Patterns of self-harm presentations at a Tertiary Urban Hospital in Kenya: A retrospective 5-year study (2018-2022).

Introduction: Self-harm represents a complex and multifaceted public health issue of global significance, exerting profound effects on individuals and communities alike. It involves intentional self-poisoning or self-injury with or without the motivation to die. Although self-harm is highly prevalent, limited research has focused on the patterns and trends of self-harm among hospital populations in low- and middle-income countries, particularly within Africa.

Effects of early palliative care intervention on medical resource use among end-of-life patients.

Background: In Taiwan, as the population ages, palliative care services (PCS) have expanded significantly to include comprehensive benefit plans for critically ill individuals, supported by reimbursements from the National Health Insurance program. However, incorporating palliative care into the medical management of these patients presents several challenges. We aim to evaluate the effects of palliative care interventions on medical resources in end-of-life scenarios, to promote earlier palliative care access and provide high-quality healthcare services for patients.

Case management in emergency care: impact evaluation of the CARED Program.

Background: Hospitals face mounting pressure to reduce unplanned utilization amid rising healthcare demands from an aging population. The Case management for At-Risk patients in the Emergency Department (CARED) program is among the first ED transitional care strategies to focus on both frail older adults and emergency department (ED) re-attenders to reduce acute hospital utilization. This study aims to evaluate the effectiveness of the CARED program in reducing hospital (re)admissions and ED re-attendances within 30- and 60 days post-discharge.

First-Attempt Success in Ultrasound-Guided vs Standard Peripheral Intravenous Catheter Insertion: The EPIC Superiority Randomized Clinical Trial.

Importance: Pediatric peripheral intravenous catheter (PIVC) insertion can be difficult and time-consuming, frequently requiring multiple insertion attempts and often resulting in increased anxiety, distress, and treatment avoidance among children and their families. Ultrasound-guided PIVC insertion is a superior alternative to standard technique (palpation and visualization) in high-risk patients.

Objective: To compare first-time insertion success of PIVCs inserted with ultrasound guidance compared with standard technique (palpation and visualization) across all risk categories in the general pediatric hospital population.

"There is always a reason why someone is doing something": The importance of life history and personhood when supporting people with dementia to "wander" in care homes.

Up to 60% of people living with dementia who reside in care homes will 'wander' at some point. A person-centred approach should be taken to support each person's individual needs through tailored interventions when wandering. This study aimed to identify care home staff perspectives on what supports safe wandering for people living with dementia in care home environments.

AI for all: bridging data gaps in machine learning and health.

Artificial intelligence (AI) and its subset, machine learning, have tremendous potential to transform health care, medicine, and population health through improved diagnoses, treatments, and patient care. However, the effectiveness of these technologies hinges on the quality and diversity of the data used to train them. Many datasets currently used in machine learning are inherently biased and lack diversity, leading to inaccurate predictions that may perpetuate existing health disparities.

Concordance Between Asthma Symptom Reports and Objective Lung Function, and Associations With Sleep Outcomes in Urban Children.

Objectives: To examine the extent to which asthma symptom concordance (ASC) or discordance (ASD) is associated with sleep outcomes in children with persistent asthma. Also, to investigate whether the association between ASC and sleep outcomes varies as a function of children's level of asthma control and severity.

Methods: A retrospective data analysis of Project NAPS (Nocturnal Asthma and Performance in School), an observational study which examined asthma and sleep outcomes in children with persistent asthma.

Mediation of modifiable risk factors in two multidomain dementia prevention trials.

Introduction: We explored which dementia risk factors in two multidomain prevention trials mediate beneficial, neutral, or counteracting effects on dementia incidence.

Methods: We pooled data from the multidomain MAPT (Multidomain Alzheimer Preventive Trial; n = 1679, up to 5-year follow-up) and preDIVA trials (Prevention of Dementia by Intensive Vascular Care; n = 3526, up to 12-year follow-up) in adults aged 70+. We used multiple mediation analysis to quantify the role of 2-year changes in body mass index, systolic blood pressure, total cholesterol, and physical activity in the intervention effects on dementia incidence.

