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  • India wants US ties based on mutual respect, says its arms purchases are on course – Reuters

    1. India wants US ties based on mutual respect, says its arms purchases are on course  Reuters
    2. India pauses plans to buy US arms after Trump’s tariffs  Dawn
    3. Hope relationship with US will continue to move forward: MEA  Tribune India
    4. India-US defence partnership is an important pillar of the bilateral partnership: MEA  Firstpost
    5. India and U.S. to hold joint military exercise in Alaska this month, says MEA  The Hindu

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  • Aleem Khan pays tribute to Shaheed Major Zeeyyad Saleem

    Aleem Khan pays tribute to Shaheed Major Zeeyyad Saleem

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    ISLAMABAD, Aug 14 (APP):On the occasion of Independence Day, Federal Minister, Abdul Aleem Khan, on Thursday visited the residence of Shaheed Major Zeeyyad Saleem to pay tribute to him.

    He offered heartfelt sympathies with the family of the martyr, offered “Fateha” and expressed his condolences, said a press release.

    Major Zeeyyad Saleem embraced “Shahadat” in Mastung, Balochistan while bravely confronting the terrorism of “Fitna-e-Khawarij”. His two brothers are serving officers in the Pakistan Army while his late father Brig. Saleem was also “Shaheed” in 2005 in the line of duty.

    Talking to the mother of Shaheed Zeeyyad Saleem, Abdul Aleem Khan said that being the mother of a martyr is one of the greatest honors, the sacrifice of your husband and son for the beloved homeland is a monumental favor upon this nation that can never be forgotten. Federal Minister emphasized that remembering the national heroes who sacrificed their lives for the country’s safety and security is a foremost duty on Independence Day. “These heroes orphaned their own children to protect us and they are indeed the pride of our nation, he added.

    Abdul Aleem Khan said that today’s freedom is the fruit of the sacrifices of those martyrs who defeated the enemy on every front and taught them lessons the whole world witnessed. He paid homage to all martyrs, declaring that every soldier who lays down his life for the homeland is the pride of the country. He was accompanied by Istehkam-e-Pakistan Party MNA and Parliamentary Secretary, Gul Asghar Baghur. The family of Major Zeeyyad Saleem expressed gratitude to the Federal Minister Abdul Aleem Khan for his visit.

    Martyr Major Zeeyyad’s brother, Major Hammad Saleem told the Federal Minister Abdul Aleem Khan that the martyr continued to fight the terrorists for 27 minutes after being shot. He recorded his own will and expressed his desire to be buried alongside his martyred father. Major Zeeyyad Saleem bravely fought until the end, inflicting heavy damage on the enemy. His brother further shared that the martyr had been married for only two years and was actively engaged in initiatives to support the families of martyrs, himself.

    Federal Minister Abdul Aleem Khan also expressed sympathy to Mrs. Brigadier Saleem, the martyr’s mother and prayed for courage and fortitude for the entire family. She stated that in the current circumstances, all citizens must be ready to defend the homeland. She thanked Abdul Aleem Khan for his visit and called her son’s martyrdom an honor. In his remarks, Abdul Aleem Khan said that we all have to leave this world one day but what truly matters is how we depart. Major Zeeyyad Saleem achieved the rank of martyrdom, setting an example every Muslim aspires to for the death of a martyr is the life of the entire nation.”

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  • What Trump team doesn’t get about India and Pakistan

    What Trump team doesn’t get about India and Pakistan

    In international diplomacy, subtlety, mutual respect and an understanding of geopolitical nuance are key to building lasting partnerships. Under President Donald Trump, however, these principles often take a backseat to a transactional, ego-driven approach. Nowhere is this more evident than in the frayed relationship between the US and India, marked by a breakdown in trust, growing strategic divergences, and a misreading of India’s geopolitical red lines.At the center of this deterioration is Trump’s fixation on projecting himself as a global dealmaker and peacemaker, a strategy driven in part by his not-so-subtle ambition to win the Nobel Peace Prize. This personal aspiration, combined with a heavy-handed use of economic pressure via tariffs, pose a formidable threat to America’s ties with its allies as shown in the case of India.

    Misreading India’s strategic autonomy

    A telling incident reflecting a grave India-US disconnect occurred in New Delhi, as reported by Washington Post, when Trump’s top adviser on India, Ricky Gill, was having dinner in New Delhi with former Indian diplomats. “Though he was in town for a global security conference, the conversation turned, inevitably, to Trump’s souring relationship with Indian Prime Minister Narendra Modi, according to two people familiar with the matter. Indian officials were expressing frustration that trade negotiations had been upended; they were also angry that Trump kept claiming credit for resolving the country’s recent military confrontation with Pakistan,” Washington Post reported.
    “Indian officials were expressing frustration that trade negotiations had been upended; they were also angry that Trump kept claiming credit for resolving the country’s recent military confrontation with Pakistan,” Washington Post reported. “Gill, the National Security Council’s senior director for South and Central Asia, tried to assuage the former diplomats, assuring them Washington still viewed New Delhi as a crucial partner, according to the two people, who spoke on the condition of anonymity to discuss private conversations. But Gill noted there was one thing irritating Trump’s team: Why were the Indians still obsessing over how the conflict in May had ended? The diplomats were “surprised” by the question, the people familiar said. India has made no secret of its long-standing position that issues with Pakistan, its nuclear arch-rival, should be handled bilaterally.”

