The increasing availability of voluntary assisted dying (VAD) signifies a major shift in how communities perceive and experience death. Access to VAD can be seen as a new step in the shared meaning-making through which communities respond to death and dying and a new opportunity to engage communities in developing death literacy. The Australian Capital Territory (ACT) VAD legislation took effect in late 2025. This paper describes the initial co-creation of a multi-phase project (Getting Ready) seeking to develop end-of-life choices education in partnership with ACT communities. A co-creation process involving researchers, healthcare and community organisations and community members. A participatory action research paradigm was used. This supported a local approach to co-creation developed in accordance with the principles and stages described by Vargas et al. and Roper et al. Key resources and communities including priority populations with structural vulnerabilities were identified. Inter-relationships and shared values between communities were analysed and utilised to support the fostering of connections. The scope of the collaboration and key contributors to safe engagement were defined. Specific approaches to supporting community participation in Getting Ready were designed, including the development and training of community facilitators to support priority population involvement in the project. Co-creation is a useful mechanism to enable community engagement with the development of projects and resources focused on end-of-life choices education. These approaches support the inclusion of priority populations in death literacy research and resource development. Death literacy is a safe and useful concept to explore within community education development in an environment where VAD has been recently legislated. The increasing availability and use of voluntary assisted dying indicates a shift in how communities think about death and dying. It also likely means that new approaches to education to prepare for death and dying would be useful. This paper describes an approach to developing these sorts of resources in the Australian Capital Territory where VAD has recently become available. To do this the research team has begun working with local community members and organisations to determine how best to develop these sorts of education resources using a research technique called co-creation. This paper describes the steps that were used to do this co-creation in the ACT and how this has made their education development research more useful, safe and successful.
Healthcare-associated infections (HAIs) remain a major source of morbidity in solid organ transplant recipients, particularly in liver transplant (LT) intensive care units (ICUs), where profound immunosuppression and extensive antimicrobial exposure shape local microbial ecology. While reductions in overall infection incidence have been reported in structured surveillance programs, longitudinal changes in pathogen distribution and antimicrobial resistance (AMR) in transplant-specific ICUs remain insufficiently characterized. We aimed to evaluate pandemic-associated shifts in microbial ecology and AMR patterns across a 10-year surveillance period in a high-volume LT ICU. This retrospective analysis was based on prospectively collected surveillance data from adult LT recipients admitted between January 2015 and December 2024. The study period was categorized into prepandemic (2015-2019), pandemic (2020-2021), and postpandemic (2022-2024) phases. All analyses were performed at the HAI-episode level. Isolation density was calculated per 1000 patient-days. Incidence rate ratios were estimated using Poisson regression models with patient-days included as an offset. Period-related differences in AMR were evaluated using logistic regression. A two-sided P value <0.05 was considered statistically significant. Among 7717 patients corresponding to 48,001 patient-days, 380 clinically significant isolates were analysed. Gram-negative organisms remained predominant throughout the study period, while Gram-positive isolates demonstrated a significant decreasing trend over time. Acinetobacter spp. (31.3%), Klebsiella spp. (25.8%), and Pseudomonas spp. (15.0%) were the leading pathogens. Isolation densities of Acinetobacter spp. and Escherichia coli were significantly higher in the prepandemic period than in the postpandemic period. In contrast, the pandemic and postpandemic phases were associated with significant increases in resistance probabilities among major Gram-negative pathogens. Acinetobacter spp. showed higher resistance to meropenem and amikacin, Klebsiella spp. demonstrated increased aminoglycoside and fluoroquinolone resistance, and Pseudomonas spp. exhibited increased ciprofloxacin resistance in 2020-2024 compared with 2015-2019. In this transplant-specific ICU, microbial ecology and resistance trajectories evolved independently of overall infection incidence trends. Pandemic-associated healthcare disruptions were accompanied by organism-specific resistance shifts rather than uniform ecological changes. Continuous surveillance and locally tailored antimicrobial stewardship strategies are essential to preserve therapeutic efficacy and mitigate the growing threat of multi-drug-resistant (MDR) pathogens in transplant ICUs.
