Medicine
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The aim of this study was to investigate the effect of enhanced recovery after surgery (ERAS) on perioperative outcomes, with an emphasis on patient-reported outcomes (PROs) and functional recovery. We compared the clinical outcomes in a cohort of 275 patients undergoing liver resection before and after the implementation of ERAS. The PROs were preoperatively and postoperatively compared until 14 days after surgery using the MD Anderson Symptom Inventory. ⋯ ERAS patients were more likely than non-ERAS patients to achieve a functional recovery (5.70 vs 6.79 days, P < .001) status in a shorter time period. The ERAS pathway, operation time, and the minimally invasive approach were independent predictors of functional recovery time. In hepatocellular carcinoma liver resection patients, the primary mechanism of ERAS is to reduce the postoperative interference burden and promote rapid functional recovery.
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Observational Study
Patterns and determinants of short and long birth intervals among women in selected sub-Saharan African countries.
Optimal birth spacing (defined as a birth spacing of 24-59 months) is incontrovertibly linked to better health outcomes for both mothers and babies. Using the most recent available Demographic and Health Survey data, we examined the patterns and determinants of short and long birth intervals among women in selected sub-Saharan African (SSA) countries. Reproductive health and sociodemographic data of 98,934 women from 8 SSA countries were analyzed. ⋯ The analysis suggested that the determinants of long and birth intervals differ and varies from country to country. The pattern of birth spacing found in this study appears to mirror the contraceptive use and fertility rate in the selected SSA countries. Birth intervals intervention addressing short birth intervals should target younger women in SSA, especially in Chad and Congo DRC, while intervention for long birth spacing should prioritize older, educated and wealthy women.
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Observational Study
Web search popularity, publicity, and utilization of direct oral anticoagulants in the United States, 2008-2018: A STROBE-compliant study.
We aimed to study the changing popularity of oral anticoagulants and the potential association between media coverage and real-world utilization practice, using time series analysis. In this STROBE-compliant study, we used Google Trends data to study public interest for direct oral anticoagulants (DOACs) (dabigatran, rivaroxaban, apixaban, and edoxaban) and warfarin in the United States (10-year coverage, beginning July 1st, 2008 ending June 30th, 2018). We validated our findings on a sample of 50 consecutive datasets (accumulated between July 6th, 2018 and October 19th, 2018), using the same search criteria. ⋯ Media coverage had a weak immediate impact on DOACs public interest and public interest patterns preceded changes in ambulatory anticoagulation visits by up to 5 months. For a long-run observation period, a single Google Trends search will suffice to produce robust estimations of the relative popularity between treatment options, such as oral anticoagulants. Media coverage has limited immediate impact and relative public interest is a potential lead indicator of changes in actual utilization.
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Lung adenocarcinoma (LUAD) is one of the most common malignancies, and is a serious threat to human health. The aim of the present study was to assess potential biomarkers for the prognosis of LUAD through the analysis of gene expression microarrays. ⋯ The discovery of these candidate genes and pathways reveals the etiology and molecular mechanisms of LUAD, providing ideas and guidance for the development of new therapeutic approaches to LUAD.