Obstructive Respiratory Disease Research Articles

Zinc fever in a painter and varnisher: a case report

BackgroundZinc fever is well described in medical literature, particularly in workers after handling zinc-containing materials at high temperatures e.g., in the welding of hot-dip galvanized steel sheets. It is not known whether zinc fever also occurs at low temperatures.Case presentationWe present the case of a 33-year-old Caucasian atopic painter and varnisher with work-related dyspnea, sweating, as well as multiple occurrences of fever. He was sent to Institute for Prevention and Occupational medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA) for the evaluation of isocyanate asthma, but an inhalative challenge with hexamethylene diisocyanate was negative. Since symptoms were closely related to the use of zinc coatings at room temperature without adequate protective measures, the diagnosis of zinc fever was made. After exposure cessation the worker immediately became symptom-free. The work as painter and varnisher may be associated with various exposures to hazardous substances. Besides solvents, epoxy compounds and isocyanates, which can cause obstructive respiratory diseases; additionally, zinc-containing agents should be considered as health hazards.ConclusionsThis case demonstrates that zinc fever may occur also after application of zinc coatings by spray painting at low temperatures.

Obstructive respiratory disease in U.S. veterans: Prevalence, characteristics, and health burden

ObjectiveTo examine the psychiatric and physical health burden of obstructive respiratory disease in a nationally representative sample of U.S. Veterans. MethodsSecondary data analyses were conducted using data from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. Veterans. Participants self-reported health professional-diagnosed obstructive respiratory disease (i.e., asthma, chronic bronchitis or chronic obstructive pulmonary disease). Veterans who reported obstructive respiratory disease (n = 502) were compared to veterans without this disease but with at least one or more other medical conditions—controls (n = 3169) on measures of sociodemographic, trauma, psychiatric, and physical health characteristics. Multivariable regression analyses examined independent associations between obstructive respiratory disease and psychiatric conditions and physical characteristics. ResultsA total 12.5% of the sample reported a diagnosis of obstructive respiratory disease. Compared to controls, veterans with obstructive respiratory disease were more likely to be female, unmarried/partnered, lower income, residing in the Midwest, receiving VA healthcare, and had greater lifetime and childhood trauma burden. In adjusted analyses, veterans with respiratory disease had 47–91% greater odds of screening positive for current posttraumatic stress, major depressive, and generalized anxiety disorders, and had 48% greater odds of current suicide ideation. They were also more likely to have lifetime nicotine use disorder and had more medical comorbidities and more severe somatic symptoms. ConclusionsObstructive respiratory disease is prevalent among U.S. veterans and associated with significant mental and physical health burden. Results highlight the need for timely screening and treatment for psychiatric and medical conditions that are highly comorbid with obstructive respiratory disease in this population.

Effects of combustible cigarettes and heated tobacco products on immune cell-driven inflammation in chronic obstructive respiratory diseases.

Since long-term effects of heated tobacco products (HTP) on the progression of chronic obstructive pulmonary disease (COPD) are unknown, we used COPD mice model to compare immune cell-dependent pathological changes in the lungs of animals which were exposed to HTP or combustible cigarettes (CCs). We also performed intracellular staining and flow cytometry analysis of immune cells which were present in the blood of CCs and HTP users who suffered from immune cell-driven chronic obstructive respiratory diseases. CCs enhanced NLRP3 inflammasome-dependent production of inflammatory cytokines in lung-infiltrated neutrophils and macrophages and increased influx of cytotoxic Th1, Th2, and Th17 lymphocytes in the lungs of COPD mice. Similarly, CCs promoted generation of inflammatory phenotype in circulating leukocytes of COPD patients. Opposite to CCs, HTP favored expansion of immunosuppressive, IL-10-producing, FoxP3-expressing T, NK, and NKT cells in inflamed lungs of COPD mice. Compared with CCs, HTP had weaker capacity to promote synthesis of inflammatory cytokines in lung-infiltrated immune cells. Significantly lower number of inflammatory neutrophils, monocytes, Th1, Th2, and Th17 lymphocytes were observed in the blood of patients who consumed HTP than in the blood of CCs users, indicating different effects of CCs and HTP on immune cells' phenotype and function.

