Two-week heart rate variability measurements and lung health: a cross-sectional analysis in the ARIC Study.

Background: Heart rate variability (HRV) is a measure of autonomic function that has been associated with worse lung function and worse respiratory health. Using data from a community-based cohort, we aimed to test if HRV is associated with lung function and self-reported chronic lung disease (CLD).

Methods: The Atherosclerosis Risk in Communities (ARIC) study is a community-based cohort that collected HRV measurements from 14-day continuous ECG patches and self-reported CLD at visit 6 (2016-2017).

Trends over Time in Practice and Outcomes of Lung Transplantation in Recipients with Human Immunodeficiency Virus.

Background: People with human immunodeficiency virus (HIV) are at an increased risk for end-stage lung disease, for which lung transplantation (LT) may be necessary.

Methods: We aimed to characterize the national practice patterns of LT in recipients with HIV (HIV R+) and post-LT outcomes, including rejection in the US over time. Using the Scientific Registry of Transplant Recipients data (from January 1, 2004, to December 1, 2024, for practice patterns and from January 1, 2016, to December 1, 2024, for outcomes), we compared 96 adult HIV R+ to 42 341 LT recipients without HIV (HIV R-).

X-ray velocimetry provides temporally and spatially-resolved biomarkers of lung ventilation in small airways disease.

Background: Small airways disease is a feature of many respiratory conditions. Currently available methods of diagnosing small airways lack sensitivity and/or cannot evaluate spatial heterogeneity. New diagnostic strategies for diagnosing small airways disease are needed.

Calibration of indoor temperature and relative humidity readings in the PurpleAir monitor.

Temperature extremes are associated with a variety of negative health outcomes, but since people living in developed areas of the world spend most of their time indoors, outdoor temperatures are a poor substitute for personal exposure assessment. And the importance of accurate indoor temperature measurement has only become more apparent alongside the growing impact of climate change on the frequency and intensity of temperature extremes on public health. The development and implementation of low-cost sensors have improved economic and practical feasibility of in-home exposure assessment for temperature and a variety of indoor contaminants.

Physical Activity, Cigarette Smoking, and Depression Among People with HIV.

People with HIV (PWH) smoke cigarettes 2-3 times more and are 3 times more likely to have clinical depression relative to the general population. Physical activity (PA) can aid in smoking cessation and reduce depression in the general population; the role of PA for smoking cessation among PWH is unknown. Data collected between October 2021-September 2022 from the Multicenter AIDS Cohort Study (MACS)/Women Interagency HIV Study (WIHS) Combined Cohort Study (MWCCS) were analyzed using logistic regression and structural equation modeling to examine associations between cigarette smoking, PA and depression.

Brief Report: The Implications of Removing Race From Interpretation of Pulmonary Function Among Persons With or Without HIV.

Background: Studies suggest that the use of race-specific pulmonary function reference equations may obscure racial inequities in respiratory health. Whether removing race from the interpretation of pulmonary function would influence analyses of HIV and pulmonary function is unknown.

Setting: Pulmonary function measurements from 1067 men (591 with HIV) in the Multicenter AIDS Cohort Study and 1661 women (1175 with HIV) in the Women's Interagency HIV Study were analyzed.

Perceived Stress is Associated with Health Outcomes, Platelet Activation, and Oxidative Stress in COPD.

Background: Individuals with chronic obstructive pulmonary disease (COPD) are disproportionately affected by social determinants of health that have been associated with worse respiratory outcomes. This study evaluates the association of perceived stress with respiratory outcomes and distinct biological mechanisms among former smokers with COPD.

Methods: Participants were assessed in an observational study at baseline, 3-months, and 6-months.

Iron Deficiency and All-Cause Hospitalization Risk in a Clinical Cohort of COPD.

Background: The impact of iron deficiency on COPD morbidity independent of anemia status is unknown. Understanding the association between iron deficiency, anemia status, and risk of hospitalization in COPD may inform an approach to these comorbidities.

Study Design And Methods: Adults ≥40 years from the Johns Hopkins COPD Precision Medicine Center of Excellence data repository with an outpatient iron profile and 1 year of subsequent follow-up time were included in the study.

Longitudinal anemia status and risk for adverse outcomes in former smokers with COPD.

Background: Anemia is a prevalent comorbidity in COPD associated with increased morbidity. However, the significance of longitudinal anemia status and variation in anemia status trends over time in COPD are not known. Furthermore, individuals with COPD and smoking history often have multiple comorbidities, in particular cardiovascular disease.

Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease: The Framingham Offspring Study.

