Annals of the American Thoracic Society最新文献

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Exhaled Volatile Organic Compound Profiles Differ between Children with Primary Ciliary Dyskinesia and Cystic Fibrosis. 原发性睫状体运动障碍和囊性纤维化儿童呼气挥发性有机化合物的特征不同。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-11-01 DOI: 10.1513/AnnalsATS.202302-165RL
Elias Seidl, Johann-Christoph Licht, Wallace B Wee, Martin Post, Felix Ratjen, Hartmut Grasemann
{"title":"Exhaled Volatile Organic Compound Profiles Differ between Children with Primary Ciliary Dyskinesia and Cystic Fibrosis.","authors":"Elias Seidl, Johann-Christoph Licht, Wallace B Wee, Martin Post, Felix Ratjen, Hartmut Grasemann","doi":"10.1513/AnnalsATS.202302-165RL","DOIUrl":"10.1513/AnnalsATS.202302-165RL","url":null,"abstract":"","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1667-1672"},"PeriodicalIF":8.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of the SARS-CoV-2 Pandemic on Outcomes of CAPTURE; a Primary Care COPD Screening Study SARS-CoV-2大流行对捕获结果的影响一项初级保健COPD筛查研究
2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-16 DOI: 10.1513/annalsats.202305-478rl
Barbara P Yawn, Barry Make, David Mannino, Camden Lopez, Susan Murray, Byron Thomashow, Randall Brown, Rowena J. Dolor, Min Joo, Hazel Tapp, Linda Zittleman, Catherine Meldrum, Stacey Anderson, Fernando J. Martinez, MeiLan K. Han
{"title":"Impact of the SARS-CoV-2 Pandemic on Outcomes of CAPTURE; a Primary Care COPD Screening Study","authors":"Barbara P Yawn, Barry Make, David Mannino, Camden Lopez, Susan Murray, Byron Thomashow, Randall Brown, Rowena J. Dolor, Min Joo, Hazel Tapp, Linda Zittleman, Catherine Meldrum, Stacey Anderson, Fernando J. Martinez, MeiLan K. Han","doi":"10.1513/annalsats.202305-478rl","DOIUrl":"https://doi.org/10.1513/annalsats.202305-478rl","url":null,"abstract":"\"Impact of the SARS-CoV-2 Pandemic on Outcomes of CAPTURE; a Primary Care COPD Screening Study.\" Annals of the American Thoracic Society, 0(ja), pp.","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Epidemiology of Maternal Critical Illness between 2008 and 2021. 2008年至2021年孕产妇危重症流行病学。
IF 6.8 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202301-071RL
Deepshikha Charan Ashana, Catherine Chen, Katrina Hauschildt, Leslie Moroz, Emily A Vail, Elizabeth M Viglianti, Kelly C Vranas, Hayley B Gershengorn
{"title":"The Epidemiology of Maternal Critical Illness between 2008 and 2021.","authors":"Deepshikha Charan Ashana, Catherine Chen, Katrina Hauschildt, Leslie Moroz, Emily A Vail, Elizabeth M Viglianti, Kelly C Vranas, Hayley B Gershengorn","doi":"10.1513/AnnalsATS.202301-071RL","DOIUrl":"10.1513/AnnalsATS.202301-071RL","url":null,"abstract":"","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1531-1537"},"PeriodicalIF":6.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Right Ventricular Dysfunction Patterns among Patients with COVID-19 in the Intensive Care Unit: A Retrospective Cohort Analysis. 重症监护病房新冠肺炎患者右心室功能障碍模式:回顾性队列分析。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202303-235OC
Pablo A Sanchez, Christian T O'Donnell, Nadia Francisco, Everton J Santana, Andrew R Moore, Ana Pacheco-Navarro, Jonasel Roque, Katherine M Lebold, Caitlin M Parmer-Chow, Shaun M Pienkos, Bettia E Celestin, Joseph E Levitt, William J Collins, Michael J Lanspa, Euan A Ashley, Jennifer G Wilson, Francois Haddad, Angela J Rogers
