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• Respiratory function is relatively frequently impaired in adult SMA patients. • Respiratory dysfunction correlates with worse motor function and disease severity. • Respiratory function appears to stabilize in adulthood, except for walking patients. • Disease duration and age do not correlate with respiratory dysfunction. Due to poor data in literature, we aimed to investigate the respiratory function in a large cohort of naïve Italian adult (≥18 years) SMA patients in a multi-centric cross-sectional study. The following respiratory parameters were considered: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and need for non-invasive ventilation (NIV). We included 145 treatment-naïve adult patients (SMA2=18, SMA3=125; SMA4=2), 58 females (40 %), with median age at evaluation of 37 years (range 18–72). Fifty-six (37 %) and 41 (31 %) patients had abnormal (<80 %) values of FVC and FEV1, respectively. Fourteen (14 %) patients needed NIV, started at median age of 21 (range 4–68). Motor function, measured by Hammersmith Functional Motor Scale Expanded and Revised Upper Limb Module as well as SMA2, loss of walking ability, surgery for scoliosis, use of NIV, and cough assisting device (CAD) were all significantly associated to lower FVC and FEV1 values, while no association with age at baseline, disease duration, gender or 6 min walking test was observed, except for a correlation between FVC and age in SMA3 walkers (p < 0.05). In conclusion, respiratory function in adult SMA patients is relatively frequently impaired, substantially stable, and significantly correlated with motor function and disease severity. [ABSTRACT FROM AUTHOR]

Significant vegetation increase in the Loess Plateau (LP) of China could strongly affect the surface water budget. Through the WRF model with the Water Vapor Tracer (WVT) method tracking moisture within the LP, this study conducted three sets of experiments from 1999 to 2018 with GLASS Fractional Vegetation Cover (FVC) data. The results indicate that vegetation has a critical role in partitioning evapotranspiration (ET) into transpiration (Et), canopy evaporation (Ecan), and soil evaporation (Edir), thus regulating terrestrial internal convective precipitation (P). The local P response largely depends on external P (E_P), while the internal P (I_P) contribution remains minor. In summer, the total wet difference of I_P in the LP is about 0.03 mm/day, almost 5 times that of E_P. Greening also causes surface runoff reduction. Thus, in spring and summer, surface water storage (W) decreases due to the greater increase in ET than in P. In autumn, W increases by about 0.06 mm/day due to a large decrease in Ecan, implying confining the increased W to shallower soils, resulting in accelerated loss of deep soil moisture. The greening trend of 2000–2018 contributed to an increase in I_P, which could not offset increased ET and reduced E_P, leading to terrestrial water storage reduction. • The Loess Plateau moisture has been tracked by the WRF-WVT model. • Greening does not necessarily increase terrestrial precipitation due to the dominance of external precipitation. • Increased ET driven by LP's greening of 2000-2018 and reduced external precipitation jointly cause terrestrial water loss. • Model inconsistencies in partitioning ET into Et, Ecan, and Edir affect vegetation's role in terrestrial hydrology. [ABSTRACT FROM AUTHOR]

Fractional vegetation cover (FVC) is a ratio of vertical projection area of green vegetation to the total area under consideration. Crops infested by pests, diseases or nutrient deficiency show their impact on the crop coverage. Therefore, FVC is a good indicator of crop health and arid soil. Recently, various models have been reported for FVC estimation using optical data, but it is still limited to different weather conditions. Therefore, it is not feasible to continue crop monitoring using optical data. On the other hand, synthetic aperture radar (SAR) data is weather independent, and has a good potential for crop monitoring in all-weather conditions. SAR data has been used for many crop parameters estimation, however has not been much explored for FVC estimation. Plenty SAR features are available which are sensitive to vegetation parameters. Some of the features are sensitive during early crop stages (e.g., entropy, DpRVI-dual polarization radar vegetation index), while others are sensitive during different stages of crops (backscattering signal of VH and VV polarization). Therefore, there is a need to critically assess all the features and find the optimum combination that provides exemplary results during the entire crop cycle. For this purpose, sixteen features are considered using the different combinations of Sentinel-1 SLC data and their temporal analysis is observed for their different phenology stages. Four machine learning (ML) based models i.e., LightGBM, Xgboost, K-nearest neighbor (KNN), and Random Forest have been explored on these features for FVC estimation. The performance of each model is assessed with the error metrics. Xgboost emerges as the best model with a minimum RMSE value of 0.159. Xgboost model has the capability to recognize the most important features. Due to the stochastic nature of the algorithm, feature priority sequence may vary, therefore, algorithm runs multiple times and the probability of each feature for every position is calculated and on the basis of the highest probability, feature importance sequences is decided. Xgboost model is developed by increasing the input features in the order of their importance sequence and the RMSE value is calculated for each input combination. It is noted that initially, the RMSE value improved from 0.22 to 0.15 for the top five input features. When additional features were included, no further improvement in the RMSE was observed. Therefore; entropy, alpha, VH, VH/VV, and VV are the top five features which are used in the Xgboost model for FVC estimation instead of all sixteen features, which delivers satisfactory results. [ABSTRACT FROM AUTHOR]

In this narrative review, we summarize the literature and provide updates on recent studies of air pollution exposures and child lung function and lung function growth. We include exposures to outdoor air pollutants that are monitored and regulated through air quality standards, and air pollutants that are not routinely monitored or directly regulated, including wildfires, indoor biomass and coal burning, gas and wood stove use, and volatile organic compounds. Included is a more systematic review of the recent literature on long-term air pollution and child lung function because this is an indicator of future adult respiratory health and exposure assessment tools have improved dramatically in recent years. We present "summary observations" and "knowledge gaps." We end by discussing what is known about what can be done at the individual/household, local/regional, and national levels to overcome structural impediments, reduce air pollution exposures, and improve child lung function. We found a large literature on adverse air pollution effects on children's lung function level and growth; however, many questions remain. Important areas needing further research include whether early-life effects are fixed or reversible; and what are windows of increased susceptibility, long-term effects of repeated wildfire events, and effects of air quality interventions. [ABSTRACT FROM AUTHOR]

