Does patient blood management represent good value for money?

Patient blood management is the umbrella term for a suite of initiatives designed to optimise blood product usage, minimise transfusion needs, and ensure appropriate and evidence-based transfusion practices. In this review we summarise published economic evaluations of patient blood management to determine whether they represent good value for money. We identified 54 economic evaluations of patient blood management, the majority of which had positive cost-effectiveness conclusions.

Preoperative iron therapy: Where are we?

Preoperative anemia affects one-third of patients undergoing major surgery and is associated with worse perioperative and postoperative outcomes; including length of hospital stay, allogeneic blood transfusion, morbidity, and mortality. Iron deficiency is the most common cause of anemia, and associative data suggests that preoperative correction of iron deficiency anemia could improve postoperative patient outcomes. However, data from randomized controlled trials (RCTs) do not appear to support the routine use of iron therapy to treat preoperative anemia.

Roads travelled: The journey to Patient Blood Management at 35 years.

Patient Blood Management evolved in recent years, focusing on the haematopoietic system as relevant to all disciplines of medicine. The allogeneic blood supply chain travels from donation, to fractionation, preservation, and storage, to therapeutic, established treatments, or prophylactics for a wide range of medical conditions. This supply chain 'connects' altruistic blood donors to patients in need, symbolising a 'gift relationship', emphasising the empathetic bond between donor and recipient.

Managing cardiovascular disease in pregnant people: Defining the pregnancy heart team.

Cardiovascular disease is a leading cause of morbidity and mortality for pregnant patients. A significant portion of cardiac morbidity and mortality is preventable and related to poor or delayed recognition of clinical warning signs and oversights in management. The establishment of pregnancy heart teams facilitates multidisciplinary planning to improve management of people with cardiovascular disease.

No evidence that breast cancer occurs at higher rates among young Arab women.

Background: Breast cancer is often thought to occur at a younger age among Arab women based on the mean or median age at diagnosis, or the proportion of women diagnosed with breast cancer at a young age.

Objective: To compare age-specific breast cancer incidence rates among women from selected Arab countries with selected high- and middle-income countries.

Methods: We examined population-based, age-specific, national or regional breast cancer incidence data for 2008-2012 and 2013-2017 from Australia, Brazil, Canada, Germany, Japan, United Kingdom, and United States of America, and compared them with data from Algeria, Bahrain, Jordan, Kuwait, Morocco, Qatar, and Saudi Arabia.

Steroids and steroid-like compounds alter the ion permeability of phospholipid bilayers distinct interactions with lipids and interfacial water.

Steroids are organic compounds found in all forms of biological life. Besides their structural roles in cell membranes, steroids act as signalling molecules in various physiological processes and are used to treat inflammatory conditions. It has been hypothesised that in addition to their well-characterised genomic and non-genomic pathways, steroids exert their biological or pharmacological activities an indirect, nonreceptor-mediated membrane mechanism caused by steroid-induced changes to the physicochemical properties of cell membranes.

Leishmania (Leishmania) amazonensis and Leishmania (Leishmania) infantum sialic acids enhance macrophage infection.

Leishmaniases affect millions of people around the world, caused by Leishmania parasites. Leishmania are transmitted by female sandflies from Phlebotominae subfamily during their blood meals. In mammals, promastigotes are phagocytosed mainly by macrophages, differentiate into amastigotes and multiply.

Effect of Defined Block Sequence Terpolymers on Antifungal Activity and Biocompatibility.

Invasive fungal infections cause over 3.7 million deaths worldwide annually, underscoring the critical need for new antifungal agents. Developing selective antifungal agents is challenging due to the shared eukaryotic nature of both fungal and mammalian cells.

Meals, Mealtimes and moments for learning: Assessment of quality in Early Childhood Education and Care services.

Objective: Early education and care (ECEC) is part of the everyday life of most children in developed economies presenting exceptional opportunity to support nutrition and ongoing food preferences. Yet, the degree to which such opportunity is captured in policy-driven assessment and quality ratings of ECEC services is unknown.

Design: Abductive thematic analysis was conducted, guided by key domains of knowledge in nutrition literature and examining identified themes within these domains.

Birth weight and prepubertal growth trajectory had a combined effect on pubertal initiation in girls.

Aim: Most studies of prepubertal weight and puberty have not used continuous or long follow-up periods. We explored the effect that birth weight and growth trajectories from 0-9 years of age had on starting puberty.

Methods: Data were obtained from 1510 children in Tianjin, China, who were born in 2013 and selected by cluster random sampling.

Equipping our public health nutrition workforce to promote planetary health - a case example of tertiary education co-designed with students.

Objective: The public health nutrition workforce is well-placed to contribute to bold climate action, however tertiary educators are seeking practical examples of how to adequately prepare our future workforce. This study examines the responses of university students engaged in a co-designed planetary health education workshop as part of their public health nutrition training.

Design: A mixed-methods approach was used to collect and interpret student responses to four interactive tasks facilitated during an in-person workshop.