{"title":"Right Ventricular Dysfunction Patterns among Patients with COVID-19 in the Intensive Care Unit: A Retrospective Cohort Analysis.","authors":"Pablo A Sanchez, Christian T O'Donnell, Nadia Francisco, Everton J Santana, Andrew R Moore, Ana Pacheco-Navarro, Jonasel Roque, Katherine M Lebold, Caitlin M Parmer-Chow, Shaun M Pienkos, Bettia E Celestin, Joseph E Levitt, William J Collins, Michael J Lanspa, Euan A Ashley, Jennifer G Wilson, Francois Haddad, Angela J Rogers","doi":"10.1513/AnnalsATS.202303-235OC","DOIUrl":"10.1513/AnnalsATS.202303-235OC","url":null,"abstract":"<p><p><b>Rationale:</b> Right ventricular (RV) dysfunction is common among patients hospitalized with coronavirus disease (COVID-19); however, its epidemiology may depend on the echocardiographic parameters used to define it. <b>Objectives:</b> To evaluate the prevalence of abnormalities in three common echocardiographic parameters of RV function among patients with COVID-19 admitted to the intensive care unit (ICU), as well as the effect of RV dilatation on differential parameter abnormality and the association of RV dysfunction with 60-day mortality. <b>Methods:</b> We conducted a retrospective cohort study of ICU patients with COVID-19 between March 4, 2020, and March 4, 2021, who received a transthoracic echocardiogram within 48 hours before to at most 7 days after ICU admission. RV dysfunction and dilatation, respectively, were defined by guideline thresholds for tricuspid annular plane systolic excursion (TAPSE), RV fractional area change, RV free wall longitudinal strain (RVFWS), and RV basal dimension or RV end-diastolic area. Association of RV dysfunction with 60-day mortality was assessed through logistic regression adjusting for age, prior history of congestive heart failure, invasive ventilation at the time of transthoracic echocardiogram, and Acute Physiology and Chronic Health Evaluation II score. <b>Results:</b> A total of 116 patients were included, of whom 69% had RV dysfunction by one or more parameters, and 36.3% of these had RV dilatation. The three most common patterns of RV dysfunction were the presence of three abnormalities, the combination of abnormal RVFWS and TAPSE, and isolated TAPSE abnormality. Patients with RV dilatation had worse RV fractional area change (24% vs. 36%; <i>P</i> = 0.001), worse RVFWS (16.3% vs. 19.1%; <i>P</i> = 0.005), higher RV systolic pressure (45 mm Hg vs. 31 mm Hg; <i>P</i> = 0.001) but similar TAPSE (13 mm vs. 13 mm; <i>P</i> = 0.30) compared with those with normal RV size. After multivariable adjustment, 60-day mortality was significantly associated with RV dysfunction (odds ratio, 2.91; 95% confidence interval, 1.01-9.44), as was the presence of at least two parameter abnormalities. <b>Conclusions:</b> ICU patients with COVID-19 had significant heterogeneity in RV function abnormalities present with different patterns associated with RV dilatation. RV dysfunction by any parameter was associated with increased mortality. Therefore, a multiparameter evaluation may be critical in recognizing RV dysfunction in COVID-19.</p>","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1465-1474"},"PeriodicalIF":8.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/84/AnnalsATS.202303-235OC.PMC10559129.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9850847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Race-Specific Interpretation of Spirometry: Impact on the Lung Allocation Score. 肺活量测量的种族特异性解释:对肺分配评分的影响。
IF 6.8 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202212-1004OC
J Henry Brems, Aparna Balasubramanian, Kevin J Psoter, Pali Shah, Errol L Bush, Christian A Merlo, Meredith C McCormack
{"title":"Race-Specific Interpretation of Spirometry: Impact on the Lung Allocation Score.","authors":"J Henry Brems, Aparna Balasubramanian, Kevin J Psoter, Pali Shah, Errol L Bush, Christian A Merlo, Meredith C McCormack","doi":"10.1513/AnnalsATS.202212-1004OC","DOIUrl":"10.1513/AnnalsATS.202212-1004OC","url":null,"abstract":"<p><p><b>Rationale:</b> Interpretation of spirometry using race-specific reference equations may contribute to health disparities via underestimation of the degree of lung function impairment in Black patients. The use of race-specific equations may differentially affect patients with severe respiratory disease via the use of percentage predicted forced vital capacity (FVCpp) when included in the lung allocation score (LAS), the primary determinant of priority for lung