Notes

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xidase (nicotinamide adenine dinucleotide phosphate oxidase) levels were significantly lower OVT+RESV group when compared to OVT+PLAC (P<.05). OPG mRNA levels were lower in OVT+PLAC compared with the SHAM+PLAC group (P<.05).

It can be concluded that resveratrol modulated alveolar bone loss during experimental periodontitis progression in estrogen-deficient rats by downregulating NADPH oxidase levels.
It can be concluded that resveratrol modulated alveolar bone loss during experimental periodontitis progression in estrogen-deficient rats by downregulating NADPH oxidase levels.In 1965, Dr Harry Angelman reported a neurodevelopmental disorder affecting three unrelated children who had similar symptoms brachycephaly, mental retardation, ataxia, seizures, protruding tongues, and remarkable paroxysms of laughter. Over the past 50 years, the disorder became Angelman's namesake and symptomology was expanded to include hyper-activity, stereotypies, and severe sleep disturbances. The sleep disorders in many Angelman syndrome (AS) patients are broadly characterized by difficulty falling and staying asleep at night. Some of these patients sleep less than 4 hours a night and, in most cases, do not make up this lost sleep during the day-leading to the speculation that AS patients may "need" less sleep. Most AS patients also have severely reduced levels of melatonin, a hormone produced by the pineal gland exclusively at night. This nightly pattern of melatonin production is thought to help synchronize internal circadian rhythms and promote nighttime sleep in humans and other diurnal species. It has been proposed that reduced melatonin levels contribute to the sleep problems in AS patients. Indeed, emerging evidence suggests melatonin replacement therapy can improve sleep in many AS patients. However, AS mice show sleep problems that are arguably similar to those in humans despite being on genetic backgrounds that do not make melatonin. This suggests the hypothesis that the change in nighttime melatonin may be a secondary factor rather than the root cause of the sleeping disorder. The goals of this review article are to revisit the sleep and melatonin findings in both AS patients and animal models of AS and discuss what AS may tell us about the underlying mechanisms of, and interplay between, melatonin and sleep.
A prolonged PR interval may adversely affect ventricular filling and, therefore, cardiac function. AV delay can be corrected using right ventricular pacing (RVP), but this induces ventricular dyssynchrony, itself harmful. Therefore, in intermittent heart block, pacing avoidance algorithms are often implemented. We tested His-bundle pacing (HBP) as an alternative.

Outpatients with a long PR interval (>200 ms) and intermittent need for ventricular pacing were recruited. We measured within-patient differences in high-precision hemodynamics between AV-optimized RVP and HBP, as well as a pacing avoidance algorithm (Managed Ventricular Pacing [MVP]).

We recruited 18 patients. Mean left ventricular ejection fraction was 44.3 ± 9%. Mean intrinsic PR interval was 266 ± 42 ms and QRS duration was 123 ± 29 ms. RVP lengthened QRS duration (+54 ms, 95% CI 42-67 ms, p < .0001) while HBP delivered a shorter QRS duration than RVP (-56 ms, 95% CI -67 to -46 ms, p < .0001). HBP did not increase QRS duration (-2 ony (unlike RVP). Clinical trials may be justified to assess whether these acute improvements translate into longer term clinical benefits in patients with bradycardia indications for pacing.
Uterine tamponade is widely promoted for treating refractory postpartum hemorrhage (PPH); however, its cost-effectiveness may vary depending on unit costs and setting.

To review available data on cost-effectiveness of uterine tamponade devices when used for PPH treatment.

PubMed and EMBASE were searched (1980 to January 2020), as well as the National Health Services Economic Evaluation database from inception (1995) to March 2015.

Eligible studies were any type of economic evaluation, or effectiveness studies that provided cost or economic data.

Two reviewers independently screened studies, extracted data, and assessed quality.

Eleven studies using a range of devices (condom catheter, uterine suction devices, Bakri, Inpress, Ellavi) were identified. Cost of condom catheter devices or kits ranged from US$0.64 to US$6, whereas purpose-designed device costs were up to US$400. Two studies that took a health system perspective assessed the cost-effectiveness of using uterine balloon tamponade and suggested that it was highly cost-effective because of the low cost per disability-adjusted life-year averted, although both used effect estimates from case series.

Evidence on the cost-effectiveness of uterine tamponade devices was limited and not generalizable. Rigorous economic evaluations based on updated effect estimates are needed.
Evidence on the cost-effectiveness of uterine tamponade devices was limited and not generalizable. Rigorous economic evaluations based on updated effect estimates are needed.
To examine whether randomization to permanent supportive housing (PSH) versus usual care reduces the use of acute health care and other services among chronically homeless high users of county-funded services.

Between 2015 and 2019, we assessed service use from Santa Clara County, CA, administrative claims data for all county-funded health care, jail and shelter, and mortality.

We conducted a randomized controlled trial among chronically homeless high users of multiple systems. We compared postrandomization outcomes from county-funded systemsusing multivariate regression analysis.

