Low levels of the key B cell activation marker,HLA-DR,in COVID-19 hospitalized cases are associated with disease severity,dexamethasone treatment,and circulating IL-6 levels

Immunologic Research -     

Trends in advanced imaging and hospitalization for emergency department syncope care before and after ACEP clinical policy

ObjectivesTo describe recent trends in advanced imaging and hospitalization of emergency department (ED) syncope patients, both considered “low-value”, and examine trend changes before and after the publication of American College Emergency Physician (ACEP) syncope guidelines in 2007, compared to conditions that had no changes in guideline recommendations.MethodsWe analyzed 2002–2015 National Hospital Ambulatory Medical Care Survey data using an interrupted-time series with comparison series design. The primary outcomes were advanced imaging among ED visits with principal diagnosis of syncope and headache and hospitalization for ED visits with principal diagnosis of syncope, chest pain, dysrhythmia, and pneumonia. We adjusted annual imaging and hospitalization rates using survey-weighted multivariable logistic regression, controlling for demographic and visit characteristics. Using adjusted outcomes as datapoints, we compared linear trends and trend changes of annual imaging and hospitalization rates before and after 2007 with aggregate-level multivariable linear regression.ResultsFrom 2002 to 2007, advanced imaging rates for syncope increased from 27.2% to 42.1% but had no significant trend after 2007 (trend change: ?3.1%; 95%CI ?4.7, ?1.6). Hospitalization rates remained at approximately 37% from 2002 to 2007 but declined to 25.7% by 2015 (trend change: ?2.2%; 95%CI ?3.0, ?1.4). Similar trend changes occurred among control conditions versus syncope, including advanced imaging for headache (difference in trend change: ?0.6%; 95%CI ?2.8, 1.6) and hospitalizations for chest pain, dysrhythmia, and pneumonia (differences in trend changes: 0.1% [95%CI ?1.9, 2.0]; ?0.9% [95%CI ?3.1, 1.3]; and ?1.2% [95%CI ?5.3, 2.9], respectively).ConclusionsBefore and after the release of 2007 ACEP syncope guidelines, trends in advanced imaging and hospitalization for ED syncope visits had similar changes compared to control conditions. Changes in syncope care may, therefore, reflect broader practice shifts rather than a direct association with the 2007 ACEP guideline. Moreover, utilization of advanced imaging remains prevalent. To reduce low-value care, policymakers should augment society guidelines with additional policy changes such as reportable quality measures.     

Does Timing of Primary Total Hip Arthroplasty Prior to or After Lumbar Spine Fusion Have an Effect on Dislocation and Revision Rates?

Background

Patients undergoing primary total hip arthroplasty (THA) following lumbar spine fusion have an increased incidence of dislocation compared to those without prior lumbar fusion. The purpose of this study is to determine if timing of THA prior to or after lumbar fusion would have an effect on dislocation and revision incidence in patients with both hip and lumbar spine pathology.

Assessing Community Readiness for Preventing Youth Substance Use in Colombia: a Latent Profile Analysis

The growing use of evidence-based preventive interventions for youth substance use in Latin American countries has prompted governments, researchers, and practitioners to ask if communities are ready for implementing these interventions, especially in light of the elevated costs and long-term commitment necessary for successful implementation. This study explores the construct validity of a measure of community readiness for prevention, using confirmatory factor and latent profile analyses of 7 measures theorized to be indicators of community readiness for implementing preventive interventions for youth substance use. Data were obtained from 211 community leaders in 16 communities in Colombia. Results indicate that community readiness can be represented as a unidimensional construct with multiple profiles of varying levels of readiness. Findings suggest that community readiness can be measured adequately as a latent construct and that its indicators can be used diagnostically to assess areas where readiness could be improved for better implementation of evidence-based preventive interventions.

     

Food Insecurity Screening in Pediatric Clinical Settings: A Caregivers’ Perspective

Maternal and Child Health Journal - Food insecurity (FI) has serious academic, social, and physical health consequences for children. A recent clinical recommendation suggests FI screening during...     

Meeting 24-h Movement Guidelines is Related to Better Academic Achievement: Findings from the YRBS 2019 Cycle

This research is designed to investigate the relationship between the 24-h movement guidelines (24-HMG) and self-reported academic achievement (AA) using nationally representative data derived from the 2019 U.S. National Youth Risk Behaviour Survey. A multiple-stage cluster sampling procedure has been adopted to ensure a representative sample (N = 9127 adolescents; mean age = 15.7 years old; male% = 49.8%). Logistic regression has been adopted to obtain the odds ratio (OR) regarding the associations between adherence to 24-HMG and AA while controlling for ethnicity, body mass index, sex and age. The prevalence of meeting the 24-h movement guidelines in isolation and combination varied greatly (physical activity = 23.3%, screen time = 32.5%, sleep = 22.3%, and 24-HMG = 2.8%), while the percentage of highest-class AA was 42.5%. Compared with the situation when none of 24-HMG is met, the achievement of any of the combined guidelines (except for meeting the physical activity guidelines) was significantly associated with higher odds of achieving first-class AA. Meeting the sleep guideline had 1.42 times increased likelihood to achieve highest-class AA as compared with not meeting the sleep guideline. Meeting screen time guidelines and physical activity guidelines, respectively, were 1.32 and 1.13 times more likely to report first-class AA; but meeting the guidelines of physical activity was not significantly related to AA. Meeting the 24-HMG had the highest odds of achieving first-class AA (OR = 2.01, 95%CI: 1.47– 2.73). In both sexes, adolescents who met 24-HMG self-reported better AA (boys OR = 2.05, 95%CI: 1.34–3.15; girls OR = 2.26, 95%CI: 1.36–3.76). Significant relationships were observed in adolescents from 9–10th grade, but not higher grades. Our research findings suggest that optimal movement behaviours can be seen as an important This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: 10.32604/IJMHP.2021.017660 ARTICLE Tech Science Press Published Online: 26 October 2021 element to better academic achievement among U.S. adolescents. Future studies can adopt our discoveries to promote adolescents’ academic achievement through implementing optimal 24-h movement behaviour patterns.