Hostdependent heterologous phrase associated with berninamycin gene cluster contributes to linear thiopeptide antibiotics

01). Past experience with severe hypoglycaemia was associated with higher worry of hypoglycaemia (p<0.01) but not avoidance behaviour (ns).
These results highlighted the multifaceted nature of FoH, which warrants further discussion between providers and patients to uncover drivers of and actions required to reduce FoH and improve patient care and outcomes.
These results highlighted the multifaceted nature of FoH, which warrants further discussion between providers and patients to uncover drivers of and actions required to reduce FoH and improve patient care and outcomes.
To explore and compare the predictors for exclusive breast feeding (EBF) among migrant and non-migrant mothers in China.
A large-scale cross-sectional study.
12 counties/districts were covered in China.
A total number of 10 408 mothers were recruited, of whom 3571 mothers of infants aged 0-5 months in urban China were used for analysis.
The practice of EBF was calculated based on the foods and drinks consumed in the last 24 hours, as recommended by WHO.
Around 30% of Chinese mothers with infants aged 0-5 months practised EBF in urban areas, with no significant difference between migrant and non-migrant mothers (p=0.433). Among the migrant mothers, factors associated with EBF included residence in big cities (adjusted OR, AOR 1.68 (95% CI 1.20 to 2.34)), premature birth (AOR 0.27 (95% CI 0.09 to 0.81)), knowledge about EBF (AOR 2.00 (95% CI 1.51 to 2.65)), low intention of breast feeding in the first month postpartum (AOR 0.59 (95% CI 0.36 to 0.97)) and mothers working in agriculture-related fields or as casual workers (AOR 1.77 (95% CI 1.18 to 2.64)). Among non-migrant mothers, in addition to similar predictors including residence in big cities (AOR 1.40 (95% CI 1.13 to 1.73)), knowledge about EBF (AOR 1.25 (95% CI 1.02 to 1.53)) and low intention of breast feeding in the first month post partum (AOR 0.46 (95% CI 0.31 to 0.70)], early initiation of breast feeding (EIBF) (AOR 1.78 (95% CI 1.35 to 2.33)) and caesarean delivery (AOR 0.74 (95% CI 0.60 to 0.89)) were also factors associated with EBF.
There was no significant difference in the prevalence of EBF between migrant and non-migrant mothers in urban China. Premature birth and maternal occupation in agriculture-related fields or casual work were distinctive factors associated with EBF for migrants, while EIBF and caesarean delivery were unique predictors for non-migrants.
ChiCTR-ROC-17014148; Pre-results.
ChiCTR-ROC-17014148; Pre-results.
The US opioid crisis and increasing prescription rates in Europe suggest inappropriate risk perceptions and behaviours of people who prescribe, take or advise on opioids physicians, patients and pharmacists. Findings from cognitive and decision science in areas other than drug safety suggest that people's risk perception and behaviour can differ depending on whether they learnt about a risk through personal experience or description.
xperiencing the
isk of overutilising
pioids among patients with chronic
on-cancer pain in
mbulatory care (ERONA) is the first-ever conducted trial that aims at investigating the effects of these two modes of learning on individuals' risk perception and behaviour in the long-term administration of WHO-III opioids in chronic non-cancer pain.
ERONA-an exploratory, randomised controlled online survey intervention trial with two parallel arms-will examine the opioid-associated risk perception and behaviour of four groups involved in the long-term administration of WHO-IIr-reviewed journals, conference presentations and social media.
DRKS00020358.
DRKS00020358.
Obesity is a growing public health problem worldwide. We evaluated the mediators and association between changes in obesity metrics and renal outcomes in the general population.
Using the Japanese nationwide health check-based cohort from April 2011 to March 2019, we selected individuals aged 40-74 years, with a baseline estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m
, whose body mass index (BMI) change was assessed. The primary outcome was combined 30% decline in eGFR, eGFR <15 mL/min/1.73 m
and end-stage renal disease.
During 245 147 person-years' follow-up among 50 604 participants (mean eGFR, 83.7 mL/min/1.73 m
; mean BMI, 24.1 kg/m
), 645 demonstrated eGFR decline (incidence rate 2.6/1000 person-years, 95% CI 2.4 to 2.8). We observed continued initial changes in BMI for over 6 years and a U-shaped association between BMI change and eGFR decline. Compared with 0% change in BMI, adjusted HRs for changes of -10%, -4%, 4% and 10% were 1.53 (95% CI 1.15 to 2.04), 1.14 (95% CI 1.01 to 1.30), 1.16 (95% CI 1.02 to 1.32) and 1.87 (95% CI 1.25 to 2.80), respectively. The percentage of excess risk of BMI increase (>4%) mediated by three risk factors (blood pressure, haemoglobin A1c and total cholesterol), was 13.3%.
In the middle-aged Japanese population, both, increase and decrease in BMI were associated with subsequent eGFR decline. Changes in risk factors mediated a small proportion of the association between BMI increase and eGFR decline. Our findings support the clinical significance of monitoring BMI as a renal risk factor.
In the middle-aged Japanese population, both, increase and decrease in BMI were associated with subsequent eGFR decline. Changes in risk factors mediated a small proportion of the association between BMI increase and eGFR decline. Our findings support the clinical significance of monitoring BMI as a renal risk factor.
Resuscitation using blood products is critical during the acute postinjury period. However, the optimal target haemoglobin (Hb) levels have not been adequately investigated. With the restrictive transfusion strategy for critically injured patients (RESTRIC) trial, we aim to compare the restrictive and liberal red blood cell (RBC) transfusion strategies.
