BMC Pulmonary Medicine最新文献

{"title":"Clinical characteristics of severe community-acquired pneumonia in children with virus mono-detection versus co-detection with bacteria.","authors":"Qian Chen, Yuejie Zheng, Heping Wang, Xiaonan Li, Jiali Gu, Zihao Liu","doi":"10.1186/s12890-025-03591-3","DOIUrl":"https://doi.org/10.1186/s12890-025-03591-3","url":null,"abstract":"<p><strong>Backgroud: </strong>By analyzing the etiological distribution and clinical characteristics of severe community-acquired pneumonia in children with virus mono-detection and co-detection with bacteria and other pathogens, to explore the clinical characteristics that can help identify mixed infections, thereby providing a basis for the more precise use of antimicrobial drugs.</p><p><strong>Methods: </strong>A retrospective study was conducted on hospitalized children aged 1 month to 14 years with severe community-acquired pneumonia who underwent bronchoscopy in Shenzhen Children's Hospital from January to December 2018. The distribution of 19 pathogens detected by nucleic acid detection in bronchoalveolar lavage fluid was analyzed. Clinical data of children were obtained from the hospital electronic patient dossiers. Data were analyzed to describe the difference between viral mono-detection and co-detection.</p><p><strong>Methods: </strong>A retrospective study was conducted on hospitalized children aged 1 month to 14 years with severe community-acquired pneumonia who underwent bronchoscopy in Shenzhen Children's Hospital from January to December 2018. The distribution of 19 pathogens detected by nucleic acid detection in bronchoalveolar lavage fluid was analyzed. Clinical data of children were obtained from the hospital electronic patient dossiers. Data were analyzed to describe the difference between viral mono-detection and co-detection.</p><p><strong>Results: </strong>A total of 479 children with severe community-acquired pneumonia were enrolled from January to December 2018, at least one pathogen was detected in 375 cases (78.3%), including 247 cases (51.6%) of viruses, 111 cases (23.2%) of atypical pathogens, and 98 cases (20.5%) of bacteria. Among all positive cases, 274 cases (73.1%) had a single pathogen detected, and 101 cases (26.9%) had co-detection (≥ 2 pathogens). Among these co-detection, 51 cases (50.5%) were virus-bacteria co-detection, and 20 cases (19.8%) were virus-atypical pathogens co-detection. There was no significant difference in the detection rates of different types of pathogens between male and female patients (p > 0.05). There were no significant differences in clinical presentation, signs, inflammation and organ function indicators, pulmonary complications, antibiotic use, glucocorticoid use, intravenous immunoglobulin use, PICU admission rate, need for mechanical ventilation, and length of hospital stay among children with virus-bacteria co-detection, virus-atypical pathogens co-detection, and virus mono-detection (p > 0.05).</p><p><strong>Conclusion: </strong>Virus-bacteria co-detection or virus-atypical pathogens co-detection are common in children with severe community-acquired pneumonia. Clinical features alone cannot distinguish between viral mono-infection and mixed bacterial or atypical pathogen infections.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"130"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Younger severe asthma patients with interleukin 4 (CC variant) and dupilumab treatment are more likely to achieve clinical remission.","authors":"Mona Al-Ahmad, Asmaa Ali, Wafaa Talat","doi":"10.1186/s12890-025-03578-0","DOIUrl":"https://doi.org/10.1186/s12890-025-03578-0","url":null,"abstract":"<p><strong>Background and objectives: </strong>Asthma is a complex condition characterized by variable respiratory symptoms and chronic inflammation. In recent years, the use of biologics in severe asthma patients led to significant improvements in symptom control and disease outcomes. This has prompted healthcare providers to explore the possibility of achieving clinical remission (CR). This study aimed to evaluate the prevalence of clinical remission in severe asthma patients treated with biologics. Additionally, to identify factors associated with achieving clinical remission.</p><p><strong>Methods: </strong>The study recruited 116 patients from a national severe asthma registry in Kuwait, focusing on patients who had been treated with biologic therapy for at least 12 months. CR was defined as the absence of exacerbations and oral corticosteroids (OCS) use, an Asthma Control Test (ACT) score of ≥ 20, Asthma Control Questionnaire (ACQ-6) score of ≤ 0.75 and forced expiratory volume in one second (FEV1) ≥ 80% predicted. Data were collected on demographics, clinical, and functional parameters; including biomarkers such as blood eosinophils count (BEC), total immunoglobulin E (IgE), and fractional exhaled nitric oxide (FeNO), as well as the polymorphism patterns of the interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-α) genes.