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2,101 results for “Cohort studies”
Data from: the characteristics and treatment for severe postpartum hemorrhage in different midwifery hospitals in one district of Beijing in China: an institution-based, retrospective cohort study
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Kidney transplantation waiting times and risk of cardiovascular events and mortality: a retrospective observational cohort study in Taiwan
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Data from: A large cohort study of postnatal events over 18 months in a not-for-profit referral centre in Vellore, South India
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Associations of serum uric acid with cardiovascular disease risk factors: a retrospective cohort study in Southeastern China
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Data from: The subcortical basis of outcome and cognitive impairment in TBI: a longitudinal cohort study
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Predictors of abnormal computed tomography findings for paediatric head injury: a retrospective cohort study
<p class="MDPI17abstract"><b>Objectives:</b> Head injuries in children are common causes for visits to the emergency department (ED). Computed tomography<b> (</b>CT) scans are useful for confirming head injury diagnoses. However, radiation exposure from CT scans might cause lethal malignancies. We aimed to examine predictors for the indication of performing CT scans necessary for diagnosis.</p> <p class="MDPI17abstract"><b>Design:</b> Retrospective cohort study.</p> <p class="MDPI17abstract"><b>Setting:</b> Three EDs in Japan</p> <p class="MDPI17abstract"><b>Participants</b>: Patients aged <16 years with head trauma who underwent CT.</p> <p class="MDPI17abstract"><b>Primary and Secondary Outcome Measures</b>: The primary outcome measure was abnormal CT findings that were evaluated using the area under the receiver-operating characteristic curve (AUC). We derived predictors from three existing CDRs: Canadian Assessment of Tomography for Childhood Head Injury (CATCH), Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE), and Paediatric Emergency Care Applied Research Network (PECARN).</p> <p class="MDPI17abstract"><b>Results:</b> Of 1,103 eligible patients, 410 were included in this study. There were 283 (68%) boys, and the median age was 2 years. In total, 35 (9%) patients showed an abnormality, 73 (18%) were admitted, and 3 (0.7%) underwent neurosurgery. We developed a CDR consisting of 6 predictors for identifying children with abnormal CT findings: (1) severe or worsening headache; (2) GCS <15; (3) signs of skull fracture; (4) hematoma; (5) loss of consciousness; and (6) altered mental status. Our CDR had a sensitivity of 74.3%, a specificity of 75.2%, a negative predictive value of 96.9%, and a positive predictive value of 21.8%. The AUC for our rule was not inferior to those for CATCH, CHALICE, and PECARN {0.75 (95% confidence interval [CI], 0.67-0.81) versus 0.64 (95% CI, 0.56-0.73; p<0.05), 0.68 (95% CI, 0.60–0.76; p=0.28), and 0.67 (95% CI, 0.60-0.74); p=0.10}.</p> <p class="MDPI17abstract"><b>Conclusions:</b> Our findings suggest that a CDR, which lowers the frequency of CT in children with head injuries, must be developed and validated.</p>
Aetiology and prognostic risk factors of mortality in pneumonia patients receiving glucocorticoids alone or glucocorticoids and other immunosuppressants: a retrospective cohort study
<p><b>Objectives:</b> Long-term use of high-dose glucocorticoids can lead to severe immunosuppression and increased risk of treatment-resistant pneumonia and mortality. We investigated the aetiology and prognostic risk factors of mortality in hospitalised patients who developed pneumonia while receiving glucocorticoid therapy alone or glucocorticoid and other immunosuppressant therapies.</p> <p><b>Design:</b> Retrospective cohort study</p> <p><b>Setting: </b>Six secondary and tertiary academic hospitals in China</p> <p><b>Participants: </b>Patients receiving glucocorticoids who were hospitalised with pneumonia between 1<sup>st</sup> January 2013 and 31<sup>st</sup> December 2019.</p> <p><b>Main Outcomes: </b>We analysed<b> </b>the prevalence of comorbidities, microbiology, antibiotic susceptibility patterns, 30-day and 90-day mortality rates, and prognostic risk factors.