    Also Read
    | Trump-Putin meet: Trump’s aide warns India of more tariffs if peace bid fails

    Trump has repeatedly boasted that it was his intervention that de-escalated the India-Pakistan conflict during Operation Sindoor. This isn’t just a case of diplomatic overreach. It is a miscalculation that strikes at the core of India’s doctrine on handling Pakistan bilaterally. For decades, India has insisted that it permits no third-party mediation in India-Pakistan affairs. By inserting himself into the narrative, Trump not only ignored this long-held position but also risked undermining India’s sovereignty in the eyes of its own population and strategic community. India was livid at Trump equating Pakistan, a perpetrator of terror, with India, a victim of that terror.

    Trump’s narrow personal agenda is ruining India-US relations

    Parallel to this geopolitical misunderstanding is Trump’s habitual use of tariffs to achieve foreign policy aims. For Trump, this is part of his broader strategy of economic coercion, a belief that tariff threats would compel nations to yield to any kind of US demands. However, the assumption of the Trump team that nations and their leaders are driven solely by economic motivations has proved to be wrong as India has refused to flatter Trump by agreeing to his false claim of brokering peace between India and Pakistan.
    India is not easily bullied. With a long-standing tradition of non-alignment and strategic autonomy, Indian policymakers were deeply offended by the assumption that trade threats could dictate foreign policy shifts. Trump’s belief that India could be pressured into acknowledging his version of the Pakistan ceasefire, or into other concessions, with an economic stick only widened the rift.
    The fallout is real and immediate. Rather than drawing India closer, Trump’s approach is pushing it to hedge its bets. India has begun recalibrating its foreign policy, getting even closer to Russia and improving limited coordination with China. These shifts signal a reversal in long efforts that have gone into forging of India-US partnership.

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    | Why the Trump-Putin Alaska meeting may not ease tensions between India, US, and Russia

    Moreover, Trump’s overtures to Pakistan, culminating in the unprecedented lunch with Pakistan’s army chief Asim Munir, sent shockwaves through New Delhi. For Indian officials, this was not just bad optics; it was a betrayal. After years of building a shared Indo-Pacific vision with the US, and deepening military and intelligence cooperation, India saw itself being sidelined in favour of a short-term public relations win.

    Underlying all of this is Trump’s desire to portray himself as a global statesman. His repeated claims of resolving conflicts, from North Korea to the Middle East, often bear little resemblance to reality. In South Asia, the disconnect was especially stark. By claiming he “coerced” India into peace, Trump not only dismissed India’s strategic autonomy but also tried to rewrite regional history to serve a narrow personal narrative.

    Such distortion isn’t just diplomatically clumsy, it is also strategically dangerous. It has led Indians to question the reliability of the US as a strategic partner. For a relationship that had taken decades to mature — spanning defense, intelligence and economic cooperation — this erosion of trust is a serious setback.

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  • Flash flood in Indian Kashmir leaves at least 56 dead and scores missing | India

    Flash flood in Indian Kashmir leaves at least 56 dead and scores missing | India

    At least 56 people have died and 80 are missing after a sudden rainstorm in Indian Kashmir, the second such disaster in the Himalayas in a little over a week.

    The incident in the town of Chashoti, Kishtwar district, occurred at a stopover point on a pilgrimage route. Days earlier, a flood and mudslide engulfed a village in the Himalayan state of Uttarakhand.

    The flood washed away a community kitchen and a security post in the village, a pit stop along the pilgrimage route to the Machail Mata temple, according to an official. “A large number of pilgrims had gathered for lunch and they were washed away,” they said.

    The Machail Yatra trail is a popular route up to the high-altitude Himalayan shrine of Machail Mata, which honours the Hindu goddess Durga, and pilgrims trek to the temple from Chashoti, where the road for vehicles ends.

    “The news is grim and accurate, verified information from the area hit by the cloudburst is slow in arriving,” Omar Abdullah, the chief minister of India’s federal territory of Jammu and Kashmir, said in a post on X.

    Television footage showed pilgrims crying as water flooded the village.

    Mohammad Irshad, a top disaster management official, said 56 bodies had been recovered from the site before rescue efforts were halted for the night.

    He said 80 people had been reported missing and 300 had been rescued, 50 of whom were severely injured and had been sent to nearby hospitals.

    Local officials said the death toll was likely to rise.

    The disaster occurred at 11.30am local time, Ramesh Kumar, the divisional commissioner of Kishtwar district, told ANI news agency, adding that local police and disaster response officials had reached the scene.

    “Army air force teams have also been activated. Search and rescue operations are under way,” Kumar said.

    A cloudburst, according to the Indian Meteorological Department, is a sudden, intense downpour of more than 100mm (4in) of rain in just one hour that can trigger sudden floods, landslides and devastation, especially in mountainous regions during the monsoon.

    The local weather office in Srinagar predicted intense showers for several regions in Kashmir on Thursday, including Kishtwar. It urged residents to stay away from loose structures, electric poles and old trees as there was a possibility of mudslides and flash floods.

    With Reuters and Agence France-Presse

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  • Buy an iPad or Mac, Get Free AirPods or an Accessory With Apple’s Back-to-School Promo

    Buy an iPad or Mac, Get Free AirPods or an Accessory With Apple’s Back-to-School Promo

    It’s that time of year again, when kids (maybe) and parents (definitely) are looking forward to a new school year. Apple regularly offers back-to-school promotions, and this year is no different. Apple isn’t one for offering direct discounts, but that doesn’t mean this promo isn’t worth checking out. Right now, when you order a new iPad or Mac, you’ll get a free pair of AirPods or an accessory thrown in. That means you could save up to $199 if you’re quick.