• FVC% predicted significantly declines with 1% per year in adult BMD patients. • FEV1 and PEF also deteriorate significantly each year. • Loss of ambulation significantly accelerates respiratory decline. • BMI and forced vital capacity are inversely correlated in non-ambulatory patients. • FVC is significantly correlated with MRC sum score but not LVEF. Becker muscular dystrophy (BMD) is a rare hereditary neuromuscular disease, caused by a genetic defect in the Duchenne Muscular Dystrophy (DMD) gene. We studied the natural history of respiratory function and its affecting factors in 23 adult BMD patients. These important data are needed for (future) clinical trials in BMD but are largely lacking. Patients had a median age of 51 years (28–78y) and median follow-up duration of 14 years (2–25y). We analysed 190 pulmonary function measurements with a median interval of one year (1–17y) and measured a 1.00% decline of Forced Vital Capacity percent predicted (FVC%pred) per year (p = 0.004). Loss of ambulation significantly increased the annual rate of FVC decline and was dependent of patient's body mass index (BMI; p = 0.015), with increases in BMI correlating with an even more rapid deterioration of FVC. A decline in Medical Research Council (MRC) sum score was significantly correlated with a decline in FVC (p = 0.003). We conclude that adult BMD patients experience a significant but mild respiratory decline. However, this decline is significantly more rapid and clinically relevant after loss of ambulation, which warrants a more vigilant follow-up of respiratory function in this subgroup. [ABSTRACT FROM AUTHOR]

Certain occupations like welding, painting, and vehicle repairing are associated with regular exposure to dust, exhausts, fuels, fumes, PM, and vapors of welding, solvents, and paint. Many studies have proved a reduction in lung functions due to exposure to these agents. The present study aims to assess and compare respiratory symptoms and pulmonary functions among exposed and non-exposed persons as well as suggests controls respectively. A cross-sectional case study was carried out among small scale industry workers having matched demographic and anthropometric parameters. Medical Research Council (MRC) questionnaire and Micro Direct computerized automated spirometer were used for recording respiratory ailments and pulmonary function tests (PFT) respectively. The percentages of mechanics, welders and painters were 40.9, 31.8, and 27.3 respectively. The highest reported respiratory symptom was chest tightness and whistling among exposed (22.7%) and unexposed (10%). Among study exposed cases, the occupational exposure was found as often (22.7%), sometimes (68.2%) and never (9.1%) while the reported use of airway protection (masks) was very low. Overall respiratory health of the exposed versus controls was reported as excellent (54.5% vs 73.4%), good (27.3% vs 23.3%) and average (18.2% vs 3.3%) respectively. The exposed group on contrary to control one has decreased mean values for FEV1 (3.12 vs 3.50), FVC (4.12 vs 4.43), FEV1/ FVC % (79.60 vs 80.79) and PEF (414.77 vs 523.16). The present study reveals that exposed workers are at increased risk of developing respiratory symptoms and decreased pulmonary functions as compared to unexposed. Such exposure research studies are instrumental in health status evaluation of workers. However, this area has been neglected by the researchers in Saudi Arabia. It is, thus, strongly recommended to carry out prospective studies to substantiate the study results including large sample size, background pollutants concentrations and biological monitoring. Control strategies should be adopted to reduce the vapor concentration in the ambient air, protect and promote respiratory health of workers. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) has systemic consequences and causes structural abnormalities throughout the respiratory system. It is associated with a high clinical burden worldwide. A network meta-analysis was performed to determine the effects of exercise programs on lung function measured by forced expiratory volume in the first second (FEV1), FEV1 as a percentage of the predicted value (FEV1%) and forced vital capacity in people with COPD. A literature search was performed to March 2023. Randomized controlled trials on the effectiveness of exercise programs on lung function in people with COPD were included. A standard pairwise meta-analysis and a network meta-analysis for direct and indirect comparisons between intervention and control/nonintervention groups were carried out to calculate the standardized mean difference and 95 % CI. The risk of bias was assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess the quality of the evidence. 35 studies with a total sample of 2909 participants were included in this network meta-analysis. The highest standardized mean difference was for active mind body movement therapy programs versus control for FEV1 and FEV1% (0.71; 95 % CI 0.32 to1.09; and 0.36; 95 % CI 0.15 to 0.58, respectively), and pulmonary rehabilitation+active mind body movements therapies versus control for forced vital capacity (0.45; 95 % CI 0.07 to 0.84). active mind body movement therapy programs were the most effective type of exercise program to improve lung function measured by FEV1 and FEV1%; pulmonary rehabilitation+active mind body movements therapies had the greatest effects on FVC in people with COPD. Exercise programs in which the abdominal muscles are strengthened could improve lung emptying, helping to overcome airway resistance in people with COPD. [ABSTRACT FROM AUTHOR]

The Tianshan Mountains are the largest mountain system in Central Asia and comprise islands of humidity within a widespread arid zone. In this study, we improve knowledge of the quantitative relationship between pollen and vegetation coverage in the region, to quantitatively reconstruct Holocene vegetation coverage. Specifically, we statistically analyzed 1058 modern pollen samples from the central Tianshan Mountains and neighbouring regions, utilizing redundancy analysis (RDA), and boosted regression trees (BRT), stepwise regression (Stepwise), the modern analogy technique (MAT), weighted average partial least squares (WA-PLS) and local weighted average (LWWA) methods, to construct a series of modern calibration sets between pollen and fractional vegetation cover (FVC). The results show that (1) FVC and modern pollen assemblages display a strong correlation (correlation coefficient of 0.66) and (2) BRT outperforms Stepwise, MAT, WA-PLS and LWWA under leave-one-out cross-validation, bootstrap, and spatial autocorrelation tests, making the BRT model the best choice. Applied to Holocene datasets, we infer that from 11.4 to 4.6 cal kyr BP, FVC changes were mainly influenced by natural climate changes. However, after 4.6 cal kyr BP, FVC changes were influenced by a combination of natural climate changes (with humidity playing a dominant role) and the intensity of human activities. • Fractional Vegetation Cover (FVC) is an important variable for pollen assemblages in central Tianshan Mountains. • Boosted regression trees (BRT) is the optimal quantitative model for simulating FVC. • FVC changes were mainly influenced by natural climate change during Holocene. [ABSTRACT FROM AUTHOR]

