Clinical phenotypes of COPD and health-related quality of life: a cross-sectional study

The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes

Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial

Aims: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s. Methods and results: In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002). Conclusions: Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring. Keywords: Anticoagulation; Atrial fibrillation; Cryptogenic stroke; Digital health; Smartphone electrocardiogram.

Dyspnea improvement in patients with lung diseases in a single session of mindful breathing: a randomized controlled study

Background and Aims: Mindful breathing has been practised in recent decades and there is a lack of study for it as a nonpharmacological method in improving dyspnea. This study was to assess the efficacy of mindful breathing in improvement of dyspnea score, oxygen saturation and respiratory rate in patients with lung diseases. Methods: Sixty three inward patients, diagnosed with lung cancer, acute exacerbation of bronchial asthma (AEBA) or acute exacerbation of chronic obstructive pulmonary disease (AECOPD), were recruited and assigned randomly into intervention and control groups. They reported their dyspnea score according to Modified Borg Dyspnea scale while oxygen saturation and respiratory rate were measured. The parameters were assessed at baseline, at 5 mins and at 20 mins. Results: Mindful breathing significantly reduced the dyspnea score among all patients in 5 min (OR = 12.886, 95% CI = 3.588, 46.282 , P < 0.001) and 20 minutes (OR = 5.378, 95% CI = 1.832, 15.790, P = 0.002), oxygen saturation in 5 min (OR = 4.050, 95% CI = 1.137, 14.432, P = 0.025) and respiratory rate in 20 min (OR = 3.069, 95% CI = 1.094, 8.613, P = 0.031). Significant early dyspnea score reduction was observed in 5 min in mindful breathing group among patients with lung cancer. (P = 0.041) In a subgroup of patients with AEBA, mindful breathing conferred significant sustained dyspnea reduction in 5 min (P = 0.006); in 20 min (P = 0.003) and early oxygen saturation in 5 min (P = 0.039). In mindful breathing group among patients with AECOPD, a significant reduction in dyspnea score was observed in 5 minute (P = 0.034) while delayed respiratory rate improvement was demonstrated in 20 min (P = 0.035). Conclusion: Mindful breathing is a quick, easy and useful therapy and has a significant effect in dyspnea reduction among patients with lung diseases. Further studies with a larger sample size are recommended to discover more potential effects of mindful breathing in the subgroups of patients

Knowledge Enhanced Neural Fashion Trend Forecasting

10.1145/3372278.3390677ICMR 2020 - Proceedings of the 2020 International Conference on Multimedia Retrieval82 - 9

The Effect of 20-Minute Mindful Breathing on the Rapid Reduction of Dyspnea at Rest in Patients With Lung Diseases: A Randomized Controlled Trial

Context: Dyspnea is a common and distressing symptom in respiratory diseases. Despite advances in the treatment of various lung diseases, the treatment modalities for dyspnea remain limited. Objectives: This study aims to examine the effect of 20-minute mindful breathing on the rapid reduction of dyspnea at rest in patients with lung cancer, chronic obstructive pulmonary disease, and asthma. Methods: We conducted a parallel-group, nonblinded, randomized controlled trial of standard care plus 20-minute mindful breathing vs. standard care alone for patients with moderate to severe dyspnea due to lung disease, named previously, at the respiratory unit of University Malaya Medical Centre in Malaysia, from August 1, 2017, to March 31, 2018. Results: Sixty-three participants were randomly assigned to standard care plus a 20-minute mindful breathing session (n = 32) or standard care alone (n = 31), with no difference in their demographic and clinical characteristics. There was statistically significant reduction in dyspnea in the mindful breathing group compared with the control group at minute 5 (U = 233.5, n 1 = 32, n 2 = 31, mean rank 1 = 23.28, mean rank 2 = 37.72, z = −3.574, P < 0.001) and minute 20 (U = 232.0, n 1 = 32, n 2 = 31, mean rank 1 = 23.00, mean rank 2 = 36.77, z = −3.285, P = 0.001). Conclusion: Our results provide evidence that a single session of 20-minute mindful breathing is effective in reducing dyspnea rapidly for patients with lung cancer, chronic obstructive pulmonary disease, and asthma. © 2019 American Academy of Hospice and Palliative Medicin

Reproducibility companion paper: Knowledge enhanced neural fashion trend forecasting

This archive contains the code and dataset for the paper "Reproducibility Companion Paper: Knowledge Enhanced Neural Fashion Trend Forecasting", which is published at the reproducibility track of ACM ICMR 2021. It aims to reproduce the primary results obtained in the paper "Knowledge Enhanced NeuralFashion Trend Forecasting", which is published at ICMR 2020. Moreover, this archive can also be accessed by the following GitHub repo: https://github.com/mysbupt/KERN_reproduce

C1–C2 fusion with absence of C1 posterior arch and presence of C2 high-riding vertebral artery: Is it possible?

The presence of anatomical anomalies such as absence of C1 posterior arch and presence of C2 high-riding vertebral artery may not allow a conventional C1–C2 fusion, and this patient will require occipitocervical fusion. A 62-year-old lady presented with cervical myelopathy. CT scan demonstrated an os odontoideum with C1–C2 dislocation. The posterior arch of atlas on right C1 vertebra was absent, and there was high-riding vertebral artery on left C2. MRI revealed severe cord compression with cord oedema. The chronic atlantoaxial dislocation was reduced successfully with skeletal traction. Hybrid C1–C2 fusion augmented with autogenous local bone graft with corticocancellous iliac crest bone graft was performed to avoid an unnecessary occipitocervical fusion. She was stable throughout surgery and discharged 6 days later. CT scan 6 months post-operation showed a solid posterior fusion mass. Hybrid C1–C2 fusion can be performed to avoid occipitocervical fusion despite presence of abnormal anatomy at C1 and C2 vertebrae. © The Author(s) 2019

Quality indicators in pediatric colonoscopy in a low-volume center: Implications for training

AIM To study implications of measuring quality indicators on training and trainees’ performance in pediatric colonoscopy in a low-volume training center. METHODS We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks. RESULTS Median (± SD) age of 121 children [males = 74 (61.2%)] who had 177 colonoscopies was 7.0 (± 4.6) years. On average, 30 colonoscopies were performed each year (range: 19-58). Except for investigations of abdominal pain (21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient (0.6%) with severe Crohn’s disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease (IBD) than non-IBD (72.9% vs 50.0% P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%. CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement