Here's an opportunity for you to make a significant difference to respiratory health in the Asia-Pacific region.

The APSR has lots of ideas for education projects, but needs the weight of commercial funding to convert those ideas into real projects. These include major research training and fellowships, workshops, etc. which will benefit both the researches and their patients.

An Industry Taskforce exists for the APSR to collaborate with Industry, ensuring full transparency and no bias.

The Industry Taskforce comprises experts from the APSR and experts from Industry, and is led by two co-chairs; one from the APSR and one from Industry.

There will soon be a vacancy for the co-chair from the APSR, and any member is most welcome to nominate themselves or another APSR member to be considered for this leadership role.

Click here for details.

Application deadline: 10 October 2019.

Dr Beasley

The 2019 APSR Medal has been awarded to Dr Charles Richard William Beasley for his great contribution to the APSR. The Award is given by the APSR in appreciation for the awardee's commitment to the advancement of respirology in the Asia-Pacific region, including major achievements in advocacy, teaching, clinical practice and leadership, enshrining excellence in respiratory research and research translation, and for the exceptional contribution made to the growth of the APSR.

He is widely recognised as one of the most outstanding clinician investigators, not just in the Asia-Pacific region but throughout the world. His long list of publications, many in the top medical journals, has made a major contribution to our knowledge of lung diseases, and asthma in particular. In addition, he has trained a whole generation of new clinician scientists to lead our discipline in the future as the Director of the Medical Research Institute of New Zealand for many years.

Dr Beasley is the 12th awardee of the annual APSR Medal since its inception in 2008:

• Philip J Thompson (2008)
• Yoshinosuke Fukuchi (2009)
• Nan-Shan Zhong (2010)
• Norbert Berend (2011)
• Teresita S De Guia (2012)
• Mary Sau-Man Ip (2013)
• Christine Jenkins (2014)
• Takashi Horie (2015)
• Chunxue Bai (2016)
• Michiaki Mishima (2017)
• Wah Kit-Lam (2018)
• Richard Beasley (2019)

Michiyoshi Harasawa Memorial Award: Prof. Arata Azuma

Prof. Azuma

• Professor of Pulmonary Medicine and Oncology, Nippon Medical School, Japan
• Visiting Professor of Nevada University
• Auditor of Japanese Respiratory Foundation
• Board Director of World Association for Sarcoidosis and Other Granulomatous Disorders (WASOG)
• Chair of the APSR Education Committee

*The Michiyoshi Harasawa Memorial Award is given in memory of the late Professor Michiyoshi Harasawa, who died September 2001. The award is given to a person who embodies the leadership and respect of his/her peers and who excels in the field of Pulmonary Medicine.

Dr Harasawa was a highly respected professor of Medicine from Japan, a clinician and a researcher in the field of Pulmonary and Geriatrics rolled into one. His leadership traits with so much dedication and commitment in the field of respiratory medicine, led him to pioneer and form the international organization of the Asian Pacific Society of Respirology (APSR) in 1986 that became a highly structured and leading society of pulmonologists in the Asia-pacific region.

Ann Janet Woolcock Memorial Award: Prof. Vanessa M McDonald

Prof. McDonald

• Professor of Nursing – Chronic Diseases
• Academic Clinician – Department of Respiratory Medicine, John Hunter Hospital, Newcastle, Australia
• Co-Director – Centre of Excellence in Severe Asthma, University of Newcastle, Australia
• Co-Director – Priority Research Centre for Healthy Lungs, University of Newcastle, Australia
• School of Nursing and Midwifery, University of Newcastle, Australia
• Honorary Professor – University of Manchester, UK
• Associate Editor – Respirology

*The Woolcock Memorial Award is given in memory of the late Professor Ann Janet Woolcock who died February 2001. The award is given to a person who embodies the leadership and respect of his/her peers and who excels in the field of Pulmonary Medicine.

Dr Woolcock was an eloquent professor of Medicine from Australia, a clinician and a researcher in the field of pulmonary medicine with particular specialization on the physiology and epidemiology of Branchial Asthma. Her dedication to the field of Pulmonary Medicine developed her analytical mind and enthusiasm to promote researchers. Her failing health did not prevent her in continuing her quest of unveiling the science of asthma. She helped Dr Harasawa to form the international organization of the Asian Pacific Society or Respirology (APSR) in 1986.

Former awardees

Prof. Barron

This annual Award is offered for the best Medical Education paper accepted for presentation at the APSR Congress in Hanoi 14–17 November 2019.

This is a new APSR Award to honour the huge contribution made by the late Professor Barron, a founding member of the APSR, and hard worker in enabling the APTA and the APSR to fulfil their Mission and Vision.

Very sadly, J Patrick Barron passed away on Saturday 17 August 2019 at the age of 71.

He was Professor Emeritus at Tokyo Medical University and Adjunct Professor at Seoul National University Bundang Hospital.

Professor Barron was also an editorial board member for Chest and an editor or an editorial consultant for a wide range of journals including Respirology, Secretary General of the World Association for Bronchology, Vice President of the World Bronchology Federation, Secretary General of the International Photodynamic Association which he had helped to found, Vice Chairman of the Board of the Japanese Society for Medical English Education, and founder of The Medical Interpreters and Translators Association.

He was a consultant for the International Society for Diseases of the Esophagus for 32 years since its founding, and also a consultant to the International College of Surgeons Japan Chapter, director of several medical societies, and ex officio member of the Executive Committee of the APSR.

Award includes:

• $500 (funded by office bearers and friends of APSR and APTA)
• Invitation to the Gala Dinner (or similar social event) at the Congress
• Commemorative certificate

Eligibility:

• An APSR member (en bloc or individual)
• Aged ≤40 at the start of the Congress
• The First Author of a Medical Education paper and able to present that paper in person at the APSR Congress in Hanoi.
• Not a winner of any other award for the same paper
• Registered for the Congress by the abstract submission deadline

Award presentation:

• The certificate will be presented during the Gala Dinner (or similar social event) at the Congress. Where the paper has more than one author, the certificate will be in the name of all the paper's authors.
• The US$500 award will be passed to the First Author by the APSR Secretariat.
• The awardee's name and photograph will appear on the APSR website, Bulletin and social media after the Congress.

Post-congress requirements:

• In accepting the award, the awardee is required to send their report (circa 500 words) of their experience at the Congress to the APSR Secretariat within one month after the Congress. The report may be published in the APSR Bulletin and/or Newsletter.

Continuing this series, we are delighted to share a tribute to Prof. Faisal Yunus, prepared by Dr Fariz Nurwidya.

This series complements our APSR Members' Honour Roll, on which as a member, you are welcome to add your appreciation of your mentor(s) at any time.

Prof. Yunus

Prof. Faisal Yunus

Prof. Yunus, obtained his Medical Doctor (M.D.) degree from the Faculty of Medicine, Universitas Indonesia (FMUI), Jakarta, Indonesia in 1976. He then graduated from Post Graduated Course of Second Department of Internal Medicine, School of Medicine, Hiroshima University, Japan, which lead to the degree of Doctor of Philosophy (PhD) and board-certified Pulmonologist degree in 1983.

Prof Yunus actively participated in several training and courses, such as training of bronchoalveolar lavage and thoracic ultrasonography at the Juntendo University, Tokyo, Japan; training of asthma at the University of Sydney Royal Prince Alfred Hospital, Sydney, Australia; training of cardiopulmonary exercise testing in Los Angeles, California, USA; and training of interstitial lung disease at the Toranomon Hospital, Tokyo, Japan.

He became Professor in Respiratory Medicine in 2003 and became the Director of Training Programme in Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta. In 2014, Prof. Yunus was the President of the Asian Pacific Society of Respirology Congress held in Bali, Indonesia. He is also a Chairperson of the APSR Membership Committee. He was a successful President of the Indonesian Society of Respirology (PDPI) for two consecutive periods and currently he is the Chairman of Indonesian College of Pulmonology and Respiratory Medicine.

Apart from being an active researcher in the field of respiratory medicine with more than 100 scientific publications, Prof. Yunus has devoted most of his time in developing Indonesian respiratory physician competencies and academic qualifications, especially in the way that allows so many respiratory physicians to obtain their Ph.D. degrees, both in international universities as well as Indonesian academic institutions. Furthermore, he is actively engaged in the establishment of the Center of Pulmonology Residency Training Programme in various universities in Indonesia.

Dr Nurwidya

Prepared by
Dr Fariz Nurwidya, MD, PhD, FAPSR
Respiratory Physician and Scientist at the Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia – Persahabatan Hospital

September 2019

"I first met Prof. Yunus as a medical student in an international scientific conference with him as the speaker. In one occasion, Prof. Yunus convinced me about the burden of respiratory diseases and the urgency of having a sufficient number of pulmonologists. During my residency, I was a mentee and eventually became a colleague of Prof. Yunus. I highly appreciate Prof. Yunus for providing the pathway to me and so many pulmonology residents to study at various universities in Japan, such as the Juntendo University, Hiroshima University and Tohoku University."

