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The uptake of foil from needle and syringe provision services and its role in smoking or snorting heroin among people who inject drugs in Scotland.

Int J Drug Policy 2021 Jul 30;98:103369. Epub 2021 Jul 30.

School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; Public Health Scotland, NHS National Services Scotland, Glasgow, Scotland.

Background: In the UK, legislation was implemented in 2014 allowing needle and syringe provision (NSP) services to offer foil to people who inject drugs (PWID) to encourage smoking rather than injecting. This paper aims to examine the association between foil uptake and smoking or snorting heroin among PWID. This is the first large scale national study to examine foil uptake and smoking or snorting heroin among PWID post legislative change. Read More

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Increased Relative Functional Gain and Improved Stroke Outcomes: A Linked Registry Study of the Impact of Rehabilitation.

J Stroke Cerebrovasc Dis 2021 Jul 30;30(10):106015. Epub 2021 Jul 30.

Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia; Translational Public Health and Evaluation Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Level 3 Hudson Institute Building, 27-31 Wright Street, Clayton, VIC 3168, Australia. Electronic address:

Objectives: It is unclear how acute care influences patient outcomes in those who receive rehabilitation. We aimed to determine the associations between acute stroke therapies, outcomes during inpatient rehabilitation and self-reported outcomes at 90-180 days after stroke.

Materials And Methods: Patient-level data from adults with acute stroke registered in the Australian Stroke Clinical Registry (AuSCR, 2014-2017) were linked with data from the Australasian Rehabilitation Outcomes Centre (AROC). Read More

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Redefining the age-specific therapeutic ranges of lamotrigine for patients with epilepsy: A step towards optimizing treatment and increasing cost-effectiveness.

Epilepsy Res 2021 Jul 22;176:106728. Epub 2021 Jul 22.

Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, PR China. Electronic address:

Objective: The pharmacokinetics of lamotrigine exhibits age-related characteristics. Nevertheless, current evidence regarding the therapeutic range of lamotrigine has been derived almost exclusively from studies in adult patients, and the applicability of this therapeutic range to the pediatric population remains unclear. The purpose of this study was to establish the appropriate age-specific therapeutic ranges of lamotrigine corresponding to adequate clinical responses for patients with epilepsy. Read More

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How neuropsychiatric comorbidity, modulatory indication, demographics, and other factors impact deep brain stimulation inpatient outcomes in the United States: A population-based study of 27,956 patients.

Clin Neurol Neurosurg 2021 Jul 26;208:106842. Epub 2021 Jul 26.

Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA.

Objective: To determine how neuropsychiatric comorbidity, modulatory indication, demographics, and other characteristics affect inpatient deep brain stimulation (DBS) outcomes.

Methods: This is a retrospective study of 45 months' worth of data from the National Inpatient Sample. Patients were aged ≥ 18 years old and underwent DBS for Parkinson Disease (PD), essential tremor (ET), general dystonia and related disorders, other movement disorder (non-PD/ET), or obsessive-compulsive disorder (OCD) at a US hospital. Read More

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Differentiating Diagnosed and Undiagnosed Primary Angle-Closure Glaucoma and Open-Angle Glaucoma: A Population-Based Study.

Ophthalmol Glaucoma 2021 Jul 30. Epub 2021 Jul 30.

Kanto General Hospital of The Mutual Aid Association of Public School Teachers, Tokyo, Japan; Department of Ophthalmology, University of Tokyo, Graduate School of Medicine, Tokyo, Japan.

Purpose: To study and compare factors contributing to the differentiation of diagnosed and undiagnosed primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in the same population.

Design: Population-based survey.

Participants: All residents aged 40 years and older in Kumejima, Japan. Read More

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Associations of tobacco use and consumption with rurality among patients with psychiatric disorders: Does smoke-free policy matter?

J Rural Health 2021 Aug 2. Epub 2021 Aug 2.

College of Nursing, University of Kentucky, Lexington, Kentucky, USA.