    All you have to do is buy an iPad, MacBook or iMac and choose one of the eligible accessories to go with it. Make sure to do it soon, though. This deal ends on Sept. 30, so you only have a limited amount of time to act. As far as back-to-school tech discounts go, these are definitely worth your while.

    The freebies differ depending on what you buy, and it can get a little complicated, so bear with us here.

    Hey, did you know? CNET Deals texts are free, easy and save you money.

    If you buy an iPad, you can choose from the following items absolutely free.

    If you’re happy to throw some money in, you can also pick up the AirPods 4 with active noise canceling, or the AirPods Pro 2 or one of the Apple Magic Keyboards.

    Pick up a MacBook instead and you’ll get the following absolutely gratis:

    • AirPods 4 (ANC)
    • Magic Mouse
    • Magic Trackpad
    • Apple Magic Keyboard with Touch ID and keypad.

    Choose to hand over some extra cash, and you can also get a discounted pair of AirPods Pro 2 if they’re more your style.

    Finally, buy an iMac and you’ll get a free pair of AirPods 4 (ANC) or you can pay a little extra and upgrade to a pair of AirPods Pro 2.

    Confused yet? We don’t blame you, so be sure to check out Apple’s back-to-school webpage to get the full lowdown on what’s on offer.

    LAPTOP DEALS OF THE WEEK

    Deals are selected by the CNET Group commerce team, and may be unrelated to this article.

    Why this deal matters

    Having the right tech for school can make all the difference, and this is the perfect chance to get kitted out while saving some money in the process — especially if you were already planning on buying some accessories or new AirPods. Alternatively, Walmart is offering an Apple M1 MacBook Air for just $599, which might just be the deal of the year.


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  • Researchers use smart watches to better understand human activity | WSU Insider

    Researchers use smart watches to better understand human activity | WSU Insider

    PULLMAN, Wash. — Researchers have long been able to use information from smartwatches to identify physical movement, such as sitting or walking, that wearers are performing in a controlled lab setting.

    Now, Washington State University researchers have developed a way, using a computer algorithm and a large dataset gathered from smartwatches, to more comprehensively identify what people are doing in everyday settings, such as working, eating, doing hobbies or running errands.

    The work, published in the IEEE Journal of Biomedical and Health Informatics , could someday lead to improve assessment and understanding of cognitive health, rehabilitation, disease management, or surgical recovery. In their study, the researchers were able to accurately identify activities 78% of the time.

    “If we want to determine whether somebody needs caregiving assistance in their home or elsewhere and what level of assistance, then we need to know how well the person can perform critical activities,” said Diane Cook, WSU Regents Professor in WSU’s School of Electrical Engineering and Computer Science who led the work. “How well can they bathe themselves, feed themselves, handle finances, or do their own errands? These are the things that you really need to be able to accomplish to be independent.”

    One of the big challenges in healthcare is trying to assess how people who are sick or elderly are managing their everyday lives. Medical professionals often need more comprehensive information about how a person performs functional activities, or higher-level, goal-directed behavior, to really assess their health. As anyone who is trying to help a distant parent with aging or health challenges knows, that information on how well a person is performing at paying their bills, running errands, or cooking meals is complex, variable, and difficult to gather — whether in a doctor’s office or with a smartwatch.

    Medical professionals often need more comprehensive information about how a person performs functional activities, or higher-level, goal-directed behavior, to really assess their health.

    “Lack of awareness of a person’s cognitive and physical status is one of the hurdles that we face as we age, and so having an automated way to give indicators of where a person is will someday allow us to better intervene for them and to keep them not only healthy, but ideally independent,” said Cook. “This work lays the foundation for more advanced, behavior-aware applications in digital health and human-centered AI.”

    For their study, the WSU researchers collected activity information over several years from several studies.

    “Whenever we had a study that collected smartwatch data, we added a question to our data collection app that asked participants to self-label their current activity, and that’s how we ended up with so many participants from so many studies,” she said. “And then we just dug in to see whether we can perform activity recognition.”

    The 503 study participants over eight years were asked at random times throughout the day to pick from a scroll-down list of 12 categories to describe what they were doing. The categories included things like doing errands, sleeping, traveling, working, eating, socializing, or relaxing. The researchers analyzed a variety of artificial intelligence methods for their ability to generalize across the population of study participants.

    The researchers developed a large-scale dataset that includes more than 32 million labeled data points, with each point representing one minute of activity. They then trained an AI model to predict what functional activity had occurred. They were able to predict activities up to 77.7% of the time.

    “A foundational step is to perform activity recognition because if we can describe a person’s behavior in terms of activity in categories that are well recognized, then we can start to talk about their behavior patterns and changes in their patterns,” said Cook. “We can use what we sense to try to approximate traditional measures of health, such as cognitive health and functional independence.”

    The researchers hope to use their model in future studies in areas such as being able to automate clinical diagnoses, and to look for links between behavior, health, genetics, and environment. The methods and dataset without any identifying information are also publicly available for other researchers to use. The work was funded by the National Institutes of Health.

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  • Case Report: Two Cases of Combined Pulmonary Fibrosis and Emphysema (C

    Case Report: Two Cases of Combined Pulmonary Fibrosis and Emphysema (C

    Introduction

    As the global population ages, the incidence of pulmonary fibrosis and emphysema has increased annually. The coexistence of these two conditions is termed “Combined Pulmonary Fibrosis and Emphysema (CPFE)”. Radiologically, CPFE presents as airspace enlargement combined with fibrosis (AEF), observed in idiopathic pulmonary fibrosis (IPF) with emphysema, smoking-related interstitial fibrosis (SRIF), and fibrosis-related interstitial lung diseases (f-ILD). CPFE’s clinical manifestations are complex, often presenting with overlapping features of chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis, including chronic cough, dyspnea, and impaired diffusing capacity (DLCO), sometimes accompanied by pulmonary hypertension or lung cancer. The prognosis is generally poor, emphasizing the importance of early and accurate diagnosis for treatment planning and prognosis evaluation.