transplantation. <b>Objectives:</b> To determine the impact of a race-specific versus a race-neutral approach to spirometry interpretation on the LAS among adults listed for lung transplantation in the United States. <b>Methods:</b> We developed a cohort from the United Network for Organ Sharing database including all White and Black adults listed for lung transplantation between January 7, 2009, and February 18, 2015. The LAS at listing was calculated for each patient under race-specific and race-neutral approaches, using the FVCpp generated from the Global Lung Function Initiative equation corresponding to each patient's race (race-specific) or from the Global Lung Function Initiative \"other\" (race-neutral) equation. Differences in LAS between approaches were compared by race, with positive values indicating a higher LAS under the race-neutral approach. <b>Results:</b> In this cohort of 8,982 patients, 90.3% were White and 9.7% were Black. The mean FVCpp was 4.4% higher versus 3.8% lower among White versus Black patients (<i>P</i> < 0.001) under a race-neutral compared with a race-specific approach. Compared with White patients, Black patients had a higher mean LAS under both a race-specific (41.9 vs. 43.9; <i>P</i> < 0.001) and a race-neutral (41.3 vs. 44.3; <i>P</i> < 0.001) approach. However, the mean difference in LAS under a race-neutral approach was -0.6 versus +0.6 for White versus Black patients (<i>P</i> < 0.001). Differences in LAS under a race-neutral approach were most pronounced for those in group B (pulmonary vascular disease) (-0.71 vs. +0.70; <i>P</i> < 0.001) and group D (restrictive lung disease) (-0.78 vs. +0.68; <i>P</i> < 0.001). <b>Conclusions:</b> A race-specific approach to spirometry interpretation has potential to adversely affect the care of Black patients with advanced respiratory disease. Compared with a race-neutral approach, a race-specific approach resulted in lower LASs for Black patients and higher LASs for White patients, which may have contributed to racially biased allocation of lung transplantation. The future use of race-specific equations must be carefully considered.</p>","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1408-1415"},"PeriodicalIF":6.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynamic Ventilatory Reserve During Incremental Exercise: Reference Values and Clinical Validation in Chronic Obstructive Pulmonary Disease. 递增运动期间的动态通气储备:慢性阻塞性肺病的参考值和临床验证。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202304-303OC
Danilo C Berton, Franciele Plachi, Matthew D James, Sandra G Vincent, Reginald M Smyth, Nicolle J Domnik, Devin B Phillips, Juan P de-Torres, Luiz E Nery, Denis E O'Donnell, J Alberto Neder
{"title":"Dynamic Ventilatory Reserve During Incremental Exercise: Reference Values and Clinical Validation in Chronic Obstructive Pulmonary Disease.","authors":"Danilo C Berton,&nbsp;Franciele Plachi,&nbsp;Matthew D James,&nbsp;Sandra G Vincent,&nbsp;Reginald M Smyth,&nbsp;Nicolle J Domnik,&nbsp;Devin B Phillips,&nbsp;Juan P de-Torres,&nbsp;Luiz E Nery,&nbsp;Denis E O'Donnell,&nbsp;J Alberto Neder","doi":"10.1513/AnnalsATS.202304-303OC","DOIUrl":"10.1513/AnnalsATS.202304-303OC","url":null,"abstract":"<p><p><b>Rationale:</b> Ventilatory demand-capacity imbalance, as inferred based on a low ventilatory reserve, is currently assessed only at peak cardiopulmonary exercise testing (CPET). Peak ventilatory reserve, however, is poorly sensitive to the submaximal, dynamic mechanical ventilatory abnormalities that are key to dyspnea genesis and exercise intolerance. <b>Objectives:</b> After establishing sex- and age-corrected norms for dynamic ventilatory reserve at progressively higher work rates, we compared peak and dynamic ventilatory reserve for their ability to expose increased exertional dyspnea and poor exercise tolerance in mild to very severe chronic obstructive pulmonary disease (COPD). <b>Methods:</b> We analyzed