Impaired cerebral blood flow in preterm neonates is a risk factor for developing brain injury. High-frame-rate (HFR) ultrasound (US) imaging using plane-wave transmissions enables spectral Doppler-based flow analysis in all imaging pixels with high spatiotemporal resolution and sensitivity, potentially providing a better indicator of neonatal cerebral blood flow. The aim was to investigate the feasibility of HFR US in measuring cerebral blood flow velocities in the periventricular zone of newborn infants. Secondary aims: (i) differentiate between venous and arterial flow, (ii) investigate the impact of unilateral brain injury on blood flow and (iii) examine the influence of patient variables on HFR results. In a prospective cohort study, 2-D HFR US imaging data in (pre)term infants were recorded with a custom HFR mode on a Zonare ZS3 system with a high-frequency linear probe (L20-5). Data were analyzed offline to calculate peak systolic velocity (PSV), end diastolic velocity, resistivity index and the new flow index (FI), defined as the average PSV across all blood flow pixels within a region of interest. HFR US was performed in 81 patients (118 HFR recordings) of which 72 recordings were excluded due to technical limitations or insufficient image quality. In the remaining 46 recordings, arterial and venous flow could be reliably distinguished. In neonates with unilateral intracranial pathology (n = 12), the median FI was higher on the affected side (1.62, IQR 1.48-1.79) compared to the contralateral side (1.41, IQR 1.33-1.50; p = 0.002). Across all recordings, FI showed no significant correlation with birth weight (ρ = 0.11, p = 0.42), post-menstrual age (ρ = 0.07, p = 0.56), z-scores or mean airway pressure in ventilated infants. Obtaining qualitative and quantitative flow indices with HFR US imaging is feasible in a population of neonates. HFR-derived perfusion indices may play an important role in understanding and preventing neonatal brain injury.
Above-ground microbial communities associated with non-native invasive plants are infrequently characterized, particularly during the early stages of an invasion event. This study compared the foliar fungal and bacterial microbiomes of two co-occurring invasive grasses found in the Mid-Atlantic United States, recently introduced Oplismenus undulatifolius and long-established Microstegium vimineum. Amplicon sequencing was used to characterize endophytic communities collected from replicate plots within two field sites, and microbial community diversity, composition, and structure were contrasted between hosts. Despite occupying the same niche space, these invasive grasses carried significantly different microbial communities. Oplismenus supported lower within-sample fungal diversity and greater among-sample heterogeneity than Microstegium, while differences in bacterial communities were weaker and depended on the diversity metric examined. Null model analyses suggested that assembly processes were host- and microbial kingdom-specific. The differences observed between hosts may have resulted from several non-exclusive mechanisms but were generally consistent with an incomplete establishment of stable host-associated symbioses by the more recent invader. Differential abundance analyses also identified multiple host-associated fungal and bacterial lineages, including increased representation of Glomerellales, Pleosporales, and Rhizobiales in Oplismenus. The results of this study contribute to our understanding of co-occurring invasive weed communities and provide insight into the formation of an emerging, invasive Oplismenus microbiome.
Red blood cell (RBC) transfusion is common during venoarterial extracorporeal membrane oxygenation (VA-ECMO), but the prognostic relevance of early cumulative transfusion burden and hemoglobin (Hb) at transfusion initiation remains uncertain. We examined associations of ECMO day-1 RBC dose and, among transfused patients, first-transfusion Hb and transfusion-pattern phenotype with in-hospital mortality. Adults aged ≥18 years initiating peripheral VA-ECMO at six Korean centers between January 2018 and March 2025 were analyzed. The primary analysis used a 24 -h landmark cohort of patients alive and still receiving ECMO beyond 24 h. Day-1 RBC dose was categorized as 0, 1-2, 3-4, or ≥5 units and modeled per 2-unit increase. Adjusted risk ratios (RRs) were estimated using modified Poisson regression. Secondary analyses assessed first-transfusion Hb and consistent- versus variable threshold phenotypes among transfused complete cases. Among 2,020 included patients, 1,708 entered the 24-h landmark cohort, and 1,140 complete cases comprised the adjusted primary analysis. Compared with no day-1 transfusion, adjusted RRs for in-hospital mortality were 1.20 (95% confidence interval [CI], 1.02-1.40) for 1-2 units, 1.37 (95% CI, 1.17-1.59) for 3-4 units, and 1.48 (95% CI, 1.28-1.71) for ≥5 units. Each 2-unit increase was associated with higher mortality (adjusted RR, 1.08; 95% CI, 1.05-1.11), with concordant findings over ECMO days 1-2 (adjusted RR, 1.06; 95% CI, 1.04-1.08). Among 1,043 transfused complete cases with qualifying pretransfusion Hb, each 1 g/dL decrease in first-transfusion Hb was associated with higher mortality (adjusted RR, 1.15; 95% CI, 1.10-1.20). The association was evident in the consistent-threshold phenotype (adjusted RR, 1.16; 95% CI, 1.10-1.22) but not in the variable-threshold phenotype (adjusted RR, 1.02; 95% CI, 0.92-1.12). In adults receiving peripheral VA-ECMO, early RBC transfusion burden showed a graded association with in-hospital mortality, whereas lower first-transfusion Hb was a prognostic marker chiefly within the consistent-threshold phenotype. These findings support dose- and threshold-aware prognostic assessment but do not establish causality or define an optimal transfusion threshold.