</p><p><strong>Results: </strong>Patients with severe asthma were predominantly female (68.9%) with an average age of 54.09 years. Most had adult-onset asthma (67.3%), comorbid allergic rhinitis (AR) (81.03%), and experienced frequent exacerbations, with a median of four corticosteroids-requiring flare-ups per year. The allergic eosinophilic phenotype was common (74.14%), and a significant portion carried the CC genotype of the IL-4 gene (51.72%) or the GG genotype of the TNFα gene (57.76%). Biologic therapy significantly improved asthma control, reduced exacerbations and OCS use while improved lung function (p = 0.001 for all). About 18.1% of patients achieved CR after at least 12 months of biologic therapy, with dupilumab being the most effective, especially in biologic-naive patients. A multiple logistic regression analysis found that increasing age was negatively associated with CR (OR 0.95, p = 0.02), while the CC genotype of the IL-4 gene (OR 4.57, p = 0.008) and the use of dupilumab (OR 3.63, p = 0.001) were strong positive predictors of CR.</p><p><strong>Conclusion: </strong>This study suggested that CR can be achieved in patients with severe asthma. However, biologic therapy, particularly dupilumab, offers a promising avenue for achieving CR in comparison to other biologics, especially in younger patients with specific genetic profiles (CC genotype of the IL-4 gene).</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"131"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the mechanistic impact of CBL0137 on airway remodeling in asthma.","authors":"Zhiheng Huang, Liangxian Li, Bingxi Zhang, Dong Yao, Bo Xiao, Biwen Mo","doi":"10.1186/s12890-025-03596-y","DOIUrl":"10.1186/s12890-025-03596-y","url":null,"abstract":"<p><strong>Background: </strong>Bronchial asthma, a chronic inflammatory airway disease, is characterized by airway remodeling, including thickening of the airway smooth muscle layer, primarily due to abnormal proliferation of airway smooth muscle cells (ASMCs). CBL0137 (Curaxin-137 hydrochloride), a histone chaperone facilitate chromatin transcription (FACT) inhibitor, has demonstrated anti-tumor properties, including inhibition of proliferation, promotion of apoptosis, and increased autophagy. However, its effects on ASMCs and airway remodeling remain unexplored.</p><p><strong>Methods: </strong>Asthma models were established using ovalbumin (OVA) in female C57BL/6 J mice, with therapeutic interventions using CBL0137 and budesonide. Lung tissues were analyzed using Hematoxylin and eosin (H&E), PAS, Masson's trichrome, and α-SMA immunofluorescence staining. ASMCs extracted from Sprague-Dawley rats were cultured in vitro experiments, with phenotypic changes assessed via flow cytometry. Gene and protein expressions were analyzed using RT-PCR and Western blotting.</p><p><strong>Results: </strong>CBL0137 significantly reduced airway resistance, goblet cell proliferation, alveolar collagen deposition, and airway smooth muscle layer thickening in asthmatic mice. In vitro, CBL0137 inhibited ASMC proliferation and induced apoptosis, downregulating cyclin-B1, Cdc2, and Bcl-2 while upregulating caspase-3.</p><p><strong>Conclusions: </strong>CBL0137 mitigates airway remodeling of asthmatic mice by modulating ASMC proliferation and apoptosis, presenting a potential therapeutic strategy for asthma treatment.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"129"},"PeriodicalIF":2.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668820","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":"Predicting postoperative pulmonary infection in elderly patients undergoing major surgery: a study based on logistic regression and machine learning models.","authors":"Jie Liu, Xia Li, Yanting Wang, Zhenzhen Xu, Yong Lv, Yuyao He, Lu Chen, Yiqi Feng, Guoyang Liu, Yunxiao Bai, Wanli Xie, Qingping Wu","doi":"10.1186/s12890-025-03582-4","DOIUrl":"10.1186/s12890-025-03582-4","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary infection (POI) is strongly associated with a poor prognosis and has a high incidence in elderly patients undergoing major surgery. Machine learning (ML) algorithms are increasingly being used in medicine, but the predictive role of logistic regression (LR) and ML algorithms for POI in high-risk populations remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of older adults undergoing major surgery over a period of six years. The included patients were randomly divided into training and validation sets at a ratio of 7:3. The features selected by the least absolute shrinkage and selection operator regression algorithm were used as the input variables of the ML and LR models. The random forest of multiple interpretable methods was used to interpret the ML models.