    This report presents two CPFE cases diagnosed through clinical imaging and pathological analysis to improve awareness among clinicians, radiologists, and pathologists.

    Case 1

    Clinical Information

    A 51-year-old male with a 30-year smoking history (1 pack/day) and a history of photosensitive dermatitis. He was admitted due to “lung interstitial changes found on physical examination for over a year”. Chest CT in November 2022 showed interstitial pneumonia and pulmonary bullae, which were not given significant attention at that time. After six months, he presented with “chest tightness, wheezing, cough, and sputum” following physical activity. Chest CT revealed findings consistent with bilateral interstitial lung disease, including reticular opacities, ground-glass attenuation, and features of chronic inflammation. Emphysematous changes and pulmonary bullae were also noted, along with a small nodule in the right upper lobe. Based on imaging characteristics, the radiologist suggested a pattern most consistent with nonspecific interstitial pneumonia (NSIP). Pulmonary function tests indicated normal ventilation function but moderate impaired diffusing capacity. Anti-neutrophil cytoplasmic antibody (p-ANCA) was positive, while anti-nuclear antibody and myositis antibody profiles were negative, was unlikely immune-related diseases. The patient still experiences chest tightness and wheezing after activity, along with dry mouth, dry eyes, and tooth loss, as well as dental caries. There is no joint redness, swelling, or mobility impairment, and no Raynaud’s phenomenon. A follow-up chest CT scan performed on December 29, 2023, demonstrated bilateral interstitial inflammation and a small nodule in the right upper lobe. Bilateral lung transparency was reduced, with diffuse thickening of the interlobular septa observed throughout both lung fields. High-density opacities—manifesting as linear, nodular, ground-glass, and reticular patterns—were predominantly distributed in the peripheral zones of both lungs, with ill-defined margins. In addition, localized honeycombing and traction bronchiectasis were present. A small, calcified nodule was also identified in the right upper lobe (Figure 1).

    Figure 1 Pathological findings of the cryobiopsy sample from the right lower lobe basal segment in Case 1. (A) ×40 magnification, low magnification shows partial lung tissue consolidation and cystic dilation of some areas with scattered inflammatory cell infiltration. (B) ×100 magnification, shows diffuse fibrous thickening of the alveolar septa, focal lymphocytic nodular infiltration, and scattered tissue cell deposits within the alveolar lumen. (C) ×200 magnification, some areas show a significant amount of mononuclear tissue cell deposits within the alveolar lumen, accompanied by lung parenchymal collapse. (D) ×100 magnification, CD68 positive tissue cells observed in the alveolar lumen.

    Pathology

    A cryobiopsy was taken from the basal segment of the right lower lobe. Microscopic examination and pathological diagnosis: Five tissue samples were sent for examination, with the largest diameter being 3 mm (1 sample) and 2 mm (4 samples). Lung parenchyma accounted for approximately 90%, respiratory bronchioles for about 10%, and a small amount of pleural tissue. The lung parenchyma was primarily composed of tissue surrounding the respiratory bronchioles, with atrophy of the lung parenchyma (reduced alveolar septa). There was a significant deposition of mononuclear cells in some alveolar spaces, with pigment-phagocytosing histiocytes (consistent with smoker’s pigment). Mild fibrous widening of the alveolar septa was noted (like fibrotic nonspecific interstitial pneumonia, NSIP), accompanied by a small number of chronic inflammatory cells (mainly B lymphocytes) and focal lymphoid nodule formation. There was an increase in smooth muscle around the small pulmonary arteries and alveolar ducts near the respiratory bronchioles. A small amount of pleural tissue showed carbon deposition.

    Immunohistochemistry

    The histiocytes expressed CD163 (++), CD68 (++), and CD31 (+); interstitial immune cells expressed CD3 (+), CD20 (++), CD4 (+), and CD8 (+, scattered); vascular structures expressed CD31 (+) and CD34 (vascular +); epithelial cells expressed CK7 (+). Special stains: Congo Red (-) (Figure 2).

    Figure 2 HRCT findings of Case 1 (2023-12-29). Top image: Significant decreased translucency in both upper lungs, showing emphysema changes. Bottom image: Diffuse thickening of the interlobular septa in both lower lungs, with strip-like, nodular, ground-glass, and reticular high-density shadows. Local honeycomb changes and traction bronchiectasis are visible.

    Diagnosis

    Histologically consistent with desquamative interstitial pneumonia (DIP), confirmed as CPFE by clinical-radiological-pathological multidisciplinary discussion.

    Follow-Up

    The patient has quit smoking and initiated systemic steroid therapy at a dose of 15 mg twice daily. After one-month, slight symptomatic improvement was observed, and the steroid dose was tapered to 10 mg twice daily. Despite another month of treatment, symptoms persisted. The regimen was then adjusted to 15 mg once daily for three months, during which inhaled corticosteroids were also introduced. Symptoms remained largely unchanged. Subsequently, the oral steroid dose was reduced to 10 mg daily, which has been maintained. Throughout the treatment course, supportive therapies including oxygen supplementation and gastric protection were provided. At the most recent follow-up, Nintedanib (an anti-fibrotic agent) was added to the regimen. Symptoms have improved mildly but not significantly, with occasional skin rashes.