Anoctamin pharmacology

TMEM16 proteins, also known as anoctamins, are a family of ten membrane proteins with various tissue expression and subcellular localization. TMEM16A (anoctamin 1) is a plasma membrane protein that acts as a calcium-activated chloride channel. It is expressed in many types of epithelial cells, smooth muscle cells and some neurons. In airway epithelial cells, TMEM16A expression is particularly enhanced by inflammatory stimuli that also promote goblet cell metaplasia and mucus hypersecretion. Therefore, pharmacological modulation of TMEM16A could be beneficial to improve mucociliary clearance in chronic obstructive respiratory diseases. However, the correct approach to modulate TMEM16A activity (activation or inhibition) is still debated. Pharmacological inhibitors of TMEM16A could also be useful as anti-hypertensive agents given the TMEM16A role in smooth muscle contraction.In contrast to TMEM16A, TMEM16F (anoctamin 6) behaves as a calcium-activated phospholipid scramblase, responsible for the externalization of phosphatidylserine on cell surface. Inhibitors of TMEM16F could be useful as anti-coagulants and anti-viral agents. The role of other anoctamins as therapeutic targets is still unclear since their physiological role is still to be defined.

Assessment of Lung Health Status by Analyzing Cough Sound Using Swaasa Artificial Intelligence Technology

Introduction: The crucial function of the respiratory system is the facilitation of blood gas exchange process. Spirometry is the diagnostic tool to detect and differentiate obstructive and restrictive respiratory diseases that impair this vital function. The need for a clinical setup, technical expertise, and patient compliance are certain limitations for utilizing spirometry in remote areas. Swaasa® artificial intelligence (AI) platform, which has a Class B manufacturing license from India’s Central Drugs Standard Control Organization, is a validated “software as a medical device,” which aids in screening and diagnosis of respiratory diseases, unbounded by location, equipment and technical expertise. Objectives: The objectives of the study were to determine the “lung health index” and the “pattern of lung health” conditions among nursing students. Materials and Methods: A cross-sectional study was conducted utilizing the Swaasa® AI platform among students of a nursing college in Central Karnataka in June 2023. Based on audiometric analysis of cough sounds, parameters such as underlying respiratory condition, cough count values, and respiratory symptoms experienced, ‘Swaasa’ AI platform derives pattern of respiratory condition (normal/obstructive/restrictive/mixed), ‘Lung Health Index,’ and presence or absence of lung health risk. Data collected in the Swaasa app were downloaded and analyzed using SPSS.v. 20. Results: Lung health risk was present in 58.2% of participants. Abnormal lung pattern was noted in 21.3% of participants (obstructive: 14.8%, restrictive: 2.5%, and mixed pattern: 4.1%). Conclusion: The Swaasa AI platform was utilized in this study to self-test lung health in real time without the need for a clinical setting. A high lung health index was found among 18% of participants. Studies adopting such cough sound analysis involving a larger population from wider geographic areas have to be conducted to detect and monitor respiratory diseases to increase its usage among the medical community in everyday clinical practice and also in remote areas.

Wireless Sensing System Based on Biodegradable Triboelectric Nanogenerator for Evaluating Sports and Sleep Respiratory.

The rapid growth of the Internet of Things and wearable sensors has led to advancements in monitoring technology in the field of health. One such advancement is the development of wearable respiratory sensors, which offer a new approach to real-time respiratory monitoring compared to traditional methods. However, the energy consumption of these sensors raises concerns about environmental pollution. To address the issue, this study proposes the use of a triboelectric nanogenerator (TENG) as a sustainable energy source. The electrical conductivity of the TENG is improved by incorporating chitosan and carbon nanotubes, with the added benefit of chitosan's biodegradability reducing negative environmental impact. A wireless intelligent respiratory monitoring system (WIRMS) is then introduced, which utilizes a degradable triboelectric nanogenerator for real-time respiratory monitoring, diagnosis, and prevention of obstructive respiratory diseases. WIRMS offers stable and highly accurate respiratory information monitoring, while enabling real-time and nondestructive transmission of information. In addition, machine learning technology is used for sleep respiration state analysis. The potential applications of WIRMS extend to wearables, medical monitoring and sports monitoring, thereby presenting innovative ideas for modern medical and sports monitoring.

Modified Frailty Index Associates With Transoral Robotic Surgery Complications and Survival: A National Database Study.

