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  1. Article ; Online: School-based health care: improving academic outcomes for inner-city children-a prospective cohort quasi-experimental study.

    Rasiah, Saisujani / Jüni, Peter / Sgro, Michael D / Thorpe, Kevin E / Maguire, Jonathon / Freeman, Sloane J

    Pediatric research

    2023  Volume 94, Issue 4, Page(s) 1488–1495

    Abstract: Background: We examined whether a school-based health center model improved academic achievement compared to usual care.: Methods: This was a quasi-experimental prospective cohort study. The primary outcome was an academic achievement. In addition, ... ...

    Abstract Background: We examined whether a school-based health center model improved academic achievement compared to usual care.
    Methods: This was a quasi-experimental prospective cohort study. The primary outcome was an academic achievement. In addition, we analyzed sociodemographic characteristics and their relationship to academic achievement, and the wait time for a developmental assessment.
    Results: The differences in change of grades over time (from 2016/2017 to 2018/2019) were small for reading (-0.83, 95% CI -3.48, 1.82, p = 0.51), writing (-1.11, 95% CI -3.25, 1.03, p = 0.28), and math (0.06, 95% CI -3.08, 2.94, p = 0.98). The experimental arm's average wait time for developmental assessment was 3.4 months.
    Conclusion: In this small, quasi-experimental prospective cohort study, we did not find evidence that our SBHC model improved academic achievement; however, the wait time at the SBHCs was considerably less than the provincial wait time for a developmental assessment.
    Trial registration: NCT04540003.
    Impact: This study describes a unique and innovative school-based health center model. Our findings support the benefits of school-based health centers in diagnosing and treating children with developmental and mental health disorders for disadvantaged communities. This study did not find an improvement in academic achievement for school-based health center users. This study found that the wait time to developmental assessment was shorter for school-based health center users compared to the wait time reported in the community. Pandemic-associated school disruptions have highlighted the importance of accessible school-based health services for children requiring mental health and developmental assessments and care.
    MeSH term(s) Child ; Humans ; Prospective Studies ; Educational Status ; Academic Success ; School Health Services ; Delivery of Health Care
    Language English
    Publishing date 2023-02-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-023-02473-w
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  2. Article ; Online: Limiting Dynamic Driving Pressure in Patients Requiring Mechanical Ventilation.

    Urner, Martin / Jüni, Peter / Rojas-Saunero, L Paloma / Hansen, Bettina / Brochard, Laurent J / Ferguson, Niall D / Fan, Eddy

    Critical care medicine

    2023  Volume 51, Issue 7, Page(s) 861–871

    Abstract: Objectives: Previous studies reported an association between higher driving pressure (∆P) and increased mortality for different groups of mechanically ventilated patients. However, it remained unclear if sustained intervention on ∆P, in addition to ... ...

    Abstract Objectives: Previous studies reported an association between higher driving pressure (∆P) and increased mortality for different groups of mechanically ventilated patients. However, it remained unclear if sustained intervention on ∆P, in addition to traditional lung-protective ventilation, improves outcomes. We investigated if ventilation strategies limiting daily static or dynamic ∆P reduce mortality compared with usual care in adult patients requiring greater than or equal to 24 hours of mechanical ventilation.
    Design: For this comparative effectiveness study, we emulated pragmatic clinical trials using data from the Toronto Intensive Care Observational Registry recorded between April 2014 and August 2021. The per-protocol effect of the interventions was estimated using the parametric g-formula, a method that controls for baseline and time-varying confounding, as well as for competing events in the analysis of longitudinal exposures.
    Setting: Nine ICUs from seven University of Toronto-affiliated hospitals.
    Patients: Adult patients (≥18 yr) requiring greater than or equal to 24 hours of mechanical ventilation.
    Interventions: Receipt of a ventilation strategy that limited either daily static or dynamic ∆P less than or equal to 15 cm H 2 O compared with usual care.
    Measurements and main results: Among the 12,865 eligible patients, 4,468 of (35%) were ventilated with dynamic ∆P greater than 15 cm H 2 O at baseline. Mortality under usual care was 20.1% (95% CI, 19.4-20.9%). Limiting daily dynamic ∆P less than or equal to 15 cm H 2 O in addition to traditional lung-protective ventilation reduced adherence-adjusted mortality to 18.1% (95% CI, 17.5-18.9%) (risk ratio, 0.90; 95% CI, 0.89-0.92). In further analyses, this effect was most pronounced for early and sustained interventions. Static ∆P at baseline were recorded in only 2,473 patients but similar effects were observed. Conversely, strict interventions on tidal volumes or peak inspiratory pressures, irrespective of ∆P, did not reduce mortality compared with usual care.
    Conclusions: Limiting either static or dynamic ∆P can further reduce the mortality of patients requiring mechanical ventilation.
    MeSH term(s) Adult ; Humans ; Respiration, Artificial/methods ; Critical Care ; Intensive Care Units ; Tidal Volume ; Registries
    Language English
    Publishing date 2023-03-27
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005844
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  3. Article ; Online: The effect of sodium-glucose cotransporter-2 inhibitors on inflammatory biomarkers: A meta-analysis of randomized controlled trials.

