Proteus Donna is a randomised controlled trial aimed at prospectively evaluating screening with digital breast tomosynthesis (DBT), including interval cancer detection (ICD) and cancer detection (CD) in the analysis as a cumulative measure over subsequent screening episodes. Consenting women aged 46 to 68 attending the regional Breast Screening Service were randomly assigned to conventional digital mammography (DM, control arm) or DBT in addition to DM (DBT, study arm). At the subsequent round all participants underwent DM. Thirty-six months follow-up allowed for the identification of cancers detected in the subsequent screening and interscreening interval. Relative risk (RR) and 95% confidence interval (95% CI) were computed. Cumulative CD and Nelson-Aalen incidence were analysed over the follow-up period. Between 31 December 2014 and 31 December 2017, 43 022 women were randomised to DM and 30 844 to DBT. At baseline, CD was significantly higher (RR: 1.44, 95% CI: 1.21-1.71) in the study arm. ICD did not differ significantly between the two arms (RR: 0.92, 95% CI: 0.62-1.35). At subsequent screening with DM, the CD was lower (nearly significant) in the study arm (RR: 0.83, 95% CI: 0.65-1.06). Over the follow-up period, the cumulative CD (comprehensive of ICD) was slightly higher in the study arm (RR: 1.15, 95% CI: 1.01-1.31). The Nelson-Aalen cumulative incidence over time remained significantly higher in the study arm for approximately 24 months. Benign lesions detection was higher in the study arm at baseline and lower at subsequent tests. Outcomes are consistent with a lead time gain of DBT compared to DM, with an increase in false positives and moderate overdiagnosis.
The year 2017 was characterized by warmer- to much-warmer-than-average conditions across much of the globe's land and ocean surfaces. Record warmth was observed across parts of the western and central Pacific Ocean, western Indian Ocean, southern South America, and the southwestern contiguous U.S. and scattered across parts of the northern Atlantic Ocean, Africa, the Middle East, and eastern Asia. Averaged separately, the global land surface temperature was 1.31C (2.36F) above the 20th century average and also the third highest in the 138-year record, behind 2016 (warmest) and 2015 (second warmest). The global oceans also had their third warmest year since global records began in 1880 at 0.67C (1.21F) above the 20th century average. Only the years 2016 and 2015 were warmer.
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The third and final season of the American television series Hannibal premiered on June 4, 2015. The season is produced by Dino de Laurentiis Company, Living Dead Guy Productions, AXN Original Productions, and Gaumont International Television, with Sidonie Dumas, Christophe Riandee, Katie O'Connell, Elisa Todd Ellis, David Slade, Steve Lightfoot, Martha De Laurentiis, and Bryan Fuller serving as executive producers. Fuller serves as the series developer and showrunner, co-writing all 13 episodes of the season.
The season was ordered in May 2014.[1] The season stars Hugh Dancy, Mads Mikkelsen, Caroline Dhavernas, Gillian Anderson, and Laurence Fishburne, with Scott Thompson and Aaron Abrams receiving "also starring" status. The series is based on characters and elements appearing in Thomas Harris' novels Red Dragon (1981), Hannibal (1999), and Hannibal Rising (2006) and focuses on the relationship between FBI special investigator Will Graham and Dr. Hannibal Lecter, a forensic psychiatrist who is secretly a cannibalistic serial killer. The first half of the season serves as a loose adaptation of Hannibal while also adapting some elements from Hannibal Rising; the second half of the season adapts the plot of Red Dragon. The first seven episodes of season are named after different courses of Italian cuisine,[2] the subsequent six are named for William Blake's series of The Great Red Dragon Paintings,[3] and the finale's title is a phrase from Revelation 6:16.[4]
In October 2014, Tao Okamoto was announced to play Lady Murasaki, "who possesses an alluring and classical beauty with a dark secret."[32] However, Fuller clarified that Okamoto would play Chiyoh, Lady Murasaki's attendant.[33] The season also introduced Will Graham's wife, Molly, in the eighth episode, with Nina Arianda joining the series in January 2015.[34][35] Soon, Glenn Fleshler joined to play Dr. Cordell Doemling, "the personal doctor to a disfigured Mason Verger, quiet, very intelligent, and definitely creepy."[36]
On July 24, 2014, part of the cast and crew attended the 2014 San Diego Comic-Con to promote the season.[48] The first teaser premiered in January 2015.[49] In October 2014, the cast and crew attended the 2014 New York PaleyFest.[33] In June 2015, Fuller attended the 2015 ATX Television Festival to promote the season and show a sneak peek of the second episode, "Primavera".[50]