Purpose: People with psychiatric disorders (PDs) have high risks for tobacco use and associated health effects; however, little is known about differences in tobacco use status and consumption by urban or rural residence. Among patients with PDs, we examined the association of smoke-free policy on tobacco use by rural/urban residence METHOD: A cross-sectional retrospective study (N = 2060) among patients in a psychiatric facility was conducted. Multi-logistic and multilinear regression analyses assessed differences in outcomes stratified by rural/urban status. Read More

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Diabetes risk reduction diet and the risk of pancreatic cancer.

Eur J Nutr 2021 Aug 2. Epub 2021 Aug 2.

Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.

Purpose: To evaluate the role of a diabetes risk reduction diet (DRRD) on pancreatic cancer risk.

Methods: We used data from a hospital-based case-control study conducted in Italy between 1991 and 2008; the study included 326 incident pancreatic cancer cases and 652 controls matched by age, gender and study center. Subjects' usual diet was collected through a valid and reproducible food frequency questionnaire. Read More

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Influence of Multimorbidity on New Treatment Initiation and Achieving Target Disease Activity Thresholds in Active Rheumatoid Arthritis: A Cohort Study Using the Rheumatology Informatics System for Effectiveness (RISE) Registry.

Arthritis Care Res (Hoboken) 2021 Aug 2. Epub 2021 Aug 2.

University of Alabama at Birmingham, Birmingham, AL, USA.

Objective: To determine whether multimorbidity is associated with treatment changes and achieving target disease activity thresholds in patients with active rheumatoid arthritis (RA).

Methods: We conducted a retrospective cohort study of adults with active RA within the Rheumatology Informatics System for Effectiveness (RISE) registry. Multimorbidity was measured using RxRisk, a medication-based index of chronic disease. Read More

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Patient characteristics associated with use of TNF vs interleukin inhibitors as first-line biologic treatment for psoriatic arthritis.

J Manag Care Spec Pharm 2021 Aug;27(8):1106-1117

MSCE, Division of Pharmacoepidemiology and Pharmacoeconomics and Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Previous studies have examined treatment patterns among patients who use tumor necrosis factor (TNF) inhibitors for psoriatic arthritis (PsA). However, little data exist for a comparison between the TNF inhibitor treatment pattern and that of newly available biologics such as interleukin (IL)-12/23 or 17 inhibitors in the United States. To (a) examine patient characteristics and their association with initiation of TNF inhibitors vs IL-12/23 or 17 inhibitors among PsA patients and (2) compare treatment persistence of PsA patients who initiated TNF inhibitors vs IL-12/23 or 17 inhibitors as first-line biologic treatment in a real-world setting in the United States. Read More

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Web-based patient portal use and medication overlap from VA and private-sector pharmacies among older veterans.

J Manag Care Spec Pharm 2021 Aug;27(8):983-994

Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr. VA Hospital, US Department of Veterans Affairs, Hines, IL, and Feinberg School of Medicine, Northwestern University, Chicago, IL.

The availability of Medicare Part D pharmacy coverage may increase veterans' options for obtaining medications outside of the Department of Veterans Affairs (VA) pharmacies. However, availability of Part D coverage raises the potential that veterans may be receiving similar medications from VA and non-VA pharmacies. The VA's personal health record portal, My HealtheVet, allows veterans to self-enter the non-VA medications that they obtained from community-based pharmacies, including those reimbursed by Medicare Part D. Read More

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Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative.

Eur Urol Open Sci 2021 Aug 24;30:37-43. Epub 2021 Jun 24.

Henry Ford Health System, Detroit, MI, USA.

Background: Renal mass biopsy (RMB) has had limited and varied utilization to guide management of renal masses (RM).

Objective: To evaluate utilization of RMB for newly diagnosed cT1 RMs across diverse practice types and assess associations of outcomes with RMB.