</p> <p><b>Results</b>: A total of 716 patients were included, with pneumonia pathogens identified in 69.8% of patients. Significant morbidities occurred, including respiratory failure (50.8%), intensive care unit (ICU) transfer (40.8%), and mechanical ventilation (36%), with a 90-day mortality rate of 26.0%. Diagnosis of pneumonia occurred within 6 months of glucocorticoid initiation for 69.7% of patients with <i>Cytomegalovirus</i> (CMV) pneumonia and 79.0% of patients with <i>Pneumocystis jirovecii</i> pneumonia (PCP). Pathogens, including <i>Pneumocystis</i>, CMV, and multidrug-resistant bacteria, were identified more frequently in patients with persistent lymphocytopenia and high-dose glucocorticoid treatment (≥ 30 mg/day of prednisolone or equivalent within 30 days before admission). The 90-day mortality rate was significantly lower for non-CMV viral pneumonias than for PCP (<i>P</i> < 0.05), with a similar mortality rate as CMV pneumonias (24.2% vs 38.1% vs 27.4%, respectively).Cox regression analysis indicated <a name="_Hlk30339725"></a><a name="_Hlk31278800">several independent negative predictors for mortality in this patient population, including septic shock, respiratory failure, </a>persistent lymphocytopenia, interstitial lung disease, and high-dose glucocorticoid use.</p> <p><b>Conclusions</b>: Patients who developed pneumonia while receiving glucocorticoid therapy experienced high rates of opportunistic infections, with significant morbidity and mortality. These findings should be carefully considered when determining treatment strategies for this patient population.</p>
Data from: Repurposing population genetics data to discern genomic architecture: a case study of linkage cohort detection in mountain pine beetle (Dendroctonus ponderosae)
Genetic surveys of the population structure of species can be used as resources for exploring their genomic architecture. By adjusting filtering assumptions, genome-wide single nucleotide polymorphism (SNP) datasets can be reused to give new insights into the genetic basis of divergence and speciation without targeted re-sampling of specimens. Filtering only for missing data and minor allele frequency, we used a combination of principle components analysis and linkage disequilibrium network analysis to distinguish three cohorts of variable SNPs in the mountain pine beetle in western Canada, including one that was sex-linked and one that was geographically associated. These marker cohorts indicate genomically localized differentiation, and their detection demonstrates an accessible and intuitive method for discovering potential islands of genomic divergence without a priori knowledge of a species' genomic architecture. Thus, this method has utility for directly addressing the genomic architecture of species and generating new hypotheses for functional research.
Data from: Quality of evidence considered by Health Canada in granting full market authorization to new drugs with a conditional approval: a retrospective cohort study
Objectives: This study examines the characteristics of studies that Health Canada uses to grant full marketing authorization for products given a conditional approval between January 1, 1998 and June 30, 2017. Design: Cohort study. Data sources: Journal articles listing drugs that fulfilled their conditions and received full marketing authorization, Notice of Compliance database, Notice of Compliance with conditions web site, Qualifying Notices listing required confirmatory studies, clinicaltrials.gov, PubMed, Embase, companies making products being analyzed, journal articles resulting from confirmatory studies. Interventions: None Primary and secondary outcome measures: Characteristics of studies - study design (randomized controlled trials, observational), primary outcome used (clinical, surrogate), blinding, number of patients in studies, patient median age, number of men and women. Results: Eleven companies confirmed 36 publications for 19 products (21 indications). Twenty-nine out of the 36 studies were randomized controlled trials (RCTs) but only 10 stated if they were blinded. Twenty used surrogate outcomes. The median age of patients was 56 (interquartile range (IQR) 44, 61). The median number of men per study/trial was 184 (IQR 58, 514) versus women - 141 (IQR 46, 263). Conclusions: Postmarket studies required by Health Canada had more rigorous methodology than those required by either the Food and Drug Administration or the European Medicines Agency. There were still deficiencies in these studies. The absence of blinding in the majority of RCTs may introduce bias in their results. The use of surrogate outcomes especially in oncology trials means that improvements in survival are not available. The relatively young age of patients, even for products for cancer, means that predicting how the elderly will respond is often unknown. The almost universal finding that men outnumbered number women may make it hard to differentiate responses by sex. These results raise potential concerns about the quality of evidence that Health Canada accepts.
