Evidence-Based Strategies to Minimize Unnecessary Primary Cesarean Sections: A Comprehensive Review.

The increase in cesarean section (CS) rates, whether they are classified as unnecessary or elective, has globally raised significant concerns due to the associated risks involving maternal and neonatal outcomes. Although CS can be a lifesaving operation in specific medical cases, its overuse is exposing mothers and neonates to complications like hemorrhage, infections, and long-term consequences such as uterine scarring, infertility, and future pregnancy problems. The contributing factors include maternal preferences for convenience, fear of labor, and financial incentives within the healthcare systems that favor surgical interventions.

Residential fungal β-(1,3)-D-glucan exposure is associated with decreased pulmonary function in fibrotic pulmonary sarcoidosis.

Background: Sarcoidosis is a multi-system disease frequently affecting the lungs. It is thought to be mediated by gene-environment interaction; for example, epidemiological data show organic aerosol exposure increases risk of pulmonary sarcoidosis.

Research Question: Does exposure to bioaerosol associate with worse lung disease in patients with pulmonary sarcoidosis?

Research Question: Using an observational, cohort study design, we measured residential exposure to fungal and bacterial cell wall material, β-(1,3)-D-glucan (BDG) and endotoxin, respectively, in healthy control subjects and those with pulmonary sarcoidosis.

Exposure to structurally unique β-d-glucans differentially affects inflammatory responses in male mouse lungs.

Pro-inflammatory fungal β-d-glucan (BDG) polysaccharides cause respiratory pathology. However, specific immunological effects of unique BDG structures on pulmonary inflammation are understudied. We characterized the effect of four unique fungal BDGs with unique branching patterns, solubility, and molecular weights in murine airways.

Innovative compounds to reduce β-D-glucans, endotoxin, and allergens newly discovered on smartphones.

Background: Eight-four percent of people own smartphones and view them 14 billion times daily, making them potential vectors for environmental hazards such as allergens, -D-glucans (BDGs), and endotoxin. Whether these toxins are prevalent and the effectiveness of cleaning solutions targeting these agents on smartphones have not been studied.

Objective: We sought to determine (1) whether phones are reservoirs of allergen, endotoxin, and BDGs and (2) if present, whether their levels can be effectively reduced by using specific cleaning methods.

Imaging-based assessment of lung function in a population cooking indoors with biomass fuel: a pilot study.

Biomass fuels (wood) are commonly used indoors in underventilated environments for cooking in the developing world, but the impact on lung physiology is poorly understood. Quantitative computed tomography (qCT) can provide sensitive metrics to compare the lungs of women cooking with wood vs. liquified petroleum gas (LPG).

Characterization of sub-pollen particles in size-resolved atmospheric aerosol using chemical tracers.

Pollen grains may contain allergens that exacerbate allergic respiratory diseases like asthma and rhinitis. In the presence of water, pollen grains (10-100 μm) can rupture to produce sub-pollen particles (SPP) with diameters <2.5 μm, which in comparison to intact pollen grains, have longer atmospheric lifetimes and greater penetration to the lower lung.

Cerium Oxide Enhances the Toxicity of Zinc Oxide Nanoparticles in Human Lung Epithelial Cell Cultures.

Recently, many approaches have been developed to improve the performance of nanomaterials. Combining more than one nanomaterial is one such approach that achieves superior results. However, during the fabrication of nanomaterials or formulation of end products, materials can be released into the ambient air and be inhaled by workers.

HEPA filtration intervention in classrooms may improve some students' asthma.

Objective: The School Inner-City Asthma Intervention Study 2 (SICAS 2) tested interventions to reduce exposures in classrooms of students with asthma. The objective of this analysis was limited to evaluating the effect of high-efficiency particulate (HEPA) filtration interventions on mold levels as quantified using the Environmental Relative Moldiness Index (ERMI) and the possible improvement in the students' asthma, as quantified by spirometry testing.

Methods: Pre-intervention dust samples were collected at the beginning of the school year from classrooms and corresponding homes of students with asthma ( = 150).

Effect of School Integrated Pest Management or Classroom Air Filter Purifiers on Asthma Symptoms in Students With Active Asthma: A Randomized Clinical Trial.

Importance: School and classroom allergens and particles are associated with asthma morbidity, but the benefit of environmental remediation is not known.

Objective: To determine whether use of a school-wide integrated pest management (IPM) program or high-efficiency particulate air (HEPA) filter purifiers in the classrooms improve asthma symptoms in students with active asthma.

Design, Setting, And Participants: Factorial randomized clinical trial of a school-wide IPM program and HEPA filter purifiers in the classrooms was conducted from 2015 to 2020 (School Inner-City Asthma Intervention Study).

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial.

We conducted a randomized trial of portable HEPA air cleaners in the homes of children age 6-12 years with asthma in the Yakima Valley, Washington. All families received asthma education while intervention families also received two HEPA cleaners (child's bedroom, living room). We collected 14-day integrated samples of endotoxin in settled dust and PM and PM in the air of the children's bedrooms at baseline and one-year follow-up, and used linear regression to compare follow-up levels, adjusting for baseline.

Lung function of primary cooks using LPG or biomass and the effect of particulate matter on airway epithelial barrier integrity.

