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Virology Journal Aug 2023Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can lead to acute... (Review)
Review
Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can lead to acute respiratory distress syndrome (ARDS), multi-organ failure and death, posing significant threat to human health. Studies have found that pathological mechanisms, such as cytokine storms caused by uncontrolled innate immune system activation, release of damage-associated molecular patterns during tissue injury and a high incidence of thrombotic events, are associated with the function and dysfunction of neutrophils. Specifically, the increased formation of low-density neutrophils (LDNs) and neutrophil extracellular traps (NETs) has been shown to be closely linked with the severity and poor prognosis in patients with COVID-19. Our work focuses on understanding the increased number, abnormal activation, lung tissue infiltration, and elevated neutrophil-to-lymphocyte ratio in the pathogenesis of COVID-19. We also explore the involvement of NETs and LDNs in disease progression and thrombosis formation, along with potential therapeutic strategies targeting neutrophil and NETs formation.
Topics: Humans; COVID-19; Neutrophils; SARS-CoV-2; Extracellular Traps; Respiratory Distress Syndrome
PubMed: 37533131
DOI: 10.1186/s12985-023-02116-w -
Current Opinion in Pediatrics Dec 2015Exposure to traffic-related air pollutants (TRAPs) has been implicated in asthma development, persistence, and exacerbation. This exposure is highly significant because... (Review)
Review
PURPOSE OF REVIEW
Exposure to traffic-related air pollutants (TRAPs) has been implicated in asthma development, persistence, and exacerbation. This exposure is highly significant because increasingly large segments of the population worldwide reside in zones that have high levels of TRAP, including children, as schools are often located in high traffic pollution exposure areas.
RECENT FINDINGS
Recent findings include epidemiologic and mechanistic studies that shed new light on the impact of traffic pollution on allergic diseases and the biology underlying this impact. In addition, new innovative methods to assess and quantify traffic pollution have been developed to assess exposure and identify vulnerable populations and individuals.
SUMMARY
This review will summarize the most recent findings in each of these areas. These findings will have a substantial impact on clinical practice and research by the development of novel methods to quantify exposure and identify at-risk individuals, as well as mechanistic studies that identify new targets for intervention for individuals most adversely affected by TRAP exposure.
Topics: Air Pollutants; Air Pollution; Asthma; Child; Child, Preschool; Eczema; Environmental Exposure; Humans; Rhinitis, Allergic, Seasonal; Schools; Vehicle Emissions
PubMed: 26474340
DOI: 10.1097/MOP.0000000000000286 -
Korean Journal of Radiology Jan 2019In pediatric thoracic CT, respiratory motion is generally treated as a motion artifact degrading the image quality. Conversely, respiratory motion in the thorax can be... (Review)
Review
In pediatric thoracic CT, respiratory motion is generally treated as a motion artifact degrading the image quality. Conversely, respiratory motion in the thorax can be used to answer important clinical questions, that cannot be assessed adequately via conventional static thoracic CT, by utilizing four-dimensional (4D) CT. However, clinical experiences of 4D thoracic CT are quite limited. In order to use 4D thoracic CT properly, imagers should understand imaging techniques, radiation dose optimization methods, and normal as well as typical abnormal imaging appearances. In this article, the imaging techniques of pediatric thoracic 4D CT are reviewed with an emphasis on radiation dose. In addition, several clinical applications of pediatric 4D thoracic CT are addressed in various thoracic functional abnormalities, including upper airway obstruction, tracheobronchomalacia, pulmonary air trapping, abnormal diaphragmatic motion, and tumor invasion. One may further explore the clinical usefulness of 4D thoracic CT in free-breathing children, which can enrich one's clinical practice.
Topics: Airway Obstruction; Artifacts; Child; Diaphragm; Four-Dimensional Computed Tomography; Humans; Lung; Lung Neoplasms; Respiration; Thorax; Tracheobronchomalacia
PubMed: 30627021
DOI: 10.3348/kjr.2018.0325 -
Radiology. Artificial Intelligence Mar 2022Quantitative imaging measurements can be facilitated by artificial intelligence (AI) algorithms, but how they might impact decision-making and be perceived by...
