Bronchiectasis has traditionally been characterized as a neutrophil-driven disease, yet emerging evidence suggested inflammatory heterogeneities. The prognostic significance of elevated serum immunoglobulin E (IgE) in patients without peripheral eosinophilia remains unclear.

We conducted a multicenter prospective cohort study between 2017 and 2020 across 16 institutions in Taiwan. Individuals with bronchiectasis but without allergic bronchopulmonary aspergillosis were included. Patients were stratified by baseline absolute eosinophil count (cutoff 300 /uL) and serum IgE level (≤ 100, 100-500, > 500 IU/mL). The primary endpoint was severe exacerbations resulting in hospitalization at one year. Secondary endpoints included all-cause mortality, distribution of sputum pathogen, imaging pattern, and lung function.

A total of 579 individuals were enrolled. Nontuberculous mycobacteria (10.7%) and Pseudomonas aeruginosa (9.0%) were the most commonly isolated microorganisms in sputum. 493 patients (85.1%) were categorized as low-eosinophil bronchiectasis, and 41 (7.1%) presented serum IgE levels exceeding 500 IU/mL. The rate of hospitalization for acute exacerbation in such group was pronouncedly higher than in patients with lower IgE levels (9.8% vs. 0.9% and 2.3%; P = 0.009). In multivariate analysis, IgE exceeding 500 IU/mL was the strongest independent predictor of hospitalization (adjusted odds ratio, 7.38; 95% confidence interval, 2.40-22.7; P < 0.001). The association was particularly pronounced in female and patients with coexisting asthma. All-cause mortality did not differ significantly among IgE strata.

Markedly elevated serum IgE independently predicted severe exacerbations resulting in hospitalization in patients with non-eosinophilic bronchiectasis, identifying a high-risk subgroup that may benefit from targeted immunomodulatory therapies.

The Prospective Respiratory Outcomes from Tracking and Evaluating Community-based TeSting study is a 2-year community-based, prospective cohort launched in 2024. The overall aim of the study is to better understand the burden and impact of acute and postacute COVID-19, influenza and respiratory syncytial virus (RSV) infections across the USA. Our key objectives are to measure the incidence and symptom burden of major respiratory viruses using home testing, measure incidence and risk factors for postacute symptoms of major respiratory viruses and investigate the impact of antivirals and vaccinations on acute and postacute symptoms of respiratory viruses.

Enrolment began in June 2024 using internet-based strategies. Eligible participants were adults aged ≥18 years who were US residents, English language proficient and had no known SARS-CoV-2, RSV or influenza infections in the 3 months before screening. We prioritised enrolment of individuals who were at high risk for severe SARS-CoV-2 outcomes. After enrolment, participants were prompted to report the presence or absence of respiratory symptoms weekly. When respiratory symptoms occurred, participants completed serial at-home multipathogen rapid antigen tests for SARS-CoV-2, RSV, influenza A and influenza B viruses, and daily symptom reporting, including timing and severity. A subset of participants provided self-collected nasopharyngeal and saliva samples for PCR testing. Following a positive test and acute symptom reporting for up to 29 days, participants were followed monthly for 6 months to capture postacute symptoms.

As of March 2025, 6206 people were enrolled in the cohort. The majority of the participants were over 50 years of age (61.4%), women (66.8%) and non-Hispanic white (75.2%), with a notable proportion having a college or postgraduate degree (68.4%) and an annual household income of >US$100 000 (40.7%). All 50 US states, the District of Columbia and Puerto Rico were represented in the cohort. Half of participants (51.8%) had received a COVID-19 vaccine in the year prior to enrolment, and 19.5% who had reported at least one SARS-CoV-2 infection had a history of antiviral use. A majority of the cohort (95.6%) had at least one underlying medical condition or risk factor for severe COVID-19. Nine-month retention (93.7%) and adherence to the study protocol among participants was high. As of 18 April 2025, 4537/6206 (73.1%) participants had reported respiratory symptoms within 10 days of onset, with a median time to report of 2 days after onset, and 3814/4537 (84.1%) conducting at least one valid rapid test. Of these 3814 participants, 489 (12.8%) had tested positive for SARS-CoV-2, 324 (8.5%) for influenza A, 22 (0.6%) for influenza B and 113 (2.9%) for RSV by study rapid or PCR tests.

