Recent studies revealed that the high production of reactive oxidative species due to exposure to fine or ultrafine particles are involved in many chronic respiratory disorders. However, the poor standard of clinical data in sub-Saharan countries makes the assessment of our knowledge on the health impacts of air pollution in urban cities very difficult. Objective: The aim of this study was to evaluate the distribution of respiratory disorders associated with exposure to fine and ultrafine air particles through the changes of some oxidative stress biomarkers among motorbike drivers from two cities of Cameroon. Methods: A cross-sectional survey using a standardized questionnaire was conducted in 2019 on 191 motorcycle drivers (MDs) working in Douala and Dschang. Then, the activities of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) were measured using colorimetric methods. The data of participants, after being clustered in Microsoft Excel, were analyzed and statistically compared using SPSS 20 software. Results: The motorbike drivers recruited from both cities were from 21 to 40 years old, with a mean age of 29.93 (±0.82). The distribution of respiratory disorders, such as a runny nose, cold, dry cough, chest discomfort, and breathlessness, was significantly increased among MDs in Douala. According to the results of biological assays, SOD and MDA were significantly greater among the MDs recruited in Douala compared to those of Dschang. The change in these oxidative stress markers was significantly positively correlated with the mobilization of monocytes and negatively correlated with neutrophils, showing the onset and progression of subjacent inflammatory reactions, and it seemed to be significantly influenced by the location MDs lived in. Conclusions: Through this study, we have confirmed the evidence supporting that the onset and progression of oxidative stress is caused by the long-term exposure to fine or ultrafine air particles among working people living in urban cities. Further studies should be conducted to provide evidence for the cellular damage and dysfunction related to the chronic exposure to fine particulate matter (PM) in the air among working people in the metropolitan sub-Saharan Africa context.

UNASSIGNED: Patients with multiple sclerosis (MS) are at higher risk of having infections due to receiving disease modifying therapies. The current study was conducted among Iranian MS patients who had experienced at least one episode of COVID-19 infection in order to evaluate the effects of COVID-19 vaccination on symptoms of their infection. Data on demographic information, MS characteristics, COVID-19 infection details, and vaccination status were collected. Statistical analyses, were performed to evaluate the association between vaccination and symptoms of COVID-19 infection.
UNASSIGNED: This cross-sectional study was conducted on confirmed MS patients. Demographic data and COVID-19 related symptoms were gathered via an online questionnaire. Confirmation of patients\' who declared to be vaccinated was checked by their COVID-19 vaccination card.
UNASSIGNED: A total of 236 MS patients participated in the study. The majority were female (79.7%), with a mean age of 36.1 ± 7.9 years. Among the participants, 72.5% had received the COVID-19 vaccine before their first episode of COVID-19 infection. The analysis showed a significant difference in the incidence of respiratory symptoms (P-value: 0.01) and headache (P-value: 0.04) between vaccinated and non-vaccinated individuals. Logistic regression analysis revealed that vaccinated MS patients had lower odds of developing respiratory symptoms (OR:0.29, 95% CI: 0.16 to 0.53, P-value<0.001) or headache (OR: 0.50, 95% CI: 0.25 to 0.98, P-value: 0.04) during their next COVID-19 infection episode. Moreover, MS patients who were receiving immunosuppressive drugs were less likely to have respiratory symptoms (OR:0.35, 95% CI: 0.16 to 0.77, P-value:0.009) but not headache (OR: 0.69, 95% CI: 0.30 to 1.60, P-value: 0.39).
UNASSIGNED: COVID-19 vaccination can reduce the incidence of respiratory symptoms and headaches in MS patients during COVID-19 infection episodes. Additionally, patients who are receiving immunosuppressive drugs may benefit from COVID-19 vaccination.

Short-term exposure to ground-level ozone (O3) poses significant health risks, particularly respiratory and cardiovascular diseases, and mortality. This study addresses the pressing need for accurate O3 forecasting to mitigate these risks, focusing on South Korea. We introduce Deep Bias Correction (Deep-BC), a novel framework leveraging Convolutional Neural Networks (CNNs), to refine hourly O3 forecasts from the Community Multiscale Air Quality (CMAQ) model. Our approach involves training Deep-BC using data from 2016 to 2019, including CMAQ\'s 72-hour O3 forecasts, 31 meteorological variables from the Weather Research and Forecasting (WRF) model, and previous days\' station measurements of 6 air pollutants. Deep-BC significantly outperforms CMAQ in 2021, reducing biases in O3 forecasts. Furthermore, we utilize Deep-BC\'s daily maximum 8-hour average O3 (MDA8 O3) forecasts as input for the AirQ+ model to assess O3\'s potential impact on mortality across seven major provinces of South Korea: Seoul, Busan, Daegu, Incheon, Daejeon, Ulsan, and Sejong. Short-term O3 exposure is associated with 0.40 % to 0.48 % of natural cause and respiratory deaths and 0.67 % to 0.81 % of cardiovascular deaths. Gender-specific analysis reveals higher mortality rates among men, particularly from respiratory causes. Our findings underscore the critical need for region-specific interventions to address air pollution\'s detrimental effects on public health in South Korea. By providing improved O3 predictions and quantifying its impact on mortality, this research offers valuable insights for formulating targeted strategies to mitigate air pollution\'s adverse effects. Moreover, we highlight the urgency of proactive measures in health policies, emphasizing the significance of accurate forecasting and effective interventions to safeguard public health from the deleterious effects of air pollution.