Group B Streptococcus (GBS) is a leading cause of neonatal morbidity, preventable via intrapartum antibiotic prophylaxis (IAP). To determine the proportion of GBS-positive mothers among the screened population, evaluate IAP protocol adherence, and identify clinical risk factors and outcomes. Single-center retrospective cohort study. Labor and Delivery Suite at King Saud University Medical City (KSUMC), Riyadh. Electronic medical records (July 2021-December 2022) were reviewed for pregnant women (≥35 weeks) who were screened or had GBS bacteriuria, along with their neonates. Multivariate logistic regression was used to determine risk factors. Proportion of GBS-positive mothers among the screened population, IAP timing, maternal febrile morbidity, neonatal intensive care unit (NICU) admissions, and culture-positive sepsis. Of the 5292 deliveries, 688 unscreened elective cesareans were excluded, leaving 4604 screened women and 180 GBS-positive dyads. The proportion of GBS-positive mothers among the screened population was 3.91% (180/4604). Although 67.2% (121/180) of colonized women received IAP, only 15.6% (28/180) received it ≥4 hours before delivery. Maternal febrile morbidity was 0% (0/180). The neonatal intensive care unit (NICU) admission rate was 8.3% (15/180), and culture-positive neonatal sepsis occurred in 1.1% (2/180) of cases. GBS bacteriuria independently predicted adverse neonatal outcomes (aOR 2.35, 95% CI: 1.12-4.92, P=.024), while preterm delivery showed a negative correlation (aOR 0.29, 95% CI: 0.11-0.76, P=.012). The proportion of GBS-positive mothers in the screened population is low (3.91%). While perinatal outcomes were generally excellent regardless of antibiotic timing, GBS bacteriuria was identified as a significant, independent predictor of adverse neonatal outcomes. These findings highlight a biologically plausible risk pathway that warrants validation in larger, multi-center prospective studies.
Tropical Africa encompasses several biodiversity hotspots, yet knowledge of ectomycorrhizal (EcM) fungi, key organisms for forest ecosystem functioning, remains fragmented. This study provides the first comprehensive synthesis of EcM fungi across the region, aiming to (i) establish a species checklist as a basis for estimating gamma diversity, (ii) analyze spatial turnover across countries, and (iii) assess the functional effects of EcM fungi on tree seedling growth. We conducted a systematic literature search following PRISMA guidelines, retaining 158 publications published between 1927 and 2025. Species occurrence records were extracted from publications and complemented with data from GlobalFungi and GBIF databases. Statistical analyses in R were used to estimate species richness (Chao2, Jackknife 1 and Jackknife 2), analyze spatial turnover (Jaccard dissimilarity, Mantel correlogram, Generalized Dissimilarity Modelling), and assess the overall effect on tree seedling growth (cross-classified random-effects meta-analysis). We recorded 711 EcM fungal species from 59 genera and 20 families. Russula (169 species), Amanita (81), and Lactifluus (71) were the most represented. Estimated richness reached 1,226 species, indicating substantial undocumented diversity. Community composition showed extremely high heterogeneity among countries (95% dissimilarity), and increased turnover over broader geographic distances (r = -0.13, p < 0.05), suggesting dispersal limitation. Meta-analysis revealed that EcM fungi increased tree seedling growth by an average of 6% per month (p < 0.05), with Scleroderma verrucosum showing particularly strong positive effects. These findings indicate that EcM fungi are unevenly distributed across tropical Africa. They refine our understanding of diversity patterns and highlight the need for targeted sampling and integrating native EcM fungi into forest restoration.