The September issue (Vol 11.9) features Respiratory Neurobiology including Sleep studies: recent update of its utility:

• Sleep Disorders Associated With Alzheimer's Disease: A Perspective.
• Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly. A Longitudinal Study.
• Effect of Supplemental Oxygen on Blood Pressure in Obstructive Sleep Apnea (SOX). A Randomized Continuous Positive Airway Pressure Withdrawal Trial.
• Intermittent Hypoxia and Cancer: Undesirable Bed Partners?
• Circulating Exosomes in Obstructive Sleep Apnea as Phenotypic Biomarkers and Mechanistic Messengers of End-Organ Morbidity.
• Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure.
• The Ageing Neuromuscular System and Sarcopenia: a Mitochondrial Perspective.
• Release of ATP by pre-Bötzinger Complex Astrocytes Contributes to the Hypoxic Ventilatory Response via a Ca2+ -Dependent P2Y1 Receptor Mechanism.
• D-serine Released by Astrocytes in Brainstem Regulates Breathing Response to CO2 Levels.
• Piezo2 Senses Airway Stretch and Mediates Lung Inflation-Induced Apnoea.

The following cases have been selected for inclusion in the November 2019 Respirology Case Reports, Volume 07 Issue 8

Case Series

Case Reports

Clinical Image

The Bangladesh Lung Foundation (BLF), will hold their 6th International Conference on lung health on 5-8 November at the Bangabandhu International Conference Center, Dhaka, Bangladesh.

The following APSR representatives have been invited to speak at the conference:

• 
  Dr Hirano
  Tsunahiko Hirano, M.D., Ph.D.
  Associate Professor of Division of Respiratory Medicine and Infectious Disease Graduate School of Medicine,
  Yamaguchi University, Japan
• 
  Dr Baba
  Tomohisa Baba, MD
  Chief Physician, Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center
  Kanagawa, Japan

See article below on e-cigarettes.

Dr Bigornia was also invited to speak on 6 March 2019 by the Philippine College of Chest Physicians, Critical Care Committee, about Surviving Sepsis Campaign Bundle 2018 Update, and on the same topic on 19 September 2019 at the 11th Biennial Conference of the Philippine Foundation for Lung Health Research and Development.

1st Congress of ISSPP (International Society for the Study of Pleura and Peritoneum) will be held at National University Hospital on 29-30 November in Singapore, preceded on 18 November by a Pleura and Pleuroscopy Workshop.

Please contact pynglee16@gmail.com for enquiries and registration form.

On World Lung Day (WLD) 25 September 2019 the APSR united with members of the Forum of International Respiratory Societies (FIRS) and WLD partner organisations to advocate for respiratory health globally and call on policymakers to ensure that everyone has access to the services they need to improve their lung health.

Respiratory diseases impose an immense worldwide health burden. The facts are shocking:

• 384 million people suffer from chronic obstructive pulmonary disease (COPD) and 3 million die from it each year, making it the third leading cause of death worldwide.
• 10 million people develop tuberculosis and 1.6 million die from it each year, making it the most common lethal infectious disease.
• 1.76 million people die from lung cancer each year, making it the deadliest cancer.
• 334 million people suffer from asthma, making it the most common chronic disease of childhood. It affects 14 percent of children globally – and is rising.
• Pneumonia kills millions of people each year making it a leading cause of death in the very young and very old.
• 91 percent of the world's population live in places where poor air quality exceeds WHO guidelines.

WLD, on 25 September, two days after the UN High-Level Meeting on Universal Health Coverage (UHC). UHC calls for all people to receive the health services they need, when they need it, without suffering financial hardship. At least half of the world's population still do not have full coverage of essential health services.

The global spotlight on UHC represents an opportunity for substantial progress in the fight against lung disease around the world. On WLD this year we are united in our message: 'Leave no one behind. On World Lung Day, we call for healthy lungs for all.'

"UHC is particularly important to persons with respiratory disease. For example, a break in the supply of medicine for patients with tuberculosis could cause the development of drug resistance, which carries serious consequences. The abrupt unavailability of asthma medicine could cause severe suffering and even death. Lack of health care provider availability usually means delay in diagnosis, which could be fatal for lung cancer patients," said Dean Schraufnagel, MD, Executive Director of FIRS.