Effectiveness of steroid therapy on pneumonic chronic obstructive pulmonary disease exacerbation: a multi-centred retrospective cohort study
<p><span>Background</span></p> <p><span>To date, no consensus exists on the effects of steroid use on pneumonic chronic obstructive pulmonary disease (COPD) owing to trial design issues in previous trials involving these conditions. Therefore, we aimed to evaluate steroid effectiveness in pneumonic COPD exacerbation patients.</span></p> <p><span>Methods</span></p> <p><span>This multi-centred, retrospective, observational study was conducted across five acute general hospitals in Japan. We analysed the association between parenteral/oral steroid therapy and time to clinical stability in pneumonic COPD exacerbation. </span></p> <p><span>We used a validated algorithm derived from the 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10) to include pneumonic COPD exacerbation patients. We excluded patients with other hypoxia causes (asthma exacerbation, pneumothorax, heart failure) and complicated pneumonia (obstructive pneumonia, empyema), those who required tracheal intubation/vasopressors, and those who were clinically stable on the admission day. </span></p> <p><span>The primary outcome was time to clinical stability. Multiple imputation was used for missing data. Propensity scores within each imputed dataset were calculated using potential confounding factors. The Fine and Gray model was used within each dataset to account for the competing risk of death and hospital discharge without clinical stability, and we combined the results.</span></p> <p><span>Results</span></p> <p><span>Altogether, 1237 patients were included. The pooled estimated subdistribution hazard ratio of time to clinical stability in steroid versus non-steroid users was 0.89 (95% confidence interval, 0.78<a name="_Hlk33128668"> to</a> 1.03). However, there were potentially unmeasured confounders, and we could not assess longer-term outcomes.</span></p> <p><span>Conclusions</span></p> <p><span>The current study recommends that steroid therapy should not be used routinely for pneumonic COPD exacerbation.</span></p>
Data from: Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru
Background: Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default). Methods: We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default. Results: Of the 1233 patients studied, 127 (10%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95% CI: 1.40-3.52), be underweight (OR = 2.08, 95% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95% CI: 1.03-2.33). Conclusions: Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental intervention prior to treatment interruption. Treatment adherence remains a barrier to successful TB care and reducing the frequency of default is important for both the patients' health and the health of the community.
Data from: Anthracycline induced cardiotoxicity: prospective cohort study from Pakistan.
Objectives: To identify anthracycline induced acute (within one month) and early onset chronic progressive (within year) cardiotoxicity in children younger than 16 years of age with childhood malignancies at tertiary care center of Pakistan. Design: Prospective Cohort study. Setting: Aga Khan University, Karachi, Pakistan. Participants: 110 children (aged 1 month to 16 years). Intervention: Anthracycline (Doxorubicin and/or Daunorubicin). Outcome measurements: All children who received anthracycline as chemotherapy and three echocardiographic evaluations (baseline, one month and 1 year) between July 2010 and June 2012 were prospectively analyzed for cardiac dysfunction. Statistical analysis including systolic and diastolic functions at baseline, 1 month and 1 year were made by repeated measures analysis of variance (r-ANOVA). Results: Mean age was 74±44 months and 75 (68.2%) were males. Acute lymphoblastic leukemia (ALL) was seen in 70 (64%) patients. Doxorubicin alone was used in 59 (54%) and combination therapy was used in 35(32%). A cumulative dose of anthracycline <300mg/m2 was in 95 (86%). Fifteen (14%) children developed cardiac dysfunction within a month and 28(25%) children within a year. Of these 10/15 (66.6%) and 12/28 (42%) had isolated diastolic dysfunction respectively, while 5/15 (33.3%) and 16/28 (57%) had combined systolic and diastolic dysfunction. Seven (6.4%) patients expired due to severe cardiac dysfunction. 8/59 (13.5%) children receiving doxorubicin showed dysfunction mostly related to higher cumulative dose (p=<0.001). Cardiotoxicity was high where combination of doxorubicin and daunorubicin was used (p=0.004). Conclusion: Anthracycline induced cardiac dysfunction is high. Long term follow-up is essential in children received any dosage of anthracyclines because of its late manifestation.
