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The PEGASUS study is the first multicentric and prospective assessment of the safety of air travel flying in pulmonary hypertension (PH) (NCT03051763). Data of air travel from 60 patients with PH was available. No severe adverse events occurred. Nine patients self-reported mild adverse events during flight (13%), while after landing, 12 patients reported events (20%). Solely one patient (2%) had an adverse event leading to medical consultation. In patients with PH and World Health Organization functional classes II and III, air travel was safe., Competing Interests: Henning Gall reports grants from the German Research Foundation and nonfinancial support from the University of Giessen during the conduct of the study, and personal fees from Actelion, AstraZeneca, Bayer, BMS, GSK, Janssen‐Cilag, Lilly, MSD, Novartis, OMT, Pfizer, and United Therapeutics outside the submitted work. Athiththan Yogeswaran reports non‐financialnonfinancial support from the University of Giessen during the conduct of the study. Natascha Sommer reports personal fees from Actelion outside the submitted work. Hossein A. Ghofrani reports grants from the German Research Foundation and nonfinancial support from the University of Giessen during the conduct of the study, and personal fees from Bayer, Actelion, Pfizer, Merck, GSK, and Takeda, grants and personal fees from Novartis, Bayer HealthCare, and Encysive/Pfizer, and grants from Aires, the German Research Foundation, Excellence Cluster Cardiopulmonary Research, and the German Ministry for Education and Research outside the submitted work. Werner Seeger reports grants from the German Research Foundation and nonfinancial support from the University of Giessen during the conduct of the study, and personal fees from Pfizer and Bayer Pharma AG outside the submitted work. Manuel J. Richter reports grants from the German Research Foundation and nonfinancial support from the University of Giessen during the conduct of the study, and grants from United Therapeutics, grants and personal fees from Bayer, and personal fees from Actelion, Mundipharma, Roche, and OMT outside the submitted work. Khodr Tello reports grants from the German Research Foundation and nonfinancial support from the University of Giessen during the conduct of the study, and personal fees from Actelion and Bayer outside the submitted work. Heinrike Wilkens received fees for lectures and/or consultations from Actelion, AOP, Bayer, Biotest, Boehringer‐Ingelheim, Daiichi Sankyo, Ferrer, GSK, Janssen Cilag, and MSD outside the submitted work. Michael Halank reports personal fees from AstraZeneca, Janssen‐Cilag, and MSD outside the submitted work. Melanie Heberling reports personal fees from Janssen‐Cilag und MSD outside the submitted work. Dr. Ulrich receives research grants from the Swiss National Science Foundation, Zurich and Swiss Lung League, Orpha‐Swiss, Emdo Foundation and travel support, lecture fees, and advisory compensation from MSD SA, Orpha Swiss, Janssen SA, Novartis SA, all unrelated to the present work. Katrin Milger reports speaker and/or advisory board honoraria from AOP Pharma, Ferrer, Janssen, MSD. Tobias J. Lange reports personal fees from Acceleron Pharma, AstraZeneca, Bayer, Böhringer Ingelheim, Ferrer, Gossamer Bio, Janssen Cilag, MSD, Orphacare, and Pfizer. Stefan Stadler reports personal fees from Acceleron Pharma, AOP Health, Gossamer Bio, Janssen Cilag, MSD, and Pfizer. Jan C. Kamp is supported by PRACTIS—Clinician Scientist Program of Hannover Medical School, funded by the German Research Foundation, grant no. ME 3696/3‐1, KFO311— 286251789. Ekkehard Grünig has received fees for lectures and/or consultations from Actelion, Bayer/MSD, Ferrer, GEBRO, GSK, Janssen, and OMT. Research grants to his institution have been received from Acceleron, Actelion, BayerHealthCare, MSD, Bellerophon, GossamerBio, GSK, Janssen, Novartis, OMT, Pfizer, REATE, and United Therapeutics outside the submitted work. Satenik Harutynova has received support from Janssen, OMT, Bayer Pharma, GSK and speaker fees from Janssen and OMT outside submitted work. Karen Olsson has received fees for lectures and/or consultations from Acceleron, Actelion, AOP, MSD, Ferrer, Janssen, and OMT. Research grants to her institution have been received from Actelion, all outside the submitted work. All other authors declare no conflicts of interest., (© 2024 The Author(s). Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute.)