Objective: Insulin resistance (IR) may be a risk factor for lung disease, but objective evidence is limited. We sought to define the relationship of longitudinal IR with radiographic imaging outcomes and examiner-identified incident lung disease in the Framingham Offspring Study.

Research Design And Methods: Participants without baseline lung disease underwent repeated measurements of fasting insulin and glucose levels over an average period of 13.

Cleaning indoor air-what works for respiratory health: An updated literature review and recommendations.

Indoor air pollution is a growing public health concern globally and is associated with increased respiratory symptoms and morbidity. Individuals spend most of their time indoors, and pollutant-related health effects are often driven by the indoor environment. Understanding effective interventions to improve indoor air quality and their impact on respiratory outcomes is key to decreasing the burden of air pollution for high-risk populations across the life-span.

Changes in Spirometry Interpretative Strategies: Implications for Classifying COPD and Predicting Exacerbations.

Background: Recent guidelines for spirometry interpretation recommend both race-neutral reference equations and use of z score thresholds to define severity of airflow obstruction.

Research Question: How does the transition from race-specific to race-neutral equations impact severity classifications for patients with COPD when using % predicted vs z score thresholds, and do changes in severity correspond to clinical risk?

Study Design And Methods: This retrospective cohort study included Black and White patients with COPD and available spirometry from the Johns Hopkins Health System. Global Lung Function Initiative (GLI) 2012 (race-specific) equations and GLI Global (race-neutral) equations were used to determine FEV % predicted and z score values.

Indoor particulate matter concentrations and air cleaner intervention association with biomarkers in former smokers with COPD.

Background: Indoor pollutants have been associated with worse clinical outcomes in chronic obstructive pulmonary disease (COPD). Elevated biomarkers are associated with ambient pollution exposure, however the association with indoor pollution remains unclear.

Methods: Former smokers with spirometry-confirmed COPD were randomized to portable air cleaner or placebo.

Evaluation of Calibration Approaches for Indoor Deployments of PurpleAir Monitors.

Low-cost air quality monitors are growing in popularity among both researchers and community members to understand variability in pollutant concentrations. Several studies have produced calibration approaches for these sensors for ambient air. These calibrations have been shown to depend primarily on relative humidity, particle size distribution, and particle composition, which may be different in indoor environments.

Decreased Cardiac Autonomic Function is Associated with Higher Exacerbation Risk and Symptom Burden in Chronic Obstructive Pulmonary Disease.

Current measures of chronic obstructive pulmonary disease (COPD) severity, including lung function, do not fully explain symptom burden, and there is a need to identify predictors of exacerbation risk and morbidity. Autonomic dysfunction may be implicated in both cardiovascular and respiratory morbidity in COPD and convey risk for exacerbations. Heart rate variability (HRV) is a marker of cardiac autonomic function that is predictive of cardiovascular health and has promise as a non-invasive COPD biomarker.

Urine and Plasma Markers of Platelet Activation and Respiratory Symptoms in COPD.

Introduction: Antiplatelet therapy has been associated with fewer exacerbations and reduced respiratory symptoms in chronic obstructive pulmonary disease (COPD). Whether platelet activation is associated with respiratory symptoms in COPD is unknown.

Methods: Former smokers with spirometry-confirmed COPD had urine 11-dehydro-thromboxane B2 (11dTxB2), plasma soluble CD40L (sCD40L), and soluble P-selectin (sP-selectin) repeatedly measured during a 6- to 9-month study period.

Indoor Air Pollution and Impaired Cardiac Autonomic Function in Chronic Obstructive Pulmonary Disease.

Indoor air pollution represents a modifiable risk factor for respiratory morbidity in chronic obstructive pulmonary disease (COPD). The effects of indoor air pollution, as well as the impact of interventions to improve indoor air quality, on cardiovascular morbidity in COPD remain unknown. To determine the association between indoor particulate matter (PM) and heart rate variability (HRV), a measure of cardiac autonomic function tied to cardiovascular morbidity and mortality, as well as the impact of household air purifiers on HRV.

Cognitive Dysfunction, Psychiatric Distress, and Functional Decline After COVID-19.

Background: There is a limited understanding of the cognitive and psychiatric sequelae of COVID-19 during the post-acute phase, particularly among racially and ethnically diverse patients.

Objective: We sought to prospectively characterize cognition, mental health symptoms, and functioning approximately four months after an initial diagnosis of COVID-19 in a racially and ethnically diverse group of patients.

Methods: Approximately four months after COVID-19 diagnosis, patients in the Johns Hopkins Post-Acute COVID-19 Team Pulmonary Clinic underwent a clinical telephone-based assessment of cognition, depression, anxiety, trauma, and function.