Data from: Labor market integration of people with disabilities: results from the Swiss Spinal Cord Injury Cohort Study
Objectives: We aimed to describe labor market participation (LMP) of persons with spinal cord injury (SCI) in Switzerland, to examine potential determinants of LMP, and to compare LMP between SCI and the general population. Methods: We analyzed data from 1458 participants of employable age from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study. Data on LMP of the Swiss general population were obtained from the Swiss Federal Statistics Office. Factors associated with employment status as well as the amount of work performed in terms of full-time equivalent (FTE) were examined with regression techniques. Results: 53.4% of the participants were employed at the time of the study. Adjusted odds of being employed were increased for males (OR=1.73, 95% CI 1.33 - 2.25) and participants with paraplegia (OR=1.78, 95% CI 1.40 - 2.27). The likelihood of being employed showed a significant concave relationship with age, peaking at age 40. The relation of LMP with education was s-shaped, while LMP was linearly related to time since injury. On average, employment rates were 30% lower than in the general population. Males with tetraplegia aged between 40 and 54 showed the greatest difference. From the 771 employed persons, the majority (81.7%) worked part-time with a median of 50% FTE (IRQ: 40%-80%). Men, those with younger age, higher education, incomplete lesions, and non-traumatic etiology showed significantly increased odds of working more hours a week. Significantly more people worked part-time than in the general population with the greatest difference found for males with tetraplegia aged between 40 and 54. Conclusions: LMP of persons with SCI is comparatively high in Switzerland. LMP after SCI is, however, considerably lower than in the general population. Future research needs to show whether the reduced LMP in SCI reflects individual capacity adjustment, contextual constraints or both on higher LMP.
Data from: Association of body mass index and age with incident diabetes in Chinese adults: a population-based cohort study
Objective. Type 2 diabetes mellitus is increasing in young adults, and greater adiposity is considered a major risk factor. However, whether there is an association between obesity and diabetes and how this might be impacted by age is not clear. Therefore, we investigated the association between body mass index (BMI) and diabetes across a wide range of age groups (20-30, 30-40, 40-50, 50-60, 60-70, ≥70 years old). Design. We performed a retrospective cohort study using healthy screening program data. Setting. A total of 211,833 adult Chinese persons > 20-years-old across 32 sites and 11 cities in China (Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, Nantong) were selected for the study; these persons were free of diabetes at baseline. Primary and secondary outcome measures. Fasting plasma glucose levels were measured and information regarding the history of diabetes was collected at each visit. Diabetes was diagnosed as fasting plasma glucose ≥ 7.00 mmol/L and/or self-reported diabetes. Patients were censored at the date of diagnosis or the final visit, whichever came first. Results. With a median follow-up of 3.1 years, 4,174 of the 211,833 participants developed diabetes, with an age-adjusted incidence rate of 7.35 per 1,000 persons. The risk of incident diabetes increased proportionally with increasing baseline BMI values, with a 23% increased risk of incident diabetes with each kg/m2 increase in BMI (95%CI: 1.22, 1.24). Across all age groups, there was a linear association between BMI and the risk of incident diabetes, although there was a stronger association between BMI and incident diabetes in the younger age groups (age × BMI interaction, P < 0.0001). Conclusions. An increased BMI is also independently associated with a higher risk of developing diabetes in young adults and the effects of BMI on incident diabetes were accentuated in younger adults.