Previous studies of air pollution and respiratory disease often relied on aggregated or lagged acute respiratory disease outcome measures, such as emergency department (ED) visits or hospitalizations, which may lack temporal and spatial resolution. This study investigated the association between daily air pollution exposure and respiratory symptoms among participants with asthma and chronic obstructive pulmonary disease (COPD), using a unique dataset passively collected by digital sensors monitoring inhaled medication use. The aggregated dataset comprised 456,779 short-acting beta-agonist (SABA) puffs across 3,386 people with asthma or COPD, between 2012 and 2019, across the state of California. Each rescue use was assigned space-time air pollution values of nitrogen dioxide (NO2), fine particulate matter with diameter ≤ 2.5 µm (PM2.5) and ozone (O3), derived from highly spatially resolved air pollution surfaces generated for the state of California. Statistical analyses were conducted using linear mixed models and random forest machine learning. Results indicate that daily air pollution exposure is positively associated with an increase in daily SABA use, for individual pollutants and simultaneous exposure to multiple pollutants. The advanced linear mixed model found that a 10-ppb increase in NO2, a 10 μg m-3 increase in PM2.5, and a 30-ppb increase in O3 were respectively associated with incidence rate ratios of SABA use of 1.025 (95 % CI: 1.013-1.038), 1.054 (95 % CI: 1.041-1.068), and 1.161 (95 % CI: 1.127-1.233), equivalent to a respective 2.5 %, 5.4 % and 16 % increase in SABA puffs over the mean. The random forest machine learning approach showed similar results. This study highlights the potential of digital health sensors to provide valuable insights into the daily health impacts of environmental exposures, offering a novel approach to epidemiological research that goes beyond residential address. Further investigation is warranted to explore potential causal relationships and to inform public health strategies for respiratory disease management.

Background  With the advent of the coronavirus disease 2019 (COVID-19) pandemic, some doubts have been raised regarding the potential respiratory problems that patients who previously underwent a phrenic nerve transfer could have. Objectives  To analyze the effects of the coronavirus infection on two populations, one from Argentina and another from Taiwan. Specific objectives were: (1) to identify the rate of COVID in patients with a history of phrenic nerve transfer for treatment of palsy; (2) to identify the overall symptom profile; (3) to compare Argentinian versus Taiwanese populations; and (4) to determine if any phrenic nerve transfer patients are at particular risk of more severe COVID. Methods  A telephonic survey that included data regarding the number of episodes of acute COVID-19 infection, the symptoms it caused, the presence or absence of potential or life-threatening complications, and the status of COVID-19 vaccination were studied. Intergroup comparisons were conducted using the nonparametric Mann-Whitney U test, with categorical variables conducted using either the Pearson χ2 analysis or the Fisher\'s exact test, as appropriate. Results  A total of 77 patients completed the survey, 40 from Taiwan and 37 from Argentina. Fifty-five (71.4%) developed a diagnosis of COVID. However, among these, only four had any level of dyspnea reported (4/55 = 7.3%), all mild. There were also no admissions to hospital or an intensive care unit, no intubations, and no deaths. All 55 patients isolated themselves at home. Conclusions  It can be concluded that an acute COVID-19 infection was very well tolerated in our patients. (Level of evidence 3b, case reports).

BACKGROUND: People with cystic fibrosis (PwCF) experience frequent symptoms associated with chronic lung disease. A complication of CF is a pulmonary exacerbation (PEx), which is often preceded by an increase in symptoms and a decline in lung function. A symptom cluster is when two or more symptoms co-occur and are related; symptom clusters have contributed meaningful knowledge in other diseases. The purpose of this study is to discover symptom clustering patterns in PwCF during a PEx to illuminate symptom phenotypes and assess differences in recovery from PExs.
METHODS: This study was a secondary, longitudinal analysis (N = 72). Participants at least 10 years of age and being treated with intravenous antibiotics for a CF PEx were enrolled in the United States. Symptoms were collected on treatment days 1-21 using the CF Respiratory Symptom Diary (CFRSD)-Chronic Respiratory Symptom Score (CRISS). K-means clustering was computed on day 1 symptom data to detect clustering patterns. Linear regression and multi-level growth models were performed.
RESULTS: Symptoms significantly clustered based on severity: low symptom (LS)-phenotype (n = 42), high symptom (HS)-phenotype (n = 30). HS-phenotype had worse symptoms and CRISS scores (p< 0.01) than LS-phenotype. HS-phenotype was associated with spending 5 more nights in the hospital annually (p< 0.01) than LS-phenotype. HS-phenotype had worse symptoms over 21 days than LS-phenotype (p< 0.0001).
CONCLUSIONS: Symptoms significantly cluster on day 1 of a CF-PEx. PwCF with HS-phenotype spend more nights in the hospital and are less likely to experience the same resolution in symptoms by the end of PEx treatment than LS-phenotype.

