Previous research into Functional Neurological Disorder (FND) has shown that there are significant barriers in providing patient-centred care. However, there has been no specific research into whether patient experiences of care for FND meet the current standards of care. This study aimed to investigate the types of problems experienced by FND patients, and whether these differed to patients with multiple sclerosis (MS). FND (n = 40) and MS patients (n = 37) were recruited from NHS tertiary neurology clinics and completed questionnaires on their experiences of health care services. Significant differences in experiences of care between the two patient groups were found, with FND patients reporting significantly more problems in their diagnosis and treatment (p = 0.003), patient-centred care (p < 0.001), relationships with healthcare professionals (p < 0.001), and in accessing community care (p = 0.001). Limitations include a small sample size, specificity to a single centre, and cross-sectional design. The results suggest that current care for FND patients is not meeting expected standards for long-term neurological conditions, highlighting the need for structured care pathways and patient-centred care.

Background:Cardiovascular diseases (CVD) still represent the leading cause of morbidity and mortality, worldwide. As, physicians have a vital role in battling the CVD epidemic by counseling and motivating people to reduce their risk, they should also set an example by taking care of their own health.

Patients diagnosed with acute pulmonary embolism (PE) are at an elevated risk for short-term mortality. An accurate prognostic model is important in guiding appropriate management. We aimed to use machine learning (ML) to predict 30-day all-cause mortality in patients diagnosed with acute PE. METHODS: 439 patients (48% men, 61AE15 years) diagnosed with acute PE at our institution were retrospectively analyzed. We included 101 variables from a range of domains including demographics, clinical, laboratory, echocardiographic, and CT imaging as candidate predictors. Machine learning algorithms including extreme gradient boosting (XGBoost), gradient boosting machine (GBM), random forest (RF), deep neural networks (DNN), and generalized linear models (GML) were evaluated on their classification performance and validated with 5-fold cross-validation. The PE severity index (PESI) and its simplified version (sPESI) were used as reference models. RESULTS: XGBoost was the best performing model in predicting 30-day all-cause mortality (AUC, 0.922 (95% confidence interval [

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Introduction Inhalation injuries (IHI) are a major source of morbidity and mortality in burn patients. The purpose of this study is to evaluate short versus long duration of nebulized heparin in IHI and its effect on ventilator-free days. Methods This was a single-center retrospective analysis of adult patients with bronchoscopy-confirmed IHI admitted to a large academic medical center with an American Burn Association-verified Burn Unit between March 2013 and March 2018, who received nebulized heparin 10,000 units every four hours for three days or until the patient no longer had carbonaceous sputum, whichever is longer. Patients were excluded if they expired within 24 hours, had less than 48 hours of mechanical ventilation, or were made comfort care. The primary outcome was ventilator-free days of the first 28 days. Secondary outcomes include in-hospital mortality, length of hospitalization, baseline and day 3 lung inhalation score, reintubation, discharge disposition, and major and minor bleeding events. Baseline demographics were compared using descriptive statistics. Nominal data was compared using Chi-square test. Continuous data was analyzed using student’s t-test or Mann-Whitney U test, as appropriate. A sample size of 24 patients to be appropriately powered (β = 0.2; α = 0.05) was required to show a mean difference of 8 days on the ventilator. Results A total of 40 patients were included in the study. Eleven patients received nebulized heparin for three days or less, and 29 patients received nebulized heparin for more than three days. Patients were primarily white, middle-aged males. More patients in the short duration group had a history of never smoking (4 vs 1, p = 0.04), and patients in the long duration group had a higher grade of inhalation injury (grade 3 vs grade 2, p = 0.01). Median ventilator free days of the first 28 was 4 days for the short duration group and 6 days for the long duration group (p = 0.88). There was no significant difference in length of hospital stay (12 days vs 20 days, p = 0.12), lung injury score, incidence of ventilator associated pneumonia, or bleeding events. No major bleeding events occurred. Conclusions This study introduces the potential use of carbonaceous sputum as a clinical marker for directing therapy and using a shorter duration of therapy as compared to previous studies. There was no difference found in ventilator free days between groups, and this study affirmed the safety of using nebulized heparin for IHI.