resting functional and incremental CPET data from 275 controls (130 men, aged 19-85 yr) and 359 Global Initiative for Chronic Obstructive Lung Disease patients with stage 1-4 obstruction (203 men) who were prospectively recruited for previous ethically approved studies in three research centers. In addition to peak and dynamic ventilatory reserve (1 - [ventilation / estimated maximal voluntary ventilation] × 100), operating lung volumes and dyspnea scores (0-10 on the Borg scale) were obtained. <b>Results:</b> Dynamic ventilatory reserve was asymmetrically distributed in controls; thus, we calculated its centile distribution at every 20 W. The lower limit of normal (lower than the fifth centile) was consistently lower in women and older subjects. Peak and dynamic ventilatory reserve disagreed significantly in indicating an abnormally low test result in patients: whereas approximately 50% of those with a normal peak ventilatory reserve showed a reduced dynamic ventilatory reserve, the opposite was found in approximately 15% (<i>P</i> < 0.001). Irrespective of peak ventilatory reserve and COPD severity, patients who had a dynamic ventilatory reserve below the lower limit of normal at an isowork rate of 40 W had greater ventilatory requirements, prompting earlier attainment of critically low inspiratory reserve. Consequently, they reported higher dyspnea scores, showing poorer exercise tolerance compared with those with preserved dynamic ventilatory reserve. Conversely, patients with preserved dynamic ventilatory reserve but reduced peak ventilatory reserve reported the lowest dyspnea scores, showing the best exercise tolerance. <b>Conclusions:</b> Reduced submaximal dynamic ventilatory reserve, even in the setting of preserved peak ventilatory reserve, is a powerful predictor of exertional dyspnea and exercise intolerance in COPD. This new parameter of ventilatory demand-capacity mismatch may enhance the yield of clinical CPET in the investigation of activity-related breathlessness in individual patients with COPD and other prevalent cardiopulmonary diseases.</p>","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1425-1434"},"PeriodicalIF":8.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9749466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Randomized Controlled Clinical Trial of Lung Volume Recruitment in Adults with Neuromuscular Disease. 成人神经肌肉疾病患者肺容量恢复的随机对照临床试验。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202212-1062OC
Nicole L Sheers, Mark E Howard, Peter D Rochford, Linda Rautela, Caroline Chao, Douglas A McKim, David J Berlowitz
{"title":"A Randomized Controlled Clinical Trial of Lung Volume Recruitment in Adults with Neuromuscular Disease.","authors":"Nicole L Sheers,&nbsp;Mark E Howard,&nbsp;Peter D Rochford,&nbsp;Linda Rautela,&nbsp;Caroline Chao,&nbsp;Douglas A McKim,&nbsp;David J Berlowitz","doi":"10.1513/AnnalsATS.202212-1062OC","DOIUrl":"10.1513/AnnalsATS.202212-1062OC","url":null,"abstract":"<p><p><b>Rationale:</b> Clinical care guidelines advise that lung volume recruitment (LVR) be performed routinely by people with neuromuscular disease (NMD) to maintain lung and chest wall flexibility and slow lung function decline. However, the evidence base is limited, and no randomized controlled trials of regular LVR in adults have been published. <b>Objectives:</b> To evaluate the effect of regular LVR on respiratory function and quality of life in adults with NMD. <b>Methods:</b> A randomized controlled trial with assessor blinding was conducted between September 2015 and May 2019. People (>14 years old) with NMD and vital capacity <80% predicted were eligible, stratified by disease subgroup (amyotrophic lateral sclerosis/motor neuron disease or other NMDs), and randomized to 3 months of twice-daily LVR or breathing exercises. The primary outcome was change in maximum insufflation capacity (MIC) from baseline to 3 months, analyzed using a linear