    Case 2

    Clinical Information

    A 58-year-old male truck driver with a 40-year smoking history (2 packs/day) and dust exposure. He was admitted due to “chest tightness and worsening cough and sputum over 2 years”. In March 2023, chest CT showed subpleural reticulation, multiple honeycombing changes, patchy ground-glass opacities, calcified nodules in the lower lobes, and enlarged mediastinal lymph nodes. The clinical diagnosis was interstitial lung disease with infection, and he was treated with antibiotics and cough suppressants, with symptom improvement. However, in November 2023, due to persistent cough with blood-streaked sputum, repeat CT revealed fibrotic interstitial pneumonia with emphysema and bullae (Figure 3). Pulmonary function tests showed moderate small airway ventilation dysfunction and moderate impairment of diffusing capacity of carbon monoxide. Upon admission, symptomatic supportive treatment including anti-inflammatory, expectorant, and antioxidant therapies was administered, along with a cryobiopsy.

    Figure 3 Pathological findings of the cryobiopsy sample from the posterior segment of the right upper lobe in Case 2. (A) ×40 magnification, low magnification shows some areas of lung consolidation and cystic dilation. (B) ×100 magnification, shows minimal chronic inflammatory cell infiltration in the alveolar septa, mild fibrous thickening, single mononuclear tissue cell deposits in the alveolar lumen, and some alveolar septa floating within the alveolar lumen, which may indicate emphysema changes. (C) ×200 magnification, some areas show significant increase in fibrous stroma in the alveolar septa, accompanied by alveolar collapse and single mononuclear tissue cell deposits. (D) ×400 magnification, high magnification shows alveolar collapse with increased interstitial fibrous stroma, tissue cell deposits within the alveolar lumen and septa. The tissue cells contain brown-yellow granular particles indicative of dust cells.

    Pathology

    Cryobiopsy of the right upper lobe was performed. Two lung tissue samples were sent for examination, with the largest diameters being 3 mm and 4 mm, respectively. The lung parenchyma accounted for approximately 80%, and small airways and blood vessels accounted for about 20%. In some areas, there was fibrous widening of the alveolar septa, with mild chronic inflammatory cell infiltration. In other areas, there were deposits of histiocytes phagocytosing dust particles in the alveolar septa and alveolar spaces. Additionally, some areas exhibited emphysema with bulla formation (Figure 4).

    Figure 4 HRCT findings of Case 2 (2023-11-29). Top image: Interstitial changes in both lungs, emphysema, and bullae in both upper lungs with fine reticular shadows. Bottom image: More pronounced reticular shadows and interlobular septal thickening in both lower lungs.

    Diagnosis

    Histologically consistent with emphysema and fibrosis, confirmed as CPFE by clinical-radiological-pathological discussion.

    Follow-Up

    The patient has not yet quit smoking, but exposure to dust has decreased. Symptoms have not improved significantly, and the patient still experiences chest tightness, cough, and sputum.

    Discussion

    The concept of CPFE was first proposed in 1948, and it was later recognized as a clinical syndrome.1 Patients with CPFE typically have normal or mildly reduced lung volume, but severe diffusion impairment, with histopathology showing emphysema, inflammation, and fibrosis.

    The exact reasons for the coexistence of emphysema and pulmonary fibrosis are not yet fully understood.2 Firstly, both conditions share common risk factors, such as smoking and environmental exposures (eg, asbestos, silica dust, etc) Emphysema primarily affects the airways, while pulmonary fibrosis mainly involves the lung interstitium, causing structural damage and fibrosis.3 Secondly, chronic inflammatory responses in the lungs serve as a common pathological basis for both conditions. Genetic changes related with telomere dysfunction and alveolar surfactant production also play a significant role in the pathogenesis of CPFE.4,5 Finally, both emphysema and pulmonary fibrosis are age-related changes. In some animal models, emphysema and pulmonary fibrosis have also been observed to occur simultaneously.6,7

    The diagnosis of CPFE relies on a comprehensive analysis of the patient’s clinical presentation, imaging, and pathology. Clinicians should utilize lung function tests as a cornerstone of assessment. While reduced carbon monoxide diffusing capacity (DLCO) is a notable finding, a critical nuance must be emphasized: the obstructive component caused by emphysema may be offset by the restrictive component induced by fibrosis. This physiological counterbalance can lead to an underestimation of the true severity of lung function impairment, underscoring the need for meticulous interpretation of test results. High-Resolution Computed Tomography (HRCT) is the preferred imaging method, as it can clearly display the coexistence of emphysema and pulmonary fibrosis. However, imaging alone can sometimes make it difficult to distinguish from other pulmonary diseases, and pathology diagnosis provides crucial evidence for confirming the disease.

    In pathology diagnosis, emphysema is a necessary condition for diagnosing CPFE. In addition to emphysema, the patient should also exhibit interstitial pneumonia-related features, such as respiratory bronchiolitis-related interstitial lung disease (RB-ILD) and smoking-related interstitial fibrosis (SRIF), and may also have other types of pulmonary fibrosis, especially desquamative interstitial pneumonia (DIP), SRIF, usual interstitial pneumonia (UIP), and pulmonary Langerhans cell histiocytosis (PLCH).