The negative effects of nutrient pollution in streams, rivers, and downstream waterbodies remain widespread global problems. Understanding the cost-effectiveness of different strategies for mitigating nutrient pollution is critical to making informed decisions and defining expectations that best utilize limited resources, which is a research priority for the US Environmental Protection Agency. To this end, we modeled nutrient management practices including residue management, cover crops, filter strips, grassed waterways, constructed wetlands, and reducing fertilizer in the upper East Fork of the Little Miami River, an 892 km 2 watershed in southwestern Ohio, United States. The watershed is 64% agriculture with 422 km 2 of row crops contributing an estimated 71% of the system's nutrient load. The six practices were modeled to treat row crop area, and among them, constructed wetlands ranked highest for their low costs per kilogram of nutrient removed. To meet a 42% phosphorus (P) reduction target for row crops, the model results suggested that the runoff from 85.5% of the row crop area would need to be treated by the equivalent of 3.61 km 2 of constructed wetlands at an estimated cost of US$2.4 million annually (or US$48.5 million over a 20-year life cycle). This prompted a series of projects designed to understand the feasibility (defined in terms of build, treatment, and cost potential) of retrofitting the system with the necessary extent of constructed wetlands. The practicalities of building this wetland coverage into the system, while leading to innovation in unit-level design, has highlighted the difficulty of achieving the nutrient reduction target with wetlands alone. Approximately US$1.2 million have been spent on constructing 0.032 km 2 of wetlands thus far and a feasibility analysis suggests a cost of US$38 million for an additional 0.409 km 2 . However, the combined expenditures would only achieve an estimated 13% of the required treatment. The results highlight the potential effectiveness of innovative design strategies for nutrient reduction and the importance of considering realistic field-scale build opportunities, which include accounting for acceptance among landowners, in watershed-scale nutrient reduction simulations using constructed wetlands.

In the recent ESC/ERS guidelines on the diagnosis and management of pulmonary hypertension (PH) several important changes have been made in respect of the definition and classification of PH.The mPAP cut-off for defining PH was lowered. PH is now defined by an mPAP > 20 mmHg assessed by right heart catheterization. Moreover, the PVR threshold for defining precapillary PH was lowered. Precapillary PH is now defined by a PVR > 2 WU and a pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg. Furthermore, the increasing evidence for the clinical relevance of pulmonary exercise hemodynamics led to the reintroduction of exercise pulmonary hypertension (EPH) 1. EPH is characterized by a mPAP/CO-slope > 3 mmHg/L/min during exercise testing. In the classification of PH five groups are distinguished: Pulmonary arterial hypertension (group 1), PH associated with left heart disease (group 2), PH associated with lung diseases and/or hypoxia (Group 3), PH