflammatory effect in COPD. It is also unclear whether COPD patients with more persistent inflammation are a subgroup that would benefit more from hypothesized immunomodulatory effects of exercise training (i.e., personalized treatment). Nevertheless, it seems that PR combined with maintenance exercise training (i.e., lifestyle change) might be more beneficial in controlling inflammation and slowing disease progress in COPD patients, specifically in those with early stages of disease. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionOxidative stress plays a crucial role in the development of multiple chronic respiratory diseases. Oxidative Balance Score (OBS) composing of 16 dietary factors and 4 lifestyle factors has been developed to evaluate the effect of oxidants/antioxidants produced by dietary intake and lifestyle habits on the overall oxidative balance. However, the relationships between OBS with asthma, COPD, and asthma-COPD overlap (ACO) are still unclear.A total of 10,942 adults aged 20 years and older from the 2013-2018 National Health and Nutrition Examination Survey were included in the analyses. ANOVA and chi-square tests were used to compare characteristics between different OBS subgroups.Multiple multivariate logistic regression was used to analyze the associations between OBS and asthma, COPD, and ACO.RCS curves were used to describe the dose-response effect of the associations. Subgroup analyses and interaction effects were employed to reflect the stability of the associations.In the fully adjusted models, OBS was found to be negatively associated with asthma, COPD, and ACO. OBS at Q2, Q3, and Q4 (OR: 0.66, 95% CI: 0.46-0.97) were negatively associated with the risk of asthma. OBS at Q2 and Q4 were negatively associated with the risk of COPD. OBS at Q2 and Q4 were negatively associated with the risk of ACO. The RCS curves reflected the negative dose-response trend of association. Moreover, the associations were stable in various subgroups.The negative associations between OBS and asthma, COPD, and ACO were found in American adults, providing evidence for dietary and lifestyle prevention. [ABSTRACT FROM AUTHOR]

ABSTRACT Deep lung delivery is crucial for respiratory disease treatment. Although nano and submicron particles exhibited a good deposition efficiency in deep regions of the lung, powder nonuniformity and particle agglomeration reduce their efficiency. Inhalation of porous particles (PPs) can overcome the mentioned challenges due to their larger size and low‐density. The present study numerically investigates the deposition and penetration efficiency of orally inhaled PPs. A revised drag coefficient was implemented for PP transport. A realistic mouth–throat to the fifth generation of the lung was reconstructed from CT‐scan images. A dilute suspension of uniformly distributed particles was considered at three inhalation flow rates (15, 30, and 45 L/min). Governing equations of the flow field and particle transport are solved using an Eulerian–Lagrangian approach. The results demonstrate that inhaling PPs significantly reduces the total and regional deposition of particles. There was also a critical porosity value under moderate and high inhalation flow rates for large PPs. Below this critical value, PP deposition efficiency substantially decreases. Additionally, it was also found that under low inhalation flow rates, the impact of porosity value is negligible. Almost 95% of the PPs penetrate the lower branches. These findings provide particle engineers and pharmaceutics with profound insight into developing novel inhalation techniques and drug delivery methods for deep lung delivery. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between dietary flavonoids and bronchitis, emphysema and asthma. Method: A total of 11743 United States adults were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2007–2008, 2009–2010 and 2017–2018. Of these, 47.7% were male and 52.3% female. Dietary flavonoid intake assessed using FDNNS and 24-hour dietary recall data. Inclusion of demographics (gender, age, education, family income), behavioral factors (BMI, smoking, drinking status, diet), chronic disease information (diabetes, hypertension) as covariates to eliminate confounding. Stepwise logistic regression was used to analyze the association between total dietary flavonoid intake and the risk of chronic respiratory disease. Weighted quantile sum regression (WQS) was used to analyze the association between 29 dietary flavonoids and the risk of chronic respiratory disease. Restricted cubic spline was used to analyze the dose-response relationship between dietary flavonoid intake and risk of chronic respiratory disease. Results: Stepwise logistic regression results showed that higher flavonoid intake in men was associated with a lower risk of CB and asthma (OR of CB: 0.55(0.31–0.97); OR of asthma: 0.72(0.52–0.99)), and WQS results showed a mixed health effect for total flavonoids and chronic respiratory tract in response to the 29 flavonoid fractions (OR of asthma: 0.97(0.94–0.99); OR of emphysema: 0.95(0.90–0.99)). Glycitein had the highest health contribution of 26.2% for emphysema; Eriodictyol had the highest health contribution of 32.13% for asthma, respectively. The RCS showed a dose-response relationship between flavonoids and respiratory tract health. The maximum dose for ingesting flavonoids to gain respiratory health benefits is 1500 mg/d. Conclusion: Higher dietary flavonoid intake was associated with lower chronic respiratory risk in adult U.S. men. Also 29 dietary flavonoid components have an overall health effect on respiratory health. Glycitein and Eriodictyol may have potential health effects on the respiratory system. 1500 mg/day may be the Tolerable Upper Intake Level of dietary flavonoids for respiratory health in U.S. adults. [ABSTRACT FROM AUTHOR]

Respiratory pathogen infections are seasonally prevalent and are likely to cause co-infections or serial infections during peak periods of infection. Since they often cause similar symptoms, simultaneous and on-site detection of respiratory pathogens is essential for accurate diagnosis and efficient treatment of these infectious diseases. However, molecular diagnostic techniques for multiple pathogens in this field are lacking. Herein, we developed a microfluidic LAMP and real-time fluorescence assay for rapid detection of multiple respiratory pathogens using a ten-channel microfluidic chip with pathogen primers pre-embedded in the chip reaction well. The microfluidic chip provided a closed reaction environment, effectively preventing aerosol contamination and improving the accuracy of the detection results. Its corresponding detection instrument could automatically collect and display the fluorescence curve in real time, which was more conducive to the interpretation of results. The results showed that the developed method could specifically recognize the nucleic acid of influenza A(H1N1), Mycoplasma pneumoniae, respiratory syncytial virus type A, and SARS-CoV-2 with low detection limits of 104 copies per mL or 103 copies per mL. The test results on clinical samples demonstrated that the developed method has high sensitivity (92.00%) and high specificity (100.00%) and even has the capability to differentiate mixed-infection samples. With simple operation and high detection efficiency, the present portable and simultaneous detection assay could significantly improve the efficiency of on-site detection of respiratory infectious diseases and promote the accurate treatment, efficient prevention and control of the diseases. [ABSTRACT FROM AUTHOR]

Introduction: Narrowed tracheal lumen diameter (TLD) in dogs caused by congenital hypoplasia or acquired tracheal stenosis can result in adverse health effects. Standardized tracheal scores calculated from radiographic measurements have been used to assess tracheal diameter however comparisons have not been made to characterize differences in tracheal lumen among breeds. Methods: The main objective of this study was to compare tracheal scores at three regions of the trachea among non-brachycephalic dogs, non-bulldog brachycephalic dogs, and bulldogs. Medical records and thoracic radiographs of clinically normal dogs were reviewed. The TLDs 79 of three different tracheal regions (caudal cervical, thoracic inlet, and intrathoracic) were standardized by the manubrium length (ML) and thoracic inlet distance (Ti-D) to calculate the manubrium and thoracic inlet tracheal indexes (M-TI and Ti-TI) at each region. Statistical analysis was used to analyze the differences in tracheal scores among the three breed populations. Results: Overall, M-TI and Ti-TI varied significantly (p < 0.0001) at the three tracheal levels among the three breed populations. Bulldogs and non-bulldog brachycephalic breeds possessed lower (p < 0.016) M-TI and Ti-TI than nonbrachycephalic breeds at the three tracheal regions, and bulldogs possessed the lowest M-TI and Ti-TI scores at all measured regions. Conclusion: Averaged M-TIs <0.38, <0.34, <0.32 in non-brachycephalic, nonbulldog brachycephalic, and bulldog breeds, respectively, may indicate tracheal hypoplasia. Utilizing M-TI can be recommended for the assessment of canine TLD however further investigation in dogs with concurrent respiratory diseases is warranted. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus is a versatile bacterium responsible for conditions ranging from mild skin and soft-tissue infections to serious disorders such as pneumonia and sepsis. Monocytes play a role in protection against pathogens by migrating to inflamed tissues and differentiating into macrophages but their specific role in the context of S. aureus pulmonary infection has not been fully elucidated. Using a CCR2-DTR transgenic mouse model we demonstrate that over the course of infection monocyte depletion resulted in worse airway clearance of S. aureus. The bronchoalveolar lavage fluid (BALF) of CCR2-DTR mice after S. aureus infection displayed significant decreases in interleukin-12 (IL-12), IFN-γ, IP-10, MIG and RANTES, all IFN-γ regulated, compared to wild-type (WT) infected controls. NK cells were identified as the main producers of IFN-γ, but both NK cells and IFN-γ were dispensable for clearance. We demonstrated through cytokine production and RNA-seq analysis that IL-12 and IL-12 regulated genes are strongly induced in monocytes upon S. aureus infection. Administration of IL-12 during infection restored the bacterial burdens in the BALF and lungs of monocyte-depleted CCR2-DTR mice to the levels of WT mice, independent of IFN-γ. In the absence of monocytes, alveolar macrophages are the primary phagocytic cells, and IL-12 influences their capacity to produce reactive oxygen species and clear S. aureus. These results show that production of IL-12 contributes to the control of S. aureus via its influence on alveolar macrophage function. Author summary: Staphylococcus aureus is an important cause of infections across numerous bodily sites. One area of significant disease is the respiratory tract, leading to pneumonia. The monocyte is a cell of the immune system that is recruited to the airway during infection. The full role this cell plays during S. aureus infection is not completely understood. We show here that it is important for clearance of S. aureus from the airway. We also demonstrate that its role is not in direct bacterial clearance but through effects exerted upon another cell, the alveolar macrophage. We show that monocytes secrete important signaling molecules, including one, IL-12, that impacts the capacity of the alveolar macrophage kill S. aureus. This work demonstrates that different cells of the immune system can accentuate the antimicrobial ability of other cell types during infection. [ABSTRACT FROM AUTHOR]

