How music can so powerfully impact our bodies and minds defies rational explanation. Through our senses, music can mysteriously reach our deepest emotions without using language or images. Even if we do not understand it intellectually, music speaks to us, and can transform our experience. Music is often a communal experience. Anthony Storr, psychoanalyst and musician, writes that when a group of people sing together, ‘a culturally agreed upon pattern of rhythm and melody, i.e. a song, that is sung together, provides a shared form of emotion that, at least during the course of the song, carries along the participants so that they experience their bodies responding emotionally in very similar ways, sharing the emotions of the music’ (Music and the Mind, HarperCollins Publishers, 1992). But why are we talking about music here? Music is integral to healing practices in many indigenous cultures. In Western medicine, the impact of music on wellbeing is increasingly explored. The beneficial impact of music on reducing anxiety and stress responses, with possible resulting immune system modulation, has been observed in individuals with a range of nervous system conditions, from autism, depression, Parkinson's and schizophrenia. In patients with dementia, music and singing can reduce hallucinations and depression, increase social interactions and may even be associated with slower cognitive impairment. During the early phases of the COVID-19 outbreak, when most of the world was in lockdown and clinical staff were under severe psychological distress, an Italian hospital piloted a music therapy programme for healthcare staff assisting COVID-19 patients (https://doi.org/10.1016/j.aip.2020.101688). After listening to playlists prepared by trained music therapists and customized to individual preferences, clinical staff reported significantly reduced tiredness, sadness, fear and worry. Similarly, in a randomized controlled trial investigating mindfulness and music therapy in nurses caring for COVID-19 patients in Turkey, work-related strain was reduced in the intervention compared to control group. (https://doi.org/10.1097/hnp.0000000000000511). British Lung Foundation (BLF) commissioned Phoene to deliver a training programme for singing leaders entitled ‘Singing for Lung Health (SLH)’, with more than 100 groups established across the UK. Service evaluation has shown that SLH is associated with improved respiratory related quality of life and reduced health care utilization (https://journals.sagepub.com/doi/10.1177/1757913918774079). In the words of a SLH participant: ‘I feel as though my airways have really opened up and my natural breathing is more fluid. Singing has so many benefits: physical, emotional and pure enjoyment’. Group singing as a treatment for patients with chronic lung diseases is increasingly explored in Europe, North America, Australia and Africa, with research ongoing to study the physiological and psychosocial benefits for participants and how this intervention could best be implemented more widely (https://www.mdpi.com/2227-9059/10/9/2086#B14-biomedicines-10-02086). None declared.

Cover LegendThe 27th Congress of the APSR (https://apsr2023.sg/) will be held in Singapore, 16–19 November 2023, hosted by the Singapore Thoracic Society (STS). Photo credit: ‘The Buddhist temple in Chinatown in Singapore’ by Stefano / stock.adobe.comimage

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with worsening health outcomes and effective treatment of each episode is essential. In this study, we aimed to investigate if plasma levels of heparan sulphate (HS) are associated with the aetiology of AECOPD. COPD patients (N = 1189), GOLD grade II-IV, from a discovery cohort (N = 638) and from a validation cohort (N = 551), were included in the study. HS and heparanase (HSPE-1) were measured longitudinally in plasma at stable state, at AECOPD and at 4 weeks follow-up. Plasma HS was higher in patients with COPD as compared with non-COPD controls and was significantly increased at AECOPD as compared to stable state (p < 0.001) in the discovery and in the validation cohorts. Four distinct exacerbation groups were classified based on aetiology (no-infection/bacterial-infection/viral-infection/bacterial and viral coinfection) in the validation cohort. The fold-increase of HS from stable state to AECOPD was associated with the aetiology of exacerbation and was higher in cases with bacterial and viral coinfections. HSPE-1 was also significantly increased at AECOPD, however, there was no association of HSPE-1 levels with the aetiology of these events. The probability of having an infection at AECOPD was raised as HS levels increased from stable state to AECOPD. This probability was higher for bacterial infections than viral infections. The results of our study indicate that circulating levels of HS are increased at AECOPD and this increase may be associated with the aetiology of these events.

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Cover LegendThe 27th Congress of the APSR (https://apsr2023.sg/) will be held in Singapore, 16–19 November 2023, hosted by the Singapore Thoracic Society (STS). Photo credit: ‘Singapore Skyline And View Of Marina Bay At Night’ by orpheus26 / stock.adobe.comimage

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34 (duplicate of AO16-9) AP06-147 (duplicate of AP06-142) AP06-167 (duplicate of AP06-163)The organizer apologizes for these errors and any confusion they may have caused.