Johan Verbraecken,Emanuele Amodio,Ozen K Basoglu,Riccardo Bellazzi,Matteo Bradicich,Marie Bruyneel,Refika Hamutcu Ersu,Francesco Fanfulla,Brigitte Fauroux,Ludger Grote,Carolina Lombardi,Walter T McNicholas,Carla Miltz,Yüksel Peker,Sofia Schiza,Monique Carolina Suarez,Renaud Tamisier,Hui-Leng Tan,Dries Testelmans,Thomy Tonia,Piet-Heijn van Mechelen,Bart Vrijsen,Maria R Bonsignore
{"title":"European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep).","authors":"Johan Verbraecken,Emanuele Amodio,Ozen K Basoglu,Riccardo Bellazzi,Matteo Bradicich,Marie Bruyneel,Refika Hamutcu Ersu,Francesco Fanfulla,Brigitte Fauroux,Ludger Grote,Carolina Lombardi,Walter T McNicholas,Carla Miltz,Yüksel Peker,Sofia Schiza,Monique Carolina Suarez,Renaud Tamisier,Hui-Leng Tan,Dries Testelmans,Thomy Tonia,Piet-Heijn van Mechelen,Bart Vrijsen,Maria R Bonsignore","doi":"10.1183/13993003.00557-2025","DOIUrl":"https://doi.org/10.1183/13993003.00557-2025","url":null,"abstract":"Telemedicine (TM) as a means of remote patient-physician interaction is gaining popularity in nearly every field, and (respiratory) sleep medicine is no exception. Because obstructive sleep apnoea (OSA) is a chronic condition, and requires a continuous treatment and monitoring of therapy success, telematic communications could be useful to establish diagnostic and therapeutic strategies. This Statement summarises the evidence and efficacy of TM options in OSA. An interdisciplinary European Respiratory Society (ERS) Task Force (TF) evaluated the scientific literature based on a systematic search and two step screening process (title/abstract and full text). Although the TF does not make recommendations for clinical practice, it describes its current practice of TM applications in OSA. Literature shows that TM has been studied in different areas of OSA management, with potential benefits. TM also served as a major research tool to provide big data related to PAP therapy. TM results in similar or improved compliance when compared with traditional face-to-face encounters. TM-based targeted troubleshooting and support based on individual patient data, and a combination via smartphone apps or coaching websites, are feasible and effective. Expanding evidence suggests that TM is likely cost-effective. However, data do not consistently support staff time savings through TM-based solutions. The potential benefits of TM include improved access to health care, and increased adherence to (chronic illness) treatment plans. Benefits should be weighed against the overall costs of TM and risks related to suboptimal compliance.","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"136 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammadreza Hajipour, Joshua B Hicks, A J Hirsch Allen, Andrew E Beaudin, Jill K Raneri, Zahra Izadi, Rachel Jen, Fréderic Series, Robert P Skomro, Rebecca Robillard, R John Kimoff, Mehrdad Mehrjoo, Sidney Fels, Amrit Singh, Eric E Smith, Patrick J Hanly, Ali Azarbarzin, Najib T Ayas
{"title":"Respiratory Event-related Physiological Biomarkers and Cognitive Performance in Obstructive Sleep Apnea.","authors":"Mohammadreza Hajipour, Joshua B Hicks, A J Hirsch Allen, Andrew E Beaudin, Jill K Raneri, Zahra Izadi, Rachel Jen, Fréderic Series, Robert P Skomro, Rebecca Robillard, R John Kimoff, Mehrdad Mehrjoo, Sidney Fels, Amrit Singh, Eric E Smith, Patrick J Hanly, Ali Azarbarzin, Najib T Ayas","doi":"10.1183/13993003.00201-2025","DOIUrl":"https://doi.org/10.1183/13993003.00201-2025","url":null,"abstract":"<p><strong>Rationale: </strong>Individuals with obstructive sleep apnea (OSA) are at increased risk of cognitive impairment. However, the physiologic mechanisms that link OSA to this impairment are unclear. We assessed the association between novel physiologic biomarkers (<i>i.e.</i>, respiratory event-related electroencephalographic (EEG) activity and autonomic responses) and the risk of cognitive impairment.</p><p><strong>Methods: </strong>Participants with OSA (AHI≥5) from the Canadian Sleep and Circadian Network observational cohort were studied. Brain Response to Event (BReTE) was derived from EEG power (defined as mean [post-event power/pre-event power][frequency-range:0.5-50 Hz]) for each individual. Event-related autonomic responses were measured by heart rate response to events (ΔHR; the difference between maximum post-event heart rate and minimum heart rate during event) and photoplethysmography-derived -derived vasoconstriction activity (event-related area and depth of photoplethysmography decline). Cognitive performance was assessed using the Montreal Cognitive Assessment(MoCA), Wechsler Digit Symbol Coding(DSC), and Rey Auditory Verbal Learning Test-Delayed Recall(RAVLT-DR). Multiple logistic regression examined the independent associations between biomarkers and outcomes.