bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-tuberculous mycobacterial lung disease in patients with bronchiectasis: perceived risk, severity and guideline adherence in a European physician survey
Authors: Wagner Dirk , van Ingen Jakko , van der Laan Roald , Obradovic Marko 
Published: April 2020

BackgroundPatients with bronchiectasis are at increased risk of developing non-tuberculous mycobacteria lung disease (NTM-LD), and published guidelines recommend regular testing for NTM infection in this patient population.ObjectiveThis study aimed to survey physicians managing patients with bronchiectasis to understand the perceived risk of NTM to their patients, perceived disease severity and frequency of testing for NTM.MethodsThe study comprised an online survey of hospital-based physicians in the UK, Germany, Italy, France and the Netherlands. The target group were hospital-based physicians who had managed at least 10 adult patients with bronchiectasis over the preceding 12 months.ResultsIn total, 280 physicians completed the survey. Most (87%) thought their patients to be at particular risk of NTM, although it was perceived as a moderate risk versus other respiratory pathogens. Most perceived NTM-LD to impact patient morbidity (84%), and 61% indicated that NTM-LD significantly impacted mortality. 68% of all respondents did not test for NTM prior to initiating macrolide monotherapy, despite guidelines recommending testing. The perceived risk of and screening for NTM varied among countries.ConclusionsThe study demonstrates that physicians understand the risk of NTM-LD and associated morbidity in patients with bronchiectasis; however, a minority do not perceive that NTM-LD significantly affects mortality. Greater awareness of the need to test for NTM infection before initiating macrolide monotherapy for bronchiectasis is essential due to potential emergence of drug-resistant NTM.
Side effects of acetazolamide: a systematic review and meta-analysis assessing overall risk and dose dependence
Authors: Schmickl Christopher N , Owens Robert L , Orr Jeremy E , Edwards Bradley A , Malhotra Atul 
Published: April 2020

IntroductionAcetazolamide (AZM) is used for various conditions (eg, altitude sickness, sleep apnoea, glaucoma), but therapy is often limited by its side effect profile. Our objective was to estimate the risk of commonly reported side effects based on meta-analyses. We hypothesised that these risks are dose-dependent.MethodsWe queried MEDLINE/EMBASE (Medical Literature Analysis and Retrieval System Online/Excerpta Medica dataBASE) up until 04/10/2019, including any randomised placebo-controlled trial in which adults received oral AZM versus placebo reporting side effects. Eligibility assessment was performed by two independent reviewers. Data were abstracted by one reviewer who verified key entries at a second time point. For side effects reported by>3 studies a pooled effect estimate was calculated, and heterogeneity assessed via I2; for outcomes reported by>5 studies effect modification by total daily dose (EMbyTDD; <400 mg/d, 400–600 mg/d, >600 mg/d) was assessed via meta-regression. For pre-specified, primary outcomes (paraesthesias, taste disturbances, polyuria and fatigue) additional subgroup analyses were performed using demographics, intervention details, laboratory changes and risk of bias.ResultsWe included 42 studies in the meta-analyses (Nsubjects=1274/1211 in AZM/placebo groups). AZM increased the risk of all primary outcomes (p<0.01, I2≤16% and low-to-moderate quality of evidence for all)—the numbers needed to harm (95% CI; nStudies) for each were: paraesthesias 2.3 (95% CI 2 to 2.7; n=39), dysgeusia 18 (95% CI 10 to 38, n=22), polyuria 17 (95% CI 9 to 49; n=22), fatigue 11 (95% CI 6 to 24; n=14). The risk for paraesthesias (beta=1.8 (95% CI 1.1 to 2.9); PEMbyTDD=0.01) and dysgeusia (beta=3.1 (95% CI 1.2 to 8.2); PEMbyTDD=0.02) increased with higher AZM doses; the risk of fatigue also increased with higher dose but non-significantly (beta=2.6 (95% CI 0.7 to 9.4); PEMbyTDD=0.14).DiscussionThis comprehensive meta-analysis of low-to-moderate quality evidence defines risk of common AZM side effects and corroborates dose dependence of some side effects. These results may inform clinical decision making and support efforts to establish the lowest effective dose of AZM for various conditions.
High FLT3 Levels May Predict Sorafenib Benefit in Hepatocellular Carcinoma
Authors: Sun Wen , Li Shi-Chao , Xu Li , Zhong Wei , Wang Zhen-Guang , Pan Chu-zhi , Li Jing , Jin Guang-Zhi , Ta Na , Dong Wei , Liu Dan , Liu Hui , Wang Hong-Yang , Ding Jin 
Published: April 2020

Abstract

Purpose:
To identify a predictive biomarker of sorafenib for hepatocellular carcinoma personalized therapy.