Beyond Food Assistance: A Scoping Review Examining Associations of Nonfood Social Safety Net Programs in the United States With Food Insecurity and Nutrition Outcomes.

Objective: To conduct a scoping review to summarize the state of the evidence on associations between participation in nonfood social safety net programs (eg, income assistance, housing assistance) in the United States and food- and nutrition insecurity-related outcomes.

Background: Food and nutrition insecurity are persistent public health challenges in the United States that increase chronic disease risk and exacerbate health disparities. Several food assistance programs enhance food and nutrition security.

Early-life adversity as a predictor of fibromyalgia syndrome: the central role of perceived stress over endocrine stress indicators.

This study investigates the associations between early childhood adversities, stress perception, and fibromyalgia syndrome (FMS). Although the interconnection between dysregulated stress systems and FMS is well documented, the interconnection between early adversities and FMS remains less understood. This study explores the relationship of early-life stress and FMS by examining its mediation through perceived stress, and acute and chronic endocrine stress indicators.

Pilot study on the development of digitally supported health promotion for seafarers on sea.

Background: Seafarers are exposed to a variety of job-specific physical and psychosocial stressors. Health promotion on board is of great importance for the salutogenesis of this occupational group. Due to the difficult accessibility of seafarers, electronically supported health management can be highly valuable.

Rare presentation of vitamin D toxicity with hypertriglyceridemia and pancreatitis.

Summary: Vitamin D is commonly recommended for daily intake as dietary sources are often insufficient. However, prolonged high-dose use can lead to serious complications. We present a rare case of a 2-month-old infant who developed severe hypercalcemia and hypertriglyceridemia due to an accidental overdose of 25-OH vitamin D, leading to hypertriglyceridemia and pancreatitis.

The Economic Burden of Management of Pituitary Adenomas: A Propensity-Score-Matched Cost Analysis.

Importance: Pituitary adenomas (PAs) present a notable economic burden on healthcare systems due to their management's reliance on multimodal, often costly interventions.

Objective: To determine total and relative healthcare costs for PAs at Ontario-based institutions.

Design: A retrospective, propensity-score-matched cohort analysis.

Four targets: an enhanced framework for guiding causal inference from observational data.

Observational studies play an increasingly important role in estimating causal effects of a treatment or an exposure, especially with the growing availability of routinely collected real-world data. To facilitate drawing causal inference from observational data, we introduce a conceptual framework centered around "four targets"-target estimand, target population, target trial, and target validity. We illustrate the utility of our proposed "four targets" framework with the example of buprenorphine dosing for treating opioid use disorder, explaining the rationale and process for employing the framework to guide causal thinking from observational data.

Microbial biopesticides: A one health perspective on benefits and risks.

Controlling insect pests that destroy crop and spread diseases will become increasingly crucial for addressing the food demands of a growing global population and the expansion of vector-borne diseases. A key challenge is the development of a balanced approach for sustainable food production and disease control in 2050 and beyond. Microbial biopesticides, derived from bacteria, viruses, fungi, protozoa, or nematodes, offer potentially significant benefits for promoting One Health and contributing to several United Nations Sustainable Development Goals (SDGs).

Emergence of Extended spectrum β-lactamase (ESBL) and carbapenemase producing in mid-stream urine cultures of patients presenting in outpatient department of tertiary care hospital with uncomplicated cystitis (2016-2022): A retrospective analysis of Laboratory data.

Objective: To determine the prevalence of antimicrobial resistance (AMR) in isolated from urine cultures of patients with uncomplicated cystitis in Pakistan. Another objective was to analyze and compare the resistance rates of to specific antibiotics, conducting a year-by-year evaluation of these rates to identify trends and changes over the past seven years.

