Diffusion Capacity Research Articles

Effect of Reinforcement Ratio and Particle Size on the Physical and Mechanical Performance of Epoxy Matrix Panels and Waste Wood from Iroko Chlorophora excelsa from Cameroon

The use of local materials developed from natural reinforcements remains a major challenge for many researchers in the development of the industry and the fight against pollution. The wood industry generates large quantities of environmental waste, including Iroko wood. To give Iroko a second life, this study uses Iroko sawdust waste to make an epoxy matrix composite material. The composite was produced using a cold pressing technique based on moving the top and bottom plates to a thickness of 10 mm. On this basis, three particle sizes [t < 0.35[, [0.35–0.63[, and [0.63–1[ were used, as well as three reinforcement (R)/matrix (M) percentages of 50R/50M, 60R/40M, and 70R/30M, where R is the reinforcement percentage and M is the matrix percentage. The physical tests, apparent and real density, porosity, moisture content, water absorption rate, absorption and desorption kinetics, diffusion theory, and activation energy were determined by the gravimetric method. A three-point bending test was carried out in accordance with the ASTM D790 for mechanical tests. The results show that the addition of Iroko particles lightens the material by reducing its density. The hydrophilic nature of Iroko particles increases the absorption rate and porosity, with good diffusion capacity as the particle size and percentage increase. The material produced can be light and porous, with possible applications in thermal insulation. In terms of kinetics, Verma et al.’s model best correlates the experimental desorption points for the 3 isotherms, while Page’s model best correlates the water absorption points. The mechanical results show that Young’s modulus and stress at break decrease with an increase in the reinforcement percentage and particle size. The mechanical results can be used to define the material’s applications in construction and furniture. In accordance with the EN312 standard, the composites produced can be classified as type 2 lightweight materials, suitable for use in dry and damp areas.

Characteristics and determinants of pulmonary long COVID.

BACKGROUNDPersistent cough and dyspnea are prominent features of postacute sequelae of SARS-CoV-2 (also termed "long COVID"); however, physiologic measures and clinical features associated with these pulmonary symptoms remain poorly defined. Using longitudinal pulmonary function testing (PFT) and CT imaging, this study aimed to identify the characteristics and determinants of pulmonary long COVID.METHODSThis single-center retrospective study included 1,097 patients with clinically defined long COVID characterized by persistent pulmonary symptoms (dyspnea, cough, and chest discomfort) lasting for 1 or more months after resolution of primary COVID infection.RESULTSAfter exclusion, a total of 929 patients with post-COVID pulmonary symptoms and PFTs were stratified as diffusion impairment and pulmonary restriction, as measured by percentage predicted diffusion capacity for carbon monoxide (DLCO) and total lung capacity (TLC). Longitudinal evaluation revealed diffusion impairment (DLCO ≤ 80%) and pulmonary restriction (TLC ≤ 80%) in 51% of the cohort overall (n = 479). In multivariable modeling regression analysis, invasive mechanical ventilation during primary infection conferred the greatest increased odds of developing pulmonary long COVID with diffusion impairment and restriction (adjusted odds ratio [aOR] = 9.89, 95% CI 3.62-26.9]). Finally, a subanalysis of CT imaging identified radiographic evidence of fibrosis in this patient population.CONCLUSIONLongitudinal PFTs revealed persistent diffusion-impaired restriction as a key feature of pulmonary long COVID. These results emphasize the importance of incorporating PFTs into routine clinical practice for evaluation of long COVID patients with prolonged pulmonary symptoms. Subsequent clinical trials should leverage combined symptomatic and quantitative PFT measurements for more targeted enrollment of pulmonary long COVID patients.FUNDINGNational Institute of Allergy and Infectious Diseases (AI156898, K08AI129705), National Heart, Lung, and Blood Institute (HL153113, OTA21-015E, HL149944), and the COVID-19 Urgent Research Response Fund at the University of Alabama at Birmingham.

Sex differences of post-Covid patients undergoing outpatient pulmonary rehabilitation

BackgroundFollowing years of pandemic severe acute respiratory syndrome coronavirus 2 infections labelled Covid-19, long lasting impairment summarized as post-Covid syndrome (PCS) challenges worldwide healthcare. Patients benefit from rehabilitation programs, but sex specific aspects of improvement remain little understood. The aim of the study was to assess whether women and men differ in response to outpatient pulmonary rehabilitation for PCS.Methods263 (54.4% female) patients partaking in outpatient pulmonary rehabilitation (OPR) due to PCS between March 2020 and July 2022 were included in a prospective observational cohort study. Outcomes were assessed at baseline and before discharge from OPR and included six-minute walking distance (6MWD), 1-second forced expiratory volume (FEV1), diffusion capacity for carbon monoxide, maximal inspiratory pressure (MIP), dyspnea (medical research council scale), and post-Covid functional status scale (PCFS). Sexspecific changes in outcomes following OPR were assessed by linear mixed model and presented as mean differences (MD) with 95% confidence intervals. Linear regression was applied to test whether 6MWD correlates with PCFS and the minimal clinically important difference (MCID) in 6MWD regarding an improvement of at least one point in PCFS was computed with logistic regression.ResultsSignificant improvement throughout OPR was observed for all outcomes (all p < 0.0001). Despite less severe Covid-19 infections, PCFS scores remained higher in females after OPR (p = 0.004) and only 19.4% of women compared to 38.5% of men achieved remission of functional impairment. At baseline as well as after OPR, females showed higher symptom load compared to men in dyspnea (p = 0.0027) and scored lower in FEV1 (p = 0.009) and MIP (p = 0.0006) assessment. Performance in 6MWD was comparable between men and women. An increase of 35 m in 6MWD was computed as minimal clinically important difference to improve functional impairment.ConclusionBoth subjective symptoms such as fatigue and dyspnea and objective impairment in performance in pulmonary function were more frequently observed among women. Despite improvement throughout OPR in both women and men, the sex-gap in symptom load could not be closed as women less often achieved remission from functional impairment due to PCS. Intensified treatment of these symptoms should be considered in women undergoing rehabilitation for PCS.

Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study

COVID-19 lung sequelae can impact the course of patient lives. We investigated the evolution of pulmonary abnormalities in post-COVID-19 patients 18-24 months after hospital discharge. A cohort of COVID-19 patients admitted to the Hospital das Clínicas da Faculdade de Medicina da USP in São Paulo, Brazil, between March and August of 2020, were followed-up 6-12 months after hospital discharge. A subset of patients with pulmonary involvement and chest computed tomography (CT) scans were eligible to participate in this second follow-up (18-24 months). Data was analyzed in an ambidirectional manner, including retrospective data from the hospitalization, and from the first follow-up (6-12 months after discharge), and compared with the prospective data collected in this new follow-up. From 348 patients eligible, 237 (68%) participated in this follow-up. Among participants, 139 (58%) patients presented ground-glass opacities and reticulations, and 80 (33%) presented fibrotic-like lesions (traction bronchiectasis and architectural distortion). Five (2%) patients improved compared to the 6-12-month assessment, but 20 (25%) of 80 presented worsening of lung abnormalities. For those with relevant assessments on both occasions, comparing the CT findings between this follow-up with the previous assessment, there was an increase in patients with architectural distortion (43 [21%] of 204 vs 57 [28%] of 204, p=0.0093), as well as in traction bronchiectasis (55 [27%] of 204 vs 69 [34%] of 204, p=0.0043). Patients presented a persistent functional impairment with demonstrated restrictive pattern in both follow-ups (87 [42%] of 207 vs 91 [44%] of 207, p=0.76), as well as for the reduced diffusion capacity (88 [42%] of 208 vs 87 [42%] of 208, p=1.0). Length of hospitalization (OR 1.04 [1.01-1.07], p=0.0040), invasive mechanical ventilation (OR 3.11 [1.3-7.5] p=0.011), patient's age (OR 1.03 [1.01-1.06] p=0.0074 were consistent predictors for development of fibrotic-like lung lesions in post-COVID-19 patients. Post-COVID-19 lung sequelae can persist and progress after hospital discharge, suggesting airways involvement and formation of new fibrotic-like lesions, mainly in patients who were in intensive care unit (ICU). São Paulo Research Foundation (22/01769-5) and Instituto Todos pela Saúde (C1721).