ABSTRACT Asafoetida is an oleo–gum‐resin mainly obtained from Ferula foetida in eastern Iran, which is employed for the treatment of stomachaches, acid reflux, nervous system disorders and respiratory diseases. Asafoetida has attracted the attention of researchers due to its sulfide compounds and their proven effects on respiratory illnesses. In this study, the shelf stability of supplement of F. foetida's oleo–gum‐resin by quantifying two key sulfide compounds including E/Z‐sec‐butyl propenyl disulfane and E/Z‐(methylthio)propyl 1‐propenyl disulfane was evaluated by 1H NMR (qH NMR) and gas chromatography–mass spectrometry (GC–MS). The similar results were obtained in both qH NMR and GC–MS methods. The qH NMR method showed good linearity in the ranges of 2–12 mg/mL for E/Z‐sec‐butyl propenyl disulfane and 2.2–17 mg/mL for E/Z‐(methylthio) propyl 1‐propenyl disulfane with a correlation coefficient of 0.99 and acceptable stability (RSD% ≤ 2.72%) for the quantification of the compounds. Therefore, despite the volatility of disulfide compounds and according to the results, the qH NMR method could be considered adequate method for quantifying these compounds in supplements containing the volatile components that requires extra extraction steps before analyses by other method. [ABSTRACT FROM AUTHOR]

Background Data on the true prevalence of respiratory syncytial virus (RSV) among medically attended acute respiratory illnesses (MAARI) has been limited by the lack of regular clinical testing of mild to moderate illnesses. Here we present a prospective evaluation of the epidemiology of RSV-associated MAARI across age groups and multimorbidity status over 3 seasons, which is informative in light of the recommendations for shared decision making for vaccination in older adults. Methods Ambulatory patients ≥6 months of age meeting a common MAARI case definition were prospectively enrolled in the Michigan Ford Influenza Vaccine Effectiveness (MFIVE) study, a subsite of the US Influenza Vaccine Effectiveness Network. All participants were tested by nasal-throat swab for RSV and influenza, including subtype, independently from clinician-directed testing. Participant illness characteristics and calculated multimorbidity-weighted index (MWI) were collected by in-person survey and electronic medical record review. Results Over 3 surveillance seasons (fall 2017 to spring 2020), 9.9% (n = 441) of 4442 participants had RSV detected. RSV-associated MAARI was more prevalent than influenza for participants 6 months to 4 years of age. Adults with RSV-MAARI had higher median MWI scores overall compared to influenza-MAARI and controls with neither virus (1.62, 0.40, and 0.64, respectively). Conclusions RSV is a significant, underrecognized cause of MAARI in both children and adults presenting for ambulatory care. Multimorbidity is an important contributor to RSV-associated MAARI in outpatient adults, providing information to support shared clinical decision making for vaccination. [ABSTRACT FROM AUTHOR]

Enterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 infections and its clinical impact during the fall-winter season of 2021–2022. From 19 European countries, 58 institutes reported 10 481 (6.8%) EV-positive samples of which 1004 (9.6%) were identified as EV-D68 (including 852 respiratory samples). Clinical data were reported for 969 cases; 78.9% of infections were reported in children (0–5 years); and 37.9% of cases were hospitalized. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases including 6 diagnosed with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of 2 novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale European EV-D68 upsurge with severe clinical impact and the emergence of B3-derived lineages. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia (SP) is an aging-related loss of muscle mass and function, affecting the respiratory system. However, the causality of the association between sarcopenia on lung diseases remains elusive. Methods: The bidirectional univariate Mendelian randomization (UVMR), multivariate MR (MVMR) analysis, and mediation MR were utilized to systematically investigate the genetic causal relationship of SP and 11 respiratory diseases. Independent genomic variants related to sarcopenia or respiratory diseases were identified as instrumental variables (IVs), and the summary level data of genome-wide associated studies (GWAS) were obtained from the UK biobank and FinnGen. MVMR analysis was conducted to explore the mediation effects of body mass index (BMI), Alcohol Use Disorders Identification Test (AUDIT), smoking, education attainment (EA), physical activity, and Type 2 Diabetes Mellitus (T2DM). Results: Forward UVMR analysis based on the primary method revealed that pneumoconiosis was associated with a higher risk of appendicular lean mass (ALM) (OR = 1.01, p = 0.03), and BMI (10.65%), smoking (10.65%), and physical activity (17.70%) had a mediating role in the effect of pneumoconiosis on ALM. In reverse MR analysis, we found that genetically predicted ALM was significantly associated with an increased risk of pulmonary embolism (PE) (OR = 1.24, p = 7.21E-05). Chronic obstructive pulmonary disease (COPD) (OR = 0.98, p = 0.002) and sarcoidosis (OR = 1.01, p = 0.004) were identified to increase the loss of left-hand grip strength (HGS). Conversely, the increase in left- HGS presented a protective effect on chronic bronchitis (CB) (OR = 0.35, p = 0.03), (OR = 0.80, p = 0.02), and asthma (OR = 0.78, p = 0.04). Similarly, the loss of the right-HGS elevated the risk of low respiratory tract infection (LRTI) (OR = 0.97, p = 0.02) and bronchiectasis (OR = 1.01, p = 0.03), which is also an independent protective factor for LRTI and asthma. In the aspects of low HGS, the risk of LRTI was increased after MVMR analysis, and the risk of sarcoidosis and pneumoconiosis was elevated in the reverse analysis. Lastly, asthma was found to be related to the loss of the usual walking pace, and the reverse MR analysis suggested a causal relationship between the usual walking pace and LRTI (OR = 0.32, p = 2.79 × 10−5), asthma (OR = 0.24, p = 2.09 × 10−6), COPD (OR = 0.22, p = 6.64 × 10−4), and PE(OR = 0.35, p = 0.03). Conclusions: This data-driven MR analysis revealed SP was bidirectional causally associated with lung diseases, providing genetic evidence for further mechanistic and clinical studies to understand the crosstalk between SP and lung diseases. [ABSTRACT FROM AUTHOR]

Liquid-liquid phase separation (LLPS) is integral to various biological processes, facilitating signal transduction by creating a condensed, membrane-less environment that plays crucial roles in diverse physiological and pathological processes. Recent evidence has underscored the significance of LLPS in human health and disease. However, its implications in respiratory diseases remain poorly understood. This review explores current insights into the mechanisms and biological roles of LLPS, focusing particularly on its relevance to respiratory diseases, aiming to deepen our understanding and propose a new paradigm for studying phase separation in this context. [ABSTRACT FROM AUTHOR]