Quantitative imaging measurements can be facilitated by artificial intelligence (AI) algorithms, but how they might impact decision-making and be perceived by radiologists remains uncertain. After creation of a dedicated inspiratory-expiratory CT examination and concurrent deployment of a quantitative AI algorithm for assessing air trapping, five cardiothoracic radiologists retrospectively evaluated severity of air trapping on 17 examination studies. Air trapping severity of each lobe was evaluated in three stages: qualitatively (visually); semiquantitatively, allowing manual region-of-interest measurements; and quantitatively, using results from an AI algorithm. Readers were surveyed on each case for their perceptions of the AI algorithm. The algorithm improved interreader agreement (intraclass correlation coefficients: visual, 0.28; semiquantitative, 0.40; quantitative, 0.84; < .001) and improved correlation with pulmonary function testing (forced expiratory volume in 1 second-to-forced vital capacity ratio) (visual = -0.26, semiquantitative = -0.32, quantitative = -0.44). Readers perceived moderate agreement with the AI algorithm (Likert scale average, 3.7 of 5), a mild impact on their final assessment (average, 2.6), and a neutral perception of overall utility (average, 3.5). Though the AI algorithm objectively improved interreader consistency and correlation with pulmonary function testing, individual readers did not immediately perceive this benefit, revealing a potential barrier to clinical adoption. Technology Assessment, Quantification © RSNA, 2021.
PubMed: 35391767
DOI: 10.1148/ryai.2021210160 -
Frontiers in Pediatrics 2023Quantitative computed tomography (QCT) offers some promising markers to quantify cystic fibrosis (CF)-lung disease. Air trapping may precede irreversible bronchiectasis;...
OBJECTIVES
Quantitative computed tomography (QCT) offers some promising markers to quantify cystic fibrosis (CF)-lung disease. Air trapping may precede irreversible bronchiectasis; therefore, the temporal interdependencies of functional and structural lung disease need to be further investigated. We aim to quantify airway dimensions and air trapping on chest CT of school-age children with mild CF-lung disease over two years.
METHODS
Fully-automatic software analyzed 144 serial spirometer-controlled chest CT scans of 36 children (median 12.1 (10.2-13.8) years) with mild CF-lung disease (median ppFEV1 98.5 (90.8-103.3) %) at baseline, 3, 12 and 24 months. The airway wall percentage (WP), bronchiectasis index (BEI), as well as severe air trapping (A3) were calculated for the total lung and separately for all lobes. Mixed linear models were calculated, considering the lobar distribution of WP, BEI and A3 cross-sectionally and longitudinally.
RESULTS
WP remained stable ( = 0.248), and BEI changed from 0.41 (0.28-0.7) to 0.54 (0.36-0.88) ( = 0.156) and A3 from 2.26% to 4.35% ( = 0.086) showing variability over two years. ppFEV1 was also stable ( = 0.276). A robust mixed linear model showed a cross-sectional, regional association between WP and A3 at each timepoint ( < 0.001). Further, BEI showed no cross-sectional, but another mixed model showed short-term longitudinal interdependencies with air trapping ( = 0.003).
CONCLUSIONS
Robust linear/beta mixed models can still reveal interdependencies in medical data with high variability that remain hidden with simpler statistical methods. We could demonstrate cross-sectional, regional interdependencies between wall thickening and air trapping. Further, we show short-term regional interdependencies between air trapping and an increase in bronchiectasis. The data indicate that regional air trapping may precede the development of bronchiectasis. Quantitative CT may capture subtle disease progression and identify regional and temporal interdependencies of distinct manifestations of CF-lung disease.
PubMed: 36816383
DOI: 10.3389/fped.2023.1068103 -
International Journal of Chronic... 2019To explore the influence of emphysema and air trapping heterogeneity on pulmonary function changes in patients with stable chronic obstructive pulmonary disease (COPD).
