---
title: "Pulmonology Clinical Research Feed | MedicHelpline"
specialty: "Pulmonology"
specialty_slug: "pulmonology"
canonical_url: "https://medichelpline.com/clinical-feed/pulmonology"
content_type: "clinical_feed_specialty"
page: 1
articles_in_batch: 30
generated_at: "2026-09-05T23:52:18.736Z"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Pulmonology — Clinical Research Feed
## Specialty Overview: Pulmonology
Latest peer-reviewed clinical trials, guidelines, and observational research in **Pulmonology**, indexed and structured for clinical intelligence and AI reasoning.
## Latest Pulmonology Publications
### 1. [Triglyceride-Glucose (TyG) Index and Mortality in Non-Diabetic Fibrotic Lung Disease on Antifibrot](https://medichelpline.com/clinical-feed/plos-one-1-association-between-triglyceride-glucose-index-and-all-cause-mortality-in-non.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Triglyceride-Glucose (TyG) Index and Mortality in Non-Diabetic Fibrotic Lung Disease on Antifibrot](https://medichelpline.com/clinical-feed/plos-one-1-association-between-triglyceride-glucose-index-and-all-cause-mortality-in-non.md)

> **Executive GIST:** - This retrospective cohort study evaluated the association between the **TyG index** (a surrogate marker of insulin resistance) and **all-cause mortality** in 144 non-diabetic patients with radiologically defined **fibrotic lung disease** who started antifibrotic therapy between 2015 and 2023. - Patients with documented diabetes, those receiving fenofibrate, or without triglyceride measurements were excluded to focus on metabolic variability within the non-diabetic range. - Baseline measures included pulmonary function tests (FVC%, FEV1%, DLCO%), 6-minute walk test distance, fasting glucose, triglycerides, and calculation of the TyG index (Ln[(TG × glucose)/2]). - Cohort characteristics: mean age 67.4 years, 31.9% female, 59.7% current smokers, median smoking 35 pack-years among smokers; 45.1% received pirfenidone and 54.9% received nintedanib. - Median follow-up was 33.8 months; 54 of 144 patients (37.5%) died during follow-up. - Mean TyG index was 8.78; median triglycerides 123 mg/dL and median glucose 100 mg/dL. Mean baseline PFTs: FVC% 74.2% and DLCO% 50.6%. - In multivariable Cox regression (adjusted for sex, smoking pack-years, COPD, and FVC%), the **TyG index** was not significantly associated with **all-cause mortality** (adjusted HR 0.80, 95% CI 0.40–1.60, p = 0.54). - Lower **FVC%** and greater cumulative smoking exposure were independently associated with mortality in the adjusted model. - No consistent association between TyG and baseline pulmonary function was observed; an exploratory weak inverse correlation with **DLCO** was reported but not robust. - Study limitations include retrospective design, selected tertiary-center cohort, exclusion of diabetic patients which reduced metabolic variability, absence of uniform adjudication of comorbidities, potential fasting-status uncertainty for labs, limited event count restricting multivariable model complexity, and limited statistical precision. - Authors conclude TyG was not significantly associated with mortality in this selected non-diabetic antifibrotic-treated cohort and recommend prospective studies in broader populations to clarify potential prognostic relevance.

### 2. [Pemafibrate as a senotherapeutic for COPD via TFEB-driven autophagy and mitophagy regulation](https://medichelpline.com/clinical-feed/medrxiv-4-senotherapeutic-role-of-pemafibrate-through-autophagy-mitophagy-regulation-in.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Pemafibrate as a senotherapeutic for COPD via TFEB-driven autophagy and mitophagy regulation](https://medichelpline.com/clinical-feed/medrxiv-4-senotherapeutic-role-of-pemafibrate-through-autophagy-mitophagy-regulation-in.md)

> **Executive GIST:** - Chronic obstructive pulmonary disease (COPD) pathogenesis involves smoking-induced cellular senescence tied to inadequate **autophagy**. Transcription factor EB (**TFEB**) is a central regulator of the autophagy-lysosome pathway and was found reduced in COPD lung epithelial cells in this study. - The investigators tested pemafibrate, a putative **TFEB** inducer, across human bronchial epithelial cells exposed to cigarette smoke (CS) extract, a long-term CS-exposed mouse model, and a retrospective patient cohort comparing pemafibrate versus bezafibrate or fenofibrate. - In vitro, pemafibrate increased **autophagy/mitophagy** flux, restored lysosomal acidification disrupted by CS extract, and reduced cellular senescence; TFEB knockdown attenuated these effects, supporting TFEB involvement. - In mice, pemafibrate upregulated TFEB, reduced alveolar enlargement and airflow obstruction, and prevented the CS-induced increase in static lung compliance after long-term CS exposure. - Bulk RNA sequencing of mouse lungs suggested that pemafibrate’s attenuation of CS-induced cellular senescence may operate through autophagy/mitophagy-related pathways; study reports that RNA-seq data are being deposited to GEO. - A retrospective cohort analysis indicated patients prescribed pemafibrate had an attenuated decline in FEV1.0 compared with patients receiving bezafibrate or fenofibrate. - Ethical approvals were obtained from The Jikei University Ethics Committee for human tissue use and the retrospective cohort; informed consent was obtained for surgical tissue donors and waived for the retrospective cohort per institutional guidelines. - Pemafibrate was provided by Kowa Company, Ltd.; one author declared research support from Kowa. The authors report no other conflicts of interest. - Data deposition (RNA-seq) is in progress; accession number will be provided upon revision. Specific experimental details, numerical outcomes, and statistical measures are reported in the source article and should be consulted there for quantitative results.

### 3. [PHIHDL: NMR-Derived HDL Index Predicts Pulmonary Hemodynamics and Survival in PAH](https://medichelpline.com/clinical-feed/medrxiv-4-phihdl-a-novel-hdl-index-predicting-baseline-pulmonary-hemodynamics-and-long.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [PHIHDL: NMR-Derived HDL Index Predicts Pulmonary Hemodynamics and Survival in PAH](https://medichelpline.com/clinical-feed/medrxiv-4-phihdl-a-novel-hdl-index-predicting-baseline-pulmonary-hemodynamics-and-long.md)

> **Executive GIST:** - This study retrospectively analyzed 100 patients with **pulmonary arterial hypertension (PAH)** from the prospective GRAPH-M registry with complete diagnostic workup including right heart catheterization and baseline serum samples. - Median survival in the cohort was 8.0 years; 46 of 100 patients died during follow-up. Baseline hemodynamics: mean pulmonary arterial pressure (mPAP) 41 ± 16 mmHg, pulmonary arterial wedge pressure (PAWP) 8.8 ± 3.2 mmHg, pulmonary vascular resistance (PVR) 8.0 ± 4.9 Wood units. - Nuclear magnetic resonance (**NMR**) spectroscopy–derived metabolites and lipoprotein parameters were assessed for association with pulmonary hemodynamics and prognosis. - A cluster of 12 **HDL**-related measures showed significant inverse associations with pulmonary hemodynamics. From these measures the authors derived PHIHDL, defined as the reversed scaled average of those HDL particle metrics. - PHIHDL correlated inversely with worse pulmonary hemodynamics and was associated with higher all-cause mortality. Adjusted for age and sex, PHIHDL had hazard ratio (HR) 2.96 (95% CI 1.52–5.70) for mortality. - The prognostic association of PHIHDL remained independent of established clinical risk scores COMPERA 2.0 and REVEAL Lite2. - The cohort characteristics: mean age 61 ± 15 years, female:male ratio 2.5, body mass index 26 ± 7 kg/m2; patients were treated at the PH clinic of LKH University Hospital, Medical University of Graz between 2011 and 2021. - Data and code availability are reported: datasets uploaded to Zenodo with DOI provided. Ethical approval and written informed consent were obtained (Ethics Committee Medical University of Graz: EK: 23-408 ex 10/11). - Competing interests for several authors are disclosed; multiple authors reported no conflicts. Funding sources included Austrian Science Fund, Austrian Research Promotion Agency, regional and European funds. - The authors conclude that PHIHDL, a pulmonary hemodynamics–based metabolomic score, provides independent prognostic information beyond established risk scores in PAH.

