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Stallings Foley posted an update 6 months, 3 weeks ago
ng them 69% less likely to be hospitalized. Conclusions and relevance In this randomized clinical trial evaluating heath care utilization effects of programs designed to address social needs among families, children enrolled in the navigation group were significantly less likely to be hospitalized after the intervention but equally likely to have an emergency department visit. These findings strengthen our understanding of the effects of addressing social needs in clinical settings as part of a comprehensive strategy to improve health and reduce health care utilization. Trial registration ClinicalTrials.gov Identifier NCT01939704.Importance Current guidelines recommend the use of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with atrial fibrillation (AF). Data regarding warfarin sodium use compared with NOAC use in patients with AF with a history of intracranial hemorrhage (ICH) are limited. Objective To compare the clinical outcomes of warfarin use and NOAC use in patients with AF with a history of ICH using a nationwide cohort with AF. Design, setting, and participants A nationwide cohort study from January 1, 2012, to December 31, 2016, was performed using data from the Taiwan National Health Insurance Research Database. The dates of analysis were July 1 to September 1, 2019. The study population comprised patients with AF with a history of ICH and a CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years , diabetes, prior stroke/transient ischemic attack/thromboembolism , vascular disease , age 65-74as the rate of ischemic stroke was similar in the 2 groups (aHR, 0.879; 95% CI, 0.678-1.141). These results were generally consistent after propensity score matching among 973 patients in each group. Conclusions and relevance Among patients with AF with prior ICH, NOAC use was associated with lower rates of ICH and major bleeding compared with warfarin use, whereas the rate of ischemic stroke was similar in the 2 groups. Among patients with AF with prior ICH, NOACs could be the preferred choice for stroke prevention.Importance DNA methylation has been proposed as an epigenetic mechanism by which the childhood neighborhood environment may have implications for the genome that compromise adult health. Objective To ascertain whether childhood neighborhood socioeconomic disadvantage is associated with differences in DNA methylation by age 18 years. Design, setting, and participants This longitudinal cohort study analyzed data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of children born between 1994 and 1995 in England and Wales and followed up from age 5 to 18 years. Data analysis was performed from March 15, 2019, to June 30, 2019. Exposures High-resolution neighborhood data (indexing deprivation, dilapidation, disconnection, and dangerousness) collected across childhood. Main outcomes and measures DNA methylation in whole blood was drawn at age 18 years. Associations between neighborhood socioeconomic disadvantage and methylation were tested using 3 prespecified ap less then 1.16 × 10-7 in genes involved in the metabolism of hydrocarbons. Associations between neighborhood disadvantage and methylation were small but robust to family-level socioeconomic factors and to individual-level tobacco smoking. Conclusions and relevance Children raised in more socioeconomically disadvantaged neighborhoods appeared to enter young adulthood epigenetically distinct from their less disadvantaged peers. This finding suggests that epigenetic regulation may be a mechanism by which the childhood neighborhood environment alters adult health.This cohort study assesses anxiety, depression, mood, and fear of workplace violence in a cohort of young physicians in China before and during the coronavirus disease 2019 outbreak.This cohort study investigates how the coronavirus disease 2019 (COVID-19) pandemic is associated with national enrollment in cancer clinical trials.Background Upper eyelid ectropion occurs as a post-blepharoplasty complication or involution change, and it causes dry eye symptoms that cannot be resolved with conservative management. Objective The aim of this study is to describe our surgical technique of anatomical correction of upper eyelid ectropion, including tarsal scoring incision. Methods The technique involves the following four steps (1) adhesiolysis at the preaponeurotic layer; (2) undermining and re-draping of the pretarsal flap in a pretarsal plane; (3) optional, partial thickness tarsal scoring incision over the central two-thirds; and (4) downward re-positioning of the pretarsal flap and lower fixation to the tarsus. Outcomes were assessed based on the position of eyelid margin and the improvement of the dry eye symptoms. Results A retrospective review of 54 cases of patients who underwent ectropion correction, including tarsal scoring incision, was performed. The eyelid margin was well positioned in 51 patients (94.4%). Of the 32 patients involved in the study who were assessed with the 7-point Patient Global Impression of Improvement (PGI-I), 29 (90.6%) reported the resolution of dry eye symptoms. Furthermore, in the 22 patients assessed with the Ocular Surface Disease Index (OSDI), the mean score significantly decreased from 43.2 ± 24.1 before surgery to 29.8 ± 23.3 (p = 0.006) after surgery. Conclusions The combination of partial-thickness tarsal plate scoring and lower flap re-draping surgical techniques resolved the upper eyelid ectropion, reducing the dry eye symptoms.The spotted wing drosophila, Drosophila suzukii Matsumura, which is widely spread in the main soft-skinned fruits production areas in China, presents a threat to importing countries. In order to develop a phytosanitary cold treatment measure for preventing the movement of this drosophila fly, cold tolerance of six immature life stages of D. suzukii was compared followed by time-mortality and large-scale confirmatory tests on the most tolerant stage in grape fruit. buy JQ1 Egg was defined as the most cold-tolerant stage by comparing the mortality of all the immature stages (egg, first, second, and third instars, early and late pupa) treated at 0 and 2°C. The minimal lethal time (LT) for 99.9968% mortality (95% confidence level ) estimated by the probit model was 10.47 d at 0°C and 11.92 d at 2°C, respectively. Hence, 11 d (at 0°C) and 12 d (at 2°C) were chosen as the target time to conduct the confirmatory tests. No survivors were found among the estimated 50,385 and 57,366 treated eggs, which resulted in the efficacy of 99.
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