PURPOSE
To explore the influence of emphysema and air trapping heterogeneity on pulmonary function changes in patients with stable chronic obstructive pulmonary disease (COPD).
PATIENTS AND METHODS
One hundred and seventy-nine patients with stable COPD were enrolled in this prospective study. All patients underwent low-dose inspiratory and expiratory CT scanning and pulmonary-function tests. CT quantitative data for the emphysema index (EI) on full-inspiration and air trapping (AT) on full-expiration were measured for the whole lung, the right and left lungs, and the cranial-caudal lung zones. The heterogeneity index (HI) values for emphysema and air trapping were determined as the ratio of the difference to the sum of the respective indexes. The cranial-caudal HI and left-right lung HI were compared between mild-to-moderate (GOLD stage I and II) and severe (GOLD stage III and IV) disease groups. The associations between HI and pulmonary-function measurements adjusted for age, sex, height, smoking history, EI and AT of the total lung were assessed using multiple linear regression analysis.
RESULTS
The absolute values for cranial-caudal HI (AT_CC_HI) and left-right lung HI (AT_LR_HI) on full-expiration were significantly larger in the mild-to-moderate group, while no significant intergroup differences were observed on full-inspiration. COPD patients with lower-zone and/or left-lung predominance showed significantly lower pulmonary function than those with upper-zone and/or right-lung predominance on full-expiration, whereas no significant differences were observed on full-inspiration. The absolute values of AT_CC_HI and AT_LR_HI significantly correlated with pulmonary-function measurements. Higher AT_CC_HI and lower AT_LR_HI absolute values indicated better pulmonary function, after adjusting for age, sex, height, smoking history, EI and AT of the total lung.
CONCLUSION
Subjects with more heterogeneous distribution and/or upper-zone predominant and/or right-lung predominant patterns on full-expiration tend to have better pulmonary function. Thus, in comparison with emphysema heterogeneity, AT heterogeneity better reflects the pulmonary function changes in COPD patients.
Topics: Aged; Female; Forced Expiratory Volume; Humans; Inspiratory Capacity; Lung; Male; Middle Aged; Multidetector Computed Tomography; Predictive Value of Tests; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Pulmonary Emphysema; Respiration; Severity of Illness Index; Total Lung Capacity; Vital Capacity
PubMed: 31839706
DOI: 10.2147/COPD.S221684 -
American Journal of Respiratory and... Dec 2013Air trapping and airflow obstruction are being increasingly identified in infants with cystic fibrosis. These findings are commonly attributed to airway infection,...
RATIONALE
Air trapping and airflow obstruction are being increasingly identified in infants with cystic fibrosis. These findings are commonly attributed to airway infection, inflammation, and mucus buildup.
OBJECTIVES
To learn if air trapping and airflow obstruction are present before the onset of airway infection and inflammation in cystic fibrosis.
METHODS
On the day they are born, piglets with cystic fibrosis lack airway infection and inflammation. Therefore, we used newborn wild-type piglets and piglets with cystic fibrosis to assess air trapping, airway size, and lung volume with inspiratory and expiratory X-ray computed tomography scans. Micro-computed tomography scanning was used to assess more distal airway sizes. Airway resistance was determined with a mechanical ventilator. Mean linear intercept and alveolar surface area were determined using stereologic methods.
MEASUREMENTS AND MAIN RESULTS
On the day they were born, piglets with cystic fibrosis exhibited air trapping more frequently than wild-type piglets (75% vs. 12.5%, respectively). Moreover, newborn piglets with cystic fibrosis had increased airway resistance that was accompanied by luminal size reduction in the trachea, mainstem bronchi, and proximal airways. In contrast, mean linear intercept length, alveolar surface area, and lung volume were similar between both genotypes.
CONCLUSIONS
The presence of air trapping, airflow obstruction, and airway size reduction in newborn piglets with cystic fibrosis before the onset of airway infection, inflammation, and mucus accumulation indicates that cystic fibrosis impacts airway development. Our findings suggest that early airflow obstruction and air trapping in infants with cystic fibrosis might, in part, be caused by congenital airway abnormalities.