FIRS call for UHC action through:

1. Strengthening health care workers.
2. Prioritising prevention, namely tobacco, as well as air pollution, and vaccinations.
3. Maintaining a continuous supply of essential medicines.
4. Stemming antibiotic resistance

In addition, FIRS call for these essential actions to reduce the burden of respiratory disease and improve global health:

1. Increase awareness among the public and policy makers that respiratory health is a major component of global health.
2. Reduce the use of all tobacco products through universal enforcement of the Framework Convention on Tobacco Control.
3. Adopt and require World Health Organization air quality standards to reduce ambient, indoor, and occupational air pollution for all countries.
4. Promote universal access to quality health care, essential medicines, and immunisations.
5. Improve early diagnosis of respiratory diseases through increasing public awareness of lung health and disease.
6. Increase training of health professionals worldwide in respiratory disease.
7. Standardise the monitoring and management of respiratory diseases with evidence-based national and international strategies.
8. Increase research to prevent and treat respiratory diseases.

"We hope World Lung Day will provide an opportunity for action, conversation, and awareness. A unified voice of all dedicated to respiratory health will be a powerful force," concludes Dr Schraufnagel.

Fact Sheet – World Lung Day 2019

• 384 million people suffer from chronic obstructive pulmonary disease (COPD) and 3 million die from it each year, making it the third leading cause of death worldwide [1].
• 10 million people develop tuberculosis and 1.6 million die from it each year, making it the most common lethal infectious disease [2].
• 1.76 million people die from lung cancer each year, making it the most deadly cancer [3].
• 334 million people suffer from asthma [1].
• Asthma is the most common chronic disease of childhood, affecting 14 percent of children globally – and rising [1].
• 4 million people die from lower respiratory tract infections and pneumonia each year [1].
• Every minute, 2 children under 5 years old die from pneumonia [4].
• 80 percent of pneumonia deaths are in children under 2 years [4].
• Most (99 percent) deaths occur in low or middle-income countries [4]
• Pneumonia is the leading cause of death in the very young and very old.
• Passive smoke exposure also leads to respiratory disease. Since 1964, about 2.5 million non-smokers died from health problems caused by exposure to second-hand smoke [1].
• 4.2 million people die every year as a result of exposure to ambient (outdoor) air pollution [5].
• 3.8 million people die every year as a result of household exposure to smoke from dirty cookstoves and fuels [5].
• 91 percent of the world's population live in places where air quality exceeds WHO guideline limits [5].

Respiratory Disease Prevention

• Fortunately, most respiratory diseases are PREVENTABLE by improving the quality of the air. Common sources of unhealthy air are tobacco smoke, indoor and outdoor air pollution, and air containing microbes, toxic particles, fumes, or allergens.
• Discouraging individuals from starting to smoke tobacco and encouraging smokers to quit smoking are the first and most important priorities in preventing COPD.
• Asthmatics who smoke have a more rapid decline in lung function than lifelong non-smokers.
• Avoiding smoking during pregnancy and avoidance of passive smoke exposure after birth can reduce asthma severity in children.
• Reducing air pollution saves lives and reduces the risk of many diseases.
• Vaccinations are essential for the control and elimination of many childhood respiratory diseases.
• Controlling unhealthy air in the workplace can prevent occupational lung disease.
• Most cases of TB can be cured if diagnosed early and treated appropriately.
• Lung cancer is largely preventable through tobacco control.
• Environmental causes of lung cancer, such as air pollution, radon, and asbestos, can be monitored and reduced.

The respiratory societies of the world believe that everyone has the right to breathe clean air and we ask lawmakers to enact and ensure clean air standards in all countries.

Universal Health Coverage

• At least half of the world's population still do not have full coverage of essential health services [6].
• About 100 million people are still being pushed into extreme poverty because they have to pay for health care [6].
• Over 800 million people (almost 12 percent of the world's population) spent at least 10 percent of their household budgets to pay for health care [6].
• To improve respiratory health globally, we need to ensure that everyone has access to the services they need to improve their lung health.
• A break in the supply of medicine for a patient with tuberculosis could cause the development of drug resistance, which carries serious consequences.
• The abrupt unavailability of asthma medicine could cause severe suffering and even death.
• Lack of health care provider availability usually means delay in diagnosis, which could be fatal for lung cancer patients.

References

1. The Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2019 Report)
2. WHO, Tuberculosis
3. WHO, Cancer
4. Fighting for Breath: A call to action on childhood pneumonia. Save the Children 2017
5. WHO, Pollution
6. WHO, Universal Health Coverage

To learn more about World Lung Day go to the FIRS World Lung Day Toolkit.

For more information about FIRS please contact Lisa Roscoe lisa.roscoe@firsnet.org.

