BMJ Open Respiratory Research最新文献

{"title":"TIDES 2.0: A protocol for examining the prevalence and longitudinal course of depression, anxiety and behaviour problems in children with cystic fibrosis under 12 years of age.","authors":"Beth A Smith, David H Barker, Anna M Georgiopoulos, Michael S Schechter, Minu P Mohan, Lovejit Singh, Gurnoor Mutti, Alexandra L Quittner","doi":"10.1136/bmjresp-2026-004611","DOIUrl":"10.1136/bmjresp-2026-004611","url":null,"abstract":"<p><strong>Introduction: </strong>Integration of mental health screening and treatment into cystic fibrosis (CF) care has been driven by the finding of elevated rates of depression and anxiety in The International Depression/Anxiety Epidemiological Study (TIDES), international mental health guidelines and CF Foundation support to screen adolescents and adults in all US CF care centres. Benefits of screening include earlier identification, greater access to care, reduced stigma and positive uptake from the CF community. However, TIDES did not include children under 12 years. Depression and anxiety have increased dramatically in young children, and new guidelines recommend mental health screening of children in primary care. Given the paediatric mental health crisis and the widespread adoption of CF transmembrane conductance regulator (CFTR) modulators, which have been associated with adverse events (AEs), there is an urgent need to gather mental health data in young children with CF.</p><p><strong>Methods and analysis: </strong>TIDES 2.0 is a longitudinal cohort study designed to evaluate the prevalence of depression, anxiety and behaviour problems in US children with CF 18 months through 11 years, evaluate and compare the performance of two widely used instruments to identify the optimal screening measures for this population and characterise neuropsychiatric AEs associated with CFTR modulator therapy. Purposive randomised sampling is used to recruit 600 children at 16 CF centres across 4 regions of the US, with oversampling of minoritised patients to ensure national representation. We will estimate the prevalence of children above the clinical cut-score on each symptom domain and evaluate their longitudinal course and predictors. Rigorous mixed-methods approaches will be used to describe potential AEs associated with modulator use.</p><p><strong>Ethics and dissemination: </strong>This study is a timely step in understanding the mental health of young children with CF. It will provide the groundwork to extend mental health screening and care to younger children with CF and inform updates to the mental healthcare guidelines. These results will be distributed at international CF meetings and submitted to peer-reviewed journals. The University at Buffalo Institutional Review Board approved the study (STUDY00008868).</p><p><strong>Trial registration number: </strong>NCT07048574.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable low-flow nasal oxygen versus ambient air in patients with chronic lung disease and exercise-induced hypoxaemia: a randomised controlled crossover non-inferiority trial.","authors":"Mona Lichtblau, Carmen Wick, Anna Titz, Julian Müller, Simon Raphael Schneider, Dinah Hertig, Zoe Bousraou, Alessandro Vella, Michael Furian, Malcolm Kohler, Esther Irene Schwarz, Silvia Ulrich","doi":"10.1136/bmjresp-2025-004048","DOIUrl":"10.1136/bmjresp-2025-004048","url":null,"abstract":"<p><strong>Background: </strong>Exercise-induced desaturation is a common symptom in chronic lung disease (CLD) and is associated with functional limitation and increased mortality. Although portable low-flow supplemental oxygen therapy (SOT) is commonly prescribed for exercise-induced hypoxaemia, evidence for SOT to improve performance is inconsistent.</p><p><strong>Method: </strong>This pragmatic, randomised, controlled, non-inferiority crossover trial enrolled patients with chronic obstructive pulmonary and interstitial lung disease who exhibited exercise-induced oxygen desaturation of >3%. Each patient performed two 6-minute walk distance (6MWD) tests in randomised order: one breathing ambient air and one using low-flow SOT delivered by a portable backpack concentrator (1-2 L/min). The primary outcome was 6MWD, secondary outcomes included perceived exertion and preference of the interventions. A predefined non-inferiority margin of 35 m was used.</p><p><strong>Results: </strong>Forty patients were enrolled (mean age 66±13 years; 14 women; 20 with chronic obstructive pulmonary disease (COPD), 20 with interstitial lung disease (ILD)). The mean difference in 6MWD between ambient air and SOT was 0 m (95% CI -14 to 13 m; p<0.001 for non-inferiority). Secondary outcomes demonstrated significantly lower dyspnoea scores with SOT both overall and within COPD/ILD subgroups. Patient preferences were split, with 49% favouring ambient air and 51% preferring SOT. A clinically meaningful improvement in 6MWD of >35 m was found in five patients.