Highlights from this issue

Using mixed effects regression analysis, the authors model lung function trajectories in children homozygous for F508del. The inhaled mucoactive drugs dornase alfa and hypertonic saline were more frequently used in the US and the authors suggest that a possible causal role should be investigated further. February traditionally brings the respiratory syncytial virus (RSV) season to a close at children’s hospitals across the Northern hemisphere.

Highlights from this issue

Come on baby light my fire Non-adherence to treatment is a common cause of tension between patients and their clinical care teams and cystic fibrosis (with patients commonly spending around 2 hours per day on treatment) is a good example of this. Gravier et al (see page 486) investigate, in a systematic review and meta-analysis, the effects of exercise training in non-small cell lung cancer as part of ‘prehabilitation’ prior to lung resection. In this issue of Thorax (see page 477) Thomsen and colleagues analysed data from a cohort of motor vehicle workers and found, not without controversy as described in the corresponding editorial (see page 426), that risk of mesothelioma was not increased in motor mechanics, in contrast with lung cancer and asbestosis both of which were increased in mechanics and lead to increased mortality.

Highlights from this issue

Failure of checkpoints A key role of Government is to implement checks and balances and as we write Airwaves this month we are hearing of the parallel universe that the Prime Minister of the UK was living in during the COVID-19 lockdown. The Government implemented checks and balances that prevented gatherings but the UK Prime Minister is alleged to have avoided these particular checkpoints. Checkpoint kinases are also involved in cell cycle control and DNA damage response and therefore have been postulated to have a role in Idiopathic Pulmonary Fibrosis.

Highlights from this issue

The shops have Christmas items on display and the old familiar hits of previous decades are playing to get shoppers in a festive mood. [...]sang Noddy Holder of Slade in 1973 (and very year since). On the tenth day of Christmas my true love gave to me the list of 10 drugs categories associated with DILD on univariate analysis, six drug categories significantly associated with increased occurrence of DILD, four case–control matches, 2 thousand plus patients with DILD and a partridge nested in a pear tree. With this in mind, Amaral and colleagues, on behalf of the BOLD collaborative research group (see page 1236), investigated the global ecological association between chronic airflow obstruction and ambient air pollution (PM2.5) across those countries representing most of the regions defined by the Global Burden of Disease.

Highlights from this issue

The authors present data from 18 586 patients with lung cancer who are compared with 4279 patients who have non-malignant end-stage respiratory diseases. In the lung cancer patients, performance status 4 months before death was higher than in those with non-malignant disease. While not associated with a similar magnitude of risk understanding the cellular profile of patients suffering from COVID-19 has relied primarily on inferences from the peripheral blood because of the challenges associated with obtaining Broncho-Alveolar Lavage samples for analysis.

Highlights from this issue

Listen to your heart Swedish pop duo Roxette, Per Gessle and Maria Fredriksson, recorded this song in the summer of 1988 and possibly this provided the inspiration for Axson and colleagues (see page 807) to investigate the relationship between heart failure and heart failure medications on the risk of moderate-to-severe acute exacerbation of COPD. [...]is exercise a substitute for airway clearance in cystic fibrosis (CF) and should exercise include forced expirations? The authors describe the effect of public health interventions (a travel ban and centralised treatment and isolation): the attack rate fell and doubling time was prolonged.

Highlights from this issue

[...]wave or ocean wave? Berney and colleagues (see page 656) and Waldauf (see page 664) delivered FES-cycling in addition to standard care with a co-primary outcome of hospital discharge muscle strength and cognitive impairment at 6 months in the Australian trial and SF-36 physical component summary at 6 months in the Czech trial. The authors completed an international, multicentre, observational cohort study with 90 PCD patients undergoing nitrogen multiple-breath washout. 379 person-years at risk contributed to the analysis with each unit increase in LCI (deterioration) associated with a 13% risk of future exacerbation.

Highlights from this issue

Using multivariate logistic regression, the authors show that night shift work is associated with a 2–3 fold increase in the risk of COVID-19 infection. In this issue of Thorax the Decisional Regret Scale and the Feelings About genomiC Testing Results Questionnaire were used to assess the impact of screening and genetic testing on undiagnosed first-degree relatives of patients with pulmonary fibrosis (see page 621). [...]the finding of some impaired lung function or ILAs did increase decisional regret slightly. [...]counselling before screening is likely to be beneficial but with regards to screening itself, please don’t tell them to can it, Janet.

Highlights from this issue

Recent additions to the collection include: the effect of meat eating on childhood asthma;why wearing a mask still matters;and the link between hormonal contraception and asthma attacks—perfect for the commute to work or for a few minutes of lockdown distraction. There is an association between an oxygen requirement during the initial hospitalisation and carbon monoxide diffusion capacity (DLCO%) and total CT score. [...]intrusive symptoms were still present in a substantial proportion: 16% were breathless, 12% had lost their sense of smell and 10% had abnormal taste.

Highlights from this issue

Patients with idiopathic pulmonary fibrosis (IPF) may develop pulmonary hypertension, out of proportion to the degree of interstitial disease. Much like Gregory being transferred from the front of the football team to the back, hyper-polarised Xenon is transferred from the alveolar air space, leading to dissolution in the lung parenchyma and plasma and then into the red blood cells. In this issue of Thorax (see page 134) Chu and colleagues performed single cell sequencing analysis on matched bronchoalveolar lavage cells and peripheral blood monocytes and used supervised and unsupervised learning methods to identify a new cluster of genes ME31 which associated with different severity of disease in a way that was not distinguishable by genotype alone.

Highlights from this issue

In this edition of Thorax (see page 64) Pearson and colleagues present intriguing data showing that chloride transport through TMEM16A may be a key requirement for human respiratory syncytial virus replication and inhibition of TMEM16A may be a new target for antiviral therapies. In this issue of Thorax (see page 37) Tsai and colleagues assessed the QoL of 1816 patients with Interstitial Lung Disease from the CAnadian REgistry for Pulmonary Fibrosis to validate the Minimal Important Difference between the European Quality of Life 5-Dimensions 5-Levels questionnaire (EQ-5D-5L) and its associated Visual Analogue Scale (EQ-VAS) scores. Using weighted gene co-expression network analysis, overcoming challenges associated with control tissue, they identify key molecular pathways that lead to the development of fibrosis and identify further molecular targets for therapeutic intervention.