This study aimed to provide a theoretical basis for improving early diagnosis and complication prevention by exploring the latent classes of pediatric bronchial foreign body complications, analyzing their associated factors, and assessing the impact of different latent classes on healthcare resource utilization. Children who underwent bronchoscopic foreign body removal at the Children's Hospital of Chongqing Medical University from January 1, 2018 to July 31, 2023, were retrospectively reviewed. Latent class analysis was performed on complications with an incidence > 10% (including pneumonia, pulmonary emphysema, granulation tissue, bronchial stenosis, atelectasis, and pulmonary consolidation). Logistic regression was used to identify risk factors among different latent complication classes, and comparative analyses compared healthcare resource utilization. Among the 238 included children, complications with an incidence exceeding 10% were analyzed and clustered into four latent classes: the "Pneumonia Group" (C1, 40 cases, 16.8%), the "Pneumonia-Atelectasis Group" (C2, 33 cases, 13.9%), the "Emphysema-Granulation tissue Group" (C3, 106 cases, 44.5%), and the "Bronchial Stenosis-Granulation tissue Group" (C4, 59 cases, 24.8%). Results identified a history of foreign body aspiration, asymmetric breath sounds, C-reactive protein ≥ 8 mg/L, and neutrophil percentage as associated factors (p < 0.05). Healthcare resource utilization was significantly lower in groups C3 and C4 regarding hospital stay, treatment costs, and antibiotic days compared to C1 and C2 (p < 0.05). These latent classes offer theoretical support and practical reference for early diagnosis, complication prevention and diagnosis-related group-based payment optimization.

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disorder that imposes a substantial burden on patients' quality of life, and whose effective management relies heavily on adherence to treatment and correct inhaler technique. We report the case of an 88-year-old woman with multiple comorbidities who had previously been diagnosed with asthma despite having neither undergone spirometry nor received inhaled therapy. Although she denied significant respiratory symptoms, her granddaughter reported chronic cough, wheezing, and dyspnea. Further evaluation revealed daily use of a codeine-phenyltoloxamine combination for approximately 10 years. Pulmonary function testing confirmed the diagnosis of COPD. The patient's clinical course was marked by difficulty discontinuing the antitussive medication and, following initiation of inhaled therapy, by poor adherence and incorrect inhaler use. Multiple therapeutic adjustments were required, including the introduction of a valved holding chamber, adjunctive mucolytic therapy, and escalation to triple inhaled therapy after a moderate exacerbation. Sustained symptomatic improvement and successful discontinuation of the antitussive were achieved only after repeated patient education, correction of inhaler technique, and dose adjustment. This case highlights the importance of a multidimensional approach to COPD management, emphasizing the role of patient education and empowerment, regular assessment of inhaler technique, and longitudinal follow-up, particularly in older adults and in patients dependent on non-recommended medications.

Some countries have experienced and may continue to experience severe devastation due to wars, epidemics, earthquakes, and other natural catastrophes. When individuals are exposed to specific psychological or physical traumas, they can develop stress-related disorders, which can lead to irreversible changes in the autonomic nervous system and the development of cardiovascular disorders. When subjected to a new stress test, traumatized participants or those previously exposed to trauma may show more pronounced behavioral changes, intolerance, and greater fatigue responses than before trauma exposure. To reduce the recurrence of trauma-associated responses, particularly among young people, it is necessary to implement preventive measures. Alternative approaches, including counseling, medication, phytotherapy, and other interventions, need to be developed. This study aims to examine how individuals cope with trauma-related situations using a biofeedback method that could be developed to manage stress-related responses. The emotional and psychological states of earthquake victims will be assessed using a protocol based on biomedical (neurocardiac) signals and the sound of the participants' hearts. This sound will be delivered at a fixed frequency or in real time with allostatic auditory stimulation. This approach aims to induce a resonance that stabilizes the autonomic nervous system by providing biofeedback to participants.

Geckos are among the few non-avian reptiles that use acoustic signals for territorial defence, mate attraction and distress signalling. Although previously considered inflexible, male tokay geckos exhibit vocal plasticity by switching to longer, louder call types in noisy environmental conditions. However, they seem to face respiratory constraints limiting longer duration calls. To test this hypothesis, we combined acoustic analysis with deep learning-based pose estimation to quantify respiratory dynamics during spontaneous advertisement calling. Calls were produced exclusively during expiration at a constant rate, supporting the hypothesis that respiratory constraints limit call duration. Tokays use two mechanisms to increase bi-note call duration. First, bi-notes contain an inspiratory 'mini-breath'-a feature previously associated only with songbirds. Second, bi-note duration is increased by adding terminal pulses, whose acoustic signatures suggest vocal fold oscillation in the air-efficient vocal fry register. These findings suggest that tokay advertisement calls function as honest signals of respiratory capacity. We also observed slow closure of the ear opening during vocalizations, indicating a mechanism for protecting the auditory system from self-generated loud sounds. Unlike the reflexive auditory attenuation mechanisms of birds and mammals, this response appears tightly coordinated with vocal-respiratory activity, representing an additional evolutionary innovation associated with tympanic hearing.

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare, preinvasive lung disorder characterized by multifocal neuroendocrine cell proliferation. Because it presents with chronic cough and wheezing, it is frequently misdiagnosed as asthma. Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) arising from DIPNECH is exceptionally rare. We present a rare case of a 62-year-old woman with a long-standing history of presumed asthma who developed ACTH-dependent Cushing syndrome. Bilateral inferior petrosal sinus sampling confirmed ectopic ACTH secretion. Subsequently, comprehensive thoracic imaging revealed a potential ectopic source in a dominant right middle lobe nodule, accompanied by subtle micronodules and mosaic attenuation, which are characteristic of DIPNECH. Targeted lobectomy achieved complete remission, yielding a histopathological diagnosis of a neuroendocrine tumor within background DIPNECH that demonstrated marked immunohistochemical ACTH heterogeneity among hyperplastic cells and tumorlets. Consistent with previously reported cases, our findings highlight that even subtle pulmonary nodules can secrete ACTH and must be evaluated in unexplained EAS. Furthermore, because these subcentimeter nodules possess secretory potential and morphological progression risks, lifelong multidisciplinary surveillance is imperative.

Very preterm birth (< 32 weeks' gestation) disrupts a critical window of lung development, placing infants at substantial risk of bronchopulmonary dysplasia (BPD) and long-term respiratory morbidity. Nutrition is increasingly recognised as a modifiable determinant of neonatal lung health across three distinct but interconnected phases: (1) During the antenatal period, maternal macronutrient and micronutrient status, including vitamin D, omega-3 fatty acids, and folate, shapes placental function, fetal lung growth, and surfactant biosynthesis. Fetal growth restriction, a consequence of placental insufficiency, profoundly impairs pulmonary vascular and alveolar development. (2) In the neonatal intensive care unit, early aggressive parenteral nutrition followed by optimised enteral feeding with human milk reduces BPD risk, while targeted macronutrient delivery and specific micronutrient supplementation support ongoing alveolarisation. (3) After hospital discharge, catch-up growth and sustained human milk feeding are associated with improved lung function, reduced respiratory hospitalisation, and lower rates of recurrent wheeze. This review synthesises current evidence and translates it into practical guidance across all three phases, to optimise nutritional strategies for vulnerable infants.