</p><p><strong>Conclusion: </strong>In patients with CLD and exercise-induced desaturation, ambient air was non-inferior to pulsed low-dose SOT by portable concentrator in 6MWD, but SOT improved dyspnoea. These findings highlight the need for more effective, patient-acceptable oxygen delivery systems and further research to identify responders to SOT.</p><p><strong>Trial registration number: </strong>NCT06385301.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable asthma inhalers: who is offered the option to change, who declines and who successfully switches?","authors":"Laura Piggott, Andrew Cumella, A Francis, S Walker, Brian Kent, Grainne d'Ancona","doi":"10.1136/bmjresp-2024-002749","DOIUrl":"10.1136/bmjresp-2024-002749","url":null,"abstract":"<p><strong>Background: </strong>The healthcare community recognises the need for lower emission inhaler options; however, in the UK, most inhalers prescribed are pressurised metered dose inhalers (pMDIs) despite dry powder inhalers (DPIs) having a markedly lower carbon footprint as they do not contain propellants. For this reason, UK clinicians have been encouraged to offer switches from pMDIs to DPIs where feasible.</p><p><strong>Methods: </strong>Using data from the Asthma+Lung UK's <i>'Life with a Lung Condition'</i> 2023 online survey, demographic, economic and clinical factors were analysed to determine who had and had not been offered a switch; whose switch had been successful and why some respondents chose not to switch.</p><p><strong>Results: </strong>9960 people with asthma responded (77.9% female; age 59.9±13.0) and 7059 (87.7%) were pMDI users. The 3753 (53.2%) who were offered a pMDI to DPI switch had a greater awareness of lower-emission inhaler options (72% vs 53.2%*), uncontrolled asthma (61% vs 54.1%*), and had required unscheduled healthcare (27.4% vs 21.2%*) or >2 courses oral corticosteroids (27.6% vs 21.6%*) in the last year (all *p<0.001). 432 (11.5%) opted not to change inhaler when offered. 3321 (88.5%) accepted the switch and it was successful in 2126 (64%).</p><p><strong>Discussion: </strong>In a large UK survey of people with asthma, over half of those on pMDIs had been offered a switch. It was successful in most who attempted it but unsuccessful switches were associated with subjective and objective markers of poor disease control. Some patients decline the switch because they like their pMDI, but some have ongoing concerns about the efficacy and safety of a DPI and is most feasible when integrated into routine reviews for patients with stable disease, alongside ongoing efforts to optimise asthma outcomes.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of time to diagnosis in patients with progressive fibrotic ILD: a systematic review.","authors":"Zhongyi Deng, Stefan Karrasch, Peter Alter, Pilar Rivera-Ortega, Juergen Behr, Rudolf Jörres","doi":"10.1136/bmjresp-2026-004356","DOIUrl":"10.1136/bmjresp-2026-004356","url":null,"abstract":"<p><strong>Introduction: </strong>Progressive fibrosing interstitial lung diseases (PF-ILDs), including idiopathic pulmonary fibrosis (IPF), are characterised by irreversible fibrosis and poor prognosis. Despite the importance of timely identification, diagnostic delays remain common. This review aimed to summarise studies reporting time to diagnosis in PF-ILDs to identify reasons for diagnostic delays and the impact on several clinical and economic outcomes.</p><p><strong>Methods: </strong>Database (Embase, MEDLINE, Cochrane Library, LILACS and grey literature) searches were conducted on 15 July 2024 and updated on 5 June 2026. Observational studies reporting time to diagnosis in PF-ILD published between 2002 and 2026 were identified.</p><p><strong>Results: </strong>34 studies representing 36 621 patients from 41 countries met the inclusion criteria. Dyspnoea, cough and fatigue were the most common presenting symptoms. Median time from symptom onset to diagnosis ranged between 6.0 and 25.2 months; mean estimates varied from 9.6 to 39.3 months in IPF and exceeded 30.2 months in non-IPF PF-ILD. Between 30% and 77% of patients experienced delays >12.0 months. An increased diagnostic time was associated with more advanced disease, worse survival, poorer quality of life and increased hospitalisation rate. Across included studies, between 21% and 87% of patients were misdiagnosed (often with cardiovascular or other respiratory diseases) and received treatment for other conditions. Predictors of delayed diagnosis included older age, comorbidities, misdiagnosis, previous therapy and absence of early imaging or multidisciplinary evaluation.