Added Value of Shaking Chills for Predicting Bacteremia in Patients with Suspected Infection.

Background: Detailed grading of chills is more useful for diagnosing bacteremia than simply classifying the presence or absence of chills. However, its value added to other clinical information has not been evaluated.

Objective: To evaluate the value of adding chills grading to other clinical information compared to simply noting the presence or absence of chills for predicting bacteremia in patients with suspected infection.

Self-Reported Time-at-Bedside and Its Association with In-Training Examination Scores of Residents in Japan.

Background: Time-at-bedside plays a central role in clinical medicine. However, the amount of time Japanese clinical residents spend at patients' bedsides remains unexplored.

Objective: To quantify time-at-bedside and examine its association with in-training examination scores during clinical residency in Japan.

The relation between resident mentorship and in-training examination scores: A nation-wide, cross-sectional study in Japan.

Background: Mentorship is a dynamic reciprocal relationship, wherein a novice (mentee) grows with the encouragement of an advanced careerist (mentor). It is widely implemented in medical training programs. However, there are few reports on mentorship's educational effects in the Japanese context.

Added value of inflammatory markers to vital signs for predicting mortality in patients with suspected infection: external validation and model development.

It is crucial to identify high-risk patients with infectious conditions for appropriate management. We previously found that inflammatory markers added value to vital signs for predicting mortality in patients with suspected infection. In this study, the aim was to externally validate the added value of the inflammatory markers and to develop a new prediction model.

Risk of Recurrent Venous Thromboembolism in Patients with Cancer: An Individual Patient Data Meta-analysis and Development of a Prediction Model.

Background:  About 7% of patients with cancer-associated venous thromboembolism (CAT) develop a recurrence during anticoagulant treatment. Identification of high-risk patients may help guide treatment decisions.

Aim:  To identify clinical predictors and develop a prediction model for on-treatment recurrent CAT.

Development of a Culinary Intervention (Cooking Class) for Salt Reduction in Japanese Home Cooking: Strategies and Assessment.

Introduction: Culinary interventions (cooking classes) are a potential educational tool for salt reduction in the home diet, but their content has never been reported in detail. This study aimed to develop a cooking class for salt reduction, describe its rationale and structure so that other parties could replicate it, and preliminarily assess its impact on salt intake.

Methods: A multidisciplinary research team developed a cooking class package to reduce salt content in the Japanese home diet.

Radiological Cutoff Values for Diagnosis of Lymph Node Metastasis in Colorectal Cancer With Multilevel Analysis.

Background/aim: A cutoff value for lymph node diameter in colorectal cancer lymph node metastases has not been established. This prospective study aimed to investigate the direct association between swollen lymph nodes identified on preoperative computed tomography (CT) and pathological findings and proposed a cutoff value.

Patients And Methods: We enrolled patients scheduled to undergo curative surgery with lymph node dissection for colorectal adenocarcinoma who underwent preoperative contrast-enhanced CT and had swollen lymph nodes ≥7 mm in diameter.

Role of inflammatory markers in the assessment of meningitis in adult patients with fever and headache.

Background: Meningitis, especially of bacterial origin, is a medical emergency that must be diagnosed promptly. However, due to the associated risks of complications of lumbar puncture, it is crucial to identify individuals who truly need it. The aim of this study was to assess the diagnostic role of inflammatory markers in distinguishing among patients without meningitis, those with aseptic meningitis, and those with bacterial meningitis.

Added value of non-contrast CT for the diagnosis of acute pyelonephritis in older patients with suspected infection with an unknown focus: a retrospective diagnostic study.

Objectives: In older patients, the diagnosis of acute pyelonephritis (APN) is challenging. The aim was to evaluate the added value of CT to history, physical examination and urinalysis for the diagnosis of APN in older patients with suspected infection with an unknown focus.

Design: Retrospective diagnostic study.

Manipulating the growth environment through co-culture to enhance stress tolerance and viability of probiotic strains in the gastrointestinal tract.

The viability of probiotics in the human gastrointestinal tract is important, as some reports indicate that the health benefits of live bacteria are greater than those of dead ones. Therefore, the higher the viability of the probiotic strain, the better it may be. However, probiotic strains lose their viability due to gastrointestinal stress such as gastric acid and bile.

Predictive Performance of MRI for Antibiotic Treatment Failure of Pyogenic Vertebral Osteomyelitis: A Validation Study.

Introduction: Intravenous antibiotics are the primary treatment of choice for pyogenic vertebral osteomyelitis (PVO). Surgical intervention is required when the initial antibiotic treatment fails but is often difficult to perform, especially in older adults with multiple comorbidities, because of the reduced physical activity. The size of the infection signal in the spinal bone on magnetic resonance imaging (MRI) at the time of diagnosis was reported to have a high predictive accuracy for antibiotic treatment failure.

