Thank you for tuning in to the Editor’s Highlight Podcast for the August 2026 issue of the journal 糖心原创®. There is a great lineup of diverse content in this month’s issue.
Over the next 15 minutes, I will provide a brief overview of key manuscripts published in each of our content areas.
First is our Asthma section. The long-term association of meconium aspiration with asthma is unknown. In this issue, Gatt and colleagues report findings from a retrospective cohort study of 326,940 eligible children who were followed from birth through six years of age, designed to determine if meconium aspiration syndrome (MAS) is associated with subsequent development of preschool asthma. Of the children, 730 had a diagnosis of MAS. MAS was associated with a 64% increase in asthma up to six years of age. Bronchiolitis and OSA were also more frequent among survivors of MAS, while atopic conditions (dermatitis, rhinitis, food allergies) did not differ significantly between groups. These findings show that MAS is associated with increased risks of asthma and bronchiolitis in early childhood. Completing this section is a research letter about the implications of Medicaid national work requirements on asthma morbidity.
Our Chest Infections content area is next. Burnout is common among health care professionals. It is unclear if team-based care, common in chronic respiratory conditions such as cystic fibrosis (CF), is protective. In this issue, Quittner and colleagues share results of a survey of a single-center CF health care team, designed to assess the risk of burnout among multidisciplinary CF care teams by profession. Providers reported moderate compassion satisfaction and low personal accomplishment with low-moderate burnout and moderate emotional exhaustion and depersonalization. Differences in burnout rates and manifestations differed by profession, sex, and length of service. Top contributors to burnout included administrative tasks, excessive documentation, insufficient staffing, insufficient time with patients, and excessive responsibility. One-half of mental health providers had sought professional help, as had one-third of physicians. These findings suggest that despite well-established team-based models of pulmonary care, burnout is substantial, with physicians at highest risk, highlighting the need for individual and system-level initiatives. Also in this section is a prospective multicenter study assessing the association of admission eosinophil count with hospital resource utilization in community-acquired pneumonia and a research letter that describes an association between cystic fibrosis transmembrane conductance regulator mutations and increased rates of pulmonary infections. Completing this section is a How I Do It review of pulmonary aspergilloma and its clinical management and a Point/Counterpoint debate on the clinical utility of monitoring drug levels in the management of patients with nontuberculous mycobacterial lung disease.
Our COPD section is next. Acute exacerbation of COPD (AE-COPD) is associated with increased cardiovascular risk. It is unclear if this risk differs between eosinophilic and noneosinophilic exacerbations. In this issue, Lin and colleagues report findings from a retrospective cohort study of 143,517 patients within the TriNetX Analytics Network, designed to determine if eosinophilic AE-COPD is associated with a lower risk of major adverse cardiovascular events (MACEs). After matching, noneosinophilic AE-COPD was associated with a higher risk of MACEs compared with eosinophilic AE-COPD (HR, 1.22). Eosinophilic AE-COPD was also associated with reduced risks for heart failure, acute myocardial infarction, cerebrovascular accident, arrhythmia, and all-cause mortality. These findings suggest that blood eosinophil count at the time of exacerbation may serve as a biomarker for stratifying long-term cardiovascular risk in COPD. Also in this section is an evaluation of the association between progression of centrilobular emphysema on chest imaging and progression of coronary artery calcification, as well as a case-control analysis of liver transplantation and the rate of lung function decline in severe α1-antitrypsin deficiency.
Next is our Critical Care content area. The impact of timely antibiotic delivery and fluid resuscitation on discharge to home after sepsis is unclear. In this issue, Prescott and colleagues report findings from an observational cohort study of 38,568 adults with sepsis from 67 hospitals in the Michigan Hospital Medicine Safety Consortium Sepsis Initiative, designed to answer this question. In the cohort, 20.6% died in hospital or were discharged to hospice, 25.8% were discharged to a postacute care facility, and 53.6% were discharged to home. Timely antibiotic administration occurred in 75.3% and timely fluid resuscitation occurred in 49.5%. They were associated with a 3% and 1.1% absolute increase in discharge to home, respectively. These findings suggest that timely treatment of sepsis may reduce downstream morbidity and health care expenditures. Completing this section is an original research study that assessed whether diaphragm thickening fraction could predict esophageal pressure or ventilator weaning in children.
On to our Diffuse Lung Disease section. The relationship between disease severity, symptoms, and anxiety and depression in people with idiopathic pulmonary fibrosis (IPF) is unclear. In this issue, Wu and colleagues report findings from a prospective observational study of 269 people with IPF, surveyed over 12 months of follow-up. The study was designed to determine the prevalence and severity of anxiety and depression in people with IPF and their association with symptoms and disease severity. At baseline, based on the Hospital Anxiety and Depression Scale (HADS), the prevalence of anxiety and depression was 27.5% and 28.2%, respectively. Baseline Dyspnea-12 and poorer Living with IPF energy were independently associated with anxiety and depression, while baseline lung function was not. At follow-up, younger age, higher Dyspnea-12 scores, and poorer energy were associated with greater increases in anxiety. Changes in FVC % predicted did not correlate with HADS. These results indicate that anxiety and depression are common in people with IPF and are associated with more dyspnea and lower energy, providing targets for symptom management. Also in this section is an analysis of pulmonary fibrosis in pediatric interstitial lung disease (ILD), a report of clinical profiles and lung function trajectories in people with idiopathic inflammatory myopathy-ILD, and a systematic review of participant sex, race, and ethnicity reporting in ILD clinical trials.