Background: Pulmonary dysfunction predicts incident cardiovascular disease (CVD).Objectives: The purpose of this study was to evaluate whether longitudinal decline in lung function is associated with incident heart failure (HF), coronary heart disease (CHD), and stroke.Methods: Among 10,351 participants in the ARIC (Atherosclerosis Risk In Communities) study free of CVD, rapid lung function decline was defined as the greatest quartile (n = 2,585) of decline in either forced expiratory volume in 1 s (FEV1) (>1.9% decline/year) or forced vital capacity (FVC) (>2.1% decline/year) over 2.9 ± 0.2 years. The relationship between rapid decline in FEV1 or FVC and subsequent incident HF, CHD, stroke, or a composite of these was assessed using multivariable Cox regression adjusting for the baseline spirometry value, demographics, height, body mass index, heart rate, diabetes, hypertension, low-density lipoprotein, use of lipid-lowering medication, N-terminal fragment of prohormone for B-type natriuretic peptide, and smoking.Results: The mean age was 54 ± 6 years, 56% were women, and 81% were white. At 17 ± 6 years of follow-up, HF occurred in 14%, CHD 11%, stroke 6%, and the composite in 24%. Rapid decline in FEV1 and in FVC were both associated with a heightened risk of incident HF (hazard ratio [HR]: 1.17; 95% confidence interval [CI]: 1.04 to 1.33; p = 0.010; and HR: 1.27; 95% CI: 1.12 to 1.44; p < 0.001; respectively), with rapid decline in FEV1 most prognostic in the first year of follow-up (HR: 4.22; 95% CI: 1.34 to 13.26; p = 0.01). Rapid decline in FEV1 was also associated with incident stroke (HR: 1.25; 95% CI: 1.04 to 1.50; p = 0.015).Conclusions: A rapid decline in lung function, assessed by serial spirometry, is associated with a higher incidence of subsequent CVD, particularly incident HF. [ABSTRACT FROM AUTHOR]

• The vegetation index ViGREEN was determinant to classify the orthomosaics. • ViGREEN had potential to estimate the RUSLE C-factor at different scales. • Different forms of sugarcane cover leads the reduction of soil loss ratio (SLR). • Canopy height limits the ability of sugarcane to protect the soil from erosion. • RGB sensors on UAVs are a reliable option for estimating SLR subfactors. The Universal Soil Loss Equation (USLE) and its derivatives express the combined effects of crop cover and rainfall patterns by the cover and management factor (C). Thus, the C-factor links the combined effect of soil surface roughness, vegetation, biomass cover, and rainfall patterns on soil erosion. This evaluation should be at each phenological stage. Due to the significant time and effort needed to access this factor for a crop, simplified methods are often used, disregarding the expected intra-annual variability and consequently increasing the uncertainty for soil loss modeling. In this scenario, we proposed a framework to collect input data at a fine-scale to estimate the C-factor by the original approach. For this, we collected data with a low-cost UAV at the middle of each phenological stage of sugarcane: sprouting, tillering, elongation, and maturation. We used orthomosaics, three vegetation indices (ExRmG, MGRVI, ViGREEN), digital surface models (DSM), and digital terrain model (DTM) to determine the canopy cover (CC), surface cover (SC), and soil roughness (SR), accessing the soil loss ratio (SLR) per phenological stage. Late on, we estimate the C-factor weighting the SLR by the rainfall erosivity. Our annual C-factor aligns with the most values applied to sugarcane studies and ranged from 0.0241 to 0.2938. Our results pointed out that using the proposed methods can access suitable annual C-factor for sugarcane areas. Furthermore, we highlighted the ViGREEN because it presented a significant performance in orthomosaics classification and has a potential already reported in other studies on C-factor at different scales. [ABSTRACT FROM AUTHOR]

Objective The purpose of the study was to evaluate the relationship of an objective functional lung parameter (FVC) and a subjective psychological factor (physical symptom concerns) with dyspnea in sarcoidosis. Dyspnea constitutes one of the most common and burdensome symptoms in sarcoidosis, yet little is known about its mechanisms and, in particular, psychological. Method A total of 107 hospitalized sarcoidosis patients (Female = 50, M age = 45.3 years) volunteered to take part in the correlational research study. Participants underwent spirometry and completed the MRC Dyspnea Scale and the Anxiety Sensitivity Index-3 (ASI) questionnaire. Linear hierarchical regression analysis was used to determine the relationship between the studied predictors and dyspnea severity. Results The best fitting model predicted 18% of variance in dyspnea severity. Physical symptom concerns subscale of ASI (β = 0.24) and FVC (β = − 0.23) were significantly related to dyspnea MRC severity, but only physical concerns remained significantly related to dyspnea when both predictors were in the model. Conclusions The current results suggest that both psychological and physiological factors should be taken into account when explaining subjective dyspnea severity in sarcoidosis. More specifically, these findings call for including cognitive vulnerability factors related to anxiety (physical symptom concerns) into the diagnostic procedures and management of dyspnea in sarcoidosis. [ABSTRACT FROM AUTHOR]

Background Lung function has previously been related to increased mortality. Whether pulmonary impairment is associated with an increased mortality independent of cardiac dysfunction remains unclear. Methods In 15010 individuals from the general population (age range 35–74 years, 51% men) in the Gutenberg Health Study we performed spirometry and transthoracic echocardiography. N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and high-sensitive troponin I (hsTnI) were measured in all individuals. 1819 individuals with pulmonary diseases were excluded from further analysis. Results The median for forced expiratory volume in 1 s (FEV1) was 94.2% and for forced vital capacity (FVC) 94.2% as a percentage of their predicted values. The median FEV1/FVC ratio was 79.1%. In 13191 subjects, 335 deaths were verified from death certificate over a median follow-up of 5.5 years. Multivariable-adjusted Cox regression analyses for common cardiovascular risk factors and heart failure revealed that an increase of one standard deviation (SD) of percent predicted (%pred.) FEV1 was associated with a 22% risk reduction (hazard ratio [HR] per SD 0.78 [95% confidence interval (CI): 0.70, 0.86]). The association remained statistically significant after additional adjustment for diastolic dysfunction, Nt-proBNP or hsTnI. Comparable results were seen for %pred. FVC. After adjustment, no association of FEV1/FVC ratio with mortality could be shown. No significant interaction by heart failure was observed. Conclusions The lung function parameters FEV1 and FVC, but not FEV1/FVC ratio, were related to all-cause mortality in individuals from the general population independent of cardiac function. [ABSTRACT FROM AUTHOR]