Design Setting And Participants: MUSIC-KIDNEY commenced data collection in September 2017 for all newly presenting patients with a cT1 RM at 14 diverse practices. Read More

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Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients.

Ann Gastroenterol Surg 2021 Jul 13;5(4):510-518. Epub 2021 Mar 13.

Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Kanazawa Japan.

Background: Preoperative sarcopenia is an important risk factor for postoperative complications in patients with gastric cancer. However, the relationship between muscle quality and postoperative complications in patients with gastric cancer is inadequately studied. Therefore, we investigated the impact of preoperative muscle quality on severe postoperative complications after radical gastrectomy. Read More

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Risk factors for cancellation after dispatch of rapid response cars for prehospital emergency care: a single-center, case-control study.

Acute Med Surg 2021 Jan-Dec;8(1):e684. Epub 2021 Jul 26.

Department of Emergency and Critical Care Medicine Juntendo University Urayasu Hospital Urayasu Chiba Japan.

Aim: The objective of this study is to identify the risk factors for cancellation after dispatch of rapid response cars (RRC) for prehospital emergency care.

Methods: We retrospectively extracted data from all RRC cases dispatched from our hospital between April 2017 and March 2019. A total of 1,440 cases were included in our study and divided into either the "cancelled" group ( = 723) or the "treated" group ( = 717), based on the occurrence of cancellation. Read More

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Clinical characteristics and clinical predictors of mortality in hospitalised patients of COVID 19 : An Indian study.

Med J Armed Forces India 2021 Jul 26;77:S319-S332. Epub 2021 Jul 26.

Classified Specialist (Medicine), Base Hospital, Delhi Cantt, India.

Background: The rapid spread of the coronavirus disease 2019 (COVID-19) with high mortality rate necessitates disease characterization and accurate prognostication for prompt clinical decision-making. The aim of this study is to study clinical characteristics and predictors of mortality in hospitalized patients with COVID-19 in India.

Methods: Retrospective cohort study was conducted in a tertiary care hospital in northern India. Read More

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Racial and Ethnic Amputation Level Disparities in Veterans Undergoing Incident Dysvascular Lower Extremity Amputation.

PM R 2021 Aug 1. Epub 2021 Aug 1.

VA Puget Sound Health Care System Rehab Care Services, University of Washington Department of Rehabilitation Medicine.

Introduction: The choice of incident amputation level can have a profound effect on clinical outcomes. Amputations at the transmetatarsal (TM) or transtibial (TT) levels result in greater preservation of function and mobility, while transfemoral (TF) amputations, typically result in a greater adverse impact. Prior investigations have explored racial/ethnic and regional variation in incident amputation level. Read More

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Longitudinal association between binge eating and metabolic syndrome in adults: findings from the ELSA-Brasil cohort.

Acta Psychiatr Scand 2021 Aug 1. Epub 2021 Aug 1.

Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

Objective: Individuals with bulimia nervosa and binge eating disorder have greater cardiovascular morbidity than the general population. Longitudinal research on the association between binge eating and metabolic syndrome is limited. We tested the longitudinal association between binge eating and metabolic syndrome and its components in a large population sample of Brazilian adults. Read More

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Delays in thrombolysis during COVID-19 are associated with worse neurological outcomes: the Society of Vascular and Interventional Neurology Multicenter Collaboration.

J Neurol 2021 Jul 31. Epub 2021 Jul 31.

Cooper Neurological Institute, Cooper University Hospital, 3 Cooper Plaza, Suite 320, Camden, NJ, 08103, USA.

Introduction: We have demonstrated in a multicenter cohort that the COVID-19 pandemic has led to a delay in intravenous thrombolysis (IVT) among stroke patients. Whether this delay contributes to meaningful short-term outcome differences in these patients warranted further exploration.

Methods: We conducted a nested observational cohort study of adult acute ischemic stroke patients receiving IVT from 9 comprehensive stroke centers across 7 U. Read More

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Triggers and Interventions of Patients Who Require Medical Emergency Team Reviews: A Cross-Sectional Analysis of Single Versus Multiple Reviews.