Next is our Education and Clinical Practice content area. Risk factors for swimming-induced pulmonary edema (SIPE) are incompletely understood. In this issue, Kristiansson and colleagues report findings from a case-control study conducted during Sweden’s largest open water swimming event, designed to determine which individual risk factors are associated with SIPE. Two hundred fifty-eight people with SIPE and 2,117 controls were included. Female sex, higher age, hypertension, heart disease, asthma, and low frequency of open water swimming during the current season were independently associated with SIPE. In a separate model, previous respiratory symptoms during open water swimming and an acute respiratory tract infection were also strongly associated with SIPE. These findings confirm previously identified risk factors for SIPE, while also identifying asthma and limited experience in open water swimming as possible risk factors. Also in this section is a research letter that explores pulmonary dynamics of the bronchodilator response in volume-responsive asthma and COPD and another that evaluates the transition from race-specific to race-neutral lung function equations in children with a history of preterm lung disease.
Our Pulmonary Vascular content area is next. Distinguishing whether pulmonary hypertension (PH) in people with connective tissue disease-related interstitial lung disease (CTD-ILD) is driven by parenchymal or vascular processes may have important clinical implications. In this issue, Khan and colleagues report CT scan findings from 275 adult patients with CTD-ILD and PH from Johns Hopkins to determine if chest imaging can be used to classify patients with CTD-ILD and PH systematically as having a parenchymal or vascular PH phenotype. Patients with CTD-ILD and a parenchymal PH phenotype were more likely to experience clinical worsening, physiologic worsening, hospitalization, and lung transplant or death. CT imaging-based PH phenotypes were more closely associated with outcomes than the World Symposium on PH group classifications. These findings show that CT imaging can classify PH phenotypes, which may help predict the risk of clinical worsening. Also in this section is an original research article that evaluated the effect of a sea-level stay on pulmonary hemodynamics in people with pulmonary arterial hypertension living at high altitude and a research letter that evaluates the clinical relevance of unclassified pulmonary hypertension. Completing this section is a How I Do It review of how to care for people with methamphetamine-associated PAH.
Next is our Sleep Medicine content area. The relationship between OSA and coronary collateral development and their impact on acute coronary syndrome (ACS) event severity is unclear. In this issue, Dodani and colleagues report findings from a post hoc analysis of 185 participants from the Impact of Sleep Apnea in the Evolution of Acute Coronary Syndrome: Effect on Intervention With CPAP trial, of whom 79.5% had OSA. The study was designed to determine the relationship between OSA and coronary collateral development and their combined impact on ACS severity. OSA was associated with greater odds of well-developed collaterals (aOR, 2.84) with a dose-response increase across OSA severity categories. The presence of robust collaterals was associated with significantly lower peak creatine kinase and cardiac troponin I levels during the ACS episode but not with improved left ventricular ejection fraction. These findings show that in patients with first-time ACS, OSA is associated with a higher prevalence of well-developed coronary collaterals, which are associated with less myocardial injury during ACS, supporting the hypothesis that OSA may promote adaptive vascular remodeling. Also in this section is a prospective cohort study that evaluates the impact of long-term PM2.5 constituent exposure and genetic susceptibility on incident sleep apnea. Completing this section is a guideline on the diagnosis of OSA in children from the Canadian Thoracic Society.
Next is our Thoracic Oncology content area. The comparative outcomes of cone beam CT imaging-guided bronchoscopic biopsy (CBCT-GB) and CT imaging-guided transthoracic needle biopsy (CT-TTNB) for the diagnosis of peripheral pulmonary lesions are not known. In this issue, Patel and colleagues report findings from a single-center, retrospective, comparative cohort study of the diagnostic accuracy and safety of CBCT-GB and CT-TTNB in 895 people with peripheral pulmonary lesions. A diagnostic result was produced in 90.7% in the CBCT-GB group and 92.6% in the CT-TTNB group. Complications occurred in 4.3% in the CBCT-GB and 41.6% in the CT-TTNB groups, including pneumothorax rates of 1.8% and 31.4%, respectively, and severe bleeding or cardiorespiratory failure in 3.3% and 6.0%, respectively. Of those meeting criteria, 86.5% in the CBCT-GB group had mediastinal staging completed during the procedure. These results show comparable 24-month diagnostic accuracy between CBCT-GB and CT-TTNB, with improved safety and concurrent mediastinal lymph node staging. Also in this section is a cohort study that evaluated the association of new and growing nodules with malignancy, as well as an analysis of the sensitivity of the 2021 US Preventive Services Task Force lung cancer screening criteria from three cohort studies. Completing this section is a Special Features review of the Quality Implementation of Lung Cancer Screening System—a system to support high-quality delivery of lung cancer screening in diverse settings.
I encourage you to read our Commentary series, where you will find a thoughtful piece on strengthening pulmonary function testing capacity in sub-Saharan Africa, as well as our Humanities series, where you will find an Exhalations piece titled, “The Translation of Breath.” Finally, please review our case series publications for the month, which provide novel and educational cases to help improve your clinical skills.
I hope you enjoy reading all of the high-quality content available in this month’s issue of the journal 糖心原创. As always, I am grateful to the authors of this work, to the reviewers who volunteered their time to improve the quality of these manuscripts, and to our editorial board for guiding everything that we do. Until next month, I hope you enjoy the August issue.