We enrolled a large, diverse cohort with a high proportion at risk for severe COVID-19. We have collected over 3000 person-years of data on symptoms, outcomes and risk factors for three major respiratory infections, with high participant retention and engagement through 9 months of data collection. Research priorities include characterising acute and postacute symptoms of major respiratory illnesses and assessing the impact of antivirals and vaccination on the development of severe symptoms.

Bronchial artery embolization (BAE) is preferred for massive hemoptysis. However, the suboptimal short-term and long-term therapeutic outcomes have necessitated the initiation of this study. The aim of this study was to identify risk factors that influence the recurrence of massive hemoptysis after BAE and determine active prevention and control measures to reduce recurrence.

Between January 2019 and November 2024, a total of 162 patients with massive hemoptysis underwent BAE, of whom 47 required re-embolization due to recurrence. Baseline data of patients, technical success, clinical success, recurrence, complications, and other relevant information were collected from outpatient and inpatient medical records and subsequently analyzed. The Cox regression analysis and Forest map were employed to analyze the risk factors associated with recurrence of massive hemoptysis after BAE.

Findings suggested that the technical success rate was (160/162) 98.76% and clinical success rate was (115/162) 70.99% during the 12-month follow-up. Mean recurrence-free time was 26 ± 3.43 days (95% CI: 19.28-32.72) among 47 patients who experienced recurrence following BAE. Multivariate Cox regression analysis showed that the risk factors for early recurrence of hemoptysis following BAE were the extent of destroyed lung (OR = 0.562 [95% CI: 0.325-0.973], p = 0.04), whether preoperative computed tomography angiography (CTA) (OR = 0.204 [95% CI: 0.083-0.499], p = 0.001), or technical factors (OR = 4.621 [95% CI: 1.936-11.028], p = 0.001), while the risk factor for late recurrence was the progression of underlying diseases (OR = 6.071 [95% CI: 1.968-18.731], p = 0.002). However, the overall risk factors for recurrent hemoptysis after BAE included the extent of destroyed lung (OR = 0.606 [95% CI: 0.404-0.91], p = 0.016), whether preoperative CTA (OR = 0.49 [95% CI: 0.266-0.905], p = 0.023), technical factors (OR = 2.176 [95% CI: 1.089-4.348], p = 0.028), and the progression of underlying diseases (OR = 1.958 [95% CI: 1.047-3.662], p = 0.035. There were no major complications related to BAE requiring immediate treatment, and only minor complications were observed.

This study preliminarily concludes that the extent of destroyed lung, whether preoperative CTA, technical factors, and the progression of underlying diseases are independent risk factors associated with hemoptysis recurrence after BAE. Through comprehensive preoperative assessments, individualized embolization strategies, and proactive postoperative management of underlying diseases, the risk of recurrent hemoptysis can be significantly reduced.

Lung ultrasound (LUS) is increasingly utilized for diagnosing pediatric pneumonia due to its bedside accessibility, radiation-free nature, and high diagnostic sensitivity. However, broader clinical adoption remains hindered by operator dependency, inconsistent interpretation, and training challenges, particularly among trainees and less-experienced health care providers. Currently, there is an unmet need for practical tools that help trainees reliably detect pneumonia-related ultrasound findings. In this technical innovation study, we evaluated a semi-automated, artificial intelligence (AI)-assisted system designed to identify clinically relevant lung abnormalities, including pleural line thickening, consolidation morphology, and B-line patterns. Our computerized analysis demonstrated the system's technical capability to accurately detect these structural changes with minimal user interaction. Although our primary aim was to assess diagnostic feasibility, the intuitive nature and real-time visual annotations provided by this AI tool highlight its strong potential for future integration into educational contexts. By visually assisting trainees in recognizing key sonographic features, this technology can facilitate learning, improve detection skills, and effectively support the training of health care providers performing pediatric LUS.

