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Background Humans are commonly exposed to various heavy metals, but their effects on human respiratory health, especially lung function and airway inflammation, remain poorly understood. Methods This study included data from the 2011–2012 National Health and Nutrition Examination Survey (NHANES) and utilized multivariable linear regression, subgroup analyses, interaction tests, Bayesian kernel machine regression (BKMR), and weighted quantile sum (WQS) regression to explore the relationship between heavy metals, airway inflammation, and lung function. Results This study included 3576 adult participants. In the fully adjusted model, a positive relationship was observed between serum mercury (Hg) and fractional exhaled nitric oxide (FeNO) [0.20 (0.02, 0.37). Serum cadmium (Cd) had a significant negative connection with FEV1 [-106.22 (-143.64, -68.80)], FVC [-74.94 (-119.22, -30.66)], and FEV1/FVC [-1.35 (-1.82, -0.88)], serum lead (Pb) also showed a significant negative association with FEV₁ [-17.85 (-27.48, -8.21)], FVC [-14.84 (-26.22, -3.45)], and FEV₁/FVC [-0.14 (-0.26, -0.02)], while serum manganese (Mn) exhibited a significant positive relationship with FEV1/FVC [0.09 (0.02, 0.15)]. Selenium (Se) exposure showed a positive association with FEV₁ and FEV₁/FVC in Model 2, although these associations were not significant in the fully adjusted model. Subgroup analyses revealed that Body Mass Index (BMI) influenced the relationship between serum Hg, Mn, Se, Pb, and FeNO. BKMR analysis suggested a negative one-way exposure-response association among Cd exposure and FeNO, FEV1, and FEV1/FVC. The overall effect of co-exposure to the five heavy metals on FeNO levels was inhibitory. WQS analysis identified Cd exposure as the most significant negative associated factor on FeNO, FEV1, and FEV1/FVC. In contrast, Hg exposure was the most significant positive factor associated with FeNO, Se contributed the strongest positive weight to FEV₁ and FEV₁/FVC. Conclusions We found inconsistent associations between heavy metals, lung function, and airway inflammation. Cd and Pb exposure was associated with reduced lung function, whereas Hg exposure was positively associated with airway inflammation. Se contributed the strongest positive weight to FEV₁ and FEV₁/FVC in the WQS analysis, although Se was not significantly associated with FEV₁ and FEV₁/FVC in the fully adjusted model. These findings underscore the imperative for strengthened environmental regulation of heavy metal exposure. Future studies should employ more prospective methodologies to clarify these relationships.

Several retrospectivee described the association of interstitial lung disease (ILD) and ANCA-associated vasculitis (AAV). However, the relationship between the ILD and mortality in AAV patients have not been established so far. This study aims to estimate the relevance of AAV-associated-ILD (AAV-ILD) and mortality risk by conducting a systematic review and meta-analysis.A comprehensive systematic review was conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). PubMed, Embase.com and the Cochrane Library (Wiley) were searched for original observational studies. Summary estimates were derived with a random-effects model and reported as risk ratio (RR), tested for publication bias and heterogeneity. Ten retrospective cohort studies were included, comprising 526 AAV-ILD patients enrolled from 1974 to 2018. Meta-analysis yielded a pooled RR of 2.90 (95% confidence interval 1.77–4.74) for death among those with AAV-ILD compared to control group. UIP pattern was associated with an even poorer prognosis in comparison to non-UIP pattern (RR 4.36, 95% confidence interval 1.14–16.78). Sensitivity analysis suggested that the meta-RR result was not skewed by a single dominant study. ILD might be associated with a higher mortality risk in AAV patients.