associated with pulmonary artery obstructions (group 4) and PH with unclear and/or multi-factorial mechanisms (group 5).In the following guideline-translation we focus on novel aspects regarding the definition and classification of PH and to provide additional background information., Competing Interests: P.D. hat keinen Interessenkonflikt in Bezug auf das Manuskript.B.E. hat von folgenden Firmen Vortragshonorare bzw. Honorare für Advisory Boards innerhalb der letzten 3 Jahre erhalten: Janssen, OMT, MSD, Bayer, AOP. Alle nicht in Zusammenhang mit dieser Arbeit.H.G. Vortrags-/Beraterhonorare von Amgen, Actelion, AstraZeneca, Bayer, BMS, Gossamer Bio, GSK, Janssen Cilag, Lilly, MSD, Novartis, OMT, Pfizer, United Therapeutics.E.G. hat Honorare für Vorträge/Konsultationen von Bayer/MSD, Ferrer, GEBRO, GSK, Janssen und OMT erhalten. Forschungsförderung für klinische Studien wurde von Acceleron, Actelion, BayerHealthCare, MSD, Bellerophon, GossamerBio, Janssen, Novartis, OMT, Pfizer, REATA und United Therapeutics erhalten.A.H. erhielt Fahrtkostenerstattungen von Actelion, Pfizer, GlaxoSmithKline, Lilly und OMT; er erhielt Rednerhonorare von Encysive, Pfizer, Actelion, Medtronic, Schiller, GlaxoSmithKline, OMT, AOP Orphan und Janssen; er erhielt Autorenhonorare von Actelion; er erhielt Beraterhonorare von Actelion, Bayer, Ethypharm und GlaxoSmithKline; er besitzt Aktien von Gilead, Merck, Merck KGAA, Johnson & Johnson, Pfizer, Abbott, Siemens und Takeda. Seine Klinik beteiligte sich an Studien von Actelion, Medtronic, Edwards, Occlutec, Novartis, Lilly, Bayer und Bristol Myers Squibb; seine Klinik erhielt Forschungsgelder von Pfizer, GlaxoSmithKline, Abbott, Actelion und Medtronic. Alle nicht in Zusammenhang mit dieser Arbeit.M.H. hat keinen Interessenskonflikt in Bezug auf das Manuskript.T.K. erhielt Honorare für Vortragstätigkeiten und Reisekostenübernahme von AstraZeneca, Berlin Chemie, Janssen und MSD. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.H.O. erhielt keine Honorare oder sonstige Unterstützung im Zusammenhang mit dieser Publikation. Er erhielt davon unabhängige Honorare für Vortrags- und Beratertätigkeiten von AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Iqvia, Janssen, MedUpdate, Menarini, MSD, Novartis und Pfizer sowie Forschungsunterstützung für die Medizinische Universität Graz durch Boehringer Ingelheim. Er ist stellvertretender Direktor des Ludwig Boltzmann Instituts für Lungengefäßforschung.H.-J.S. hat Honorare für Vortragstätigkeiten von den Firmen Janssen-Cilag und Ferrer erhalten. Keine in Zusammenhang mit der aktuellen Arbeit.A.Y. hat Honorare für Vortragstätigkeiten von der Firma MSD erhalten. Kein Zusammenhang mit dieser Arbeit.S.U. hat Forschungsgelder des Schweizerischen Nationalfond, der Zürcher und Schweizer Lungenliga, der EMDO Foundation, zudem Forschungsgelder und Unterstützung für Vorträge, Reisen und Beratungshonorare von Janssen SA, Orpha Swiss, MSD und Novartis erhalten, alle nicht im Zusammenhang mit dieser Arbeit.G.K. hat von folgenden Firmen Forschungsunterstützung, Vortragshonorare bzw. Honorare für Advisory Boards innerhalb der letzten 3 Jahre erhalten: Janssen, Boehringer-Ingelheim, AstraZeneca, Bayer, MSD, Chiesi, Ferrer, AOP., (Thieme. All rights reserved.)