COVID-19 presents with a plethora of neurological signs and symptoms despite being characterized as a respiratory disease, including seizures, anxiety, depression, amnesia, attention deficits, and alterations in consciousness. The olfactory nerve is widely accepted as the neuroinvasive route by which the etiological agent SARS-CoV-2 enters the brain, but the trigeminal nerve is an often-overlooked additional route. Based on this consensus, we initially conducted a pilot experiment investigating the olfactory nerve route of SARS-CoV-2 neuroinvasion via intranasal inoculation in AC70 human ACE2 transgenic mice. Notably, we found that the trigeminal ganglion is an early and highly efficient site of viral replication, which then rapidly spread widely throughout the brain where neurons were primarily targeted. Despite the extensive viral infection across the brain, obvious evidence of tissue pathology including inflammatory infiltration, glial activation, and apoptotic cell deaths were not consistently observed, albeit inflammatory cytokines were significantly induced. However, the expression levels of different genes related to neuronal function, including the neurotransmitter dopamine pathway as well as synaptic function, and markers of neuronal damage were altered as compared to mock-infected mice. Our findings suggest that the trigeminal nerve may serve as a neuroinvasive route complementary to the olfactory nerve and that the ensuing neuroinvasion presented a unique neuropathological profile. This study provides insights into potential neuropathogenic mechanisms utilized by coronaviruses. [ABSTRACT FROM AUTHOR]

The pathology of respiratory syncytial virus (RSV) infection remains unclear. An unbalanced immune response to RSV infection can lead to immunopathology, causing airway damage and impaired exchange of oxygen and carbon dioxide between the air and the bloodstream. We aimed to evaluate the association of the expression of inflammatory and antiviral genes in peripheral blood with severe hypoxemia in children with RSV infection seen in the hospital emergency room. We conducted a cross-sectional study on 121 RSV-infected children seen in hospital emergency rooms between 2015 and 2023. Total RNA was extracted from whole blood samples, and gene expression (IL-6, TNFa, CXCL8, ISG15, IFIT1, RIGI, IFNb, CCL5, and CXCL10) was quantified using quantitative RT-PCR. The outcome variable was having severe hypoxemia (SpO2 = 90%). The association analysis was performed using a volcano plot, adjusted logistic regression, and orthogonal partial least squares discriminant analysis (OPLSDA). We found that 26 of 121 children had severe hypoxemia (SpO2 = 90%). CXCL8 was overexpressed [fold changes (FC) > 2; q-value < 0.05], and ISG15, IFIT1, RIGI, IFNb, CCL5, and CXCL10 were underexpressed (FC <0.5; q-value <0.05) in children with severe hypoxemia. These associations were ratified using adjusted logistic regression. The OPLS-DA showed that the gene expressions of CXCL8, ISG15, IFIT1, RIGI, and CXCL10 had values of variable importance in projection (VIP) =1, being the most relevant features. In conclusion, an imbalance favoring inflammation over antiviral defense may contribute to the pathogenesis of severe hypoxemia in RSV-infected children. These findings provide valuable insights into the pathology of RSV infection. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease is characterized by progressive and partially reversible airflow restriction, and is a preventable and treatable respiratory disease. More and more attention has been paid to its complications, including osteoporosis, cardiovascular and cerebrovascular diseases, metabolic syndrome, diabetes, anxiety, depression, etc.Osteoporosis, as the main extrapulmonary complication of chronic obstructive pulmonary disease, seriously threatens the physical and mental health of patients.There are many causes of secondary osteoporosis in chronic obstructive pulmonary disease, including hypoxia, malnutrition, decreased weight and exercise ability, glucocorticoids use, smoking, etc.This article reviews the causes and treatment methods of secondary osteoporosis in chronic obstructive pulmonary disease, aiming to provide theoretical basis for the prevention and treatment of secondary osteoporosis in chronic obstructive pulmonary disease. [ABSTRACT FROM AUTHOR]

Background: With the use of heated tobacco products (HTPs) becoming more widespread in Japan, interest in the health effects of HTP has grown. Since the majority of HTP users are former smokers, information about the user's smoking history and health status before HTP use is needed when assessing the health effects of HTP use. The limited epidemiological studies available did not consistently consider this information adequately, therefore we conducted a cross-sectional study investigating the association between HTP use and respiratory chronic diseases and symptoms. Methods: The questionnaires were sent to a research panel members in Japan via the Internet, and individuals who met the study criteria and were either current exclusive HTP users, current exclusive cigarette users or those had never used tobacco products were selected. Information about the participants' smoking history and health status before they used HTPs was obtained. The effects of participant smoking history before HTP use and the impacts on outcomes upon switching to HTP were assessed using a logistic regression model. The odds ratio (OR) for current exclusive HTP users relative to never tobacco users was calculated. The OR was calculated under two scenarios, one in which the smoking history was ignored or one in which the smoking history was considered. Results: Of the participants from whom responses to the questionnaires were obtained, 17,406 participants were included in the analysis. Almost all participating current exclusive HTP users had a history of long-term smoking (mean: 30.8 years), and the occurrence of outcomes both before and after the start using HTP was reported. The ORs, without adjustment and with adjustment for smoking history before HTP use were, 3.23 (95% CI: 1.37–7.61) and 1.85 (95% CI: 0.70–4.89) respectively in COPD, same as other outcomes. Conclusions: These results suggest that smoking history before HTP using affects the occurrence of outcomes, and underscore the importance of considering smoking history when assessing the health effect of HTP use. Since the duration of HTP use is considerably shorter than that of cigarette use at present, further research, such as follow-up surveys assessing the long-term respiratory effects of HTP use, will be necessary. [ABSTRACT FROM AUTHOR]

Introduction: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, accounting for 74% of deaths annually. Satellite imagery provides previously unattainable data about factors related to NCDs that overcome limitations of traditional, non-satellite-derived environmental data, such as subjectivity and requirements of a smaller geographic area of focus. This systematic literature review determined how satellite imagery has been used to address the top NCDs in the world, including cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. Methods: A literature search was performed using PubMed (including MEDLINE), CINAHL, Web of Science, Science Direct, Green FILE, and Engineering Village for articles published through June 6, 2023. Quantitative, qualitative, and mixed-methods peer-reviewed studies about satellite imagery in the context of the top NCDs (cancer, cardiovascular disease, chronic respiratory disease, and diabetes) were included. Articles were assessed for quality using the criteria from the Oxford Centre for Evidence-Based Medicine. Results: A total of 43 studies were included, including 5 prospective comparative cohort trials, 22 retrospective cohort studies, and 16 cross-sectional studies. Country economies of the included studies were 72% high-income, 16% upper-middle-income, 9% lower-middle-income, and 0% low-income. One study was global. 93% of the studies found an association between the satellite data and NCD outcome(s). A variety of methods were used to extract satellite data, with the main methods being using publicly available algorithms (79.1%), preprocessing techniques (34.9%), external resource tools (30.2%) and publicly available models (13.9%). All four NCD types examined appeared in at least 20% of the studies. Conclusion: Researchers have demonstrated they can successfully use satellite imagery data to investigate the world's top NCDs. However, given the rapid increase in satellite technology and artificial intelligence, much of satellite imagery used to address NCDs remains largely untapped. In particular, with most existing studies focusing on high-income countries, future research should use satellite data, to overcome limitations of traditional data, from lower-income countries which have a greater burden of morbidity and mortality from NCDs. Furthermore, creating and refining effective methods to extract and process satellite data may facilitate satellite data's use among scientists studying NCDs worldwide. [ABSTRACT FROM AUTHOR]