[Display omitted] • More residential greenspace was not associated with better lung function. • Increased NDVI was associated with a slightly faster decline in FVC. • Residing near green spaces might be associated with a faster decline in FEV 1 and FVC. The few studies that have examined associations between greenspace and lung function in adulthood have yielded conflicting results and none have examined whether the rate of lung function decline is affected. We explored the association between residential greenspace and change in lung function over 20 years in 5559 adults from 22 centers in 11 countries participating in the population-based, international European Community Respiratory Health Survey. Forced expiratory volume in 1 s (FEV 1) and forced vital capacity (FVC) were measured by spirometry when participants were approximately 35 (1990 – 1994), 44 (1999 – 2003), and 55 (2010 – 2014) years old. Greenness was assessed as the mean Normalized Difference Vegetation Index (NDVI) in 500 m, 300 m, and 100 m circular buffers around the residential addresses at the time of lung function measurement. Green spaces were defined as the presence of agricultural, natural, or urban green spaces in a circular 300 m buffer. Associations of these greenspace parameters with the rate of lung function change were assessed using adjusted linear mixed effects regression models with random intercepts for subjects nested within centers. Sensitivity analyses considered air pollution exposures. A 0.2-increase (average interquartile range) in NDVI in the 500 m buffer was consistently associated with a faster decline in FVC (−1.25 mL/year [95% confidence interval: −2.18 to −0.33]). These associations were especially pronounced in females and those living in areas with low PM 10 levels. We found no consistent associations with FEV 1 and the FEV 1 /FVC ratio. Residing near forests or urban green spaces was associated with a faster decline in FEV 1 , while agricultural land and forests were related to a greater decline in FVC. More residential greenspace was not associated with better lung function in middle-aged European adults. Instead, we observed slight but consistent declines in lung function parameters. The potentially detrimental association requires verification in future studies. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Over the past few decades, there have been significant scientific advances leading to improved understanding of asthma as a disease and treatment providing immediate relief. However, prevention of recurrent attacks, exacerbations and disease cure remains a challenge. Ayurveda refers to bronchial asthma as Tamaka Swasa and it is well explained in Charaka Samhita . Management of asthma in Ayurveda includes removal of vitiated Kapha through Shodhana, Shamana procedures, herbal and herbomineral formulations in addition to advising a healthy lifestyle and diet. Several clinical trials on Ayurvedic formulations for treatment of asthma are reported, however, whole system management of asthma has rarely been studied in the manner in which it is actually being practiced. Ayurveda therapeutics provides Dosha specific approaches, which needs biological investigation. Aim of the study The objective of our study was to investigate lung functions and cytokine changes in Asthmatic individuals in response to Ayurvedic intervention. Methods The study design was approved by the Institutional Ethics Committee of Tilak Ayurveda Mahavidyalaya (TAMV) & Sheth Tarachand Ramnath Charitable Ayurveda Hospital and followed guidelines of the Declaration of Helsinki and Tokyo for humans. It was conducted as a whole system individualized pragmatic clinical trial and written consent of patients was collected before enrollment. One hundred and fifteen patients with mild-to-moderate asthma were divided into 2 sub-groups depending on their disease subsets and administered phenotype specific ayurvedic interventions. Seventy six asthma patients completed the treatment. Serum IgE levels, blood eosinophil counts, spirometry and blood cytokine levels were measured before the start of treatment and six months at the end of treatment. Age and sex matched healthy participants (n=69) were recruited in the study for comparison of cytokines levels. Results Significant improvements in FEV1(% predicted) (p<0.0001) and FVC (% predicted) (p=0.0001) was observed in asthmatic patients who underwent Ayurvedic treatment. Circulating levels of IgE (p<0.03) and eosinophil numbers (p=0.001) reduced significantly in the asthmatics after Ayurvedic treatment. This was associated with significant reduction in levels of circulating cytokines. Levels of Th2, Th1 and inflammatory cytokines in the peripheral blood were higher than healthy control participants at baseline (p values <0.0001) and reduced significantly after ayurvedic intervention. Conclusion This proof of concept study highlights the potential benefits and possible mechanism of Ayurvedic interventions in patients with mild-to-moderate asthma. The interventions significantly reduced IgE and eosinophil count, also improved lung function and reduced levels of circulating Th2 cytokines. [ABSTRACT FROM AUTHOR]

Introduction The visceral theory in Sasang constitutional medicine proposes the hypothesis that specific types of Sasang constitutions have different functional activities in the internal organs. This population-based cohort study examined whether there were differences in the lung function according to the Sasang constitutional types (SCTs) using the pulmonary function test (PFT). Methods A total of 1320 individuals who participated in the Korean Genome and Epidemiology Study and completed the PFT were included. SCTs were classified by an integrated diagnostic model. We determined the values of the forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ), and FEV 1 /FVC (%) for each of the SCTs. Individuals who had pulmonary diseases based on the chest X-ray examination were excluded. Results Tae-Eum (TE) type had a significantly lower FVC than So-Eum and So-Yang types ( P = 0.034) even after adjusting for confounding factors including age, sex, weight, height, smoking, and presence of diabetes mellitus. FEV 1 did not differ among the SCTs ( P = 0.65). In the analysis stratified by gender, there was no significant difference in FVC, FEV 1 , and FEV 1 /FVC in males, whereas females with the TE type had the lowest value of FVC among the SCTs ( P = 0.016). Conclusions This study found that females with the TE type had the poorest lung function, in terms of the lung volume. [ABSTRACT FROM AUTHOR]