    RB-related interstitial pneumonia typically shows macrophage accumulation in the distal bronchioles and surrounding airspaces, with a distribution centered around the lobular core, without associated inflammation or fibrosis. DIP, on the other hand, shows relatively uniform, diffuse pulmonary interstitial inflammation and fibrosis, with the presence of alveolar macrophages that have phagocytized pigments. SRIF typically presents on chest CT as subpleural cystic lesions. Histopathologically, these correspond to thick-walled cysts resulting from distal (paraseptal) emphysema, with the cystic spaces primarily composed of degenerating alveolar epithelial cells. UIP shows honeycomb changes, with fibrosis distributed in a patchy pattern. Normal lung structure collapses, and fibrosis includes fibroblast foci and mild patchy lymphocytic infiltration, in contrast to the uniform, low-cellularity, dense eosinophilic fibrosis in SRIF.

    The two most common complications of CPFE are lung cancer and pulmonary hypertension.8,9 In CPFE, lung cancer tends to occur in areas of dense fibrosis, primarily in the peripheral and lower lobes, supporting the possibility that cancer development is related to fibrotic regions. Additionally, patients with CPFE combined with pulmonary hypertension experience more severe symptoms than those with isolated IPF or COPD. This may be due to the combined effects of emphysema and fibrosis, leading to a reduction in the pulmonary capillary bed and hypoxic vasoconstriction, which in turn increases pulmonary vascular resistance more significantly.

    One of our cases presented with intermittent cutaneous eruptions. For over two decades, the patient experienced recurrent rashes on sun-exposed areas during the spring and summer months, with spontaneous improvement in the autumn. This clinical pattern suggests a possible association with seasonal hypersensitivity reactions. The patient’s report of symptom relief following corticosteroid therapy further supports a potential underlying allergic or autoimmune component. Nevertheless, whether this phenomenon is mechanistically linked to the pathogenesis of combined pulmonary fibrosis and emphysema (CPFE) remains uncertain and warrants further case accumulation and comprehensive investigation.

    The treatment of CPFE needs to be tailored to the individual patient’s specific situation,10 typically including smoking cessation, pulmonary rehabilitation, pharmacotherapy (such as antifibrotic drugs, bronchodilators, corticosteroids, and immunosuppressants), vaccination, oxygen therapy, and, in end-stage cases, lung transplantation.11 Both IPF and COPD increase the risk of lung cancer compared to the general population, but the risk in CPFE patients may exceed that of patients with isolated emphysema or IPF. Early identification, diagnosis, and timely intervention, combined with regular follow-up monitoring, can help improve patient prognosis.

    Conclusion

    This case highlights CPFE as a complex pulmonary disorder requiring vigilance from clinicians, radiologists, and pathologists. Clinicians should prioritize lung function tests: reduced CO diffusing capacity (DLCO) is common, but the counterbalance between emphysema-induced obstruction and fibrosis-induced restriction may mask true impairment severity, necessitating careful interpretation. Radiologists identify characteristic imaging (eg, upper-lobe emphysema and subpleural fibrosis on HRCT) for early detection, with pathologists confirming diagnosis via histopathology. Multidisciplinary collaboration—led by clinicians—is critical for accurate diagnosis. Ongoing research into mechanisms and targeted therapies remains essential for improving outcomes.

    Ethics Approval and Informed Consent

    This report was published with the patients’ written informed consents and approval from the Ethics Committee of “Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University”. Written informed consents were obtained from the patients for both participation in this case report and the publication of relevant case details. The patients were informed in writing that all efforts would be made to ensure anonymity and that no identifiable information (such as name, images, or personal details) would be disclosed in the publication. They also acknowledged and understood that the published report may be accessible in public and academic domains.

    Consent for Publication

    All the authors reviewed and agreed on all versions of the article before submission, agreed to the submission of this article, and agreed to take responsibility and be accountable for the contents of the article.

    Author Contributions

    All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

    Funding

    This research was supported by National Natural Science Foundation of China (82404065 and 82203183), Nanjing Health Science and Technology Development Special Fund Project Plan (YKK23095 and YKK22099).

    Disclosure

    The authors declare that there is no conflict of interest regarding the publication of this paper.

    References

    1. Cottin V, Selman M, Inoue Y, et al. Syndrome of combined pulmonary fibrosis and emphysema: an Official ATS/ERS/JRS/ALAT research statement. Am J Respir Crit Care Med. 2022;206(4):e7–e41. doi:10.1164/rccm.202206-1041ST

    2. Sangani R, Ghio A, Culp S, Patel Z, Sharma S. Combined pulmonary fibrosis emphysema: role of cigarette smoking and pulmonary hypertension in a rural cohort. Int J Chron Obstruct Pulmon Dis. 2021;16:1873–1885. doi:10.2147/COPD.S307192

    3. Sato S, Tanino Y, Misa K, et al. Identification of clinical phenotypes in idiopathic interstitial pneumonia with pulmonary emphysema. Intern Med. 2016;55(12):1529–1535. doi:10.2169/internalmedicine.55.6009

    4. Alder JK, Guo N, Kembou F, et al. Telomere length is a determinant of emphysema susceptibility. Am J Respir Crit Care Med. 2011;184(8):904–912. doi:10.1164/rccm.201103-0520OC

    5. Armanios M. Telomerase and idiopathic pulmonary fibrosis. Mutat Res. 2012;730(1–2):52–58. doi:10.1016/j.mrfmmm.2011.10.013

    6. Scadding JG. Health and disease: what can medicine do for philosophy? J Med Ethics. 1988;14(3):118–124. doi:10.1136/jme.14.3.118

    7. Amariei DE, Dodia N, Deepak J, et al. Combined pulmonary fibrosis and emphysema: pulmonary function testing and a pathophysiology perspective. Medicina. 2019;55(9):580. doi:10.3390/medicina55090580

    8. Hashimoto N, Matsuzaki A, Okada Y, et al. Clinical impact of prevalence and severity of COPD on the decision-making process for therapeutic management of lung cancer patients. BMC Pulm Med. 2014;14:14. doi:10.1186/1471-2466-14-14

    9. Kim YS, Jin GY, Chae KJ, et al. Visually stratified CT honeycombing as a survival predictor in combined pulmonary fibrosis and emphysema. Br J Radiol. 2015;88(1055):20150545.

