American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2018
Comparative StudyMechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes.
Diaphragm dysfunction worsens outcomes in mechanically ventilated patients, but the clinical impact of potentially preventable changes in diaphragm structure and function caused by mechanical ventilation is unknown. ⋯ Diaphragm atrophy developing during mechanical ventilation strongly impacts clinical outcomes. Targeting an inspiratory effort level similar to that of healthy subjects at rest might accelerate liberation from ventilation.
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Am. J. Respir. Crit. Care Med. · Jan 2018
Review Comparative StudyLung Cancer Screening and Smoking Cessation Clinical Trials: SCALE Collaboration.
National recommendations for lung cancer screening for former and current smokers aged 55-80 years with a 30-pack-year smoking history create demand to implement efficient and effective systems to offer smoking cessation on a large scale. These older, high-risk smokers differ from participants in past clinical trials of behavioral and pharmacologic interventions for tobacco dependence. There is a gap in knowledge about how best to design systems to extend reach and treatments to maximize smoking cessation in the context of lung cancer screening. ⋯ Unique data elements, such as perceived risk of lung cancer and costs of tobacco treatment, are of interest. Lung cancer screening presents a new and promising opportunity to reduce morbidity and mortality resulting from lung cancer that can be amplified by effective smoking cessation treatment. SCALE teamwork and collaboration promise to maximize knowledge gained from the clinical trials.
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Am. J. Respir. Crit. Care Med. · Jan 2018
Comparative StudyDisease Staging and Prognosis in Smokers Using Deep Learning in Chest Computed Tomography.
Deep learning is a powerful tool that may allow for improved outcome prediction. ⋯ A deep-learning approach that uses only computed tomography imaging data can identify those smokers who have COPD and predict who are most likely to have ARD events and those with the highest mortality. At a population level CNN analysis may be a powerful tool for risk assessment.