CHEST

Comparison of clinically meaningful improvements following center-based and home-based tele rehabilitation in people with COPD
Cox DNS, McDonald DC, Burge DAT, Hill DCJ, Bondarenko MJ and Holland PAE
Response to pulmonary rehabilitation is not equal for all participants, and may vary across health outcomes for any one individual. Alternative modes of pulmonary rehabilitation delivery, e.g. telerehabilitation, may improve program access but could also affect response to rehabilitation.
Response
Ang HL and Khor YH
Effects of β-blockers on the Outcomes in Patients with Pulmonary Arterial Hypertension Stratified by the Presence of Comorbid Conditions: a Multicenter Prospective Cohort Study (BNP-PL)
Waligóra M, Kurzyna M, Mularek-Kubzdela T, Skoczylas I, Chrzanowski Ł, Błaszczak P, Jaguszewski M, Kuśmierczyk B, Ptaszyńska K, Grześk G, Mizia-Stec K, Malinowska E, Peregud-Pogorzelska M, Lewicka E, Tomaszewski M, Jacheć W, Florczyk M, Mroczek E, Gąsior Z, Pawlak A, Betkier-Lipińska K, Pruszczyk P, Widejko K, Zabłocka W and Kopeć G
The current guidelines do not recommend β-blockers in pulmonary arterial hypertension (PAH) unless indicated by comorbidities. However, the evidence regarding the role of β-blockers in PAH is contradictory.
Sarcoidosis Treatment Patterns in the United States: 2016-2022
Sangani R, Bosch NA, Govender P, Scarpato B, Walkey AJ, Newman J, Law AC, Gillmeyer KR and Shankar DA
There are limited FDA-approved medications and real-world data on sarcoidosis treatment in the U.S. and concordance of practice patterns with guideline recommendations have not been well characterized.
Response
Sulmasy DP, DeCock CA, Tornatore CS, Roberts AH, Giordano J and Donovan GK
Plasma Protein Biomarkers of Spirometry Measures of Impaired Lung Function
Aggarwal M, Hwang SJ, Lee DH, Huan T, McNeill JN, Courchesne P, Joehanes R, Ho JE, Dupuis J, Hedman ÅK, O'Connor G and Levy D
Impaired pulmonary function carries significant risks for lung, cardiovascular, and metabolic disorders.
Associations of socioeconomic status and phenotypic frailty with incident chronic obstructive pulmonary disease: findings from UK Biobank participants
Feng Z, Li G, He Q, Sun N, Li T, Han Q, Zhao H, Ma Z, Sun M, Liu B, Wang Y, Lou Z, Ma S, Shi Y, Li J, Sun Z, Jiang M and Shen Y
The independent, mediation, interaction, and joint effects of socioeconomic status (SES) and phenotypic frailty on the incidence of chronic obstructive pulmonary disease (COPD) are unclear.
Enhancing Future Research and Clarifying the Role of Minocycline in Refining Delirium Prevention in Critical Care
Xu S and Lu Z
Lung Nodules and Masses in non-HIV Immunocompromised Patients: A Clinical-Imaging Algorithmic Approach
Franquet T, Raoof S, Lee K, Han J, Gimenez A, Brenes J, Asmar J and Domingo P
The incidence of pulmonary nodules and masses in non-HIV immunocompromised patients has significantly increased due to advancements in hematopoietic stem cell transplantation (HSCT), solid organ transplantation (SOT), and the widespread use of chemotherapy and immunosuppressive therapies. Differentiating between infectious and non-infectious causes is critical for appropriate diagnosis and management, especially as radiological and clinical presentations can be nonspecific.
Dietary pattern, sputum DNA methylation, and lung health: an epidemiological study in people who ever smoked
Feng Y, Kang H, Sood A, Guest DD, Fung TT, Rowe CL, Picchi MA, Pankratz VS, Belinsky SA and Leng S
We previously identified a panel of sputum DNA methylation that predicts lung ageing and risk for lung cancer.
Pulmonary hypertension associated with Trastuzumab-Emtansine: an analysis of French PH registry and WHO pharmacovigilance database
Poisson C, Hlavaty A, Favrolt N, Chaumais MC, Grynblat J, Jutant EM, Lechartier B, Maurac A, Mouillot P, Palat S, Rambach L, Antigny F, Cottin V, Beltramo G, Humbert M, Khouri C, Bonniaud P and Montani D
Trastuzumab-emtansine have been recently suspected to be associated with the development of pulmonary arterial hypertension (PAH).