The modified frailty index (mFI-5) is a National Surgical Quality Improvement Program-derived 5-factor index that has been proven to reflect frailty and predict morbidity and mortality. We hypothesize that mFI-5 is a valid predictive measure in the transoral robotic surgery (TORS) population. Retrospective study utilizing the TriNetX US-collaborative health records network querying for TORS patients. Cohorts were stratified by mFI-5 score which uses five ICD-10 codes: nonindependent functional status, hypertension, obstructive respiratory disease, heart failure, and diabetes mellitus. Cohorts were matched by age using propensity score matching. Outcome measures included survival, infection, pneumonia, tracheostomy dependence, and percutaneous endoscopic gastrostomy dependence. Reported odds ratios were normalized to mFI-5 = 0. A total of 9,081 patients were included in the final analysis. Greater mFI-5 scores predicted decreased survival and increased incidence of postoperative infection and pneumonia. Odds of 5-year mortality were 1.93 (p = 0.0003) for mFI-5 = 2 and 1.90 (p = 0.0002) for mFI-5 = 3. Odds of 2-year mortality were 1.25 (p = 0.0125) for mFI-5 = 1, 1.58 (p = 0.0002) for mFI-5 = 2, and 1.87 (p = 0.003) for mFI-5 = 3. Odds of postoperative infection were 1.51 (p = 0.02) for mFI-5 = 2 and 1.78 (p = 0.05) for mFI-5 = 3. Two-year odds of developing pneumonia were 1.69 (p = 0.0001) for mFI-5 = 2 and 2.84 (p < 0.0001) for mFI-5 = 3. Two-month odds of pneumonia were 1.50 (p = 0.0259) for mFI-5 = 2 and 2.55 (p = 0.0037) for mFI-5 = 3. mFI-5 = 4 or 5 had too few patients to analyze. Using polynomial regression to model age versus incident 5-year post-TORS death (R2 = 0.99), mFI-5 scores better predicted survival than age alone. This study demonstrates that mFI-5 predicts mortality, pneumonia, and postoperative infection independently of age. 4 Laryngoscope, 2024.

A Retrospective Analysis: Investigating Factors Linked to High Lung-RADS Scores in a Nonsmoking, Non-Family History Population.

Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer. This study aimed to identify risk factors for lung cancer in individuals who do not meet the current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency's low-dose computed tomography (LDCT) screening policy. A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20-80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021. Logistic regression demonstrated that several factors, including age over 55 years, female gender, a body mass index (BMI) less than 23, a previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma), and previous respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans. These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and a family history of lung cancer may improve the efficiency of lung cancer screening.

The impact of lung transplantation on esophageal motility and inter-relationships with reflux and lung mechanics in patients with restrictive and obstructive respiratory disease.

For many patients with lung disease the only proven intervention to improve survival and quality of life is lung transplantation (LTx). Esophageal dysmotility and gastroesophageal reflux (GER) are common in patients with respiratory disease, and often associate with worse prognosis following LTx. Which, if any patients, should be excluded from LTx based on esophageal concerns remains unclear. Our aim was to understand the effect of LTx on esophageal motility diagnosis and examine how this and the other physiological and mechanical factors relate to GER and clearance of boluses swallowed. We prospectively recruited 62 patients with restrictive (RLD) and obstructive (OLD) lung disease (aged 33-75 years; 42 men) who underwent high resolution impedance manometry and 24-h pH-impedance before and after LTx. RLD patients with normal motility were more likely to remain normal (p = 0.02), or if having abnormal motility to change to normal (p = 0.07) post-LTx than OLD patients. Esophageal length (EL) was greater in OLD than RLD patients' pre-LTx (p < 0.001), reducing only in OLD patients' post-LTx (p = 0.02). Reduced EL post-LTx associated with greater contractile reserve (r = 0.735; p = 0.01) and increased likelihood of motility normalization (p = 0.10). Clearance of reflux improved (p = 0.01) and associated with increased mean nocturnal baseline impedance (p < 0.001) in RLD but not OLD. Peristaltic breaks and thoraco-abdominal pressure gradient impact both esophageal clearance of reflux and boluses swallowed (p < 0.05). RLD patients are more likely to show improvement in esophageal motility than OLD patients post-LTx. However, the effect on GER is more difficult to predict and requires other GI, anatomical and pulmonary factors to be taken into consideration.