Although COVID-19 is a disease consisting of mostly upper and lower respiratory symptoms, a subset of patients develop cardiac sequelae including myocarditis and pericarditis. For these patients, a standardized set of diagnostic imaging techniques and treatments has not been established. While there have been numerous case reports on this topic, there are few reviews that evaluate the effectiveness of different treatment modalities with a significant number of cases. We reviewed 146 cases of patients (ages ranging from 2 months old to mid 80 s) obtained from searches on PubMed, Google Scholar, and several case report journals. ECG abnormalities, elevated inflammatory markers, and reduced left ventricular ejection fraction were most associated with COVID-19 myocarditis. While classic symptoms of COVID-19 include upper respiratory symptoms, a subset of patients diagnosed with COVID-19 displayed no signs of respiratory disease at all. In 22% of cases, cardiac sequelae was not present until after the patient recovered from COVID-19. Steroids were given in 57.5% of cases. Cardiac MRI was used in 40.4% of cases for diagnosis of myocarditis. Of all the patients who were treated with ECMO, 82.1% of these patients were able to fully recover. The use of cardiac MRI and transthoracic echocardiogram for diagnosis of COVID-19 myocarditis should be heavily considered in any patient with COVID-19 infection. ECMO, IVIG, steroids, and anticoagulants should also be heavily considered. A randomized controlled trial should be conducted to better associate treatments with outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite receiving adequate treatment, many tuberculosis (TB) survivors are left with post-tuberculosis complications, possibly due to lung tissue damage incurred during the active period of the disease. Current TB programs worldwide deliver quality care throughout the course of active TB treatment, yet often fail to provide organized follow-up once treatment ends. Post-tuberculosis lung disease (PTLD) is a prominent, yet underrecognized cause of chronic lung disease, managed similarly to chronic respiratory diseases with pharmacotherapy and/or personalized pulmonary rehabilitation interventions. Basic pulmonary rehabilitation packages for people finishing TB treatment are still lacking in low- and middle-income countries (LMICs). We offer a study protocol to evaluate the implementation of spirometry and symptom screening for PTLD among people who have completed TB treatment in a rural district in Mozambique. Methods: The overall objective of this study is to evaluate the introduction of a new screening program that utilizes symptom screening and spirometry for diagnosing PTLD among adolescents and adults that have completed TB treatment. This research protocol consists of three complementary components: 1) assessing the prevalence of PTLD among patients enrolled in the National TB Control Program (NTCP) at Carmelo Hospital (CHC) in Chókwè District, Mozambique; 2) evaluating anticipated implementation outcomes through the identification of the site-, provider-, and individual-level determinants that either facilitate or hinder the successful adoption, implementation, and maintenance of the spirometry screening program, and 3) evaluating the real-time implementation outcomes/processes in order to provide practical evidence-based key indicators of successful implementation of the spirometry screening program. Discussion: Providing well-organized, evidence-based care for individuals with a history of TB who are experiencing symptoms of PTLD can relieve chronic respiratory issues, enhance quality of life, and potentially lower the risk of further pulmonary infections, including recurrent TB. However, there is a significant gap in the literature regarding the implementation of best practices of HIV and TB health services delivery. Addressing this gap could assist Mozambique in improving diagnosis, treatment, and continuity of care for people formerly living with TB. The insights from this study will help decision-makers improve spirometry screening coverage, enhance intervention effectiveness, and translate our findings to evidence-based programming. Trial registration: ISRCTN92021748 retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Pulmonary rehabilitation (PR) is widely recommended for short-term benefits in chronic respiratory diseases, yet long-term outcomes remain uncertain. This retrospective cohort study addresses this gap, comparing 20-year mortality rates between PR participants and matched controls, and hypothesizing that the short-term benefits of PR contribute to improved long-term survival. Methods: The 20-year mortality of stable chronic respiratory patients who participated in an outpatient PR program was compared with a matched control group based on the type of lung disease. Demographic and clinical variables, and the dates of deaths, were extracted and compared between two groups with two sample t-test and chi-square tests. Kaplan-Meier plots and Cox regression analyses were employed to evaluate survival differences. Results: Between 2000 and 2002, 238 individuals enrolled in a pulmonary rehabilitation (PR) program (58% male, mean age ± SD: 69 ± 8 years, mean FEV1% predicted ± SD: 46 ± 21%). An equal number of people with comparable lung disease were selected as controls (88% COPD, 5% ILD). Controls had lower FEV1% predicted values (mean ± SD: 39 ± 17%, P < 0.001), smoked more (mean ± SD: 48 ± 35 pack-years, P = 0.032), and no differences in age, BMI, sex, and Index of Relative Socio-economic Advantage and Disadvantage (IRSAD). Median (IQR) follow-up time was 68 months (34–123), with 371 (78%) deaths. Univariable (HR = 1.71, p < 0.001) and multivariable (HR = 1.64, p < 0.001) Cox regression found higher mortality risk in controls. Subgroup analysis for COPD replicated these findings (HR = 1.70, P < 0.001). Discussion: Despite some methodological limitations, our study suggests that clinically stable patients with chronic respiratory disease who undertake PR may have lower mortality than matched controls. Trial registration: Retrospectively registered. [ABSTRACT FROM AUTHOR]

This study investigates the burden of COPD attributable to air pollution in South Asia using data from the Global Burden of Disease Study from 1990 to 2019. Method Data for this study were obtained from the Global Burden of Disease Study 2019. The burden was measured in terms of death, disability-adjusted life years (DALYs), and Years of life lost (YLLs). Results Since 1990, several countries in South Asia registered substantial declines in mortality rates attributed to COPD, ranging from −37.47% in Pakistan to −66.25% in Bangladesh. Similar trends were observed for DALYs and YLLs as well, which have potentially contributed to a considerable decrease in mortality rates at the regional level (−43.13%) compared to a 32.59% decline in Low SDI and 56.87% decline globally. Conclusion Despite significant declines since 1990, the burden of COPD attributable to air pollution reductions in the South Asian region’s rates remains alarmingly high. [ABSTRACT FROM AUTHOR]

Asthma is a chronic inflammatory disease that affects millions of people worldwide. Obesity, particularly visceral adipose tissue (VAT), is known to secrete adipokines and pro-inflammatory factors, which are closely associated with various metabolic and cardiovascular diseases. Research indicates that these metabolic disturbances can exacerbate inflammatory conditions, contributing to both cardiovascular and respiratory diseases, including asthma. Despite these associations, studies on the specific relationship between VAT and asthma remain limited and warrant further investigation. Utilizing the NHANES database from 2011 to 2018, we included a total of 11,137 participants. Multivariable regression analysis was performed, stratifying subjects based on VAT levels and adjusting for various confounders. Subgroup interaction analysis and nonlinear analysis were conducted to explore potential effect modifiers and nonlinear associations. In this study, 11,137 participants were included, with 49.74% being female. Among the 509 asthma patients, 69.35% were female. The number of asthma patients among Non-Hispanic Whites was 212, representing 41.65% of the total, the highest proportion among the studied groups. The VAT for asthma patients was 529 g, significantly higher than the 455 g in the non-asthma group (P < 0.001). Multivariable regression analysis showed that for every 200 g increase in VAT, the risk of asthma increased by 10.4% (P = 0.032), 20.8% (P < 0.001), and 20.3% (P = 0.004) across three models (unadjusted, adjusted for demographic factors, and fully adjusted). Subgroup analysis indicated a stronger association between VAT and asthma risk in females and individuals over 40 years old. Nonlinear analysis uncovers a J-shaped relationship between VAT and asthma, with the lowest risk observed at 464.57 g (P < 0.001). The study findings suggest that increased VAT is associated with elevated asthma risk, particularly among females and older individuals. These results underscore the importance of considering VAT in asthma risk assessment and highlight potential targeted interventions to reduce asthma risk associated with excess visceral adiposity. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a risk factor for all-cause mortality in older adults. Iron deficiency may also be associated with adverse outcomes, independent of its role in causing anemia. This study tested the hypotheses that anemia, and low ferritin among non-anemic participants, were associated with all-cause and cause-specific mortality in a community-based cohort of older adults. Methods: Fasting blood was obtained from 5,070 ARIC participants (median age: 75 years) in 2011–2013. Anemia was defined by hemoglobin concentrations <12 g/dL in women and <13 g/dL in men. We classified 4,020 non-anemic participants by quartiles of plasma ferritin, measured by the SomaScan proteomics platform. Cox proportional hazards regression was used. Mortality was ascertained via phone calls with proxies as part of twice-yearly cohort follow-up, surveillance of local hospital discharge indexes, state death records, and linkage to the National Death Index. Results: Of the total participants, 21% had anemia at baseline. Over a median of 7.5 years, there were 1,147 deaths, including 357 due to cardiovascular disease (CVD), 302 to cancer, and 132 to respiratory disease. Compared to those with normal hemoglobin, participants with anemia had a higher risk of all-cause mortality (hazard ratio 1.81 [95% CI: 1.60–2.06]), and mortality due to CVD (1.77 [1.41–2.22]), cancer (1.81 [1.41–2.33]), and respiratory disease (1.72 [1.18–2.52]) in demographics-adjusted models. In fully adjusted models, associations with all-cause mortality (1.37 [1.19–1.58]) and cause-specific mortality were attenuated. In non-anemic participants, lower ferritin levels were not associated with all-cause or cause-specific mortality, though associations were observed among participants with lesser evidence of inflammation (CRP below the median level of 1.9 mg/L) and for cancer mortality in men only. Conclusion: Anemia is common among older adults and is associated with all-cause mortality, as well as mortality due to CVD, cancer, and respiratory disease. Our results do not provide evidence that iron deficiency, independent of anemia, is associated with mortality in this population. [ABSTRACT FROM AUTHOR]