### 4. [Impact of elexacaftor-tezacaftor-ivacaftor on lung function trajectories in children with cystic f](https://medichelpline.com/clinical-feed/medrxiv-10-lung-function-trajectories-in-children-with-cystic-fibrosis-aged-3-17-years.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Impact of elexacaftor-tezacaftor-ivacaftor on lung function trajectories in children with cystic f](https://medichelpline.com/clinical-feed/medrxiv-10-lung-function-trajectories-in-children-with-cystic-fibrosis-aged-3-17-years.md)

> **Executive GIST:** - This prospective observational study assessed lung function trajectories in children aged 3–17 years with **cystic fibrosis** before and after starting **elexacaftor-tezacaftor-ivacaftor (ETI)** using lung clearance index (LCI). - Children with at least two LCI tests before and two after ETI were used to model trajectories; those with at least one pre- and one post-ETI LCI were used to estimate acute change. - Age-adjusted LCI trajectories for pre-ETI and post-ETI periods were estimated with linear mixed-effects models; paired Wilcoxon tests compared pre- and post-ETI LCI values. - Mean longitudinal change in LCI before ETI was −0.007 turnovers/year (95% CI −0.28 to 0.27; n=35) and after ETI was 0.12 turnovers/year (95% CI −0.17 to 0.41; n=20). - The proportion of patients with impaired LCI (≥7.1 turnovers) decreased from 57% (30/53) pre-ETI to 26% (14/53) post-ETI. - Median LCI difference pre- versus post-ETI was −0.70 turnovers (95% CI −0.84 to −0.46), p<0.001, indicating an acute improvement in LCI after ETI initiation. - Within-individual variability in LCI measurements declined after starting ETI, suggesting greater stability of lung function up to three years post-initiation. - The study reports real-world, longitudinal evidence of both an acute improvement in **LCI** and maintained stability in LCI trajectories following **ETI** initiation. - Ethics approval was obtained from Children's Health Queensland HREC [HREC/19/QCHC/51727]. Funding sources included the Cystic Fibrosis Foundation (USA), Children's Hospital Foundation, and the National Health and Medical Research Council (grant 1193840).

### 5. [Effect of London’s Ultra Low Emission Zone on PM2.5 and respiratory prescribing: synthetic control](https://medichelpline.com/clinical-feed/medrxiv-0-the-impact-of-london-s-ultra-low-emission-zone-on-respiratory-prescribing-a.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-01
- **Detail Markdown URL:** [Effect of London’s Ultra Low Emission Zone on PM2.5 and respiratory prescribing: synthetic control](https://medichelpline.com/clinical-feed/medrxiv-0-the-impact-of-london-s-ultra-low-emission-zone-on-respiratory-prescribing-a.md)

> **Executive GIST:** - This preprint assessed the causal impact of all three stages of London’s **Ultra Low Emission Zone (ULEZ)** on air quality and respiratory medication prescribing using a generalised synthetic control method applied at the general practice level. - Air quality was measured via **PM2.5** levels; respiratory outcomes used prescribing records for bronchodilators and inhaled corticosteroids (quantity and average daily quantity, ADQ). - Stage 1 of the ULEZ was associated with a statistically significant but very small **0.77% reduction in PM2.5**, with no detectable change in prescribing patterns at general practice level. - Stage 2 showed a paradoxical **2.69% increase in PM2.5**. Concurrently there was a **4.44% decrease in inhaled corticosteroid quantity** but a **12.51% increase in inhaled corticosteroid ADQ**, interpreted as potential worsening of disease severity among existing patients rather than case numbers increasing. - Stage 3 produced a **2.69% reduction in PM2.5** and a modest **2.18% decrease in bronchodilator ADQ** usage. - Spillover effects outside the ULEZ boundary were statistically significant but quantitatively negligible. - Overall, across all three stages the ULEZ produced minimal effects on both measured air quality (PM2.5) and respiratory prescribing in this analysis. - Authors conclude the zone’s measured impacts are considerably smaller than some prior reports, and they suggest that ULEZ implementation may need integration with broader policy measures to achieve meaningful public health improvement. - Data used were publicly available from sources including English prescribing data, Public Health England (Fingertips), GP data hub (QOF), and Freedom of Information returns from Transport for London. The manuscript is a preprint and has not been peer reviewed.

### 6. [Social functioning in Primary Ciliary Dyskinesia: lived experience, relationships and support needs](https://medichelpline.com/clinical-feed/medrxiv-20-social-functioning-in-primary-ciliary-dyskinesia-pcd-a-study-of-lived.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-27
- **Detail Markdown URL:** [Social functioning in Primary Ciliary Dyskinesia: lived experience, relationships and support needs](https://medichelpline.com/clinical-feed/medrxiv-20-social-functioning-in-primary-ciliary-dyskinesia-pcd-a-study-of-lived.md)

> **Executive GIST:** - The study investigated **social functioning** in people with **Primary Ciliary Dyskinesia (PCD)** using qualitative work and a multilingual online questionnaire nested within the international Living with PCD study. - Initial qualitative data came from one focus group and two semi-structured interviews with adults and parents; these thematic findings informed questionnaire development. - The online survey was completed by 277 participants: 225 adults and adolescents with PCD (81%) and 52 parents reporting for children with PCD (19%). - Many participants reported active social lives and strong close relationships; 39% of adults/adolescents and 41% of parents reported a positive impact of PCD on family relationships. - Regarding romantic and intimate relationships among adults/adolescents, 49% reported a positive or no impact from PCD, while 17% had avoided or ended a relationship because of PCD. - PCD affected daily roles: 54% of respondents reported impact on meeting responsibilities, 58% reported reduced free time, and 53% reported increased planning effort. - Participants felt more comfortable discussing PCD with family, friends, and partners than in work or education settings; only 29% reported receiving support in work/educational contexts. - The most frequently identified unmet needs were financial support, flexible work or educational policies, and better-trained healthcare professionals. - Authors conclude that maintaining **social functioning** with PCD requires considerable individual and relational effort and that systemic responses in healthcare, education and employment are needed alongside close-network support. - Ethical approvals were obtained (Cantonal Research Ethics Committee in 2020; updated in 2025) and data are available on reasonable request to the corresponding author. Competing interests and funding declarations were reported in the source.

### 7. [Impulse Oscillometry Shows Increased Peripheral Airway Resistance in Symptomatic GERD](https://medichelpline.com/clinical-feed/medrxiv-0-peripheral-airway-dysfunction-in-symptomatic-gastroesophageal-reflux-disease-a.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-26
- **Detail Markdown URL:** [Impulse Oscillometry Shows Increased Peripheral Airway Resistance in Symptomatic GERD](https://medichelpline.com/clinical-feed/medrxiv-0-peripheral-airway-dysfunction-in-symptomatic-gastroesophageal-reflux-disease-a.md)

> **Executive GIST:** - This laboratory-based cross-sectional study evaluated peripheral airway function in medical undergraduates with and without symptomatic **Gastroesophageal Reflux Disease (GERD)** using the **Impulse Oscillometry System (IOS)** and spirometry, following ATS/ERS guidelines. - Among 811 students screened (mean age 22.9 years; 31.1% male), symptomatic GERD prevalence by GerdQ ≥8 was 29.8% (242/811). The most frequent symptoms were heartburn (89.6%) and regurgitation (85.5%). - After excluding participants with chronic respiratory disease or recent respiratory symptoms, 50 symptomatic GERD cases and 50 age- and sex-matched healthy controls underwent IOS and spirometry testing. - IOS-derived measures of peripheral airway function—R5–R20, resonance frequency (Fres), and reactance area (AX)—were significantly higher in the GERD group than in controls (R5–R20: 15.29% vs 9.69%, p=0.002; Fres: 14.95 1/s vs 13.37 1/s, p=0.04; AX: 0.66 vs 0.48, p=0.02), indicating increased **peripheral airway resistance**. - Conventional spirometry parameters (FEV1, FVC, PEFR) did not differ between groups, suggesting IOS detected subtle peripheral changes not evident on spirometry. - Authors propose that gastric acid stimulation of vagal nerve endings in the lower esophagus may produce vagally mediated bronchoconstriction affecting peripheral airways. - The study is a preprint and has not been peer reviewed; ethical approval was obtained from the Rajarata University Ethics Review Committee (ERC/2024/60). Data are available on request from the corresponding author.

