Understanding the effectiveness and underlying mechanisms of lifestyle modification interventions in adults with learning disabilities: a mixed-methods systematic review.

Background: Adults with learning disabilities face increased risks of unhealthy lifestyle behaviours, including alcohol consumption, smoking, low physical activity, sedentary behaviour and poor diet. Lifestyle modification interventions that target health-risk behaviours can prevent or reduce their negative effects. The goal of this project was to investigate the effectiveness and underlying mechanisms of lifestyle modification interventions in adults with learning disabilities.

Equalizing the Playing Field and Improving School Food Literacy Programs Through the Eyes of Teens: A Grounded Theory Analysis Using a Gender and Sport Participation Lens.

: School food literacy programs (e.g., home economics) are an opportunity to improve the dietary habits of teens.

Efficacy, Safety, and Injection Frequency with Novel Aflibercept 8 mg in Neovascular Age-Related Macular Degeneration: A Comparison with Existing Anti-VEGF Regimens Using a Bayesian Network Meta-Analysis.

Introduction: Aflibercept 8 mg administered in extended dosing intervals has shown non-inferior visual gains and comparable safety profile to aflibercept 2 mg in the PULSAR pivotal randomized clinical trial and has the potential to reduce the treatment burden of treating neovascular age-related macular degeneration (nAMD). This study aimed at gathering robust evidence to assess the comparative efficacy, safety, and treatment burden of aflibercept 8 mg against other anti-vascular endothelial growth factor (VEGF) agents as ranibizumab, brolucizumab, faricimab, and bevacizumab in patients with nAMD.

Methods: A systematic literature review (SLR) was conducted, targeting clinical trials of anti-VEGF agents in patients with nAMD.

"Where" and "What" Do Adolescent Athletes Learn When It Comes to Food Literacy Compared With Adolescents that Do Not Play Sports? A Gender-Based Thematic Analysis.

Background: Food literacy skills (e.g., nutrition knowledge, social, cultural, economic, and environmental impacts of food) play a role in high school (13-18 y) athletes' health and performance.

Assessing the Value of Further Investment in R&D Using Mixed Methods: A Case Study of Biosensor-Integrated Arteriovenous Grafts.

This study illustrates the utility of a mixed-methods approach in assessing the value of an example novel technology-biosensor-integrated self-reporting arteriovenous grafts (smart AVGs). Currently in preclinical development, the device will detect arteriovenous graft stenosis (surveillance-only use case) and treat stenosis (interventional use case). The approach to value assessment adopted in this study was multifaceted, with one stage informing the next and comprised a stakeholder engagement with clinical experts to explore the device's clinical value, a cost-utility analysis (CUA) from a US Medicare perspective to estimate pricing headroom, and an investment model estimating risk-adjusted net present value analysis (rNPVs) to determine commercial viability.

Exploring adolescents' experiences navigating the intersection of their gender, sport, and dietary identities: an interpretative phenomenological study.

Not all adolescents have positive sport experiences. Research has repeatedly identified ties between unfavorable eating patterns and food beliefs (i.e.

Integrating food is medicine and regenerative agriculture for planetary health.

The urgent need to address both human and environmental health crises has brought attention to the role of food systems in driving climate change, biodiversity loss, and diet-related diseases. This paper explores the intersection of Food is Medicine (FIM) and regenerative agriculture (RA) as an emerging approach with the potential to help address the interconnected challenges of human and ecological health within healthcare and food systems. FIM programs, such as produce prescriptions and medically tailored meals, aim to improve health outcomes by increasing access to nutritious foods and promoting nutrition equity.

A Case Report of Deterioration in a Non-frail Octogenarian Burn Patient.

While advancements in critical care and burn treatment have improved over the decades, elderly burn victims continue to face high mortality rates. Measurements of frailty among patients have become popular tools for predicting burn outcomes over chronological age. In this report, we provide a case of a non-frail octogenarian burn victim who deteriorated rapidly during treatment, suggesting that frailty alone is not sufficient in predicting outcomes in older burn patients.