The Duffy antigen receptor for chemokines (DARC) on the human red blood cell (RBC) surface is a key receptor for Plasmodium vivax and Plasmodium knowlesi invasion. Non-synonymous polymorphisms in the DARC transcriptional unit generate two codominant alleles, FY*A (FY*01) and FY*B (FY*02), which confer Duffy-positive phenotypes, and the FY*ES (FY*02N.01), which in homozygosity results in a Duffy-negative phenotype that impairs RBC invasion by both species. A less frequent variant, the FY*X (FY*02W.01) allele, reduces DARC abundance on the RBC membrane and is predominantly found in Caucasian populations. Its impact on P. knowlesi RBC invasion remains poorly investigated. Here, we measured the impact of FY*X homozygosity on the human-adapted P. knowlesi line A1-H.1 invasion. Duffy phenotypes of seven blood donors were determined using agglutination-based assays, and targeted sequencing confirmed FY*X homozygosity in one donor. Plasmodium knowlesi invasion was quantified in RBCs from donors with different Duffy types in a single experiment. After one invasion cycle, fold multiplication was markedly reduced in FY*X homozygous RBCs (1.5) compared to Duffy-positive donors (5.1-6.5). These findings demonstrate that, despite its low frequency, the FY*X allele substantially limits RBC invasion of P. knowlesi in vitro, underscoring the need for accurate Duffy typing in culture-based studies.
The arginine-sparing potential of guanidinoacetic acid (GAA) has been well documented; however, information regarding its effects on energy dynamics and nitrogen balance in broilers is limited. This study evaluated the effects of dietary GAA supplementation on heat increment, net energy, efficiency of energy utilization, and nitrogen and energy balance in broilers using closed-circuit calorimetry chambers. One-d-old Ross 308 male broilers (39 ± 1 g, n = 80) were fed common starter and grower diets until 18 d of age. From d 19, birds continued to receive the grower diet supplemented with 0, 0.03%, 0.06%, or 0.09% GAA. Following an acclimation period in chambers (d 22-25), indirect calorimetry measurements were conducted from d 25 to 28. Each dietary treatment consisted of eight replicate chambers with 2 birds per chamber divided across two consecutive experimental runs. In each run, there were four replicate chambers per treatment. The efficacy of GAA on growth performance was evidenced by a linear improvement in feed conversion ratio (FCR; P = 0.022), along with a tendency for quadratic responses in weight gain (WG; P = 0.057) and feed intake (P = 0.080) as GAA levels increased. Dietary GAA did not affect (P > 0.05) apparent metabolizable energy (AME) or nitrogen-corrected AME (AMEn) of the feed. However, dietary net energy (NE) tended to increase linearly (P = 0.063) with increasing GAA inclusion. The efficiency of AME utilization for NE, expressed as NE/AME and NE/AMEn, was affected by GAA supplementation, with a linear increase in NE/AMEn (P = 0.017) and a tendency for a linear increase in NE/AME (P = 0.062). Dietary GAA linearly decreased (P = 0.031) AME intake per unit of WG while it had no impact (P > 0.05) on NE intake. Increasing dietary GAA levels increased nitrogen (N) retention in a quadratic manner (P = 0.017) and linearly improved N utilization efficiency (P = 0.002). Heat production decreased linearly (P = 0.015) with increasing GAA concentration. The retained energy as protein increased quadratically (P = 0.022) and retained energy as fat tended to decrease linearly (P = 0.090) with increasing GAA levels. In conclusion, dietary GAA reduced heat production and the efficiency of AME utilization for NE, and favourably modulated body energy partitioning by enhancing energy retention as protein, thereby improving feed efficiency in broilers.
During the COVID-19 pandemic, inter-hospital transfer of critically ill patients between intensive care units was widely used to manage capacity shortages. While several individual studies have compared outcomes of transferred and non-transferred patients, no systematic synthesis of this evidence exists. This systematic review aims to determine whether inter-hospital ICU-to-ICU transfer of adult COVID-19 patients is associated with increased mortality or other adverse clinical outcomes. We systematically searched PubMed, Web of Science, and Scopus for observational studies comparing clinical outcomes of adult COVID-19 patients who underwent inter-hospital ICU-to-ICU transfer with non-transferred ICU patients. Two reviewers screened, selected, and extracted data independently and in duplicate. Risk of bias was assessed using the Newcastle-Ottawa Scale and ROBINS-I, and certainty of evidence using GRADE. Exploratory random-effects meta-analyses were performed separately for each effect measure, with Hartung-Knapp and crude-effect sensitivity analyses. Nine observational studies from seven countries were included (approximately 6,100 transferred and 29,200 non-transferred ICU patients). None of the adjusted effect estimates showed a statistically significant mortality disadvantage for transferred patients. Pooled adjusted subgroup estimates were an odds ratio of 1.29 (95% CI 0.84 to 1.98; k = 3) and a hazard ratio of 0.71 (95% CI 0.34 to 1.46; k = 2). Length of stay was longer in transferred patients in most studies. The available observational evidence did not show a clear increase in mortality among transferred compared with non-transferred COVID-19 ICU patients. These findings support the use of inter-hospital transfer as a safe strategy for managing ICU surge capacity. PROSPERO CRD420261356915.
