Alvarezsnyder7677
Regular applications of structured benefit-risk assessment, whether qualitative, quantitative, or both, enabled by easy-to-understand graphical presentations that capture uncertainties around the benefit-risk metric, may aid shared decision-making and enhance transparency of those decisions.
To examine the association between the degree of risk factor control and cardiovascular disease (CVD) risk in type 2 diabetes and to assess if the presence of cardio-renal disease modifies these relationships.
A retrospective cohort study using data from English practices from CPRD GOLD (Clinical Practice Research Datalink) and the SCI-Diabetes dataset (Scottish Care Information-Diabetes), with linkage to hospital and mortality data. We identified 101 749 with type 2 diabetes (T2D) in CPRD matched with 378 938 controls without diabetes and 330 892 with type 2 diabetes in SCI-Diabetes between 2006 and 2015. The main exposure was number of optimized risk factors nonsmoker, total cholesterol ≤4 mmol/L, triglycerides ≤1.7 mmol/L, glycated haemoglobin (HbA1c) ≤53 mmol/mol (≤7.0%), systolic blood pressure <140mm Hg, or <130 mm Hg if high risk. Cox models were used to assess cardiovascular risk associated with levels of risk factor control.
In CPRD, the mean baseline age in T2D was 63 years and 28% had c T2D have a 21% higher CVD risk when compared with controls. People with T2D without cardio-renal disease would be predicted to benefit greatly from CVD risk factor intervention.
Optimally managed people with T2D have a 21% higher CVD risk when compared with controls. People with T2D without cardio-renal disease would be predicted to benefit greatly from CVD risk factor intervention.
Persistent post-concussive symptoms (PPCS) often include attention deficits, particularly orienting and executive attention. Research in other clinical populations has demonstrated that neurofeedback therapy (NFT) is effective at improving orienting and executive attention, although its effects on attentional networks in patients with PPCS are unknown.
In this single-group pilot study, we examined attention-related event-related potentials (ERPs) - N1 and P3 - and cognitive outcomes following Live Z-score training (LZT), a variant of NFT.
No changes in early selective attention, as indexed by N1 amplitude, were observed; however, P3 amplitude, which indexes neural resource allocation, increased following LZT and returned to baseline by 3months. Cognitive performance improved following treatment, which was sustained at 3months. The magnitude of change in P3 and ANT performance did not differ between orienting or executive attention, suggesting LZT improved general attentional processing efficiency.
Our results suggest that LZT may positively affect attention globally, but does not target specific attention networks. These pilot data warrant the initiation of a clinical trial evaluating the effectiveness of LZT for treating attention deficits in patients with PPCS.
Our results suggest that LZT may positively affect attention globally, but does not target specific attention networks. These pilot data warrant the initiation of a clinical trial evaluating the effectiveness of LZT for treating attention deficits in patients with PPCS.1. Moribund or diseased poultry requiring euthanasia are often dehydrated. To understand how dehydration influences the efficacy of various killing methods, this experiment investigated the effect of water deprivation (WD) on times to unconsciousness and death.2. Broiler chickens (n = 179) were water-deprived for 0, 24, 48 or 72 hours to mimic dehydration, then killed via manual cervical dislocation, mechanical cervical dislocation (Koechner Euthanising Device (KED)), or non-penetrating captive bolt (Zephyr-EXL), at 8, 22, 36 or 50 d of age. Degree of WD was confirmed by skin turgor, packed cell volume and body weight loss. Method efficacy was evaluated by the time to unconsciousness and death using pupillary light (PUP), palpebral blink (PAL) and nictitating membrane (NIC) reflexes, feather erection (FE), cloacal winking (CW) and convulsions (CN). The extent of damage caused by each method was examined via radiography, gross pathology and histopathology. The main effects of WD time and euthanasia method were analysed by two-way analyses of variance (CRD, PROC MIXED, SAS 9.4) with a-priori contrasts to compare water-deprived versus non-water-deprived (NON) birds.3. DL-Alanine in vitro Skin turgor, packed cell volume and body weight loss had a quadratic relationship with WD, with highest values for those birds which were water-deprived for 72 h. WD level did not affect time to unconsciousness. Time to death was longer for WD birds than NON, with longer latencies to FE, CW and CN for water-deprived birds. WD only affected radiography or gross pathology scores on d 8, with the extent of subcutaneous haemorrhage within the neck decreasing as WD increased.4. The shortest latency to PUP loss, at all ages, and to PAL and NIC loss, at 22 d, was with the Zephyr-EXL. KED had the longest time to unconsciousness (PUP, PAL and NIC), at all ages, and to death, at 36 and 50 d.5. Overall, WD increased time to death, but did not affect the onset of unconsciousness, with no interaction between methods and WD level.
All first- and second-year (i.e., pre-clinical) medical students at a large, Midwestern medical school with three campuses were invited to participate in a two-arm, parallel educational study comparing the efficacy of two types of curricular interventions. Students at the main campus attended the modified contact-based education panel or the didactic lecture in person, while students at the two distance campuses attended the modified contact-based education or lecture remotely using the University's videoconferencing system.
A total of 109 students participated in the study (average age 24.2 years (
= 2.6), 64.2% female, 79.8% white, 56.0% second-year students, 67.9% attended on main campus, lecture = 52 participants, modified contact-based = 57 participants). Baseline responses were similar across groups. Following the session, participants in both interventions rated drug abuse (percent increase = 21.2%,
< .001) and prescription drug diversion (percent increase = 7.6%,
= .004) as more serious problems.