Value-based medicine

BACKGROUND: Climate change is the greatest threat to human health. Medical students, as future health-care workers, are important in promoting sustainable behaviours, which are strongly associated with individuals' emotional responses to climate change. At Würzburg University Hospital (Würzburg, Germany), a one-term optional course (40 learning units) about planetary health and two lectures within the curricular course Environmental Medicine were introduced in 2021. We aimed to examine the effects of these courses on the emotions and motivations of students in acting against climate change...

BACKGROUND: Given the urgency of transitioning towards sustainable nutrition, dietary shifts that provide co-benefits to human health and the environment are imperative. There is currently no database of the environmental impacts of foods that reflects Canada's unique geographical and agri-climatic context and regional inputs and emissions. To determine sustainable diets, harmonising nutritional considerations with environmental impacts is also essential for an equitable comparison of foods...

OBJECTIVE: Early detection and effective management of hearing loss constitute the key to improving the quality of life of individuals with hearing loss. However, in standardized pure tone audiometry, it is sometimes difficult for elderly patients to understand and follow all instructions. Audiologists also require time, expertise, and patience to ensure that an elderly can identify the faintest levels of stimuli during a hearing test. Therefore, this study aimed to devise and validate a formula to predict the pure tone threshold at each frequency across 0...

BACKGROUND: Defining healthcare facility catchment areas is a key step in predicting future healthcare demand in epidemic settings. Forecasts of hospitalisations can be informed by leading indicators measured at the community level. However, this relies on the definition of so-called catchment areas or the geographies whose populations make up the patients admitted to a given hospital, which are often not well-defined. Little work has been done to quantify the impact of hospital catchment area definitions on healthcare demand forecasting...

BACKGROUND: Overuse of medical care is a pervasive problem. Studies using hypothetical scenarios suggest that physicians' risk literacy influences medical decisions; real-world correlations, however, are lacking. We sought to determine the association between physicians' risk literacy and their real-world prescriptions of potentially hazardous drugs, accounting for conflicts of interest and perceptions of benefit-harm ratios in low-value prescribing scenarios. SETTING AND SAMPLE: Cross-sectional study-conducted online between June and October 2023 via field panels of Sermo (Hamburg, Germany)-with a convenience sample of 304 English general practitioners (GPs)...

INTRODUCTION: This study aims to reduce potentially inappropriate prescribing (PIP) of statins and foster healthy lifestyle promotion in cardiovascular disease (CVD) primary prevention in low-risk patients. To this end, we will compare the effectiveness and feasibility of several de-implementation strategies developed following the structured design process of the Behaviour Change Wheel targeting key determinants of the clinical decision-making process in CVD prevention. METHODS AND ANALYSIS: A cluster randomised implementation trial, with an additional control group, will be launched, involving family physicians (FPs) from 13 Integrated Healthcare Organisations (IHOs) of Osakidetza-Basque Health Service with non-zero incidence rates of PIP of statins in 2021...

OBJECTIVES: To develop and validate a predictive method for axillary lymph node (ALN) metastasis of breast cancer by using radiomics based on mammography and MRI. MATERIALS AND METHODS: A retrospective analysis of 492 women from center 1 (The affiliated Hospital of Qingdao University) and center 2 (Yantai Yuhuangding Hospital) with primary breast cancer from August 2013 to May 2021 was carried out. The radscore was calculated using the features screened based on preoperative mammography and MRI from the training cohort of Center 1 (n = 231), then tested in the validation cohort (n = 99), an internal test cohort (n = 90) from Center 1, and an external test cohort (n = 72) from Center 2...

PURPOSE: Further acceleration of DWI in diagnostic radiology is desired but challenging mainly due to low SNR in high b-value images and associated bias in quantitative ADC values. Deep learning-based reconstruction and denoising may provide a solution to address this challenge. METHODS: The effects of SNR reduction on ADC bias and variability were investigated using a commercial diffusion phantom and numerical simulations. In the phantom, performance of different reconstruction methods, including conventional parallel (SENSE) imaging, compressed sensing (C-SENSE), and compressed SENSE acceleration with an artificial intelligence deep learning-based technique (C-SENSE AI), was compared at different acceleration factors and flip angles using ROI-based analysis...

PET scans provide additional clinical value but are costly and not universally accessible. Salehjahromi et al.1 developed an AI-based pipeline to synthesize PET images from diagnostic CT scans, demonstrating its potential clinical utility across various clinical tasks for lung cancer.

Diabetic retinopathy (DR) is a kind of ocular complication of diabetes, and its degree grade is an essential basis for early diagnosis of patients. Manual diagnosis is a long and expensive process with a specific risk of misdiagnosis. Computer-aided diagnosis can provide more accurate and practical treatment recommendations. In this paper, we propose a multi-view joint learning DR diagnostic model called RT2Net, which integrates the global features of fundus images and the local detailed features of vascular images to reduce the limitations of single fundus image learning...