Background Polycyclic aromatic hydrocarbons (PAHs) are environmental contaminants that can cause a variety of health problems. This study sought to determine whether there was a relationship between PAHs and current asthma in adults. Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016 and employed multifactor logistic regression, subgroup analyses, and smoothed curve fitting to examine the linear and nonlinear associations between PAHs and current asthma. Results A total of 8729 adult participants were included in the study. We found a linear positive association between current asthma and the six PAHs. In the fully adjusted model, log 3-Hydroxyfluorene, log 2-Hydroxyfluorene, and log 1-Hydroxypyrene remained significantly associated with current asthma. Subgroup analyses stratified by smoking status, gender, age, and body mass index (BMI) showed consistent associations between PAHs and current asthma, with some subgroups displaying stronger positive correlations. Specifically, positive correlations between log 1-Hydroxynaphthalene, log 3-Hydroxyfluorene, and log 2-Hydroxyfluorene with current asthma were independently significant in smokers. Among women, log 3-Hydroxyfluorene and log 2-Hydroxyfluorene were also significantly associated with current asthma. In participants with a BMI ≥ 30 kg/m 2 , log 1-Hydroxynaphthalene, log 2-Hydroxynaphthalene, and log 1-Hydroxypyrene were significantly correlated with current asthma. For individuals aged 20–40 years, log 3-Hydroxyfluorene and log 1-Hydroxypyrene showed independent associations with current asthma, with age modifying the relationship between log 1-Hydroxypyrene and current asthma ( p for interaction < 0.05), while p for interaction values in other subgroups were not statistically significant. Additionally, a variable relationship between log 1-Hydroxypyrene and current asthma was identified by smoothing curve fitting. The data suggested that below the inflection point of 1.87, the association fluctuates, while above this point, a linear increase in current asthma is observed, as indicated by a two-piecewise linear regression model. Conclusions We found a positive association between PAHs and current asthma in adults, with a variable relationship between log 1-Hydroxypyrene and current asthma, suggesting that high levels of 1-Hydroxypyrene exposure may increase the risk of current asthma. More prospective studies are needed to confirm our findings.

PDT is well established in the domain of interventional pulmonology, and functions well as part of a multidisciplinary approach for treating lung cancer with the following advantages[2] [Supplementary Figure 1, http://links.lww.com/CM9/C162]: (1) minimally invasive; (2) nonionizing radiation causes limited injury to connective tissue structures, thus preserving framework for healing after treatment; (3) high selectivity for tumor tissue, with less impact on healthy cells; (4) low and transient systemic toxicity compared to some treatments, e.g., chemotherapy and radiotherapy; (5) no cross-resistance; reducing or reversing drug resistance by inhibiting escape pathways in standard therapies, e.g., chemotherapy and targeted therapy; (6) it can be repeated locally in the short term, which is unfeasible with some established treatments, e.g., surgery, chemotherapy, and radiotherapy; (7) immunogenic cell death induced by PDT can potentially augment the efficacy of immunotherapy. Preoperative PDT has been shown to convert 50–80% of inoperable advanced cases into operable tumors and reduce the resection area for 27–86% of surgical candidates. [16,17] It can decrease pathological stage in 64% of surgical NSCLC cases when combined with chemotherapy and/or radiation, and increase the survival rate from 51% to 60% in patients with T3 disease compared with surgery alone. [...]available evidence currently supports that combining PDT and current antitumor therapy can provide more chances for symptom relief and survival.

Soft actuators have garnered widespread attention due to their distributed actuation and high error tolerance. However, fabricating biomimetic actuators with small-size, simple structure, low energy consumption, and multifunctionality remains challenging. Here, we present a monolayer nanocomposite achieved by incorporating polymer dots into a polyvinylidene fluoride terpolymer. Through interfacial hydrogen bonding and temperature modulation, a gradient distribution of highly polarized regions is achieved within the nanocomposite. This yields ultrahigh electromechanical performance, with an actuation strain of 14.4% and an output mechanical energy density of 1.92 J cm − ³ at 100 MV m − ¹. Multifunctional soft actuators are formed from this nanocomposite, weighing only 50 mg, and can skillfully imitate both caterpillar crawling and butterfly flight, unlocking the potential for multimodal locomotion. This insect-sized bionic actuator consumes a mere 3-8 mW. The combination of simple architecture and low energy consumption may pave the way for future development of truly bionic soft robots. Fabricating small actuators with low energy consumption remains a challenge. Here, the authors incorporate polymer dots into a polyvinylidene fluoride terpolymer to create a simple, single-layer actuator, achieving high electrostriction performance with low power consumption

