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Nutritional support in the critically ill aims to avoid under and overfeeding, adjusting to changes in energy expenditure during critical illness. The sedation propofol provides significant fat and energy load. We investigated whether changing from 1% to a 2% propofol, would decrease non-nutritional energy, avoid energy overfeeding and increase the amount of protein delivered.
A retrospective observational study was performed. The primary outcome was protein delivery. Secondary outcomes were energy from propofol fat and the total energy delivered from nutrition and propofol.
In total, 100 patients were investigated, with 50 patients in each group. The propofol dose was comparable for each group. The nutrition energy prescribed was significantly less for the 1% compared to 2% group, taking the energy from propofol into consideration. Both groups had similar protein targets, although the amount delivered was significantly higher in the 2% group. Thirty-six percent of individuals receiving 1% exceeded 45% of total energy from fat. The poor delivery of nutrition resulted in inadequate energy and protein, irrespective of propofol dose.
We investigated the impact of propofol on energy overfeeding and under delivery of protein, and highlighted suboptimal nutritional provision. Work is needed to investigate the harm that high-fat delivery may pose in light of poor nutrition delivery.
We investigated the impact of propofol on energy overfeeding and under delivery of protein, and highlighted suboptimal nutritional provision. Work is needed to investigate the harm that high-fat delivery may pose in light of poor nutrition delivery.Skin cancer is among the 10 most common cancers. Recent research revealed the superiority of artificial intelligence (AI) over dermatologists to diagnose skin cancer from predesignated and cropped images. However, there remain several uncertainties for AI in diagnosing skin cancers, including lack of testing for consistency, lack of pathological proof or ambiguous comparisons. Hence, to develop a reliable, feasible and user-friendly platform to facilitate the automatic diagnostic algorithm is important. The aim of this study was to build a light-weight skin cancer classification model based on deep learning methods for aiding first-line medical care. The developed model can be deployed on cloud platforms as well as mobile devices for remote diagnostic applications. We reviewed the medical records and clinical images of patients who received a histological diagnosis of basal cell carcinoma, squamous cell carcinoma, melanoma, seborrheic keratosis and melanocytic nevus in 2006-2017 in the Department of Dermatology in Kaohsiung Chang Gung Memorial Hospital (KCGMH). We used the deep learning models to identify skin cancers and benign skin tumors in the manner of binary classification and multi-class classification in the KCGMH and HAM10000 datasets to construct a skin cancer classification model. The accuracy reached 89.5% for the binary classifications (benign vs malignant) in the KCGMH dataset; the accuracy was 85.8% in the HAM10000 dataset in seven-class classification and 72.1% in the KCGMH dataset in five-class classification. Our results demonstrate that our skin cancer classification model based on deep learning methods is a highly promising aid for the clinical diagnosis and early identification of skin cancers and benign tumors.
Colorectal cancer (CRC) has emerged as a major public health concern. However, little is known about the burden attributable to specific risk factors. The present study aimed to estimate the temporal trends and geographical variation of CRC burden attributable to a diet low in milk in China.
Following the general analytic strategy used in the 2017 Global Burden of Disease study, we assessed the age-, sex-, and province-specific mortality and disability-adjusted life-years (DALYs) of CRC caused by a diet low in milk in China from 1990 to 2017.
In 2017, a diet low in milk contributed 32032 [95% uncertainty interval (UI)=11350-53806] deaths and 726710 (95% UI=256651-1218153) DALYs for CRC with a population attributable fraction of 17.1%. The age-standardised mortality and DALY rates per 100000 were 1.7 (95% UI=0.6-2.9) and 36.8 (95% UI=13.0-61.7), respectively. An upward trend with age in rates of mortality and DALYs was observed. Males had higher age-standardised rates than females. The number of deaths and DALYs increased significantly from 1990 to 2017, whereas the corresponding age-standardised rates showed relatively stable trends. In 2017, Hunan and Liaoning were ranked as the top two provinces in terms of disease burden. Socio-demographic index had a weak correlation with the age-standardised mortality (r=0.348, P=0.047).
The present study shows a substantial increase in the CRC burden attributable to a diet low in milk over the past three decades. Greater priority in CRC prevention should be given to males and the elderly population throughout China, particularly in less-developed provinces.
The present study shows a substantial increase in the CRC burden attributable to a diet low in milk over the past three decades. Greater priority in CRC prevention should be given to males and the elderly population throughout China, particularly in less-developed provinces.
Very few studies have evaluated the quality of life (QoL) of children suffering from low-flow vascular malformations. This is the first study investigating the influencing factors.
To identify the factors influencing QoL in children with low-flow vascular malformations.
We conducted a qualitative study employing focus group interviews (Clinical Trials Number NCT03440827). Blebbistatin molecular weight The study was a prospective, interventional, non-comparative, multicentre study performed in four expert centres for vascular anomalies. Qualitative data about personal experiences, feelings, difficulties, needs and various factors influencing behaviours were collected. Theme-based content analysis (manual and specialist textural software guided) were used to analyse the verbatim transcripts of all focus group sessions. Manual qualitative discourse analysis was performed to identify the different themes and categories. Informatics' analyses were subsequently performed for each individual category.
Ten focus groups (26 individuals including 10 children aged 11 to 15years) were conducted until saturation.
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