### 8. [GLP-1 Receptor Agonists in Sleep Medicine: Pan-European Practice Patterns and Unmet Needs](https://medichelpline.com/clinical-feed/pubmed-42639925.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-25 | DOI: [10.1080/25310429.2026.2722795](https://doi.org/10.1080%2F25310429.2026.2722795)
- **Detail Markdown URL:** [GLP-1 Receptor Agonists in Sleep Medicine: Pan-European Practice Patterns and Unmet Needs](https://medichelpline.com/clinical-feed/pubmed-42639925.md)

> **Executive GIST:** - A pan-European survey by the European Sleep Apnoea Database (ESADA) network examined real-world integration of **GLP-1 receptor agonists (GLP-1RAs)** and dual GIP/GLP-1 agonists in sleep clinics for patients with obesity and suspected or established **obstructive sleep apnoea (OSA)**. - The survey included 24 centres across 14 European countries and captured current diagnostic, treatment-initiation, monitoring, and follow-up practices. - Forty-two percent of centres reported that **sleep physicians** can initiate GLP-1RA therapy directly within the sleep clinic setting. - Indications for GLP-1RA use were consistent across centres, primarily targeting moderate-to-severe obesity with metabolic comorbidities. - Most centres continued to recommend diagnostic sleep studies after GLP-1RA initiation: 92% for symptomatic patients and 81% for asymptomatic patients. - A weight loss threshold greater than 10% was viewed as a clinically meaningful trigger for OSA reassessment by 61% of centres. - Despite expectations of reduced OSA severity with GLP-1RA–associated weight loss, only 14% of centres reported proactive **positive airway pressure (PAP)** re-titration or withdrawal. - Monitoring practices emphasized weight trajectory, patient symptoms, and PAP telemonitoring; structured interdisciplinary pathways were largely absent. - The study concluded that while GLP-1RAs are increasingly incorporated into European sleep practice, substantial variability exists in diagnostic timing, PAP management, and follow-up strategies, highlighting the need for harmonized guidance and coordinated multidisciplinary care.

### 9. [Feasibility of cranial electrotherapy stimulation (Alpha-Stim AID) for anxiety with breathlessness](https://medichelpline.com/clinical-feed/medrxiv-17-evaluating-cranial-electrotherapy-stimulation-for-anxiety-associated-with.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-25
- **Detail Markdown URL:** [Feasibility of cranial electrotherapy stimulation (Alpha-Stim AID) for anxiety with breathlessness](https://medichelpline.com/clinical-feed/medrxiv-17-evaluating-cranial-electrotherapy-stimulation-for-anxiety-associated-with.md)

> **Executive GIST:** - This mixed-methods feasibility study evaluated the acceptability and tolerability of **cranial electrotherapy stimulation (CES)** using the **Alpha-Stim AID** device in adults with advanced chronic respiratory disease receiving hospice care who had clinically significant anxiety and breathlessness. - Design: multicentre, non-randomised interventional feasibility study with a parallel usual-care control group; intervention lasted eight weeks with a four-week follow-up; study not powered for efficacy. - Participants: recruited from hospice services; 12.5% of screened patients at the primary site were eligible, and 29 unique participants enrolled. Three participants (10.3%) withdrew; withdrawals were not attributed to CES. - Intervention arms: participants used Alpha-Stim AID for eight weeks at either a fixed or personalised dose; delivery occurred within hospice services. - Safety and tolerability: most adverse events were mild. Headache was reported commonly across both intervention and control groups. No withdrawals were directly due to CES. - Acceptability and adherence: the device was generally acceptable and deliverable in the hospice setting. Outcome measure completion rates were high, with missing data under 6.4%. - Outcomes: daily numerical rating scales for anxiety and breathlessness fluctuated and were broadly static overall; Generalized Anxiety Disorder-7 (**GAD-7**) scores improved over time across all groups, though this trial was not designed to establish clinical efficacy. - Recommendations and next steps: authors conclude CES with Alpha-Stim AID is feasible in this population and support progression to a fully powered randomized controlled trial against a sham device to determine clinical effectiveness for anxiety in people with breathlessness. - Ethics and registration: Brighton and Sussex NHS Research and Ethics Committee approved the study (ref 23/LO/0276); trial registration NCT06066658; data available from corresponding author on reasonable request. - Funding and disclosures: funders included NIHR, Wellcome Trust, and Stoneygate Trust; authors declared no competing interests.

### 10. [AB-free kava kavalactones suppress cigarette smoke–induced lung inflammation via PKA/CREB/COX-2 si](https://medichelpline.com/clinical-feed/biorxiv-23-ab-free-kava-and-its-kavalactones-suppress-cigarette-smoke-and.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-08-25
- **Detail Markdown URL:** [AB-free kava kavalactones suppress cigarette smoke–induced lung inflammation via PKA/CREB/COX-2 si](https://medichelpline.com/clinical-feed/biorxiv-23-ab-free-kava-and-its-kavalactones-suppress-cigarette-smoke-and.md)

> **Executive GIST:** - Cigarette smoke–induced lung inflammation drives pulmonary disease and current anti-inflammatory agents have limited efficacy, motivating search for structurally distinct therapeutics. - An **AB-free kava** formulation (Piper methysticum; depleted of flavokavains A/B) containing six major **kavalactones** previously suppressed smoke-induced lung inflammation in mice. - This study sought to identify bioactive kavalactone(s) and mechanisms using in vitro macrophage assays, cigarette smoke condensate models, and mouse exposures to cigarette smoke or lipopolysaccharide (LPS). - A clear structure–activity relationship emerged for suppression of LPS-stimulated **PGE2** production in macrophages: **desmethoxyyangonin (DMY)** was the most potent, while **dihydrokavain (DHK)** showed minimal activity. - DMY reduced LPS-induced **IL-6** and **TNF-α** production; DHK did not. DMY attenuated **COX-2** induction and lowered phosphorylation of **CREB**, whereas DHK lacked these effects. - Pharmacological inhibition of **protein kinase A (PKA)** similarly reduced p-CREB, COX-2 and PGE2, supporting a **PKA-dependent CREB/COX-2** signaling axis mediating PGE2 suppression. These effects were reported to be independent of **NF-κB** and **AP-1** signaling. - DMY and DHK produced similar relative effects against cigarette smoke condensate–induced proinflammatory pathways and PGE2 in vitro, and in vivo DMY suppressed cigarette smoke–induced lung inflammation while DHK did not. - **Dihydromethysticin (DHM)** showed the greatest in vivo anti-inflammatory efficacy despite only moderate in vitro potency, a discrepancy attributed by the authors to superior bioavailability of DHM relative to DMY. - Cigarette smoke exposure increased p-CREB and COX-2 in mouse lungs; these increases were attenuated by AB-free kava and its bioactive kavalactones with the degree of suppression correlating with in vivo anti-inflammatory efficacy. - DHM also suppressed LPS-induced neutrophil accumulation in mouse lungs. - The authors conclude that bioactive kavalactones in AB-free kava suppress cigarette smoke– and LPS-induced lung inflammation through modulation of the **PKA/CREB/COX-2** axis, supporting further development of structurally distinct anti-inflammatory agents targeting smoke-induced pulmonary inflammation. - Competing interest: the AB-free kava product evaluated is based on IP owned by Kuality Herbceutics; one author holds 75% ownership in that company. Funding reported from the Florida Department of Health. Details such as specific doses, exposure regimens, and full experimental parameters were not reported in the provided abstract.

### 11. [Connexin 43 in Hyperoxia-Induced Bronchopulmonary Dysplasia and Associated Pulmonary Hypertension](https://medichelpline.com/clinical-feed/plos-one-19-role-of-connexin-43-in-hyperoxia-induced-bronchopulmonary-dysplasia-and.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-24
- **Detail Markdown URL:** [Connexin 43 in Hyperoxia-Induced Bronchopulmonary Dysplasia and Associated Pulmonary Hypertension](https://medichelpline.com/clinical-feed/plos-one-19-role-of-connexin-43-in-hyperoxia-induced-bronchopulmonary-dysplasia-and.md)

> **Executive GIST:** - Premature infants often require supplemental oxygen, which can cause hyperoxia-driven lung injury and lead to **bronchopulmonary dysplasia (BPD)** with arrested alveolarization and inflammation. - **Connexin 43 (Cx43)** forms gap junctions that regulate intercellular communication in lung cells, including type I/II alveolar epithelial cells, endothelium, macrophages and smooth muscle cells. - Prior models show Cx43 upregulation with lung inflammation and that genetic or pharmacologic reduction of Cx43 can alter inflammatory cell recruitment and airway responses. - This study tested whether pharmacological inhibition of Cx43 with the peptide **43Gap26** modifies hyperoxia-induced experimental BPD and associated **pulmonary hypertension (PH-BPD)** using neonatal rats exposed to 90% O2 for 14 days and human fetal pulmonary artery smooth muscle cells (HfPA-SMC) exposed to 60% O2. - Outcomes assessed included lung morphology and alveolarization, lung function, surfactant protein expression, extracellular matrix markers, macrophage phenotype and cytokine secretion, oxidative stress markers, pulmonary artery remodeling and survival. - In vivo, 43Gap26 reduced hyperoxia-induced **Cx43** overexpression and produced a partial improvement in alveolar structure but did not prevent impaired lung function, decreased surfactant protein-B, extracellular matrix remodeling, M2 macrophage polarization, increased TIMP-1 secretion, pulmonary hypertension, or increased mortality. - In vitro, hyperoxia increased Cx43 expression in HfPA-SMC but 43Gap26 did not change hyperoxia-induced secretion of pro-inflammatory cytokines under the tested conditions. - Classical markers of oxidative damage were not significantly increased in the experimental settings, although heme oxygenase-1 expression was elevated. - The authors conclude that **Cx43-GJ signaling** contributes to regulation of alveolar structure during hyperoxic injury, but selective pharmacological inhibition with 43Gap26 alone is insufficient to prevent the complex structural and vascular pathology characteristic of experimental BPD and PH-BPD. - Methods and additional experimental details are provided in the paper's supporting information; specific quantitative data, statistical values and some experimental details are reported in the full article.

### 12. [Effect of Very Low Nicotine Cigarettes on Alcohol and Cannabis Use During a 12-Week Trial](https://medichelpline.com/clinical-feed/pubmed-41934243.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-24 | DOI: [10.1093/ntr/ntag070](https://doi.org/10.1093%2Fntr%2Fntag070)
- **Detail Markdown URL:** [Effect of Very Low Nicotine Cigarettes on Alcohol and Cannabis Use During a 12-Week Trial](https://medichelpline.com/clinical-feed/pubmed-41934243.md)

> **Executive GIST:** - This secondary analysis evaluated whether a **reduced nicotine standard (RNS)**—operationalized as randomization to very low nicotine content (**VLNC**) versus normal nicotine cigarettes—affected alcohol or cannabis use over 12 weeks. - Participants were randomized during 2018–2022 and had access to non-combusted nicotine products via an experimental tobacco marketplace; additional trial details (sample size, demographics) were not reported in the abstract. - Analyses examined two groups separately: participants reporting use of alcohol or cannabis at baseline (to assess changes in frequency) and participants reporting non-use at baseline (to assess uptake during the study). - Among baseline users, study condition (VLNC vs normal nicotine) did not significantly change frequency of alcohol use (mean difference = 0.90; 95% CI, -5.33 to 7.03) or cannabis use (mean difference = 0.87; 95% CI, -8.00 to 9.24). - Among baseline non-users, study condition did not significantly change frequency of alcohol use (mean difference = 0.83; 95% CI, -0.14 to 1.80) or cannabis use (mean difference = -1.92; 95% CI, -5.02 to 1.19). - Likelihood of uptake among baseline non-users was not significantly different by condition: adjusted odds ratio for alcohol uptake = 1.09 (95% CI, 0.85 to 1.38) and for cannabis uptake = 1.20 (95% CI, 0.97 to 1.45). - The authors conclude that unintended increases in alcohol or cannabis use following implementation of an **RNS** are unlikely in people who smoke, supporting public health benefit from a reduced nicotine policy. - The study emphasizes ecological validity by allowing access to alternative nicotine products during the randomized 12-week period. - The abstract does not report some trial specifics such as participant numbers, statistical models used beyond the summary statistics provided, or subgroup analyses; those details are not available in the abstract.

### 13. [SDOH ICD-10 Z-codes in US Asthma Hospitalizations (2016–2022): National Cross-Sectional Findings](https://medichelpline.com/clinical-feed/medrxiv-7-using-social-determinants-of-health-icd-10-z-codes-to-identify-non-medical.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-22
- **Detail Markdown URL:** [SDOH ICD-10 Z-codes in US Asthma Hospitalizations (2016–2022): National Cross-Sectional Findings](https://medichelpline.com/clinical-feed/medrxiv-7-using-social-determinants-of-health-icd-10-z-codes-to-identify-non-medical.md)

> **Executive GIST:** - This pooled cross-sectional analysis used the 2016–2022 Nationwide Inpatient Sample (NIS) to examine documentation of social determinants of health (**SDOH**) using **ICD-10 Z-codes** (Z55–Z65) among 200,452 U.S. hospitalizations with a primary diagnosis of asthma. - Overall, 3,149 hospitalizations had any SDOH Z-code documented (1.57% in unweighted counts). - The most frequently recorded Z-codes were **homelessness** (Z59.0; n=942) and **unemployment** (Z56.0; n=349). - Weighted chi-square analyses indicated that all selected patient- and hospital-level variables were associated with presence of an SDOH Z-code. - Multivariable logistic regression showed higher adjusted odds of SDOH Z-code documentation for hospitalizations involving **male** patients (aOR 1.51; 95% CI 1.39–1.63; P < .001) versus female patients. - Hospitalizations at **rural hospitals** had lower adjusted odds of SDOH Z-code documentation (aOR 0.57; 95% CI 0.47–0.70; P < .001) compared with urban teaching hospitals. - The authors highlight that housing- and employment-related codes dominated SDOH documentation and recommend future analyses to explore causality and how these documented SDOH could inform public health interventions. - Data were obtained from HCUP (AHRQ); HCUP data use agreements prevent redistribution of the underlying dataset. Ethics committees at Augusta University, University of Maryland, and CDC waived ethical approval for this work.

### 14. [AI-driven Test-free Claims Model Predicts Trajectory Events in Fibrotic Interstitial Lung Disease](https://medichelpline.com/clinical-feed/medrxiv-5-natural-history-of-fibrotic-interstitial-lung-disease-using-ai-driven-test-free.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-22
- **Detail Markdown URL:** [AI-driven Test-free Claims Model Predicts Trajectory Events in Fibrotic Interstitial Lung Disease](https://medichelpline.com/clinical-feed/medrxiv-5-natural-history-of-fibrotic-interstitial-lung-disease-using-ai-driven-test-free.md)

> **Executive GIST:** - This study developed a test-free, claims-based digital-twin framework (ZeBRA) to generate individualized, time-updated forecasts for patients with **fibrosing ILD**, including **IPF**, using de-identified longitudinal administrative claims. - The analytic cohort comprised 345,918 patients with fibrosing ILD, of whom 17,284 had IPF; models used evolving diagnosis, pharmacy, and procedure codes from Merative MarketScan Commercial and Medicare Supplemental databases. - Horizon-specific models forecast seven claims-observable events: supplemental oxygen escalation, pulmonary hypertension, an acute respiratory failure/ARDS composite, nausea, diarrhea, liver injury, and gastrointestinal bleeding. - Predictions were evaluated in a time-updated follow-up setting at 1-month, 6-month, and 1-year horizons to provide near-term and longer-term risk estimates. - Predictive discrimination was consistent across events and horizons: in fibrosing ILD AUCs ranged from 0.691 (liver injury at 1 year) to 0.912 (oxygen dependence at 1 month); PPVs ranged from 0.189 to 0.714 across outcomes and horizons. - At 1 month in the full fibrosing ILD cohort, oxygen dependence achieved AUC 0.912 ± 0.005 with PPV 0.473 ± 0.005; pulmonary hypertension achieved AUC 0.881 ± 0.005 with PPV 0.539 ± 0.005. - In the IPF subcohort, AUCs ranged from 0.687 to 0.855 and PPVs from 0.245 to 0.817; at 1 month PPV was 0.753 ± 0.015 for oxygen dependence and 0.817 ± 0.011 for pulmonary hypertension. - The approach requires no imaging, pulmonary function tests, laboratory data, clinical notes, or patient-facing data collection and could support low-burden reassessment, anticipatory care planning, and earlier recognition of elevated near-term risk. - Code and an API implementation for the pulmonary hypertension prediction pipeline are available at the authors' GitHub; source claims data cannot be publicly released and are subject to data-use agreements. - The authors declared no competing interests and report that institutional review board approval covered use of de-identified MarketScan data under the noted protocol.

