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Large cohort analyses from the COPDGene cohort also showed that fSAD quantified by CT-PRM was common in subjects who had not yet developed airflow limitation diagnosed by spirometry and was associated with accelerated FEV 1 decline and adverse clinical outcomes during follow-up, which reinforced the value of imaging fSAD in early identification and risk stratification (83)

40 Hulsker, Jan, The new complete Van Gogh : paintings, drawings, sketches , Amsterdam, 1996, pp

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However, responsible use, good ventilation, and awareness can significantly mitigate these risks

Given the well-established efficacy of bariatric surgery and the Crowns obligations under Te Tiriti o Waitangi (TToW), equitable distribution of surgical resources is imperative