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Testing a Web-Based Interactive Comic Tool to Decrease Obesity Risk Among Racial and Ethnic Minority Preadolescents: Randomized Controlled Trial.
JMIR Form Res
January 2025
Graduate School of Public Health Policy, City University of New York, New York, NY, United States.
Background: Childhood obesity prevalence remains high, especially in racial and ethnic minority populations with low incomes. This epidemic is attributed to various dietary behaviors, including increased consumption of energy-dense foods and sugary beverages and decreased intake of fruits and vegetables. Interactive, technology-based approaches are emerging as promising tools to support health behavior changes.
View Article and Find Full Text PDFSafety and Efficacy of Tranexamic Acid in General Surgery.
JAMA Surg
January 2025
Population Health Research Institute, Hamilton, Ontario, Canada.
Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.
Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.
Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.
Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.
Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
Ammonia and beyond - biomarkers of hepatic encephalopathy.
Metab Brain Dis
January 2025
Fundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVA, Valencia, 46010, Spain.
Ammonia is a product of amino acid metabolism that accumulates in the blood of patients with liver cirrhosis, leading to neurotoxic effects and hepatic encephalopathy (HE). HE manifestations can range from mild, subclinical disturbances in cognition, or minimal HE (mHE) to gross disorientation and coma, a condition referred to as overt HE. Many blood-based biomarkers reflecting these neurotoxic effects of ammonia and liver disease can be measured in the blood allowing the development of new biomarkers to diagnose cirrhosis patients at risk of developing HE.
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