### 15. [Nanopore Metagenomic Detection of Bacterial and Viral Pathogens in Community-Acquired Pneumonia Us](https://medichelpline.com/clinical-feed/medrxiv-0-evaluating-non-invasive-respiratory-samples-for-bacterial-and-viral-pathogen.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-21
- **Detail Markdown URL:** [Nanopore Metagenomic Detection of Bacterial and Viral Pathogens in Community-Acquired Pneumonia Us](https://medichelpline.com/clinical-feed/medrxiv-0-evaluating-non-invasive-respiratory-samples-for-bacterial-and-viral-pathogen.md)

> **Executive GIST:** - This preprint evaluates **Nanopore metagenomic sequencing** for detecting bacterial and viral pathogens in community-acquired pneumonia (CAP) using non-invasive respiratory samples. - The study analysed samples from 37 hospitalized CAP patients and 9 controls, totalling 60 specimens: 46 swabs, 12 sputa and 2 pleural fluids. - The sequencing workflow included host depletion, library preparation and Nanopore sequencing; taxonomic calls were assessed using genome breadth and read-dispersion analyses to increase confidence. - Because no single gold-standard comparator existed, results were adjudicated by multidisciplinary clinical review and classified as probable, possible or unlikely aetiological agents. - Pathogen detection was strongly dependent on sample type: **lower respiratory tract (LRT) samples**, particularly sputum, produced higher bacterial read counts and broader genome coverage than swabs, supporting higher-confidence identifications. - Metagenomic sequencing identified pathogens missed by routine diagnostics, including RSV-A, Mycoplasmoides pneumoniae, Streptococcus pneumoniae and Moraxella catarrhalis. - In paired samples, pathogens were often detected in LRT samples but were absent or present only at low-confidence thresholds in matched swabs. - Sensitivity relative to a composite clinical reference was higher for LRT samples than for swabs (50% vs 25%), per the authors' composite comparison. - The authors conclude that Nanopore metagenomic sequencing applied to sputum and other LRT samples is a feasible non-invasive approach for pathogen detection and characterisation in CAP when invasive sampling is not possible. - Ethical approval was obtained (Northwest Haydock Research Ethics Committee Ref: 23/NW/0103; Health Research Authority Ref: 323039) and sequencing data are deposited under BioProject PRJNA1335824.

### 16. [Elastic tape enhances pulmonary rehabilitation outcomes in nonobese men with moderate-to-very seve](https://medichelpline.com/clinical-feed/pubmed-42614062.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-19 | DOI: [10.1080/25310429.2026.2718606](https://doi.org/10.1080%2F25310429.2026.2718606)
- **Detail Markdown URL:** [Elastic tape enhances pulmonary rehabilitation outcomes in nonobese men with moderate-to-very seve](https://medichelpline.com/clinical-feed/pubmed-42614062.md)

> **Executive GIST:** - This randomized controlled trial evaluated whether adding **elastic tape** (ET) to an 8-week **pulmonary rehabilitation** (PR) program enhances outcomes in nonobese men with moderate-to-very severe **COPD**. - Forty-two nonobese male patients were randomized to ET or Sham during PR. The primary outcome was endurance shuttle walk test (ESWT) time; secondary outcomes included COPD Assessment Test (CAT), Chronic Respiratory Questionnaire (CRQ), and Hospital Anxiety and Depression Scale (**HADS**). - The ET group increased ESWT time by +329 seconds, a change that exceeded the minimal clinically important difference (MCID) and corresponded to a moderate-to-large effect size (d = 0.89). - Health status measured by **CAT** improved more in the ET group (p = 0.02), and a higher proportion of ET participants reached the CAT MCID (48% vs. 29%; p = 0.02). - Psychological symptoms improved preferentially with ET: only the ET group achieved MCIDs for depression (HADS-D, p = 0.003) and anxiety (HADS-A, p = 0.02). The time × group interaction was significant only for HADS-D (p = 0.001). - Effect sizes reported for psychological outcomes were moderate-to-large for HADS-A (d = 0.51) and large for HADS-D (d = 1.02). - Health-related quality of life (HRQoL) measured by CRQ improved similarly in both ET and Sham groups; no between-group difference was reported for HRQoL. - Ethics approval was obtained from the University of São Paulo ethics committee (approval 55617321.20000.0068) and all participants provided written informed consent. The trial is registered as NCT05939999 (registered October 26, 2025). - The trial conclusion was that adding **elastic tape** to standard **pulmonary rehabilitation** potentiated benefits on exercise capacity, health status, and psychological symptoms in this selected population. Details such as exact PR program components, adverse events, and fuller demographic breakdown were not reported in the abstract.

### 17. [Olfactory Dysfunction in Primary Ciliary Dyskinesia: Prevalence, Testing, and Clinical Implications](https://medichelpline.com/clinical-feed/medrxiv-9-olfactory-dysfunction-in-primary-ciliary-dyskinesia-a-systematic-review-and.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-19
- **Detail Markdown URL:** [Olfactory Dysfunction in Primary Ciliary Dyskinesia: Prevalence, Testing, and Clinical Implications](https://medichelpline.com/clinical-feed/medrxiv-9-olfactory-dysfunction-in-primary-ciliary-dyskinesia-a-systematic-review-and.md)

> **Executive GIST:** - This systematic review and meta-analysis evaluated **olfactory dysfunction** in patients with **Primary Ciliary Dyskinesia (PCD)** using data from 12 observational studies totaling 865 participants. - Searches were PRISMA-compliant across five databases to February 2026 and the protocol was registered on PROSPERO (CRD420251006332). - Risk of bias was assessed with the **Newcastle–Ottawa Scale**. A random-effects meta-analysis used the Freeman–Tukey double arcsine transformation to pool prevalences with 95% confidence intervals and prediction intervals. - Overall pooled prevalence of olfactory dysfunction was 43.4% (95% CI 25.2–62.5%; 95% PI 0.1–99.0%). - Objective psychophysical testing produced a higher pooled prevalence (66.1%; 95% CI 55.5–76.0%; 95% PI 38.4–88.9%) than patient-reported outcome measures (30.5%; 95% CI 11.4–54.0%). - Multiple studies reported a notable discordance between objective olfactory impairment and patients’ subjective awareness of smell loss. - Worse olfactory function was associated with older age, greater sinonasal disease burden, and certain ciliary ultrastructural defects. - Authors conclude olfactory dysfunction is common and under-recognised in PCD and recommend routine **objective olfactory screening** be integrated into multidisciplinary PCD care. - Data supporting the review are available from the corresponding author on reasonable request. The authors declared no competing interests.

