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Growth and development of a major international size of socio-economic place according to household resources.
BACKGROUND Annual lung cancer screening with low-dose computed tomography is recommended for adults aged 55-80 with a ≥30 pack-year smoking history that currently smoke or quit less then 15-years ago. The 50% who are current smokers should be offered cessation interventions, but information about the impact of adding cessation to screening is limited. METHODS We used an established lung cancer simulation model to compare the effects on mortality of a hypothetical one-time cessation intervention and annual screening vs. annual screening only among screen-eligible individuals born in 1950 or 1960. Model inputs were derived from national data and included smoking history, probability of quitting with and without intervention, lung cancer risk and treatment effectiveness, and competing tobacco-related mortality. We tested the sensitivity of results to different assumptions about screening use and cessation efficacy. RESULTS Smoking cessation reduces lung cancer mortality and decreases overall deaths vs. screening only across all assumptions. For example, if screening was used by 30% of screen-eligible individuals born in 1950, adding an intervention with a 10% quit probability reduces lung cancer deaths by 14% and increases life-years gained by 81% compared to screening alone. The magnitude of cessation benefit varied by screening uptake rates, cessation effectiveness, and birth cohort. CONCLUSIONS Smoking cessation interventions have the potential to greatly enhance the impact of lung cancer screening programs. Evaluation of specific interventions, including costs and feasibility of implementation and dissemination, are needed to determine the best possible strategies and realize the full promise of lung cancer screening. The use of terrestrial raw materials to replace fish meal (FM) and fish oil (FO) in marine fish diets may affect fish growth performance and health. In the last years functional additives have been profiled as good candidates to reduce the effects on health and disease resistance derived from this replacement, via reinforcement of the fish immune system. selleck screening library In the present study, three isoenergetic and isonitrogenous diets with low FM and FO (10% and 6% respectively) were tested based on supplementation either with 0.5% galactomannanoligosaccharides (GMOS diet) or 0.02% of a mixture of essential oils (PHYTO diet), a non-supplemented diet was defined as a control diet. Fish were fed the experimental diets in triplicate for 9 weeks and then they were subjected to a stress by confinement as a single challenge (C treatment) or combined with an experimental intestinal infection with Vibrio anguillarum (CI treatment). Along the challenge test, selected stress and immunological parameters were evaluated at 2, 24 and 168ly (p less then 0.05) down-regulated StAR and casp-3 gene expression 2h after challenge test, denoting that PHYTO diet reinforced fish capacity of stress response via protection of head kidney leucocytes from stress-related apoptotic processes, with lower caspase-3 gene expression and a higher il-1β gene expression when an infection occurs. Additionally, dietary supplementation with GMOS and PHYTO compounds increased fish serum lysozyme after infection. Both functional additives entailed a better capability of the animals to cope with infection in European sea bass when fed low FM and FO diets. BACKGROUND The past 20 years have seen increasing Caesarean section (CS) rates in Australia. Increasing antenatal morbidity means that post-CS surgical site infection (SSI) is an issue impacting Australian women, mostly low-socioeconomic and regional communities. Recent trends supporting development of evidence-based bundled approaches to SSI reduction, have not proved efficacy nor supported bundle implementation. AIMS This pilot study aimed to develop, implement and assess an evidence-based Caesarean Infection Prevention ("CIP") bundled intervention to reduce post-CS SSI rates in a high risk population. METHODS The study was a pre-post-intervention study, including women undergoing CS at one referral hospital between December 1st 2016 and December 31st 2018. A 12 month retrospective pre-intervention review identified women who developed a post-CS SSI. A comprehensive literature review informed the development of the intervention, which was implemented in December 2017. Data was collected for the subsequent 12 months on women undergoing CS. RESULTS A total of 710 procedures were monitored with 346 and 364 women in the pre and post-intervention groups respectively. Demographic and comorbidity variables remained consistent over time. Post-CS SSI rates significantly reduced post-intervention (5.5% vs. 1.6%, p = 0.007), the greatest benefit in class II and III obese patients (12.2% vs. 2.5%, p = 0.019). Higher hypertension rates (24% vs. 9%, p = 0.01) and lower maternal mean age (27 vs. 30, p = 0.01) were seen in patients with SSI. CONCLUSION The "CIP" bundle effectively reduced post-CS SSIs in a high risk population. Our findings substantiate the need for development and evaluation of multifaceted, evidenced-based interventions to reduce post-CS SSIs. TRIAL REGISTRATION Retrospectively registered. TRIAL REGISTRATION ACTRN12619001001189, July 2019. Crown V. All rights reserved.BACKGROUND Adult congenital heart disease (ACHD) patients may be at risk of sudden cardiac death and be candidates for an implantable cardioverter-defibrillator (ICD). We evaluated the long-term rates of ventricular arrhythmias requiring treatment and mortality in these patients. METHODS A single-center retrospective case-series identified ACHD patients with an ICD and were evaluated for the primary outcome of appropriate ICD intervention or ablation for ventricular tachyarrhythmias. Secondary endpoints were mortality and complication rates. Survival analyses to generate Kaplan-Meier curves for the primary and secondary outcomes were performed. RESULTS There were 125 adult patients (median age 35.5 years, 68.8% male) with congenital heart disease and an ICD. The median follow-up was 6.4 years (interquartile range 2.8-9.1 years). Transposition of the Great Arteries (TGA) was present in 62 patients (49.6%) and Tetralogy of Fallot (ToF) in 33 (26.4%). The indication for an ICD was primary prevention in 90 patients (72%) and secondary prevention in 35 patients (28%).
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