bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative systematic review: Sources of inaccuracy in manually measured adult respiratory rate data
Authors: Kallioinen Noa , Hill Andrew , Christofidis Melany J. , Horswill Mark S. , Watson Marcus O. 
Published: October 2020

AbstractAimsTo identify the potential sources of inaccuracy in manually measured adult respiratory rate (RR) data and quantify their effects.DesignQuantitative systematic review with meta‐analyses where appropriate.Data SourcesMedline, CINAHL, and Cochrane Library (from database inception to 31 July 2019).Review MethodsStudies presenting data on individual sources of inaccuracy in the manual measurement of adult RR were analysed, assessed for quality, and grouped according to the source of inaccuracy investigated. Quantitative data were extracted and synthesized and meta‐analyses performed where appropriate.ResultsIncluded studies (N = 49) identified five sources of inaccuracy. Theawareness effectcreates an artefactual reduction in actual RR, andobservation methodsinvolving shorter counts cause systematic underscoring. Individual RR measurements can differ substantially in either direction between observations due tointer‐orintra‐observer variability.Value bias, where particular RRs are over‐represented (suggesting estimation), is a widespread problem.Recording omissionis also widespread, with higher average rates in inpatient versus triage/admission contexts.ConclusionThis review demonstrates that manually measured RR data are subject to several potential sources of inaccuracy.ImpactRR is an important indicator of clinical deterioration and commonly included in track‐and‐trigger systems. However, the usefulness of RR data depends on the accuracy of the observations and documentation, which are subject to five potential sources of inaccuracy identified in this review. A single measurement may be affected by several factors. Hence, clinicians should interpret recorded RR data cautiously unless systems are in place to ensure its accuracy. For nurses, this includes counting rather than estimating RRs, employing 60‐s counts whenever possible, ensuring patients are unaware that their RR is being measured, and documenting the resulting value. For any given site, interventions to improve measurement should take into account the local organizational and cultural context, available resources, and the specific measurement issues that need to be addressed.
CSF‐1R inhibition disrupts the dialog between leukaemia cells and macrophages and delays leukaemia progression
Authors: Li Kun , Xu Wenfu , Lu Ke , Wen Yuxi , Xin Tianqing , Shen Yaqing , Lv Xueyan , Hu Shimin , Jin Runming , Wu Xiaoyan 
Published: October 2020

AbstractResearch in the last few years has revealed that leukaemic cells can remodel the bone marrow niche into a permissive environment favouring leukaemic stem cell expansion. Tumour‐associated macrophages (TAMs) are prominent components of the tumour microenvironment and play an important role in the onset and progression of solid tumours. However, little is known about their role in the development of acute lymphoblastic leukaemia (ALL). Using a unique mouse model of T‐ALL induced by injection of EL4 T‐cell lymphoma cells to syngeneic C57BL/6 mice, we report herein that ALL leads to the invasion of leukaemia‐associated monocyte‐derived cells (LAMs) into the bone marrow and spleen of T‐ALL mice. Furthermore, we found that leukaemia cells could polarize bone marrow–derived macrophages (BMDMs) into LAMs. In turn, LAMs were able to protect leukaemia cells from drug‐induced apoptosis in vitro. Therapies targeted against the TAMs by inhibiting colony stimulating factor‐1 receptor (CSF‐1R) have emerged as a promising approach for cancer treatment. In this study, we demonstrate that CSF‐1R inhibition inhibits the viability of BMDMs, blocks LAMs polarization and reduces the abundance of LAMs in T‐ALL mice. In vivo, combination treatment of CSF‐1R inhibitor and vincristine (VCR) dramatically increased the survival of T‐ALL mice and delayed leukaemia progression compared with VCR monotherapy. Finally, these data reinforce the role of microenvironments in leukaemia and suggest that macrophages are a potential target for the development of novel therapeutic strategies in T‐ALL.
3D wide‐field multispectral photoacoustic imaging of human melanomas in vivo: a pilot study
Authors: Park B. , Bang C.H. , Lee C. , Han J.H. , Choi W. , Kim J. , Park G.S. , Rhie J.W. , Lee J.H. , Kim C. 
Published: October 2020