### 18. [FibroSight: AI-assisted quantitative histopathology for interstitial lung disease](https://medichelpline.com/clinical-feed/biorxiv-2-an-ai-assisted-platform-for-quantitative-histopathological-analysis-in.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-08-19
- **Detail Markdown URL:** [FibroSight: AI-assisted quantitative histopathology for interstitial lung disease](https://medichelpline.com/clinical-feed/biorxiv-2-an-ai-assisted-platform-for-quantitative-histopathological-analysis-in.md)

> **Executive GIST:** - The authors present **FibroSight**, a standalone AI-assisted platform for automated, compartment-resolved quantification of lung remodeling in Sirius Red–stained sections. - FibroSight integrates deep learning–based structural segmentation with color-based feature extraction to enable whole-lobe analysis without complex computational setup. - The platform reports multiple complementary metrics, including **parenchymal collagen fraction**, parenchymal tissue density, nuclear area fraction, parenchymal airspace fraction, and airway- and vascular-associated remodeling. - Validation in the bleomycin-induced fibrosis model showed strong correlation between FibroSight metrics and expert **Ashcroft** scoring; FibroSight metrics had stronger associations with histological severity than a semi-automated ImageJ workflow. - FibroSight also distinguished inflammatory versus fibrotic remodeling in influenza-induced lung injury and demonstrated translational proof-of-concept utility on human ILD biopsy specimens. - The authors highlight limitations of conventional histopathological evaluation: semi-quantitative scoring, labor intensity, inter-observer variability, and limited field sampling; FibroSight addresses these by scalable, reproducible whole-lobe quantification. - The platform is intended to expand fibrosis evaluation by integrating fibrotic, inflammatory, airway, and vascular readouts to support preclinical and translational ILD research. - Code and resources are available at the project repository: https://github.com/Anas-Odeh/FibroSight (as reported by the authors). - The study emphasizes the need for improved quantitative histopathology in ILD because existing antifibrotic therapies slow but do not reverse fibrosis and 30–40% of ILD patients develop fibrotic disease with poor prognosis. - The authors declared no competing interests in the preprint.

### 19. [Correction: Author affiliation update for GDF15 and epithelial cell senescence in radiation-induce](https://medichelpline.com/clinical-feed/plos-one-7-correction-gdf15-participates-in-epithelial-cell-senescence-in-radiation.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-17
- **Detail Markdown URL:** [Correction: Author affiliation update for GDF15 and epithelial cell senescence in radiation-induce](https://medichelpline.com/clinical-feed/plos-one-7-correction-gdf15-participates-in-epithelial-cell-senescence-in-radiation.md)

> **Executive GIST:** - This PLOS One correction notes errors in the author affiliations for the article titled **GDF15 participates in epithelial cell senescence in radiation-induced lung injury through the ERK1/2-p16 signaling pathway**. - The corrected author list is Jing Liu, Dongyang Lv, Hengjiao Wang, Defu Yang, Ying Xu, and Ying Yan. - The corrected affiliations assign Jing Liu dual affiliation: **Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, China** (affiliation 1) and **Graduate School of Dalian Medical University, Dalian, China** (affiliation 2). - All other authors (Dongyang Lv, Hengjiao Wang, Defu Yang, Ying Xu, Ying Yan) are affiliated with the Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, China (affiliation 1). - The correction was published August 17, 2026, under DOI 10.1371/journal.pone.0356407 and cites the original article (PLOS One 2026;21(6):e0350042) as the item being corrected. - The correction notice includes the formal citation and indicates the article is Open Access under the Creative Commons Attribution License. - The correction references the original article page and related identifiers (DOI and PubMed ID) but does not report changes to the article content, methods, results, or conclusions. - The notice appears as a standalone correction entry in PLOS One and links to the original article and PDF; it serves primarily to rectify the institutional affiliations associated with the authors.

### 20. [Overground running has higher energetic cost than 1%‑grade treadmill running in trained endurance](https://medichelpline.com/clinical-feed/plos-one-20-overground-running-incurs-a-higher-energetic-cost-than-treadmill-running-at-a-1.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-17
- **Detail Markdown URL:** [Overground running has higher energetic cost than 1%‑grade treadmill running in trained endurance](https://medichelpline.com/clinical-feed/plos-one-20-overground-running-incurs-a-higher-energetic-cost-than-treadmill-running-at-a-1.md)

> **Executive GIST:** - This within-subject crossover study compared physiological and metabolic demands of **overground running** and **treadmill running at 1% grade** in 12 male, nationally licensed endurance runners (mean age 21.3 ± 2.4 years). - Participants completed a ramp test for V̇O2max followed by identical stepwise protocols (8–15 km·h⁻¹; 3‑min stages) on a treadmill and a 400 m outdoor track. - Primary outcomes were **running economy (RE)** (mL·kg⁻¹·min⁻¹), **oxygen cost of transport (O2‑COT)** (mL·kg⁻¹·km⁻¹), and **energy cost (EC)** (J·kg⁻¹·m⁻¹), averaged from breath‑by‑breath gas exchange over the final 60–90 s of each stage. - Two‑way repeated‑measures ANOVA found significant main effects of Condition and Intensity domain for RE, O2‑COT, and EC (all p ≤ 0.012). - **RE** was significantly higher during overground running (51.3 ± 2.2 vs. 49.6 ± 3.1 mL·kg⁻¹·min⁻¹; p‑FDR = 0.01), with the divergence mainly between 70% and 100% of VT2. - **O2‑COT** was consistently greater in overground running across all intensities (204.2 ± 11.3 vs. 197.1 ± 12.3 mL·kg⁻¹·km⁻¹; p‑FDR ≤ 0.01) with no Condition×Intensity interaction, indicating a stable between‑condition difference. - **Energy cost (EC)** was also higher overground (3.87–4.60 vs. 3.65–4.10 J·kg⁻¹·m⁻¹ across intensities; p‑FDR < 0.001) and showed a significant Condition×Intensity interaction (p = 0.045). - Carbohydrate oxidation was significantly increased during overground running at intensities approaching VT2 (p‑FDR = 0.02), suggesting greater glycolytic contribution near high submaximal intensities. - The findings indicate that the commonly used **1% treadmill grade correction** does not fully replicate the energetic demands of overground running, with implications for laboratory CPET and performance evaluation.

### 21. [EBUS-Guided Fine Needle Biopsy vs Fine Needle Aspiration for Mediastinal Lymphadenopathy](https://medichelpline.com/clinical-feed/pubmed-42605262.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-17 | DOI: [10.1097/LBR.0000000000001085](https://doi.org/10.1097%2FLBR.0000000000001085)
- **Detail Markdown URL:** [EBUS-Guided Fine Needle Biopsy vs Fine Needle Aspiration for Mediastinal Lymphadenopathy](https://medichelpline.com/clinical-feed/pubmed-42605262.md)

> **Executive GIST:** - This single-center, single-blinded, randomized, parallel-group superiority trial compared **endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)** using 19‑G FNA versus 22‑G FNB with a Franseen tip for patients with mediastinal lymphadenopathy. - The trial enrolled 150 consecutive patients between August 2022 and July 2023; mean age was 44.5 ± 15.1 years and 50.7% were female. - The prespecified primary endpoint was **diagnostic yield**; secondary endpoints included specimen adequacy and complication rates. - Overall diagnostic yield did not differ significantly between groups: FNB 94.7% versus FNA 89.3% (difference 5.4%; 95% CI: -4.0% to 15.0%; P = 0.23). - FNB provided higher specimen quality: specimen adequacy was 98.6% for FNB versus 86.7% for FNA (difference 11.9%; 95% CI: 4.0%–22.0%; P < 0.001). - Mean core tissue length was greater with FNB (11.52 mm) than with FNA (9.29 mm); mean difference 2.23 mm (95% CI: 1.4–3.1 mm; P < 0.001). - In a post hoc analysis, FNB produced a higher diagnostic yield for histologic samples (90.7% vs. 76.0%; difference 14.7%; 95% CI: 3.0%–27.0%; P = 0.016); authors note this finding is hypothesis-generating. - Procedures were well tolerated overall; complications were limited to minor bleeding. No conflicts of interest were reported by the authors. - Authors conclude that although overall diagnostic yield was similar, **FNB** yielded larger, more adequate core tissue samples that may benefit comprehensive diagnosis and advanced pathological work-up.