Background: Cooks exposed to biomass fuel experience increased risk of respiratory disease and mortality. We sought to characterize lung function and environmental exposures of primary cooking women using two fuel-types in southeastern India, as well as to investigate the effect of particulate matter (PM) from kitchens on human airway epithelial (HAE) cells in vitro.

Methods: We assessed pre- and post-bronchodilator lung function on 25 primary female cooks using wood biomass or liquified petroleum gas (LPG), and quantified exposures from 34 kitchens (PM, PM < 40 μm, black carbon, endotoxin, and PM metal and bacterial content).

The home air in agriculture pediatric intervention (HAPI) trial: Rationale and methods.

Background: Data addressing air quality effects on children with asthma in rural U.S. communities are rare.

Household endotoxin reduction in the Louisa Environmental Intervention Project for rural childhood asthma.

Endotoxin exacerbates asthma. We designed the Louisa Environmental Intervention Project (LEIP) and assessed its effectiveness in reducing household endotoxin and improving asthma symptoms in rural Iowa children. Asthmatic school children (N = 104 from 89 homes) of Louisa and Keokuk counties in Iowa (aged 5-14 years) were recruited and block-randomized to receive extensive (education + professional cleaning) or educational interventions.

Inhalable and Respirable Particulate and Endotoxin Exposures in Kentucky Equine Farms.

Adverse respiratory health effects in the agricultural industry have been linked to particulate endotoxin exposure. However, whether the endotoxin concentration is significantly correlated to the size of the particle remains an open question. To date, limited research has been conducted to assess particulate endotoxin exposures in the agricultural industry in general or the equine industry in particular.

Recirculating Immunocompetent Cells in Colitic Mice Intensify Their Lung Response to Bacterial Endotoxin.

Background: Patients with inflammatory bowel disease have higher incidence of airway hyperresponsiveness compared to the general population. Lung inflammation leading to airway hyperresponsiveness causes illnesses for more than ten percent of the population in USA.

Aims: We investigated the lung response to bacterial endotoxin in colitic mice.

Atopy as a Modifier of the Relationships Between Endotoxin Exposure and Symptoms Among Laboratory Animal Workers.

Background: Exposure to endotoxin is known to trigger airway inflammation and symptoms, and atopy may modify the relationship between endotoxin exposure and symptom development.

Objective: To test the a priori hypothesis that atopic status modifies the relationship between endotoxin exposure and respiratory symptom development.

Methods: A prospective study of laboratory workers at The Jackson Laboratories was conducted.

House Dust Endotoxin Levels Are Associated with Adult Asthma in a U.S. Farming Population.

Rationale: Endotoxin initiates a proinflammatory response from the innate immune system. Studies in children suggest that endotoxin exposure from house dust may be an important risk factor for asthma, but few studies have been conducted in adult populations.

Objectives: To investigate the association of house dust endotoxin levels with asthma and related phenotypes (wheeze, atopy, and pulmonary function) in a large U.

Urban Enhancement of PM Bioaerosol Tracers Relative to Background Locations in the Midwestern United States.

Bioaerosols are well-known immune-active particles that exacerbate respiratory diseases. Human exposures to bioaerosols and their resultant health impacts depend on their ambient concentrations, seasonal and spatial variation, and co-pollutants, which are not yet widely characterized. In this study, chemical and biological tracers of bioaerosols were quantified in respirable particulate matter (PM) collected at three urban and three background sites in the Midwestern United States across four seasons in 2012.

Innate Immunity and Asthma Risk in Amish and Hutterite Farm Children.

Background: The Amish and Hutterites are U.S. agricultural populations whose lifestyles are remarkably similar in many respects but whose farming practices, in particular, are distinct; the former follow traditional farming practices whereas the latter use industrialized farming practices.

Performance of electrostatic dust collectors (EDCs) for endotoxin assessment in homes: Effect of mailing, placement, heating, and electrostatic charge.

Electrostatic Dust Collectors (EDCs) are in use for passive sampling of bioaerosols, but particular aspects of their performance have not yet been evaluated. This study investigated the effect of mailing EDCs on endotoxin loading and the effect of EDC deployment in front of, and away from, heated ventilation on endotoxin sampling. Endotoxin sampling efficiency of heated and unheated EDC cloths was also evaluated.

Endotoxin Exposure: Predictors and Prevalence of Associated Asthma Outcomes in the United States.

Rationale: Inhaled endotoxin induces airway inflammation and is an established risk factor for asthma. The 2005-2006 National Health and Nutrition Examination Survey included measures of endotoxin and allergens in homes as well as specific IgE to inhalant allergens.

Objectives: To understand the relationships between endotoxin exposure, asthma outcomes, and sensitization status for 15 aeroallergens in a nationally representative sample.

Mouse allergen exposure and decreased risk of allergic rhinitis in school-aged children.

Background: Little is known about exposure to mouse allergen (Mus m 1) and allergic rhinitis (AR).

Objective: To evaluate the association between mouse allergen exposure and AR in children.

Methods: We examined the relation between mouse allergen level in house dust and AR in 511 children aged 6 to 14 years in San Juan, Puerto Rico.