</p><p><strong>Results: </strong>We studied 537 individuals (42%female) with a median age of 55 years. In fully adjusted models, each standard deviation(sd) decrease in BReTE was associated with higher odds of poor cognitive performance indicated by MoCA<26 (OR[95%CI]=1.42[1.13,1.79];p=0.003), DSC< 25th percentile (OR[95%CI]=1.35[1.02,1.84];p=0.04), and RAVLT-DR<25th percentile (OR [95%CI]=1.50[1.13,2.02];p=0.007). Additionally, those with low ΔHR compared to the mid-range group were at increased risk of poor cognitive performance. Vasoconstriction indices were not associated with cognitive performance.</p><p><strong>Conclusion: </strong>Blunted EEG and heart rate responses to respiratory events are linked to poorer cognitive performance in OSA, highlighting the value of EEG in identifying individuals at risk for cognitive impairment.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pregnancy, asthma and exacerbations: a population-based cohort.","authors":"Bohee Lee, Ernie Wong, Tricia Tan, Hitasha Rupani, Chloe I Bloom","doi":"10.1183/13993003.01327-2025","DOIUrl":"https://doi.org/10.1183/13993003.01327-2025","url":null,"abstract":"<p><strong>Background: </strong>Asthma exacerbations during pregnancy are associated with adverse maternal and perinatal outcomes. Identifying modifiable risk factors are essential for improving health outcomes. We aimed to describe exacerbation patterns during pregnancy and identify exacerbation risk factors, particularly modifiable risk factors such as inhaled corticosteroid (ICS) use.</p><p><strong>Methods: </strong>A cohort study using UK primary care and hospital data (2004-2020) to identify pregnant women with asthma. Exacerbations were defined as a short course of oral corticosteroids, emergency department visit, or unscheduled hospital admission. Multivariable logistic regression was used to assess associations between maternal characteristics and exacerbations (primary outcome) and ICS use (secondary outcome).</p><p><strong>Results: </strong>Among 40 196 pregnant women with asthma, total exacerbations declined by ∼30% during pregnancy. However, exacerbations associated with hospital admission increased by 30-45% during the second and third trimesters, declining abruptly after delivery. ICS prescriptions were reduced in 31% of women during pregnancy. Decreased ICS use was associated with suboptimal asthma control pre-pregnancy, age, ethnicity and smoking. The strongest exacerbation risk factors were a history of exacerbations (adjusted-OR, 95% CI: 4.09, 3.81-4.39), reduced ICS during pregnancy (2.29, 2.12-2.47) and ≥4 prescriptions/year for ICS+another-preventer before pregnancy (2.11, 1.87-2.37). Additional risk factors included blood eosinophilia, smoking and obesity.</p><p><strong>Conclusions: </strong>Despite fewer total exacerbations, exacerbations associated with a hospital admission increased during pregnancy. One-third of women reduced ICS use during pregnancy, yet this was the second largest exacerbation risk factor, and completely modifiable. Other major risk factors were type-2 inflammation and another modifiable risk factor, suboptimal asthma control pre-pregnancy.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jayanth Kumar Narayana, Yolanda Koo Wei Ling, Micheál Mac Aogáin, Sanjay H Chotirmall
{"title":"Characterizing research trends in bronchiectasis through AI-powered analytics.","authors":"Jayanth Kumar Narayana, Yolanda Koo Wei Ling, Micheál Mac Aogáin, Sanjay H Chotirmall","doi":"10.1183/13993003.00894-2025","DOIUrl":"https://doi.org/10.1183/13993003.00894-2025","url":null,"abstract":"<p><strong>Background: </strong>Interest in bronchiectasis is increasing and no prior study has used Artificial Intelligence (AI) to interrogate its rich, multidimensional literature to characterize research trends, themes and knowledge gaps.</p><p><strong>Methods: </strong>We reviewed original bronchiectasis research between 1949-2024 (75-year period) to identify, characterize and assess research trends and trajectories using two AI-powered approaches: (1) ATLAS, an AI-topic modelling tool and (2) a custom model, leveraging ChatGPT embedding and text-generation models.</p><p><strong>Results: </strong>AI-powered analytics reveal a nine-fold increase in bronchiectasis research speed since 2000, typified by enhanced richness with four new research topics emerging every five years. Publication trends mirror clinical and technological advances, exemplified by significant rises in computed tomography (CT), microbiome and clinical studies following adoption of HRCT (1970s), next-generation sequencing (2005) and the first clinical guidelines (2008-2010). Topics with sustained growth (<i>i.e.