Nursing home (NH) residents have a high burden of multimorbidity and disability and are frequently hospitalized. Comprehensive geriatric assessment might reduce hospitalization. However, few geriatricians are working in NHs. Technology might be used to overcome this problem.

This study aims to verify if a geriatric telemanagement model improves patient outcomes in NH residents recently discharged from the hospital.

Clinical outcomes of NH residents recently discharged from the hospital are compared before and after the implementation of GTM, where a geriatrician evaluates each patient during televisits with NH staff and discusses the case with the general practitioner. NH residents aged ≥70 years readmitted to NHs after hospitalization in the 3 years prior to the COVID-19 pandemic (2017-2019) represent the control group enrolled in the retrospective preintervention phase. The primary outcome of the study is the hospital readmission rate during 6-month follow-up. Health technology assessment evaluates the cost-effectiveness of model implementation.

A total of 333 NH residents were included in the preintervention retrospective study. Data collection started in February 2022 and was completed in February 2023. A total of 104 NH residents were recruited in the intervention study, from March 2024 to March 2025. Data analysis is currently in progress.

Currently, NHs in Italy are striving to manage the complexity of older patients who are often hospitalized. A geriatric telemanagement model might reduce hospitalizations, and therefore negative outcomes, as well as health care costs in this vulnerable population.

Everyday digital technologies such as social media, gaming, and internet use are deeply integrated into the lives of children, adolescents, and young adults. While these platforms can foster connection, learning, and entertainment, concerns have grown about their potential to influence mental, physical, and social well-being. Research on this topic has expanded rapidly over the past decade, yet much of it remains cross-sectional, limiting insights into long-term outcomes. Longitudinal studies are essential to capture evolving patterns of digital engagement, identify causal relationships, and guide effective policies and interventions that support youth in navigating digital environments. In particular, evidence is needed to distinguish between beneficial and harmful forms of digital engagement, such as social connection versus problematic use, and to understand how these impacts differ across diverse populations and contexts. The COVID-19 pandemic further accelerated young people's technology use, underscoring the urgency of examining both risks and opportunities. This review, therefore, synthesizes longitudinal research to map trends, identify knowledge gaps, and inform future directions.

The study aimed to systematically identify and map longitudinal studies examining associations between everyday digital technology use (eg, social media, gaming, and internet use) and the health and well-being of youth (25 years or younger) and to chart the types of evidence available by technology category, outcomes, and geographical setting in order to highlight key gaps for future research.

A systematic search of PubMed, Embase, and PsycArticles (2014-2024) was conducted and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Data extraction covered demographics, digital technology categories, and health outcomes. Studies were grouped into 6 key themes: social media use and mental health, digital addiction and behavioral outcomes, physical activity and digital technology, digital health technologies and cognitive development, parental influence and digital technology, and digital well-being and risk behaviors.

Of the 456 studies identified, 267 were longitudinal studies relevant to our research aims. Internet use (n=201 studies), social media (n=140 studies), and gaming (n=83 studies) dominated the themes. Mental health was the most frequently assessed outcome, with a focus on anxiety and depression. Geographically, 15% (40/267) of studies originated from low- and middle-income countries, with the majority from high-income settings such as the United States (n=76 studies) and Australia (n=15 studies). Nearly half (131/267, 49%) were published post 2020, reflecting heightened interest during the COVID-19 pandemic.

Longitudinal evidence on everyday digital technology use and youth health is growing but remains concentrated in mental health outcomes and high-income settings, with notable gaps in physical health, educational outcomes, and equity-focused research. These findings highlight the need for more diverse, methodologically robust longitudinal studies to inform context-sensitive policies and interventions that balance the risks and benefits of digital engagement for young people.

The COVID-19 pandemic prompted an abrupt transition to telemedicine for HIV care, necessitating the exploration of provider attitudes and experiences to understand its ongoing viability and impact.