We extracted encounter data from an integrated database capturing health care at county-funded facilities, shelter and jails, county housing placement, and death certificates.

We enrolled 423 participants (199 intervention; 224 control). Eighty-six percent of those randomized to PSH received housing compared with 36 percent inusual care. On average, the 169 individuals housed by the PSH intervention have remained housed folize.
The intervention placed and retained frequent user, chronically homeless individuals in housing. It decreased psychiatric ED visits and shelter use, and increased outpatient mental health care, but not medical ED visits or hospitalizations. Limitations included more than one-third of usual care participants received another form of subsidized housing, potentially biasing results to the null, and loss of power due to high death rates. PSH can house high-risk individuals and reduce emergent psychiatric services and shelter use. Reductions in hospitalizations may be more difficult to realize.
This paper demonstrates that localized and chronic stop-question-and-frisk (SQF) practices are associated with community members' utilization of emergency department (ED) resources. To explain this relationship, we explore the empirical applicability of a legal epidemiological framework, or the study of legal institutional influences on the distribution of disease and injury.

Analyses are derived from merging data from the Philadelphia Vehicle and Pedestrians Investigation, the National Historical Geographic Information System, and the Southeastern Philadelphia Community Health database to zip code identifiers common to all datasets. Weighted multilevel negative binomial regressions measure the influence that local SQF practices have on ED use for this population. Analytic methods incorporate patient demographic covariates including household size, health insurance status, and having a doctor as a usual source of care.

Findings reveal that both tract-level frisking and poor health are linked to more frecal lens through which stakeholders can make sense of these challenges and their implications.
To estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States.

Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction case filing data obtained from The Eviction Lab (2008-2016). Additional economic and demographic data were obtained from the United States Census Bureau and Bureau of Labor Statistics.

We conducted a retrospective cohort analysis using 7.3 million births from 1,633 counties. We defined threatened eviction exposures as the z-score of average case filings over the pregnancy and by trimester. Our primary outcome was an indicator for preterm birth (born<37 completed weeks of gestation). Secondary outcomes included a continuous measure for gestational length, a continuous measure for birth weight, and an indicator for low birth weight (born<2500g). We estimated within-county associations controlling for individuat of threatened evictions on maternal and child health outcomes.
Higher exposure to eviction case filings within counties, particularly in the latter stages of a pregnancy, was associated with an increased risk of adverse birth outcomes. Future research should identify the causal effect of threatened evictions on maternal and child health outcomes.
To evaluate the performance of the Swede score to detect cervical intraepithelial neoplasia (CIN) in women with HIV-1 in Johannesburg, South Africa.

A cross-sectional study using secondary data analysis from the HPV in Africa Research Partnership (HARP) study that compared the performance of three different screening tests to detect CIN. Colposcopy was performed on any woman who screened positive and findings were recorded using the Swede score. A biopsy of any lesion and a four-quadrant biopsy was taken. The score was evaluated against a histological diagnosis of >CIN1. The sensistivity, specificity, PPV and NPV for each score was calculated.

Median age and CD4+ count of the 576 women eligible from the Johannesburg cohort was 34years (IQR, 30-39) and 427cells/mm
(IQR, 323-579), respectively. Almost two-thirds (64%) were on ART and about 21% had CIN2+ on histology. A Swede score of 5 or greater had the best combination of sensitivity and specificity for CIN2+ with an AUC of 0.72 (95% CI, 0.68-0.76) corresponding to a sensitivity of 72.1 (95% CI, 63.5-79.6) and specificity of 71.8 (95% CI, 67.4-75.9).

The Swede score can assist in determining whether women with HIV/AIDS should have treatment at the first colposcopy visit versus those who may be followed up, thereby individualizing treatment.
The Swede score can assist in determining whether women with HIV/AIDS should have treatment at the first colposcopy visit versus those who may be followed up, thereby individualizing treatment.
To assess if early pregnancy (≤14weeks of gestation) 25-hydroxyvitamin D (25(OH)D) level is associated with risk of gestational diabetes mellitus (GDM).

A nested case-control study (60 women in each arm) was conducted at Saad Abualila Hospital (Khartoum, Sudan) during the period of January to November 2017. Clinical and obstetrical data were gathered, 25(OH)D concentration was measured at the first prenatal visit, and a 75-g oral glucose tolerance test was performed at 24-28weeks of gestation.

Compared with women without GDM, in women with GDM, the median of the 25(OH)D level was significantly lower (7.3 [interquartile range 5.7-8.8] ng/mL versus 8.4 [interquartile range 6.6-11.9] ng/mL, P=0.001). All women in the study (with and without GDM) had vitamin D deficiency (25(OH)D<20ng/mL). The results of the logistic regression showed that a low 25(OH)D level was the only factor associated with GDM (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.73-0.95, P=0.010). Women with 25(OH)D less than 6.0ng/mL were at a higher risk of GDM (OR 3.
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