    Buttice, Leonardo / Ghani, Maryam / Suthakar, Janahan / Gnanalingham, Sathyan / Carande, Elliott / Kennedy, Brett W C / Pitcher, Alex / Gamble, James H P / Ahmad, Mahmood / Lewis, Andrew / Jüni, Peter / Rider, Oliver J / Stephens, Jeffrey W / Bray, Jonathan J H

    Diabetes, obesity & metabolism

    2024  

    Abstract: Aims: To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers.: Methods: Medline, Embase and the Cochrane Library were searched for RCTs ... ...

    Abstract Aims: To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers.
    Methods: Medline, Embase and the Cochrane Library were searched for RCTs investigating the effect of SGLT2 inhibitors on inflammatory biomarkers, adipokine profiles and insulin sensitivity.
    Results: Thirty-eight RCTs were included (14 967 participants, 63.3% male, mean age 62 ± 8.6 years) with a median (interquartile range) follow-up of 16 (12-24) weeks. Meta-analysis showed that SGLT2 inhibitors significantly improved adiponectin, interleukin-6, tumour necrosis factor receptor-1 (vs. placebo alone: standardized mean difference [SMD] 0.34 [95% confidence interval {CI} 0.23, 0.45], mean difference [MD] -0.85 pg/mL [95% CI -1.32, -0.38], SMD -0.13 [95% CI -0.20, -0.06], respectively), leptin and homeostatic model assessment of insulin resistance index (vs.
    Control: SMD -0.20 [95% CI -0.33, -0.07], MD -0.83 [95% CI -1.32, -0.33], respectively). There were no significant changes in C-reactive protein (CRP), tumour necrosis factor-α, plasminogen activator inhibitor-1, fibroblast growth factor-21 or monocyte chemoattractant protein-1.
    Conclusions: Our analysis shows that SGLT2 inhibitors likely improve adipokine biomarkers and insulin sensitivity, but there is little evidence that SGLT2 inhibitors improve other inflammatory biomarkers including CRP.
    Language English
    Publishing date 2024-04-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.15586
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  4. Article ; Online: Linee guida ESC 2023 per il trattamento delle sindromi coronariche acute.

    Byrne, Robert A / Rossello, Xavier / Coughlan, J J / Barbato, Emanuele / Berry, Colin / Chieffo, Alaide / Claeys, Marc J / Dan, Gheorghe-Andrei / Dweck, Marc R / Galbraith, Mary / Gilard, Martine / Hinterbuchner, Lynne / Jankowska, Ewa A / Jüni, Peter / Kimura, Takeshi / Kunadian, Vijay / Leosdottir, Margret / Lorusso, Roberto / Pedretti, Roberto F E /
    Rigopoulos, Angelos G / Rubini Gimenez, Maria / Thiele, Holger / Vranckx, Pascal / Wassmann, Sven / Wenger, Nanette Kass / Ibanez, Borja

    Giornale italiano di cardiologia (2006)

    2024  Volume 25, Issue 2 Suppl 2, Page(s) e1–e112

    Title translation 2023 ESC Guidelines for the management of acute coronary syndromes.
    MeSH term(s) Humans ; Acute Coronary Syndrome/therapy ; Platelet Aggregation Inhibitors/therapeutic use ; Risk Assessment
    Chemical Substances Platelet Aggregation Inhibitors
    Language Italian
    Publishing date 2024-01-30
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2272414-X
    ISSN 1972-6481 ; 1827-6806
    ISSN (online) 1972-6481
    ISSN 1827-6806
    DOI 10.1714/4191.41785
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  5. Article ; Online: 2023 ESC Guidelines for the management of acute coronary syndromes.

    Byrne, Robert A / Rossello, Xavier / Coughlan, J J / Barbato, Emanuele / Berry, Colin / Chieffo, Alaide / Claeys, Marc J / Dan, Gheorghe-Andrei / Dweck, Marc R / Galbraith, Mary / Gilard, Martine / Hinterbuchner, Lynne / Jankowska, Ewa A / Jüni, Peter / Kimura, Takeshi / Kunadian, Vijay / Leosdottir, Margret / Lorusso, Roberto / Pedretti, Roberto F E /
    Rigopoulos, Angelos G / Rubini Gimenez, Maria / Thiele, Holger / Vranckx, Pascal / Wassmann, Sven / Wenger, Nanette Kass / Ibanez, Borja

    European heart journal

    2024  Volume 44, Issue 38, Page(s) 3720–3826

    MeSH term(s) Humans ; Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/therapy ; Myocardial Infarction ; Angina, Unstable
    Language English
    Publishing date 2024-03-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehad191
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  6. Article ; Online: Effectiveness of Virtual Reality-Based Well-Being Interventions for Stress Reduction in Young Adults: Systematic Review.