    10. Caceres JD, Venkata A. Combined pulmonary fibrosis and emphysema. Curr Opin Pulm Med. 2024;30(2):167–173. doi:10.1097/MCP.0000000000001044

    11. Nemoto M, Koo CW, Scanlon PD, Ryu JH. combined pulmonary fibrosis and emphysema: a narrative review. Mayo Clin Proc. 2023;98(11):1685–1696. doi:10.1016/j.mayocp.2023.05.002

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  • Scientists Reveal the Potato Dish That Raises Diabetes Risk the Most – SciTechDaily

    1. Scientists Reveal the Potato Dish That Raises Diabetes Risk the Most  SciTechDaily
    2. Diabetes risk hinges on how you cook potatoes  News-Medical
    3. Do You Like Eating Fries? Pay Attention To How To Process It So It Doesn’t Trigger Diabetes  VOI.ID
    4. Easy food swaps to reduce risk of type 2 diabetes  The Portugal News
    5. Eat French fries and get diabetes—eat boiled spuds, and don’t  wddty.com

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  • Sinéad O’Connor Biopic Chronicling Singer’s Early Years In the Works

    Sinéad O’Connor Biopic Chronicling Singer’s Early Years In the Works

    The early life and times of late Irish singer Sinéad O’Connor will be the subject of an upcoming biopic. According to Variety, the project covering O’Connor’s origin story is being helmed by Irish production company ie: entertainment, which executive produced and worked with the singer on the 2022 O’Connor documentary Nothing Compares; O’Connor died in July 2023 at age 56 of natural causes.

    Among the reported co-producers on the film are Irish indie film production company Nine Daughters (God’s Creatures, Lady Macbeth) and See Saw Films (Slow Horses, The Power of the Dog). At press time spokespeople for O’Connor and ie:entertainment had not returned Billboard‘s request for comment on the film.

    Variety reported that the movie has been in the works since the release of the earlier doc, with Josephine Decker (Shirley) tapped to direct a script by Irish writer Stacey Gregg (Here Before, Ballywalter), with former Robbie Williams manager and music industry veteran Tim Clark on board as an executive producer through ie: entertainment. BBC Films is funding the film’s development.

    The film will reportedly focus on O’Connor’s early life and journey through the music industry, telling the story of how “one young woman from Dublin took on the world, examining how her global fame may have been built on her talent, but her name became synonymous with her efforts to draw attention to the crimes committed by the Catholic Church and the Irish state.”

    O’Connor burst onto the music scene in 1987 with her genre agnostic debut album, The Lion and the Cobra, which mixed beat-driven pop, goth rock, confessional folk, shoegaze and ethereal chants. The singer’s shocking bald headed look and powerful vocals on songs such as the college rock hit “Mandinka” and the jangly “I Want Your (Hands on Me)” made her an instant fascination and landed her a Grammy nomination for best female rock vocal performance.

    From the beginning, O’Connor was a voice to be reckoned with, never holding her tongue or pulling punches when it came to calling out injustice or the abuse of power. She became a reluctant global superstar thanks to her Grammy-winning 1990 sophomore album, I Do Not Want What I Haven’t Got, which featured her beloved cover of the Prince-written “Nothing Compares 2 U.”

    The intense scrutiny sometimes proved to be a struggle for O’Connor, who was an outspoken critic of the Catholic church and famously ripped up a picture of then Pope John Paul II on Saturday Night Live in 1992 while saying “fight the real enemy” nearly a decade before John Paul publicly acknowledged the Catholic Church’s long history of child sex abuse. O’Connor — who said she suffered sexual and emotional abuse as a child — was criticized by the likes of Madonna, actor Joe Pesci and the Anti-Defamation League for the action and two weeks later was booed during a 30th anniversary tribute concert for Bob Dylan at Madison Square Garden.

    The singer went on to release eight more albums during a career, jumping from reggae, to traditional Irish songs and fairly straight-ahead pop.

    The O’Connor biopic will come amidst a recent bumper crop of re-tellings of famous rock and pop legends, including the Queen film Bohemian Rhapsody, the Elton John biopic Rocketman, last year’s Bob Dylan A Complete Unknown, as well as the upcoming Bruce Springsteen film Deliver Me From Nowhere, a quartet of Beatles movies in 2028 and either a TV series of film version of Madonna’s early years.

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  • E-Bike Use Is Rising — Will It Replace Public Transit?

    E-Bike Use Is Rising — Will It Replace Public Transit?

    Northeastern transport and urban experts examine the popularity of e-bikes and what is hindering them from rivaling bus, metro and rail networks.

    Men on Lime electric bicycles shown waiting at a traffic light.
    The rise of rental e-bikes has led to a 340% in their use in London’s financial district between 2022 and 2024. (Photo by Mike Kemp/In Pictures via Getty Images)

    LONDON — “I’m going to Lime it” has become a phrase heard frequently on the streets of the world’s major cities.

    Lime is not the only international provider of rental electric bikes, but it is the largest, operating in more than 30 countries across five continents, including the United States, the United Kingdom and Australia.

    In the City of London — the British capital’s financial district — a survey in 2024 found the use of rental e-bikes had increased rapidly, climbing by 340% in only two years and accounting for one in six bikes on the road in what is known as “the square mile”.