Lung diseases and hypoventilation syndromes are often associated with pulmonary hypertension (PH). In most cases, PH is not severe. This is defined hemodynamically by a mean pulmonary arterial pressure (PAPm) > 20 mmHg, a pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg and a pulmonary vascular resistance of ≤ 5 Wood units (WU). Both the non-severe (PVR ≤ 5 WU) and much more the severe PH (PVR > 5 WU) have an unfavorable prognosis.If PH is suspected, it is recommended to primarily check whether risk factors for pulmonary arterial hypertension (PAH, group 1 PH) or chronic thromboembolic pulmonary hypertension (CTEPH, group 4 PH) are present. If risk factors are present or there is a suspicion of severe PH in lung patients, it is recommended that the patient should be presented to a PH outpatient clinic promptly.For patients with severe PH associated with lung diseases, personalized, individual therapy is recommended - if possible within the framework of therapy studies. Currently, a therapy attempt with PH specific drugs should only be considered in COPD patients if the associated PH is severe and a "pulmonary vascular" phenotype (severe precapillary PH, but typically only mild to moderate airway obstruction, no or mild hypercapnia and DLCO < 45 % of predicted value) is present. In patients with severe PH associated with interstitial lung disease phosphodiesterase-5-inhibitors may be considered in individual cases. Inhaled treprostinil may be considered also in non-severe PH in this patient population., Competing Interests: M.H.: Honorare für Vortrags- und Beratertätigkeiten von AstraZeneca, Janssen und MSD. Reisekosten von Janssen. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.K.E.Z.: Reisekosten und Vortragstätigkeiten von Fa. MSD, Janssen und Ferrer. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.N.S.: Honorare für Berater- und Vortragstätigkeiten von MSD und Janssen. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.S.U.: Forschungsgelder vom Schweizerischen Nationalfond, der Lungenliga Schweiz, der Lunge Zürich, der Emdo Foundation, von Janssen SA, Orpha Swiss. Reisekosten und Vortragstätigkeiten von Janssen SA, Orpha Swiss, MSD und Novartis, alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.M.H.: Beratungshonorare: Actelion, Bayer Healthcare, Bristol Myers Squibb, Boehringer Ingelheim, Janssen, MSD, Pfizer. Honorare für Vorträge von: Actelion, AstraZeneca, Bayer HealthCare, Berlin Chemie, Boehringer Ingelheim, Bristol Myers Squibb, Daichi Sankyo, Janssen, MSD, Pfizer, Santis.T.K.: Honorare für Vortragstätigkeiten und Reisekostenübernahme von AstraZeneca, Berlin Chemie, Janssen und MSD. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.V.F.: Honorare für Vortragstätigkeiten und Reisekostenübernahme von Boehringer Ingelheim, BMS, Chiesi, Janssen, MSD, alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.M.H.: keineC.N.: Honorare für Vortrags- und Beratertätigkeiten von AstraZeneca, Janssen und MSD. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.J.R.: keineS.H.: Zuwendungen von Janssen, Bayer und MSD, die in keinem Zusammenhang mit dieser Arbeit stehen.D.S.: Vortrags- und Beratungshonorare und/oder Forschungsunterstützung von AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, GSK, Janssen, MSD, Sanofi, DFG, BMBF. Alle nicht im Zusammenhang mit der aktuellen Übersichtsarbeit.N.K.: erhielt finanzielle Zuwendungen von Janssen, Ferrer, Bayer und MSD, die in keinem Zusammenhang mit dieser Arbeit stehen.J.B.: Honorare für Vorträge und Beratertätigkeit von AstraZeneca, Biogen, Boehringer-Ingelheim, BMS, Ferrer, Novartis, Roche, and Sanofi-Genzyme. Für Tätigkeiten im Rahmen von Data Monitoring and Safety Boards erhielt er Honorare von Actelion und Galapagos. Es besteht kein Zusammenhang mit der vorliegenden Publikation., (Thieme. All rights reserved.)

