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  • 1
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    Online Resource
    Digitally recorded and remotely classified lung auscultation compared with conventional stethoscope classifications among children aged 1–59 months enrolled in the Pneumonia Etiology Research for Child Health (PERCH) case–control study
    BMJ ; 2022
    In:  BMJ Open Respiratory Research Vol. 9, No. 1 ( 2022-05), p. e001144-
    Details
    In: BMJ Open Respiratory Research, BMJ, Vol. 9, No. 1 ( 2022-05), p. e001144-
    Abstract: Diagnosis of pneumonia remains challenging. Digitally recorded and remote human classified lung sounds may offer benefits beyond conventional auscultation, but it is unclear whether classifications differ between the two approaches. We evaluated concordance between digital and conventional auscultation. Methods We collected digitally recorded lung sounds, conventional auscultation classifications and clinical measures and samples from children with pneumonia (cases) in low-income and middle-income countries. Physicians remotely classified recordings as crackles, wheeze or uninterpretable. Conventional and digital auscultation concordance was evaluated among 383 pneumonia cases with concurrently (within 2 hours) collected conventional and digital auscultation classifications using prevalence-adjusted bias-adjusted kappa (PABAK). Using an expanded set of 737 cases that also incorporated the non-concurrently collected assessments, we evaluated whether associations between auscultation classifications and clinical or aetiological findings differed between conventional or digital auscultation using χ 2 tests and logistic regression adjusted for age, sex and site. Results Conventional and digital auscultation concordance was moderate for classifying crackles and/or wheeze versus neither crackles nor wheeze (PABAK=0.50), and fair for crackles-only versus not crackles-only (PABAK=0.30) and any wheeze versus no wheeze (PABAK=0.27). Crackles were more common on conventional auscultation, whereas wheeze was more frequent on digital auscultation. Compared with neither crackles nor wheeze, crackles-only on both conventional and digital auscultation was associated with abnormal chest radiographs (adjusted OR (aOR)=1.53, 95% CI 0.99 to 2.36; aOR=2.09, 95% CI 1.19 to 3.68, respectively); any wheeze was inversely associated with C-reactive protein 〉 40 mg/L using conventional auscultation (aOR=0.50, 95% CI 0.27 to 0.92) and with very severe pneumonia using digital auscultation (aOR=0.67, 95% CI 0.46 to 0.97). Crackles-only on digital auscultation was associated with mortality compared with any wheeze (aOR=2.70, 95% CI 1.12 to 6.25). Conclusions Conventional auscultation and remotely-classified digital auscultation displayed moderate concordance for presence/absence of wheeze and crackles among cases. Conventional and digital auscultation may provide different classification patterns, but wheeze was associated with decreased clinical severity on both.
    Type of Medium: Online Resource
    ISSN: 2052-4439
    URL: Article
    DOI: 10.1136/bmjresp-2021-001144
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2736454-9
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  • 2
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    Digital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in children
    Wiley ; 2020
    In:  Pediatric Pulmonology Vol. 55, No. 11 ( 2020-11), p. 3197-3208
    Details
    In: Pediatric Pulmonology, Wiley, Vol. 55, No. 11 ( 2020-11), p. 3197-3208
    Abstract: Whether digitally recorded lung sounds are associated with radiographic pneumonia or clinical outcomes among children in low‐income and middle‐income countries is unknown. We sought to address these knowledge gaps. Methods We enrolled 1 to 59monthold children hospitalized with pneumonia at eight African and Asian Pneumonia Etiology Research for Child Health sites in six countries, recorded digital stethoscope lung sounds, obtained chest radiographs, and collected clinical outcomes. Recordings were processed and classified into binary categories positive or negative for adventitial lung sounds. Listening and reading panels classified recordings and radiographs. Recording classification associations with chest radiographs with World Health Organization (WHO)‐defined primary endpoint pneumonia (radiographic pneumonia) or mortality were evaluated. We also examined case fatality among risk strata. Results Among children without WHO danger signs, wheezing (without crackles) had a lower adjusted odds ratio (aOR) for radiographic pneumonia (0.35, 95% confidence interval (CI): 0.15, 0.82), compared to children with normal recordings. Neither crackle only (no wheeze) (aOR: 2.13, 95% CI: 0.91, 4.96) or any wheeze (with or without crackle) (aOR: 0.63, 95% CI: 0.34, 1.15) were associated with radiographic pneumonia. Among children with WHO danger signs no lung recording classification was independently associated with radiographic pneumonia, although trends toward greater odds of radiographic pneumonia were observed among children classified with crackle only (no wheeze) or any wheeze (with or without crackle). Among children without WHO danger signs, those with recorded wheezing had a lower case fatality than those without wheezing (3.8% vs. 9.1%, p  = .03). Conclusions Among lower risk children without WHO danger signs digitally recorded wheezing is associated with a lower odds for radiographic pneumonia and with lower mortality. Although further research is needed, these data indicate that with further development digital auscultation may eventually contribute to child pneumonia care.