    An e-bike boom is being experienced on both sides of the Atlantic. An Ipsos mobility study in 2024 found that one in five households in Europe now owns an electric bike, while the U.S. Department of Energy reported that sales in the States reached 1.1 million in 2022, almost a four-fold increase since 2019.

    Ka Ho Tsoi, an assistant professor in transport planning at Northeastern University in London, says e-bikes offer convenience and an immediacy that have helped fuel their popularity.

    The lack of physical exertion needed when riding an e-bike, which uses a motor and battery to assist a rider’s pedaling efforts, allows users to travel farther, he says, as well as letting them bypass road congestion and the stress and wait times of transit systems.

    “An e-bike also has a very distinctive advantage,” adds Tsoi, “in terms of providing a door-to-door service, whereas bus networks cannot do that in the same way. After getting off the bus, for example, you might still have to walk five to 10 minutes to your destination.

    “When a lot of these issues add up, they act as a push factor for people to choose e-bikes over other forms of transportation.”

    Urban officials have tended to support the growth of e-bikes as they see them as a way of removing cars from the road and increasing the mobility of people who may struggle with longer journeys on a traditional bike.

    A pamphlet titled “Electric bikes in Boston” published by City Hall says that e-bike users on average are older, with around three-quarters of users in the Massachusetts city being over the age of 65.

    E-bikes have the ability to connect areas that are underserved by other forms of transportation, according to Jonathan Rokem, a Northeastern associate professor in politics and sustainability.

    “They are very good at plugging in parts of a city which haven’t been catered for before, providing easy, accessible transport, something which you can leave anywhere,” says the urban planning specialist. 

    “It solves a lot of the younger population’s needs in terms of getting from the pub to the Tube or to work. There are lots of these in-between journeys which e-bikes are very good for, and I think that is where they really come into play — it is a really important role that they have in the transport network.”

    Hollywood star Timothee Chalamet was recently a walking advertisement for the convenience factor that Tsoi and Rokem mention. The 29-year-old turned up to the London premiere of “A Complete Unknown,” a biopic about singer Bob Dylan in which he plays the lead role, on a Lime bike in order to beat traffic.

    But with any booming trend comes negatives. Less considerate e-bikers have been known to carelessly discard their rentals after their trips, leaving them strewn in the middle of sidewalks or even dumping them in canals. The speed at which they can travel means injuries can be far worse for riders and pedestrians during crashes than with standard bicycles. And the “click, clack” noise that Lime and other rental bikes make when their security mechanism is overridden by those not wanting to pay has been described as the “sound of summer,” blighting many cities during the warmer months.

    There have been attempts to solve those issues. Lime, a Silicon Valley firm, caps its battery assist at 15 mph. Users are also issued a warning for bad parking. Repeat offenses in the U.K. can lead to fines, starting at £2 ($2.70) and scaling up to £20 ($27) before the account faces a complete ban. Docking services, like Boston’s Bluebike scheme, also make poor parking less of a problem.

    One London council upped the ante recently by stating that it will charge companies £80 ($100) for every bike parked dangerously on its streets after local businesses described the parking situation as a “Wild West.” Hackney Council, in east London, plans to create 1,000 designated spaces for dockless e-bike parking that it states will be managed “much more stringently” under a new £93 million ($125 million) contract.

    The £80 fines are highly likely to be passed on to users, Tsoi believes, in a move that could deter people from using the service.

    “I think they would just shift the responsibility to the user because, after you have used an e-bike, you have to park it in a designated area and then take a photo to complete the journey,” he explains.

    “I think [the fines] could cause some hidden problems. If people are worried about the system not working properly and that they could be fined as a result, that could discourage people from using them.”

    Rokem says it is clear that better regulation and infrastructure are required if e-bikes are to become a fully integrated form of daily transport.

    “We need the supporting infrastructures to support these because otherwise they can become a nuisance to the neighborhood and people start complaining,” he says.

    He argues that there needs to be cooperation among local authorities if e-bikes are going to thrive. In London, for example, a rider on a rental e-bike can find that their power cuts out as they cross into another council’s jurisdiction if the company does not have permission to operate. Each borough also has its own rules when it comes to where to park e-bikes.

    Dott, a rental e-bike provider, pulled out of London in 2023, opting to instead focus its attention on Paris and Rome, after criticising the patchwork regulation in the city.

    Countries like the U.K., says Rokem, need to learn from places like Denmark and Netherlands, which he describes as “bike cultural” countries.

    “If you want e-bikes to be part of the future of transport in the U.K., then you need to set your rules of engagement on the policy side. E-bikes are a good in-between option which can cater for a lot of shorter journeys and can connect different transports,” he says. 

    “It’s not a solution to all the transport problems but it is not supposed to be, in my view. But if we don’t have the supporting infrastructure, the supporting policies, the overarching support so that everyone has the same rules, it will fail.”

    Even with the growth in ridership, Tsoi says he does not see e-bikes being able to rival other mass transit networks, mainly due to the hindering factor of distance.

    With the majority of urban residents tending to live in the outskirt suburbs of a city for affordability reasons, high-capacity mass transport modes are likely to remain the big players for a long while yet, he argues.

    “An e-bike cannot fulfil the purpose of traveling those kinds of distances — you need to have a large metro, rail or bus network to really connect these dots,” says Tsoi. 

    “If you look at Transport for London data for the share of trips by bike or cycling, it is around 4%. That is because a lot of trips cannot be substituted by bike. I think even in the long term, e-bikes cannot be a direct rival.”

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