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Introduction: Colorectal adenoma (CRA) is a precancerous lesion for colorectal cancer. Endoscopic resection is the first-line treatment for CRA. However, CRA recurrence rate is high. This proposed study aims to determine if Chinese herbal medicine (CHM) reduces CRA recurrence.
Methods And Analysis: This project encompasses an observational, registry-based, cohort study and a nested qualitative study. The cohort study aims to include 364 postpolypectomy CRA participants at Guangdong Provincial Hospital of Chinese Medicine (GPHCM), China, with a follow-up phase of up to 1 year. In addition to routine care, these participants will receive a CHM treatment prescribed by experienced Chinese medicine (CM) clinicians. The CHM treatment encompasses CHM products and CHM formulae according to CM syndromes. The primary outcome is CRA recurrence rate at 1 year after enrolment. Secondary outcomes include characteristics of recurrent CRA, incidence of colorectal polyp (except for CRA), incidence of advanced CRA, incidence of colorectal cancer, improvement of gastrointestinal symptoms commonly seen in CRA patients, faecal occult blood test result, lipid level, fasting plasma glucose level, uric acid level, carcinoembryonic antigen, carbohydrate antigen 19-9, quality of life and safety evaluations. Logistic regression analysis will be used to explore the correlation between exposure and outcome. Qualitative interviews will be conducted among approximate 30 CRA patients from the cohort study and 10 CM practitioners in Department of Gastroenterology at GPHCM. Thematic analysis will be used to analyse qualitative data.
Ethics And Dissemination: Ethical approval has been obtained from the Human Research Ethics Committee (HREC) of GPHCM (YF2022-320-02) and registered at Royal Melbourne Institute of Technology (RMIT) HREC. The results will be disseminated in peer-reviewed journals and international academic conferences.
Trial Registration Number: ChiCTR2200065713.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660202 | PMC |
http://dx.doi.org/10.1136/bmjopen-2023-073969 | DOI Listing |
Curr Opin Infect Dis
September 2025
Department of Microbiology, Royal Melbourne Hospital.
Purpose Of Review: Diagnostic stewardship (DS) aims to optimise the use of laboratory testing to improve patient care while reducing unnecessary tests. This review examines recent evidence on DS interventions to optimise the use of resources, focusing on three key areas: reducing unnecessary testing, maximising the impact of existing tests, and avoiding the overdiagnosis of hospital-acquired infections.
Recent Findings: Multiple interventions have demonstrated effectiveness in reducing unnecessary blood and urine culture testing, including clinical decision support tools, education programs, and multidisciplinary approaches.
JMIR Res Protoc
September 2025
Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
Background: With the availability of more advanced and effective treatments, life expectancy has improved among patients with metastatic breast cancer (MBC), but this makes communication with their medical oncologist more complex. Some patients struggle to learn about their therapeutic options and to understand and articulate their preferences. Mobile health (mHealth) apps can enhance patient-provider communication, playing a crucial role in the diagnosis, treatment, quality of life, and outcomes for patients living with MBC.
View Article and Find Full Text PDFJ Med Internet Res
September 2025
Department of Statistics and Probability, Michigan State University, East Lansing, MI, United States.
We estimated linear mixed-effects models to analyze changes in language patterns (as measured using Linguistic Inquiry and Word Count) among neurodiverse youth to introduce a novel assessment useful for research into the potential benefits of special interests while minimizing respondent and researcher burden.
View Article and Find Full Text PDFJMIR Res Protoc
September 2025
Center for Alcohol & Addiction Studies, School of Public Health, Brown University, Providence, RI, United States.
Background: Digital media frequently contains positive portrayals of alcohol content, which has been shown to be associated with alcohol-related cognitions and behaviors. Because youth are heavy media consumers and have access to unsupervised, repeat viewing of media content on their personal mobile devices, it is critical to understand the frequency of encountering alcohol content in adolescents' daily lives and how adolescents engage with the content.
Objective: This paper outlines the study protocol for examining adolescents' exposure to alcohol-related content in digital media within their natural environments.
JAMA Intern Med
September 2025
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Importance: Hospitals have reported growing difficulty in discharging patients in a timely manner, often citing bottlenecks in postacute care. Medicare Advantage plans, now the dominant form of Medicare coverage, may contribute to these delays due to administrative and network constraints, yet national evidence is lacking.
Objective: To quantify changes in hospital length of stay for Medicare Advantage vs traditional Medicare beneficiaries.