Performance assessment of activated carbon thermally modified with iron in the desulfurization of biogas in a static batch system supported by headspace gas chromatography

A static batch arrangement composed of anti-leak vials coupled to gas chromatography is proposed as a complementary system for performance assessment of biogas desulfurization by adsorption. For testing, a modified commercial activated carbon produced by controlled thermal treatment in the presence of iron(III) species improved biogas desulfurization. The adsorbents showed a superior hydrogen sulfide removal compared to ordinary one. Pseudo-first-order, pseudo-second-order, and Bangham’s kinetic models were used to fit experimental data. All studied samples followed pseudo-first-order model, indicating the predominance of physisorption, and Bangham’s model, confirming that the micropores structure played an important role for gases diffusion and adsorbent capacity. Additionally, the materials were characterized by N2 adsorption–desorption, X-ray diffraction, infrared spectroscopy, scanning electron microscopy and energy-dispersive spectroscopy. The thermal treatment associated with iron impregnation caused significant modifications in the surface of the materials, and the iron species showed two main benefits: an expressive increase in the specific area and the formation of specific adsorption sites for hydrogen sulfide removal. The results reinforce the advantages of iron-modified adsorbents in relation to their non-modified counterparts. The analytical methodology based on the confinement of multiple gases contributes to improving the understanding of the hydrogen sulfide adsorption process using pressure swing adsorption technology.Graphical

Scalable and economical production of oxygen deficient vanadium oxide with tunable vacancies concentration for bendable zinc ion batteries

Although vanadium oxides have high theoretical capacity and low cost, their practical application in aqueous zinc ion batteries (AZIBs) is bottlenecked by sluggish diffusion kinetics and capacity decline. Herein, the oxygen-deficient V2O5-x·nH2O (defined as VOd) with tunable oxygen vacancy concentration has been obtained via an economic and scalable method. The introduction of oxygen vacancies not only provides extra sites for Zn2+ storage, but also reduces the electrostatic barrier for Zn2+ intercalation, resulting in enhanced capacity and cycling stability. As a result, VOd cathode with proper amount of oxygen defect exhibits a high capacity of 415 mAh g−1 and energy density of 294 Wh kg−1 at 0.2 A g−1, estimating a roughly chemical costs of $64/kWH for VOd cathode. Besides, the VOd exhibits excellent stability at 20 A g−1 with average capacity decay of 0.004 % per cycle for 5000 cycles. Moreover, the bendable quasi-solid VOd//Zn battery maintains stable capacity of 200 mAh g−1 at 2 A g−1 even when repeatedly bending to straight angles. Therefore, the economical production of VOd cathode and construction of bendable quasi-solid battery provides a feasible way to boost the construction of efficient flexible energy storage devices and broadened application of AZIBs.

Effect of Ultramarathon Trail Running at Sea Level and Altitude on Alveolar-Capillary Function and Lung Diffusion.

Endurance exercise at altitude can increase cardiac output and pulmonary vascular pressure to levels that may exceed the stress tolerability of the alveolar-capillary unit. This study examined the effect of ultramarathon trail racing at different altitudes (ranging from <1000 m to between 1500 and 2700 m) on alveolar-capillary recruitment and lung diffusion. Cardiac and lung function were examined before and after an ultramarathon in 67 runners (age: 41 ± 9 yr, body mass index: 23 ± 2 kg·m -2 , 10 females), and following 12-24 h of recovery in a subset ( n = 27). Cardiac biomarkers (cTnI and BNP) were assessed from whole blood, whereas lung fluid accumulation (comet tails), stroke volume (SV), and cardiac output ( Q ) were quantified via echocardiography. Lung diffusing capacity for carbon monoxide (DLco) and its components, alveolar membrane conductance (Dm) and capillary blood volume (Vc), were determined via a single-breath method at rest and during three stages of submaximal semirecumbent cycling (20, 30, and 40 W). Average race time was 25 ± 12 h. From pre- to post-race, there was an increase in cardiac biomarkers (cTnI: 0.04 ± 0.02 vs 0.13 ± 0.03 ng·mL -1 , BNP: 20 ± 2 vs 112 ± 21 pg·mL -1 ; P < 0.01) and lung comet tails (2 ± 1 vs 7 ± 6, P < 0.01), a decrease in resting and exercise SV (76 ± 2 vs 69 ± 2 mL, 40 W: 93 ± 2 vs 88 ± 2 mL; P < 0.01), and an elevation in Q at rest (4.1 ± 0.1 vs 4.6 ± 0.2 L·min -1 , P < 0.01; 40 W: 7.3 ± 0.2 vs 7.4 ± 0.3 L·min -1 , P = 0.899). Resting DLco and Vc decreased after the race ( P < 0.01), whereas Dm was unchanged ( P = 0.465); however, during the three stages of exercise, DLco, Vc, and Dm were all reduced from pre- to post-race (40 W: 36.3 ± 0.9 vs 33.0 ± 0.8 mL·min -1 ·mm Hg -1 , 83 ± 3 vs 73 ± 2 mL, 186 ± 6 vs 170 ± 7 mL·min -1 ·mm Hg -1 , respectively; P < 0.01). When corrected for alveolar volume and Q , DLco decreased from pre- to post-race ( P < 0.01), and changes in DLco were similar for all ultramarathon events ( P > 0.05). Competing in an ultramarathon leads to a transient increase in cardiac injury biomarkers, mild lung-fluid accumulation, and impairments in lung diffusion. Reductions in DLco are predominantly caused by a reduced Vc and possible pulmonary capillary de-recruitment at rest. However, impairments in alveolar-capillary recruitment and Dm both contribute to a fall in exertional DLco following an ultramarathon. Perturbations in lung diffusion were evident across a range of event distances and varying environmental exposures.