This paper reports the splitting morphology of low-viscous fingers in the microchannels that are associated with flat T-shaped, curved T-shaped, and Y-shaped junctions. The numerical simulations are based on the finite volume approach and the volume of the fluid model. In this study, microchannels are filled with silicon oil. Perfluorodecalin is used to displace silicon oil from the microchannels. Due to viscosity differences, the low-viscous finger (LVF)-shaped instability evolves at the interface of fluids. A single LVF propagates in the parent channel, and at the junction, it splits into two identical LVFs. It is noted that the splitting morphology of LVF depends upon the shape of the junction and its wettability. Therefore, there are three different junctions, i.e. flat T-shaped, curved T-shaped, and Y-shaped, with three different wettability conditions (θ) , i.e. hydrophilic (6 0 ∘ ), hydrophobic (1 2 0 ∘ ), and superhydrophobic (1 5 0 ∘ ) are used for numerical investigation. It is found that a LVF splits symmetrically at all three different junctions but tips of LVFs are found to be convex in superhydrophobic conditions. The LVFs-shaped are curved in the limbs of curved T-shaped microchannel and straight in the limbs of flat T-shaped and Y-shaped microchannels. The findings of this paper may be used in lung biomechanics, respiratory diseases, biochemical testing, and many more. [ABSTRACT FROM AUTHOR]

Background: Pertussis is a highly contagious, vaccine-preventable acute respiratory infection caused by Bordetella pertussis (B. Pertussis) and affects all age groups. Since 1947, the Global Expanded Program on Immunization (EPI) was executed, and its incidence has been effectively curtailed. The reasons for the resurgence are multifactorial including the waning of vaccine acquired immunity, the difference in vaccination strategies, the adaptation of B. Pertussis strains, and an increase in disease awareness due to the strengthening of diagnostic sensitivity and surveillance sensitivity. Notably, Hewlett and Edwards proposed that the shift in pertussis transmission patterns plays an important role in pertussis resurgence. Diphtheria is an acute infectious disease of upper respiratory tract caused by toxigenic strains of Corynebacterium Diphtheriae (CD) and Corynebacterium other than diphtheriae (COD). The organism is locally invasive and causes exotoxin - mediated illness and can lead to complications like stridor, respiratory obstruction, myocarditis, nerve palsy, renal insufficiency and death in severe cases. The objective of the present study is to isolate and identify the etiological agents in clinically suspected cases of Diphtheria and Pertussis. Materials & Methods: This Prospective study has been conducted in the department of Microbiology from Feb 2022 to Aug 2024. Samples with high clinical suspicion were received and processed. Two Throat swabs were collected in patients with clinical suspicion of Diphtheria. They were inoculated on Blood agar, Potassium Tellurite agar, Tinsdale agar. Gram staining and Albert staining were done. Molecular testing also performed for C. diphtheriae. Two nasopharyngeal swabs were collected in patients with clinical suspicion of Pertussis. They were inoculated on Bordet Gengou medium, Charcoal Agar with Cephalexin and Blood Agar and Mac Conkey agar. Gram Staining was performed and Biochemical testing was carried out. Molecular testing was carried out for B. Pertussis and B. parapertussis. Results: Out of 53 samples with clinical suspicion of Diphtheriae, 6 were positive for Corynebacterium diphtheria by culture. Molecular testing was also done for testing of rpo B gene and Tox A gene. 6 samples came to be positive for C. diphtheria rpo B gene where as one was positive for tox gene production. Out of 20 cases with strong suspicion of Pertussis, culture was positive for Bordetella pertussis in 2 samples. Molecular testing came out to be positive for one sample. Testing for the antibodies by ELISA two patients were serologically positive for Pertussis. Both Culture and molecular testing was positive in one sample. Both culture and serology was positive in one sample. Only serology was positive in one sample. Conclusion: A constant surveillance is needed for vaccine preventable diseases to predict the outbreak or resurgence of cases. [ABSTRACT FROM AUTHOR]

This study systematically analyzes the relationship of vitamin A on the neonatal respiratory diseases. An extensive literature search for relevant studies was conducted on PubMed, Web of Science, and so on. After screening in strict accordance with the inclusion and exclusion criteria, 12 articles on vitamin A deficiency and 12 articles on vitamin A supplementation were included. Stata 17.0 software was used to perform meta‐analysis, heterogeneity test, and sensitivity analysis, and the corresponding mathematical model was used to merge the data. The meta‐analysis results of the relationship between vitamin A deficiency and neonatal respiratory diseases indicated that compared with the neonates with normal vitamin A, the neonates with vitamin A deficiency had adverse health outcomes of neonatal respiratory diseases (OR = 4.86, 95% CI: 2.68–8.84), of which neonatal respiratory distress syndrome (NRDS) (OR = 4.10, 95% CI: 2.32–7.23) and neonatal pneumonia (OR = 3.22, 95% CI: 2.18–4.77) were analyzed by subgroup analysis. The meta‐analysis of the relationship between vitamin A supplementation therapy and neonatal respiratory diseases showed that vitamin A supplementation was an effective therapeutic measure for neonatal respiratory diseases (RR = 1.06, 95% CI: 1.04–1.07): NRDS (RR = 1.03, 95% CI: 1.02–1.05) and NBPD (RR = 1.08, 95% CI: 1.01–1.15). The funnel chart method results show that there was publication bias in studies on vitamin A deficiency induced to and vitamin A supplementation therapy for neonatal respiratory diseases. The sensitivity analysis results showed that excluding some special article had some effect on the final pooled effect. But generally speaking, the result of meta‐analysis was stable. There is a statistical correlation of vitamin A on the neonatal respiratory diseases from two aspects of etiological exploration and effect evaluation of treatment. [ABSTRACT FROM AUTHOR]

Background: PM2.5 has been associated with various adverse health effects, particularly affecting lung function and chronic respiratory diseases. However, the genetic causality relationship between PM2.5 exposure and lung function as well as chronic respiratory diseases remains poorly understood. Method: We conducted a two-sample Mendelian randomization analysis to investigate the causal impact of PM2.5 on lung function and chronic respiratory diseases. Instrumental variables were carefully selected, with significance thresholds (P < 5 × 10− 8), and linkage disequilibrium with an r2 value below 0.001. Additionally, SNPs with an F-statistic exceeding 10 were included to mitigate potential bias stemming from weak instrumental variables. The primary analytical approach employed the Inverse Variance Weighted method, supplemented by the Weighted Median, MR-Egger, Simple Model, and Weighted Model. Furthermore, pleiotropy and heterogeneity were evaluated through the MR-Egger intercept test and Cochrane's Q test, with a sensitivity analysis conducted using the leave-one-out method. Results: Eight SNPs significantly associated with PM2.5 exposure were identified as Instrumental variables. Mendelian randomization analysis revealed a significant causal association between PM2.5 exposure and lung function (FEV), with an OR of 0.7284 (95% CI: 0.5799–0.9150). Similarly, PM2.5 exposure demonstrated a substantial causal effect on asthma, with an OR of 1.5280 (95% CI: 1.0470–2.2299). However, no causal association was observed between PM2.5 exposure and chronic obstructive pulmonary disease, with an OR of 1.5176 (95% CI: 0.8294–2.7768). Conclusion: These findings emphasize the necessity for continued research efforts in environmental health to develop effective strategies for the prevention and management of chronic respiratory diseases. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of a combination of high-flow nasal oxygen therapy (HFNO) and ipratropium bromide (IB) on Th1/Th2 balance and inflammation in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure (RF). Methods: A retrospective analysis was conducted on the clinical data of patients with COPD and RF admitted to the Affiliated Nanjing Brain Hospital of Nanjing Medical University from June 2021 to March 2023. A total of 162 patients were included, with 79 patients received respiratory support using HFNO (HFNO group) and 83 patients who were treated using combined HFNO/IB (combined group). Treatment effect, lung function, levels of Th1/Th2, and inflammatory state were compared before and after the treatment. Results: Total effeicacy of patients in the combined group was significantly higher than that of the HFNO group (P<0.05). After the treatment, pulmonary function levels of the two groups was higher than that before the treatment, and was significantly better in the combined group compared to the HFNO group (P<0.05). The treatment was associated with a significant increase in the levels of Th1/Th2 in both groups. Post-treatment levels of these indexes in the combined group were markedly higher compared to the HFNO group (P<0.05). After the treatment, the inflammatory response of the two groups decreased, and was lower in the combined group that in the HFNO group (P<0.05). Conclusions: In COPD patients with RF, HFNO combined with IB is efficient in alleviating the inflammatory state of patients, restoring Th1/Th2 balance, and improving lung function compared to HFNO alone. [ABSTRACT FROM AUTHOR]