</p><p><strong>Conclusions: </strong>Patients with PF-ILD, including IPF, face a long time to diagnosis, associated with unfavourable clinical and healthcare resource outcomes, with limited evidence on cost outcomes. Direct economic burden resulting from delayed diagnosis is currently poorly understood and needs further research.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of PERMISSive lung-protective ventilation on outcome in critically ill, invasively ventilated patients (PERMISS): protocol for a feasibility and safety randomised clinical trial.","authors":"Alessandro Caroli, Amarens Hoogenboom, Guillermo Bugedo, Felipe L Damiani, Juliana Ferreira, Marcelo Gama de Abreu, Jan-Willem Geerts, Bart P Grady, Stephanie S List, David M P van Meenen, Luis Morales-Quinteros, Frederique Paulus, Ary Serpa Neto, Marcus J Schultz, Arthur S Slutsky, Kanwalpreet Sodhi, Louise Urlings-Strop, Laura A Buiteman-Kruizinga","doi":"10.1136/bmjresp-2026-004532","DOIUrl":"10.1136/bmjresp-2026-004532","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical power (MP) of ventilation is a summary variable of determinants of ventilator-induced lung injury and is consistently associated with worse outcomes. Lung-protective ventilation (LPV) using a lower respiratory rate (RR) is an appealing strategy to reduce MP, but it is unclear whether reducing RR is feasible and safe in critically ill patients under invasive mechanical ventilation. Therefore, we test the hypothesis that a ventilation strategy that targets the lowest acceptable RR is feasible and safe.</p><p><strong>Methods and analysis: </strong>The 'Effects of PERMISSive Lung-protective Ventilation on Outcome in Critically Ill, Invasively Ventilated Patients (PERMISS)' pilot study is an international, multicentre randomised clinical feasibility and safety trial in critically ill, invasively ventilated adult patients with an expected duration of ventilation >24 hours. Patients will be randomly assigned to 'permissive' LPV with a lower RR, within safety limits of arterial partial pressure of carbon dioxide (PaCO₂) and pH, compared with conventional LPV with RR to target normal PaCO₂ and pH. The primary endpoint is the difference in RR between the two groups from the start of ventilation until the first extubation. Secondary endpoints include safety, assessed by the incidence of unacceptable hypercapnia (PaCO₂>70 mm Hg and pH<7.20), severe hypoxaemia (arterial partial pressure of oxygen (PaO₂)<60 mm Hg), ventilator-associated complications and compliance with the protocol and quality of data collection.</p><p><strong>Ethics and dissemination: </strong>The current version of the protocol is V.3 (issued on 11 December 2025). The trial was approved by the medical research ethics committee of Leiden Den Haag Delft (approval number NL-009624.P25.028) on 2 June 2025, including all amendments, and was registered on www.</p><p><strong>Clinicaltrials: </strong>gov (NCT07077174). The PERMISS pilot is currently recruiting patients.</p><p><strong>Trial registration number: </strong>NCT07077174.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant views of case finding for COPD after lung cancer screening: the C FIND COPD study.","authors":"Olivia R Phillips, Tricia M McKeever, Joanne Porte, Paula C A Almeida, Emma L O'Dowd, Rachael L Murray, Charlotte E Bolton","doi":"10.1136/bmjresp-2025-003875","DOIUrl":"10.1136/bmjresp-2025-003875","url":null,"abstract":"<p><strong>Background: </strong>Early and accurate diagnosis of chronic obstructive pulmonary disease (COPD) is essential to ensure correct management and minimise future morbidity. Therefore, case finding in symptomatic at-risk individuals is highly valuable. The C FIND COPD study invited symptomatic people at risk of COPD for a COPD case-finding diagnostic assessment. These individuals had undergone a previous lung cancer screening low-dose CT. The diagnostic assessment used a mobile research unit stationed in community car parks across Nottinghamshire. This current qualitative study aimed to gather participants' opinions about this research study and the associated lung assessment.</p><p><strong>Methods: </strong>15 participants accepted an interview using a semi-structured interview guide by an independent researcher. At the visit, seven interviewees had been given a new diagnosis of COPD and eight had no current evidence of the condition. The interviews were transcribed verbatim and analysed in NVivo (V.14) using inductive thematic analysis.</p><p><strong>Results: </strong>Across five themes, highlights included praise for the clinical research staff, the accessibility and atmosphere of the research unit, convenience of appointment and opportunity of case finding. Subsequent suboptimal communication with general practitioner surgeries was flagged as a key issue in the weeks following the assessment.