</p><p><strong>Results: </strong>Of the 9481 older adults in our study, 951 developed POI. Among the different algorithms, LR performed the best with an AUC of 0.80, whereas the decision tree performed the worst with an AUC of 0.75. Furthermore, the LR model outperformed the other ML models in terms of accuracy (88.22%), specificity (90.29%), precision (44.42%), and F1 score (54.25%). Despite employing four interpretable methods for RF analysis, there existed a certain degree of inconsistency in the results. Finally, to facilitate clinical application, we established a web-friendly version of the nomogram based on the LR algorithm; In addition, patients were divided into three significantly distinct risk intervals in predicting POI.</p><p><strong>Conclusions: </strong>Compared with popular ML algorithms, LR was more effective at predicting POI in older patients undergoing major surgery. The constructed nomogram could identify high-risk elderly patients and facilitate perioperative management planning.</p><p><strong>Trial registration: </strong>The study was retrospectively registered (NCT06491459).</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"128"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662430","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":"Ureaplasma in neonatal gastric fluid contributing to bronchopulmonary dysplasia.","authors":"Longli Yan, Hua Deng, Jia Chen, Ying Liu, Shunyan Duan, Zhu Wang, Lanlan Du, Shu Liang, Linli Xu, Di Zhong, Weiwei Gao, Liang Zhang","doi":"10.1186/s12890-025-03579-z","DOIUrl":"10.1186/s12890-025-03579-z","url":null,"abstract":"<p><strong>Background: </strong>The association between the presence of common pathogens in the maternal cervicovaginal tract as well as neonatal gastric fluid and adverse outcomes in preterm newborns remains uncertain.</p><p><strong>Methods: </strong>Cervicovaginal swabs were collected from 98 mothers, and gastric fluid specimens were obtained from 121 premature infants with gestational ages of ≤ 32 weeks within 24 h of birth. Thirteen pathogens were tested using suspension microarray. Neonatal outcomes were monitored until either death or discharge. RESULTS UREAPLASMA: was the predominant species identified in both maternal cervicovaginal swabs and neonatal gastric fluid. Preterm newborns with Ureaplasma in gastric fluid at birth exhibited a smaller gestational age (P < 0.001), a lower 1-min Apgar score (P = 0.01), an increased requirement for pulmonary surfactant (P = 0.029), and a higher incidence of bronchopulmonary dysplasia (BPD) (P = 0.02) compared to those who tested negative for Ureaplasma. Similarly, pregnant women with Ureaplasma colonization in the genital tract were more likely to deliver babies with a smaller gestational age (P = 0.002), a higher rate of tracheal intubation after birth (P = 0.013), a lower proportion of small for gestational age (SGA) infants (P = 0.018), and an increased occurrence of BPD (P = 0.048) than mothers without the agent. Furthermore, the presence of Ureaplasma in the gastric fluid of premature infants was identified as a risk factor for BPD, with an odds ratio (OR) of up to 6, alongside gestational age and SGA as independent predictors of BPD.</p><p><strong>Conclusions: </strong>These findings suggest that antenatal exposure to Ureaplasma is correlated with the occurrence of BPD in premature infants, which has potential clinical implications.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"127"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662432","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":"Nonlinear association of TSH with pulmonary ventilation: insights from bidirectional Mendelian randomization and cross-sectional study.","authors":"Yuxin Wang, Jinmei Luo, Rong Huang, Yi Xiao","doi":"10.1186/s12890-025-03584-2","DOIUrl":"10.1186/s12890-025-03584-2","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormones play a crucial role in numerous physiological processes, including pulmonary function. However, the relationship between thyroid function and different patterns of pulmonary ventilation remains unclear.