The new guidelines for the diagnosis and treatment of pulmonary hypertension include a new diagnostic algorithm and provide specific recommendations for the required diagnostic procedures, including screening methods. These recommendations are commented on by national experts under the auspices of the DACH. These comments provide additional decision support and background information, serving as a further guide for the complex diagnosis of pulmonary hypertension., Competing Interests: K.T.: Vortrags- und/oder Beratungshonorare von Janssen.N.K.: Vortrags- und/oder Beratungshonorare von Janssen.M.J.R.: Vortrags- und/oder Beratungshonorare von Bayer vital, Janssen, MSD.J.B.: Honorare für Vorträge und Beratertätigkeit von AstraZeneca, Biogen, Boehringer-Ingelheim, BMS, Ferrer, Novartis, Roche, and Sanofi-Genzyme. Für Tätigkeiten im Rahmen von Data Monitoring and Safety Boards erhielt er Honorare von Actelion und Galapagos. Es besteht kein Zusammenhang mit der vorliegenden Publikation.B.E. hat von folgenden Firmen Vortragshonorare bzw. Honorare für Advisory Boards innerhalb der letzten 3 Jahre erhalten: Janssen, OMT, MSD, Bayer, AOP. Alle nicht in Zusammenhang mit dieser Arbeit.A.H. erhielt Fahrtkostenerstattungen von Actelion, Pfizer, GlaxoSmithKline, Lilly und OMT; er erhielt Rednerhonorare von Encysive, Pfizer, Actelion, Medtronic, Schiller, GlaxoSmithKline, OMT, AOP Orphan und Janssen; er erhielt Autorenhonorare von Actelion; er erhielt Beraterhonorare von Actelion, Bayer, Ethypharm und GlaxoSmithKline; er besitzt Aktien von Gilead, Merck, Merck KGAA, Johnson & Johnson, Pfizer, Abbott, Siemens und Takeda. Seine Klinik beteiligte sich an Studien von Actelion, Medtronic, Edwards, Occlutec, Novartis, Lilly, Bayer und Bristol Myers Squibb; seine Klinik erhielt Forschungsgelder von Pfizer, GlaxoSmithKline, Abbott, Actelion und Medtronic. Alle nicht in Zusammenhang mit dieser Arbeit.H.G.: Vortrags-/Beraterhonorare von Amgen, Actelion, AstraZeneca, Bayer, BMS, Gossamer Bio, GSK, Janssen Cilag, Lilly, MSD, Novartis, OMT, Pfizer, United Therapeutics.M.H. erhielt Beratungshonorare von Bayer Healthcare, Bristol Myers Squibb, Boehringer Ingelheim, Janssen, MSD, Pfizer; Honorare für Vorträge von AstraZeneca, Bayer HealthCare, Berlin Chemie, Boehringer Ingelheim, Bristol Myers Squibb, Daichi Sankyo, Janssen, MSD, Pfizer, Santis.Alle anderen Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Intrinsically disordered proteins (IDPs) are important for a broad range of biological functions and are involved in many diseases. An understanding of intrinsic disorder is key to develop compounds that target IDPs. Experimental characterization of IDPs is hindered by the very fact that they are highly dynamic. Computational methods that predict disorder from the amino acid sequence have been proposed. Here, we present ADOPT (Attention DisOrder PredicTor), a new predictor of protein disorder. ADOPT is composed of a self-supervised encoder and a supervised disorder predictor. The former is based on a deep bidirectional transformer, which extracts dense residue-level representations from Facebook's Evolutionary Scale Modeling library. The latter uses a database of nuclear magnetic resonance chemical shifts, constructed to ensure balanced amounts of disordered and ordered residues, as a training and a test dataset for protein disorder. ADOPT predicts whether a protein or a specific region is disordered with better performance than the best existing predictors and faster than most other proposed methods (a few seconds per sequence). We identify the features that are relevant for the prediction performance and show that good performance can already be gained with <100 features. ADOPT is available as a stand-alone package at https://github.com/PeptoneLtd/ADOPT and as a web server at https://adopt.peptone.io/., (© The Author(s) 2023. Published by Oxford University Press on behalf of NAR Genomics and Bioinformatics.)

Introduction and Hypothesis: The Global Prevalence Study of Infections in Urinary tract in Community Setting (GPIU.COM) includes epidemiological aspects of acute cystitis (AC) in women in Germany and Switzerland. The primary study relates to the German version of the Acute Cystitis Symptom Score (ACSS), a self-reporting questionnaire for self-diagnosis and monitoring the symptomatic course of AC in women. The current study aimed to analyze the validity and reliability of the German ACSS in German-speaking female patients with AC in Switzerland., Methods: Anonymized patient data were collected and analyzed from women with AC at the first visit (diagnosis) and follow-up visits as baseline and controls, respectively. Data from 97 patients with a median age of 41 years underwent analysis. Psychometric and diagnostic characteristics of the ACSS were measured and statistically analyzed., Results: Average internal consistency of the ACSS resulted in a Cronbach's alpha (95% CI) of 0.86 (0.83; 0.89) and did not differ significantly between the Swiss and German cohorts. Diagnostic values of the ACSS for the Swiss cohort were relatively lower than for the German cohort, possible due to discrepancies between definitions of UTI in national guidelines., Conclusions: The analysis showed that the German version of the ACSS is also suitable for use in the German-speaking female population of Switzerland. Minor differences in definitions of AC between German and Swiss guidelines explain the observed discrepancies in diagnostic values of the ACSS between cohorts., (© 2021. The Author(s).)