Prognosis and prediction of antibiotic benefit in adults with clinically diagnosed acute rhinosinusitis: an individual participant data meta-analysis.

Background: A previous individual participant data meta-analysis (IPD-MA) of antibiotics for adults with clinically diagnosed acute rhinosinusitis (ARS) showed a marginal overall effect of antibiotics, but was unable to identify patients that are most likely to benefit from antibiotics when applying conventional (i.e. univariable or one-variable-at-a-time) subgroup analysis.

What are Effective Strategies to Reduce Low-Value Care? An Analysis of 121 Randomized Deimplementation Studies.

Background: Low-value care is healthcare leading to no or little clinical benefit for the patient. The best (combinations of) interventions to reduce low-value care are unclear.

Purpose: To provide an overview of randomized controlled trials (RCTs) evaluating deimplementation strategies, to quantify the effectiveness and describe different combinations of strategies.

Covariate-specific ROC curve analysis can accommodate differences between covariate subgroups in the evaluation of diagnostic accuracy.

Objectives: We present an illustrative application of methods that account for covariates in receiver operating characteristic (ROC) curve analysis, using individual patient data on D-dimer testing for excluding pulmonary embolism.

Study Design And Setting: Bayesian nonparametric covariate-specific ROC curves were constructed to examine the performance/positivity thresholds in covariate subgroups. Standard ROC curves were constructed.

Accuracy of physicians' intuitive risk estimation in the diagnostic management of pulmonary embolism: an individual patient data meta-analysis.

Background: In patients clinically suspected of having pulmonary embolism (PE), physicians often rely on intuitive estimation ("gestalt") of PE presence. Although shown to be predictive, gestalt is criticized for its assumed variation across physicians and lack of standardization.

Objectives: To assess the diagnostic accuracy of gestalt in the diagnosis of PE and gain insight into its possible variation.

Prediction Models for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Meta-analysis.

Context: Approximately 10% to 20% of patients with Kawasaki disease (KD) are refractory to initial intravenous immunoglobulin (IVIG) therapy. KD is mainly associated with coronary artery abnormalities.

Objectives: To identify and evaluate all developed prediction models for IVIG resistance in patients with KD and synthesize evidence from external validation studies that evaluated their predictive performances.

Systematic review finds "spin" practices and poor reporting standards in studies on machine learning-based prediction models.

Objectives: We evaluated the presence and frequency of spin practices and poor reporting standards in studies that developed and/or validated clinical prediction models using supervised machine learning techniques.

Study Design And Setting: We systematically searched PubMed from 01/2018 to 12/2019 to identify diagnostic and prognostic prediction model studies using supervised machine learning. No restrictions were placed on data source, outcome, or clinical specialty.

Systematic review identifies the design and methodological conduct of studies on machine learning-based prediction models.

Background And Objectives: We sought to summarize the study design, modelling strategies, and performance measures reported in studies on clinical prediction models developed using machine learning techniques.

Methods: We search PubMed for articles published between 01/01/2018 and 31/12/2019, describing the development or the development with external validation of a multivariable prediction model using any supervised machine learning technique. No restrictions were made based on study design, data source, or predicted patient-related health outcomes.

Spontaneous Tension Hemothorax in a Patient with Asbestosis.

Case Presentation: A 75-year-old man with a history of asbestosis presented to the emergency department with sudden-onset dyspnea and hemoptysis, triggered by coughing. The patient was hemodynamically unstable and in respiratory distress. Computed tomography revealed a massive hemothorax on the left side and compression of the descending thoracic aorta.

Diagnostic Performance of Physician Gestalt for Bacteremia in Patients in the Process of Being Admitted With Suspected Infection.

Background: Due to potentially fatal consequences of missed bacteremia, blood cultures are often overused. While there are several prediction models that can be used to identify patients who truly need blood cultures, physicians often rely on their gestalt. We evaluated the diagnostic performance of physician gestalt for bacteremia in comparison with 2 existing prediction models: Takeshima and Shapiro.

Door-to-oral time and in-hospital outcomes in older adults with aspiration pneumonia undergoing dysphagia rehabilitation.

Background & Aims: Aspiration pneumonia (AP) is a public health concern among older adults. Previous studies have reported the association between oral intake initiation within 48 h after hospital admission and better in-hospital outcomes among patients with AP. We investigated the association between initiation of oral intake within 24 h and in-hospital outcomes of older patients with AP undergoing dysphagia rehabilitation.

Clinical prediction models for mortality in patients with covid-19: external validation and individual participant data meta-analysis.

Objective: To externally validate various prognostic models and scoring rules for predicting short term mortality in patients admitted to hospital for covid-19.

Design: Two stage individual participant data meta-analysis.

Setting: Secondary and tertiary care.