Annals of the American Thoracic Society最新文献

{"title":"COVID-19 has taught us that not all COPD exacerbations are created equal.","authors":"William W Stringer","doi":"10.1093/annalsats/aaoag153","DOIUrl":"10.1093/annalsats/aaoag153","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1435-1436"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207231","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":"Lung health lessons learned abroad are critical to understanding lung health at home.","authors":"Seyram Kaali, Darby Jack, Alison G Lee","doi":"10.1093/annalsats/aaoag189","DOIUrl":"10.1093/annalsats/aaoag189","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1439-1440"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383296","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":"Cardiovascular and mortality risks following COVID-19-related versus non-COVID-19-related chronic obstructive pulmonary disease exacerbations.","authors":"Brian K Kirui, Huiqi Li, Oskar Wallström, Lowie E G W Vanfleteren, Ailiana Santosa, Carl Bonander, Caroline Stridsman, Mats Börjesson, Fredrik Nyberg","doi":"10.1093/annalsats/aaoag084","DOIUrl":"10.1093/annalsats/aaoag084","url":null,"abstract":"<p><strong>Rationale: </strong>Chronic obstructive pulmonary disease (COPD) exacerbations, often triggered by viral infections like COVID-19, are associated with increased cardiovascular risk. We hypothesized that COVID-19-related exacerbations carry higher short-term cardiovascular and mortality risks than non-COVID-19-related exacerbations.</p><p><strong>Objectives: </strong>To compare 28-day risk of stroke, pulmonary embolism (PE), acute myocardial infarction (AMI), major adverse cardiovascular events (MACE), and all-cause mortality following COVID-19-related vs non-COVID-19-related COPD exacerbations and assess variation across the pandemic.</p><p><strong>Methods: </strong>Using Swedish national registers, we identified COPD with moderate (treated with oral corticosteroids with/without antibiotics) or severe (hospitalized) exacerbations from March 2020 to June 2023. Exacerbations with infection, hospitalization, or intensive care admission for COVID-19 were defined as COVID-19 related. A target trial was emulated and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) were estimated for each outcome, stratified by exacerbation severity and COVID-19 variants.</p><p><strong>Results: </strong>Among 266 273 exacerbations (87.2% moderate, 12.8% severe), 5425 (2%) were COVID-19 related. COVID-19-related vs non-COVID-19-related moderate exacerbations were associated with risk of PE (aHR, 2.26 [95% CI, 1.49-3.42]), overall cardiovascular events (1.94 [1.47-2.56]), MACE (1.88 [1.28-2.76]), and mortality (4.58 [4.06-5.17]), but not significantly with AMI and stroke. Severe COVID-19-related exacerbations were only associated with higher mortality (1.46 [1.28-1.66]). Cardiovascular risks were highest during pre-Alpha and Delta for moderate exacerbations. Mortality remained elevated for both moderate and severe exacerbations, particularly during the same periods.</p><p><strong>Conclusions: </strong>COVID-19-related exacerbations increased MACE, short-term cardiovascular, and mortality risks, mainly for moderate exacerbations, with attenuation during Alpha and Omicron, highlighting the need for proactive cardiovascular care during respiratory outbreaks.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1476-1487"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640785","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":"Development and usability testing of a Spanish version of a mobile app-based adaptive coping skills intervention for critical illness survivors: Blueprint en español.","authors":"Katie E Mosack, Cirila Estela Vasquez Guzman, Carolyn J Marentes Ruiz, Edlyn Wolwowicz, Kristy Johnson, Rafaela Avallone Mantelli, Aliza Anderson, Madeline McDougal, Luz Mejia-Flores, Rosa Gonzalez-Guarda, Thanh H Neville, Robin L Baudier, Jodi A Lapidus, Laura S Porter, Aluko A Hope, Marc Moss, Cynthia D Morris, Catherine L Hough, Christopher E Cox","doi":"10.1093/annalsats/aaoag089","DOIUrl":"10.1093/annalsats/aaoag089","url":null,"abstract":"<p><strong>Rationale: </strong>The exclusion of Spanish-speaking participants in psychobehavioral trials among critical illness survivors limits the generalizability of evidence-based interventions. However, adapting interventions for inclusivity is challenging, and few examples exist in the field for replication.</p><p><strong>Objectives: </strong>To describe the cultural and linguistic adaptation of the Blueprint mobile app-based adaptive coping skills intervention to Spanish for inclusion in a multicenter trial, its usability testing, and lessons learned from the process.