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9%) reported receiving mental health consultation services (men 8.8%, women 11.9%). Overall, an increased social participation was significantly associated with increased odds of using forms of mental health consultation (OR = 1.65, 95% CI 1.31-2.09). Conclusions In this study, significant evidence of the links between social participation and utilization of mental health consultation was discovered among at risk individuals with suicidal ideation. Suicide prevention policies and programs designed to enhance social participation could potentially encourage people at suicide risk to seek the help they need. Further research focusing on social approaches can produce useful information to plan and implement comprehensive and effective strategies.Background The cardiopulmonary resuscitation guidelines revised in 2015 recommend target chest compression rate (CCR) and chest compression depth (CCD) of 100-120 compressions per minute (cpm) and 5-6 cm, respectively. We hypothesized that the new guidelines are harder to comply with, even with proper feedback. Methods This prospective observational study using data collected from the participants of an Immediate Cardiac Life Support course included the evaluation of chest compressions using performance data from a feedback device after the completion of the course. Participants completed chest compressions for 1 min and were provided with feedback, after which they performed another cycle of CC. Primary outcome measures were CCR and CCD as well as the correct CCR percentage and CCD percentage for pre and post feedback. Results The study included a total of 88 participants. The median pre-CCR was 112.5 cpm (interquartile range [IQR] 108-116 cpm), and the median correct pre-CCR percentage was 96% (IQR 82.5-99.5%). After the feedback, there was a slight increase in the correct CCR percentage (99% [IQR 92.5-100%]). ML349 Conversely, the median pre-CCD was 5.4 cm (IQR 4.9-5.8 cm), and the median pre-correct CCD percentage was 66% (IQR 18.5-90%). The increase in the median post-correct CCD percentage to 72% (IQR 27-94%) observed after the feedback was not statistically significant (P = 0.361). Conclusions Compliance with the new guidelines for chest compressions, especially those regarding the CCD, might be difficult. However, whether the changes in guidelines affect outcomes in actual clinical settings is uncertain and requires further investigation.Background A prognostic model combining biomarkers of metaphase-anaphase transition of the cell cycle was developed for invasive breast cancer. The prognostic value and clinical applicability of the model was evaluated in comparison with the routine prognosticators of invasive breast carcinoma. Methods The study comprised 1135 breast cancer patients with complete clinical data and up to 22-year follow-up. Regulators of metaphase-anaphase transition were detected immunohistochemically and the biomarkers with the strongest prognostic impacts were combined into a prognostic model. The prognostic value of the model was tested and evaluated in separate patient materials originating from two Finnish breast cancer centers. Results The designed model comprising immunoexpressions of Securin, Separase and Cdk1 identified 8.4-fold increased risk of breast cancer mortality (p 75%) of patients resulting with favorable as opposed to unfavorable outcome of the model. Along with nodal status, the model showed independent prognostic impact for all breast carcinomas and for subgroups of luminal, N+ and N- disease. Conclusions The impact of the proposed prognostic model in predicting breast cancer survival was comparable to nodal status. However, the model provided additional information in N- breast carcinoma in identifying patients with aggressive course of disease, potentially in need of adjuvant treatments. Concerning N+, in turn, the model could provide evidence for withholding chemotherapy from patients with favorable outcome.Background Racial disparities are well-documented in preventive cancer care, but they have not been fully explored in the context of lung cancer screening. We sought to explore racial differences in lung cancer screening outcomes within a lung cancer screening program (LCSP) at our urban academic medical center including differences in baseline low-dose computed tomography (LDCT) results, time to follow-up, adherence, as well as return to annual screening after additional imaging, loss to follow-up, and cancer diagnoses in patients with positive baseline scans. Methods A historical cohort study of patients referred to our LCSP was conducted to extract demographic and clinical characteristics, smoking history, and lung cancer screening outcomes. Results After referral to the LCSP, blacks had significantly lower odds of receiving LDCT compared to whites, even while controlling for individual lung cancer risk factors and neighborhood-level factors. Blacks also demonstrated a trend toward delayed follow-up, decreased adherence, and loss to follow-up across all Lung-RADS categories. Conclusions Overall, lung cancer screening annual adherence rates were low, regardless of race, highlighting the need for increased patient education and outreach. Furthermore, the disparities in race we identified encourage further research with the purpose of creating culturally competent and inclusive LCSPs.Background Alcohol Use Disorder is a severe mental disorder affecting the individuals concerned, their family and friends and society as a whole. Despite its high prevalence, novel treatment options remain rather limited. Two innovative interventions used for treating severe disorders are the use of real-time functional magnetic resonance imaging neurofeedback that targets brain regions related to the disorder, and mindfulness-based treatments. In the context of the TRR SFB 265 C04 "Mindfulness-based relapse prevention as an addition to rtfMRI NFB