    Type of Medium: Online Resource
    ISSN: 8755-6863 , 1099-0496
    URL: Issue
    URL: Article
    DOI: 10.1002/ppul.v55.11
    DOI: 10.1002/ppul.25046
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1491904-7
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  • 3
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    Reporting of Resistance Training Dose, Adherence, and Tolerance in Exercise Oncology
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Medicine & Science in Sports & Exercise Vol. 52, No. 2 ( 2020-2), p. 315-322
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 2 ( 2020-2), p. 315-322
    Abstract: While general guidelines (such as CONSORT or Consensus on Exercise Reporting Template) exist to enhance the reporting of exercise interventions in the field of exercise science, there is inadequate detail facilitating the standardized reporting of resistance training adherence in the oncology setting. The purpose of this study was to apply a novel method to report resistance training dose, adherence, and tolerance in patients with cancer. Methods A total of 47 prostate cancer patients (70.1 ± 8.9 yr, body mass index, 28.6 ± 4.0) with bone metastatic disease completed an exercise program for 12 wk. We assessed traditional metrics of adherence (attendance and loss to follow-up), in addition to novel proposed metrics (exercise-relative dose intensity, dose modification, and exercise interruption). Total training volume in kilograms (repetitions × sets × training load (weight)) was calculated for each patient. Results Attendance assessed from traditional metrics was 79.5% ± 17.0% and four patients (9%) were lost to follow-up. The prescribed and actual cumulative total dose of resistance training was 139,886 ± 69,150 kg and 112,835 ± 83,499 kg, respectively, with a mean exercise-relative dose intensity of 77.4% ± 16.6% (range: 19.4% –99.4%). Resistance training was missed (1–2 consecutive sessions) or interrupted (missed ≥3 consecutive sessions) in 41 (87%) and 24 (51%) participants, respectively. Training dose was modified (reduction in sets, repetitions, or weight) in 40 (85%) of patients. Importantly, using attendance as a traditional metric of adherence, these sessions would have all counted as adherence to the protocol. Conclusions Traditional reporting metrics of resistance training in exercise oncology may overestimate exercise adherence. Our proposed metrics to capture resistance training dose, adherence, and tolerance may have important applications for future studies and clinical practice.
    Type of Medium: Online Resource
    ISSN: 1530-0315 , 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000002127
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 4
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    Pathogenesis And Symptomology Of The Exercise-hypogonodal Male Condition : 3683 Board #122 June 4, 9
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Medicine & Science in Sports & Exercise Vol. 48 ( 2016-05), p. 1026-
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 48 ( 2016-05), p. 1026-
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/01.mss.0000488086.72956.7b
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 5
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    Which PCDAI Version Best Reflects Intestinal Inflammation in Pediatric Crohn Disease?
