Notes

Analysing and also quantifying the consequence regarding predictors of stroke primary costs within South Africa employing quantile regression.
ternationally to examine the impact of DPP service delivery on participation. When implementing a large-scale DPP, heterogeneity in service provision between different providers and sites can result in variable participation beyond that attributable to case mix, with potential consequences for effectiveness and health inequalities. Extending out-of-hours provision may improve participation in prevention programs.Preclinical findings from Stanford University may help explain the lack of efficacy with CAR T-cell therapies in some patients with large B-cell lymphomas. The researchers pinpointed the CD58-CD2 axis as a novel resistance mechanism, then figured out how next-generation CAR T cells could be engineered to overcome this issue.
This study aimed to investigate the association between self-reported depressive symptoms and oral diseases in US adults, including periodontitis, caries, missing teeth and untreated dental caries.

This study was designed as a secondary data analysis of a cross-sectional survey. We conducted descriptive, multivariable logistic and Poisson regression analyses on weighted data.

US National Health and Nutrition Examination Survey 2009-2014 data.

Individuals aged ≥30 years who completed a periodontal examination and depression screening (n=9799).

21.6% (28.9 million) of adults aged ≥30 years reported depressive symptoms, with a higher prevalence among females, current smokers and participants with lower income and education status. More than half of the adults with moderate depressive symptoms had periodontal diseases, and more than one-third had teeth with untreated dental caries. After adjusting for sociodemographics, behavioural factors, having diabetes and psychotherapeutic medication use, depressivng patients with depressive symptoms can inform both dental and mental health providers to develop tailored treatment and help patients achieve overall wellness.Smoking tobacco is a major public health issue and a significant cause of increased mortality. People with a first episode of psychosis are more likely to smoke and the subgroup that goes on to have schizophrenia will have a significantly reduced life expectancy to the general population. The City & Hackney Early and Quick Intervention in Psychosis Team is a community mental health team at East London NHS Foundation Trust, providing outpatient care for adults presenting with first episode psychosis. This project aimed to increase the number of smoking cessation referrals from EQUIP to national smoking cessation services to 15% of the total team caseload over 6 months initially. A secondary measure was to complete an assessment of the smoking status for 90% of the caseload at all times. Change ideas were tested using plan-do-study-act cycles. A smoking cessation referral pathway was created and disseminated to the outpatient and inpatient services. The project was discussed at least monthly at the clinical team meeting. An education and skills building session was organised and took place at the team away day and an education drop-in session for patients was organised. The project was slow to take-off and patient participation was essential in driving progress. The aim was achieved at 23 months. A collateral benefit indicated that 25.7% of the total number of smokers had been recorded as having stopped smoking during the course of this project. This project demonstrates the effectiveness of quality improvement methodology facilitated by efficient leadership, collaborative teamwork, patient participation and persistence to address a complex problem that has significant consequences to patient health.
To investigate whether redness and crusting at the bacille Calmette-Guérin inoculation site (BCGitis), identified during acute illness owing to Kawasaki disease (KD), is an independent risk factor for development of cardiac complications.

Retrospective cohort study using data from the nationwide KD survey in Japan.

Survey respondents included hospitals specialising in paediatrics and hospitals with ≥100 beds and a paediatric department throughout Japan.

We included 17 181 patients with KD across Japan during 2005-2006.

BCGitis and cardiac complications resulting from KD.

BCGitis was identified in 7549 (44%) patients with KD. Compared with patients without BCGitis, those with BCGitis were younger, more likely to be male, less likely to have recurrent status and visited a hospital and underwent initial intravenous immunoglobulin (IVIG) treatment earlier after KD onset. In the unadjusted model, patients with BCGitis were significantly less likely to have cardiac complications (crude OR 0.81, 95% CI 0.71 to 0.92). However, after including treatment factors (days of illness at initial IVIG and treatment responsiveness) in the adjusted model, the association was no longer significant (adjusted OR 0.89, 95% CI 0.77 to 1.03), indicating that BCGitis was not an independent factor associated with cardiac complication and might be confounded by treatment factors.

BCGitis was identified in comparatively early illness stages of KD. Selisistat Our findings indicated that BCGitis was not an independent factor associated with developing cardiac complications but was confounded by prompt initial IVIG administration, which might result in successful treatment and prevention of cardiac complications.
BCGitis was identified in comparatively early illness stages of KD. Our findings indicated that BCGitis was not an independent factor associated with developing cardiac complications but was confounded by prompt initial IVIG administration, which might result in successful treatment and prevention of cardiac complications.
To analyse the therapeutic effects and toxicity of the eponymous concoction described in Roald Dahl's book
.

Literature review.

Two literature loving households in England.

