Flavonoids are of particular interest for their antioxidant property and anti-inflammatory, and a therapeutic potential for age-related diseases has been s

Background: The present study aimed to evaluate the association between the cumulative dose of glucocorticoids (GCs) and case fatality in hospitalized patients who developed pneumonia while receiving glucocorticoid therapy.Methods: This retrospective cohort study included 625 patients receiving long-term GC treatment who were hospitalized with pneumonia (322 male and 303 female). Data were obtained from the Dryad Digital Repository and were used to perform secondary analysis. Multivariable Cox proportional hazard regression model and restricted cubic splines (RCS) were used to evaluate the association between the cumulative dose of GCs and case fatality. Sensitivity analyses and subgroup analyses were performed.Results: The 30-day and 90-day death rates were 22.9 and 26.2%, respectively. After adjusting for potential confounders, compared with those in the lowest quintile (≤ 1.5 g), the Cox proportional hazard regression model analysis showed that patients with different cumulative doses of GCs (1.5 to 2.95, 2.95 to 5, 5 to 11.5, and > 11.5 g) had lower risks for 30-day death, with respective hazard ratios of 0.86 (95% CI, 0.52 to 1.42), 0.81 (0.49 to 1.33), 0.29 (0.15 to 0.55), and 0.42 (0.22 to 0.79). The multivariable-adjusted RCS analysis suggested a statistically significant N-shaped association between the cumulative dose of GCs and 30-day death. A higher cumulative dose of GC tended to first lead to an increase in 30-day death within 1.8 g, then to a statistically significant decrease until around 8 g [HR for 1 g = 0.82 (0.69 to 0.97)], and again to an increase afterward. Similar results were found in the subgroup analyses and sensitivity analyses.Conclusion: N-shaped association between the cumulative dose of GCs and case fatality was observed in patients receiving long-term GC treatment who were hospitalized with pneumonia. Our findings may help physicians manage these patients.

Global countries often apply containment policies (CPs) to combat infectious disease surges. Whether countries with longer cumulative duration of CPs are associated with slower long-term epidemic progression necessitates a thorough evaluation. We collected CP and COVID-19 data of 185 territories during 2020-2022, with a total of 23 CPs. Using the target trial emulation and cloning-censoring-weighting approaches, we assessed the effectiveness of CPs with different cumulative durations in delaying countries from reaching the 1% and 10% cumulative infection incidence end points (i.e. 10,000 and 100,000 COVID-19 cases per million population, respectively) over a 3-year observation period. For reaching the 1% cumulative infection incidence, recommending closing workplaces and limiting gatherings to 10 people, each presented that a longer cumulative duration of those CPs is associated with a lower proportion of countries achieving this end point throughout 2020-2022. For reaching the 10% cumulative infection incidence, mandatory bans on public events and domestic movements, closing public transports, and screening and quarantining inbound tourists, each showed similar associations. Notably, long-lasting border bans upon high-risk regions are associated with a higher proportion of countries reaching the 10% cumulative infection incidence. From the long-term perspective, we highlight CPs that warrant extending the duration to achieve slower epidemic progression. By contrast, our findings demonstrate the limited effectiveness of the ban on regions in slowing the long-term epidemic progression.

Backgroud: China has introduced series of policies to improve the professional self-image of GPs, however, Chinese general practitioners (GPs) generally have a low professional identity. This study evaluated the effects of on-job-training for medical health professionals that focuses on the recognition of GPs’ roles. Methods At a representative training base in Guangdong Province, the most economically developed province in Southern China, 62 workers from community health service centers underwent training for 6 months according to a before-after self-controlled design. A specific module related to professional value recognition was integrated into the training course. Trainees were invited to participate in the open-ended self-questionnair survey. Thematic analysis was used to explore themes within the data. Kappa test was used to compare consistency of career prospects before and after the training. Results Before training, participants generally lacked a full and clear understanding of the professional responsibilities of GPs. After the training, participants showed increased awareness of six aspects of general medical practice including a broad understanding of the term, disease treatment, disease prevention, service mode, role of general services in promoting public health, and role of GPs in a service team. Moreover, 84% of participants had a positive opinion of GPs’ career prospects and 90.3% preferred general practice to specialization as a career choice after the training. Current GPs preferred to become a specialist mainly for the higher salary, but current specialists preferred to be a GP for self-growth and sense of community. Conclusions These results demonstrate that appropriate on-the-job training can improve GPs’ professional identity in China, and should therefore be included in policies and integrated into programs for medical health professionals.