This is a cluster-randomised, crossover, non-inferiority trial of patients with severe trauma at 22 hospitals that have been randomised in a 11 ratio based on the use of a restrictive or liberal transfusion strategy with target Hb levels of 70-90 or 100-120 g/L, respectively, during the first year. Subsequently, after 1-month washout period, another transfusion strategy will be applied for an additional year. RBC transfusion requirements are usually unclear on arrival at the emergency department. Therefore, patients with severe bleeding, which could lead to haemorrhagic shock, will be included in the trial based on the attending physician's judgement. EachN Clinical Trials Registry; UMIN000034405. Registered 8 October 2018.
UMIN Clinical Trials Registry; UMIN000034405. #link# Registered 8 October 2018.
Complementary and alternative medicine (CAM) is frequently used in Western countries within general medicine and internal medicine. Information on the use in orthopaedic and trauma surgery is widely lacking. see more of this study was to investigate usage and needs regarding CAM for these patients.
Prospective paper-based, pseudoanonymous, cross-sectional survey.
From August to December 2018, a questionnaire composed of 17 questions was distributed to all eligible patients.
In-house patients in orthopaedic and trauma surgery at a high-volume medical centre in Germany.
Previous or current usage of CAM, interest and requests towards CAM as well as communication about CAM.
Overall, 457 orthopaedic and trauma surgical patients took part in the survey. They were on average 52 years old and 54% were male. Most of the patients were admitted due to bone fractures and most underwent operative therapy. Previous or current CAM usage was stated by 76% and 30% of patients, respectively. Most of the patients stated to be interested in usage of CAM and demanded for more clinical usage of CAM and reliable information about CAM. More than 90% of patients did not discuss CAM interest or usage with their treating physicians. Patients stated that physicians should have knowledge about CAM. They wish to be treated in a holistic manner and want to strengthen self-efficacy.
Usage of CAM of patients in orthopaedic and trauma surgery appears to be high. Only a few patients discuss their interest and usage of CAM with their treating physician. Therefore, surgeons should ask their patients about CAM and should consider evidence-based CAM approaches for complementary treatment.
DRKS0001544.
DRKS0001544.
Recruitment and retention in child and adolescent healthy lifestyle intervention services for childhood obesity is challenging, and inequalities across social groups are persistent. This study aimed to understand the barriers and facilitators to engagement in a multicomponent assessment-and-intervention healthy lifestyle programme for children and their families, based in the home and community.
Qualitative interview-based study of past users (n=76) of a family-based multicomponent healthy lifestyle programme in a mixed urban-rural region of New Zealand. Semistructured, home-based interviews were conducted and thematically analysed with peer debriefing for validity.
Families were selected through stratified random sampling to include a range of levels of engagement, including those who declined their referral, with equal numbers of interviews with Indigenous and non-Indigenous families.
Three interactive and compounding determinants were identified as influencing engagement in Whānau Pakari acute and grammes and ongoing engagement in healthcare services overall.
While participant engagement in healthy lifestyle programmes is affected by determinants which appear to operate outside immediate service provision, the programme is an opportunity to acknowledge past instances of stigma and the wider challenges of healthy lifestyle change. The experience of the referral to Whānau Pakari is important for setting the scene for future engagement in the programme. Respectful, compassionate care is critical to enhanced retention in multidisciplinary healthy lifestyle programmes and ongoing engagement in healthcare services overall.
Endometriosis is considered as a serious gynaecological disease in women at a reproductive age. link2 Lower body mass index (BMI) is thought to be a risk factor. However, recent studies indicated that women with normal BMI were also more likely to develop endometriosis, suggesting the association with BMI is controversial. We therefore investigated the association of BMI and surgically diagnosed endometriosis in a cohort of Chinese women.
Retrospective case-control study.
Tertiary hospital.
709 women with endometriosis and 807 age matched controls between January 2018 and August 2019.
Age at diagnosis, parity, gravida, BMI and self-reported dysmenorrhoea status were collected and the association of BMI and endometriosis was analysed.
Overall, the median BMI was not different between patients and controls (21.1 kg/m
vs 20.9 kg/m
, p=0.223). According to the BMI categories for Asians/Chinese by WHO (underweight <18.5 kg/m
, normal weight 18.5-22.99 kg/m
, overweight 23-27.49 kg/m
, obese ≥27.50 kmal weight. Obesity was also a risk factor for severe dysmenorrhoea.
There is growing recognition around the importance of multimorbidity in low-income and middle-income country (LMIC) settings, and specifically the need for pragmatic intervention studies to reduce the risk of developing multimorbidity, and of mitigating the complications and progression of multimorbidity in LMICs. One of many challenges in completing such research has been the selection of appropriate outcomes measures. link3 A 2018 Delphi exercise to develop a core-outcome set for multimorbidity research did not specifically address the challenges of multimorbidity in LMICs where the global burden is greatest, patterns of disease often differ and health systems are frequently fragmented. We, therefore, aimed to summarise and critically review outcome measures suitable for studies investigating mitigation of multimorbidity in LMIC settings.
LMIC.
People with multimorbidity.
Identification of all outcome measures.
We present a critical review of outcome measures across eight domains mortality, quality of life, function, health economics, healthcare access and utilisation, treatment burden, measures of 'Healthy Living' and self-efficacy and social functioning.