Methods: Retrospective analysis of susceptibility data of isolated from midstream urine culture samples of patients presenting in outpatient department with uncomplicated cystitis, from January 2016 to December 2022 in the section of Microbiology, Liaquat University of Medical and Health Sciences was done.

Examining factor structure and psychometric properties of Ethical Leadership Questionnaire with Healthcare Professionals in Saudi Arabia.

Objective: The study aimed to examine the factor structure and psychometric properties of ethical leadership questionnaire (ELQ) by using a healthcare professional sample in Saudi Arabia.

Methods: A cross-sectional study was conducted, and a total of 387 healthcare professionals completed the 15-items ELQ questionnaire between 18 October, 2023 and 17 January, 2024. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and a reliability test were performed on the obtained data.

The burden of cutaneous fungal infections in a tertiary care hospital in Pakistan.

Objective: In Pakistan, the real extent of fungal infection is unknown. Our objective was to estimate the burden of major fungal diseases here to emphasize their public health importance.

Methods: In this retrospective study, the medical records (January 2019 - December 2019) of 863 patients diagnosed with superficial fungal infection (SFI) were reviewed at the dermatology department of Aga Khan University Hospital (AKUH) Karachi.

Irregular Pulse and Cardiovascular Disease From NHANES (1999-2018): A Cross-Sectional Study.

Background And Aims: Pulse is an easily accessible life sign, while irregular pulse could be easily detected in daily life during blood pressure test. However, whether irregular pulse was associated with cardiovascular disease (CVD) or mortality has not been reported on a large population scale. Here, we investigated the association between irregular pulse, CVD, and CVD mortality, to explore the potential of irregular pulse as screening indicator for CVD and mortality, thus influencing health policy.

Exploring the Epidemiological Characteristics and Survival Analysis Among Prostate Cancer Patients Under 50: A Seer-Based Population Study.

Background And Aims: Even though aging is a known risk factor for prostate cancer incidence and mortality, there has been an increase in incidence among young men since the late 1980s with notably lower survival rates than those among older men. However, there is insufficient knowledge about recent trends in the incidence and survival of this disease.

Methods: We analyzed prostatic cancer incidence trends in men under 50 from 1975 to 2020 using Surveillance, Epidemiology, and End Results (SEER) 8 registries data.

Contagious acquisition of antimicrobial resistance is critical for explaining emergence in western Canadian feedlots-insights from an agent-based modelling tool.

Introduction: Antimicrobial resistance (AMR) is a growing threat to the efficacy of antimicrobials in humans and animals, including those used to control bovine respiratory disease (BRD) in high-risk calves entering western Canadian feedlots. Successful mitigation strategies require an improved understanding of the epidemiology of AMR. Specifically, the relative contributions of antimicrobial use (AMU) and contagious transmission to AMR emergence in animal populations are unknown.

Association between lipid accumulation product and chronic obstructive pulmonary disease: a cross-sectional study based on U.S. adults.

Background: Lipid Accumulation Product (LAP), which is derived from measurements of waist circumference and triglyceride (TG) levels, serves as a comprehensive indicator of lipid accumulation. Emerging research indicates that lipid accumulation dysfunction might significantly contribute to the pathogenesis of Chronic Obstructive Pulmonary Disease (COPD). Nevertheless, the investigation into the association between LAP and COPD risk is still insufficient, particularly in population-based research.

Risk and Prognosis of Hepatocellular Carcinoma in Mexican Americans with Type 2 Diabetes Mellitus.

Introduction: Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.

A narrative review on sexual wellbeing and dysfunctions: Research in the past 15 years.

Background: Psychosexual health is an important aspect of mental and physical wellbeing. Though Indian culture has a rich history of sexuality, over the years, our population has been reticent in talking about the same. With the advent of technology and new legislations protecting the rights of LGBTQIA population, awareness is also on the rise.