intervention for patients with Alcohol Use Disorder (MiND)" study, both interventions will be combined to a state-of-the art intervention that will use mindfulness-based relapse prevention to improve the efficacy of a real-time neurofeedback intervention targeting the ventral striatum, which is a brain region centrally involved in cue-reactivity to alcohol-related stimuli. Methods/design After inclusion, N = 88 patients will be randomly assigned to one of four groupeatment approaches targeting mechanisms of Alcohol Use Disorder with the goal to reduce relapse rates after discharge from the hospital. Trial registration This trial is pre-registered at clinicaltrials.gov (trial identifier NCT04366505; WHO Universal Trial Number (UTN) U1111-1250-2964). Registered 30 March 2020, published 29 April 2020.Background Childhood vaccinations are a vital preventive measure to reduce disease incidence and deaths among children. link2 As a result, immunisation coverage against measles was a key indicator for monitoring the fourth Millennium Development Goal (MDG), aimed at reducing child mortality. India was among the list of countries that missed the target of this MDG. Immunisation targets continue to be included in the post-2015 Sustainable Development Goals (SDG), and are a monitoring tool for the Indian health care system. The SDGs also strongly emphasise reducing inequalities; even where immunisation coverage improves, there is a further imperative to safeguard against inequalities in immunisation outcomes. This study aims to document whether socioeconomic inequalities in immunisation coverage exist among children aged 12-59 months in India. Methods Data for this observational study came from the fourth round of the National Family Health Survey (2015-16). We used the concentration index to assess inequalities in whtors that affect poor uptake and disparities in immunisation coverage in India in order to improve child health and survival and meet the SDGs.Background Coronary heart disease is one of the diseases with the highest mortality rate. Due to the important position of cardiovascular disease prevention and diagnosis in the medical field, the segmentation of cardiovascular images has gradually become a research hotspot. How to segment accurate blood vessels from coronary angiography videos to assist doctors in making accurate analysis has become the goal of our research. Method Based on the U-net architecture, we use a context-based convolutional network for capturing more information of the vessel in the video. The proposed method includes three modules the sequence encoder module, the sequence decoder module, and the sequence filter module. The high-level information of the feature is extracted in the encoder module. Multi-kernel pooling layers suitable for the extraction of blood vessels are added before the decoder module. In the filter block, we add a simple temporal filter to reducing inter-frame flickers. Results The performance comparison with other method shows that our work can achieve 0.8739 in Sen, 0.9895 in Acc. From the performance of the results, the accuracy of our method is significantly improved. link3 The performance benefit from the algorithm architecture and our enlarged dataset. Conclusion Compared with previous methods that only focus on single image analysis, our method can obtain more coronary information through image sequences. In future work, we will extend the network to 3D networks.Background The Binge Eating Genetics Initiative (BEGIN) is a multipronged investigation examining the interplay of genomic, gut microbiota, and behavioral factors in bulimia nervosa and binge-eating disorder. Methods 1000 individuals who meet current diagnostic criteria for bulimia nervosa or binge-eating disorder are being recruited to collect saliva samples for genotyping, fecal sampling for microbiota characterization, and recording of 30 days of passive data and behavioral phenotyping related to eating disorders using the app Recovery Record adapted for the Apple Watch. Discussion BEGIN examines the interplay of genomic, gut microbiota, and behavioral factors to explore etiology and develop predictors of risk, course of illness, and response to treatment in bulimia nervosa and binge-eating disorder. We will optimize the richness and longitudinal structure of deep passive and active phenotypic data to lay the foundation for a personalized precision medicine approach enabling just-in-time interventions that will allow individuals to disrupt eating disorder behaviors in real time before they occur. Trial registration The ClinicalTrials.gov identifier is NCT04162574. November 14, 2019, Retrospectively Registered.Background Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community-acquired pneumonia (CAP) in children. The coinfection rate of M. pneumoniae pneumonia (MPP) can reach 52% in some areas, but the effects of coinfection with different pathogens have not been clearly recognized. Methods The cases of MPP hospitalized in Beijing Children's Hospital from 1/1/2014 to 12/31/2016 were screened. MPP patients coinfected with Human adenovirus (HAdV) were categorized into the research group. Patients with single M. pneumoniae infection were categorized into the control group, matching the research group by age and admission time with a ratio of 13. Clinical manifestations, laboratory examinations, and disease severity were compared between these two groups. Results A total of 2540 hospitalized MPP cases were screened in Beijing Children's Hospital, among which thirty cases were enrolled in the research group and ninety cases were enrolled in the control group. The results indicated that patients in the research group had longer hospital stays, longer fever durations and a higher rate of dyspnea, as well as a larger proportion applications of oxygen therapy and noninvasive continuous positive airway pressure (NCPAP).
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