Annals of medicine
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Providing the highest quality care with no biases is the goal of every healthcare system. As a part of that goal hospital readmission has been investigated due to its impact on healthcare cost and case fatality rate in patient outcome. Patient's demographics, substance use and insurance barriers have been investigated as factors for readmission rate but the impact of COVID-19 pandemic on those biases and barriers have not been studied extensively yet. ⋯ Our multivariable analysis showed that the rate of readmissions during the COVID-19 pandemic was statistically higher among substance users (p = 0.003) and Medicaid insured (p = 0.038), and less likely among Spanish speakers p = 0.003. This study is limited due to small sample size and does not accurately represent the full population of the United States. Our hope is to further investigate the impact of COVID-19 pandemic on the readmission rate and to identify any influencing factors, biases, and barriers that contributed to the increased rate of readmission to learn and avoid future readmissions during straining times in medicine such as during COVID-19 pandemic.
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The construction of a robust healthcare information system is fundamental to enhancing countries' capabilities in the surveillance and control of hepatitis B virus (HBV). Making use of China's rapidly expanding primary healthcare system, this innovative approach using big data and machine learning (ML) could help towards the World Health Organization's (WHO) HBV infection elimination goals of reaching 90% diagnosis and treatment rates by 2030. We aimed to develop and validate HBV detection models using routine clinical data to improve the detection of HBV and support the development of effective interventions to mitigate the impact of this disease in China. ⋯ Suspected case detection models of HBV, showing potential for clinical deployment, have been developed to improve HBV surveillance in primary care setting in China. (Word count: 264).
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Obesity is an important health concern that poses many public health challenges. Evidence-based treatment modalities, capable of cost-effectively reaching large patient groups are needed. In this paper, we present the design and methods of the updated national, 12-month, digital weight management program, the Healthy Weight Coaching (HWC). ⋯ In addition, patients can make use of diaries and peer group chats for additional support. Data collected from the consenting patients will be used for research purposes with the weight change from baseline to 12 months as the main outcome in the real-life observational study. The study will provide invaluable insights into the application of digital modalities in the treatment of obesity.
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The performance of host immune responses biomarkers and clinical scores was compared to identify infection patient populations at risk of progression to sepsis, ICU admission and mortality. ⋯ Patients exhibiting low severity signs of infection but high IL-10 levels showed an elevated probability of developing sepsis. Combining IL-10 with the NEWS score provides a reliable tool for predicting the progression from infection to sepsis at an early stage. Utilizing IL-6 in the emergency room can help identify patients with low NEWS or SIRS scores.
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Hypertension is one of the major risk factors for cardiovascular events. This study aims to analyse the association of endothelial function and limb artery indices with coronary artery stenosis (CAS) severity in hypertension based on easily accessible and detailed clinical information, and to help accurately identify high-risk groups and avoid missed diagnosis and misdiagnosis. ⋯ This study shows that baPWV, ABI and FMD are independent risk factors for CHD, of which, baPWV and ABI are strongly associated with CAS severity in hypertensive patients. The predictive ability of CHD in hypertensive patients may be enhanced through combining the three endothelial function and limb artery indicators. The results may help to facilitate clinical decision-making during treatment and management of coronary artery disease.