Data from: Circulating cortisol and cognitive and structural brain measures in a middle-aged cohort: the Framingham Heart Study
Objective: To assess the association of early morning serum cortisol with cognitive performance and brain structural integrity in community-dwelling young and middle-aged adults without dementia. Methods: We evaluated dementia-free Framingham Study (Generation 3) participants (mean age 48.5 years; 46.8% men), who underwent cognitive testing for memory, abstract reasoning, visual perception, attention, and executive function (n= 2231), and brain MRI (n=2018) to assess total white matter, lobar gray matter, and white matter hyperintensity volumes and fractional anisotropy (FA) measures. We used linear and logistic regression to assess the relations of cortisol (categorized in tertiles, with the middle tertile as referent) to measures of cognition, MRI volumes, presence of covert brain infarcts (CBI) and cerebral microbleeds (CMB), and voxel-based microstructural white matter integrity and gray matter density, adjusting for age, sex, APOE and vascular risk factors. Results: Higher cortisol (highest tertile vs. middle tertile) was associated with worse memory and visual perception, as well as lower total cerebral brain, occipital and frontal lobar gray matter volumes. Higher cortisol was associated with multiple areas of microstructural changes (decreased regional FA), especially in the splenium of corpus callosum and the posterior corona radiata. The association of cortisol with total cerebral brain volume varied by sex (p interaction=0.048); higher cortisol was inversely associated with cerebral brain volume in women [p=0.001] but not in men [p=0.717]). There was no effect modification by the apoE4 genotype of the relations of cortisol and cognition or imaging traits. Conclusions: Higher serum cortisol was associated with lower brain volumes and impaired memory in asymptomatic younger to middle-aged adults, with the association being evident particularly in women.
Data from: An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: an observational cohort study
Objective. To determine the prevalence of initiating the sepsis 3-hour bundle of care and estimate effects of bundle completion on risk-adjusted mortality among ED patients screened-in by electronic surveillance. Materials and Methods. This was a multiple center observational cohort study conducted in 2016. The study population was comprised of patients screened-in by St. John Sepsis Surveillance Agent within four hours of ED arrival, had a sepsis bundle initiated, and admitted to hospital. We built multivariable logistic regression models to estimate impact of a 3-hour bundle completed within three hours of arrival on mortality outcomes. Results. Approximately 3% ED patients were screened-in by electronic surveillance within four hours of arrival and admitted to hospital. Nearly 7 in 10 (69%) patients had a bundle initiated, with most bundles completed within three hours of arrival. The fully-adjusted risk model achieved good discrimination on mortality outcomes (AUROC = .82, 95% CI = .79 to .85) and estimated 34% reduced mortality risk among patients with a bundle completed within three hours of arrival compared to non-completers. Discussion. The sepsis bundle is an effective intervention for many vulnerable patients, and likely to be completed within three hours after arrival when electronic surveillance with reliable alert notifications are integrated into clinical workflow. Beginning at triage, the platform and sepsis program enables identification and management of patients with greater precision, and increases the odds of good outcomes. Conclusion. Sepsis surveillance and clinical decision support accelerate accurate recognition and stratification of patients, and facilitate timely delivery of healthcare.