</i> popular) include bronchiectasis-COPD overlap, microbiome-infection, cardiovascular health and exacerbations while those with sudden, short-term increased interest (<i>i.e.</i> trending) focused on microbial pathogens and primary ciliary dyskinesia (PCD) genetics. Mortality represents a nascent topic demonstrating highest year-on-year interest. Growth of research within the \"vicious vortex\" demonstrates thematic imbalance with few studies overlapping with non-vortex components. Evolving research focus toward inflammation is evident, with increased work on comorbidities and quality of life demonstrating a shift from disease- to patient-centric research.</p><p><strong>Conclusion: </strong>AI captures bronchiectasis as a dynamic and interdisciplinary field in continuing growth. Emerging research topics extend beyond the \"vicious-vortex\" framework indicating transition from disease- to patient-centric approaches to optimize clinical care.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Linezolid for the treatment of drug-resistant tuberculosis.","authors":"Christoph Lange,Clifton Barry,Giovanni Sotgiu","doi":"10.1183/13993003.00927-2025","DOIUrl":"https://doi.org/10.1183/13993003.00927-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"15 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Winfried J Randerath, Sophia E Schiza, Michael Arzt, Maria Rosaria Bonsignore, Raphael Heinzer, Carolina Lombardi, Robert Lyssens, Gianfranco Parati, Thomas Penzel, Jean Louis Pepin, Dirk Pevernagie, Silke Ryan, Luca Vignatelli, Esther I Schwarz
{"title":"European Respiratory Society and European Sleep Research Society statement on the treatment of central sleep apnoea with adaptive servo-ventilation.","authors":"Winfried J Randerath, Sophia E Schiza, Michael Arzt, Maria Rosaria Bonsignore, Raphael Heinzer, Carolina Lombardi, Robert Lyssens, Gianfranco Parati, Thomas Penzel, Jean Louis Pepin, Dirk Pevernagie, Silke Ryan, Luca Vignatelli, Esther I Schwarz","doi":"10.1183/13993003.00263-2025","DOIUrl":"10.1183/13993003.00263-2025","url":null,"abstract":"<p><p>Adaptive servo-ventilation (ASV) has been considered effective in controlling various forms of central sleep apnoea (CSA) and also any additional obstructive sleep apnoea (OSA) component. However, after the publication of the SERVE-HF study, its use was restricted in patients with systolic heart failure (HF) and prevalent CSA, and was withheld from many patients with symptomatic CSA. In the meantime, the devices have been further developed and the algorithms adapted, and there is new evidence from randomised controlled trials and observational studies that makes it necessary to re-evaluate some societies' statements on the use of ASV, especially in patients with HF and CSA and with the current ASV devices. This short statement is based on a review of the effect of ASV on hard cardiovascular end-points, echocardiographic parameters and exercise capacity as well as on sleep architecture and sleep quality, symptoms and quality of life (QoL) in patients with congestive HF. The expert group concludes that ASV has positive effects on CSA and QoL in various forms of CSA, that current ASV devices have no negative effect on hard cardiovascular end-points, and that ASV has positive effects on patient-reported outcomes. Moreover, it is used by Task Force members after optimal treatment of the underlying disease and after an unsuccessful continuous positive airway pressure trial in patients with HF with preserved ejection fraction, but also in patients with left ventricular ejection fraction 30-45%. In the latter group, however, initiation is performed in expert centres only. In severe systolic HF, ASV is sometimes evaluated in a palliative therapy concept for severely symptomatic patients with CSA.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply: Use of total correlation and other information-theoretic quantities to describe distributions of clinical datasets, with reference to risk models for pulmonary endarterectomy.","authors":"James Liley,Katherine Bunclark,Mark Toshner","doi":"10.1183/13993003.01198-2025","DOIUrl":"https://doi.org/10.1183/13993003.01198-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"19 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Constantine,Konstantinos Dimopoulos,Colm McCabe
{"title":"Cardiopulmonary exercise testing unmasks right ventricular failure in pulmonary arterial hypertension risk stratification: time to reframe the role of the 6-minute walk test?","authors":"Andrew Constantine,Konstantinos Dimopoulos,Colm McCabe","doi":"10.1183/13993003.00849-2025","DOIUrl":"https://doi.org/10.1183/13993003.00849-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"24 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}