Mesoscale mechanics investigation of multi-component solid propellant systems

Abstract To enhance the mechanical properties of the Nitrate Ester Plasticized Polyether solid propellant matrix, the uniaxial tension of multi-component systems is simulated and the factors influencing the mechanical properties of the propellant matrix are investigated. First, mesoscale models of five types of systems include poly alpha olefin (PAO(3)), polyethylene glycol (PEG200, PEG400, PEG600), and 1,4-butanediol (BDO) are established, followed by uniaxial tensile simulations. The results show PEG600, PEG400, PEG200, BDO, and PAO(3) in order of enhancing the mechanical performance of the matrix. Second, the diffusion behavior of nitroglycerin (NG) and butanetriol trinitrate (BTTN) in various systems is investigated. The results show that NG exhibits higher diffusion capacity than BTTN, and the diffusion coefficient increases with an increment in the molecular weight of PEG. Additionally, the influence of different plasticizer ratios (2.8–3.0), curing parameters (1.58–1.62), and chain extension parameters (0.08–0.10) on the mechanical properties of the PEG600 system are investigated. The results demonstrate that as the plasticizer ratio increases, there is a gradual decrease in the modulus of the matrix. Additionally, an increase in the curing parameter leads to a substantial enhancement in the tensile strength of the matrix, while increasing the chain extension parameter significantly expands the maximum tensile length of the matrix. Finally, employing the Slip-Spring model, the effects of the physical and chemical cross-linked network of the propellant are simulated. The result shows that increasing the content of a chemical cross-linked network significantly improves the tensile strength of the matrix.

Residual radiological opacities correlate with disease outcomes in ICU-treated COVID-19.

Few studies consider both radiological and functional outcomes in COVID-19 survivors treated in the intensive care unit (ICU). We investigated clinical findings and pulmonary abnormalities on chest computed tomography (CT) and compared outcomes of severe versus mild-moderate acute respiratory distress syndrome (ARDS) on long-term follow-up. This longitudinal cohort study included 118 COVID-19 patients (median age, 58 years; 79% men). Thoracic CT scans were performed 4, 10, and 22 months after hospital discharge. Two independent blinded radiologists analyzed the 10 months scans and scored the radiology findings semi-quantitatively, as no/minor versus widespread opacities [low-radiology opacity grade (ROG) versus high-ROG]. ARDS severity was based on the PaO2/FiO2 ratio. The 6 min walk test (6MWT) was performed after 3 and 9 months, and lung diffusion capacity for carbon monoxide (DLCO) and lung volume measurement after 9 and 15 months. Dynamic spirometry was done at all time points. Residual symptoms and health-related quality-of-life (HRQL) were evaluated using validated questionnaires. At 10 months, most patients (81/118; 69%) were classified as high-ROG, of which 70% had severe ARDS during hospitalisation; 69% of those with mild-moderate ARDS also had high-ROG. Patients with high-ROG had longer ICU stay and lower PaO2/FiO2 during hospitalisation (p < 0.01). At 9 months follow-up, patients with high-ROG had smaller lung volumes as % of predicted values [mean (±CI): 80 (77-84) vs. 93 (88-98) (p < 0.001)], lower DLCO as % of predicted values [74 (70-78) vs. 87 (82-92) (p < 0.001)], lower oxygen saturation during 6MWT (p = 0.02), and a tendency to more severe dyspnoea (p = 0.07), but no difference was found in HRQL compared with no/minor ROG (p = 0.92). A higher opacity score was related to lower DLCO at follow-up (r = -0.48, p < 0.001, Spearman rank test). Severe ARDS patients had slightly more severe fatigue at 9 months compared to mild-moderate, but no differences in dyspnoea or lung function at follow-up. Fibrotic-like changes were found in 93% of patients examined with CT scans at 2 years (55/118; 47%). Severe ARDS could predict widespread opacities (ROG > 25%) in most patients at follow-up at 10 months (AUC 0.74). Residual radiological abnormalities in ICU-treated COVID-19 patients, evaluated for up to 2 years, relate to persisting symptoms and impaired lung function, demanding careful follow-up regardless of ARDS severity at hospitalisation.