Background: Groundbreaking new laws granting community pharmacists the authority to prescribe human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) medications have the potential to substantially expand PrEP access in high-risk communities. However, whether patients will be accepting of pharmacists as PrEP providers is underexplored within the literature., Objectives: To assess patient perspectives of pharmacist PrEP prescribing and identify potential barriers to acceptance of pharmacist-prescribed PrEP., Methods: Adult patients currently receiving antiretroviral therapy for HIV prophylaxis or treatment at a specialty pharmacy were surveyed telephonically from January 2020-April 2020. A 4-point Likert scale was used to measure perceptions in addition to open-ended questions., Results: The participation rate was 87.5%. Of the 49 included patients, 100% agreed/strongly agreed that pharmacists were knowledgeable about medications, but they were less likely to strongly agree that pharmacists were knowledgeable about HIV drugs (14.3% vs. 75.5% for other drugs, P < 0.001). Most (93.9%) of the patients agreed/strongly agreed that they would feel comfortable seeking a pharmacist for PrEP information or HIV testing. With respect to PrEP prescribing, 16.3% disagreed that they would feel comfortable having a pharmacist prescribe their first fill of PrEP, preferring to speak to their physician or expressing concerns that pharmacists have inadequate training. All patients expressed a desire for additional HIV/PrEP training requirements for pharmacists before allowing them to prescribe PrEP. A portion of the respondents (18.4%) expressed concerns that the increased availability of PrEP would lead to persons becoming lax about barrier protection. However, 100% of the patients agreed/strongly agreed that having pharmacist-prescribed PrEP would benefit their community., Conclusion: Patients receiving antiretroviral therapy reported overall favorable perceptions of pharmacist PrEP prescribing; however, some concerns relating to pharmacists' level of training in HIV exist. This may be ameliorated through increased pharmacist education, including how to counsel patients seeking PrEP on behavioral risk reduction., (Copyright © 2021 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background:  Implant of indwelling pleural catheters (IPC) represents an established therapy method in addition to pleurodesis for symptomatic recurrent benign and malignant pleural effusions (BPE and MPE).There are only few studies on IPC safety during follow-up, especially with regard to infection and pneumothorax rates.The aim of our investigation was to determine the complication frequency after IPC implant and its predictive factors in patients with BPE vs. MPE., Methods:  Retrospective analysis of all IPC implantations in the pneumology department at the University Hospital Dresden during 2015 - 2018., Results:  An IPC was implanted in 86 patients (43 m/f each; age 66.9 ± 13.3 years) with symptomatic BPE and MPE. BPE and MPE was present in 12.8 % (11/86) and 87.2 % (75/86) of the patients, respectively.A predominantly small and asymptomatic pneumothorax was detectable as an immediate complication in 43/86 (50 %) of patients; 34/43 (79 %) of patients did not require any specific therapy. For 9/43 patients, IPC suction was required for a median period of three days; 8/43 patients had a large pneumothorax with partial or complete regression after a median period of two days.Catheter infection developed in 15.1 % (13/86) of the total group and 36.4 % (4/11) of the BPE vs. 12 % (9/75) of the MPE after a median period of 87 (BPE/MPE 116/87) days. This was more common in BPE (p = 0.035), large pneumothorax (4/8 patients; p = 0.015) and longer catheter dwell times (124 ± 112 vs. 71 ± 112 days; p = 0.07)., Conclusion:  Small pneumothoraxes are frequent after IPC implantation, but usually do not require specific therapy. IPC infection was detected in 15.1 % of all patients after a median period of 87 days. This was more common in patients with BPE, longer catheter dwell times and large pneumothorax., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)