Background Kilauea Volcano on the Island of Hawai'i has erupted continuously since 1983, releasing approximately 300–12000 metric tons per day of sulfur dioxide (SO 2 ). SO 2 interacts with water vapor to produce an acidic haze known locally as “vog”. The combination of wind speed and direction, inversion layer height, and local terrain lead to heterogeneous and variable distribution of vog over the island, allowing study of respiratory effects associated with chronic vog exposure. Objectives We characterized the distribution and composition of vog over the Island of Hawai'i, and tested the hypotheses that chronic vog exposure (SO 2 and acid) is associated with increased asthma prevalence, respiratory symptoms, and reduced pulmonary function in Hawai'i Island schoolchildren. Methods We compiled data of volcanic emissions, wind speed, and wind direction over Hawai'i Island since 1992. Community-based researchers then measured 2- to 4-week integrated concentrations of SO 2 and fine particulate mass and acidity in 4 exposure zones, from 2002 to 2005, when volcanic SO 2 emissions averaged 1600 metric tons per day. Concurrently, community researchers recruited schoolchildren in the 4th and 5th grades of 25 schools in the 4 vog exposure zones, to assess determinants of lung health, respiratory symptoms, and asthma prevalence. Results Environmental data suggested 4 different vog exposure zones with SO 2 , PM2.5, and particulate acid concentrations (mean ± s.d.) as follows: 1) Low (0.3 ± 0.2 ppb, 2.5 ± 1.2 μg/m 3 , 0.6 ± 1.1 nmol H +/m 3 ), 2) Intermittent (1.6 ± 1.8 ppb, 2.8 ± 1.5 μg/m 3 , 4.0 ± 6.6 nmol H +/m 3 ), 3) Frequent (10.1 ± 5.2 ppb, 4.8 ± 1.9 μg/m 3 , 4.3 ± 6.7 nmol H +/m 3 ), and 4) Acid (1.2 ± 0.4 ppb, 7.2 ± 2.3 μg/m 3 , 25.3 ± 17.9 nmol H +/m 3 ). Participants (1957) in the 4 zones differed in race, prematurity, maternal smoking during pregnancy, environmental tobacco smoke exposure, presence of mold in the home, and physician-diagnosed asthma. Multivariable analysis showed an association between Acid vog exposure and cough and strongly suggested an association with FEV1/FVC < 0.8, but not with diagnosis of asthma, or chronic persistent wheeze or bronchitis in the last 12 months. Conclusions: Hawai'i Island's volcanic air pollution can be very acidic, but contains few co-contaminants originating from anthropogenic sources of air pollution. Chronic exposure to acid vog is associated with increased cough and possibly with reduced FEV1/FVC, but not with asthma or bronchitis. Further study is needed to better understand how volcanic air pollution interacts with host and environmental factors to affect respiratory symptoms, lung function, and lung growth, and to determine acute effects of episodes of increased emissions. [ABSTRACT FROM AUTHOR]

Introduction The impact of outdoor air pollution exposure on long-term lung development and potential periods of increased lung susceptibility remain unknown. This study assessed associations between early-life and current residential exposure to air pollution and lung function at 15-years of age in two German birth cohorts. Methods Fifteen year-old participants living in an urban and rural area in Germany underwent spirometry before and after bronchodilation ( N = 2266). Annual average (long-term) exposure to nitrogen dioxide (NO 2 ), particles with aerodynamic diameters less than 2.5 μg/m 3 (PM 2.5 ) mass and less than 10 μg/m 3 (PM 10 ) mass, PM 2.5 absorbance and ozone were estimated to each participant's birth-, 10- and 15-year home address using land-use regression and kriging (ozone only) modelling. Associations between lung function variables and long-term pollutant concentrations were assessed using linear regression models adjusted for host and environmental covariates and recent short-term air pollution exposures. Results Long-term air pollution concentrations assessed to the birth-, 10- and 15-year home addresses were not associated with lung function variables, before and after bronchodilation, in the complete or study area specific populations. However, several lung function variables were negatively associated with long-term NO 2 concentrations among asthmatics. For example, NO 2 estimated to the 15-year home address was associated with the ratio of forced expiratory volume in one second to forced vital capacity (FEV 1 /FVC) and the mean flow rate between 25% and 75% of FVC (−3.5%, 95% confidence interval [−6.0, −1.0] and −297.4 ml/s [−592.6, −2.1] per 5.9 μg/m 3 increase in NO 2 , respectively). Nearly all effect estimates for the associations between the short-term PM 2.5 mass, PM 10 mass and ozone concentrations and the lung function variables were negative in the complete population. Conclusions Early-life and current long-term air pollution exposures and lung function at the age of 15 years were not associated in the complete study population. Asthmatics may represent a vulnerable group. [ABSTRACT FROM AUTHOR]

In the present study, we evaluated the association between dietary patterns and pulmonary functions in Korean women older than 40 years. This study analyzed the data from the Korea National Health and Nutrition Examination Survey IV and V (2007–2010). In total, 7615 women were included in the analysis. Using principal component analysis, two dietary patterns were identified, namely a balanced diet pattern (vegetables, fish, meat, seaweed, and mushrooms) and a refined diet (snacks, bread, milk, dairy products, and fast food). The refined diet pattern was positively associated with energy from fat but negatively associated with vitamin A, β-carotene, niacin, and fiber. After adjusting for potential confounders, the refined diet pattern was negatively associated with levels of predicted forced vital capacity (odds ratio (OR): 0.84, 95% confidence intervals (CIs): 0.70, 0.99) and predicted forced expiratory volume in 1 second (OR: 0.79, 95% CIs: 0.66, 0.93). In conclusion, the refined diet pattern was associated with decreased pulmonary function in Korean women. This information may be useful toward the development of nutritional guidelines for improving pulmonary function in Korean women. [ABSTRACT FROM AUTHOR]