Keeping up with technological innovation: the moral imperative for pragmatic clinical trials in interventional pulmonology
Maldonado F, Paez R, Lentz RJ, Ratwani A and Casey JD
The advances in minimally invasive lung cancer diagnostics of the last decade have transformed patient care but have also raised important concerns about the regulatory processes used to approve new devices and the best way to generate data to support their use. Disruptive technologies, such as robotic bronchoscopy, have been widely adopted by interventional pulmonologists in the absence of robust data demonstrating improved patient outcomes. Comparative research is needed to inform patient care, but traditional methods of conducting clinical trials in which research teams operate separately from clinical teams are ill-suited to testing the safety and effectiveness of technologies being introduced on the market at unprecedented speed. Pragmatic clinical trials, which integrate trial procedures into routine clinical care, represent an appealing alternative approach for generating much-needed data to inform clinical care. In this manuscript we illustrate the advantages and disadvantages of these research paradigms using two recently completed randomized controlled trials in navigational bronchoscopy and highlight the barriers and facilitators to using pragmatic trials to address the gap in comparative effectiveness research: these include the need for increased clarity of research regulations for pragmatic trials, adequate federal and private funding for such research, and alignment of incentives between clinicians, researchers, regulators, and industry.
Evolution of DL in LAM: Historical Perspectives and the Role of Advanced Imaging
Yang BE, Elinoff JM, Campbell-Washburn AE, Wen H and Moss J
Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease affecting women and is characterized by the proliferation of abnormal smooth muscle-like cells within the lungs, kidneys, and lymphatic system. Forced expiratory volume in 1 second (FEV) and diffusing capacity of the lungs for carbon monoxide (DL) are two commonly used markers for evaluating the status of LAM, although the disease may predominantly be associated with changes in only one of these parameters. In this special feature, we trace the historical evolution of DL and FEV in LAM up to their current uses, beginning with their relationship in early studies with histopathology and imaging. We transition to the use of DL and FEV in the context of sirolimus therapy and monitoring rates of change in lung function. Finally, we examine modern imaging modalities and how these techniques have contributed to our understanding of LAM progression, with a focus on the unique and perhaps undervalued role of DL. The LAM Histology Score (LHS), which measures the involvement of cysts and LAM cells in the lung via biopsy, relates to disease stages and aligns more with DL than FEV. The Cyst Score, calculated from high-resolution computed tomography (HRCT) scans, is a measure of the lung parenchyma occupied by cysts and correlates with disease progression. Large cysts as visualized by HRCT predominantly influence FEV, whereas smaller cysts, which impact a greater surface area of the lung and may be underestimated, tend to affect DL.
Improving Diagnosis and Management of Pulmonary Hypertension in Interstitial Lung Disease
Hao L and Xue J
Results of the SHARP Study: A Randomized, Placebo-Controlled, Double-Blind, Repeated-Measures, Crossover, Phase IV Clinical Trial of the Effect of the Wake-Promoting Agent Solriamfetol on Cognitive Function in Obstructive Sleep Apnea With Excessive Daytime Sleepiness and Cognitive Impairment
Van Dongen HPA, Leary EB, Drake C, Bogan R, Jaeger J, Rosenberg R, Streicher C and Tabuteau H
Obstructive sleep apnea (OSA) causes episodes of fragmented sleep and intermittent hypoxia and leads to excessive daytime sleepiness (EDS). Deficits in cognitive function are a troublesome symptom in patients with OSA and EDS.
Are Lung Ultrasound B-Lines Better Than Pulmonary Function Tests in Predicting the Prognosis of Patients With Systemic Sclerosis?
Yakisik C, Azakli D and Satici C
Quantitative Computed Tomography Analysis in Rheumatoid Arthritis-Related Interstitial Lung Disease
Humphries SM, Adegunsoye A, Demoruelle MK, Wei Kam ML, Amigues I, Bang TJ, Teague SD, Lynch DA, Chung JH, Strek ME, Swigris JJ and Solomon JJ
Quantitative chest computed tomography (CT) may be a useful predictor of outcome in rheumatoid arthritis-related interstitial lung disease (RA-ILD).
Prophylactic Minocycline for Delirium With Unexpected Death Benefits: What Was Treated Unexpectedly?
Wang SY and Wei JC
Clinical accuracy and risk of harm in asthma related content on TikTok
Murray JK, McNally E and Kent BD
Current Brain Death Clinical Criteria Are Adequate When Strictly Applied
DePietro M
Chronic obstructive pulmonary disease-associated expiratory central airway collapse: current concepts and new perspectives
Zhou P, Yu W, Zhang W, Ma J, Xia Q and He C
Chronic obstructive pulmonary disease (COPD)-associated expiratory central airway collapse (ECAC) is a frequently overlooked benign airway obstructive disease, with complex causes and unclear pathological and physiological mechanisms. Although interventions such as noninvasive positive pressure ventilation, airway stenting, and tracheobronchoplasty have shown definite efficacy in the treatment of COPD-associated ECAC, the diagnosis and treatment of this disease remain challenging. This article provides a systematic evaluation and outlook of the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, treatment of COPD-associated ECAC.