Annals of the American Thoracic Society最新文献

{"title":"Reply to Khan et al.: Home Improvement Programs and Deadly Countertops: The Need to Protect Workers.","authors":"Andrew H Stephen, Debasree Banerjee","doi":"10.1093/annalsats/aaoag054","DOIUrl":"10.1093/annalsats/aaoag054","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"830"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How much oxygen do they need? Clearing the air, and the bank account.","authors":"Jessica Lozier, Dee W Ford","doi":"10.1093/annalsats/aaoag058","DOIUrl":"10.1093/annalsats/aaoag058","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"702-703"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Mass Index-related genetic factors and COPD imaging phenotypes.","authors":"Jingzhou Zhang, Matthew Moll, Catherine L Debban, Brian D Hobbs, Heena Rijhwani, George R Washko, Bartolome R Celli, Edwin K Silverman, Per Bakke, Elizabeth C Oelsner, R Graham Barr, Alvar Agustí, Rosa Faner, Guy G Bruselle, Stephen M Humphries, David A Lynch, Josée Dupuis, Ani W Manichaikul, George T O'Connor, Michael H Cho","doi":"10.1093/annalsats/aaoag007","DOIUrl":"10.1093/annalsats/aaoag007","url":null,"abstract":"<p><strong>Rationale: </strong>While low body mass index (BMI) is associated with emphysema and obesity is associated with airway disease in chronic obstructive pulmonary disease (COPD), the underlying mechanisms are unclear.</p><p><strong>Objectives: </strong>To examine the association between BMI-related genetic variants and emphysema and airway disease imaging phenotypes.</p><p><strong>Methods: </strong>We aggregated genetic variants from population-based genome-wide association studies to generate a polygenic score of BMI (PGSBMI). We examined associations of the PGSBMI with automated quantification and visual interpretation of computed tomographic emphysema and airway wall thickness (AWT) in COPD-enriched and community-based cohorts. We summarized the results using meta-analysis.</p><p><strong>Measurements and main results: </strong>In the meta-analyses combining results of all cohorts (n = 16 349), a standard-deviation increase of the PGSBMI was associated with less emphysema as quantified by log-transformed percent of low attenuation areas ≤950 Hounsfield units (β = -0.062, P < .0001) and 15th percentile value of lung density histogram (β = 2.27, P < .0001), and increased AWT as quantified by the square root of wall area of a 10-mm lumen perimeter airway (β = 0.016, P = .0006) and mean segmental bronchial wall area percent (β = 0.26, P = .0013). For imaging characteristics assessed by visual interpretation, a higher PGSBMI was associated with reduced emphysema in both COPD-enriched cohorts (odds ratio [OR] for a higher severity grade = 0.89, P = .0080) and in the community-based Framingham Heart Study (OR for the presence of emphysema = 0.82, P = .0034), and a higher risk of airway wall thickening in the COPDGene study (OR = 1.17, P = .0023).</p><p><strong>Conclusions: </strong>In individuals with and without COPD, a higher BMI polygenic risk is associated with both quantitative and visual decreased emphysema and increased AWT, suggesting genetic determinants of BMI affect both emphysema and airway wall thickening.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"720-727"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential long-acting tuberculosis treatment for people with HIV: cost-effectiveness benchmarks.","authors":"Amy Zheng, Eden Pletner, Keren Middelkoop, Anne M Neilan, C Robert Horsburgh, A David Paltiel, Kenneth A Freedberg, Robin Wood, Krishna P Reddy","doi":"10.1093/annalsats/aaoaf072","DOIUrl":"10.1093/annalsats/aaoaf072","url":null,"abstract":"<p><strong>Rationale: </strong>Long-acting tuberculosis (TB) drugs could improve treatment outcomes in South Africa, where there is high prevalence of HIV and TB coinfection and high attrition from standard TB treatment, but potential benefits must be weighed against costs.</p><p><strong>Objectives: </strong>To identify scenarios where a long-acting TB treatment would provide clinical benefit and be cost-effective compared with standard TB treatment for people with HIV in South Africa.