</p><p><strong>Methods: </strong>A multidisciplinary team of native English and Spanish speakers conducted an iterative 3-step adaptation. Step 1 involved an initial cultural and linguistic adaptation of key scripted content of an existing psychobehavioral intervention for critical illness survivors (\"Blueprint\") to Spanish by a group that included community members, members of a Latino-serving health advocacy group, and clinicians. In Step 2, bilingual trial network members created final versions of all text and images, which were then professionally produced for an equivalent Spanish language version of the Blueprint mobile application. Step 3 involved a formal usability test of the final Spanish version among bilingual participants (n = 10) by comparing observed to target values of the Systems Usability Scale (SUS).</p><p><strong>Results: </strong>The team successfully developed adaptations of 35 elements of audio, video, and text content. The mean SUS score of 83.1 (10.7 SD) exceeded our a priori usability target of 80. Key lessons learned included that translation software is inadequate to comprehensively incorporate cultural norms, diverse dialect representation is essential, extensive time and expense is required, and consensus must be balanced against cost and time constraints.</p><p><strong>Conclusions: </strong>We conducted a successful cultural and linguistic adaptation of an English language psychobehavioral intervention to a highly usable Latin American Spanish version using a methodologically rigorous process. Lessons learned from this project can assist researchers seeking to increase the number of Spanish language psychobehavioral interventions and the generalizability of future trials.</p><p><strong>Clinical trial registration: </strong>The parent trial is registered on ClinicalTrials.gov as NCT06538246 (https://clinicaltrials.gov/study/NCT06538246).</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1509-1517"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679498","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":"Reply to Schwartz: external beam radiation therapy and interventions for malignant central airway obstruction: a false dichotomy.","authors":"Roshen Mathew, Nikhil Meena, Levent Dalar","doi":"10.1093/annalsats/aaoag139","DOIUrl":"10.1093/annalsats/aaoag139","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1572-1573"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977783","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":"External beam radiation therapy versus bronchoscopy for malignant central airway obstruction: apples and oranges are not the same.","authors":"Eric J Seeley, Yaron B Gesthalter","doi":"10.1093/annalsats/aaoag226","DOIUrl":"10.1093/annalsats/aaoag226","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1574-1575"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815142","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":"From guidelines to practice: the PuSHCon health-coach model for COPD and asthma.","authors":"Arianne K Baldomero","doi":"10.1093/annalsats/aaoag185","DOIUrl":"10.1093/annalsats/aaoag185","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1432-1434"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392971","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":"Representation of minoritized people with cystic fibrosis in the Cystic Fibrosis Therapeutics Development Network clinical trials.","authors":"Tijana Milinic, Amalia S Magaret, Crystal E Brown, Oliver J McElvaney, Nicole Mayer-Hamblett, Siddhartha G Kapnadak, Susan R Heckbert, Kathleen J Ramos, Christopher H Goss","doi":"10.1093/annalsats/aaoag085","DOIUrl":"10.1093/annalsats/aaoag085","url":null,"abstract":"<p><strong>Rationale: </strong>Black and Hispanic people with cystic fibrosis (PwCF) experience worse health outcomes related to pulmonary disease compared with White, non-Hispanic PwCF. Improving outcomes in minoritized PwCF is a crucial need in the CF community, but prior evidence suggests that these communities are underrepresented in CF clinical research.</p><p><strong>Objective: </strong>To determine whether CF clinical studies are representative of the overall CF population.