Long-term outcome of pulmonary involvement in patients with coronavirus disease 2019: The role of high-resolution computed tomography and functional status - A prospective single-center observational study.

Since its first outbreak, coronavirus disease 2019 (COVID-19) has led to a great deal of published literature highlighting the short-term determinants of morbidity and mortality. Recently, several studies have reported radiological and functional sequelae from 3 months to 1 year among hospitalized COVID-19 survivors; however, long-term (more than 1 year) respiratory consequences in this population remain to be evaluated. To assess the long-term radiological and pulmonary function outcomes of patients with COVID-19 2 years after resolution of the initial infection. Hospitalized COVID-19 patients with moderate to severe disease who survived acute illness were included in this prospective and partially retrospective study. Clinical assessment, laboratory tests, high-resolution computed tomography scans, and pulmonary function tests (PFTs) were performed at baseline, followed by radiological and lung function assessments at 6 and 24 months. Among 106 enrolled participants (mean age 62 ± 13.5 years; males: 61), 44 (41.5%) and 27 (25.4%) underwent radiological assessment at 6 and 24 months, respectively. Overall, 22.6% (24) of patients had residual radiological abnormalities. Overt fibrosis was observed in 12.2% of patients. Computed tomography disease severity and extent diminished significantly at 6 (13 ± 6, P < 0.001) and 24 months (11 ± 6, P < 0.001) from baseline. PFTs were performed in 65 (61.3%), 22 (20.7%), and 34 (32%) patients at baseline, 6 and 24 months, respectively. Impaired diffusion capacity (median diffusion capacity for carbon monoxide: 60%, interquartile range [IQR]: 51-80), restrictive lung defect (mean total lung capacity: 73.4% ± 18% predicted), and reduced exercise tolerance (median 6-min walk distance: 360 m, IQR: 210-400) were the predominant features at baseline. With the exception of exercise tolerance, a statistically significant improvement was observed in lung function parameters at the extended follow-up (2 years). Hospitalized COVID-19 survivors are at increased risk of developing long-term pulmonary complications, including lung fibrosis. A protocol-based approach to the management of post-COVID-19 patients is mandatory to improve future outcomes.

Two- and 3-year outcomes in convalescent individuals with COVID-19: A prospective cohort study.

As the long-term consequences of coronavirus disease 2019 (COVID-19) have not been defined, it is necessary to explore persistent symptoms, long-term respiratory impairment, and impact on quality of life over time in COVID-19 survivors. In this prospective cohort study, convalescent individuals diagnosed with COVID-19 were followed-up 2 and 3 years after discharge from hospital. Participants completed an in-person interview to assess persistent symptoms and underwent blood tests, pulmonary function tests, chest high-resolution computed tomography, and the 6-min walking test. There were 762 patients at the 2-year follow-up and 613 patients at the 3-year follow-up. The mean age was 60 years and 415 (54.5%) were men. At 3 years, 39.80% of the participants had at least one symptom; most frequently, fatigue, difficulty sleeping, joint pain, shortness of breath, muscle aches, and cough. The participants experienced different degrees of pulmonary function impairment, with decreased carbon monoxide diffusion capacity being the main feature; results remained relatively stable over the 2-3 years. Multiple logistic regression analysis demonstrated that female sex and smoking were independently associated with impaired diffusion capacity. A subgroup analysis based on disease severity was performed, indicating that there was no difference in other parameters of lung function except forced vital capacity at 3-year follow-up. Persistent radiographic abnormalities, most commonly fibrotic-like changes, were observed at both timepoints. At 3 years, patients had a significantly improved Mental Component Score compared with that at 2 years, with a lower percentage with anxiety. Our study indicated that symptoms and pulmonary abnormalities persisted in COVID-19 survivors at 3 years. Further studies are warranted to explore the long-term effects of COVID-19 and develop appropriate rehabilitation strategies.

Evaluation of airway responsiveness and pulmonary function test results among obese and non-obese patients with obstructive sleep apnea syndrome.