This study aimed to assess providers' attitudes toward and experiences with telemedicine at HIV clinics in the Chicago area during the COVID-19 pandemic at 2 time points and at 2 clinical sites.

We conducted a convergent mixed methods study to evaluate and explore providers' attitudes toward and experiences with telemedicine at HIV clinics in the Chicago area during the COVID-19 pandemic, applying the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the updated Consolidated Framework for Implementation Research. This study assessed HIV providers via surveys at 2 time points, capturing responses on the acceptability, appropriateness, feasibility, and maintenance of telemedicine. Semistructured key informant interviews were conducted on a random selection of 10 participants to explore perceived experiences with telemedicine.

Among emailed providers, 43 of 83 (51.8%) and 27 of 82 (32.9%) responded to survey 1 and survey 2, respectively. The first survey recorded telemedicine usage at 75%, which decreased to 58% by the second survey. Overall, the majority of respondents agreed with statements that assessed telemedicine as appropriate, acceptable, and feasible. There were overall few statistical differences in responses between sites, although more providers at the community site indicated at least some potential value in telemedicine when compared to providers at the university hospital (100% agree or strongly agree vs 82.3%; P=.04) in survey 1. In survey 1, providers with more than 10 years of experience were less likely to report telemedicine helped them see more patients (31.6% agree or strongly agree vs 70.6% for providers with ≤10 y of experience; P=.008). Fewer experienced providers felt they could talk about private issues with their patients during telemedicine (57.9% of more experienced vs 88.3% of less experienced providers; P=.03). Key informant interviews provided qualitative insights into telemedicine integration, revealing mixed sentiments; providers appreciated the flexibility and accessibility that telemedicine offered but preferred in-person visits for their thoroughness, especially for physical examinations and laboratory tests. Despite initial barriers such as technical challenges and patient preferences for in-person visits, telemedicine was deemed feasible for maintaining communication and care quality. Providers highlighted the need for better technological support and ongoing training to optimize telemedicine usage.

Our study underscores telemedicine as a sustainable adjunct to traditional HIV care, emphasizing the importance of addressing technological and training barriers to enhance its efficacy.

The 2024 National Strategy for Suicide Prevention identifies suicide as "an urgent and growing public health crisis" driven partly by mental health and overdose rates, the COVID-19 pandemic, and declining social connectedness. Yet, data constraints have limited long-term investigations of suicide trends. Acknowledging limits in data sequence continuity, we constructed the Suicide Trends and Archival Comparative Knowledgebase (STACK), harmonizing data from 1900-2021. Coupling visualizations with Joinpoint regressions, we examine the contemporary suicide crisis in historical perspective. Data reveal patterns that both support and challenge prevailing understandings of suicide risk, trends, and drivers. Overall, we document a cyclical, dampening, and downward-trending pattern of suicide over 120 y, contrasting sharply with trends in other causes of death. However, this trend is offset by a sharp rise and unique patterning for persons under 35, beginning in the mid-to-late 1950s. The contemporary "youth crisis" spans a broader age range and begins much earlier than typically acknowledged. Each successive generation faces risk at younger ages, accompanied by a startling rise in suicide by hanging since the 1980s among both males and females. Despite ongoing concerns about rural populations and the elderly, living in large metropolitan areas (versus suburban and rural areas) and being older have recently emerged as protective factors. While analyses by race or rurality remain limited to the last half century because of data availability, the long-term temporal, geographic, and sociodemographic complexity of suicide mortality trends offers critical insights and intriguing avenues for next-generation research, treatment, and prevention efforts.

