Glaucoma is the leading cause of irreversible blindness with early detection and intervention critical to slowing disease progression. However, half of those affected are undiagnosed. This is largely due to the early stages of disease being asymptomatic; current population-based screening measures being unsupported; and a lack of current efficient prediction models.
View Article and Find Full Text PDFBackground: Few treatments are available for individuals with marked treatment-resistant depression (TRD).
Objective: Evaluate the safety and effectiveness of FDA-approved adjunctive vagus nerve stimulation (VNS) in patients with marked TRD.
Methods: This 12-month, multicenter, double-blind, sham-controlled trial included 493 adults with marked treatment-resistant major depression who were randomized to active or no-stimulation sham VNS for 12 months.
Background: Depression treatments aim to minimize symptom burden and optimize quality of life (QoL) and psychosocial function.
Objective: Compare the effects of adjunctive versus sham vagus nerve stimulation (VNS) on QoL and function in markedly treatment-resistant depression (TRD).
Methods: In this multicenter, double-blind, sham-controlled trial, 493 adults with TRD and ≥4 adequate but unsuccessful antidepressant treatment trials (current episode) were randomized to active (n = 249) or sham (n = 244) VNS (plus treatment as usual) over a 12-month observation period.
Background: There are large and persistent social inequalities in children's educational attainment, with children from more socioeconomically disadvantaged families consistently having lower attainment. Despite this being widely reported, the mechanisms underlying the association between socioeconomic disadvantage and educational attainment are not well understood. It is important to understand the potential mechanisms by which socioeconomic disadvantage may impede on educational outcomes, as this knowledge could then be used to help target possible interventions to improve educational outcomes for socioeconomically disadvantaged children.
View Article and Find Full Text PDFStudy Objective: We performed a systematic review and Bayesian network meta-analysis to determine which pharmacologic therapies are relatively more effective and safer for migraine in adult patients who present to the emergency department (ED).
Methods: We searched MEDLINE, Embase, and Web of Science from inception to February 9, 2024. Eligible studies were randomized controlled trials that enrolled adult participants presenting to ED with migraine and compared one pharmacologic therapy to another or placebo.
Objectives: To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes.
Design: A randomised crossover trial.
Setting: Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub.
Methods: The authors performed a computerized search using PubMed, Embase, and Google Scholar. The search terms used were "chemotherapy AND surgery", "immunotherapy AND surgery", "radiotherapy AND surgery", "nutrition AND surgery", "(oculoplastic OR orbit OR eyelid OR lacrimal OR puncta) AND (chemotherapy OR immunotherapy OR radiotherapy)", "(facial OR facial plastic OR oculoplastic) AND (chemotherapy OR immunotherapy OR radiotherapy)", "(cancer OR malignancy) AND surgery", "(cancer OR malignancy) AND (surgery OR surgical) complications", "wound healing AND (cancer OR malignancy)", "infection AND (cancer OR malignancy)", "(bleeding OR blood loss) AND (cancer OR malignancy) AND surgery", "(chemotherapy OR immunotherapy OR radiotherapy) AND wound healing", "(chemotherapy OR immunotherapy OR radiotherapy) AND (bleeding OR blood loss)", "(chemotherapy OR immunotherapy OR radiotherapy) AND infection".
Results: A total of 89 articles, published from 1993 to 2023 in the English language or with English translations were included.
The purpose of this project was to examine a free tailored childbirth education (CBE) program's impact on fear of childbirth and birth preferences in Black, Indigenous, and people of color women. Expectant mothers ( = 8) completed an investigator-designed questionnaire before attending a prenatal community-based CBE program. Post-CBE surveys were not analyzed due to participant data not matching the pre-CBE surveys.
View Article and Find Full Text PDFBackground: Warmblood horses are a popular breed around the world for equestrian sports. Previous studies have investigated ocular findings in other breeds of horses; however, no studies exist for the Warmblood breed.
Objectives: To determine the prevalence of ocular abnormalities in a convenience sample of Warmblood horses in South Africa and to determine if the prevalence of lens and chorioretinal lesions increase with age.
Purpose: To determine the pre-operative, peri-operative, or post-operative risk factors that contribute to pediatric frontalis sling infection or exposure.
Methods: Retrospective study of 193 eyelids that underwent silicone-rod frontalis sling surgery at a single institution between 2014 and 2019.
Results: A total of 222 eyelids were originally identified.
CPT Pharmacometrics Syst Pharmacol
November 2024
In drug development, quantitative systems pharmacology (QSP) models are becoming an increasingly important mathematical tool for understanding response variability and for generating predictions to inform development decisions. Virtual populations are essential for sampling uncertainty and potential variability in QSP model predictions, but many clinical efficacy endpoints can be difficult to capture with QSP models that typically rely on mechanistic biomarkers. In oncology, challenges are particularly significant when connecting tumor size with time-to-event endpoints like progression-free survival while also accounting for censoring due to consent withdrawal, loss in follow-up, or safety criteria.
View Article and Find Full Text PDFBackground: Experiential learning through simulation allows students to apply didactic knowledge to real-world situations. Tabletop simulation allows for the exploration of a variety of topics, including cybersecurity in health care. Due to its low frequency, yet high-risk nature, simulation is a perfect educational modality to practice responding to a cybersecurity attack.
View Article and Find Full Text PDFObjectives: Approximately 10% of patients with syncope have serious or life-threatening causes that may not be apparent during the initial emergency department (ED) assessment. Consequently, researchers have developed clinical decision rules (CDRs) to predict adverse outcomes and risk stratify ED syncope patients. This systematic review and meta-analysis (SRMA) aims to cohere and synthesize the best current evidence regarding the methodological quality and predictive accuracy of CDRs for developing an evidence-based ED syncope management guideline.
View Article and Find Full Text PDFTree growth-survival relationships link two demographic processes that individually dictate the composition, structure and functioning of forest ecosystems. While these relationships vary intra-specifically, it remains unclear how this reflects environmental variation and disturbance. We examined the influence of a 700-m elevation gradient and an = 6.
View Article and Find Full Text PDFBackground: The clinical course of idiopathic pulmonary fibrosis (IPF) is highly variable and unpredictable, with multiple genetic variants influencing IPF outcomes. Notably, rare pathogenic variants in telomere-related genes are associated with poorer clinical outcomes in these patients. Here we assessed whether rare qualifying variants (QVs) in monogenic adult-onset pulmonary fibrosis (PF) genes are associated with IPF survival.
View Article and Find Full Text PDFBackground: In non-nephrology settings, specialty Palliative Care (PC) improves decision-making, patient's quality of life (QoL), advance care planning (ACP), and certain indicators of the quality of end-of-life (EoL) care. This pilot RCT explored the feasibility and acceptability of a PC intervention, CKD-EDU, for older adults ≥75 years with eGFR ≤25 ml/min and their caregivers.
Methods: Participants randomized to the control group received standard nephrology care and routine kidney therapy (KT) education, while those randomized to CKD-EDU received a decision aid and met with a PC clinician up to three times to discuss KT decisions and EoL planning.