Associations of Tai Chi With Depression and Anxiety Among Older Adults: Nationwide Study Findings From a Network Perspective.

Within the global population, depression and anxiety are common among older adults. Tai Chi is believed to have a positive impact on these disturbances. This study examined the network structures of depression and anxiety among older Tai Chi practitioners vs non-practitioners.

Early Initiation of Breastfeeding and Exclusive Breastfeeding in Anglophone and Francophone West African Countries: Systematic Review and Meta-Analysis of Prevalence.

Early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) are highly effective forms of preventive medicine in many low- and middle-income countries, including Anglophone and Francophone West African countries. Despite the proven benefits of EIBF and EBF in reducing mortality and morbidity, there is limited systematic evidence from West African countries. Hence, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of EIBF and EBF in Anglophone and Francophone West African countries.

Effects of double data extraction on errors in evidence synthesis: a crossover, multicenter, investigator-blinded, randomized controlled trial.

Objectives: The objective was to investigate the role of double extraction in reducing data errors in evidence synthesis for pharmaceutical and non-pharmaceutical interventions.

Design: Crossover randomized controlled trial (RCT).

Setting: University and hospital with teaching programs in evidence-based medicine.

A systematic review of neurocognition and social cognition in body dysmorphic disorder.

Objective: Neurocognitive underpinnings are implicated in the aetiology and maintenance of body dysmorphic disorder (BDD); however, inconsistent findings across a range of neurocognitive domains suggest that a comprehensive synthesis of the literature using a hierarchical framework of neurocognition is needed.

Methods: A final search across OVID Medline, PsycNET, Scopus and Web of Science databases was conducted on 20 June 2024 to identify research that examined performance on behavioural tasks of objective neurocognition in BDD. Risk of bias was assessed using the Newcastle-Ottawa Scale.

Digital health interventions in adult intensive care and recovery after critical illness to promote survivorship care.

Digital health refers to the field of using and developing technology to improve health outcomes. Digital health and digital health interventions (DHIs) within the area of intensive care and critical illness survivorship are rapidly evolving. Digital health interventions refer to technologies in clinical interventional format.

Optic nerve-mediated modulation of temporally interfering electric fields for potential targeted retinal disease therapy: a computational modeling study.

Introduction: Traditional extraocular electrical stimulation typically produces diffuse electric fields across the retina, limiting the precision of targeted therapy. Temporally interfering (TI) electrical stimulation, an emerging approach, can generate convergent electric fields, providing advantages for targeted treatment of various eye conditions.

Objective: Understanding how detailed structures of the retina, especially the optic nerve, affects electric fields can enhance the application of TI approach in retinal neurodegenerative and vascular diseases, an essential aspect that has been frequently neglected in previous researches.

Robust and interpretable AI-guided marker for early dementia prediction in real-world clinical settings.

Background: Predicting dementia early has major implications for clinical management and patient outcomes. Yet, we still lack sensitive tools for stratifying patients early, resulting in patients being undiagnosed or wrongly diagnosed. Despite rapid expansion in machine learning models for dementia prediction, limited model interpretability and generalizability impede translation to the clinic.

Coral histology reveals consistent declines in tissue integrity during a marine heatwave despite differences in bleaching severity.

Marine heatwaves are starting to occur several times a decade, yet we do not understand the effect this has on corals across biological scales. This study combines tissue-, organism-, and community-level analyses to investigate the effects of a marine heatwave on reef-building corals. Adjacent conspecific pairs of coral colonies of and that showed contrasting phenotypic responses (, bleached .

Association between somatic microsatellite instability, hypermutation status, and specific T cell subsets in colorectal cancer tumors.

Background: Microsatellite instability-high (MSI-high) tumors comprise ~15% of sporadic colorectal cancers (CRC) and are associated with elevated T cell infiltration. However, the universality of this response across T cell subtypes with distinct functions is unknown.

Methods: Including 1,236 CRC tumors from three observational studies, we conducted T cell profiling using a customized 9-plex (CD3, CD4, CD8, CD45RA, CD45RO, FOXP3, KRT, MKI67, and DAPI) multispectral immunofluorescence assay.

Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis.

Introduction: The critical role played by vascular dysfunction and ineffective angiogenesis in the pathophysiology of systemic sclerosis (SSc) suggests that circulating biomarkers reflecting these alterations may be useful in the clinical evaluation of this patient group. We sought to address this issue by conducting a systematic review and meta-analysis of studies investigating a such candidate biomarker, endostatin, an endogenous glycoprotein exerting anti-angiogenic effects, in SSc patients and healthy controls.

Methods: A literature search was conducted in the electronic databases Web of Science, PubMed, and Scopus from inception to 27 May 2024.

Outcomes for smokers who develop melanoma: a systematic review and meta-analysis.

Background: There is compelling evidence that the incidence of melanoma in cigarette smokers is substantially lower than in non-smokers. However, the risks of both recurrence and death appear to be higher in smokers if melanoma does develop. The magnitude of these increased risks is poorly documented.