Notes

Continuing development of a balanced scorecard being a ideal performance measurement system with regard to scientific radiology being a charge center.
Patients with peripheral arterial disease (PAD) are at increased risk for systemic arterial thromboembolic events. Females represent a unique subset of patients with PAD, who differ from males in important ways they have smaller diameter vessels, undergo lower extremity bypass less frequently and experience higher rates of graft occlusion, amputation and mortality than males. Females also trend towards higher rates of major coronary events and cardiovascular mortality. Current guidelines recommend monoantiplatelet therapy (MAPT) for secondary prevention in patients with symptomatic PAD. However, indications for more intensive antithrombotic therapy in this cohort-especially among females who are frequently under-represented in randomised controlled trials (RCTs)-remain unclear. As newer antithrombotic therapies emerge, some RCTs have demonstrated differential effects in females versus males. A systematic review is needed to quantify the rates of arterial thromboembolic and bleeding events with different anteviewed journal and for presentation at national and international scientific meetings.

This protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (ID# CRD42020196933).
This protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (ID# CRD42020196933).
In Kenya, distance to health facilities, inefficient vertical care delivery and limited financial means are barriers to retention in HIV care. Furthermore, the increasing burden of non-communicable diseases (NCDs) among people living with HIV complicates chronic disease treatment and strains traditional care delivery models. Potential strategies for improving HIV/NCD treatment outcomes are differentiated care, community-based care and microfinance (MF).

We will use a cluster randomised trial to evaluate integrated community-based (ICB) care incorporated into MF groups in medium and high HIV prevalence areas in western Kenya. We will conduct baseline assessments with n=900 HIV positive members of 40 existing MF groups. Group clusters will be randomised to receive either (1) ICB or (2) standard of care (SOC). The ICB intervention will include (1) clinical care visits during MF group meetings inclusive of medical consultations, NCD management, distribution of antiretroviral therapy (ART) and NCD medications, and point-of-care laboratory testing; (2) peer support for ART adherence and (3) facility referrals as needed. MF groups randomised to SOC will receive regularly scheduled care at a health facility. Findings from the two trial arms will be compared with follow-up data from n=300 matched controls. The primary outcome will be VS at 18 months. Secondary outcomes will be retention in care, absolute mean change in systolic blood pressure and absolute mean change in HbA1c level at 18 months. We will use mediation analysis to evaluate mechanisms through which MF and ICB care impact outcomes and analyse incremental cost-effectiveness of the intervention in terms of cost per HIV suppressed person-time, cost per patient retained in care and cost per disability-adjusted life-year saved.

The Moi University Institutional Research and Ethics Committee approved this study (IREC#0003054). We will share data via the Brown University Digital Repository and disseminate findings via publication.

NCT04417127.
NCT04417127.
We examined sedentary time and physical activity in different contexts among ageing workers, between their workdays and days off, and recent retirees, between their weekdays and weekend days.

Cross-sectional study.

Finnish Retirement and Aging study and Enhancing physical activity and healthy ageing among recent retirees-Randomised controlled in-home physical activity trial.

137 workers (544 measurement days) and 53 retirees (323 days), who provided data for at least 1 workday/weekday and 1 day off/weekend day.

Physical activity behaviour was measured with a combined Global Positioning System and accelerometer device (SenseDoc V.2.0), providing information on sedentary time, light physical activity and moderate-to-vigorous physical activity (MVPA) by locations (home or non-home) and trips (active travel, ie, speed <20 km/hour and passive travel, ie, speed ≥20 km/hour).

Workers accumulated more sedentary time and physical activity at non-home locations than at home on workdays, while the opposite was confirmed for days off (p<0.01). Workers accrued more MVPA on days off than on workdays (34 vs 28 min, p<0.05), of which 9 min on workdays and 14 min on days off was accrued during active travel. Retirees' physical activity behaviour did not differ between weekdays and weekend days (p>0.05). Regardless of the day, retirees accumulated 33 min of daily MVPA, of which 14 min was accrued during active travel.

Workers accumulated more MVPA on days off than on workdays, and their activity behaviour varied between workdays and days off at different locations. Our results showed that a large proportion of the MVPA was accumulated during travel at slower speeds, which suggests that active travel could be a feasible way to increase MVPA among older adults.

NCT03320746.
NCT03320746.
To determine whether a panel of neonatal experts could address evidence gaps in local and international neonatal guidelines by reaching a consensus on four clinical decision algorithms for a neonatal digital platform (NeoTree).

Two-round, modified Delphi technique.

Participants were neonatal experts from high-income and low-income countries (LICs).

This was a consensus-generating study. In round 1, experts rated items for four clinical algorithms (neonatal sepsis, hypoxic ischaemic encephalopathy, respiratory distress of the newborn, hypothermia) and justified their responses. Items meeting consensus for inclusion (≥80% agreement) were incorporated into the algorithms. Items not meeting consensus were either excluded, included following revisions or included if they contained core elements of evidence-based guidelines. In round 2, experts rated items from round 1 that did not reach consensus.

Fourteen experts participated in round 1, 10 in round 2. CC-92480 datasheet Nine were from high-income countries, five from LICs.
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