Abstract: Fractional vegetation cover (FVC) is an important indicator of mountain ecosystem status. A study on the seasonal changes of FVC can be beneficial for regional eco-environmental security, which contributes to the assessment of mountain ecosystem recovery and supports mountain forest planning and landscape reconstruction around megacities, for example, Beijing, China. Remote sensing has been demonstrated to be one of the most powerful and feasible tools for the investigation of mountain vegetation. However, topographic and atmospheric effects can produce enormous errors in the quantitative retrieval of FVC data from satellite images of mountainous areas. Moreover, the most commonly used analysis approach for assessing FVC seasonal fluctuations is based on per-pixel analysis regardless of the spatial context, which results in pixel-based FVC values that are feasible for landscape and ecosystem applications. To solve these problems, we proposed a new method that incorporates the use of a revised physically based (RPB) model to correct both atmospheric and terrain-caused illumination effects on Landsat images, an improved vegetation index (VI)-based technique for estimating the FVC, and an adaptive mean shift approach for object-based FVC segmentation. An array of metrics for segmented FVC analyses, including a variety of area metrics, patch metrics, shape metrics and diversity metrics, was generated. On the basis of the individual segmented FVC values and landscape metrics from multiple images of different dates, remote sensing of the seasonal variability of FVC was conducted over the mountainous area of Beijing, China. The experimental results indicate that (a) the mean value of the RPB–NDVI in all seasons was increased by approximately 10% compared with that of the atmospheric correction-NDVI; (b) a strong consistency was demonstrated between ground-based FVC observations and FVC estimated through remote sensing technology (R 2 =0.8527, RMSE=0.0851); and (c) seasonal changes in the landscape characteristics existed, and the landscape diversity reached its maximum in May and June in the study area. [Copyright &y& Elsevier]

Systemic inflammation is associated with impaired lung function. Studies, most cross-sectional, report a stronger association between systemic inflammation and lung function impairment in men than women. The aim was to evaluate gender differences in the longitudinal association between systemic inflammation and lung function. We used data from randomly chosen residents of Reykjavík, born 1940-54, who were investigated in three stages: Baseline (1973-75; 1983-85) and follow-up (2001-03). The participants (n = 1049, 574 women) had a mean age of 28 ± 6 years at baseline and mean follow-up time of 27 ± 4 years. At each stage lung function (FEV1 and FVC) and C-reactive protein (CRP) were evaluated. Change in FEV1 (p = 0.04) and FVC (p = 0.01) was associated with baseline CRP in men but not in women. In the multiple variable analysis, CRP at baseline was associated with a decline in FEV1 (-3.1 mL/year, 95% CI: -5.1, -0.99) and FVC (-2.5 mL/year, 95% CI: -4.4, -0.65) in men but not in women. Similarly during follow-up, change in CRP, standardised to 1SD, was associated with a decline in FEV1 (-0.19 mL/year, 95% CI: -0.30, -0.07) and FVC (-0.11 mL/year, 95% CI: -0.22, -0.01)) in men but not in women. This prospective study confirms a stronger association between systemic inflammation and lung function decline in men than in women. This may indicate a gender difference in the mechanisms of lung function decline. [ABSTRACT FROM AUTHOR]

Background: Two recent large meta-analyses of genome-wide association studies of lung function in general populations of European descent identified 11 candidate genes/regions. The importance of these genes in lung function in white and African American subjects with asthma is unknown. Objectives: To determine whether genes that regulate lung function in general populations are associated with lung function abnormalities in subjects with asthma from different racial groups. Methods: Single nucleotide polymorphisms (SNPs) were tested in 5 asthma populations (N = 1441) for association with pulmonary function, and meta-analysis was performed across populations. The SNPs with the highest significance were then tested for association with bronchodilator reversibility and bronchial hyperresponsiveness to methacholine. A joint analysis of consistently replicated SNPs was performed to predict lung function in asthma. Results: Hedgehog interacting protein (HHIP) on chromosome 4q31 was associated with lung function in all 5 populations (rs1512288: P meta = 9.62E-05 and 3.23E-05 for percent predicted FEV1 [ppFEV1] and percent predicted forced vital capacity [ppFVC], respectively). The SNPs in HHIP were also associated with reversibility (P < .05) but not bronchial hyperresponsiveness to methacholine. Because of differences in linkage disequilibrium in the African American subjects, the most relevant SNPs in HHIP were identified. A subset of normal lung function genes, including HHIP, family with sequence similarity 13, member A (FAM13A), and patched homolog 1 (PTCH1), together predict lung function abnormalities, a measure of severity in white and African American subjects with asthma. Conclusion: A subset of the genes, including HHIP, that regulate lung function in general populations are associated with abnormal lung function in asthma in non-Hispanic white and African American subjects. [ABSTRACT FROM AUTHOR]

Summary: Background: The methacholine challenge test performed with the tidal breathing method induces a greater fall in FEV1 than the dosimeter method; however, the effect of the challenge method on methacholine-induced fall in FVC has not been investigated. Objective: To determine the influence of the challenge method on methacholine-induced changes in FEV1 and FVC. Methods: Airway responsiveness to methacholine was determined by dosimeter method and tidal breathing method in 37 subjects with suspected asthma. The dosimeter was modified to deliver an identical volume to that obtained with the tidal breathing method and the same nebulizer model was used for the two challenges. The response was expressed by the provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) and by the percent fall in FVC at the PC20 value relative to FVC after saline inhalation. Results: The PC20 values obtained with the tidal breathing method and the dosimeter method were similar, with geometric mean values of 3.15 (95%CI, 1.85–5.34 mg/mL) and 2.51 (1.37–4.61 mg/mL, P = 0.092), respectively. The percent fall in FVC at the PC20 value obtained with the dosimeter was significantly greater than that obtained with the tidal breathing method, with mean values of 11.8 (95%CI, 10.0–13.5%) and 9.4 (95%CI, 8.1–10.8, P = 0.002), respectively. Conclusions: Differences in methacholine PC20 values obtained with the two challenge methods recommended in guidelines may be overcome by introducing some technical modifications in the dosimeter method. However, the technical factors that affect methacholine sensitivity and air trapping are at least partially different. [ABSTRACT FROM AUTHOR]