In this research, we aimed to elucidate the effect of obstructive sleep apnea syndrome (OSAS) and obesity on pulmonary volumes and bronchial hyperreactivity, and particularly the effect of supine position on pulmonary volume and functions. This was a prospective, cross-sectional study with a total of 96 patients (age range, 20-65 years). Based on the body mass index (BMI) and Apnea-Hypopnea Index (AHI) scores, the patients were divided into four groups: Group 1: AHI≥15/h, BMI≥30 kg/m2 (n=24), Group 2: AHI≥15/h, BMI<30 kg/m2 (n=24), Group 3: AHI<15/h, BMI≥30 kg/m2 (n=24), and Group 4: AHI<15/h, BMI<30 kg/m2 (n=24). All patients first had static and dynamic pulmonary function tests and carbon monoxide diffusion tests (TLco and Kco) in the sitting and supine positions. A bronchial provocation test with methacholine was applied to all patients in the sitting position one day later. Analysis of variance (ANOVA) and multivariate linear regression was used in the statistical analysis. Airway responsiveness was observed in 4 of the patients included in the study, and there was no statistically significant difference between the groups. A statistically significant decrease was observed in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), total lung capacity (TLC) and functional residual capacity (FRC), especially in Group 1 in sitting position compared to Group 4 (p=0.001, p=0.001, p=0.025, p=0.043, and p=0.001, respectively). Changes in pulmonary functions in the transition from sitting to a supine position did not show any significant difference in the study groups (p<0.05). We observed no difference in the diffusion capacity in the sitting and supine positions among the groups (p<0.05). The severity of AHI and BMI particularly affect the lower airway, but changes in the position did not show any significant difference in the study groups.

Long COVID exhibits clinically distinct phenotypes at 3–6 months post-SARS-CoV-2 infection: results from the P4O2 consortium

BackgroundFour months after SARS-CoV-2 infection, 22%–50% of COVID-19 patients still experience complaints. Long COVID is a heterogeneous disease and finding subtypes could aid in optimising and developing treatment for the...

БИОЛОГИЧЕСКИЕ МАРКЕРЫ ФИБРОЗООБРАЗОВАНИЯ У БОЛЬНЫХ САРКОИДОЗОМ ЛЕГКИХ

Introduction. Sarcoidosis-associated pulmonary fibrosis still lacks biomarkers to predict progression. Whole-genome association studies and other genetic research over the past few years have identified several single nucleotide polymorphisms that are associated with an increased risk of developing pulmonary fi brosis. In sarcoidosis, relatively reliable predictors of the disease activity include serum angiotensin-converting enzyme, soluble interleukin-2 receptor (sIL-2R) and chitotriosidase. Levels of inetrleukin-5 and, possibly, interleukin-7 were found to be elevated in patients with a fibrotic phenotype. Aim. In the present study, we sought to find the relationship between serum non- coding RNA- microRNA expression in patients with pulmonary sarcoidosis and the likelihood of pulmonary fibrosis developing in these patients. Materials and Methods. A total of 52 research subjects (sarcoidosis patients with/without fibrosis and healthy subjects) were included in the study. RNA samples from two groups of sarcoidosis patients (with and without fibrosis) and the control group were analyzed using the PCR Array. TaqMan QRT-PCR Assay was used for data verification. Results and Discussion. A significant decrease in the lung diffusion capacity was detected in 12 of 15 patients with chest-CT fibrosis signs. Lung diffusion capacity was normal in 17 patients without any fibrosis signs. There was a significant negative correlation among miR-15a, miR-150, and the level of lung diffusion capacity. Сonclusions. A set of non-coding RNA- microRNAs, i. e., miR-15a, miR-22, miR-106b, miR-107, and miR-150, was identified that can be further used as diagnostic markers for sarcoidosis fibrosis.

Survival and Lung Function Changes in Hypersensitivity Pneumonitis According to Radiological Phenotypes Compared With Idiopathic Pulmonary Fibrosis.