    Xu, Joy / Khanotia, Areej / Juni, Shmuel / Ku, Josephine / Sami, Hana / Lin, Vallen / Walterson, Roberta / Payne, Evelyn / Jo, Helen / Rahimpoor-Marnani, Parmin

    JMIR mental health

    2024  Volume 11, Page(s) e52186

    Abstract: Background: Adolescents can be especially vulnerable to various stressors as they are still in their formative years and transitioning into adulthood. Hence, it is important for them to have effective stress management strategies.: Objective: This ... ...

    Abstract Background: Adolescents can be especially vulnerable to various stressors as they are still in their formative years and transitioning into adulthood. Hence, it is important for them to have effective stress management strategies.
    Objective: This systematic review investigates current well-being interventions that are aimed at reducing stress among young adults. In particular, interventions using the medium of virtual reality (VR) are explored.
    Methods: This mixed methods systematic review follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines, and papers were gathered from databases such as PsycINFO, PubMed, Science Direct, Web of Science, OpenGrey, and Edutopia. Predetermined criteria and specific keywords were used to search for the papers. Search results were screened and extracted with all article screening or extraction delegated among all authors. Any disagreements after reconciliation were settled by a third author. The quality and risk of bias of included studies were assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) Tool for Quantitative Studies. Studies were analyzed qualitatively.
    Results: In total, 20 studies were included, and qualitative analysis was performed to evaluate the effectiveness of VR-based interventions in 3 domains: nature, stress, and academics.
    Conclusions: Studies using VR interventions, overall, promoted a reduction in stress and an increase in well-being. The findings suggest that VR may serve as an accessible and affordable medium of stress reduction for students and young adults. Larger sample sizes, and a greater number of included studies, may be required in future directions.
    MeSH term(s) Adolescent ; Young Adult ; Humans ; Systematic Reviews as Topic ; Meta-Analysis as Topic ; Bias ; Virtual Reality
    Language English
    Publishing date 2024-03-29
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2798262-2
    ISSN 2368-7959 ; 2368-7959
    ISSN (online) 2368-7959
    ISSN 2368-7959
    DOI 10.2196/52186
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  7. Article ; Online: The Effect of Low Preoperative Ejection Fraction on Mortality After Cardiac Surgery in Indonesia.

    Kurniawaty, Juni / Setianto, Budi Yuli / Supomo / Widyastuti, Yunita / Boom, Cindy E

    Vascular health and risk management

    2022  Volume 18, Page(s) 131–137

    Abstract: Background: Among cardiac surgery patients, low preoperative left ventricular ejection fraction (LVEF) is common and has been associated with poor outcomes. The objective of this study was to assess the association between LVEF and postoperative ... ...

    Abstract Background: Among cardiac surgery patients, low preoperative left ventricular ejection fraction (LVEF) is common and has been associated with poor outcomes. The objective of this study was to assess the association between LVEF and postoperative mortality in patients undergoing open-heart surgery in several hospitals in Indonesia.
    Methods: We conducted a multicenter study with the retrospective design using data from patients undergoing open-heart surgery in 4 institutions in Indonesia. Data regarding LVEF and other potential risk factors were extracted from medical records and compiled in one datasheet. Statistical analyses were performed to assess if low LVEF was associated with postoperative mortality and identify other potential risk factors.
    Results: A total of 4789 patients underwent cardiac surgery in participating centers during the study period. Of these, 189 subjects (3.9%) had poor preoperative LVEF. Poor LVEF was associated with postoperative mortality (adjusted OR 2.761, 95% CI 1.763-4.323, p < 0.001). Based on types of surgery, LVEF had a significant association with mortality only in CABG patients, while there was no such association in valve surgery and inconclusive in congenital surgery patients. Other significant independent predictors of in-hospital mortality included age more than 65 years old, non-elective surgery, the complexity of procedures, history of cardiac surgery, organ failure, CARE score ≥ 3, NYHA class ≥ III, and poor right ventricular function.
    Conclusion: Patients with low preoperative LVEF undergoing open-heart surgery had a higher risk of postoperative mortality. Cardiac surgery can be performed with acceptable mortality rates. Accurate selection of patients, risk/benefit evaluation, and planning of surgical and anesthesiological management are mandatory to improve outcomes.
    MeSH term(s) Aged ; Cardiac Surgical Procedures/adverse effects ; Humans ; Indonesia/epidemiology ; Retrospective Studies ; Stroke Volume ; Ventricular Function, Left
    Language English
    Publishing date 2022-03-24
    Publishing country New Zealand
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2186568-1
    ISSN 1178-2048 ; 1176-6344
    ISSN (online) 1178-2048
    ISSN 1176-6344
    DOI 10.2147/VHRM.S350671
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    Zs.A 6066: Show issues Location:
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  8. Article ; Online: Anti-Inflammatory, Analgesic, Functional Improvement, and Chondroprotective Effects of