</p><p><strong>Methods: </strong>We used a microsimulation model to compare clinical and cost outcomes of (1) standard-of-care 6-month oral TB treatment (SOC); and (2) a long-acting treatment regimen, entailing standard oral therapy for 2 months followed by a one-time injection (LA). Base case parameters for the SOC/LA strategies included efficacy, 97.6%/97.6%; disengagement on oral therapy, 4.8% per month; TB relapse, 0.34%/0.34% per month starting 5 months after regimen completion; and total regimen cost, US$50.40/$199.80 (cost of long-acting injectable drug alone, $175). We varied these parameters in sensitivity analysis. Outcomes included mortality, treatment completions, TB relapses, life-years, and health system costs. We defined LA to be cost-effective compared to SOC when its incremental cost-effectiveness ratio (ICER) was <$3,000 per year-of-life saved (YLS).</p><p><strong>Results: </strong>In base case simulations, the LA strategy would produce lower all-cause mortality (11.4% vs 11.6%) and less disengagement (12.9% vs 20.9%) than SOC at 6 months. LA would be cost-effective in the base case at the lifetime horizon (ICER $520/YLS) and at 24 months (ICER $2230/YLS). Over the lifetime horizon, LA would be cost-effective compared with SOC over all parameter ranges evaluated in one-way sensitivity analysis. At 24 months, LA would not be cost-effective compared to SOC when LA efficacy is <96%, monthly probability of disengagement from the oral regimen component of SOC and LA is <4%, or cost of the long-acting injectable drug is >$200.</p><p><strong>Conclusions: </strong>There are combinations of efficacy, cost, and care disengagement at which a long-acting injectable TB treatment regimen could be cost-effective compared with the conventional oral treatment. Cost-effectiveness could be achieved if the long-acting treatment regimen maintains high efficacy at reasonable cost, especially when disengagement from -standard oral treatment is high.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"745-753"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond linear assumptions in pulmonary function analysis: a methodological critique of veteran health outcome models.","authors":"Yoshiyasu Takefuji","doi":"10.1093/annalsats/aaoag016","DOIUrl":"10.1093/annalsats/aaoag016","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"831-832"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Takefuji: Beyond linear assumptions in pulmonary function analysis: a methodological critique of veteran health outcome models.","authors":"Siyang Zeng, Nisha C Jani, Anays M Sotolongo, Gang Luo, Michael J Falvo, Mehrdad Arjomandi","doi":"10.1093/annalsats/aaoag017","DOIUrl":"10.1093/annalsats/aaoag017","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"833-835"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-delivered psychotherapeutic intervention for family members of patients in intensive care: a nonrandomized pilot study.","authors":"Annika von Heymann, Eva R Nissen, Anne S Ågård, Ingrid Egerod, Marietta Kokla, Ingeborg Farver-Vestergaard, Holly G Prigerson, Wendy G Lichtenthal, Christoffer Johansen, Robert Zachariae, Mia S O'Toole","doi":"10.1093/annalsats/aaoag015","DOIUrl":"10.1093/annalsats/aaoag015","url":null,"abstract":"<p><strong>Rationale: </strong>Family members of patients in intensive care units (ICUs) experience psychological distress both during and after the ICU stay. Yet, past interventions are few and largely ineffective.</p><p><strong>Objectives: </strong>We developed a flexible, tele-delivered psychotherapeutic intervention based on contemporary cognitive therapeutic methods and tested its feasibility in a one-arm pilot study. Although evaluated in family members of patients with COVID-19, the intervention was developed to be broadly applicable to mental health problems in ICU family caregivers.</p><p><strong>Methods: </strong>Adult family members of patients with COVID-19 in 5 ICUs across Denmark received weekly sessions with clinical psychologists during the ICU stay and on a needs basis for 8 weeks postdischarge. The intervention manual specified a catalog of treatment principles and methods from contemporary cognitive therapies. Questionnaires evaluating peritraumatic distress, anxiety, depression, stress, rumination, worry, and tolerance of uncertainty were administered at preintervention, postintervention, and 6- and 12-month follow-up. Mixed-effects models estimated the change in mental health symptoms over time. A subset of family members and psychologists completed in-depth interviews postintervention analyzed with thematic analysis.