AbstractBackgroundThe Breslow depth is an important parameter to determine the excision margin and prognosis of melanoma. However, it is difficult to accurately determine the actual Breslow depth before surgery using the existing ocular micrometer and biopsy technique.ObjectivesTo evaluate the use of 3D wide‐field multispectral photoacoustic imaging to non‐invasively measure depth and outline the boundary of melanomas for optimal surgical margin selection.MethodsSix melanoma patients were examined in vivo using the 3D multispectral photoacoustic imaging system. For five cases of melanomas (one in situ, three nodular, and one acral lentiginous type melanoma), the spectrally unmixed photoacoustic depths were calculated and compared against histopathological depths.ResultsSpectrally unmixed photoacoustic depths and histopathological depths match well within a mean absolute error of 0.36 mm. In particular, the measured minimum and maximum depths in the in situ and nodular type of melanoma were 0.6 and 9.1 mm, respectively. In the 3D photoacoustic image of one metastatic melanoma, feeding vessels were visualized in the melanoma, suggesting the neovascularization around the tumour.ConclusionsThe 3D multispectral photoacoustic imaging not only provides well‐measured depth and sizes of various types of melanomas, it also visualizes the metastatic type of melanoma. Obtaining accurate depth and boundary information of melanoma before surgery would play a useful role in the complete excision of melanoma during surgery.
Primary prevention of bleeding from esophageal varices in patients with liver cirrhosis: An update and review of the literature
Authors: Garbuzenko Dmitry Victorovich , Arefyev Nikolay Olegovich 
Published: October 2020

AbstractAll patients with liver cirrhosis and portal hypertension should be stratified by risk groups to individualize different therapeutic strategies to increase the effectiveness of treatment. In this regard, the development of primary prophylaxis of variceal bleeding and its management according to the severity of portal hypertension may be promising. This paper is to describe the modern principles of primary prophylaxis of esophageal variceal bleeding in patients with liver cirrhosis. The PubMed and EMbase databases, Web of Science, Google Scholar, and the Cochrane Database of Systematic Reviews were used to search for relevant publications from 1999 to 2019. The results suggested that depending on the severity of portal hypertension, patients with cirrhosis should be divided into those who need preprimary prophylaxis, which aims to prevent the formation of esophageal varices, and those who require measures that aim to prevent esophageal variceal bleeding. In subclinical portal hypertension, therapy should be etiological and pathogenetic. Cirrhosis with clinically significant portal hypertension should receive nonselective β‐blockers if they have small esophageal varices and risk factors for variceal bleeding. Nonselective β‐blockers are the first‐line drugs for the primary prevention of bleeding from medium to large‐sized esophageal varices. Endoscopic band ligation is indicated for the patients who are intolerant to nonselective β‐blockers or in the case of contraindications to pharmacological therapy. In summary, the stratification of cirrhotic patients by the severity of portal hypertension and an individual approach to the choice of treatment may increase the effectiveness of therapy as well as improve survival rate of these patients.
Effect of tube wall material on electrostatic separation of plant raw‐materials
Authors: Xing Qinhui , Kyriakopoulou Konstantina , de Wit Martin , Boom Remko M. , Schutyser Maarten A. I. 
Published: October 2020

AbstractThe influence of charging tube materials and diameter on the separation efficiencies of a gluten‐starch model mixture and lupine flour was studied. Offline analysis of tribo‐charging with different tube materials showed that gluten takes a positive and starch a negative charge. However, the charge of the mixture was found not equal to the sum of the charge of the individual components and measured charges could not be related to the triboelectric series. During electrostatic separation significant protein enrichment was observed for both plant raw‐materials. For the model mixture differences in protein, enrichment were observed between tube materials, but this was not the case for lupine flour. The lupine protein content increased from 37 to 65 g/100 g dry flour. Concluding, electrostatic separation needs to be evaluated during separation experiments, as particle‐particle interactions dominate the charging process and thus separation of mixtures.Practical applicationsThe combination of dry milling and electrostatic separation is investigated as a sustainable and mild route for protein fractionation. The results of this study showed that offline charging tube experiments could not predict separation performance of for example finely milled lupin flours. Instead, performance should be directly assessed during separation experiments, which is explained as charging is rather related to differences in material or triboelectric charging properties between powder particles than to charging tube wall properties. The results of this study benefit development of new applications for electrostatic separation.
Opportunistic upper endoscopy during colonoscopy as a screening strategy for countries with intermediate gastric cancer risk
Authors: Lau Joel Wen Liang , Khoo Mark Junn Wei , Leong Xue Hao , Lim Tian Zhi , Shabbir Asim , Yeoh Khay Guan , Koh Calvin Jianyi , So Jimmy Bok Yan 
Published: October 2020