Industrial oily wastewater and oil spills pose serious environmental threats, demanding efficient and scalable separation materials. In this work, a hydrophobic/oleophilic ZIF-8/polyurethane sponge (ZIF-8/PUS) composite was fabricated via a simple dip-coating and drying process at room temperature. The composite was characterized by X-ray diffraction, FTIR, scanning electron microscopy (SEM), Brunauer-Emmett-Teller (BET) surface area analysis, and Barrett-Joyner-Halenda (BJH) pore size distribution, confirming successful ZIF-8 deposition and a well-developed porous architecture. The water contact angle increased from 96.8 to 148.4°, while the oil contact angle remained 0°. The sponge achieved an oil absorption capacity of 36.1 g g⁻1 for 15W-40 oil and a water flux of 107 L m⁻2 h⁻1. Temperature-dependent separation tests (25-85 °C) yielded COD removal efficiencies of 99.24-97.55% and oil and grease removal of 99.20-97.74%. Statistics on triple experiments validated these results' robustness: One-way ANOVA showed significant differences in COD and oil/grease removal among experimental groups (p < 0.0001), and Tukey's HSD test showed that optimally adjusted samples outperformed controls (p < 0.05). The sponge retained performance after ten absorption-squeezing cycles. Application to real drilling rig wastewater (RIG-69 Fath unit) achieved 94.97% COD removal (6689 to 67 mg L⁻1) and 99.07% oil and grease removal, demonstrating practical potential for industrial oily wastewater treatment.
Physical literacy integrates physical, affective, cognitive and social elements into a holistic framework for physical activity. Despite the increasing recognition of physical literacy across many sectors, the entire field lacks a prospective roadmap for research, practice and policy. Seeking to determine the content of a 'Global Physical Literacy (GloPL) Action Framework,' this study aimed to define goals, principles, actions and pathways that can advance the physical literacy field worldwide. A group Delphi study (based on published protocol) engaged 59 physical literacy-focused academics from 46 countries, 7 representatives of literature gaps, and 24 individuals representing societies/organisations. The representatives independently generated ideas for action through online surveys (Qualtrics). The ideas underwent reflexive thematic analysis (NVivo), informing the subsequent discussions in six online meetings. All decisions were supported by formal voting with pre-defined agreement thresholds for two rounds of voting. Analysis resulted in 849 initial codes grouped into five themes: advocacy, practice, education, assessment and research. Members discussed 15 central topics, of which six reached agreement in the first voting round and nine in the second voting round. Key recommendations included: establishing a core set of physical literacy elements/principles (advocacy); generating more resources/programmes on physical literacy (practice); aligning physical education curricula with physical literacy principles (education); assessing physical literacy at the population level (assessment); and emphasising implementation science (research). The comprehensive consensus findings will inform the pillars of the first GloPL Action Framework. Its release marks the beginning of a dynamic process intended to guide coordinated actions on physical literacy in education, public health, sport, healthcare/promotion, rehabilitation, active recreation and community services/development.
To determine the effect of initial rhythm on 6-month survival with favourable functional outcomes in patients supported with extracorporeal cardio pulmonary resuscitation (ECPR) for in-hospital cardiac arrest and out-of-hospital cardiac arrest (IHCA and OHCA).Design/Setting/Participants: This multicentre cohort study used secondary data from the EXCEL registry, a binational extracorporeal membrane oxygenation (ECMO) database across Australia and New Zealand. Adults receiving ECPR between February 2019 and December 2022 were included. The primary outcome was 6-month survival with a favourable functional outcome, defined using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 (12-item survey). Secondary outcomes included: survival (intensive care unit [ICU], hospital, 90- and 180-day), duration of ECMO and ventilation, ICU and hospital length of stay, and work status at 6 months. Among 249 patients, 123 (49.4%) had an initial shockable rhythm and 126 (50.6%) had a nonshockable rhythm. Overall, 16% (40/249) survived with favourable functional outcomes. Rates were higher in the shockable group (21% vs. 11%, p = 0.031), despite the non-shockable group having more witnessed arrests (98 vs. 90%, p = 0.005) and shorter low-flow times (46.8 vs 65.5 min, p = 0.003). Survivors with a nonshockable rhythm had longer ICU (19.8 vs. 12.7 days, p = 0.028) and hospital stays (39.6 vs. 27.0 days, p = 0.003). Unemployment due to health issues at 6 months was similar between the shockable (14/40 [35%]) and nonshockable (12/32 [37.5%]) groups (p = 0.826). An initial shockable rhythm was associated with higher 6-month survival with favourable functional outcomes after ECPR. Larger studies are needed to confirm whether rhythm-guided selection may improve patient outcomes.