Crit Care Nurse 2021 Aug;41(4):e1-e10

Mary B. Quirke is a research fellow, Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin.

Background: Medical emergency teams constitute part of the escalation protocol of early warning systems in many hospitals. The literature indicates that medical emergency teams may reduce hospital mortality and cardiac arrest. A greater understanding of pathways of patients who experience multiple medical emergency team reviews will inform clinical decision-making. Read More

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Disturbed sleep in children born extremely preterm is associated with behavioural and emotional symptoms.

Sleep Med 2021 Jul 14;85:157-165. Epub 2021 Jul 14.

Department of Health Sciences, University of Leicester, Leicester, United Kingdom. Electronic address:

Aim: To determine whether children born extremely preterm are at increased risk for sleep disturbances and to explore relationships between extremely preterm birth, sleep and attention-deficit/hyperactivity disorder (ADHD) symptoms and emotional symptoms.

Method: EPICure2 cohort study. Parents of 165 children born ≤26 weeks' gestation (53% male) and 121 children born at term (43% male) completed the Children's Sleep Habits Questionnaire, sleep disordered breathing subscale of the Pediatric Sleep Questionnaire, the emotional problems scale of the Strengths and Difficulties Questionnaire and the ADHD Rating Scale-5 at 11 years of age. Read More

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Oral Immunotherapy (OIT)-related awareness, attitudes, and experiences among a Nationally-Representative Sample of Food Allergy Patients/Caregivers.

J Allergy Clin Immunol Pract 2021 Jul 29. Epub 2021 Jul 29.

Northwestern University Feinberg School of Medicine Department of Preventive Medicine, Center for Food Allergy & Asthma Research, Chicago, IL; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. Electronic address:

Background: Advances in oral immunotherapy (OIT) have led to recently expanded treatment options for food allergy (FA) patients. However, to inform future outreach efforts and ensure equitable access to emerging treatments, a greater understanding of current OIT-related awareness, attitudes and experiences is needed.

Objective: To characterize current OIT awareness, attitudes and experiences among a nationally-representative sample of US adults with FA and parents/caregivers of pediatric patients. Read More

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Impact of cancer diagnosis on causes and outcomes of 5.9 million US patients with cardiovascular admissions.

Int J Cardiol 2021 Jul 29. Epub 2021 Jul 29.

Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK; Department of Cardiology, Thomas Jefferson University, Philadelphia, USA. Electronic address:

Introduction: There are limited data on causes of cardiovascular (CV) admissions and associated outcomes among patients with different cancers.

Methods: All CV admissions from the US National Inpatient Sample between October 2015 to December 2017 were stratified by cancer type as well as metastatic status. Multivariable logistic regression was performed to determine the adjusted odds ratios (aOR) of in-hospital mortality in different groups. Read More

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Endometrial thickness in the prediction of neonatal adverse outcomes in frozen cycles for singleton pregnancies.

Reprod Biomed Online 2021 Apr 24. Epub 2021 Apr 24.

Department of Obstetrics and Gynaecology, Monash University, Clayton Victoria, Australia.

Research Question: Does endometrial thickness (EMT) predict adverse neonatal outcomes in singleton pregnancies after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) frozen embryo transfer (FET)?

Design: This retrospective study involved 13,383 women undergoing IVF/ICSI FET cycles between January 2010 and December 2018 in Women's Hospital of Zhejiang University. The primary outcome was preterm delivery (PTD). The secondary outcomes were small for gestational age (SGA), large for gestational age (LGA) and low birthweight (LBW). Read More

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Systematic Review and Meta-Analysis of Sex Specific Differences in Adverse Events After Open and Endovascular Intact Abdominal Aortic Aneurysm Repair: Consistently Worse Outcomes for Women.

Eur J Vasc Endovasc Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of Surgery and Cancer, Imperial College London, UK.