</p><p><strong>Conclusion: </strong>Overall, case finding of COPD after lung cancer screening as part of the C FIND COPD study was considered a valuable assessment and experience. Interviewees were grateful for the service and aside from some practical aspects, people supported a wider roll-out.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasternal intercostal muscle thickening fraction predicts weaning failure in invasively ventilated patients with COPD: a prospective observational study.","authors":"Aslıhan Gürün Kaya, Deniz Doğan Mülazımoğlu, Miraç Öz Kahya, Serhat Erol, Fatma Arslan, Akın Kaya","doi":"10.1136/bmjresp-2026-004266","DOIUrl":"10.1136/bmjresp-2026-004266","url":null,"abstract":"<p><strong>Background: </strong>Weaning from invasive mechanical ventilation (IMV) is a critical phase of intensive care in patients with chronic obstructive pulmonary disease (COPD), in whom weaning failure is associated with increased morbidity and prolonged intensive care unit stay. Although diaphragm ultrasonography has been extensively studied, the contribution of accessory respiratory muscles during the weaning process remains insufficiently explored. We aimed to investigate whether parasternal intercostal muscle thickening fraction (IMTF), assessed by ultrasound, is associated with weaning outcomes in invasively ventilated patients with COPD.</p><p><strong>Methods: </strong>In this prospective observational study, patients with COPD undergoing IMV were evaluated immediately before their first spontaneous breathing trial (SBT). Parasternal intercostal muscle thickness was measured at end-expiration and end-inspiration using ultrasound, and IMTF was calculated. Weaning success or failure was defined according to standard criteria. Associations between IMTF and weaning outcomes were examined using univariable and multivariable logistic regression models adjusting for gas exchange parameters and illness severity scores.</p><p><strong>Results: </strong>A total of 131 patients were included; 106 (81.0%) were successfully weaned, while 25 (19.0%) experienced weaning failure. IMTF was significantly higher in patients with weaning failure compared with those successfully weaned (11.9±1.7% vs 7.4±1.8%, p<0.001). Higher IMTF was associated with impaired gas exchange, showing an inverse correlation with PaO₂/FiO₂ and a positive correlation with PaCO₂ measured at initiation of IMV (both p <0.001). In separate multivariable models, IMTF remained independently associated with weaning failure after adjustment for gas-exchange parameters, APACHE II score or SOFA score, with ORs ranging from approximately 3.3 to 4.0 per 1-percentage-point increase in IMTF.</p><p><strong>Conclusions: </strong>In invasively ventilated patients with COPD, increased parasternal IMTF measured immediately before the first SBT was independently associated with weaning failure. Parasternal intercostal muscle ultrasound may provide complementary information during weaning assessment.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal dynamics of respiratory microbiome composition in infants after new tracheostomy placement.","authors":"Rebecca Steuart, Samantha N Atkinson, Lucas R Hoffman, Long Hung, Xiangming Ding, Nita Salzman, Christopher J Russell","doi":"10.1136/bmjresp-2026-004378","DOIUrl":"10.1136/bmjresp-2026-004378","url":null,"abstract":"<p><strong>Objectives: </strong>This prospective longitudinal study characterised respiratory microbiome dynamics following new tracheostomy placement among infants.</p><p><strong>Setting: </strong>A tertiary care paediatric hospital system in the United States.</p><p><strong>Participants: </strong>Fifteen infants ≤12 months of age contributed 84 tracheal aspirate samples collected from day 1 through 3-4 months post-placement.</p><p><strong>Primary and secondary outcome measures: </strong>Bacterial composition, including abundance, from 16S rRNA gene sequencing; alpha and beta diversity measures over time.</p><p><strong>Results: </strong>16S rRNA gene sequencing revealed immediate and sustained bacterial community shifts. <i>Staphylococcus</i> abundance increased and alpha diversity decreased in the first 30 days post-tracheostomy (p<0.05) before returning to baseline. Beta diversity demonstrated compositional changes immediately and with ongoing divergence through 3-4 months. Time and clinical factors (prematurity, ventilation and neurologic impairment) were significantly associated with microbiome structure (p=0.001).</p><p><strong>Conclusions: </strong>This study provides novel evidence that new tracheostomy placement induces rapid and prolonged airway microbiome disruption in infants, highlighting a previously uncharacterised window of vulnerability with implications for respiratory health.