Bronquiolitis obliterante posinfecciosa secundaria a adenovirus

Bronchiolitis obliterans is a rare chronic obstructive respiratory disease secondary to damage of the lower respiratory tract causing inflammation and partial or total obliteration of it. There are different causes, being infectious the most frequent in pediatrics, mainly due to adenovirus. We present the case of an 18-month-old male infant with a history of admission to the Pediatric Intensive Care Unit at 8 months of age due to bronchitis secondary to respiratory syncytial virus and adenovirus. After this episode, he presented persistent respiratory distress and pathological pulmonary auscultation. High resolution pulmonary computed tomography showed a mosaic pattern with areas of air trapping and decreased vascular caliber in the affected areas, findings suggestive of bronchiolitis obliterans.

Associations of Depressive and Anxiety Disorders with Pulmonary Disorders in the Community: The PneumoLaus and PsyCoLaus Studies

Introduction: Mental health disorders figure among the many comorbidities of obstructive respiratory diseases. The multisystemic characteristics of chronic respiratory disease and its impact on quality of life could affect depressive and/or anxiety disorders. We aimed to evaluate the association of spirometric indices, ventilatory disorders, and self-reported respiratory diseases with psychiatric disorders considering potential confounders. Methods: We analysed data from CoLaus|PsyCoLaus, a Swiss population-based cohort study, consisting of 2’774 participants (56% women; mean age: 62.3 (standard deviation = ±9.9) years) who performed spirometry and completed semi-structured psychiatric interviews. We defined ventilatory disorders using GLI-2012 references. Major depressive episode (MDE) and anxiety disorders were defined using the DSM-IV (Diagnostic and Statistical Manual). Results: 630 subjects (22.7%) presented a recent MDE. Reversible obstructive ventilatory disorders were associated with recent MDE (OR = 1.94, 95% confidence interval (95% CI) 1.10–3.43) and recent anxiety disorders (2.21 [1.16–4.22]) only in unadjusted model. Self-reported chronic obstructive pulmonary (COPD) and asthma were associated with MDE with ORs of 2.49 (95% CI, 1.19–5.27) and 1.56 (95% CI, 1.04–2.35) after adjustment, respectively. Possible restrictive ventilatory impairment was positively associated with recent anxiety disorders (OR = 2.46, 1.10–5.51). Z-scores of FEV1, FVC, and maximal mid-expiratory flow were not associated with psychiatric disorders. There was no association between ventilatory disorders and MDE in adjusted models. Conclusions: In this cross-sectional population-based study, the association between respiratory disorders and depressive disorders was observed for self-reported COPD and asthma, but not with objective diagnoses based on spirometry. Lung volumes are not associated with psychiatric disorders. Further prospective studies will be necessary to understand the significance of the association.

Comparison between patients with COPD and healthy subjects on spatiotemporal, moment and kinematic parameters: A quasi-experimental study.

Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls. Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle. The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference (p = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference (p = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups (p = 0.01). The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases.

Effect of COVID-19 and Air Pollution on the Risk Factors Attributed to COPD, Cardiovascular, and Respiratory Diseases

Context: A wide range of complications, including chronic respiratory diseases, asthma attacks, cardiovascular diseases (CDs), various cancers (blood, lung, and brain), and even death, can result from air pollution. It is essential to assess the health effects on humans caused by environmental air pollutants and non-communicable diseases (NCDs), including coronavirus disease 2019 (COVID-19). The purpose of this review study was to investigate the synergistic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and air pollutants on the risk factors for chronic obstructive pulmonary disease (COPD), CDs, and respiratory diseases (RDs). Evidence Acquisition: An extensive literature review was conducted. A total of 1 005 articles were retrieved from sources, including Google Scholar, Springer, PubMed, Web of Science, and Springer databases. In the final stage of the literature review, a significant association between mortality related to COVID-19 and air pollution emissions was identified, contributing to the risk factors associated with CDs and RDs. Results: The result showed that air pollution can have synergistic effects on the transmission of SARS-CoV-2 viruses and has an increasing effect on the incidence of RDs [such as SARS and Middle East respiratory syndrome (MERS)] and CDs. According to the findings, exposure to toxic air pollutants, whether chronic or acute, can have severe effects, including a decrease in airway ciliary function, damage to the mucous membrane, reduced air sac elasticity, decreased lung capacity, and an increased risk of CDs. Conclusions: COVID-19 and air pollutants pose a serious threat to human and animal health. Epidemiological studies have shown that in addition to environmental conditions, individual sensitivity plays a key role in the development of conditions such as COPD, CDs, RDs, cancer, and mortality.