</p><p><strong>Methods: </strong>This study employed a bidirectional two-sample Mendelian randomization (MR) approach combined with a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) to explore the relationship between thyroid function and pulmonary ventilation indicators. We used genomic data from the ThyroidOmics Consortium and the UK Biobank to derive instrumental variables for thyroid and pulmonary functions. Adults from the NHANES 2007-2012 were included to validate the MR findings through weighted generalized linear model (GLM) regression and restricted cubic spline (RCS) analysis.</p><p><strong>Results: </strong>Genetically predicted thyroid-stimulating hormone (TSH) was associated with pulmonary ventilatory function (forced expiratory volume in 1 s (FEV1): β = 0.0223, 95% confidence interval (CI) 0.0040-0.0406, p-value = 0.0170), particularly with a restrictive ventilatory pattern (forced vital capacity (FVC): β = 0.0237, 95% CI 0.0047-0.0427, p-value = 0.0143). This association was more robust in the low TSH subgroup. Additionally, the NHANES data revealed a nonlinear relationship between both FEV1% predicted and FVC% predicted and TSH, characterized by a positive relationship at lower TSH ranges and a negative relationship at higher TSH ranges.</p><p><strong>Conclusions: </strong>Our findings highlight a significant association between TSH levels and a restrictive ventilatory pattern, underscoring the importance of thyroid health in the clinical evaluation of certain pulmonary diseases. These insights may guide more personalized interventions in respiratory medicine.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"126"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662428","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 patient admission source on respiratory intensive care unit outcomes.","authors":"Büşra Durak, Gökay Güngör, Sinem Güngör, İbrahim Durak, Barış Yılmaz, Gül Erdal Dönmez, Eylem Tuncay, Hamide Gül Şekerbey, Özlem Yazıcıoğlu Moçin, Nalan Adıgüzel, Zühal Karakurt","doi":"10.1186/s12890-025-03583-3","DOIUrl":"10.1186/s12890-025-03583-3","url":null,"abstract":"<p><strong>Background: </strong>Research is limited in describing the association between admission source and mortality in critically ill patients. Therefore, this study investigated how intensive care units (ICUs) admission source (emergency department (ED) or ward) correlates with mortality rates.</p><p><strong>Methods: </strong>This retrospective observational cross-sectional study was conducted in a tertiary pulmonology teaching hospital's ICU from January 1, 2018, to December 31, 2019. Patients were ICU patients admitted for acute respiratory failure. Demographic, comorbidities, diagnoses, APACHE II score, ICU admission (ED or ward), mechanical breathing support (invasive or noninvasive), length of stay, and mortality were recorded. Comparisons of ICU admission sources and mortality factors were established.</p><p><strong>Results: </strong>A total of 2,173 ICU patients were studied; 1,011 (46%) were admitted from the ED and 1,162 (54%) from the ward. Their mean age was 70 years, and 66% of them were men. Pneumonia was the leading cause of ICU admission at 60% and Chronic Obstructive Pulmonary Disease (COPD) was the most common comorbidity at 54%. When both groups were evaluated in terms of respiratory support, non-invasive mechanical ventilation use was higher in patients admitted from the emergency room (ED: 50% vs. Ward: 35%), invasive mechanical ventilation was more frequently required in patients admitted from the ward compared to those admitted from the emergency department (ED: 17% vs. Ward: 25%). Length of ICU stay (2 vs. 3 days P < 0.001) and ICU mortality (odds ratio: 1.66, 95% confidence interval 1.297-2.124, P < 0.001) were higher in patients admitted from the ward than in patients admitted from the emergency department. In addition, pneumonia patients and those with malignancies, interstitial lung disease, or noninvasive mechanical ventilation (NIV) failure were associated with higher mortality.</p><p><strong>Conclusion: </strong>Our study suggests that ward-to-ICU patients had higher mortality rates compared to ED-to-ICU patients. Triage protocols to better identify potentially critically ill patients in the ED may improve outcomes by avoiding delays in care and better assignment of admission location.