</p><p><strong>Results: </strong>Of 43 eligible family members, 40 (93%) participated. Two withdrew consent during the intervention. On average, family members received 6 sessions (range, 0-15) over 9 to 118 days. Both the tele-delivery format and the intervention methods were found feasible and acceptable by family members as well as psychologists, and family members found the intervention beneficial in validating and addressing their evolving needs and helping them manage distress. Preliminary effects at postintervention were large reductions in mental health symptoms for peritraumatic distress (Hedges' g = -0.86 [95% CI, -1.1 to -0.62]), anxiety (g = -2.46 [95% CI, -2.36 to -1.51]), and depression (g = -1.77 [95% CI, -2.5 to -0.88]), also seen at follow-up, together with medium improvements for perceived stress.</p><p><strong>Conclusions: </strong>This tele-based psychotherapeutic intervention for family members of patients in ICUs was feasible and acceptable. Tele-delivered contemporary cognitive therapies present a promising approach for reducing peritraumatic distress, anxiety, and depression.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT04409821).</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"782-790"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends in sarcoidosis-associated mortality, 2001-2023: insights from the World Health Organization mortality database.","authors":"Ko Harada, Mariko Fujii, Nanami Sako, Quynh Thi Vu, Yoshito Nishimura, Keith Pardillada Belangoy, Hanane Ouddoud, Tatsuaki Takeda, Yoshito Zamami, Hideharu Hagiya, Toshihiro Koyama","doi":"10.1093/annalsats/aaoag026","DOIUrl":"10.1093/annalsats/aaoag026","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"823-827"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home improvement programs and deadly countertops: the need to protect workers.","authors":"Alya Khan, Robert Harrison, Peter Budinger, Kristin J Cummings","doi":"10.1093/annalsats/aaoag052","DOIUrl":"10.1093/annalsats/aaoag052","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"828-829"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of inspiratory muscle training on obstructive sleep apnea: a systematic review and meta-analysis.","authors":"Chengcheng Zuo, Jie Qin, Zhe Wang, Ming Yan, Ze Chen, Ziyu Qiao, Jia Wang, Dahai Wu","doi":"10.1093/annalsats/aaoag041","DOIUrl":"10.1093/annalsats/aaoag041","url":null,"abstract":"<p><strong>Rationale: </strong>Inspiratory muscle training (IMT) is a relatively new intervention for obstructive sleep apnea (OSA), with the aim of improving respiratory muscle strength and mitigating OSA-related symptoms. However, its effects on key clinical endpoints remain unclear.</p><p><strong>Objectives: </strong>To evaluate the effects of IMT on OSA severity, sleep quality, respiratory function, and cardiovascular outcomes.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, CENTRAL, and Web of Science for randomized controlled trials (RCTs) assessing IMT in adults with OSA. Studies assessed IMT vs control/placebo with outcomes, including the apnea-hypopnea index (AHI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), maximal inspiratory pressure (MIP), lowest oxygen saturation (LSaO2), blood pressure (BP), and body mass index (BMI).</p><p><strong>Results: </strong>Ten RCTs (166 IMT vs 157 control participants) found significant improvements in OSA with IMT across multiple domains. The intergroup difference in mean BMI reduction (mean difference [MD], -1.48; 95% credible interval [CI], -2.39 to -0.57), mean PSQI gain (-3.15; -3.69 to -2.62), mean LSaO2 gain (2.86; 1.01 to 4.71), mean ESS reduction (-3.18; -4.50 to -1.87), mean MIP gain (25.54; 11.09 to 40.00), the percentage of predicted values for forced vital capacity predicted gain (17.20; 9.53 to 24.87), and mean systolic blood pressure reduction (-6.63; -13.26 to -0.00) indicated the benefit of IMT over the control therapy. However, there was no significant improvement in AHI (1.00; -2.57 to 4.56). Heterogeneity primarily stemmed from differences in intervention protocols and baseline disease severity among the patients.</p><p><strong>Conclusions: </strong>Inspiratory muscle training resulted in clinically meaningful symptomatic benefits across OSA phenotypes by enhancing respiratory strength, sleep quality, and cardiovascular health. However, the lack of significant improvement in AHI suggests that IMT may not affect primary pathophysiological markers of OSA. Thus, IMT may be an adjunctive intervention, rather than a primary therapy, for reducing event frequency in OSA.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"800-810"},"PeriodicalIF":5.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}