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Pediatric Gastroenterology & Nutrition Vol. 64, No. 2 ( 2017-02), p. 254-260
    Details
    In: Journal of Pediatric Gastroenterology & Nutrition, Ovid Technologies (Wolters Kluwer Health), Vol. 64, No. 2 ( 2017-02), p. 254-260
    Abstract: There is increasing interest in measuring mucosal inflammation in Crohn disease (CD), but there are minimal data correlating the Pediatric Crohn's Disease Activity Index (PCDAI) versions (PCDAI, weighted Pediatric Crohn's Disease Activity Index [wPCDAI], abbreviated Pediatric Crohn's Disease Activity Index [abbrPCDAI] , and the short Pediatric Crohn's Disease Activity Index [shPCDAI]) with mucosal inflammation. Methods: We aimed to compare the 4 PCDAI versions head to head with endoscopic degree of inflammation as measured by the Simple Endoscopic Score for Crohn's Disease (SES-CD), fecal calprotectin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and to explore cut-off values that are associated with mucosal healing. We used the prospectively collected data from the ImageKids study on 100 children with CD undergoing colonoscopy and from the Growth Relapse and Outcomes with Therapy study (n = 222), in which 145 children had calprotectin data at week 12 after diagnosis. Results: All 4 PCDAI versions had fair correlation with the SES-CD ( r  = 0.42–0.45, all P   〈  0.001) and CRP ( r  = 0.32–0.45, all P   〈  0.01); the wPCDAI and PCDAI were superior to the shorter versions when comparing the blood tests. All versions had poor correlation with calprotectin, and only the wPCDAI reached significance ( r  = 0.26, P  = 0.002 vs r  = 0.15, P = 0.07 for PCDAI; r  = 0.08, P  = 0.37 for shPCDAI; r  = 0.06, P  = 0.5 for abbrPCDAI). The best cut-off to identify endoscopic mucosal healing was 〈 12.5 points for the wPCDAI (sensitivity 58% and specificity 84%) and 〈 10 for PCDAI (sensitivity 63% and specificity 77%). Conclusions: The more feasible wPCDAI and the PCDAI had comparable correlation with measures of endoscopic inflammation. These were slightly superior to the other 2 shorter versions, but still none of the PCDAI versions can give a valid assessment of mucosal healing.
    Type of Medium: Online Resource
    ISSN: 0277-2116 , 1536-4801
    URL: Article
    DOI: 10.1097/MPG.0000000000001227
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2078835-6
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  • 6
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    Liquid Chromatographic Determination of Glyphosate in Water-Soluble Granular Formulations: Collaborative Study
    Oxford University Press (OUP) ; 1997
    In:  Journal of AOAC INTERNATIONAL Vol. 80, No. 3 ( 1997-05-01), p. 464-468
    Details
    In: Journal of AOAC INTERNATIONAL, Oxford University Press (OUP), Vol. 80, No. 3 ( 1997-05-01), p. 464-468
    Abstract: A liquid chromatographic (LC) method for the determination of glyphosate in various water-soluble granular formulations was tested by 28 laboratories. Samples were dissolved in mobile phase and injected directly into an LC system with a 25 cm SAX column and a mobile phase of 96% aqueous buffer solution, 0.0062M KH2PO4, and 4% methanol. Detection was by UV absorption at 195 nm. Manual or automated injections were made via fixed-volume loops. Calculations were based on peak area comparisons with external standards. The collaborative study analyzed 5 matched pairs of 4 water-soluble granular formulations, with one determination per sample. The study generated 138 matched pairs, which were analyzed by using the AOAC spreadsheet and Youden’s matched-pair calculations. Coefficients of variation for the 4 formulations ranged from 0.65 to 1.37%. The LC method for the determination of glyphosate in water-soluble granular formulations has been adopted first action by AOAC INTERNATIONAL.
    Type of Medium: Online Resource
    ISSN: 1060-3271 , 1944-7922
    URL: Article
    DOI: 10.1093/jaoac/80.3.464
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 1997
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  • 7
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    Regulation of the synthesis of extracellular matrix components in chondroblasts transformed by a temperature-sensitive mutant of Rous sarcoma virus
    Elsevier BV ; 1982
    In:  Cell Vol. 30, No. 2 ( 1982-09), p. 373-383
    Details
    In: Cell, Elsevier BV, Vol. 30, No. 2 ( 1982-09), p. 373-383
    Type of Medium: Online Resource
    ISSN: 0092-8674
    URL: Article
    DOI: 10.1016/0092-8674(82)90235-5
    RVK:
    XA 36269
    RVK:
    WA 15000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 1982
    detail.hit.zdb_id: 187009-9
    detail.hit.zdb_id: 2001951-8
    SSG: 12
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  • 8
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    Five-Phase Replication of Behavioral Health Integration in Pediatric Primary Care
    American Academy of Pediatrics (AAP) ; 2021
    In:  Pediatrics Vol. 148, No. 2 ( 2021-08-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 148, No. 2 ( 2021-08-01)