mixed model approach. <b>Results:</b> Seventy-six participants (47% woman; median age, 57 [31-68] years; mean baseline vital capacity, 40 ± 18% predicted) were randomized (LVR, <i>n</i> = 37). Seventy-three participants completed the study. There was a statistically significant difference in MIC between groups (linear model interaction effect <i>P</i> = 0.002, observed mean difference, 0.19 [0.00-0.39] L). MIC increased by 0.13 (0.01-0.25) L in the LVR group, predominantly within the first month. No interaction or treatment effects were observed in secondary outcomes of lung volumes, respiratory system compliance, and quality of life. No adverse events were reported. <b>Conclusions:</b> Regular LVR increased MIC in a sample of LVR-naive participants with NMD. We found no direct evidence that regular LVR modifies respiratory mechanics or slows the rate of lung volume decline. The implications of increasing MIC are unclear, and the change in MIC may represent practice. Prospective long-term clinical cohorts with comprehensive follow-up, objective LVR use, and clinically meaningful outcome data are needed. Clinical trial registered with anzctr.org.au (ACTRN12615000565549).</p>","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1445-1455"},"PeriodicalIF":8.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/63/AnnalsATS.202212-1062OC.PMC10559144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10086606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mobile Mindfulness for Psychological Distress and Burnout among Frontline COVID-19 Nurses: A Pilot Randomized Trial. 移动正念治疗新冠肺炎一线护士心理困扰和精疲力竭:一项随机试验。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202301-025OC
Elias H Pratt, Levant Hall, Christina Jennings, Maren K Olsen, Adina Jan, Alice Parish, Laura S Porter, Christopher E Cox
{"title":"Mobile Mindfulness for Psychological Distress and Burnout among Frontline COVID-19 Nurses: A Pilot Randomized Trial.","authors":"Elias H Pratt,&nbsp;Levant Hall,&nbsp;Christina Jennings,&nbsp;Maren K Olsen,&nbsp;Adina Jan,&nbsp;Alice Parish,&nbsp;Laura S Porter,&nbsp;Christopher E Cox","doi":"10.1513/AnnalsATS.202301-025OC","DOIUrl":"10.1513/AnnalsATS.202301-025OC","url":null,"abstract":"<p><p><b>Rationale:</b> The coronavirus disease (COVID-19) pandemic exacerbated psychological distress and burnout in frontline healthcare workers. Interventions addressing psychological distress and burnout among these workers are lacking. <b>Objectives:</b> To determine the feasibility and explore the impact of mobile mindfulness to treat psychological distress and burnout among nurses in frontline COVID-19 units. <b>Methods:</b> We conducted a pilot randomized trial of 102 nurses working in COVID-19 units at a single hospital between May 2021 and January 2022. Participants were randomized to mobile mindfulness (intervention) or waiting list (control). The primary outcome was feasibility, assessed by comparing rates of randomization, retention, and intervention completion to predefined targets. Secondary outcomes were changes in psychological distress (Patient Health Questionnaire-9, General Anxiety Disorder-7, Perceived Stress Scale-4) and burnout symptoms (Maslach Burnout Inventory) after 1 month. <b>Results:</b> We randomized 102 of 113 consented individuals (90%, target 80%), and 88 completed follow-up (86%, target 80%). Among 69 intervention participants, 19 completed ⩾1 mindfulness session per week (28%, target 60%), and 13 completed ⩾75% of mindfulness sessions (19%, target 50%). Intervention participants had greater decreases in Patient Health Questionnaire-9 scores than control subjects (difference in differences, -2.21; 95% confidence interval, -3.99, -0.42; <i>P</i> = 0.016), but the Maslach Burnout Inventory depersonalization scores decreased more in the control arm than in the intervention arm (difference in differences, 1.60; 95% confidence interval, 0.18, 3.02; <i>P</i> = 0.027). There were no other changes in emotional distress or burnout symptoms. <b>Conclusions:</b> This trial of mobile mindfulness in frontline nurses met feasibility targets for randomization and retention, but participants had modest intervention use. Intervention participants had a reduction in depression symptoms, but not in burnout. Clinical trial registered with www.clinicaltrials.gov (NCT04816708).