    Jo, Hee-Geun / Baek, Chae Yun / Lee, JunI / Hwang, Yeseul / Baek, Eunhye / Hwang, Ji Hye / Lee, Donghun

    Nutrients

    2024  Volume 16, Issue 7

    Abstract: Osteoarthritis (OA) is a degenerative bone disease characterized by inflammation as a primary pathology and currently lacks therapeutic interventions to impede its progression. ...

    Abstract Osteoarthritis (OA) is a degenerative bone disease characterized by inflammation as a primary pathology and currently lacks therapeutic interventions to impede its progression.
    MeSH term(s) Animals ; Mice ; Rats ; Erigeron ; Research Design ; Anti-Inflammatory Agents, Non-Steroidal ; Osteoarthritis/chemically induced ; Osteoarthritis/drug therapy ; Pain/drug therapy ; Plant Extracts/pharmacology
    Chemical Substances Anti-Inflammatory Agents, Non-Steroidal ; Plant Extracts
    Language English
    Publishing date 2024-04-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu16071035
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  9. Article ; Online: 2023 ESC Guidelines for the management of acute coronary syndromes.

    Byrne, Robert A / Rossello, Xavier / Coughlan, J J / Barbato, Emanuele / Berry, Colin / Chieffo, Alaide / Claeys, Marc J / Dan, Gheorghe-Andrei / Dweck, Marc R / Galbraith, Mary / Gilard, Martine / Hinterbuchner, Lynne / Jankowska, Ewa A / Jüni, Peter / Kimura, Takeshi / Kunadian, Vijay / Leosdottir, Margret / Lorusso, Roberto / Pedretti, Roberto F E /
    Rigopoulos, Angelos G / Rubini Gimenez, Maria / Thiele, Holger / Vranckx, Pascal / Wassmann, Sven / Wenger, Nanette Kass / Ibanez, Borja

    European heart journal. Acute cardiovascular care

    2023  Volume 13, Issue 1, Page(s) 55–161

    MeSH term(s) Humans ; Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/therapy ; Myocardial Infarction ; Angina, Unstable
    Language English
    Publishing date 2023-09-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2663340-1
    ISSN 2048-8734 ; 2048-8726
    ISSN (online) 2048-8734
    ISSN 2048-8726
    DOI 10.1093/ehjacc/zuad107
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  10. Article ; Online: Improving the Design of Future PCI Trials for Stable Coronary Artery Disease: JACC State-of-the-Art Review.

    Marquis-Gravel, Guillaume / Moliterno, David J / Francis, Darrel P / Jüni, Peter / Rosenberg, Yves D / Claessen, Bimmer E / Mentz, Robert J / Mehran, Roxana / Cutlip, Donald E / Chauhan, Cynthia / Quella, Susan / Zannad, Faiez / Goodman, Shaun G

    Journal of the American College of Cardiology

    2020  Volume 76, Issue 4, Page(s) 435–450

    Abstract: The role of percutaneous coronary interventions in addition to medical therapy for patients with stable coronary artery disease continues to be debated in routine clinical practice, despite more than 2 decades of randomized controlled trials. The ... ...

    Abstract The role of percutaneous coronary interventions in addition to medical therapy for patients with stable coronary artery disease continues to be debated in routine clinical practice, despite more than 2 decades of randomized controlled trials. The residual uncertainty arises from particular challenges facing revascularization trials. Which endpoint do doctors care about, and which do patients care about? Which participants should be enrolled? What background medical therapy should we use? When is placebo control relevant? In this paper, we discuss how these questions can be approached and examine the merits and disadvantages of possible options. Engaging multiple stakeholders, including patients, researchers, regulators, and funders, to ensure the design elements are methodologically valid and clinically meaningful should be an aspirational goal in the development of future trials.
    MeSH term(s) Coronary Artery Disease/surgery ; Humans ; Percutaneous Coronary Intervention/methods ; Quality Improvement ; Randomized Controlled Trials as Topic/methods ; Randomized Controlled Trials as Topic/standards ; Research Design
    Language English
    Publishing date 2020-04-28
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2020.05.060
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