Experimental Design:
The patients treated with or without sorafenib after hepatocellular carcinoma recurrence from multicenters were matched with propensity score matching analysis. The expression levels of Fms-like tyrosine kinase 3 (FLT3) in hepatocellular carcinoma specimens of the matched patients (n = 276) were analyzed by IHC. The optimal cut-off point of FLT3 levels for overall survival (OS) was defined via Cutoff Finder. Subgroup analysis of OS was employed to investigate the association between FLT3 levels and sorafenib benefit. The predictive value was assessed via Cox regression models with an interaction term. Hepatocellular carcinoma and paratumoral normal tissues were used to investigate the expression and copy-number variation of FLT3. Patient-derived xenograft (PDX) models were used to confirm the association between FLT3 levels and sorafenib response.

Results:
Patients with FLT3-high hepatocellular carcinoma exhibited a superior OS upon sorafenib treatment. High FLT3 levels were predictive of sorafenib benefit in terms of OS (Pinteraction = 0.00006). Copy-number losses and decreased expression of FLT3 in hepatocellular carcinoma were detected in about 64% of patients. Moreover, the PDXs derived from tumors with high FLT3 levels also displayed a better response to sorafenib.

Conclusions:
Sorafenib may be able to delay tumor progression in patients with FLT3-high hepatocellular carcinoma. This potential biomarker needs to be further validated in independent cohorts prior to helping stratify patients for precision therapy in advanced hepatocellular carcinoma.
Radiological Patterns of Drug-induced Interstitial Lung Disease (DILD) in Early-phase Oncology Clinical Trials
Authors: Terbuch Angelika , Tiu Crescens , Candilejo Irene Moreno , Scaranti Mariana , Curcean Andra , Bar Dan , Estevez Timon Miriam , Ameratunga Malaka , Ang Joo Ern , Ratoff Jonathan , Minchom Anna R. , Banerji Udai , de Bono Johann S. , Tunariu Nina , Lopez Juanita S. 
Published: April 2020

Abstract

Purpose:
Drug-induced interstitial lung disease (DILD) is a rare, but potentially fatal toxicity. Clinical and radiological features of DILD in the early experimental setting are poorly described.

Patients and Methods:
A total of 2,499 consecutive patients with advanced cancer on phase I clinical trials were included. DILD was identified by a dedicated radiologist and investigators, categorized per internationally recognized radiological patterns, and graded per Common Terminology Criteria for Adverse Events (CTCAE) and the Royal Marsden Hospital (RMH) DILD score. Clinical and radiological features of DILD were analyzed.

Results:
Sixty patients overall (2.4%) developed DILD. Median time to onset of DILD was 63 days (range, 14–336 days). A total of 45% of patients who developed DILD were clinically asymptomatic. Incidence was highest in patients receiving drug conjugates (7.4%), followed by inhibitors of the PI3K/AKT/mTOR pathway (3.9%). The most common pattern seen was hypersensitivity pneumonitis (33.3%), followed by nonspecific interstitial pneumonia (30%), and cryptogenic organizing pneumonia (26.7%). A higher DILD score [OR, 1.47, 95% confidence interval (CI), 1.19–1.81; P &lt; 0.001] and the pattern of DILD (OR, 5.83 for acute interstitial pneumonia; 95% CI, 0.38–90.26; P = 0.002) were significantly associated with a higher CTCAE grading. The only predictive factor for an improvement in DILD was an interruption of treatment (OR, 0.05; 95% CI, 0.01–0.35; P = 0.01).