AbstractBackground and AimScreening upper endoscopy can detect esophagogastric (OG) cancers early with improved outcomes. Recent cost‐utility studies suggest that opportunistic upper endoscopy at the same setting of colonoscopy might be a useful strategy for screening of OG cancers, and it may be more acceptable to the patients due to cost‐saving and convenience. We aim to study the diagnostic performance of this screening strategy in a country with intermediate gastric cancer risk.MethodsA retrospective cohort study using a prospective endoscopy database from 2015 to 2017 was performed. Patients included were individuals age > 40 who underwent opportunistic upper endoscopy at the same setting of colonoscopy without any OG symptoms. Neoplastic OG lesions are defined as cancer and high‐grade dysplasia. Pre‐neoplastic lesions include Barrett's esophagus (BE), intestinal metaplasia (IM), and atrophic gastritis (AG).ResultsThe study population involved 1414 patients. Neoplastic OG lesions were detected in five patients (0.35%). Pre‐neoplastic lesions were identified in 174 (12.3%) patients. IM was found in 146 (10.3%) patients with 21 (1.4%) having extensive IM. The number needed to scope to detect a neoplastic OG lesion is 282.8 with an estimated cost of USD$141 400 per lesion detected. On multivariate regression, age ≥ 60 (RR: 1.84, 95% CI: 1.29–2.63) and first‐degree relatives with gastric cancer (RR: 1.64, 95% CI: 1.06–2.55) were independent risk factors for neoplastic or pre‐neoplastic OG lesion.ConclusionFor countries with intermediate gastric cancer risk, opportunistic upper endoscopy may be an alternative screening strategy in a selected patient population. Prospective trials are warranted to validate its performance.
Endoscopic findings in the soft palatal mucosa are associated with the risk of esophageal squamous cell carcinoma
Authors: Waki Kotaro , Ishihara Ryu , Maekawa Akira , Inoue Takahiro , Shoji Ayaka , Matsueda Katunori , Miyake Muneaki , Fukuda Hiromu , Shichijo Satoki , Kanesaka Takashi , Takeuchi Yoji , Higashino Koji , Uedo Noriya , Michida Tomoki 
Published: October 2020

AbstractBackground and AimWe investigated endoscopic findings of the soft palatal mucosa to identify factors associated with esophageal squamous cell carcinoma (ESCC).MethodsThis study was conducted during endoscopic examinations of subjects at Osaka International Cancer Institute from January 2020 through May 2020. We took endoscopic images of the soft palate under non‐magnifying and mild‐magnifying observations. Subjects with ESCC or a history of ESCC were defined as the ESCC group. Two endoscopists who were blinded to subjects' clinical information interpreted 10 endoscopic findings: melanosis, brownish changes, whitish epithelium, vasodilation, circular alignment of dilated vessels, uneven surface, uneven epithelial color, uneven vessel visibility, palate ridge, and erosion. Subjects were interviewed about their alcohol use, smoking, and flushing reactions.ResultsTwo hundred eighty‐two subjects, including 151 in the ESCC group and 131 in the non‐ESCC group, were included in the analysis. Univariate analyses and multivariate logistic regression demonstrated that melanosis, whitish epithelium, and vasodilation were significantly associated with ESCC. The positive likelihood ratios (PLRs) of melanosis, whitish epithelium, and vasodilation were 3.3, 4.2, and 2.8, respectively. Additionally, the PLRs for three of the endoscopic findings in subjects with drinking and smoking habits were higher than in those without these habits—PLRs ranging from 7.23 to 19.1. High PLRs for three endoscopic findings suggested a high possibility of ESCC. Interobserver agreement was substantial for whitish epithelium, moderate for melanosis, and fair for vasodilation.ConclusionsThree endoscopic findings in soft palate were considered to be useful as alarming signs that indicate ESCC risk.
Benefits of phone consultation for endoscopy‐related clinics in the COVID‐19 pandemic
Authors: Zorron Cheng Tao Pu Leonardo , Singh Gurpreet , Rajadurai Anton , Terbah Ryma , De Silva Rahil , Vaughan Rhys , Efthymiou Marios , Chandran Sujievvan 
Published: October 2020