Several studies on long-term air pollution exposure and sleep have reported inconsistent results. Large-scale studies on short-term air pollution exposures and sleep have not been conducted. We investigated the associations of long- and short-term exposure to ambient air pollutants with sleep in a Chinese population based on over 1 million nights of sleep data from consumer wearable devices. Air pollution data including particulate matter (PM 2.5 , PM 10 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide (CO), and ozone (O 3 ) were collected from the Ministry of Ecology and Environment. Short-term exposure was defined as a moving average of the exposure level for different lag days from Lag0 to Lag0-6. A 365-day moving average of air pollution was regarded as long-term exposure. Sleep data were recorded using wearable devices from 2017 to 2019. The mixed-effects model was used to evaluate the associations. We observed that sleep parameters were associated with long-term exposure to all air pollutants. Higher levels of air pollutant concentrations were associated with longer total sleep and light sleep duration, shorter deep sleep duration, and decreases in wake after sleep onset (WASO), with stronger associations of exposures to NO 2 and CO [a 1-interquartile range (IQR) increased NO 2 (10.3 μg/m 3 ) was associated with 8.7 min (95% CI: 8.08 to 9.32) longer sleep duration, a 1-IQR increased CO (0.3 mg/m 3 ) was associated with 5.0 min (95% CI: − 5.13 to − 4.89) shorter deep sleep duration, 7.7 min (95% CI: 7.46 to 7.85) longer light sleep duration, and 0.5% (95% CI: − 0.5 to − 0.4%) lower proportion of WASO duration to total sleep]. The cumulative effect of short-term exposure on Lag0-6 is similar to long-term exposure but relatively less. Subgroup analyses indicated generally greater effects on individuals who were female, younger (< 45 years), slept longer (≥ 7 h), and during cold seasons, but the pattern of effects was mixed. We supplemented two additional types of stratified analyses to reduce repeated measures of outcomes and exposures while accounting for individual variation. The results were consistent with the overall results, proving the robustness of the overall results. In summary, both short- and long-term exposure to air pollution affect sleep, and the effects are comparable. Although people tend to have prolonged total sleep duration with increasing air pollutant concentrations, their sleep quality might remain poor because of the reduction in deep sleep.

Introduction Parenchymal lung involvement occurs in <10% of Hodgkin lymphoma and <5% of non‑Hodgkin lymphoma, and its diagnosis during pregnancy is particularly challenging due to nonspecific symptoms that overlap with gestation and the potential fetal impact of diagnostic procedures. While tissue biopsy is essential, conventional minimally invasive techniques often yield insufficient samples, and surgical biopsy is more invasive that carries risks for the fetus. Case presentation We present the case of a pregnant woman with fever and pulmonary lesions. A multidisciplinary team employed transbronchial lung cryobiopsy under general anesthesia, which provided crucial clues for definitive diagnosis of Epstein-Barr virus positive cytotoxic T-cell lymphoma and enabled the initiation of timely treatment. Conclusion This case suggests that transbronchial lung cryobiopsy may be a potential feasible and relatively safe option for selected pregnant women with rapidly progressive and diagnostically challenging lung lesions. However, it should be performed in experienced centers under multidisciplinary team management and close monitoring. It underscores that necessary procedures should not be delayed due to pregnancy and highlights the critical role of individualized risk-benefit assessment in achieving a timely diagnosis and guiding management.

To explore the role of bronchoscopy for the assessment of checkpoint inhibitor pneumonitis (CIP), a retrospective single-center study was conducted to assess patients diagnosed with CIP at grade 2 or above and also underwent bronchoscopy between January 2020 and December 2022. Clinical data and bronchoscopic findings were recorded. The treatment data and prognosis information were collected. Twenty-one patients who underwent bronchoscopy and were diagnosed with CIP were enrolled in this study. All patients underwent bronchoalveolar lavage fluid (BALF) analysis. Of them, T lymphocyte subsets of BALF were tested in 15 cases. Transbronchial cryobiopsy (TBCB) was performed in 8 patients, and transbronchial lung biopsy was performed in 5 patients. 3 patients developed pneumothorax after TBCB and all recovered without serious compilations.14 patients experienced grade 2 CIP, while 7 patients ≥ grade 3 CIP. Symptoms were improved in 19 (90.5%) patients after standard treatment adhering to CIP guidelines. However, 5 patients relapsed during steroid tapering. Factors related to the severity and recurrence of CIP were analyzed. Patients with previous interstitial lung disease (ILD) were more likely to develop high grade CIP than those without [83.3% (5/6) versus 15.4% (3/15), P = 0.011].The odds ratio (OR) was 32.5 (95% CI 2.284–443.145, P = 0.009). Increased BALF lymphocyte percentage was associated with high grade CIP, OR 1.095 (95% CI 1.001–1.197, P = 0.047), and higher possibility of CIP relapse, OR 1.123 (95% CI, 1.005–1.225, P = 0.040). Lymphocyte subsets were tested in 15 patients. CD4/CD8 > 1 was found in 80% (4/5) of relapsed patients and 20% (2/10) of patients without relapse (P = 0.047). The OR was 16.00 (95% CI 1.093–234.24, P = 0.043). In this retrospective study, patients with previous ILD was more likely to develop high grade CIP. Higher lymphocyte percentage in BALF was associated with high grade CIP and susceptibility to relapse during treatment of CIP. A CD4/CD8 ratio greater than 1 in lymphocyte subsets of BALF was associated with higher possibility of CIP relapse. We found that TBCB is a safe procedure in CIP patients.

Unprecedented pollution control actions during the Beijing Olympics provided a quasi-experimental opportunity to examine biologic responses to drastic changes in air pollution levels. To determine whether changes in levels of biomarkers reflecting pulmonary inflammation and pulmonary and systemic oxidative stress were associated with changes in air pollution levels in healthy young adults. We measured fractional exhaled nitric oxide, a number of exhaled breath condensate markers (H(+), nitrite, nitrate, and 8-isoprostane), and urinary 8-hydroxy-2-deoxyguanosine in 125 participants twice in each of the pre- (high pollution), during- (low pollution), and post-Olympic (high pollution) periods. We measured concentrations of air pollutants near where the participants lived and worked. We used mixed-effects models to estimate changes in biomarker levels across the three periods and to examine whether changes in biomarker levels were associated with changes in pollutant concentrations, adjusting for meteorologic parameters. From the pre- to the during-Olympic period, we observed significant and often large decreases (ranging from -4.5% to -72.5%) in levels of all the biomarkers. From the during-Olympic to the post-Olympic period, we observed significant and larger increases (48-360%) in levels of these same biomarkers. Moreover, increased pollutant concentrations were consistently associated with statistically significant increases in biomarker levels. These findings support the important role of oxidative stress and that of pulmonary inflammation in mediating air pollution health effects. The findings demonstrate the utility of novel and noninvasive biomarkers in the general population consisting largely of healthy individuals.

Background Neoadjuvant immunochemotherapy (NICT) has shown promising therapeutic benefits in patients with locally advanced gastric cancer (LAGC). Our study aimed to predict the pathological response to NICT in LAGC before surgery by correlating the metabolic parameters of baseline and post-treatment 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) of the primary lesion with the pathological response following radical surgery. Methods Thirty-six LAGC patients who received three cycles of NICT (combination of sintilimab and CapeOx), followed by radical surgery, were included in this study. Both baseline 18 F-FDG PET/CT (bPET) and post-treatment 18 F-FDG PET/CT (pPET) were conducted, the metabolic parameters derived from the PET/CT scans, including the maximum standardized uptake value (SUV max ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on bPET and pPET (bSUV max and pSUV max , bMTV and pMTV, bTLG and pTLG), as well as their reductions post-treatment (ΔSUV max , ΔMTV, and ΔTLG), were assessed for their correlation with treatment efficacy and tumor regression grade (TRG) following NICT. Results Out of the 36 patients, 13 patients had a good response (GR), which included 5 cases with TRG 0 and 8 cases with TRG 1. Conversely, 23 patients exhibited a poor response (PR), with 20 patients having TRG 2 and 3 patients having TRG 3. Univariate analysis revealed that pMTV and pTLG in the GR group were significantly lower compared to the PR group (all p  < 0.05). The identified cutoff values of pMTV and pTLG were 1.68 cm³ (area under the cure (AUC) = 0.683) and 4.71 cm³ (AUC = 0.683) for the GR and PR groups, respectively. On receiver operating characteristic (ROC) curve analyses, these values corresponded to sensitivity, specificity, and accuracy of 68.8%, 80.0%, and 73.1%, respectively, with no statistically significant differences between them after the DeLong test and McNemar test (all p > 0.05). Furthermore, bSUV max , bMTV, bTLG, ΔSUV max , ΔMTV, and ΔTLG in the TRG 0 group were significantly higher than those in the TRG 1 group (all p  < 0.05). Upon performing ROC curve analyses for the TRG 0 group, the thresholds for bSUV max , bMTV, bTLG, ΔSUV max , ΔMTV, and ΔTLG were determined to be 7.8 (AUC = 0.916), 36.76 (AUC = 0.768), 105.55 (AUC = 0.819), 4.82 (AUC = 0.923), 22.64 (AUC = 0.807), and 104.7 (AUC = 0.845), with no statistically significant differences between them after the DeLong test (all p > 0.05). These thresholds demonstrated high sensitivity (80% for bMTV and 100% for others), specificity (83.9%, 71.0%, 67.7%, 83.9%, 61.3%, and 71.0%), and accuracy (86.1%, 66.7%, 72.2%, 86.1%, 66.7%, and 75.0%) in predicting TRG 0 after NICT, with no statistically significant differences between them after the McNemar test (all p > 0.05). Conclusions Imaging biomarkers from the combination of baseline and post-treatment 18 F-FDG PET/CT showed potential in predicting pathological response to NICT in LAGC patients before surgery.