ObjectiveTo evaluate the technical performance and patient-ventilator synchronization of different invasive mechanical ventilators.MethodsSix ventilators were tested using the ASL5000 active lung simulator. Ventilators were categorized by air supply type: central (Dräger V600, Maquet Servo-u, Mindray SV800) and turbine-based (Savina 300, SV300, Resvent RS300). The measured parameters included tidal volume (VT), plateau pressure (Pplat), positive end-expiratory pressure (PEEP), peak pressure (Ppeak), time to reach 90% of inspiratory pressure (T (90%)), triggering delay (DT), and leak compensation. Ventilators were evaluated in volume assist-control (V-A/C), pressure assist-control (P-A/C), and pressure support ventilation (PSV) modes under acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD) conditions using ASL5000™ lung simulator, with or without intentional leak (4.4 L/min). For each ventilator under these different conditions, we analyzed pressurization accuracy, VT accuracy, inspiratory muscle effort, and response efficiency.ResultsThe pressurization accuracy of ventilators with central air supply did not differ significantly from that of turbine-driven ventilators during V-A/C and P-A/C ventilation, irrespective of spontaneous breathing or air leakage. The mean absolute errors of target VT were 8.9% (V600), 10.3% (Servo-U), 14.4% (SV800), 4.6% (Savina300), 18.8% (SV300), and 19.9% (RS300), and ventilators with central air supply generally have better VT accuracy, except for Savina300 (P<0.05). In V-A/C with different triggers and leaks, Savina 300 showed comparable stability and accuracy to central air supply ventilators in the ARDS lung model. Significant differences in VT accuracy and PEEP were observed among ventilators (P<0.05). During PSV, V600 and Servo-u exhibited shorter response efficiency than SV800 under identical simulated patient effort (P<0.05), suggesting faster and easier patient support.ConclusionsThe Savina 300 alone matched or exceeded central air supply models in pressurization and VT accuracy. In terms of inspiratory trigger performance, the V600 and Servo-u demonstrated better patient-ventilator synchrony than the SV800 under PSV mode.

Pulmonary rehabilitation (PR) is a cornerstone for the management of chronic obstructive pulmonary disease (COPD), yet global uptake remains low due to geographic and resource barriers. Digital health technologies, specifically smartphone apps, offer a promising platform for delivering accessible home-based PR. In addition, music-assisted interventions not only offer unique physiological and psychological benefits but may also serve as an innovative approach to enhancing patient engagement and improving the effectiveness of rehabilitation in home settings.

This study aimed to evaluate the effectiveness of a smartphone app-based, music-facilitated multicomponent PR program (integrating rhythm-guided walking [RW] and singing) for improving exercise capacity and other clinical outcomes in patients with COPD compared with usual care (UC).

This 3-arm, parallel-group, multicenter randomized controlled trial included 70 participants in China. Participants were randomized into a multimodule training (MT) group, which included a multicomponent PR program integrating RW and singing training (n=25); a RW group, which included RW training (n=23); or a UC group (n=22). The MT and RW groups received 12-week asynchronous home-based training via a smartphone app, and all arms received structured patient education. The primary outcome was the distance achieved in the incremental shuttle walking test (ISWT) at 12 weeks. The secondary outcomes included dyspnea, quality of life, and pulmonary function.

The modified intention-to-treat principle was used to analyze the 70 study patients. At 12 weeks, the ISWT distance was significantly greater in the MT group than in the UC group (mean difference [MD] 56.35 m, 95% CI 6.66-106.04 m; P=.03; Cohen d=0.30). Significant improvements were observed in the MT group compared with the UC group in the modified Medical Research Council dyspnea scale (mMRC) score (MD -0.44, 95% CI -0.80 to -0.08; P=.02), COPD Assessment Test score (MD -3.23, 95% CI -6.18 to -0.29; P=.03), Hospital Anxiety and Depression Scale-anxiety subscale score (MD -2.31, 95% CI -3.99 to -0.63; P=.008), and inspiratory capacity (MD 15.98% predicted, 95% CI 4.76 to 27.21; P=.01). However, no significant differences were found between the RW and UC groups in primary or secondary outcomes. Compared with RW, MT was significantly better at decreasing the mMRC score (P=.03).

The findings of this study demonstrate that our smartphone app-based music-facilitated multicomponent PR program (including tempo-guided walking and singing) caused clinically meaningful improvements in exercise capacity among patients with COPD compared to UC. Moreover, secondary outcomes, including dyspnea, quality of life, psychological status, and inspiratory capacity, showed better improvements with MT than with UC.