### 22. [Air purification reduces PM-related cardiopulmonary risks in children via nasal Rothia and exhaled](https://medichelpline.com/clinical-feed/pubmed-42203014.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-15 | DOI: [10.1016/j.envpol.2026.128441](https://doi.org/10.1016%2Fj.envpol.2026.128441)
- **Detail Markdown URL:** [Air purification reduces PM-related cardiopulmonary risks in children via nasal Rothia and exhaled](https://medichelpline.com/clinical-feed/pubmed-42203014.md)

> **Executive GIST:** - This randomized crossover trial evaluated the short-term effects of **air purification** on particulate matter (PM)-related health outcomes, nasal microbiota, and exhaled breath condensate (EBC) metabolites in children living near a coking plant. The study enrolled 67 children. - Analyses used linear mixed-effects models to assess associations between PM exposure and physiological and molecular outcomes. - PM exposure was associated with changes in cardiopulmonary measures, specifically reductions in **vital capacity** and alterations in **heart rate**. - PM exposure reduced the abundance of nasal **Rothia**, a genus in the upper respiratory tract microbiota. - Changes in nasal Rothia abundance were closely connected to alterations in EBC metabolites, including **hexylresorcinol** and **β-carotene**. - Network and mediation analyses suggested a **PM–Rothia–metabolite axis** that may influence cardiopulmonary function; **β-carotene** was identified as a likely mediator for the effect of PM on vital capacity. - The authors conclude that short-term air purification can lower PM-associated cardiopulmonary risks in children by modulating Rothia-dependent metabolic pathways detectable in exhaled breath. - The trial is reported as a randomized controlled crossover study; the authors declared no competing financial interests or personal relationships. - Keywords reported: Air purification; Children; **Exhaled breath condensate metabolomics**; Nasal **Rothia**; PM. - Full methodological specifics, including exact purification protocol, exposure concentrations, duration of interventions, and detailed statistical estimates, were not reported in the PubMed abstract and would require consulting the full text.

### 23. [Acceptance-based healthy lifestyle programme for community patients with pneumoconiosis: pilot RCT](https://medichelpline.com/clinical-feed/pubmed-42599106.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-14 | DOI: [10.1080/25310429.2026.2717021](https://doi.org/10.1080%2F25310429.2026.2717021)
- **Detail Markdown URL:** [Acceptance-based healthy lifestyle programme for community patients with pneumoconiosis: pilot RCT](https://medichelpline.com/clinical-feed/pubmed-42599106.md)

> **Executive GIST:** - Respiratory symptoms such as cough and dyspnoea are common in patients with **pneumoconiosis**, reducing daily activity and causing psychological distress. - Researchers tested a 6‑week **acceptance-based** healthy lifestyle programme delivered in four biweekly interactive sessions for community‑dwelling patients with pneumoconiosis. - Design: two‑arm, prospective, multicenter, waitlist pilot randomized controlled trial with 1:1 allocation to intervention or waitlist group. - Primary outcome: change in **psychological inflexibility**; other measured outcomes included exercise self‑efficacy, body weight, and additional health outcomes assessed at baseline, Week 6, and Week 14. - Eighty patients were randomized (40 per group). Trained research assistants performed outcome assessments at three time points. - Analysis used generalized estimating equations to compare intervention versus waitlist effects over time. - At Week 6 the intervention group showed a significant reduction in **psychological inflexibility** (β = -5.83, p = 0.002) and improvement in **exercise self‑efficacy** (β = 11.68, p = 0.007) compared with waitlist. - At Week 14 the intervention group showed a significant reduction in body weight (β = -1.09, p < 0.001) compared with waitlist. - No significant between‑group differences were reported for other measured outcomes; moderate effect sizes were noted for psychological inflexibility and exercise self‑efficacy at Week 6. - Conclusion reported by authors: integrating acceptance‑based components into pneumoconiosis management may reduce psychological inflexibility and promote engagement in exercise. - Details such as session content specifics, secondary outcome measures beyond those reported, adverse events, long‑term follow‑up beyond Week 14, and sample size calculation were not reported in the abstract provided.

### 24. [Determinants of Quality of Life in Pulmonary Tuberculosis: Protocol for a Systematic Review and Me](https://medichelpline.com/clinical-feed/bmj-open-5-factors-influencing-quality-of-life-in-patients-with-pulmonary-tuberculosis-a.md)
- **Source:** BMJ Open | **Published:** 2026-08-14
- **Detail Markdown URL:** [Determinants of Quality of Life in Pulmonary Tuberculosis: Protocol for a Systematic Review and Me](https://medichelpline.com/clinical-feed/bmj-open-5-factors-influencing-quality-of-life-in-patients-with-pulmonary-tuberculosis-a.md)

> **Executive GIST:** - This protocol addresses the fragmented evidence on factors influencing **quality of life (QoL)** in adults with **pulmonary tuberculosis (PTB)** and proposes a systematic review and meta-analysis to synthesise determinants. - The review is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement to ensure rigorous reporting. - Eight electronic databases will be searched from inception to 30 November 2025: PubMed, Web of Science, The Cochrane Library, Embase, Scopus, China National Knowledge Infrastructure, Chinese Scientific Journals Database, and Wanfang. - Eligible studies are observational investigations of associations between potential influencing factors and QoL or health-related quality of life (HRQoL) among adult patients with PTB. - Two reviewers will independently screen records, extract data, and assess methodological quality; disagreements resolved by discussion or a third reviewer. - Meta-analysis will be undertaken only when studies are sufficiently comparable across population, factors, QoL measurement, and effect estimates; otherwise, results will be presented narratively. - Quantitative synthesis, where appropriate, will use Review Manager software; subgroup and sensitivity analyses will be performed when data permit. - No formal ethical approval is required because the review uses previously published data. - Findings will be disseminated via peer-reviewed publication and conference presentations to inform targeted nursing interventions and patient management strategies. - PROSPERO registration number provided: CRD420251196862.

### 25. [Effects of Smoking Cessation on Pulmonary Precancerous Nodules: scRNA-seq and Immune Repertoire Fi](https://medichelpline.com/clinical-feed/plos-one-5-regulatory-effects-of-smoking-cessation-on-the-cellular-microenvironment-and.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-13
- **Detail Markdown URL:** [Effects of Smoking Cessation on Pulmonary Precancerous Nodules: scRNA-seq and Immune Repertoire Fi](https://medichelpline.com/clinical-feed/plos-one-5-regulatory-effects-of-smoking-cessation-on-the-cellular-microenvironment-and.md)

> **Executive GIST:** - The study used a benzo[a]pyrene (B[a]P])-induced mouse model to generate pulmonary **precancerous lesions** and then simulated smoking cessation by discontinuing B[a]P exposure for 4 or 8 weeks. - Lung nodules were identified and quantified by high-field micro-MRI and validated by histopathology (H&E) showing AT2 cell hyperplasia and nuclear atypia consistent with precancerous lesions. - Withdrawal of B[a]P reduced the formation of new nodules and decreased diameter, area, and volume of existing nodules; it also attenuated cellular atypia and local inflammation. - Single-cell RNA sequencing (scRNA-seq) and immune repertoire sequencing (IR-seq) were applied to profile cellular composition, intercellular signaling, and adaptive immune receptor diversity in lesions after exposure and withdrawal. - B[a]P withdrawal increased proportions of **T cells**, **B cells**, and **NK cells**, while reducing monocytes and neutrophils, suggesting a shift toward enhanced immune surveillance in the microenvironment. - Key genes downregulated after withdrawal included Vim, GPX1, Atf3, CD44, and Arpc5; upregulated genes included Hsph1, Hsp90aa, and Hspa1b, implicating changes in stress-response, stem-like features, inflammation, and ferroptosis-related pathways. - B[a]P withdrawal upregulated co-stimulatory molecules CD80 and ICOS and suppressed specific intercellular communication axes such as Icam1-(Itgal+Itgb2), Ppia-Bsg, and Thbs1-Cd47. - The APP–CD74 signaling axis was identified as a novel regulator in these precancerous lesions based on intercellular communication analysis. - IR-seq showed restoration of T- and B-cell receptor diversity, alterations in CDR3 sequences, and changes in V(D)J gene usage following B[a]P withdrawal, consistent with adaptive immune repertoire recovery. - The authors conclude that smoking-cessation–like withdrawal of B[a]P may limit lesion progression by modulating immune cell composition, signaling pathways, and gene expression, promoting ferroptosis, suppressing inflammation, and reducing tumor stem cell–like traits. - Data generated in the study are available in GEO under accession GSE296378. Funding sources and ethical approvals were reported; no competing interests declared.