George Kranky and grandma Kranky.

Clinical and toxic effects of the individual ingredients checked against those listed in ToxBase, the National Poisons Information Service's poisons database.

The medicine contained 34 ingredients. The most common toxic effect identified on ToxBase was nausea and vomiting (16 ingredients, 47%). Potentially life threatening effects were associated with 13 (38%) ingredients, including depression of the central nervous system, kidney injury, convulsions, cardiac toxicity, and mucosal erosion. The effects described in the book were accurate initially but then diverted from the most likely clinical outcome (death).

Although Dahl ought to be applauded for his initial accuracy about the toxicology of the ingredients in George's marvellous medicine, the overall effect would be fatal catastrophic physiological collapse. Scientific exploration and experimentation should be encouraged in children, although any medicinal ingredients need to be checked for potential toxicity before being administered-to grandmas or anyone else.
Although Dahl ought to be applauded for his initial accuracy about the toxicology of the ingredients in George's marvellous medicine, the overall effect would be fatal catastrophic physiological collapse. Scientific exploration and experimentation should be encouraged in children, although any medicinal ingredients need to be checked for potential toxicity before being administered-to grandmas or anyone else.
To identify any medical or public health rationale for claims that the time to act is now.

Pseudo-systematic review.

PubMed.

Studies that included the claim "time is now" in the title, with or without exclamation marks. No language or date restriction was applied.

512 articles were included for review. No relationship was identified between time to act and disease burden, severity, or specialty. Claims that the time to act was Christmas were almost entirely without basis. A clustering of claims that it is time to act in the first quarter of the year suggested a possible association with New Year's resolutions.

Now is as good a time as any.
Now is as good a time as any.
The accuracy of statistical reporting that informs medical and public health practice has generated extensive debate, but no studies have evaluated the frequency or accuracy of effect size (the magnitude of change in outcome as a function of change in predictor) reporting in prominent health journals.

To evaluate effect size reporting practices in prominent health journals using the case study of ORs.

Articles published in the
(
),
(
),
(
) and
from 1 January 2010 through 31 December 2019 mentioning the term 'odds ratio' in all searchable fields were obtained using PubMed. One hundred randomly selected articles that reported original research using ORs were sampled per journal for in-depth analysis.

We report prevalence of articles using ORs, reporting effect sizes from ORs (reporting the magnitude of change in outcome as a function of change in predictor) and reporting correct effect sizes.

The proportion of articles using ORs in the past decade declined in
and
, remained similave effect size reporting and its accuracy should be considered.
Articles that used ORs in prominent journals frequently omitted presenting the effect size of their predictor variables. When reported, the presented effect size was usually incorrect. When used, ORs should be paired with accurate effect size interpretations. New editorial and research reporting standards to improve effect size reporting and its accuracy should be considered.Cardiac arrhythmia is associated with high morbidity, and its underlying mechanisms are poorly understood. Computational modelling and simulation approaches have the potential to improve standard-of-care therapy for these disorders, offering deeper understanding of complex disease processes and sophisticated translational tools for planning clinical procedures. This review provides a clinician-friendly summary of recent advancements in computational cardiology. Organ-scale models automatically generated from clinical-grade imaging data are used to custom tailor our understanding of arrhythmia drivers, estimate future arrhythmogenic risk and personalise treatment plans. Recent mechanistic insights derived from atrial and ventricular arrhythmia simulations are highlighted, and the potential avenues to patient care (eg, by revealing new antiarrhythmic drug targets) are covered. Computational approaches geared towards improving outcomes in resynchronisation therapy have used simulations to elucidate optimal patient selection and lead location. Technology to personalise catheter ablation procedures are also covered, specifically preliminary outcomes form early-stage or pilot clinical studies. To conclude, future developments in computational cardiology are discussed, including improving the representation of patient-specific fibre orientations and fibrotic remodelling characterisation and how these might improve understanding of arrhythmia mechanisms and provide transformative tools for patient-specific therapy.
To investigate the effect of therapeutic suggestions played to patients through earphones during surgery on postoperative pain and opioid use.

Blinded randomised controlled study.

Five tertiary care hospitals in Germany.

385 of 400 patients consecutively recruited from January to December 2018 who were to undergo surgery for 1-3 hours under general anaesthesia. In the per protocol analysis 191 patients were included in the intervention group and 194 patients in the control group.

The intervention comprised an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence to patients through earphones during general anaesthesia. Patients in the control group were assigned to a blank tape.

The main outcome was dose of opioid administered by patient controlled analgesia or nurse controlled analgesia within the first postoperative 24 hours, based on regular evaluation of pain intensity on a numerical rating scale (range 0-10, with higher scores representing more severe pain).
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