This paper proposed a novel approach for detecting lung sound disorders using deep learning feature fusion. The lung sound dataset are oversampled and converted into spectrogram images. Then, extracting deep features from CNN architectures, which are pre-trained on large-scale image datasets. These deep features capture rich representations of spectrogram images from the input signals, allowing for a comprehensive analysis of lung disorders. Next, a fusion technique is employed to combine the extracted features from multiple CNN architectures totlaly 8064 feature. This fusion process enhances the discriminative power of the features, facilitating more accurate and robust detection of lung disorders. To further improve the detection performance, an improved CNN Architecture is employed. To evaluate the effectiveness of the proposed approach, an experiments conducted on a large dataset of lung disorder signals. The results demonstrate that the deep feature fusion from different CNN architectures, combined with different CNN Layers, achieves superior performance in lung disorder detection. Compared to individual CNN architectures, the proposed approach achieves higher accuracy, sensitivity, and specificity, effectively reducing false negatives and false positives. The proposed model achieves 96.03% accuracy, 96.53% Sensitivity, 99.424% specificity, 96.52% precision, and 96.50% F1 Score when predicting lung diseases from sound files. This approach has the potential to assist healthcare professionals in the early detection and diagnosis of lung disorders, ultimately leading to improved patient outcomes and enhanced healthcare practices. [ABSTRACT FROM AUTHOR]

Audio-based classification techniques for body sounds have long been studied to aid in the diagnosis of respiratory diseases. While most research is centered on the use of coughs as the main acoustic biomarker, other body sounds also have the potential to detect respiratory diseases. Recent studies on the coronavirus disease 2019 (COVID-19) have suggested that breath and speech sounds, in addition to cough, correlate with the disease. Our study proposes fused audio instance and representation (FAIR) as a method for respiratory disease detection. FAIR relies on constructing a joint feature vector from various body sounds represented in waveform and spectrogram form. We conduct experiments on the use case of COVID-19 detection by combining waveform and spectrogram representation of body sounds. Our findings show that the use of self-attention to combine extracted features from cough, breath, and speech sounds leads to the best performance with an area under the receiver operating characteristic curve (AUC) score of 0.8658, a sensitivity of 0.8057, and a specificity of 0.7958. Compared to models trained solely on spectrograms or waveforms, the use of both representations results in an improved AUC score, demonstrating that combining spectrogram and waveform representation helps to enrich the extracted features and outperforms the models that use only one representation. While this study focuses on COVID-19, FAIR's flexibility allows it to combine various multi-modal and multi-instance features in many other diagnostic applications, potentially leading to more accurate diagnoses across a wider range of diseases. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, there was increased interest in the issue of thrombotic complications of acute respiratory infections. Clinical reports and pathological studies have revealed that thrombus formation in COVID-19 may involve the venous and arterial vasculature. As thrombotic complications of infectious respiratory diseases are increasingly considered in the context of COVID-19, the fact that thrombosis in lung diseases of viral and bacterial etiology was described long before the pandemic is overlooked. Pre-pandemic studies show that bacterial and viral respiratory infections are associated with an increased risk of thrombotic complications such as myocardial infarction, ischemic stroke, pulmonary embolism, and other critical illnesses caused by arterial and venous thrombosis. This narrative review article aims to summarize the current evidence regarding thrombotic complications and their pathogenesis in acute lower respiratory tract infections. [ABSTRACT FROM AUTHOR]

Despite numerous scientific reports on the negative impact of vitamin D3 deficiency on many respiratory diseases, little is known about the influence of this phenomenon on the development and progression of hypersensitivity pneumonitis (HP). The presented study is an attempt to shed light on this occurrence. The research was performed on mouse strain C57BL/6J exposed to the antigen of Pantoea agglomerans (etiological factor of HP). To induce vitamin D3 deficiency, mice received a diet with a 10 times lower amount of cholecalciferol than the main control group. VD3-deficient mice inhaled 25(OH)-VD3 or 1,25(OH)2-VD3 used separately or with SE-PA. At the beginning of the experiment and after 14 and 28 days of inhalation, respiratory function was examined using whole-body plethysmography. Moreover, at indicated time points, mice were sacrificed and samples collected for histological examination, flow cytometry, and ELISA. The performed study revealed that inhalations with 25(OH)-VD3 and 1,25(OH)2-VD3 effectively eliminated most of the negative changes in the respiratory system caused by vitamin D3 deficiency by restoring the physiological concentration of 1,25(OH)2-VD3 in the body. VD3-deficient mice which inhaled P. agglomerans antigen and vitamin D3 metabolites also demonstrated the ability of the tested compounds to eliminate, or at least weaken, the negative effects of the HP causative factor and desired effect, including improvement of respiratory functions and attenuation of inflammation and signs of fibrosis. The obtained results suggested that the beneficial influence of inhaled vitamin D3 metabolites on HP development was associated with the restoration of the physiological concentration of 1,25(OH)2-VD3 in the pulmonary compartments in VD3-deficient mice. [ABSTRACT FROM AUTHOR]

Respiratory diseases (RDs) constitute a common public health problem both in industrialized and developing countries. The comprehension of the pathophysiological mechanisms underlying these conditions and the development of new therapeutic strategies are critical for improving the quality of life of affected patients. β2-adrenergic receptor (β2AR) and transient receptor potential vanilloid 1 (TRPV1) are both involved in physiological responses in the airways. β2AR is implicated in bronchodilation, mucociliary clearance, and anti-inflammatory effects, while TRPV1 is involved in the mediation of pain and cough reflexes. In RDs, such as respiratory infections, asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis, the concentration and expression of these receptors can be altered, leading to significant consequences. In this review, we provided an update on the literature about the role of β2AR and TRPV1 in these conditions. We reported how the diminished or defective expression of β2AR during viral infections or prolonged therapy with β2-agonists can increase the severity of these pathologies and impact the prognosis. Conversely, the role of TRPV1 was pivotal in neuroinflammation, and its modulation could lead to innovative treatment strategies in specific patients. We indicate future perspectives and potential personalized treatments in RDs through a comprehensive analysis of the roles of these receptors in the physiological and pathological mechanisms of these pathologies. [ABSTRACT FROM AUTHOR]

Background: Spontaneous pneumothorax is a common clinical condition due to several etiologies. Appropriate radiologic assessment helps avoid re-imaging and guide individualized management. Objective: To describe the etiologic factors of spontaneous pneumothorax in children from a radiological perspective. Materials and methods: Thirty-nine children with spontaneous pneumothorax were evaluated according to their demographic characteristics, the presence of underlying lung diseases, and imaging findings. Results: Twenty-one patients without underlying lung disease were assessed as primary spontaneous pneumothorax; eight of these 21 patients (38.9%) had subpleural air cysts in the apices/upper lobes of the lung on chest computed tomography (CT). In the remaining 18 patients with secondary spontaneous pneumothorax, the most common causes were respiratory diseases (33.3%), infectious lung diseases (33.3%), interstitial lung diseases (27.7%), and connective tissue diseases (5.5%). The mean age of children with secondary spontaneous pneumothorax was lower than that of children with primary spontaneous pneumothorax (P = 0.002). Recurrences occurred in 11 patients (52.3%) with primary spontaneous pneumothorax and three patients (16.6%) with secondary spontaneous pneumothorax. Bilateral pneumothorax was observed in three of the 18 patients with secondary spontaneous pneumothorax. Conclusion: Identifying the etiologic factors of spontaneous pneumothorax may help clinicians plan how to reduce the risk of recurrence. Radiologists should keep in mind the possible underlying diseases and assess imaging methods in children with spontaneous pneumothorax for subpleural air cysts and be suspicious about an underlying disease in cases of bilateral pneumothorax and in younger patients. [ABSTRACT FROM AUTHOR]

Chronic health conditions (CHCs) involve physical, psychological, and social challenges and can have a significant negative impact on work ability, which can then affect performance and job satisfaction. However, the various effects of CHCs on business operations and maintenance among self‐employed workers are understudied. This study examined four common CHCs that are characterised by persistent symptoms and can prompt major life changes: respiratory disease, heart conditions, inflammatory bowel disease, and cancer survivorship. Groups were compared regarding the CHC's impact on business maintenance (declining in income and activity, and slowing business growth), and well‐being. A sample of 294 self‐employed workers with these CHCs completed questionnaires about how their conditions affect their businesses, physical symptoms, and well‐being. The four CHCs had substantial negative effects on business maintenance. Differences were found in reported changes in income, activity, and growth between individuals with inflammatory bowel disease and cancer. No differences in well‐being occurred among self‐employed people with different CHCs. In the overall sample, work absences and slowing business growth were negatively associated with well‐being. Although the groups differed in the severity of symptoms, threat to life, and treatment regimen, the CHCs had similar effects on most business maintenance factors and well‐being. Moreover, the results indicate that the inability to maintain a business can negatively affect well‐being. [ABSTRACT FROM AUTHOR]

Patient-reported outcomes (PROs) are often used as primary outcomes in clinical research studies. PROs are usually measured in ordinal scales and they tend to have excess variability beyond the binomial distribution, a property called overdispersion. Beta-binomial distribution has been previously proposed in this context in order to fit PROs, and beta-binomial regression (BBR) as a good alternative for modelling purposes, including the extension to mixed-effects models in a longitudinal framework. Many PROs have various health dimensions, which are commonly correlated within subjects. However, in clinical analysis, dimensions are separately analysed. In this work, we propose a multidimensional BBR model that incorporates a multidimensional outcome including several PROs in a joint analysis. The proposal has been evaluated and compared to the independent analysis through a simulation study and a real data application with patients with respiratory disease. Results show the advantages that a multidimensional approach offers in terms of parameter significance and interpretation. Additionally, the methods proposed in this work are implemented in the PROreg R-package developed by the authors. [ABSTRACT FROM AUTHOR]

Introduction: Non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is heterogeneous in both phenotypes and endotypes. Due to insufficient head-to-head comparison studies, it is hard to decide which biological to initiate. This study aimed to compare the efficacy of omalizumab and mepolizumab which can be used in the treatment of patients with severe eosinophilic asthma diagnosed with N-ERD. Methods: The population of this observational, cross-sectional study comprised of N-ERD patients who received omalizumab or mepolizumab for at least 6 months for severe asthma. Outcomes included the asthma control test (ACT), and sino-nasal outcome test scores (SNOT-22), blood eosinophil counts at initiation of biological treatment (T0, baseline) and at the end of 6th months (T6). Adverse effects related to biological treatment and changes of oral corticosteroids dose was recorded. Results: The study included a total of 22 patients, of whom 11 received mepolizumab and 11 received omalizumab. The change in ACT, SNOT-22, eosinophil counts, and adverse effects related to biologicals were similar at T6 (p = 0.606, p = 0.168, p = 0.05, p = 0.053, respectively). However, when examining the SNOT-22 and ACT based on the cumulative distribution curve (SUCRA), mepolizumab (SUCRA value: 0.61, 0.72, respectively) demonstrated greater efficacy compared to omalizumab (SUCRA value: 0.19, 0.35, respectively). The oral corticosteroids discontinuation rate was similar between the two groups (p = 0.05). Conclusion: We found both omalizumab and mepolizumab to be effective in treatment; however, we determined that mepolizumab may have a potential superiority in efficacy. [ABSTRACT FROM AUTHOR]

Introduction: Diagnostic of aspirin (ASA) hypersensitivity is largely based on provocation tests. However, they have significant limitations including influence of medications, necessity of hospitalization, and safety issues. Basophil activation test (BAT) seems to be a promising in vitro alternative. It has already proven to be a useful tool for diagnosing IgE-mediated allergy to certain food and airborne allergens as well as insects venoms. The aim of the study was to assess performance of BAT in diagnosing aspirin hypersensitivity in comparison with current golden standard (oral provocation test, OPT). Methods: The study group comprised 148 adult patients with suspicion of aspirin hypersensitivity, including 51 (36%) with chronic urticaria, 73 (51%) with asthma, and 55 (39%) with chronic sinusitis. The control group was 10 healthy adult patients who used NSAIDs during preceding year with good tolerance. BAT with ASA was conducted in all the participants. Additionally, in the study group, OPT was performed with cumulative dose of 1,000 mg of ASA. Results: Out of 148 study group participants, 114 underwent BAT and ASA provocation with conclusive results acquired in both tests. In this group, the threshold for positive BAT was 4.9%. Sensitivity and specificity of BAT were found to be 55.9% and 75%, respectively, with a positive predictive value of 77% and a negative predictive value of 54%. The highest sensitivity (78%) was found in subgroup patients with chronic urticaria, while specificity was highest in the subgroup with chronic respiratory diseases (87%). Conclusion: Despite significant advantages of BAT such as safety, no influence of drugs, and objectivity, its performance makes it inferior to current standard in ASA hypersensitivity. [ABSTRACT FROM AUTHOR]

Background: The substantial exposure to chronic non-communicable respiratory diseases in news coverage impacts readers' understanding of the situation's seriousness. Hence, in the context of Texas newspapers, this study explores the coverage of non-communicable respiratory disease issues. Methods: News articles were gathered spanning from January 2020 to April 2022 to investigate the media coverage of noncommunicable respiratory diseases within Texas newspapers. To identify meaningful associations, a co-occurrence network was employed, revealing the prevalent co-occurring keywords. Complementing this, sentiment analysis was applied to discern the prevailing emotional tones conveyed within the news narratives. These methodologies provide a comprehensive understanding of the media's portrayal of respiratory diseases and the underlying emotions, enhancing insights into public perception and awareness. Results: The outcomes identified a comprehensive understanding of implications of respiratory ailments. Notably, individuals afflicted with chronic obstructive pulmonary disease (COPD) may also contend with other persistent health conditions. Pollution, particularly air pollution, has been recognized as a significant contributor to the development and exacerbation of chronic non-communicable respiratory conditions. Sentiment analysis revealed that words that contain the trust emotion appeared in about 24% of news frames. The second most prevalent emotion was anticipation, which appeared in 17% of news frames. The presence of fear (16%) and sadness (13%) emotions was also notable. Conclusions: Although previous research attempted to explore the portrayal of different public health issues in the news media, no study has been conducted to explore the coverage of chronic non-communicable respiratory diseases in newspapers within the context of Texas. Thus, this research provides insights into how health policymakers can shape health strategies based upon news coverage by focusing on the crucial frames identified in this study. [ABSTRACT FROM AUTHOR]

As the COVID‐19 pandemic persists, SARS‐CoV‐2 infection is increasingly associated with long‐term neurological side effects including cognitive impairment, fatigue, depression, and anxiety, colloquially known as "long‐COVID." While the full extent of long‐COVID neuropathology across years or even decades is not yet known, we can perhaps take direction from long‐standing research into other respiratory diseases, such as influenza, that can present with similar long‐term neurological consequences. In this review, we highlight commonalities in the neurological impacts of influenza and COVID‐19. We first focus on the common potential mechanisms underlying neurological sequelae of long‐COVID and influenza, namely (1) viral neurotropism and (2) dysregulated peripheral inflammation. The latter, namely heightened peripheral inflammation leading to central nervous system dysfunction, is emerging as a shared mechanism in various peripheral inflammatory or inflammation‐associated diseases and conditions. We then discuss historical and modern examples of influenza‐ and COVID‐19‐associated cognitive impairment, depression, anxiety, and fatigue, revealing key similarities in their neurological sequelae. Although we are learning that the effects of influenza and COVID differ somewhat in terms of their influence on the brain, as the impacts of long‐COVID grow, such comparisons will likely prove valuable in guiding ongoing research into long‐COVID, and perhaps foreshadow what could be in store for individuals with COVID‐19 and their brain health. [ABSTRACT FROM AUTHOR]

This series of three articles will explore the fundamentals related to anatomy, physiology and pathophysiology in relation to three important topics: the cardiac system, the respiratory system and the endocrine system. This series is intended to provide an informative and evidence-based summary of each topic for both students and clinicians. This second article explores the maternal respiratory system, outlining the key physiological adaptations in pregnancy and summarises the key pathophysiological conditions that may occur. [ABSTRACT FROM AUTHOR]

Appropriate status epilepticus (SE) management is key to minimize admission to the pediatric intensive care unit (PICU). We retrospectively describe 115 children admitted to the PICU of the tertiary-care referral hospital of Padova for seizures, SE, and SE-related complications (59% from second-level hospitals, 41% from the referral hospital) and compare SE management among hospitals. Compared with the referral center, in second-level hospitals, anesthetics were more often administered as first/second drug (P <.001), and intubation was more frequent (P <.001). Intubation was significantly associated with SE onset at home (P =.045) and benzodiazepine-associated respiratory depression (P =.044). There was no association between intubation and SE duration, etiology, PICU length of stay, and morbidity at discharge. In conclusion, adherence to treatment protocols on SE management after the first-line drug differs between referral center and second-level hospitals. Lack of association with SE characteristics and patient's outcome suggests PICU admission could be due to inappropriate invasive management. [ABSTRACT FROM AUTHOR]