Background Paint industry workers are constantly exposed to paints and organic solvents that contain a substantial quantity of volatile organic compounds (VOCs). Exposure to VOC emissions could result in pulmonary, neurobehavioral, and hematological consequences. Limited studies have been undertaken in India to assess the health consequences of VOCs among paint industry workers in unorganized sectors. Aim To assess the effects of VOCs on pulmonary function in paint industry workers of unorganized sectors. Methodology A hundred and twenty full-time male construction painters and small-scale paint manufacturing workers aged 25-60 were assessed for respiratory symptoms using a questionnaire, and pulmonary functions using Wright\'s Peak Expiratory Flow Meter (PEFR). Participants were randomly selected for VOC assessment and the cumulative solvent exposure index was calculated. A pulmonary function test (PFT) was performed on a subset of construction painters (n=30) using a Koko spirometer. Results The concentration of VOCs such as benzene, ethylbenzene, toluene, and xylene (BETX) and dichloromethane levels exceeded American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit values (TLVs) among the paint manufacturing workers. About 52% of paint workers reported respiratory symptoms. Around 22% of the participants showed reduced pulmonary function (PEFR<400 L/min). There was a significant weak negative correlation between PEFR and work experience (r = -0.2, p=0.03). PFT parameters among a subset of construction painters revealed a significant moderate negative correlation with work experience [forced expiratory volume at the onset of the first second (FEV1) (r = -0.6, p=0.001) and forced vital capacity (FVC) (r = -0.53, p=0.005)] and cumulative VOC exposure index [FEV1 (r = -0.53, p = 0.004) and FVC (r = -0.5, p = 0.008)]. Conclusion The concentration of VOCs was higher among paint industry workers of unorganized sectors and they reported respiratory symptoms and diminished pulmonary function. To reduce morbidity, it is critical to enhance awareness about occupational safety and services in these unorganized sectors.

UNASSIGNED: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission.
UNASSIGNED: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not.
UNASSIGNED: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]).
UNASSIGNED: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

BACKGROUND: Exposure to gases and particulate matter released during volcanic eruptions can prove harmful to population health. This paper reports the preliminary results of the ASHES study, aimed at ascertaining the respiratory health effects of the 2021 volcanic eruption in La Palma Island (Spain) on the adult population without previous respiratory disease.
METHODS: Ambispective cohort study on the healthy adult population. Three exposure groups were considered: Group 1, high exposure; Group 2, moderate exposure; and Group 3, minor or no exposure. We carried out a descriptive analysis of symptoms during and after the eruption, as well as measure lung function after the eruption (through forced spirometry and diffusing capacity of carbon monoxide).
RESULTS: The analysis included 474 subjects: 54 in Group 1, 335 in Group 2, and 85 in Group 3. A significant increase in most symptoms was observed for subjects in the groups exposed during the eruption. After the eruption, this increase remained for some symptoms. There seems to be a dose-response relationship, such that the higher the exposure, the higher the odds ratio. A prebronchodilator FEV1/FVC ratio<70% was observed in 13.0% of subjects in Group 1, 8.6% of subjects in Group 2, and 7.1% of subjects in Group 3.
CONCLUSIONS: This study is the first to report a dose-response relationship between exposure to volcanic eruptions and the presence of symptoms in adults. Furthermore, there is a tendency toward obstructive impairment in individuals with higher exposure.

UNASSIGNED: Gastric adenocarcinoma can present uncommonly. This emphasizes the need for intensified vigilance in the absence of typical gastrointestinal symptoms, particularly in areas where infectious diseases are common.
UNASSIGNED: Gastric adenocarcinoma, a common advanced-age global malignancy is typically associated with abdominal symptoms. However, atypical presentations such as back pain and respiratory distress particularly in younger patients represent diagnostic challenges. We present a case of a late-30s male who presented initially with back pain, shortness of breath, and constitutional symptoms. A diagnosis of tuberculosis was established presumptively with immediate initiation of treatment. Later on, he presented with abdominal pain and intractable vomiting. Oesophagoduodenoscopy (OGD), tissue histology, and immunohistochemistry confirmed a diffuse type gastric adenocarcinoma. He died as a result of complications from an advanced disease. This particular instance emphasizes the importance of maintaining a high index of skepticism even in atypical presentations, as well as the significance of prompt OGD alongside potential genetic testing if any. Gastric adenocarcinoma should be contemplated by clinicians in a variety of clinical scenarios, especially when handling younger patients from settings with limited resources to facilitate timely diagnosis and effective treatment.