Stakeholders' perspectives on disinvestment of low-value healthcare interventions and practices in Malaysia: an online survey.

Objectives: Healthcare disinvestment requires multi-level decision-making, and early stakeholder engagement is essential to facilitate implementation and acceptance. This study aimed to explore the perceptions of Malaysian healthcare stakeholders to disinvestment initiatives as well as identify disinvestment activities in the country.

Methods: A cross-sectional online survey was conducted from February to March 2023 among Malaysian healthcare stakeholders involved in resource allocation and decision-making at various levels of governance.

What methods are currently available for incorporating implementation considerations within the economic evaluation of health technologies? A scoping review.

Background: When clinically effective, cost-effective health interventions are not fully implemented in clinical practice, population health suffers. Economic factors are among the most commonly cited reasons for suboptimal implementation. Despite this, implementation and economic evaluation are not routinely performed in conjunction with one another.

Economic evaluation of diagnosis and treatment for latent tuberculosis infection among contacts of pulmonary tuberculosis patients in Thailand.

Currently, interferon-gamma release assay (IGRA) is costly and not included as latent tuberculosis infection (LTBI) screening test strategy in Thailand's Universal Coverage Scheme (UCS) benefit package. The objective of this study was to assess the cost-utility of LTBI screening strategies among tuberculosis (TB) contacts in Thailand. A hybrid decision tree and Markov model was developed to compare the lifetime costs and health outcomes of tuberculin skin test (TST) and IGRA, in comparison to no screening, based on a societal perspective.

Bisoprolol in Patients With Chronic Obstructive Pulmonary Disease at High Risk of Exacerbation: The BICS Randomized Clinical Trial.

Importance: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Observational studies report that β-blocker use may be associated with reduced risk of COPD exacerbations. However, a recent trial reported that metoprolol did not reduce COPD exacerbations and increased COPD exacerbations requiring hospital admission.

Invasive Endotyping in Patients With Angina and No Obstructive Coronary Artery Disease: A Randomized Controlled Trial.

Background: We investigated the usefulness of invasive coronary function testing to diagnose the cause of angina in patients with no obstructive coronary arteries.

Methods: Outpatients referred for coronary computed tomography angiography in 3 hospitals in the United Kingdom were prospectively screened. After coronary computed tomography angiography, patients with unobstructed coronary arteries, and who consented, underwent invasive endotyping.

The coronary microvascular angina cardiovascular magnetic resonance imaging trial: Rationale and design.

Background: Coronary microvascular dysfunction may cause myocardial ischemia with no obstructive coronary artery disease (INOCA). If functional testing is not performed INOCA may pass undetected. Stress perfusion cardiovascular MRI (CMR) quantifies myocardial blood flow (MBF) but the clinical utility of stress CMR in the management of patients with suspected angina with no obstructive coronary arteries (ANOCA) is uncertain.

MED12 mutation activates the tryptophan/kynurenine/AHR pathway to promote growth of uterine leiomyomas.

Uterine leiomyomas cause heavy menstrual bleeding, anemia, and pregnancy loss in millions of women worldwide. Driver mutations in the transcriptional mediator complex subunit 12 (MED12) gene in uterine myometrial cells initiate 70% of leiomyomas that grow in a progesterone-dependent manner. We showed a distinct chromatin occupancy landscape of MED12 in mutant MED12 (mut-MED12) versus WT-MED12 leiomyomas.

Health financing challenges in Southeast Asian countries for universal health coverage: a systematic review.

Background: Universal Health Coverage (UHC) has received much attention and many countries are striving to achieve it. The Southeast Asian region, in particular, comprises many developing countries with limited resources, exacerbating challenges around attaining UHC. This paper aims to specifically explore the health financing challenges these countries face in achieving UHC via a systematic review approach and formulate recommendations that will be useful for policymakers.