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term exposure to heat associated with lower lung function in older adults: analysis of the Lung VITAL cohort.","authors":"Nicholas Nassikas, Wenli Ni, Heike Luttmann-Gibson, Vadim Bubes, Antonella Zanobetti, Brent Coull, Julie E Buring, JoAnn E Manson, Diane R Gold, Mary B Rice","doi":"10.1136/bmjresp-2026-004661","DOIUrl":"10.1136/bmjresp-2026-004661","url":null,"abstract":"<p><strong>Background: </strong>High temperatures are associated with respiratory symptoms, hospitalisations and mortality. Yet, the effects on lung function are not well described. The aim of this study was to determine associations of acute exposure to high temperatures with lung function in adults.</p><p><strong>Methods: </strong>We included 1923 study participants from Lung VITamin D and OmegA-3 TriaL (VITAL) cohort, an ancillary study of VITAL, who underwent spirometry (two per participant) between 2010 and 2018. We assigned daily mean temperature, relative humidity, air pollution to geocoded participant home addresses. Forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and forced expiratory flow (FEF_25-75) were obtained at baseline and 2-year follow-up across 11 US sites. We used distributed lag nonlinear models to examine potentially nonlinear associations of temperature with FEV₁ and FVC in primary analyses as well as FEF_25-75. Effect estimates reported as estimated mean difference in lung function for a contrast of 30°C vs 20°C. All models adjusted for age, sex, height, weight, trial intervention arm, current tobacco use, season, social vulnerability, relative humidity, PM_2.5 and O₃, testing site.</p><p><strong>Results: </strong>Median (IQR) daily mean temperature was 13.6°C (17.4°C) for the study population. Daily exposures moderately correlated (r_s-0.31 to 0.34). Cumulative short-term exposure to high temperature (lag 1-7 days) was associated with 49.96 mL (95% CI -96.32 to -3.61) lower FEV₁ and 89.74 mL (95% CI -157.07 to -22.42) lower FVC compared with reference temperature (30°C vs 20°C).</p><p><strong>Conclusions: </strong>Short-term exposure to high temperatures over the preceding 7 days was associated with lower lung function in older US adults. Increases in heat exposure warrant interventions to protect older adults.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world experience: correlation of three dyspnoea questionnaires with measures of disease severity and progression in patients with interstitial lung diseases.","authors":"Andres Moran-MacDonald, Sami Alyami, Sharina Aldhaheri, Maxine Kish, Sean Davison, Onofre Moran-Mendoza","doi":"10.1136/bmjresp-2024-002726","DOIUrl":"10.1136/bmjresp-2024-002726","url":null,"abstract":"<p><strong>Background: </strong>Dyspnoea is an important clinical and research outcome in patients with interstitial lung diseases (ILD) and idiopathic pulmonary fibrosis (IPF).We evaluated the correlation of the British Medical Research Council (MRC) dyspnoea scale, University of California, San Diego Shortness of Breath (UCSD) questionnaire and St. George's Respiratory Questionnaire (SGRQ) with measures of disease severity and progression in patients with ILD and IPF.</p><p><strong>Methods: </strong>We applied the three questionnaires to all patients with ILD during initial assessment (baseline visit), at 3-6 months (visit 2) and 9-12 months (visit 3). We used univariate analyses and multiple regression adjusting for age, sex, pulmonary hypertension, ILD diagnosis and forced vital capacity (FVC) to estimate the correlations of questionnaires with pulmonary function tests, 6 min walk test (6MWT) parameters and perceived dyspnoea at baseline visit (disease severity). We assessed the correlation between change (Δ) in dyspnoea questionnaires with change in functional variables between baseline and follow-up visits (progression).</p><p><strong>Results: </strong>We enrolled 151 patients with ILD, 57 of them had IPF. At baseline, all questionnaires significantly correlated with FVC%, total lung capacity (TLC%), carbon monoxide diffusing capacity (DLCO%) and 6MWT metrics. Between visits 1 and 2, MRC-Δ correlated with TLC%-Δ and perceived dyspnoea-Δ and UCSD-Δ with perceived dyspnoea-Δ. Between visits 1 and 3, MRC-Δ correlated with FVC%-Δ and 6MWT distance-Δ; UCSD-Δ correlated with TLC%-Δ . SGRQ-Δ did not correlate with any variables in multivariable analyses.</p><p><strong>Conclusions: </strong>All questionnaires correlated well with ILD/IPF disease severity at baseline but not with disease progression. Improved questionnaires are needed for patients with ILD.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}