    Abstract: Because of severe and protracted shortages of pediatric behavioral health (BH) specialists, collaboration between pediatric primary care practitioners (PCPs) and BH specialists has the potential to increase access to BH services by expanding the BH workforce. In a previous study, we demonstrated that phase 1 of a behavioral health integration program (BHIP) enrolling 13 independently owned, community-based pediatric practices was associated with increased access to BH services while averting substantial cost increases and achieving high provider self-efficacy and professional satisfaction. The current study was undertaken to assess whether the initial access findings were replicated over 4 subsequent implementation phases and to explore the practicality of broad dissemination of the BHIP model. METHODS After phase 1, BHIP was extended over 4 subsequent phases in a stepped-wedge design to 46 additional pediatric practices, for a total cohort of 59 practices (354 PCPs serving & gt;300 000 patients). Program components comprised BH education and consultation and support for integrated practice transformation; these components facilitated on-site BH services by an interprofessional BH team. Outcomes were assessed quarterly, preprogram and postprogram launch. RESULTS Across combined phases 1 to 5, BHIP was associated with increased primary care access to BH services (screening, psychotherapy, PCP BH visits, psychotropic prescribing) and performed well across 7 standard implementation outcome domains (acceptability, appropriateness, feasibility, fidelity, adoption, penetration, and sustainability). Emergency BH visits and attention-deficit/hyperactivity disorder prescribing were unchanged. CONCLUSIONS These findings provide further support for the potential of integrated care to increase access to BH services in pediatric primary care.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2020-001073
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2021
    detail.hit.zdb_id: 1477004-0
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  • 9
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    Five-Year Outcomes of Behavioral Health Integration in Pediatric Primary Care
    American Academy of Pediatrics (AAP) ; 2019
    In:  Pediatrics Vol. 144, No. 1 ( 2019-07-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 144, No. 1 ( 2019-07-01)
    Abstract: In the context of protracted shortages of pediatric behavioral health (BH) specialists, BH integration in pediatric primary care can increase access to BH services. The objectives of this study were to assess the structure and process of pediatric BH integration and outcomes in patient experience (access and quality), cost, and provider satisfaction. METHODS: In 2013, we launched a multicomponent, transdiagnostic integrated BH model (Behavioral Health Integration Program [BHIP]) in a large pediatric primary care network in Massachusetts. Study participants comprised the first 13 practices to enroll in BHIP (Phase-1). Phase-1 practices are distributed across Greater Boston, with ∼105 primary care practitioners serving ∼114 000 patients. Intervention components comprised in-depth BH education, on-demand psychiatric consultation, operational support for integrated practice transformation, and on-site clinical BH service. RESULTS: Over 5 years, BHIP was associated with increased practice-level BH integration (P & lt; .001), psychotherapy (P & lt; .001), and medical (P = .04) BH visits and guideline-congruent medication prescriptions for anxiety and depression (P = .05) and attention-deficit/hyperactivity disorder (P = .05). Total ambulatory BH spending increased by 8% in constant dollars over 5 years, mainly attributable to task-shifting from specialty to primary care. Although an initial decline in emergency BH visits from BHIP practices was not sustained, total emergency BH spending decreased by 19%. BHIP providers reported high BH self-efficacy and professional satisfaction from BHIP participation. CONCLUSIONS: Findings from this study suggest that integrating BH in the pediatric setting can increase access to quality BH services while engendering provider confidence and satisfaction and averting substantial increases in cost.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2018-3243
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2019
    detail.hit.zdb_id: 1477004-0
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  • 10
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    Collagen Synthesis in Virus‐transformed Cellsa
    Wiley ; 1985
    In:  Annals of the New York Academy of Sciences Vol. 460, No. 1 ( 1985-12), p. 202-213
    Details
    In: Annals of the New York Academy of Sciences, Wiley, Vol. 460, No. 1 ( 1985-12), p. 202-213
    Type of Medium: Online Resource
    ISSN: 0077-8923 , 1749-6632
    URL: Issue
    URL: Article
    DOI: 10.1111/nyas.1985.460.issue-1
    DOI: 10.1111/j.1749-6632.1985.tb51168.x
    RVK:
    TD 7650
    Language: English
    Publisher: Wiley
    Publication Date: 1985
    detail.hit.zdb_id: 2834079-6
    detail.hit.zdb_id: 211003-9
    detail.hit.zdb_id: 2071584-5
    SSG: 11
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