Summary: Background: Extensively used current guidelines of the American Thoracic Society/European Respiratory Society (ATS/ERS) define a positive aerosolized bronchodilator (BD) response as: “…an increase in FEV1 and/or FVC≥12% of control and ≥200mL.” We hypothesized that BD responsiveness was better assessed using a statistical approach, linked to each individual''s spirometric measurements, rather than the variability of others. Design: We retrospectively analyzed 1-year''s pre- and post-BD spirometric tests from our hospital''s clinical laboratory. Using measurements of forced expiratory volume in 1-s (FEV1), forced expiratory volume in 3-s (FEV3), and forced vital capacity (FVC) from each of three satisfactory forced pre-BD and three satisfactory forced post-BD spirometric maneuvers, we classified each of 313 consecutive patient studies as responders or non-responders in two ways. First, we used ATS/ERS guideline criteria based on population variability. Second, we used unpaired, single-tailed t-tests at P <0.05 for FEV1, FEV3, and FVC, considering the variability of and difference between each individual''s pre- and post-BD maneuvers. Results: 135 studies were both ATS/ERS and t-test non-responders, three were ATS/ERS responders and t-test non-responders, 86 were ATS/ERS and t-test responders, and 89 were ATS/ERS non-responders and t-test responders. The latter 89 included many patients with either low baseline FEV1 (<1.50L) who could not reach the 200mL increase criterion or high baseline FEV1 (>3.00L) who could not reach the 12% increase criterion. Conclusions: We believe individual t-tests may categorize patient''s BD responsiveness better than ATS/ERS guideline criteria which are based on population responses and require both fixed volume and percentage changes. Its usefulness by others remains to be shown. [Copyright &y& Elsevier]

Summary: Study objective: The present study evaluated the relationship between health status (HS) and peripheral muscle histochemical characteristics in chronic obstructive pulmonary disease (COPD), and identified selected independent respiratory and extrapulmonary variables that predicted the HS of these patients. Design: Cross-sectional study. Setting: Outpatient respiratory clinic of a university hospital. Patients and methods: We studied 29 patients (63±10yrs) with a forced expiratory volume in 1s (FEV1) of 39±12%. All patients underwent vastus lateralis muscle biopsies for histochemical analysis. They also had spirometry, arterial blood gas analysis, body mass index (BMI), dyspnea determined with the MMRC scale and responded to the St. George''s Respiratory Questionnaire (SGRQ) for HS assessment. Results: SGRQ total score correlated with fiber type distribution. A stepwise multiple regression identified three independent predictors of SGRQ total score: type I fiber proportion, BMI, and FEV1; and . Conclusions: These results indicate that impaired HS in COPD is related to the peripheral muscle changes characterized by less type I fibers proportion. The findings argue in favor of an important contribution of the systemic consequences on the HS in COPD independently from the airflow limitation severity, and help to explain the observation of the poor correlation between the degree of airflow limitation and SGRQ total score. [Copyright &y& Elsevier]

Summary: Early prediction of respiratory muscle involvement and chronic hypoventilation (CH) in amyotrophic lateral sclerosis (ALS) patients can help to plan mechanical ventilatory aids and palliative care interventions well before respiratory failure occurs. To describe the natural history of the progressive pulmonary dysfunction leading to CH, and to identify potential parameters associated with its development in ALS, we prospectively followed 38 ALS patients up to 26 months, starting from their first presentation at our Clinic. At study entry, median FVC was 87% (interquartile range: 72–104%) and declined by 10% after 6 months (range: 2–49%), showing a very high inter-patient variability. Over the 26-months follow-up, 19 patients (50%) presented CH in the first 12 months, and eight patients (21%) developed CH in the remaining 14 months of the study. The remaining 29% of patients did not show signs of CH during the whole period of observation. In the Cox model, the category of disease progression (rapid vs. intermediate and slow), assessed using the Appel ALS Rating Scale (AARS) in the first 3 months after presentation, was the only variable associated with a significantly increased likelihood of CH. We conclude that CH can occur within 1 year from presentation in a great proportion of patients, independently from their initial respiratory status. Including the patients in specific categories of early disease progression, as assessed with the AARS, could be a sensitive method to identify patients with different risk of developing CH, and may help physicians to more efficiently plan the frequencies of respiratory evaluations, initiate mechanical ventilation and discuss advance directives with the patients and their caregivers. [Copyright &y& Elsevier]

Background: The relationship and behavior of serum immunoglobulin E (IgE) level, peripheral blood mononuclear cell (PBMC) human leukocyte antigen DR (HLA-DR) expression and erythrocyte glutathione antioxidant pathway in asthma patients treated with systemic ozone therapy have not been studied before. Methods: Asthma patients were treated about 1 year with three cycles (5 or 6 months each) with three different ozone therapy protocols. Ozone major autohemotherapy (MAHT) was applied at doses of 4 and 8 mg, 15 sessions each cycle; and ozone rectal insufflations (RI) at a dose of 10 mg, 20 sessions each cycle. Serum IgE, HLA-DR expression in PBMC and biomarkers for antioxidant pathway were measured before and at the end of each cycle. Lung function and symptoms test were recorded at the beginning and after the third cycle. Results: IgE and HLA-DR decreased with the three types of treatments, while increments in reduced glutathione, glutathione peroxidase, glutation reductase and glutathione S-transferase were achieved with all treatments. Lung function and symptoms test were markedly improved. However, in all parameters the best response was obtained in the order: MAHT at 8 mg better than MAHT at 4 mg better than RI at 10 mg. Before ozone treatment, glutathione antioxidant parameters were under the normal reference values, suggesting the occurrence of oxidative stress associated with atopic asthma. Conclusions: This study demonstrates the effectiveness of ozone therapy in reducing IgE and inflammatory mediators along with the induction of antioxidant elements. The study raises the role of systemic ozone therapy in atopic asthma by means of its immunomodulatory and oxidative stress regulation properties. [Copyright &y& Elsevier]