Conclusions:
DILD in early-phase clinical trials is a toxicity of variable onset, with diverse clinical and radiological findings. Radiological findings precede clinical symptoms. The extent of the affected lung parenchyma, scored by the RMH DILD score, correlates with clinical presentation. Most events are low grade, and improve with treatment interruption, which should be considered early.
On the Relationship between the TKE Dissipation Rate and the Temperature Structure Function Parameter in the Convective Boundary Layer
Authors: Luce Hubert , Kantha Lakshmi , Hashiguchi Hiroyuki , Doddi Abhiram , Lawrence Dale , Yabuki Masanori 
Published: April 2020

Abstract
Under stably stratified conditions, the dissipation rate ε of turbulence kinetic energy (TKE) is related to the structure function parameter for temperature

, through the buoyancy frequency and the so-called mixing efficiency. A similar relationship does not exist for convective turbulence. In this paper, we propose an analytical expression relating ε and

in the convective boundary layer (CBL), by taking into account the effects of nonlocal heat transport under convective conditions using the Deardorff countergradient model. Measurements using unmanned aerial vehicles (UAVs) equipped with high-frequency response sensors to measure velocity and temperature fluctuations obtained during the two field campaigns conducted at Shigaraki MU observatory in June 2016 and 2017 are used to test this relationship between ε and

in the CBL. The selection of CBL cases for analysis was aided by auxiliary measurements from additional sensors (mainly radars), and these are described. Comparison with earlier results in the literature suggests that the proposed relationship works, if the countergradient term γ

D
in the Deardorff model, which is proportional to the ratio of the variances of potential temperature θ and vertical velocity w, is evaluated from in situ (airplane and UAV) observational data, but fails if evaluated from large-eddy simulation (LES) results. This appears to be caused by the tendency of the variance of θ in the upper part of the CBL and at the bottom of the entrainment zone to be underestimated by LES relative to in situ measurements from UAVs and aircraft. We discuss this anomaly and explore reasons for it.
Feelings, thoughts and experiences of caregivers of patients with schizophrenia
Authors: Bademli Kerime , Lök Neslihan 
Published: April 2020

Background: Caregivers have different experiences in the patient care process during which the role of providing care is fulfilled. Aim: The aim of this study was to provide data on the feelings, thoughts and experiences of the caregivers of patients with schizophrenia. Method: In this study, the phenomenological method was used. Results: The results of this study revealed the following themes: meaning of schizophrenia, the meaning of being caregiver, life before being caregiver, feeling of patients’ relatives, difficult areas while providing care, coping situations and metaphors produced by the caregivers. Conclusion: The results obtained from the study revealed that the caregivers of patients with schizophrenia need information about the mental illness and have a higher emotional burden. Practice Implications: Nurses should listen to caregivers’ experiences, inquire about the experience of caregivers regarding patient care and advise caregivers on how to take care of their patients.
Balint-style reflective practice groups in a year 4 undergraduate general practice attachment: experience of the first two years
Authors: Richards Helen , Polnay Adam , Wilkinson Peter , Read Elizabeth , Young Hilary 
Published: April 2020

Background and aims Many undergraduate medical curricula include reflective practice sessions based on traditional Balint-groups. Those sessions can help students to acknowledge that experiencing ‘negative’ feelings in relation to patients is normal and may contain important information about the clinical encounter. They may also help to protect students from some of the emotional challenges of studying medicine. The Edinburgh University scheme provides all students in their first clinical year with two dedicated reflective practice sessions. Here we report on experience of the first two years. Methods Students’ attitudes to the sessions were ascertained using a questionnaire, and views of the group leaders were assessed using a questionnaire and through informal verbal and email discussions. Practical difficulties were recorded as they arose. Results Students generally rated the sessions positively with regard to exploring relationships and self-reflection, and they found the sessions interesting and helpful. The sessions did not seem to affect career choice. The free-text comments suggested four positive themes and four areas for future modification. Conclusion We have succeeded in providing all undergraduate students with an opportunity to take part in a reflective practice. We have highlighted aspects which have been successful and suggested future improvements.
Contribution of street food to dietary intake of habitual urban consumers: A cross-sectional study in Kampala city, Uganda
Authors: Sseguya Wenceslaus , Matovu Nicholas , Swann Jessica , Draper Alizon 
Published: April 2020