Sleep and quality of life characteristics in a pediatric population with chronic obstructive respiratory diseases.

To describe sleep and quality of life of pediatric patients with chronic obstructive respiratory diseases and toascertain whether or notsleep quality correlates with quality of life in this population. Participants aged 5 to 18 years with cystic fibrosis (CF), severe asthma, or postinfectious bronchiolitis obliterans (PIBO) receiving regular follow-up at a pediatric respiratory medicine center were recruited. Two questionnaires were used: the Brazilian version of the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Quality of Life Inventory (Peds-QL). A total of 46 individuals were included: 30 with CF, 9 with severe asthma, and 7 with PIBO. Almost two-thirds of the patients and their parents or guardians scored at least 39 points on the SDSC, suggesting poor sleep quality. Significantly higher overall median scores were observed in those with severe asthma. Patients and their parents or guardians scored a median of 77 and 80 points respectively on the Peds-QL, with parents of patients withCF scoring higher than any other group. There was a moderate inverse correlation between sleep disorders and quality of life (r = - 0.532 for patients and r = - 0.606 for parents; p < 0.001). Children and adolescents with chronic obstructive respiratory diseases experience impairment in their sleep quality and quality of life. Sleep disorders and quality of life have a moderate negative correlation.

CYP2A6 associates with respiratory disease risk and younger age of diagnosis: a phenome-wide association Mendelian Randomization study.

CYP2A6, a genetically variable enzyme, inactivates nicotine, activates carcinogens, and metabolizes many pharmaceuticals. Variation in CYP2A6 influences smoking behaviors and tobacco-related disease risk. This phenome-wide association study examined associations between a reconstructed version of our weighted genetic risk score (wGRS) for CYP2A6 activity with diseases in the UK Biobank (N = 395 887). Causal effects of phenotypic CYP2A6 activity (measured as the nicotine metabolite ratio: 3'-hydroxycotinine/cotinine) on the phenome-wide significant (PWS) signals were then estimated in two-sample Mendelian Randomization using the wGRS as the instrument. Time-to-diagnosis age was compared between faster versus slower CYP2A6 metabolizers for the PWS signals in survival analyses. In the total sample, six PWS signals were identified: two lung cancers and four obstructive respiratory diseases PheCodes, where faster CYP2A6 activity was associated with greater disease risk (Ps < 1×10-6). A significant CYP2A6-by-smoking status interaction was found (Psinteraction < 0.05); in current smokers, the same six PWS signals were found as identified in the total group, whereas no PWS signals were found in former or never smokers. In the total sample and current smokers, CYP2A6 activity causal estimates on the six PWS signals were significant in Mendelian Randomization (Ps < 5×10-5). Additionally, faster CYP2A6 metabolizer status was associated with younger age of disease diagnosis for the six PWS signals (Ps < 5×10-4, in current smokers). These findings support a role for faster CYP2A6 activity as a causal risk factor for lung cancers and obstructive respiratory diseases among current smokers, and a younger onset of these diseases. This research utilized the UK Biobank Resource.

Dysanapsis and its role in the occurrence of chronic obstructive respiratory diseases in children and adults: A review

The literature review, written on the basis of world literature data and the results of the authors' own research, is devoted to an important pathogenetic mechanism of development and progression of chronic obstructive pulmonary diseases in children and adults dysanapsis, which is understood as a mismatch in the size or growth of the airways to the volume or growth of the lung parenchyma, while the diameter of the airways is disproportionately smaller than the volume of the lung parenchyma. Modern methods of diagnosis of dysanapsis are based on the use of computed tomography of the chest organs, spirometry (accounting for the volume of forced exhalation in 1 second, forced vital capacity of the lungs, calculation of the coefficient of dysanapsis). Dysanapsis, which has genetic and age-dependent mechanisms of formation, makes an important contribution to the development of bronchial hyperreactivity and bronchial asthma, especially in combination with overweight and obesity, determining the uncontrolled course of asthma. The phenomenon of dysanapsis can be explained by the clinical and functional indicators of the respiratory system (hypoxemia, bronchial obstruction) in premature infants, including patients with bronchopulmonary dysplasia, patients with postinfectious obliterating bronchiolitis. In addition, imbalance is an important pathogenetic component of chronic obstructive pulmonary disease, causing the defeat of patients with this disease, regardless of the presence and length of smoking.