### 26. [Role of fucosyltransferases in asthma: epithelial dysfunction, senescence, and airway inflammation](https://medichelpline.com/clinical-feed/pubmed-42587212.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-13 | DOI: [10.1007/s12016-026-09192-0](https://doi.org/10.1007%2Fs12016-026-09192-0)
- **Detail Markdown URL:** [Role of fucosyltransferases in asthma: epithelial dysfunction, senescence, and airway inflammation](https://medichelpline.com/clinical-feed/pubmed-42587212.md)

> **Executive GIST:** - Glycosylation is a key post-translational modification governing protein folding, stability, and cell communication; among glycans, **fucosylation** (added by **fucosyltransferases**, FUTs) is important for immune regulation, epithelial homeostasis, and host-pathogen interactions. - Dysregulated fucosylation is increasingly implicated in chronic inflammatory airway diseases, including **asthma**, which features airway inflammation, epithelial barrier dysfunction, mucus hypersecretion, and airway remodeling. - Specific **FUT isoforms** have been reported to influence epithelial integrity, mucin glycosylation, immune-cell recruitment, and inflammatory signaling in the context of airway disease. - Emerging evidence links FUT-mediated fucosylation to airway remodeling and **cellular senescence**, but direct mechanistic proof in asthma remains limited; many inferences derive from related respiratory diseases and experimental models. - The reviewed literature distinguishes established asthma-specific findings from mechanistic hypotheses drawn from broader respiratory research and models. - FUTs are proposed as potential sources of biomarkers and targets for precision therapies in asthma, though translational application faces unresolved challenges. - The review identifies current knowledge gaps, methodological hurdles, and research directions needed to clarify FUT roles in epithelial dysfunction, mucus secretion, immune regulation, remodeling, and senescence in asthma. - Declarations reported: ethical approval not applicable; authors declared no conflict of interest.

### 27. [Kinesiophobia in COPD: qualitative insights into fear, avoidance, and consequences](https://medichelpline.com/clinical-feed/nature-5-experiences-of-kinesiophobia-in-patients-with-chronic-obstructive-pulmonary.md)
- **Source:** Nature Medicine | **Published:** 2026-08-12
- **Detail Markdown URL:** [Kinesiophobia in COPD: qualitative insights into fear, avoidance, and consequences](https://medichelpline.com/clinical-feed/nature-5-experiences-of-kinesiophobia-in-patients-with-chronic-obstructive-pulmonary.md)

> **Executive GIST:** - Aim: To explore lived experiences of patients with **chronic obstructive pulmonary disease (COPD)** who exhibit **kinesiophobia** and to inform coping strategies for clinicians. - Design and setting: A qualitative phenomenological study using purposive sampling at a tertiary hospital and an affiliated community health center in China. - Participants: Twenty-one patients with COPD were recruited and interviewed using semi-structured methods; data were analyzed with Colaizzi’s seven-step method. - Core finding: Five interconnected themes described kinesiophobia experiences: manifestations of fear, catastrophic symptom cognition, heightened risk perception by patients and families, behavioral avoidance, and perceived negative consequences. - Manifestations: Fear centered on breathlessness, pain, fatigue, and falls during activity. - Catastrophic cognition: Patients often believed exercise would provoke diverse discomforts and sometimes misinterpreted normal post-exercise sensations as signs of acute exacerbation. - Social reinforcement: Family members frequently amplified risk perception around activity, contributing to avoidance behaviors. - Behavioral patterns: Avoidance included both active strategies (deliberate restriction of activity) and passive strategies (relying on others, increased sedentary behaviour). - Consequences: Participants reported reduced endurance and increased sedentary time, suggesting a downward spiral in physical function. - Interpretation: **Kinesiophobia** in COPD is multidimensional, dynamic, and socially reinforced; breaking the **fear–avoidance cycle** requires comprehensive interventions targeting cognitive, behavioral, and family domains. - Ethics and transparency: Study approved by institutional ethics committee (NO.KYLL-2026-033); authors declared no competing interests. - Source limitations: This summary reflects the unedited manuscript provided by the authors and notes that further editing of the manuscript may occur before final publication.

### 28. [Consensus Definition Of Rapidly Progressive Interstitial Lung Disease: A Critical Unmet Need To](https://medichelpline.com/clinical-feed/european-respiratory-journal-9-consensus-definition-of-rapidly-progressive-interstitial-lung-disease-a-critical-unmet-need-to-be-led-by-pneumologists.md)
- **Source:** European Respiratory Journal | **Published:** 2026-04-02
- **Detail Markdown URL:** [Consensus Definition Of Rapidly Progressive Interstitial Lung Disease: A Critical Unmet Need To](https://medichelpline.com/clinical-feed/european-respiratory-journal-9-consensus-definition-of-rapidly-progressive-interstitial-lung-disease-a-critical-unmet-need-to-be-led-by-pneumologists.md)

> **Executive GIST:** Extract The recent European Respiratory Society (ERS)/European Alliance of Associations for Rheumatology (EULAR) clinical practice guidelines for connective tissue disease-associated interstitial lung disease (CTD-ILD) represent a commendable collaborative effort and an important step toward harmonising clinical practice and improving outcomes for patients with these complex disorders [1, 2]. We commend the authors for addressing key aspects of disease assessment and treatment.

### 29. [Geographic Variation In Prevalence And Phenotypic Traits Of Stroke Patients With Suspected Obstr](https://medichelpline.com/clinical-feed/european-respiratory-journal-8-geographic-variation-in-the-prevalence-and-phenotypic-traits-of-stroke-patients-with-suspected-obstructive-sleep-apnoea-a-european-sleep-apnea-database-esada-analysis.md)
- **Source:** European Respiratory Journal | **Published:** 2026-04-02
- **Detail Markdown URL:** [Geographic Variation In Prevalence And Phenotypic Traits Of Stroke Patients With Suspected Obstr](https://medichelpline.com/clinical-feed/european-respiratory-journal-8-geographic-variation-in-the-prevalence-and-phenotypic-traits-of-stroke-patients-with-suspected-obstructive-sleep-apnoea-a-european-sleep-apnea-database-esada-analysis.md)

> **Executive GIST:** Extract Stroke remains the second leading cause of death and the primary cause of adult disability in the European Union, despite advances in acute care and secondary prevention [1]. Obstructive sleep apnoea (OSA) is a significant independent risk factor for stroke [2], affecting nearly one billion people globally [3]. Post-stroke, OSA is highly prevalent, with up to two-thirds of stroke patients experiencing some degree of OSA and 40% exhibiting an apnoea - hypopnoea index (AHI) above 20 events&middot;h - 1 even months after the event [4].

### 30. [Emerging Evidence on Lung Ultrasound for RA-ILD Detection and Need for Standardised Protocols](https://medichelpline.com/clinical-feed/european-respiratory-journal-7-emerging-prospective-evidence-shows-that-lung-ultrasound-can-reliably-detect-rheumatoid-arthritis-associated-ild-need-for-standardised-protocols-and-consideration-in-future-guidelines.md)
- **Source:** European Respiratory Journal | **Published:** 2026-04-02
- **Detail Markdown URL:** [Emerging Evidence on Lung Ultrasound for RA-ILD Detection and Need for Standardised Protocols](https://medichelpline.com/clinical-feed/european-respiratory-journal-7-emerging-prospective-evidence-shows-that-lung-ultrasound-can-reliably-detect-rheumatoid-arthritis-associated-ild-need-for-standardised-protocols-and-consideration-in-future-guidelines.md)

> **Executive GIST:** Extract We have read with great interest the European Respiratory Society (ERS)/European Alliance of Associations for Rheumatology (EULAR) clinical practice guidelines for connective tissue disease-associated interstitial lung disease (CTD-ILD), which are commendable for providing evidence-based recommendations on the management of screening, diagnosis and treatment of patients with CTD-ILD and rheumatoid arthritis-associated ILD (RA-ILD) [1].

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