Background: Street food has continued to be a popular food source in the urban settings of developing countries and is proving to be a vital urban dietary source. However, its dietary contribution among urban populations is yet to be comprehensively understood. Aim: To assess how street food contributes to the dietary intake of habitual street food consumers. Methods: We conducted a community-based cross-sectional study among habitual street food consumers in Kampala city. We defined habitual intake as consumption of a serving of any street food for ≥2 days/week regardless of the food group and number of times it was consumed in a particular day. Questionnaires were used to capture quantitative data on sociodemographic characteristics, anthropometry, 24-hour diet intake and 2-month street food consumption frequency. The Nutritics® diet analysis software version 4.3 and STATA version 13.0 were used for nutrient and statistical analyses respectively. Results: Street food contributed considerably to the daily intake of fat (49.1%), sodium (38.4%) and calcium (36.5%) and least towards the daily intake of vitamin A (11.3%). The majority of consumers opted for street food at breakfast (50%) whereas lunch and snacks featured the least for overall street food inclusion (all 20%). Overall, men demonstrated more dietary intake and inclusion at meals from street food than women. Conclusions: This study indicates a significant contribution of street food for urban consumers but men derive more benefit than women in terms of nutrient intake and inclusion of street food in meals.
Staging liver fibrosis on multiparametric MRI in a rabbit model with elastography, susceptibility-weighted imaging and T1ρ imaging: a preliminary study
Authors: Zou Li-Qiu , Zhao Feng , Zhang Hao , Zhang Kai , Xing Wei 
Published: April 2020

Background Magnetic resonance elastography (MRE), susceptibility-weighted imaging (SWI), and T1ρ are three techniques for staging of liver fibrosis (LF). Purpose To assess the value of MRE, SWI, and T1ρ imaging in staging LF. Material and Methods Sixty rabbits were injected with 50% CCl4oil solution, whereas 20 rabbits were given normal saline. All rabbits underwent pathological examination to determine LF stages. The liver stiffness (LS), liver-to-muscle signal intensity ratio (SIR), and T1ρ values were measured from MRE, SWI, and T1ρ imaging, respectively. Results The number of rabbits was 14, 11, 10, 9, and 11 for F0, F1, F2, F3, and F4, respectively. LS ( r = 0.91) and T1ρ ( r = 0.51) positively correlated with LF stages, while negative correlation was present for SIR ( r = –0.81). Among the three parameters, the LS values revealed the best diagnostic efficacy in staging LF, with an AUC value of 0.95 for ≥F1, 0.95 for ≥F2, 0.99 for ≥F3, and 0.98 for ≥F4. The combination of LS and SIR could best predict LF stages ≥F1, ≥F2, ≥F3 and ≥F4, with AUC values of 0.97, 0.98, 0.99, and 0.99, respectively, which were greater than those of the other two-paired parameters. A multiparametric analysis showed that the combination of all three parameters had AUC values of 0.97, 0.98, 1.00, and 1.00 for staging ≥F1, ≥F2, ≥F3, and ≥F4, respectively. Conclusion Multiparametric MR imaging was superior to individual imaging for LF staging.
Alexithymia, traumatic stress symptoms and burnout in female healthcare professionals
Authors: Riethof Norbert , Bob Petr , Laker Matthew , Zmolikova Jana , Jiraskova Terezie , Raboch Jiri 
Published: April 2020

Objective The burnout syndrome represents a defence mechanism against stress and includes stages with decreased ability to experience feelings and emotional states. This finding suggests that burnout might be closely linked to emotional ‘blindness’ as a defence mechanism against negative and overwhelming emotions known as alexithymia. The aim of this study is to examine the relationships between burnout syndrome, alexithymia, depression and traumatic stress symptoms in healthcare professionals. Methods This empirical study assessed female healthcare professionals who work with a population of patients with diabetes, utilizing the Maslach Burnout Inventory (MBI-HSSMP), Burnout Measure (BM), Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI-II) and Traumatic Stress Checklist (TSC-40). Data were analysed using Spearman’s correlation coefficient. Results A total of 114 female participants were included (age range, 31–60 years; mean age, 46.62 ± 8.71 years). Statistically significant associations were found between burnout syndrome (BM scores) and alexithymia (TAS-20) ( r = 0.41), and between BM scores and traumatic stress (TSC-40; r = 0.63). The MBI-HSSMP emotional exhaustion subscale also correlated with alexithymia (TAS-20) ( r = 0.37). Conclusion Findings of this study suggest that alexithymia and traumatic stress are related to burnout symptoms. This dynamic may be potentially useful for detecting and preventing burnout syndrome.
Peripapillary choroidal thickness in eyes with high myopia
Authors: Song Aiping , Hou Xincen , Zhuo Jian , Yu Tao 
Published: April 2020