Topics: Airway Obstruction; Airway Resistance; Animals; Bronchi; Bronchography; Cystic Fibrosis; Lung Volume Measurements; Multidetector Computed Tomography; Pulmonary Alveoli; Swine; Trachea
PubMed: 24168209
DOI: 10.1164/rccm.201307-1268OC -
Pressure-driven distillation using air-trapping membranes for fast and selective water purification.Science Advances Jul 2023Membrane technologies that enable the efficient purification of impaired water sources are needed to address growing water scarcity. However, state-of-the-art engineered...
Membrane technologies that enable the efficient purification of impaired water sources are needed to address growing water scarcity. However, state-of-the-art engineered membranes are constrained by a universal, deleterious trade-off where membranes with high water permeability lack selectivity. Current membranes also poorly remove low-molecular weight neutral solutes and are vulnerable to degradation from oxidants used in water treatment. We report a water desalination technology that uses applied pressure to drive vapor transport through membranes with an entrapped air layer. Since separation occurs due to a gas-liquid phase change, near-complete rejection of dissolved solutes including sodium chloride, boron, urea, and -nitrosodimethylamine is observed. Membranes fabricated with sub-200-nm-thick air layers showed water permeabilities that exceed those of commercial membranes without sacrificing salt rejection. We also find the air-trapping membranes tolerate exposure to chlorine and ozone oxidants. The results advance our understanding of evaporation behavior and facilitate high-throughput ultraselective separations.
Topics: Distillation; Permeability; Gases; Water Purification; Membranes, Artificial
PubMed: 37450594
DOI: 10.1126/sciadv.adg6638 -
Radiology. Artificial Intelligence Jan 2022To develop a convolutional neural network (CNN)-based deformable lung registration algorithm to reduce computation time and assess its potential for lobar air trapping...
PURPOSE
To develop a convolutional neural network (CNN)-based deformable lung registration algorithm to reduce computation time and assess its potential for lobar air trapping quantification.
MATERIALS AND METHODS
In this retrospective study, a CNN algorithm was developed to perform deformable registration of lung CT (LungReg) using data on 9118 patients from the COPDGene Study (data collected between 2007 and 2012). Loss function constraints included cross-correlation, displacement field regularization, lobar segmentation overlap, and the Jacobian determinant. LungReg was compared with a standard diffeomorphic registration (SyN) for lobar Dice overlap, percentage voxels with nonpositive Jacobian determinants, and inference runtime using paired tests. Landmark colocalization error (LCE) across 10 patients was compared using a random effects model. Agreement between LungReg and SyN air trapping measurements was assessed using intraclass correlation coefficient. The ability of LungReg versus SyN emphysema and air trapping measurements to predict Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages was compared using area under the receiver operating characteristic curves.
RESULTS
Average performance of LungReg versus SyN showed lobar Dice overlap score of 0.91-0.97 versus 0.89-0.95, respectively ( < .001); percentage voxels with nonpositive Jacobian determinant of 0.04 versus 0.10, respectively ( < .001); inference run time of 0.99 second (graphics processing unit) and 2.27 seconds (central processing unit) versus 418.46 seconds (central processing unit) ( < .001); and LCE of 7.21 mm versus 6.93 mm ( < .001). LungReg and SyN whole-lung and lobar air trapping measurements achieved excellent agreement (intraclass correlation coefficients > 0.98). LungReg versus SyN area under the receiver operating characteristic curves for predicting GOLD stage were not statistically different (range, 0.88-0.95 vs 0.88-0.95, respectively; = .31-.95).
CONCLUSION
CNN-based deformable lung registration is accurate and fully automated, with runtime feasible for clinical lobar air trapping quantification, and has potential to improve diagnosis of small airway diseases. Air Trapping, Convolutional Neural Network, Deformable Registration, Small Airway Disease, CT, Lung, Semisupervised Learning, Unsupervised Learning © RSNA, 2021
PubMed: 35146437
DOI: 10.1148/ryai.2021210211