Data from: Linkage into care among newly diagnosed HIV-positive individuals tested through outreach and facility-based HIV testing models in Mbeya, Tanzania: a prospective mixed-method cohort study
Objective: Linkage to care is the bridge between HIV testing and HIV treatment, care and support. In Tanzania, mobile testing aims to address historically low testing rates. Linkage to care was reported at 14% in 2009 and 28% in 2014. The study compares linkage to care of HIV-positive individuals tested at mobile/outreach versus public health facility-based services within the first 6 months of HIV diagnosis. Setting: Rural communities in four districts of Mbeya Region, Tanzania. Participants: A total of 1012 newly diagnosed HIV-positive adults from 16 testing facilities were enrolled into a two-armed cohort and followed for 6 months between August 2014 and July 2015. 840 (83%) participants completed the study. Main outcome: measures We compared the ratios and time variance in linkage to care using the Kaplan-Meier estimator and Log rank tests. Cox proportional hazards regression models to evaluate factors associated with time variance in linkage. Results: At the end of 6 months, 78% of all respondents had linked into care, with differences across testing models. 84% (CI 81% to 87%, n=512) of individuals tested at facility-based site were linked to care compared to 69% (CI 65% to 74%, n=281) of individuals tested at mobile/outreach. The median time to linkage was 1 day (IQR: 1–7.5) for facility-based site and 6 days (IQR: 3–11) for mobile/outreach sites. Participants tested at facility-based site were 78% more likely to link than those tested at mobile/outreach when other variables were controlled (AHR=1.78; 95% CI 1.52 to 2.07). HIV status disclosure to family/relatives was significantly associated with linkage to care (AHR=2.64; 95% CI 2.05 to 3.39). Conclusions: Linkage to care after testing HIV positive in rural Tanzania has increased markedly since 2014, across testing models. Individuals tested at facility-based sites linked in significantly higher proportion and modestly sooner than mobile/outreach tested individuals. Mobile/outreach testing models bring HIV testing services closer to people. Strategies to improve linkage from mobile/outreach models are needed.
Data from: Delays and loss to follow up before treatment of drug-resistant TB following implementation of Xpert MTB/RIF in South Africa: a retrospective cohort study
Background: South Africa has a large burden of rifampicin-resistant tuberculosis (RR-TB), with 18,734 patients diagnosed in 2014. The number of diagnosed patients has increased substantially with the introduction of the Xpert MTB/RIF test, used for TB diagnosis for all patients with presumptive TB. Routine aggregate data suggest a large treatment gap (pre-treatment loss to follow up) between the numbers of laboratory confirmed RR-TB patients and those reported to have started second-line treatment. We aimed to assess the impact of Xpert MTB/RIF implementation on the delay to treatment initiation and loss to follow-up before second-line treatment for RR-TB across South Africa. Methods and findings: A nationwide retrospective cohort study was conducted to assess second-line treatment initiation and treatment delay among laboratory diagnosed RR-TB patients. Cohorts, including approximately 300 sequentially diagnosed RR-TB patients per South African province, were drawn from 2011 and 2013, before and after Xpert implementation. Patients with prior laboratory RR-TB diagnoses within 6 months and currently treated patients were excluded. Treatment initiation was determined through data linkage with national and local treatment registers, medical record review, interviews with healthcare staff, and direct contact with patients or household members. Additional laboratory data were used to track cases. National estimates of percentage treatment initiation and time to treatment were weighted to account for the sampling design. There were 2,508 and 2,528 eligible patients in the 2011 and 2013 cohorts respectively; 92% were newly diagnosed with RR-TB (new RR-TB, no prior RR-TB diagnoses). Nationally, among 2,340 and 2,311 new RR-TB patients in the 2011 and 2013 cohorts, 55% (95% CI 53-57) and 63% (95% CI 61-65) respectively started treatment within 6 months of their diagnostic specimen being sent (p<0.001). However, in 2013, there was no difference in the percentage of patients who initiated treatment at six months between the 1,368174 new RR-TB patients diagnosed by Xpert (62%, 95% CI 59-65) and the 943ose diagnosed by other methods (64%, 95% CI 61-67) (p=0.39). The median time to treatment decreased from 44 (IQR 20-69) days in 2011 to 22 (IQR 2-43) days in 2013 (p<0.001). In 2013, across the nine provinces, there were substantial variations in both treatment initiation (range 51-73% by six months) and median time to treatment (range 15-36 days, N=1,450), and only 53% of 1,448 new RR-TB who received treatmented patients were recorded on the national RR-TB register. This retrospective study is limited by the lack of information to assess reasons for non-initiation of treatment, particularly pre-treatment mortality data. Other limitations include the use of names and dates of birth to locate patient-level data, potentially resulting in missed treatment initiation among some patients. Conclusions: In 2013, there was a large treatment gap for RR-TB in South Africa which varied significantly across provinces. Xpert implementation, while reducing treatment delay, had not contributed substantially to reducing the treatment gap in 2013. However, given improved case detection with Xpert, overall a larger proportion of the total RR-TB burden has received treatment, with reduced delays. Nonetheless, strategies to further improve linkage to treatment for all diagnosed RR-TB patients are urgently required.
