JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Comparative Study
Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial.
Rapid growth and elevated weight status in early childhood increase risk for later obesity, but interventions that improve growth trajectories are lacking. ⋯ Among primiparous mother-child dyads, a responsive parenting intervention initiated in early infancy compared with a control intervention resulted in a modest reduction in BMI z scores at age 3 years, but no significant difference in BMI percentile. Further research is needed to determine the long-term effect of the intervention and assess its efficacy in other settings.
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Comparative Study
Association of Broad-Based Genomic Sequencing With Survival Among Patients With Advanced Non-Small Cell Lung Cancer in the Community Oncology Setting.
Broad-based genomic sequencing is being used more frequently for patients with advanced non-small cell lung cancer (NSCLC). However, little is known about the association between broad-based genomic sequencing and treatment selection or survival among patients with advanced NSCLC in a community oncology setting. ⋯ Among patients with advanced non-small cell lung cancer receiving care in the community oncology setting, broad-based genomic sequencing directly informed treatment in a minority of patients and was not independently associated with better survival.
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Practice Guideline
Screening for Atrial Fibrillation With Electrocardiography: US Preventive Services Task Force Recommendation Statement.
Atrial fibrillation is the most common type of cardiac arrhythmia (irregular heartbeat), and its prevalence increases with age, affecting about 3% of men and 2% of women aged 65 to 69 years and about 10% of adults 85 years and older. Atrial fibrillation is a major risk factor for ischemic stroke, increasing risk of stroke by as much as 5-fold. Approximately 20% of patients who have a stroke associated with atrial fibrillation are first diagnosed with atrial fibrillation at the time of stroke or shortly thereafter. ⋯ The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with ECG. (I statement).
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In adults and children prescribed antibiotics, is co-administration of a probiotic associated with a lower risk of symptomatic Clostridium difficile infection without an increase in adverse events? ⋯ Moderate-quality evidence suggests that probiotics are associated with a lower risk of C difficile infection and very low-quality evidence suggests that probiotics are associated with fewer adverse events vs placebo or no treatment.