AbstractBackground and AimDuring COVID‐19 outbreak, restrictions to in‐person consultations were introduced with a rise in telehealth. An indirect benefit of telehealth could be better attendance. This study aimed to assess “failure‐to‐attend” (FTA) rate and satisfaction for two endoscopy‐related compulsory telehealth clinics during the COVID‐19 outbreak.MethodsConsecutive patients booked for endoscopy‐related telehealth clinics at a tertiary hospital were prospectively assessed. In‐person clinic control data were assessed retrospectively. Sample size was calculated to detect an anticipated increase in attendance of 8%. Secondary outcomes included FTA differences between clinics and evaluation of patients and doctors satisfaction. Satisfaction was assessed based on six Likert scale questions used in previous telehealth research and asked to both patients and doctors (6Q_score). This study was exempt from IRB review after institutional IRB review.ResultsThere were 691 patients booked for appointments in our endoscopy clinics during the study periods (373 in 2020). FTA rates were lowered by half during the compulsory telehealth clinics (12.6% to 6.4%, P < 0.01). The patient 6Q_score was higher for the advanced endoscopy clinic (84.6% vs 73.8%, P < 0.01), while the doctor 6Q_score was similar between both advanced clinics and post endoscopy clinics (91.1% vs 92.5% respectively, P = 0.80). An in‐person follow‐up consultation was suggested for 3.5% of the appointments, while the necessity of physical examination was flagged in 5.1%.ConclusionsThe use of phone consultations in endoscopy‐related clinics during the COVID‐19 outbreak has improved FTA rates while demonstrating high satisfaction rates. The need for in‐person follow‐up consultations and physical examination were low.
Effect of a Multifactorial Fall Injury Prevention Intervention on Patient Well‐Being: The STRIDE Study
Authors: Gill Thomas M. , Bhasin Shalender , Reuben David B. , Latham Nancy K. , Araujo Katy , Ganz David A. , Boult Chad , Wu Albert W. , Magaziner Jay , Alexander Neil , Wallace Robert B. , Miller Michael E. , Travison Thomas G. , Greenspan Susan L. , Gurwitz Jerry H. , Rich Jeremy , Volpi Elena , Waring Stephen C. , Manini Todd M. , Min Lillian C. , Teresi Jeanne , Dykes Patricia C. , McMahon Siobhan , McGloin Joanne M. , Skokos Eleni A. , Charpentier Peter , Basaria Shehzad , Duncan Pamela W. , Storer Thomas W. , Gazarian Priscilla , Allore Heather G. , Dziura James , Esserman Denise , Carnie Martha B. , Hanson Catherine , Ko Fred , Resnick Neil M. , Wiggins Jocelyn , Lu Charles , Meng Can , Goehring Lori , Fagan Maureen , Correa‐de‐Araujo Rosaly , Casteel Carri , Peduzzi Peter , Greene Erich J. 
Published: October 2020

BACKGROUND/OBJECTIVESIn the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study, a multifactorial intervention was associated with a nonsignificant 8% reduction in time to first serious fall injury but a significant 10% reduction in time to first self‐reported fall injury relative to enhanced usual care. The effect of the intervention on other outcomes important to patients has not yet been reported. We aimed to evaluate the effect of the intervention on patient well‐being including concern about falling, anxiety, depression, physical function, and disability.DESIGNPragmatic cluster‐randomized trial of 5,451 community‐living persons at high risk for serious fall injuries.SETTINGA total of 86 primary care practices within 10 U.S. healthcare systems.PARTICIPANTSA random subsample of 743 persons aged 75 and older.MEASUREMENTSThe well‐being measures, assessed at baseline, 12 months, and 24 months, included a modified version of the Fall Efficacy Scale, Patient‐Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scales, and Late‐Life Function and Disability Instrument.RESULTSParticipants in the intervention (n = 384) and control groups (n = 359) were comparable in age: mean (standard deviation) of 81.9 (4.7) versus 81.8 (5.0) years. Mean scores were similar between groups at 12 and 24 months for concern about falling, physical function, and disability, whereas the intervention group's mean scores on anxiety and depression were .7 points lower (i.e., better) at 12 months and .6 to .8 points lower at 24 months. For each of these outcomes, differences between the groups' adjusted least square mean changes from baseline to 12 and 24 months, respectively, were quantitatively small. The overall difference in means between groups over 2 years was statistically significant only for depression, favoring the intervention: −1.19 (99% confidence interval, −2.36 to −.02), with 3.5 points representing a minimally important difference.CONCLUSIONSSTRIDE's multifactorial intervention to reduce fall injuries was not associated with clinically meaningful improvements in patient well‐being.
Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes
Authors: Song Sunah , Wilson Brigid M. , Bej Taissa , Gravenstein Stefan , Carter Rebecca R. , Marek Joseph , Jump Robin L. P. 
Published: October 2020