Snakes of the genus Boa are outstanding elements of the New World biota with a broad sociological influence on pop culture. Historically, several taxa have been recognized in the past 300 years, being mostly described in the early days of binomial nomenclature. As a rule, these taxa were recognized based on a suite of phenotypic characters mainly those from the external morphology. However, there is a huge disagreement with respect to the current taxonomy and available molecular phylogenies. In order to reconcile both lines of evidence, we investigate the phylogenetic reconstruction (using mitochondrial and nuclear genes) of the genus in parallel to the detailed study of some phenotypic systems from a geographically representative sample of the cis-Andean mainland Boa constrictor...

OBJECTIVES: The goal of this investigation was to identify the main compounds and the pharmacological mechanism of the traditional Chinese medicine formulation, Gong Ying San (GYS), by infrared spectral absorption characteristics, metabolomics, network pharmacology, and molecular-docking analysis for mastitis. The antibacterial and antioxidant activities were determined in vitro. METHODS: The chemical constituents of GYS were detected by ultra-high-performance liquid chromatography Q-extractive mass spectrometry (UHPLC-QE-MS)...

The pharmacokinetic profile of paracetamol in koalas is described when administered orally at 15 mg/kg; followed by the same dose, administered every 12 hours (hrs), repeated five times. After the initial oral administration, the median (range) maximal plasma concentration (Cmax), the time Cmax was reached (Tmax) and elimination half-life (t1/2) were 16.93 μg/mL (13.66 to 20.25 μg/mL); 4 hrs (4 to 8 hrs) and 5.54 hrs (4.66 to 7.67 hrs), respectively. When paracetamol was administered orally at 15 mg/mL every 12 hrs, the trough total plasma concentration range remained comparable to the therapeutic range in humans i...

OBJECTIVES: To determine the most appropriate method of functional assessment for "patellofemoral pain" (PFP)/"chondromalacia patella" for its diagnostic value, (validity, reliability, sensitivity, specificity, predictive value and clinical applicability); to outline initial interpretations of the questionnaires and their appropriateness, through the cut-off points determined in their scores based on physical test and Magnetic Resonance Imaging (MRI); to establish which methods should be used in conjunction with each other to obtain clinical diagnoses that are robust effective and efficient...

The short-term prediction of single well production can provide direct data support for timely guiding the optimization and adjustment of oil well production parameters and studying and judging oil well production conditions. In view of the coupling effect of complex factors on the daily output of a single well, a short-term prediction method based on a multi-agent hybrid model is proposed, and a short-term prediction process of single well output is constructed. First, CEEMDAN method is used to decompose and reconstruct the original data set, and the sliding window method is used to compose the data set with the obtained components...

Traditional optical flame detectors (OFDs) in flame detection are susceptible to environmental interference, which will inevitably cause detection errors and miscalculations when confronted with a complex environment. The conventional deep learning-based models can mitigate the interference of complex environments by flame image feature extraction, which significantly improves the precision of flame recognition. However, these models focus on identifying the general profile of the static flame, but neglect to effectively locate the source of the dynamic flame...

OBJECTIVES: Carpal tunnel syndrome (CTS) stands as the most prevalent upper extremity entrapment neuropathy, with a multifaceted etiology encompassing various risk factors. This study aimed to investigate whether anthropometric measurements of the hand, grip strength, and pinch strength could serve as predictive indicators for CTS through machine learning techniques. METHODS: Enrollment encompassed patients exhibiting CTS symptoms (n = 56) and asymptomatic healthy controls (n = 56), with confirmation via electrophysiological assessments...

This bioassay evaluated the bioavailability (RBV) of a novel nanoparticle of methionine (nano-Met) relative to DL-methionine (DL-Met), and estimated methionine requirements for both sources in starting broilers. Five supplemental levels (0.05, 0.10, 0.15, 0.20, and 0.25% of diet) of DL-Met or nano-Met were added to a basal diet containing 0.35% standardized ileal digestible (SID) methionine to create 11 experimental diets, including a basal diet and 10 experimental diets containing 0.40, 0.45, 0.50, 0.55, and 0...

Crime remains a crucial concern regarding ensuring a safe and secure environment for the public. Numerous efforts have been made to predict crime, emphasizing the importance of employing deep learning approaches for precise predictions. However, sufficient crime data and resources for training state-of-the-art deep learning-based crime prediction systems pose a challenge. To address this issue, this study adopts the transfer learning paradigm. Moreover, this study fine-tunes state-of-the-art statistical and deep learning methods, including Simple Moving Averages (SMA), Weighted Moving Averages (WMA), Exponential Moving Averages (EMA), Long Short Term Memory (LSTM), Bi-directional Long Short Term Memory (BiLSTMs), and Convolutional Neural Networks and Long Short Term Memory (CNN-LSTM) for crime prediction...

As place-based conservation organizations, zoos are in a central position to support individuals in making small changes in their lives that will support the protection of wildlife and their habitats. This paper describes the secondary analysis of data collected from multi-phase front-end, exploratory evaluation that informed the development of a conservation action campaign in association with a non-profit, urban zoo. In phase one, internal organization staff were invited to attend workshops during which they brainstormed potential conservation actions that they felt were important for the zoo to promote...