Objective: Previously, reports have shown that women experience a higher mortality rate than men after elective open (OAR) and endovascular (EVAR) repair of abdominal aortic aneurysm (AAA). With recent improvements in overall AAA repair outcomes, this study aimed to identify whether sex specific disparity has been ameliorated by modern practice, and to define sex specific differences in peri- and post-operative complications and pre-operative status; factors which may contribute to poor outcome.

Methods: This was a systematic review, meta-analysis, and meta-regression of sex specific differences in 30 day mortality and complications conducted according to PRISMA guidance (Prospero registration CRD42020176398). Read More

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Neurology trial registrations on ClinicalTrials.gov between 2007 and 2018: A cross-sectional analysis of characteristics, early discontinuation, and results reporting.

J Neurol Sci 2021 Jul 14;428:117579. Epub 2021 Jul 14.

Stanford University School of Medicine, Stanford, CA, United States of America.

Background: Increasing neurological disease burden and advancing treatment options require clinical trials to expand the evidence base of clinical care. We aimed to characterize neurology clinical trials registered between October 2007 and April 2018 and identify features associated with early discontinuation and results reporting.

Methods: We compared 16,994 neurology (9. Read More

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Compression depth measured by accelerometer vs. outcome in patients with out-of-hospital cardiac arrest.

Resuscitation 2021 Jul 28. Epub 2021 Jul 28.

Department of Biostatistics, University of Washington, Seattle, WA.

Background: Analyses of data recorded by monitor-defibrillators that measure CPR depth with different methods show significant relationships between the process and outcome of CPR. Our objective was to evaluate whether chest compression depth was significantly associated with outcome based on accelerometer-recordings obtained with monitor-defibrillators from a single manufacturer, and to assess whether an accelerometer-based analysis corroborated evidence-based practice guidelines on performance of CPR.

Methods And Results: We included 5,434 adult patients treated from seven US and Canadian cities between January 2007 and May 2015. Read More

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Number and Type of Blood Products are Negatively Associated With Outcomes Following Cardiac Surgery.

Ann Thorac Surg 2021 Jul 28. Epub 2021 Jul 28.

Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD.

Background: The association between blood transfusion and adverse outcome is documented in cardiac surgery. However, the incremental significance of each unit transfused, whether red blood cell (RBC) or non-RBC, is uncertain. This study examined the relationship of patient outcomes with type and number of blood product units transfused. Read More

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Day-by-day blood pressure variability in hospitalized patients with COVID-19.

J Clin Hypertens (Greenwich) 2021 Jul 31. Epub 2021 Jul 31.

The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

In a retrospective analysis, the authors investigated day-by-day blood pressure variability (BPV) and its association with clinical outcomes (critical vs. severe and discharged) in hospitalized patients with COVID-19. The study participants were hospitalized in Tongji Hospital, Guanggu Branch, Wuhan, China, between February 1 and April 1, 2020. Read More

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Lower 24-h urinary potassium excretion is negatively associated with excessive daytime sleepiness in the general population.

Sleep Breath 2021 Jul 31. Epub 2021 Jul 31.

Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China.

Objectives: Uncertainty remains about the association of potassium (K) intake and sleepiness. Therefore, we aimed to explore the relationship between K excretion using 24-h urine samples and excessive daytime sleepiness (EDS) in the general population.

Methods: In a cross-sectional study, we used multi-stage proportional random sampling to obtain a study sample aged ≥ 18 years from Emin, China between March and June 2019. Read More

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Distinct opposing associations of upper and lower body fat depots with metabolic and cardiovascular disease risk markers.

Int J Obes (Lond) 2021 Jul 30. Epub 2021 Jul 30.

Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Oxford, UK.

Background: To examine the associations of total and regional adiposity with metabolic and cardiovascular disease (CVD) risk markers.

Methods: This cross-sectional study included 1080 (53.8% men, aged 39-44 years) individuals from South India. Read More

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