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"125"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656187","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":"Prevalence of chronic obstructive pulmonary disease in high-risk populations at low, intermediate, high altitudes: a population based cross-sectional study in Yunnan Province, China.","authors":"Geyi Wen, Jinliang Meng, Huadan Wang, Puxian Peng, Yanyan Xu, Ruiqi Wang, Zhengmao Yan, Bangyan Du, Aihan Wen, Guohong Luo, Wenlong Cui, Songyuan Tang, Yunhui Zhang","doi":"10.1186/s12890-025-03565-5","DOIUrl":"10.1186/s12890-025-03565-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) represents a significant public health challenge. This study aimed to investigate the epidemiological characteristics of COPD across different altitudes and evaluate the potential influence of altitude on its prevalence of high-risk populations.</p><p><strong>Methods: </strong>This cross-sectional study employed a multi-stage randomized cluster sampling method and enrolled 11,095 adult residents aged ≥ 20 years at different elevations in Yunnan Province, China. Screening questionnaires identified high-risk individuals among participants, who then underwent pulmonary function tests. COPD was diagnosed based on post-bronchodilator test results. We utilized multivariate logistic regression models to examine the association between altitudes and COPD prevalence while controlling for demographic variables, lifestyle factors, and disease characteristics.</p><p><strong>Results: </strong>A total of 2,252 (20.3%) were in the high-risk group. The prevalence of COPD in high-risk populations increased with age across low, intermediate, and high altitude areas. COPD patients in high-risk populations at high-altitude areas had a higher prevalence of ethnic minorities and significant biomass fuel exposure. Conversely, the proportion of COPD patients in the severe stages (GOLD III-IV) was notably lower in high-altitude regions. Logistic regression models revealed COPD prevalence in high-risk populations at high altitudes to be significantly lower than at low altitudes, with odds ratios of 0.538(95% CI: 0.343-0.844), 0.470(95% CI: 0.289-0.766), and 0.518 (95% CI: 0.316-0.848) for Models 1, 2, and 3, respectively (all P < 0.05).</p><p><strong>Conclusion: </strong>The prevalence of COPD in high-risk populations is the lowest in the high-altitude regions of Yunnan Province, and high altitude is an independent factor negatively associated with COPD.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"124"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656188","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":"A clinical data-driven machine learning approach for predicting the effectiveness of piperacillin-tazobactam in treating lower respiratory tract infections.","authors":"Yemeng Yang, Kun Han, Jiatao Li, Tao Zhang, Zhijing Zhu, Ling Su, Zhaoyong Han, Chunyan Xu, Yi Lu, Likun Pan, Tao Yang","doi":"10.1186/s12890-025-03580-6","DOIUrl":"10.1186/s12890-025-03580-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In hospitalized patients, inadequate antibiotic dosage leading to bacterial resistance and increased antimicrobial use intensity due to overexposure to antibiotics are common problems. In the present study, we constructed a machine learning model based on patients' clinical information to predict the clinical effectiveness of Piperacillin-tazobactam (TZP) (4:1) in treating bacterial lower respiratory tract infections (LRTIs), to assist clinicians in making better clinical decisions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We collected data from patients diagnosed with LRTIs or equivalent diagnoses admitted to the Department of Pulmonary and Critical Care Medicine at Shanghai Pudong Hospital, Shanghai, between January 1, 2021, and July 31, 2023. A total of 26 relevant clinical features were extracted from this cohort. Following data preprocessing, we trained four models: Logistic Regression, Random Forest, Support Vector Machine, and Gaussian Naive Bayes. The dataset was split into training and test sets using a 7:3 ratio. The top-performing models, as determined by Receiver Operating Characteristic (ROC)-Area Under the Curve (AUC) on the independent test set, were subsequently ensembled. Ensemble model (EL) performance was evaluated using bootstrap resampling on the training set and ROC-AUC, recall, accuracy, precision, F1-score, and log loss on an independent test set. The optimal model was then deployed as a web application for clinical outcome prediction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,314 patients primarily treated with TZP as initial empiric antibiotic therapy were enrolled in the analysis. The success group comprised 995 patients (75.7%), while the failure group consisted of 319 patients (24.3%). We constructed an ensemble learning model based on the Logistic Regression, Support Vector Machine and Random Forest models, which showed better overall performance. The EL model demonstrated robust performance on an independent test set, exhibiting a ROC-AUC of 0.69, a recall of 0.69, an accuracy of 0.64, a precision of 0.40, a F1-score of 0.50, and a log loss of 0.66. A corresponding web application was then developed and made available at http://106.12.146.54:1020/ .