: ObjectivesThe study was done to ascertain the degree to which abnormalities in resting lung function correlate with the disease severity of patients with primary pulmonary hypertension (PPH).: BackgroundPatients with PPH are often difficult to diagnose until several years after the onset of symptoms. Despite the seriousness of the disorder, the diagnosis of PPH is often delayed because it is unsuspected and requires invasive measurements. Although PPH often causes abnormalities in resting lung function, these abnormalities have not been shown to be statistically significant when correlated with other measures of PPH severity.: MethodsResting lung mechanics and diffusing capacity for carbon monoxide DLco were assessed in 79 patients whose findings conformed to the classical diagnostic criteria of PPH and who had no evidence of secondary causes of pulmonary hypertension. These findings were correlated with severity of disease as assessed by cardiac catheterization, New York Heart Association (NYHA) class, and cardiopulmonary exercise testing.: ResultsWhen PPH patients were first evaluated at our referral clinic, the DLco and lung volumes were decreased in approximately three-quarters and one-half, respectively. The decreases in DLco, and to a lesser extent lung volumes, correlated significantly with decreases in peak oxygen uptake (reflecting maximum cardiac output), peak oxygen pulse (reflecting maximum stroke volume), and anaerobic threshold (reflecting sustainable exercise capacity) and higher NYHA class.: ConclusionsPatients with PPH commonly have abnormalities in lung mechanics and DLco levels that correlate significantly with disease severity. These measurements can be useful in evaluating patients with unexplained dyspnea and fatigue. [Copyright &y& Elsevier]

: ObjectivesWe sought to test the hypothesis that patients with decompensated heart failure (HF) lose a compensatory process whereby nitric oxide (NO) maintains pulmonary vascular tone.: BackgroundExhaled nitric oxide (eNO) partially reflects vascular endothelial NO release. Levels of eNO are elevated in patients with compensated HF and correlate inversely with pulmonary artery pressures (PAP), reflecting pulmonary vasodilatory activity.: MethodsWe measured the mean mixed expired NO content of a vital-capacity breath using chemiluminescence in patients with compensated HF (n = 30), decompensated HF (n = 7) and in normal control subjects (n = 90). Pulmonary artery pressures were also measured in patients with HF. The eNO and PAP were determined sequentially during therapy with intravenous vasodilators in patients with decompensated HF (n = 7) and in an additional group of patients with HF (n = 13) before and during administration of milrinone.: ResultsThe eNO was higher in patients with HF than in control subjects (9.9 ± 1.1 ppb vs. 6.2 ± 0.4 ppb, p = 0.002) and inversely correlated with PAP (r = −0.81, p < 0.00001). In marked contrast, patients with decompensated HF exhibited even higher levels of eNO (20.4 ± 6.2 ppb) and PAP, but there was a loss of the inverse relationship between these two variables. During therapy (7.3 ± 6 days) with sodium nitroprusside and diuresis, hemodynamics improved, eNO concentrations fell (11.2 ± 1.2 ppb vs. before treatment, p < 0.05), and the relationship between eNO and PAP was restored. After milrinone, eNO rose proportionally with decreased PAP (p < 0.05).: ConclusionsElevated eNO may reflect a compensatory circulatory mechanism in HF that is lost in patients with clinically decompensated HF. The eNO may be an easily obtainable and quantifiable measure of the response to therapy in advanced HF. [Copyright &y& Elsevier]

Objective: To analyze longitudinal trends of pulmonary function testing in patients with congenital diaphragmatic hernia (CDH) followed in our multidisciplinary clinic.Study Design: This was a retrospective cohort study of CDH patients born between 1991 and 2013. A linear mixed effects model was fitted to estimate the trends of percent predicted forced expiratory volume in 1 second (FEV1pp), percent predicted forced vital capacity (FVCpp), and FEV1/FVC over time.Results: Of 268 patients with CDH who survived to discharge, 119 had at least 1 pulmonary function test study. The FEV1pp (P < .001), FVCpp (P = .017), and FEV1/FVC (P = .001) decreased with age. Compared with defect size A/B, those with defect size C/D had lower FEV1pp by an average of 11.5% (95% CI, 2.9%-20.1%; P = .010). A history of oxygen use at initial hospital discharge also correlated with decreased FEV1pp by an average of 8.0% (95% CI, 1.2%-15.0%; P = .023).Conclusions: In a select cohort of CDH survivors, average pulmonary function declines with age relative to expected population normative values. Those with severe CDH represent a population at risk for worsening pulmonary function test measurements who may benefit from recognition and monitoring for complications. [ABSTRACT FROM AUTHOR]

Background: Lung function is a long-term predictor of mortality and morbidity. Objective: We sought to identify single nucleotide polymorphisms (SNPs) associated with lung function. Methods: We performed a genome-wide association study (GWAS) of FEV1, forced vital capacity (FVC), and FEV1/FVC in 1144 Hutterites aged 6 to 89 years, who are members of a founder population of European descent. We performed least absolute shrinkage and selection operation regression to select the minimum set of SNPs that best predict FEV1/FVC in the Hutterites and used the GRAIL algorithm to mine the Gene Ontology database for evidence of functional connections between genes near the predictive SNPs. Results: Our GWAS identified significant associations between FEV1/FVC and SNPs at the THSD4-UACA-TLE3 locus on chromosome 15q23 (P = 5.7 × 10−8 to 3.4 × 10−9). Nine SNPs at or near 4 additional loci had P < 10−5 with FEV1/FVC. Only 2 SNPs were found with P < 10−5 for FEV1 or FVC. We found nominal levels of significance with SNPs at 9 of the 27 previously reported loci associated with lung function measures. Among a predictive set of 80 SNPs, 6 loci were identified that had a significant degree of functional connectivity (GRAIL P < .05), including 3 clusters of β-defensin genes, 2 chemokine genes (CCL18 and CXCL12), and TNFRSF13B. Conclusion: This study identifies genome-wide significant associations and replicates results of previous GWASs. Multimarker modeling implicated for the first time common variation in genes involved in antimicrobial immunity in airway mucosa that influences lung function. [Copyright &y& Elsevier]