Notes

Clinical training course as well as eating habits study COVID-19 sufferers having a history of cerebrovascular disease: a retrospective review in Wuhan.
In this study the authors hypothesized that "Lean management" within a dedicated ablation protocol could standardize the pulmonary vein isolation (PVI) procedure and improve quality.

There is a large variability in safety, effectiveness, and efficiency of PVI.

This was a single-center prospective study with inclusion of all consecutive PVI procedures from 2017 to2019. A 3-step intervention was introduced based on Lean management step 1) simplification (CLOSE protocol); step2) waste elimination (higher power shorter duration); and step 3) improved standardization (Lab Optimization Tool [LOT]). PVI was divided into steps that were tracked (in minutes) using LOT. Parameters were compared in 6-month intervals.

Overall, 295 patients (146 patients with LOT) were analyzed. Step 1 reduced skin-to-skin procedure duration (2017 119 ± 21min vs. 2018 77 ± 15min; p<0.001) and variance (from 2018 to 2019p=0.024). Step 2 reduced the radiofrequency time (2017 38 ± 6min vs. 2018 20 ± 3min; p<0.001) and variance mprove health care utilization, increased efficiency should become an accepted goal in addition to procedural safety and effectiveness.Schizophrenia is a complex brain disorder with genetic and environmental factors contributing to its etiology. Complement C4 genes are schizophrenia susceptibility loci and are activated in response to infections and gut microbiome imbalances. selleck We hypothesize that C4 genetic susceptibility predisposes individuals to neuropathological effects from pathogen exposures or a microbiome in dysbiosis. In 214 individuals with schizophrenia and 123 non-psychiatric controls, we examined C4 gene copy number and haplotype groups for associations with schizophrenia and microbial plasma biomarkers. C4A copy number and haplotypes containing HERV-K insertions (C4A-long; C4AL-C4AL) conferred elevated odds ratios for schizophrenia diagnoses (OR 1.58-2.56, p less then 0.0001), while C4B-short (C4BS) haplogroups conferred decreased odds (OR 0.43, p less then 0.0001). Haplogroup-microbe combinations showed extensive associations with schizophrenia including C4AL with Candida albicans IgG (OR 2.16, p less then 0.0005), C4AL-C4BL with cytomegalovirus (CMV) IgG (OR 1.79, p less then 0.008), C4BS with lipopolysaccharide-binding protein (LBP) (OR 1.18, p less then 0.0001), and C4AL-C4AL with Toxoplasma gondii IgG (OR = 17.67, p less then 0.0001). In controls, only one haplogroup-microbe combination was significant C4BS with CMV IgG (OR 0.52, p less then 0.02). In schizophrenia only, LBP and CMV IgG levels were inversely correlated with C4A and C4S copy numbers, respectively (R2 = 0.13-0.16, p less then 0.0001). C4 haplogroups were associated with altered scores of cognitive functioning in both cases and controls and with psychiatric symptom scores in schizophrenia. Our findings link complement C4 genes with a susceptibility to infections and a dysbiotic microbiome in schizophrenia. These results support immune system mechanisms by which gene-environmental interactions may be operative in schizophrenia.
Is the level of shared decision-making (SDM) higher after introduction of a SDM package (including encounter decision aids on treatment options for heavy menstrual bleeding and training for clinicians) than before?.

This before-after study, performed in OB-GYN practice, compared consultations before and after introduction of a SDM package. The target sample size was 25 patients per group. Women seeking treatment for heavy menstrual bleeding were eligible. After their appointments, patients filled out a three-item patient-reported SDM measure. Treatment discussions were audio-recorded and rated for SDM using Observer OPTION
. Consultation transcripts in the 'after' group were checked for adherence to the steps required for intended use of decision aids.

16 gynaecologists participated. 25 patients participated before introduction of the decision aids and 28 after. The proportion of women reporting optimal SDM was higher after introduction (75 %) than before (50 %;p < 0.001). The mean observer-rated level of SDM was also significantly higher after than before (MD = 12.50,95 % CI 5.53-19.47).

The level of SDM was higher after the introduction of the package than before.

This study was conducted in a real-life setting in three clinics, both large academic and small rural, offering opportunities for implementation in different type of organizations.
This study was conducted in a real-life setting in three clinics, both large academic and small rural, offering opportunities for implementation in different type of organizations.
Integrating constructs from three prominent health behavior theories including the extended parallel process model, the health belief model, and the theory of planned behavior, this study seeks to identify sociopsychological factors that influenced American's intention to receive a COVID-19 vaccine.

An online survey was delivered to a U.S. sample (N = 934), assessing the influences of risk perception and fear associated with COVID-19, beliefs about and attitudes toward COVID-19 vaccines, self-efficacy, social and psychological contexts, and demographic characteristics on people's intention to get COVID-19 vaccines.

Most respondents intended to get vaccinated. However, they tended to underestimate their risks of contracting COVID-19. Disease exposure led to higher uptake intent via the mediation of fear. Safety concerns negatively influenced vaccination intention, while perceived community benefits were positively associated with vaccination intention. Positive attitudes toward vaccines and recent vaccine history were positively linked to vaccination intent.

This study attests the effectiveness of HBT constructs in predicting people's intention to receive a COVID-19 vaccine.

The results point to the importance of fostering confidence in vaccine safety and countering overoptimism of individual susceptibility to the disease in interventions promoting COVID-19 vaccines uptake.
The results point to the importance of fostering confidence in vaccine safety and countering overoptimism of individual susceptibility to the disease in interventions promoting COVID-19 vaccines uptake.
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