On Wednesday 18 September, India's cabinet announced a ban on the production, import and sale of electronic cigarettes, saying they pose a risk to health. An executive order was approved banning vaping products because of their impact on young people, Finance Minister Nirmala Sitharaman said.

Although only a small percentage of Indians vape at present, the ban cuts off a vast potential market of 1.3 billion consumers for e-cigarettes who are desperate to compensate for falling demand for cigarettes.

The sale, use and importation of e-cigarettes is illegal in several countries and laws are stiffening. Yet there's evidence that the law is widely ignored and there is a flourishing black market. Pushing e-cigarettes underground can make them more appealing to rebellious youth.

A Bloomberg article cites a class action lawsuit against an e-cigarette maker for illegally marketing nicotine-delivery devices to minors and deceiving consumers about the risks of vaping.

E-cigarette shop in Hong Kong
Similar outlets can be seen in Tokyo's district of Harajuku (the favourite shopping area for school children), and elsewhere in the region.

The plaintiff is suing the company on the grounds that he became addicted to nicotine and suffered worsening asthma symptoms after he began using the company's device at the age of 16.

The suit alleges that the company used ad campaigns aimed at children, using similar marketing practices that are now banned for the tobacco industry. These included glamorizing cigarette smoking while downplaying its addictiveness and deleterious health effects.

Young people can easily be enticed by the candy-flavoured cartridges in brightly-coloured hi-tech packs. Vaping can be seen as a "style statement".

Appealing for children; hence an appealing market for investors.

Read the full 20 August article at www.bloomberg.com/news/articles/2019-08-19/juul-philip-morris-sued-under-racketeer-act-for-targeting-kids

The Bronchoscopy and Interventional Techniques Assembly looks forward to your attendance at the APSR in Hanoi in November. The organizing committee have established a practical and relevant set of pre-congress workshops as well as a topical symposium session. In addition, there have been a record number of abstract submissions reflective of the large number of clinical projects in interventional pulmonology in the Asia-Pacific region.

We would also like our members to keep an eye out for an Interventional Pulmonology invited review series that will be published by Respirology, the journal of the APSR, in the next 12 months.

Finally, the 1st Congress of ISSPP (International Society for the Study of Pleura and Peritoneum) will be held at National University Hospital on 29-30 November in Singapore.

A Pleura and Pleuroscopy Workshop will be held on 28th November in Singapore.

Guest Faculty:

• Carla Lamb
  Director of Interventional Pulmonology
  Lahey Clinic, Boston, Massachusetts, USA
• Gary Lee
  Professor of Respiratory Medicine, University of Western Australia.
• Benjamin Kwan
  Consultant and Head, Respiratory and Sleep Medicine, Sutherland Hospital, Australia

Local Faculty

• Lee Pyng, Course Director
  Associate Professor
  Director of Interventional Pulmonology
  National University Hospital
• T Agasthian
  Associate Professor, Thoracic Surgery
• Lynette Teo
  Senior Consultant, Thoracic Imaging,
  National University Hospital
• Seet Ju Ee
  Senior Consultant, Diagnostic Pathology
  National University Hospital
• Teoh Chia Meng
  Senior Consultant, National University Hospital

Please contact pynglee16@gmail.com for enquiries and registration form.

A warm welcome to the following members who have recently joined APSR assemblies. They will undoubtedly enjoy working with and networking with their assembly colleagues.

The following members have kindly sent their donation towards the Society's goals, as outlined at apsresp.org/members/donors.php.

• Dr Yasser Alkassar
• Dr Chunxue Bai
• Dr Norbert Berend
• Dr Philip Eng
• Dr Zarfiardy Aksa Fauzi
• Dr Yoshinosuke Fukuchi
• Dr Sau-Man Mary Ip
• Dr Shoji Kudoh
• Dr Yun Chor Gary Lee
• Dr Kazuto Matsunaga
• Dr Takahide Nagase
• Dr Yoichi Nakanishi
• Dr Arth Nana
• Dr Young Soo Shim
• Dr Kazuhisa Takahashi

The APSR is profoundly grateful for their generosity.

Congratulations to the following members who have recently become Fellows of the APSR:

• Dr Selvi C FAPSR
• Dr Bunpaul Chhar FAPSR
• Dr Zarfiardy Aksa Fauzi FAPSR
• Dr Mrinmoy Mitra FAPSR

If you have news or announcements that may be of interest to other APSR members, please send details to Bulletin Coordinator Dr Arata Azuma (a-azuma@nms.ac.jp) or APSR Bulletin (bulletin@apsresp.org).