Data from: Clinical characteristics and lipid lowering treatment of patients initiated on Proprotein convertase subtilisin/kexin type 9 inhibitors – a nationwide cohort study
Objectives: Given the novelty of proprotein convertase subtilisin–kexin type 9 inhibitors (PCSK9i), little is known regarding overall implementation or clinical characteristics among patients who initiate treatment. We aimed to assess the total number of patients initiated on PCSK9i along with a description of the clinical characteristics and lipid lowering treatment (LLT) of such patients. Setting: A register based descriptive cohort study of patients receiving a PCSK9i in the time period from 01-01-2016 to 31-03-2017 using a cross-linkage between three nationwide Danish registers. Information regarding PCSK9i prescriptions, patient demographics, concurrent pharmacotherapy, comorbidities, and previous coronary procedures was identified. Results: Overall, 137 patients initiated treatment with PCSK9i in the study period from 11 in the first quarter of 2016 to 40 in the first quarter of 2017. The majority had a history of ischemic heart disease (67.9%) with ischemic stroke and diabetes mellitus being present in 7.3% and 16.8% of patients, respectively. All patients initiated on PCSK9i had been previous prescribed statin treatment with Atorvastatin and Simvastatin being most frequently prescribed in 53% and 36% of patients, respectively. The majority of patients had received both statins and Ezetimibe (94.9%) and approximately half of these patients had also received bile acid sequestrant (45.3%). Clinical characteristics mainly differed in patients receiving triple LLT compared to patients not receiving triple LLT in the regards of heart failure. Conclusion: Patients treated with PCSK9i were rare, characterized by having ischemic heart disease and had received various and intensive conventional LLT prior to PCSK9i initiation in agreement with current international guidelines.
Clinical Usefulness of Capnographic Monitoring for Feeding Tube Insertion in Critically Ill Patients: Retrospective Cohort Study
<p><strong>Background</strong>: It is not rare for a small-bore feeding tube to be inserted incorrectly into the respiratory system in critically ill patients. Thus, monitoring is necessary to prevent respiratory malplacement of the tube. We investigated the utility of capnographic monitoring for the prevention of respiratory complications due to feeding tube mispositioning in critically ill patients.</p> <p><strong>Methods:</strong> This study is a pre- and post-intervention study, including a total of 445 feeding tube placements events that were retrospectively studied in the medical and surgical intensive care units of the Samsung Medical Center. We compared the outcomes between the time periods before and after the capnographic monitoring and respiratory complications.</p> <p><strong>Results:</strong> Feeding tubes were inserted in 275 cases without capnographic monitoring. Capnographic monitoring was performed in 170 cases. Sixteen patients (4%) had respiratory complications in total tube placements. Tracheal insertion was in 11 (2%) patients and pneumothorax in 5 (1%) patients. Fourteen cases of respiratory complications were detected in control group (14/275, 5%, ten tracheal insertions and four pneumothoraxes). Two cases of respiratory complications were detected in the capnographic monitoring group (2/170, 1%, one tracheal insertions and one pneumothorax). Respiratory complications were less detected in capnographic monitoring group than control group.</p> <p><strong>Conclusions:</strong> Capnographic monitoring is simple, easy to learn, and may be useful to prevent respiratory complication during feeding tube insertion in critically ill patients.</p>
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These curated guides explain access requirements, typical timelines, costs, and reuse considerations for widely used research datasets.
Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
Annotated Behaviour and Observability Dataset (ABODe)
ABODe is a University of Edinburgh DataShare dataset for behavior classification in group-housed mice using home-cage video, identities, bounding boxes, ground-plate positions, and annotator labels.
DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.