Joshua Rivera of Business Insider stated that "Hannibal is a show that puts all of its chips on the table, blows up that table, and then builds something even more fascinating from what remains", and hailed it as one of the best shows on television.[71] Dominic Patten of Deadline Hollywood also gave the first few episodes positive reviews also stating the show returns better than ever.[72] The acting of Mads Mikkelsen and Gillian Anderson was particularly praised, with Bloody Disgusting writing, "Gillian Anderson's performance pushes Mads Mikkelsen in ways never thought possible," while also giving praise to creator and writer Bryan Fuller saying he creates "meticulously detailed scripts that define his characters in completely unpredictable ways." The review concludes by stating season 3 "re-establishes Hannibal as the best horror show on television."[73] Chris Cabin of Slant Magazine gave it a very positive review, with four stars, and wrote that season 3 is "even more incisively and ambitiously written than the last season, and sporting the most radically expressive imagery currently on television."[74] Jeff Jensen of Entertainment Weekly rated it an "A-" and wrote, "Hannibal remains the most engrossing (and gross) serial-killer drama on television, and the most beautiful."[75]
Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability. Identifying which patients, procedures and settings are most at risk would offer a significant contribution to HAI management and prevention. The purpose of this study is to estimate 1) orthopaedic implantable device-related infection (OIDRI) prevalence in Italian hospitals and 2) the gap between the remuneration paid by the Italian healthcare system and the real costs sustained by Italian hospitals to treat these episodes.
This is a cross-sectional study based on hospital discharge forms registered in 2012 and 2014. To address the first goal of this study, the national database was investigated to identify 1) surgical procedures associated with orthopaedic device implantation and 2) among them, which patient characteristics (age, sex), type of admission, and type of discharge were associated with a primary diagnosis of infection. To address the second goal, 1) each episode of infection was multiplied by the remuneration paid by the Italian healthcare system to the hospitals, based on the diagnosis-related group (DRG) system, and 2) the total days of hospitalization required to treat the same episodes were multiplied by the average daily cost of hospitalization, according to estimates from the Ministry of the Economy and Finance (MEF).
Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability on a global scale [1, 2]. In Europe, 3,2 million patients are estimated to receive an HAI diagnosis each year, of whom approximately 37,000 die [3]. Point prevalence surveys from 23 European countries estimated HAI prevalence to be 6.5% in acute care hospitals and 3.9% in long-term care facilities [4]. This is consistent with recent trends observed in Italian healthcare settings, where the prevalence of HAI episodes was estimated to be between 6.5 and 7.1% in acute care [5, 6] and between 3.4 and 3.9% in long-term care settings [6, 7]. The levels of antimicrobial resistance were also high in both settings, most frequently affecting the bloodstream, lower respiratory tract, and surgical site [5, 8,9,10,11].
The aim of this study is to estimate 1) OIDRI prevalence in Italian hospitals, both in general and in relation to specific procedures, demographic characteristics of patients, type of admission and type of discharge, and 2) the gap between the remuneration paid by the SSN to Italian hospitals and the real costs sustained by the latter to treat OIDRI episodes.
The authors selected only those forms that reported an orthopaedic implantation procedure and a diagnosis of infection as primary codes [29, 30]. This decision was made for several reasons: 1) the degree of HDF compilation varies significantly among professionals, since some operators report only the main reason for admission, while others fill the form more comprehensively; therefore, selecting only primary codes is a way to ensure that the patient was admitted due to an episode of OIDRI; 2) a diagnosis of infection may be reported in the form of a secondary (or further) admission even if the actual episode of infection occurred and was treated in a previous admission; therefore, a singular episode of infection followed by complications and readmissions could be reported two or more times.
The HDF database was analysed for 2 years, 2012 and 2014, to measure the eventual change in overall prevalence. Detailed information on which procedures, patient ages and sex, types of admission and types of discharge were more frequently associated with an episode of OIDRI are reported only for 2014 in order to describe the latest data available and offer a more concise view of the results. be457b7860
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