暂无摘要（点击查看详情）
Type 2 diabetes is a major risk factor for cardiovascular disease, and reducing this excess risk is a central goal of clinical management. Sustained adherence to glucose-lowering medication is considered a key component of this strategy. However, long-term patterns of medication-taking behavior in real-world settings, and their relationship with cardiovascular outcomes, remain insufficiently characterized. We conducted a nationwide cohort study of Danish adults with newly diagnosed type 2 diabetes who initiated non-insulin glucose-lowering medication between 2005 and 2012. Medication adherence was estimated from pharmacy dispensing data, and group-based trajectory modeling was used to identify longitudinal adherence patterns. The primary outcome was a composite cardiovascular outcome including ischemic heart disease, stroke, or heart failure. Associations between adherence trajectories and cardiovascular outcomes over 10 years of follow-up were assessed with Cox proportional-hazards models. Among 79,510 individuals with newly diagnosed type 2 diabetes (median age, 61 (IQR: 52-69); 57% men), we identified three long-term adherence trajectories defined by high (n = 32,912; 41%), intermediate (n = 25,822; 33%), and low (n = 20,776; 26%) adherence. During follow-up, 15,276 cardiovascular events occurred. Compared with the high-adherence group, adjusted hazard ratios for the composite cardiovascular outcome were 1.07 (95% CI, 1.03-1.12) and 1.27 (95% CI, 1.21-1.33) in the intermediate- and low-adherence groups, respectively. Participants with high adherence remained free of cardiovascular events for an average of 220 more days (95% CI, 204-237) over 10 years. Associations were largely driven by ischemic heart disease, with no significant associations for heart failure. Long-term adherence to glucose-lowering medication was associated with lower cardiovascular rate and longer event-free survival time among individuals with newly diagnosed type 2 diabetes. Novo Nordisk Foundation and the European Innovation Council.
Nonattendance can substantially decrease the effectiveness of existing and potential future population-based screening programmes for (prostate) cancer. We evaluated the long-term association between nonattendance and prostate cancer-specific mortality (PCSM) in the European Randomised Study of Screening for Prostate Cancer (ERSPC), with up to 20 yr of follow-up. This secondary analysis included 161 380 men aged 55-69 yr randomised to receive invitations for Prostate-specific antigen-based (PSA)-based screening (n = 72 460, screening arm [SA]) or to the control arm (CA) (n = 88,920) across seven ERSPC centres. Within the SA, men were classified as screening never-attenders (no attendance at any screening round) or screening ever-attenders (attended at least one screening round). The primary endpoint was PCSM. Cumulative incidence of PCSM was calculated using competing risk analysis, accounting for death from other causes as a competing event. Poisson regression was used to estimate rate ratios (RR) of cumulative PCSM between three groups: screening never-attenders, ever-attenders, and CA. Of the 72 460 men in the SA, 12,401 (17%) were defined as never-attenders. At 20 yr, the cumulative PCSM was 1.4% (95% confidence interval [CI], 1.2-1.6) among never-attenders, 1.2% (95% CI, 1.2-1.3) in the CA, and 1.0% (95% CI, 0.9-1.0) in ever-attenders. For PCSM, we observed an RR of 1.39 (95% CI, 1.2-1.6; p < 0.001) for never-attenders compared to the CA, while for ever-attenders compared to the CA, we observed an RR of 0.77 (95% CI, 0.69-0.85; p < 0.001). Data on determinants of attendance are lacking. Men randomised to the SA but who never attended had higher observed PCSM than men in the CA who were not offered screening. Conversely, men in the SA who attended screening had lower observed PCSM than men in the CA, with a larger observed difference than that reported in prior intention-to-screen analyses. Trial registration: ISRCTN49127736.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）