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discuss their potential interests and limitations in older individuals. BACKGROUND & AIMS Nutritional status is an important prognostic factor in patients with heart failure (HF). In a pilot study we previously observed that the Mini Nutritional Assessment Short Form tool (MNA-SF) was the best approach for the screening of nutritional status in HF outpatients over other screening tools. The current study aimed to determine whether the MNA-SF has prognostic value in outpatients with HF and whether the impact of malnutrition differs depending on left ventricular ejection fraction (LVEF). METHODS Prospective study performed in outpatients attending a HF clinic at a university hospital. All subjects completed the MNA-SF at study entry. The primary endpoint was all-cause mortality. Secondary end-points were the number of recurrent HF-related hospitalizations and the composite end-point of all-cause death or HF-related hospitalizations. Patients with malnutrition and at risk of malnutrition were merged and considered as having abnormal nutritional status for statistical analysis. RESULsite end-point (HR 2.53 [95%CI 1.30-4.94], p = 0.006) only in HFmrEF patients. Patients with abnormal nutritional status suffered double the crude number of recurrent HF-related hospitalizations (16.4 vs. 8.4 per 100 patients-years, p  less then  0.001). CONCLUSIONS The implementation of MNA-SF as a routine screening tool allowed the detection of abnormal nutritional status in almost one out of five ambulatory HF patients. Nutritional status assessed by the MNA-SF was an independent predictor of all-cause death and the composite end-point of all-cause death or HF-related hospitalization in outpatients with HFmrEF. Furthermore, abnormal nutritional status was significantly related to recurrent hospitalizations across the HF spectrum. BACKGROUND Cytomegalovirus (CMV) are ubiquitously distributed worldwide, causing a wide range of clinical manifestations from congenital infection to a life-threatening disease in immunocompromised individuals. CMV can be transmitted via human-to-human contact through body fluids; however, the risk of CMV infection among healthcare workers (HCWs) has not been fully evaluated. AIM This study aimed to assess the risk of CMV infection among HCWs through daily medical practices. METHODS Serum samples from HCWs at Osaka University Hospital (Japan) were analysed. Initially, we compared CMV IgG seropositivity among HCWs (medical doctors, nurses, and others) in 2017, which was examined after 1 year to evaluate seroconversion rates among those with seronegative results. Then, we examined CMV seroconversion rates in HCWs who were exposed to blood and body fluids. FINDINGS We analysed 1153 samples of HCWs (386 medical doctors, 468 nurses, and 299 others), of which CMV seropositivity rates were not significantly different (68.9%, 70.3%, and 70.9%, respectively). Of these, 63.9% (221/346) of CMV seronegative HCWs were followed after 1 year, with CMV seroconversion rates of 3.2% (7/221). Among 72 HCWs who tested negative for CMV IgG when exposed to blood and body fluids, the CMV seroconversion rate was 2.8% (2/72). The CMV seroconversion rates between the two situations were not significantly different. CONCLUSION Our study indicated that CMV infection through daily patient care seems quite rare. Further well-designed studies with a large sample size are warranted to verify our finding. Diagnostic error is the most frequent cause of allegations of negligence in emergency care in the United States and is estimated to contribute to the death of hundreds of thousands of patients worldwide each year. In this special contribution, we elucidate the cognitive mechanisms that emergency physicians use to make decisions and identify how these mechanisms can become sources of diagnostic error. The discussion centers on the appraisal of proposed methods to reduce the risk of diagnostic error, including debiasing strategies and a brief discussion of the theoretical basis for interventions to improve clinician empathy. PURPOSE The purpose of this study was to compare the efficacy of artificial tears and warm compress with an eyelid warming mask (EWM) in alleviating dry eye syndrome (DES) in contact lens wearers METHODS This study was a prospective, randomized, active-controlled trial. Participants included 81 university students aged 19 or over, who had been wearing contact lenses for more than 1 year; they were randomly categorized into three groups. In the artificial tear group, one single-use artificial tear was administered every day as needed over a period of 4 weeks. In the EWM group, participants were instructed to apply a warm compress using a disposable EWM for 30 min before bedtime daily. Participants in the control group maintained their normal lifestyle without any treatment regimen. Ocular Surface Disease Index (OSDI) and Schirmer test scores for all participants were checked before the experiment and after 4 weeks. RESULTS After treatment, the EWM and artificial tears group had significantly decreased OSDI scores compared with the control group. However, there was no significant difference between the former two groups. The post-treatment Schirmer test scores for the right eye did not differ between three groups, whereas those for the left eye were significantly higher in the two treatment groups than in the control group. However, there was no significant difference between the EWN and artificial tears groups. CONCLUSION Contact lens wearers who were instructed to apply a warm compress using EWM had significantly increased OSDI and Schirmer test scores, indicating that it has a positive effect on DES. In conclusion, applying a warm compress with EWM can be recommended as a treatment for DES in contact lens wearers who use lenses for an extended period. PURPOSE A number of studies have examined the association between vitamin D and dry eye disease in different populations, but findings are inconclusive. selleck compound Herein, available observational studies were systematically reviewed to elucidate the overall relationship between vitamin D and dry eye disease among adult population. METHODS PubMed, Scopus, Google scholar and ISI web of science databases were searched until January 2020 for studies assessing the association between vitamin D and dry eye disease. The Newcastle-Ottawa Quality Assessment Scale was used to examine the quality of each study. RESULTS A total of 14 studies out of 252 met the inclusion criteria and were included in this systematic review and meta-analysis. Serum 25(OH) D3 was lower in dry eye disease subjects compared to healthy ones (WMD -5.93; 95 % CI, -7.47 to -4.40; P less then 0.001) with evidence of significant heterogeneity (I2 = 94.6 % p less then 0.001). Also, in final analysis, vitamin D correlated significantly with ocular surface disease index (Fisher's Z -0.