</p>","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1475-1482"},"PeriodicalIF":8.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/59/AnnalsATS.202301-025OC.PMC10559143.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10054149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The Effect of Definitions and Cancer Prevalence on Diagnostic Yield Estimates of Bronchoscopy: A Simulation-based Analysis. 定义和癌症患病率对支气管镜诊断率估计的影响:基于模拟的分析。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202302-182OC
Anil Vachani, Fabien Maldonado, Balaji Laxmanan, Meijia Zhou, Iftekhar Kalsekar, Philippe Szapary, Lisa Dooley, Septimiu Murgu
{"title":"The Effect of Definitions and Cancer Prevalence on Diagnostic Yield Estimates of Bronchoscopy: A Simulation-based Analysis.","authors":"Anil Vachani,&nbsp;Fabien Maldonado,&nbsp;Balaji Laxmanan,&nbsp;Meijia Zhou,&nbsp;Iftekhar Kalsekar,&nbsp;Philippe Szapary,&nbsp;Lisa Dooley,&nbsp;Septimiu Murgu","doi":"10.1513/AnnalsATS.202302-182OC","DOIUrl":"10.1513/AnnalsATS.202302-182OC","url":null,"abstract":"<p><p><b>Rationale:</b> Studies of bronchoscopy have reported diagnostic yield (DY) using different calculation methods, which has hindered comparisons across studies. <b>Objectives:</b> To quantify the effect of the variability of four methods on DY estimates of bronchoscopy. <b>Methods:</b> We performed a simulation-based analysis of patients undergoing bronchoscopy using variations around base case assumptions for cancer prevalence (60%), distribution of nonmalignant findings, and degree of follow-up information at a fixed sensitivity of bronchoscopy for malignancy (80%). We calculated DY, the rate of true positives and true negatives (TNs), using four methods. Method 1 considered malignant and specific benign findings at index bronchoscopy as true positives and TNs, respectively. Method 2 included nonspecific benign findings as TNs. Method 3 considered nonspecific benign findings cases as TNs only if follow-up confirmed benign disease. Method 4 counted all cases with a nonmalignant diagnosis as TNs if follow-up confirmed benign disease. A scenario analysis and probabilistic sensitivity analysis were conducted to demonstrate the effect of parameter estimates on DY. A change in DY of >10% was considered clinically meaningful. <b>Results:</b> Across all pairwise comparisons of the four methods, a DY difference of >10% was observed in 76.7% of cases (45,992 of 60,000 comparisons). Method 4 resulted in DY estimates that were >10% higher than estimates made with other methods in >90% of scenarios. Variation in cancer prevalence had a large effect on DY. <b>Conclusions:</b> Across a wide range of clinical scenarios, the categorization of nonmalignant findings at index bronchoscopy and cancer prevalence had the largest impact on DY. The large variability in DY estimates across the four methods limits the interpretation of bronchoscopy studies and warrants standardization.</p>","PeriodicalId":8018,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1491-1498"},"PeriodicalIF":8.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Beneficial Effects of Early Intervention Telemedicine-based Follow-Up in Sleep Apnea: A Randomized Controlled Multicenter Trial. 基于远程医疗的睡眠呼吸暂停早期干预随访的有益效果:一项随机对照多中心试验。
IF 8.3 2区 医学
Annals of the American Thoracic Society Pub Date : 2023-10-01 DOI: 10.1513/AnnalsATS.202208-723OC
Benedikt Fridriksson, Marianne Berndtson, Henrik Hamnered, Erik Faeder, Ding Zou, Jan Hedner, Ludger Grote
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