Objective To investigate characteristics of peripapillary choroidal thickness (PCT) in Chinese patients with myopia without myopic maculopathy. Methods We retrospectively assessed 95 Chinese patients (95 eyes) with myopia without myopic maculopathy, who had visited the myopia clinic of Shandong Provincial Qianfoshan Hospital. Thirteen patients were excluded; the remaining 82 patients were divided into Groups 1 (spherical equivalent [SE], −0.5 to −6.0 D; axial length, 24–26 mm; n = 26), 2 (SE, −6.0 to −10.0 D; axial length, 26 to 28 mm; n = 34), and 3 (SE, ≥−10.0 D; axial length, ≥28 mm; n = 22). Enhanced depth imaging optical coherence tomography was used to measure PCT in inferior, superior, nasal, and temporal quadrants. Continuous variables were compared using one-way analysis of variance. Associations of PCT with SE and axial length were analyzed by Pearson correlation. Results PCT decreased with increasing SE and axial length in all quadrants. For each group, PCT was thickest in the temporal quadrant and thinnest in the inferior quadrant. PCT significantly differed between Groups 1 and 3 in superior, nasal, and temporal quadrants. Conclusions PCT decreased with increasing SE and axial length. PCT was thickest in the temporal quadrant and thinnest in the inferior quadrant in Chinese patients with myopia.
Lymph node metastasis in the space between the right carotid artery and jugular vein in papillary thyroid carcinoma
Authors: Chen Jian , Zhang Deguang , Fang Liang , He Gaofei , Gao Li 
Published: April 2020

Background The oblique brachiocephalic trunk and right common carotid artery constitute the right carotid sheath space (RCSS). The aim of this study was to detect the clinicopathologic factors associated with RCSS lymph node metastasis. Methods In total, 232 papillary thyroid carcinoma (PTC) patients with preoperative contrast-enhanced computed tomography scans were analyzed for associations between RCSS lymph node metastasis and clinicopathological factors. Results Among the 232 cases, 18 (7.76%) had suspicious RCSS lymph nodes, which was correlated with the presence of >5 metastatic lymph nodes, a larger thoracic inlet, and primary tumor size >2.15 cm. All pathologically confirmed metastatic lymph nodes were >1 cm in diameter. Conclusions The concept of “RCSS lymph node metastasis” was first introduced by this study. For PTC patients, a larger thoracic inlet, increased number of metastatic lymph nodes, and larger primary tumor size were related to RCSS lymph nodes, and more attention should be paid to patients who have lymph nodes >1 cm. A future prospective study will be designed to identify the potential risk factors for RCSS lymph node metastasis.
Erector spine plane block as postoperative rescue analgesia in thoracic surgery
Authors: Rispoli Marco , Tamburri Roberta , Nespoli Moana Rossella , Esposito Marianna , Mattiacci Dario Maria , Santonastaso Domenico Pietro , Casazza Dino , Amore Dario , Corcione Antonio 
Published: April 2020

Objective: Erector spine plane block (ESPB) is a newly defined regional anesthesia technique performed by injection of local anesthetic beneath the erector spine muscle. We tested ESPB as a regional rescue analgesia bedside technique to be performed in the thoracic surgical ward, reporting a 7-patient case series. Methods: We report our experience in rescue analgesia after thoracic surgery. During the postoperative stay, numeric rating scale (NRS) score >3 and inability to perform physiotherapy or effective cough due to postoperative pain represented the criteria for proposing rescue analgesia with ESPB. NRS at rest and during movements was recorded; blood gas analysis and spirometry were performed to evaluate PaO2/FiO2 (P/F), forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) before ESPB execution. After performing the ESPB, static and dynamic NRS, P/F, and FVC and FEV1 were recorded at 40 minutes and 80 minutes. Results: NRS had a reduction at rest and in dynamic assessment. The P/F did not improve but spirometric measures improved. FVC had a relevant improvement only after 80 minutes; FEV1 was increased after 40 minutes. Conclusion: The use of ESPB as postoperative rescue analgesia can offer several advantages due to effective rescue analgesia and safety that makes it easy to perform in the thoracic surgical ward or in an outpatient clinic setting.