The main objective of this study was to estimate survival and changes in lung function in patients with chronic hypersensitivity pneumonitis (HP), both fibrotic (f-HP) and nonfibrotic (nf-HP), and to compare them with those in patients with idiopathic pulmonary fibrosis (IPF). HP was diagnosed based on antigen exposure, HRCT (high-resolution CT scan), BAL (bronchoalveolar lavage), and histology. According to HRCT, HP was classified into fibrotic and non-fibrotic phenotypes. In most cases, IPF was diagnosed based on HRCT findings. We identified 84 patients: 46 with IPF, 18 with f-HP, and 20 with nf-HP. Five-year survival was 23.9% in IPF, 72% in f-HP, and 100% in nf-HP (p <0.0001). Honeycombing was associated with decreased survival in IPF (p <0.001) and in f-HP (p <0.0001). The mean loss of FVC (forced vital capacity) % pred. (percent predicted) was -18.3% in IPF (p =0.001), -4.8% in f-HP, and -6.0% in nf-HP. The mean change in DLCO (diffusion capacity for carbon monoxide) % pred. was -10.2% in IPF (p <0.002), -0.5% in f-HP, and +1.9% in nf-HP. The agreement between radiological phenotypes and histology in HP was 89.6%. We found shorter survival in IPF, followed by f-HP, and nf-HP. Over time, we did not find significant changes in FVC% pred. or DLCO% pred. in HP, while a significant decline in IPF was noted. In HP, we found strong agreement between radiological phenotypes and histology. Radiological signs suggestive of lung fibrosis in HP were reliable for the diagnosis of f-HP and seem to have intrinsic prognostic value.

Clinical, functional and imaging parallels in the objective status of patients after community-acquired COVID-19-associated pneumonia

OBJECTIVE. To determine the dynamics of clinical symptoms in patients with community-acquired COVID-19-associated pneumonia, imaging and functional examination methods in the early post-acute period of the disease, establishing clinical, functional and imaging parallels in the objective status of patients.&#x0D; MATERIALS AND METHODS. We examined 56 patients after coronavirus disease (COVID-19). The severity of dyspnoea, anamnesis, objective status, pulse oximetry, lung ultrasound (LUS), computed tomography (CT) data, spirometry, body plethysmography, lung diffusion capacity were assessed. Non-parametric methods were used.&#x0D; RESULTS AND DISCUSSION. According to LUS 6 (10.7 %) patients had no pathological changes. Other patients had changes ranging from 3 to 11 points; 24 (48.0 %) had mild interstitial lung lesions, other – moderate. Every second patients showed signs of interstitial inflammation (single, multifocal, confluent B-lines), no more than three segments. Almost all patients (98.0 %) had single A-lines. LUSS was “recruited” mainly due to the LUS-pattern of consolidation (76.0 %) or thickened/ uneven pleura (90.0 %). The area of lung lesions on CT correlated with LUS (r=0.79; p&lt;0.001).&#x0D; CONCLUSIONS. LUS is a highly sensitive method for visualising interstitial changes in the lungs in the post-acute period after COVID-19-associated pneumonia. Most often, there are no impairments in lung ventilation function, but about 20 % of patients require further examination.

Pulmonary diffusing capacity for carbon monoxide and nitric oxide after COVID-19: A prospective cohort study (the SECURe study).

Many patients exhibit persistently reduced pulmonary diffusing capacity after coronavirus disease 2019 (COVID-19). In this study, dual test gas diffusing capacity for carbon monoxide and nitric oxide (DL,CO,NO) metrics and their relationship to disease severity and physical performance were examined in patients who previously had COVID-19. An initial cohort of 148 patients diagnosed with COVID-19 of all severities between March 2020 and March 2021 had a DL,CO,NO measurement performed using the single-breath method at 5.7months follow-up. All patients with at least one abnormal DL,CO,NO metric (n=87) were revaluated at 12.5months follow-up. The DL,CO,NO was used to provide the pulmonary diffusing capacity for nitric oxide (DL,NO), the pulmonary diffusing capacity for carbon monoxide (DL,CO,5s), the alveolar-capillary membrane diffusing capacity and the pulmonary capillary blood volume. At both 5.7 and 12.5months, physical performance was assessed using a 30 s sit-to-stand test and the 6min walk test. Approximately 60% of patients exhibited a severity-dependent decline in at least one DL,CO,NO metric at 5.7months follow-up. At 12.5months, both DL,NO and DL,CO,5s had returned towards normal but still remained abnormal in two-thirds of the patients. Concurrently, improvements in physical performance were observed, but with no apparent relationship to any DL,CO,NO metric. The severity-dependent decline in DL,NO and DL,CO observed at 5.7months after COVID-19 appears to be reduced consistently at 12.5months follow-up in the majority of patients, despite marked improvements in physical performance.

Prevalence, causes, and clinical associations of anemia in patients with systemic sclerosis: A cohort study.