Over the last decade, there have been widespread efforts to reduce non-evidence-based therapies for viral bronchiolitis. We question whether this change in practice has inadvertently impacted the diagnosis and management of other pediatric lower-respiratory-tract illnesses. We used the Pediatric Health Information System (PHIS) and logistic regression to describe trends in relative diagnosis frequency of bronchiolitis, viral pneumonia, and reactive airway disease (RAD)/asthma as well as systemic corticosteroid use among children of the age range 1 to 4 years over a 10-year period. Among 169,207 children, the relative frequency of asthma/RAD diagnoses declined over a 10-year period, while bronchiolitis and viral pneumonia diagnoses increased among children of the age range 1 to 3 years and 2 to 4 years, respectively. Frequency of systemic corticosteroid use declined. We question whether the observed shift in diagnosis from asthma/RAD to bronchiolitis or viral pneumonia is reflective of true disease pathophysiology or if it represents an unintended consequence of campaigns surrounding bronchiolitis. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is triggered by many environmental factors. We sought to determine the relationship between birth weight, infectious diseases, and AD. This retrospective cohort study analyzed data from the CGR Database for the period 2004 through 2015 in Taiwan. All diseases were classified using the International Classification of Disease codes. Logistic regression adjusted for birth weights and comorbidities were analyzed by SAS (version 9.4). P <.05 were considered statistically significant. In children with AD, bronchiolitis was significantly associated with the development of AD, whether the patients were aged < 2 years (odds ratio [OR] = 1.497; P =.014) or ≥ 2 years (OR = 1.882; P =.022). There was also no difference in the association between AD and different birth weights. We conclude that AD is associated with a previous history of bronchiolitis in children, regardless of age (less than or greater than 2 years). [ABSTRACT FROM AUTHOR]

Introduction: Azithromycin is an effective treatment for various respiratory conditions but its effect on cough is poorly understood. We synthesised data from randomised controlled trials (RCTs) and noncomparative studies (NCT) examining its effect on objective and subjective cough. Methods: After prospective registration on PROSPERO, we searched MEDLINE, EMBASE, and CENTRAL for both RCTs and NCT trials examining the effect azithromycin on cough in respiratory disease. Results: We identified 1240 studies of which 6 (4 RCTs and 2 NCT studies) were included in the meta-analysis, with a total of 275 patients. Azithromycin was associated with significant improvement in Leicester Cough Questionnaire scores at follow-up when compared to baseline scores (SMD = 0.62 [95% CI 0.12 to 1.12], p = 0.01). However, when only RCTs were synthesised, no significant effect was observed (SMD = 0.12 [95% CI − 0.36 to 0.60], p = 0.62). There was no significant reduction in cough severity VAS score (SMD = − 0.39 [95% CI − 0.92 to 0.14], p = 0.15). There was no significant reduction in objective cough count (SMD = − 0.41 [95% CI − 1.04 to 0.32], p = 0.09). Conclusion: Azithromycin therapy improves cough-related quality of life in various chronic respiratory diseases; however, there was no significant effect on cough outcomes when only data from RCTs were synthesised. We believe that to accurately identify which patients whose cough would benefit from azithromycin a large-scale clinical trial of patients with a broad spectrum of respiratory diseases, with sufficiently severe cough, should be undertaken with subgroup analysis of individual disease areas. [ABSTRACT FROM AUTHOR]

A 15-year-old girl presented to her local hospital with a 4-month history of fatigue, anorexia, and a 6-kg weight loss. She also reported fever, productive cough, and chest pain on the left lower chest posteriorly for 4 days before admission. Her medical history and systemic review were unremarkable for any respiratory or other organ disease. The patient was taking iron and multivitamin supplements. At her local hospital, she was febrile; chest radiography showed anemia and a left lower lobe infiltrate. She received a transfusion and was started on empiric antibiotics that were continued for 10 days without improvement. Subsequently, CT scan of the chest and upper abdomen showed a lung abscess and left renal mass that led to a referral to our center. [ABSTRACT FROM AUTHOR]

Introduction: Mounier-Kuhn syndrome or tracheobronchomegaly, is a rare condition that consists of abnormal dilation of the trachea and main bronchi due to a pathological arrangement of smooth muscle fibers in this area. Case report: We present the case of a 46-year-old woman with poorly controlled asthma and recurrent infections, who was diagnosed with Mounier-Kuhn syndrome through a computed tomography scan revealing an unusual enlargement of the trachea with associated bronchiectasis. Results: The diagnosis of Mounier-Kuhn syndrome is radiological, involving measurement of the trachea where a diameter >25 mm in men and >21 mm in women is observed. While diagnosis is sometimes incidental, there is an association with respiratory diseases such as asthma or COPD, hence clinical suspicion is important in patients with poorly controlled underlying conditions who present with recurrent infections, inadequate secretion management, or even hemoptysis. Conclusions: Despite its rarity, this syndrome significantly impacts patients' quality of life. Diagnosis and management involve comprehensive evaluations including computed tomography, with a multidisciplinary approach including pulmonologists and radiologists. Exploring its clinical features, associations with other respiratory diseases and treatment options is crucial in managing this rare respiratory condition. [ABSTRACT FROM AUTHOR]

Introduction: Respiratory syncytial virus (RSV) leads to significant morbidity in newborn infants in the United Kingdom (UK). Nirsevimab, a long-acting monoclonal antibody, received approval from the European Medicines Agency and has been licensed by the Medicines and Healthcare products Regulatory Agency for preventing RSV lower respiratory tract disease (LRTD) in neonates and infants during their first RSV season. The objective of this study was to assess the potential impact of nirsevimab on RSV-associated LRTDs, related costs, and loss of quality-adjusted life years (QALYs) in infants experiencing their first RSV season. Methods: The impact of administering nirsevimab across all infant populations compared to palivizumab in the high-risk palivizumab-eligible population was assessed via a static decision-analytic model specified for a UK birth cohort experiencing their first RSV season. The RSV-related health events of interest included primary care (PC), accident and emergency (A&E) visits, hospitalizations [including hospitalizations alone and those resulting in intensive care unit (ICU) admissions], recurrent wheezing in infants who were previously hospitalized, and all-cause LRTD hospitalizations. Results: Under the current standard of practice (SoP), RSV was estimated to result in 329,425 RSV LRTDs annually, including 24,381 hospitalizations and ICU admissions, representing £117.8 million (2024 GBP) in costs. Comparatively, universal immunization of all infants with nirsevimab could avoid 198,886 RSV LRTDs, including 16,657 hospitalizations and ICU admissions, resulting in savings of £77.2 million in RSV treatment costs. Considering the impact on all-cause LRTD of a universal immunization strategy, nirsevimab could be valued between £243 and £274, assuming willingness-to-pay (WTP) thresholds of £20,000 and £30,000 per QALY saved, respectively. Conclusions: This analysis demonstrated that the health and economic burden of RSV would be substantially reduced in all infants experiencing their first RSV season in the UK (including term, preterm, and palivizumab-eligible infants) as a result of a universal immunization strategy with nirsevimab. [ABSTRACT FROM AUTHOR]

Mycoplasmapneumoniae pneumonia (MPP) is a common respiratory tract infection disease in children. To date, there have been few studies on the relationship between cytological changes in bronchoalveolar lavage fluid (BALF) and clinical features. The objective of this study is to investigate the correlation between changes in the proportion of cell classifications in BALF and the clinical features in children with severe MPP (SMPP). In total, the study included 64 children with SMPP requiring bronchoalveolar lavage who were admitted to our hospital between March and September 2022 (study group) and 11 children with bronchial foreign bodies without co-infection (control group), who were admitted during the same period. The proportion of cell classifications in BALF was determined by microscopic examination after performing Wright-Giemsa staining. Patients were grouped according to different clinical characteristics, and between-group comparisons were made regarding the variations in the proportion of cell classifications in BALF. The levels of blood routine neutrophil percentage (GRA%), C-reactive protein, D-dimer and lactate dehydrogenase in the study group were higher than those in the control group (P < 0.05). There were differences in the GRA% and macrophage percentage in the BALF between the two groups (P < 0.05). The GRA% and blood lymphocyte percentage were associated with pleural effusion. Multiple indicators correlated with extrapulmonary manifestations (P < 0.05). Moreover, the percentage of lymphocytes in the BALF correlated with pleural effusion, extrapulmonary manifestations and refractory MPP (RMPP) (P < 0.05). Logistic regression showed that BALF lymphocytes were protective factors for RMPP, while serum amyloid A and extrapulmonary manifestations were risk factors (P < 0.05). Conclusion: The BALF of children with SMPP is predominantly neutrophilic. A lower percentage of lymphocytes is related to a higher incidence of pleural effusion, extrapulmonary manifestations and progression to RMPP, as well as a longer length of hospitalisation. What Is Known: • Mycoplasma pneumonia in children is relatively common in clinical practice. Bronchoalveolar lavage (BAL) is a routine clinical procedure. What Is New: However, there are relatively few studies focusing on the cytomorphological analysis of cells in BAL fluid. [ABSTRACT FROM AUTHOR]