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this study, we successfully developed and validated an EL model that effectively predicts the clinical effectiveness of TZP (4:1) in treating bacterial LRTIs. The model achieved a balanced performance across key evaluation metrics, demonstrating the model's potential utility in clinical decision-making. The web-based application makes this model readily accessible to clinicians, potentially helping optimize antibiotic dosing decisions and reduce both inadequate treatment and overexposure. While promising, future studies with larger datasets and prospective validation are needed to further improve the model's performance and validate its clinical utility. This work represents a step forward in using machine ","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"123"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647275","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":"Effect of asthma education intervention on self-management knowledge and control level in Tigray, Northern Ethiopia: a quasi experimental study.","authors":"Tirhas Gebremedhin Gebresilassie, Alemayehu Worku, Ahmed Ali Ahmed, Negussie Deyessa Kabeta","doi":"10.1186/s12890-025-03574-4","DOIUrl":"10.1186/s12890-025-03574-4","url":null,"abstract":"<p><strong>Background: </strong>Asthma self-management education empowers patients to manage their condition effectively. However, evidence on its impact in Ethiopia remains limited. This study evaluated the effect of asthma education on asthma control and self-management knowledge among adult asthma patients in Ethiopia.</p><p><strong>Methods: </strong>A quasi-experimental design was employed, with a total of 204 participants, comprising 102 individuals in the intervention group and 102 in the control group at baseline. After accounting for follow-up losses (20.6% in the intervention group and 23.5% in the control group), 81 participants from the intervention group and 78 from the control group were retained six months after the completion of the education (post-intervention). Pre- and post-intervention assessments were conducted using validated questionnaires to measure asthma control levels and self-management knowledge. The intervention group received a structured, small-group asthma education program comprising three sessions over six months. The intervention's effect was analyzed using linear regression models for difference-in-differences and interaction effects, while heterogeneity analysis was performed using a generalized linear model.</p><p><strong>Results: </strong>10% of the intervention group and 7.8% of the control group reported prior asthma management education, most of which (60%) was over a decade ago. Asthma control levels significantly improved in the intervention group, with a 19.4% increase compared to 0.6% in the control group. The overall increase in the intervention group was 18.8% higher than in the control group (P = 0.03). Similarly, self-management knowledge improved markedly in the intervention group, with a 24.3% increase compared to 0.7% in the control group. The intervention group demonstrated a 23.6% overall improvement relative to the control group (P = 0.000).Participants in the intervention group were six times more likely to achieve well-controlled asthma and 13 times more likely to exhibit good self-management knowledge compared to the comparison group (p < 0.01). The intervention's impact was consistent across subgroups, with no significant variations by socio-demographic and asthma related factors.</p><p><strong>Conclusions: </strong>Asthma self-management education interventions significantly enhance asthma management knowledge and control levels. This study highlights the need to implement and expand asthma education programs during patient follow-ups to empower patients, to reduce medical costs, unscheduled hospital visits, emergency department visits, and premature mortality.</p><p><strong>Trial registration: </strong>Registered retrospectively with TRN PACTR202407741896902.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"120"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633663","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}