BACKGROUNDData describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics.DESIGNRetrospective cohort study.SETTINGTwenty‐nine U.S. nursing homes in the same healthcare corporation.PARTICIPANTSResidents receiving skilled care in 2016.MEASUREMENTSWe used pharmacy invoice and nursing home census data to calculate the days of antibiotic therapy per 1,000 days of skilled care (1,000 DOSC), the rate of antibiotic starts per 1,000 DOSC, the length of antibiotic therapy, and the average antibiotic spectrum index. We also assessed correlations between antibiotic use and nursing home characteristics.RESULTSAntibiotics accounted for an average of 9.6% (±0.6%) of systemic medications prescribed among residents receiving skilled care. On average, 26.8% (±2.9%) of antibiotics were intravenous. Fluoroquinolones were prescribed at the highest rates (19% across all facilities), followed by beta‐lactam/beta‐lactamase inhibitors (11%), first‐ and second‐generation cephalosporins, sulfonamides, and oral tetracyclines (each at 9%). Both the proportion of residents using enrolled in Medicare and number of unique prescribers responsible for systemic prescriptions positively correlated with the rate of antibiotic starts.CONCLUSIONSOur study demonstrates that pharmacy invoices represent a useful and preexisting source of data for assessing antibiotic prescriptions among individuals receiving skilled nursing care. The correlation between the number of unique prescribers and antibiotic starts suggests that prescribers are central to efforts to improve antibiotic use in nursing homes.
Cancer cachexia: an overview of diagnostic criteria and therapeutic approaches for the accredited practicing dietitian
Authors: van der Meij B. S. , Teleni L. , McCarthy A. L. , Isenring E. A. 
Published: October 2020

AbstractBackgroundCancer cachexia (CC) is a multifactorial syndrome characterised by ongoing skeletal muscle loss that leads to progressive functional impairment driven by reduced food intake and abnormal metabolism. Despite the traditional use of non‐volitional weight loss as the primary marker of CC, there is no consensus on how to diagnose and manage CC.MethodsThe aim of this narrative review was to describe and discuss diagnostic criteria and therapeutic approaches for the accredited practicing dietitian with respect to identifying and managing CC.ResultsAvailable diagnostic criteria for cachexia include the cancer‐specific (Fearon and Cachexia Score) and general criteria (Evans and Global Leadership Initiative on Malnutrition). These include phenotypic criteria [weight loss, body mass index, (objective) muscle mass assessments, quality of life] and aetiological criteria (disease burden, inflammation, energy expenditure, anorexia and inadequate food intake) and can be incorporated into the nutrition care process (NCP). This informs the nutrition diagnosis of ‘chronic disease‐ or condition‐related malnutrition (undernutrition) as related to increased nutrient needs, anorexia or diminished intake due to CC’. Optimal nutrition care and management of CC is multidisciplinary, corrects for increased energy expenditure (via immunonutrition/eicosapentaenoic acid), suboptimal protein/energy intake and poor nutrition quality of life, and includes a physical exercise intervention. Monitoring of intervention efficacy should focus on maintaining or slowing the loss of muscle mass, with weight change as an alternative gross indicator.ConclusionsDietitians and the NCP can play an essential role with respect to identifying and managing CC, focusing on aspects of nutrition screening, assessment and intervention.