Anemia is considered a risk factor of severity in systemic sclerosis. Yet, limited data are available on the frequency and causes of anemia in systemic sclerosis. The objectives of our study were to determine the frequency and causes of anemia in systemic sclerosis, to analyze the clinical and biological characteristics of patients with anemia, and to assess the association between anemia and systemic sclerosis prognosis. We conducted a prospective single-center study from January 2017 to May 2022. Patients underwent a hemoglobin assay and a standardized etiological workup to determine the causes of anemia at the initial visit. Clinical and biological parameters were compared between patients with anemia and those with normal hemoglobin levels. We followed up patients until May 2023 and compared their survival. A total of 502 systemic sclerosis patients, including 107 diffuse cutaneous systemic sclerosis, were included. At enrollment, 100 patients had anemia. The primary cause of anemia was iron deficiency (40%). Among the 32 patients with iron deficiency-associated anemia who underwent gastrointestinal exploration, 56% had digestive bleeding, with upper gastrointestinal tract involvement being the main cause (90%). Patients with anemia at enrollment had higher systemic sclerosis severity scores and more gastrointestinal symptoms compared to patients without anemia (p < 0.05). They exhibited higher systolic pulmonary artery pressure, lower anemia-corrected diffusing capacity for carbon monoxide, and lower forced vital capacity (p < 0.05). During follow-up, 65 patients (14.8%) died. After adjusting for age, systemic sclerosis subtypes, forced vital capacity, and pulmonary arterial hypertension, anemia at inclusion was associated with a higher mortality rate (hazard ratio: 1.94 (95% confidence interval: 1.39-2.48), p = 0.02). Our study shows a high frequency of anemia among patients with systemic sclerosis. Most anemias are due to iron deficiency, and gastrointestinal exploration can identify bleeding in the majority of the cases. In addition, our study confirms that systemic sclerosis patients with anemia have a more severe disease and a higher mortality rate.

Leaf diffusional capacity largely contributes to the reduced photosynthesis in rice plants under magnesium deficiency

Numerous studies have clarified the impacts of magnesium (Mg) on leaf photosynthesis from the perspectives of protein synthesis, enzymes activation and carbohydrate partitioning. However, it still remains largely unknown how stomatal and mesophyll conductances (gs and gm, respectively) are regulated by Mg. In the present study, leaf gas exchanges, leaf hydraulic parameters, leaf structural traits and cell wall composition were examined in rice plants grown under high and low Mg treatments to elucidate the impacts of Mg on gs and gm. Our results showed that reduction of leaf photosynthesis under Mg deficiency was mainly caused by the decreased gm, followed by reduced leaf biochemical capacity and gs, and leaf outside-xylem hydraulic conductance (Kox) was the major factor restricting gs under Mg deficiency. Moreover, increased leaf hemicellulose, lignin and pectin contents and decreased cell wall effective porosity were observed in low Mg plants relative to high Mg plants. These results suggest that Kox and cell wall composition play important roles in regulating gs and gm, respectively, in rice plants under Mg shortages.

Investigation of Hydrogen-Blended Natural Gas Pipelines in Utility Tunnel Leakage and Development of an Accident Ventilation Strategy for the Worst Leakage Conditions

The development of hydrogen-blended natural gas (HBNG) increases the risk of gas transportation and presents challenges for pipeline security in utility tunnels. The objective of this study is to investigate the diffusion properties of HBNG in utility tunnels and evaluate the effectiveness of various ventilation mechanisms. The numerical simulation software Fluent 2023 R1 is applied to simulate and analyze the leakage of small holes in a HBNG pipeline in the natural gas compartment. By examining the leaking behavior of HBNG through small holes in different circumstances, we aimed to identify the most unfavorable operational situation for leakage. Subsequently, we analyzed the ventilation strategy for sub-high-pressure pipes at various pressure levels in this unfavorable condition. This study’s findings demonstrate that blending hydrogen improves the gas diffusion capacity and increases the likelihood of explosion. The primary factors that influence the pattern of leakage are the size of the leaking holes and the pressure of the pipeline. The gas compartment experiences the most unfavorable working conditions for natural gas pipeline leaks when there are higher pressures, wider leak openings, higher hydrogen blending ratios (HBRs), and leaks in close proximity to an air inlet. When the HBR is 20%, the minimum accident ventilation rates for pressures of 0.4 MPa and 0.8 MPa are 15 air changes per hour and 21 air changes per hour, respectively. The maximum allowable wind speed for accident ventilation is 5 m/s, as regulated by China’s national standard, GB 50838-2015. This regulation makes it difficult to minimize the risk of leakage in a 1.6 MPa gas pipeline. It is recommended to install a safety interlock device to quickly shut off the pipeline in the event of a leak in order to facilitate the dispersion of the substance.