Evaluating the use of intraoperative magnetic resonance imaging in paediatric brain tumour resection surgeries: a literature review.

Brain tumours are the most common solid neoplasm in children, posing a significant challenge in oncology due to the limited range of treatment. Intraoperative magnetic resonance imaging (iMRI) has recently emerged to aid surgical intervention in neurosurgery resection with the potential to delineate tumour boundaries. This narrative literature review aimed to provide an updated evaluation of the clinical implementation of iMRI in paediatric neurosurgical resection, with an emphasis on the extent of brain tumour resection, patient outcomes and its drawbacks.

Plasma levels of coagulation factors VIII and IX and risk of venous thromboembolism: Systematic review and meta-analysis.

Introduction: The associations of plasma factor VIII (FVIII) and factor IX (FIX) levels with risk of venous thromboembolism (VTE) are not well defined. We performed a systematic review and meta-analysis of these associations.

Methods: Random effects inverse-variance weighted meta-analysis was used to estimate pooled odds ratios for comparisons across equal quartiles of the distributions and 90 % thresholds (higher versus lower), and for testing linear trends.

Effect of Medication Therapy Management by Pharmaceutical Care on Blood Pressure and Cardiovascular Risk in Hypertension: A Systematic Review, Meta-Analysis, and Meta-Regression.

Medication therapy management by pharmaceutical care (MTM-PC) has been shown to improve the effectiveness of antihypertensive treatments. The aim was to answer the question: what are the MTM-PC models and their impact on hypertensive patients' outcomes? This is a systematic review with meta-analysis. The search strategies were run on 27 September 2022 in the following databases: PubMed, EMBASE, Scopus, LILACs, Central Cochrane Library, Web of Science; and International Pharmaceutical Abstracts.

Stroke resource utilisation and all-cause mortality in Thailand 2017-2020: A retrospective, cross-sectional study.

Objective: To determine resource utilisation, costs and all-cause mortality related to stroke in Thailand.

Design: Retrospective, cross-sectional study.

Setting And Participants: Patients with first-ever stroke in the Thai national claims database between 2017 and 2020 were included for analysis.

MetaBayesDTA: codeless Bayesian meta-analysis of test accuracy, with or without a gold standard.

Background: The statistical models developed for meta-analysis of diagnostic test accuracy studies require specialised knowledge to implement. This is especially true since recent guidelines, such as those in Version 2 of the Cochrane Handbook of Systematic Reviews of Diagnostic Test Accuracy, advocate more sophisticated methods than previously. This paper describes a web-based application - MetaBayesDTA - that makes many advanced analysis methods in this area more accessible.

Availability of stroke services and hospital facilities at different hospital levels in Thailand: a cross-sectional survey study.

Background: Stroke has one of the biggest burden of disease in Thailand and all health regions have been tasked to develop their service delivery to achieve the national key performance indicators set out by the Thai service plan strategy 2018-2022. Our aim was to characterise stroke services and hospital facilities by investigating differences in facilities across different hospital levels in Thailand.

Methods: Self-complete questionnaires were distributed to 119 hospitals in 12 health regions between November-December 2019.

Effects on heavy menstrual bleeding and pregnancy of uterine artery embolization (UAE) or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: The FEMME randomized controlled trial.

Objective: To determine treatment options (myomectomy vs. uterine artery embolization (UAE)) for women wishing to avoid hysterectomy.

Methods: A multicenter randomized controlled trial was conducted on 254 women and data were collected on fibroid-specific quality of life (UFS-QOL), loss of menstrual blood, and pregnancy.

How do multiple long-term conditions impact on the cost-of-illness in early rheumatoid arthritis?

Objective: Multiple long-term conditions (MLTCs) are prevalent in rheumatoid arthritis (RA) and associated with worse outcomes and greater economic burden. However, little is known about the impact of MLTCs on the cost-of-illness (COI) in early RA, including direct and indirect costs. The objective of this study was to quantify this impact on COI.