Allosteric modulator potentiates β2AR agonist-promoted bronchoprotection in asthma models.

Asthma is a chronic inflammatory disease associated with episodic airway narrowing. Inhaled β2-adrenergic receptor (β2AR) agonists (β2-agonists) promote - with limited efficacy - bronchodilation in asthma. All β2-agonists are canonical orthosteric ligands that bind the same site as endogenous epinephrine. We recently isolated a β2AR-selective positive allosteric modulator (PAM), compound-6 (Cmpd-6), which binds outside of the orthosteric site and modulates orthosteric ligand functions. With the emerging therapeutic potential of G-protein coupled receptor allosteric ligands, we investigated the impact of Cmpd-6 on β2AR-mediated bronchoprotection. Consistent with our findings using human β2ARs, Cmpd-6 allosterically potentiated β2-agonist binding to guinea pig β2ARs and downstream signaling of β2ARs. In contrast, Cmpd-6 had no such effect on murine β2ARs, which lack a crucial amino acid in the Cmpd-6 allosteric binding site. Importantly, Cmpd-6 enhanced β2 agonist-mediated bronchoprotection against methacholine-induced bronchoconstriction in guinea pig lung slices, but - in line with the binding studies - not in mice. Moreover, Cmpd-6 robustly potentiated β2 agonist-mediated bronchoprotection against allergen-induced airway constriction in lung slices obtained from a guinea pig model of allergic asthma. Cmpd-6 similarly enhanced β2 agonist-mediated bronchoprotection against methacholine-induced bronchoconstriction in human lung slices. Our results highlight the potential of β2AR-selective PAMs in the treatment of airway narrowing in asthma and other obstructive respiratory diseases.

Non-Genetic Risk Factors for Dementia and Alzheimer’s Disease

Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder linked to multiple genetic and environmental factors. Despite its complex pathology and still undetermined etiology, a number of factors have been found to be closely associated with the incidence of AD. Although the molecular mechanisms linking many of these factors with AD are unclear and not necessarily causative, their identification and control might be key preventative measures. Cardiovascular diseases, diabetes, obesity and other life-style habits are recognized as established risk factors for AD. Other emerging factors investigated as potential contributors to the overall risk of dementia include anemia, obstructive respiratory diseases, vitamin D deficiency, thyroid imbalance, inflammation and depression. This review summarizes established risk factors; it also provides an insight into emerging factors as modifiable elements, the control of which may reduce the risk of AD and dementia.

Convolutional Neural Network Classification of Exhaled Aerosol Images for Diagnosis of Obstructive Respiratory Diseases

Aerosols exhaled from the lungs have distinctive patterns that can be linked to the abnormalities of the lungs. Yet, due to their intricate nature, it is highly challenging to analyze and distinguish these aerosol patterns. Small airway diseases pose an even greater challenge, as the disturbance signals tend to be weak. The objective of this study was to evaluate the performance of four convolutional neural network (CNN) models (AlexNet, ResNet-50, MobileNet, and EfficientNet) in detecting and staging airway abnormalities in small airways using exhaled aerosol images. Specifically, the model’s capacity to classify images inside and outside the original design space was assessed. In doing so, multi-level testing on images with decreasing similarities was conducted for each model. A total of 2745 images were generated using physiology-based simulations from normal and obstructed lungs of varying stages. Multiple-round training on datasets with increasing images (and new features) was also conducted to evaluate the benefits of continuous learning. Results show reasonably high classification accuracy on inbox images for models but significantly lower accuracy on outbox images (i.e., outside design space). ResNet-50 was the most robust among the four models for both diagnostic (2-class: normal vs. disease) and staging (3-class) purposes, as well as on both inbox and outbox test datasets. Variation in flow rate was observed to play a more important role in classification decisions than particle size and throat variation. Continuous learning/training with appropriate images could substantially enhance classification accuracy, even with a small number (~100) of new images. This study shows that CNN transfer-learning models could detect small airway remodeling (&lt;1 mm) amidst a variety of variants and that ResNet-50 can be a promising model for the future development of obstructive lung diagnostic systems.

Filling gaps in female gout: a cross-sectional study of comorbidities in 192 037 hospitalised patients

ObjectiveThere is room for improvement in the knowledge of female gout, often noted at risk of gender blindness. This study aims to compare the prevalence of comorbidities in women versus...