</p><p><strong>Methods: </strong>The study cohort included participants from recent CF transmembrane conductance regulator modulator studies: Characterizing CFTR Modulated Changes in Sweat Chloride and their Association with Clinical Outcomes (CHEC-SC), A Prospective Study to Evaluate Biological and Clinical Effects of Significantly Corrected CFTR Function (PROMISE), Prospective Longitudinal Study of CFTR-dependent Disease Profiling in CF (PROSPECT), and the G551D Observational Study. Persons seen at the same centers who were eligible for these studies based on the inclusion and exclusion criteria but did not enroll were used as a comparator cohort from the Cystic Fibrosis Foundation Patient Registry (CFFPR). Rates of study enrollment were assessed separately for Black race and Hispanic ethnicity versus non-Hispanic White PwCF. Propensity-weighted Poisson regression models were used to account for potential confounders in the relationship between race and study participation.</p><p><strong>Results: </strong>Demographic characteristics were compared between 3594 PwCF in the 4 modulator studies with 14 888 individuals from the CFFPR who were eligible but did not enroll. Enrollees were younger (median age 19 years), more likely to have had at least 3 clinic visits per year, and more likely to live within 30 miles of the study site. Black and Hispanic PwCF were less likely to have private insurance and less likely to live far from study centers. Multivariable analysis revealed that Black individuals were significantly less likely than non-Hispanic White individuals to enroll in CHEC-SC and PROMISE, with a 17% and 32% lower likelihood, respectively. Hispanic individuals had a 34% lower enrollment rate than non-Hispanic White individuals in PROMISE but had a higher enrollment in PROSPECT. Differences in enrollment rates were greater at sites with fewer minority participants.</p><p><strong>Conclusion: </strong>These results suggest that Black and Hispanic PwCF are, overall, significantly less likely to be included in CF clinical research than non-Hispanic White PwCF. Future research is needed to better understand if these differences are upheld in studies with varying inclusion/exclusion criteria and clinical sites.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1446-1454"},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679348","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":"Global Tuberculosis Burden Attributable to Household and Outdoor Air Pollution.","authors":"Siobhan Carroll, Ana Pereda, Beatriz Escobar, Breanna Crane, Richard van Zyl-Smit, Olivia A Wackowski, Stephen B Gordon, Vanessa Garcia, Olufunmilola Ibironke, Qingyu Meng, Diego Salazar, Pamela Ohman-Strickland, Yingting Zhang, Michael Brauer, Jill Baumgartner, Aaron J Cohen, Stephan Schwander","doi":"10.1093/annalsats/aaoag299","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag299","url":null,"abstract":"<p><p>Air pollution is an emerging risk factor for Mycobacterium tuberculosis infection and tuberculosis incidence and poor treatment outcomes, yet evidence has not been comprehensively synthesized or translated into burden estimates to inform policy. This systematic review and meta-analysis examines global evidence on household and outdoor air pollution and tuberculosis risk and outcomes and estimates tuberculosis burden attributable to fine particulate matter (PM2.5). We reviewed 140 studies published through August 2024, applying random-effects meta-analysis and Burden of Proof meta-regression to generate conservative effect estimates and quantify the tuberculosis burden attributable to PM2.5. Household solid fuel use was associated with higher tuberculosis incidence (risk ratio [RR] = 1.82, 95% confidence interval [CI]: 1.52-2.17), with larger effects in children (<15 years: RR = 2.25, 95% CI: 1.12-4.52) and females (RR = 2.62, 95% CI: 1.95-3.52). Short-term (≤3 months) exposure to outdoor PM2.5 (RR = 1.03, 95% CI: 1.00-1.05 per 10 µg/m³) was also associated with increased tuberculosis incidence. In 2023, there were an estimated 4.15 million tuberculosis cases (95% UI: 3.68-4.66 million), 23.58 million disability-adjusted life years (95% UI: 20.79-26.66 million), and 534,947 tuberculosis-related deaths (95% UI: 458,878-614,458) globally associated with PM2.5 exposure. We estimate that PM2.5 exposure was associated with 49.9% (95% UI: 44.5-55.5%) of tuberculosis cases worldwide in 2023. These findings suggest that exposure to household and outdoor air pollution are important risk factors for tuberculosis, supporting air quality interventions as a component of global tuberculosis control strategies.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083257","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":"Already Low by School Age: Is there still time to change the Lung Function Trajectory?","authors":"Shyamali C Dharmage, Yaoyao Qian, Hiran Selvadurai","doi":"10.1093/annalsats/aaoag308","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag308","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076130","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}