The association of smoking with different eating and dietary behaviours: A cross-sectional analysis of 80 296 United Kingdom adults.

BACKGROUND AND AIMS: Smokers typically have a lower body mass index (BMI) than non-smokers, while smoking cessation is associated with weight gain. In pre-clinical research, nicotine in tobacco smoking suppresses appetite and influences subsequent eating behaviour; however, this relationship is unclear in humans. This study measured the associations of smoking with different eating and dietary behaviours. DESIGN: A cross-sectional analysis of data from health assessments conducted between 2004 and 2022. SETTING: An independent healthcare-based charity within the United Kingdom. PARTICIPANTS: A total of 80 296 men and women (mean ± standard deviation [SD]: age, 43.0 ± 10.4 years; BMI, 25.7 ± 4.2 kg/m2; 62.5% male) stratified into two groups based on their status as a smoker (n = 6042; 7.5%) or non-smoker (n = 74 254; 92.5%). MEASUREMENTS: Smoking status (self-report) was the main exposure, while the primary outcomes were selected eating and dietary behaviours. Age, sex and socioeconomic status (index of multiple deprivation [IMD]) were included as covariates and interaction terms, while moderate-to-vigorous exercise and sleep quality were included as covariates only. FINDINGS: Smokers had lower odds of snacking between meals and eating food as a reward or out of boredom versus non-smokers (all odds ratio [OR] ≤ 0.82; P < 0.001). Furthermore, smokers had higher odds of skipping meals, going more than 3 h without food, adding salt and sugar to their food, overeating and finding it hard to leave something on their plate versus non-smokers (all OR ≥ 1.06; P ≤ 0.030). Additionally, compared with non-smokers, smoking was associated with eating fried food more times per week (rate ratio [RR] = 1.08; P < 0.001), eating fewer meals per day, eating sweet foods between meals and eating dessert on fewer days per week (all RR ≤ 0.93; P < 0.001). Several of these relationships were modified by age, sex and IMD. CONCLUSIONS: Smoking appears to be associated with eating and dietary behaviours consistent with inhibited food intake, low diet quality and altered food preference. Several of these relationships are moderated by age, sex and socioeconomic status.

Improved clinical outcomes in response to a 12-week blended digital and community-based long-COVID-19 rehabilitation programme.

Introduction: Two million people in the UK are experiencing long COVID (LC), which necessitates effective and scalable interventions to manage this condition. This study provides the first results from a scalable rehabilitation programme for participants presenting with LC. Methods: 601 adult participants with symptoms of LC completed the Nuffield Health COVID-19 Rehabilitation Programme between February 2021 and March 2022 and provided written informed consent for the inclusion of outcomes data in external publications. The 12-week programme included three exercise sessions per week consisting of aerobic and strength-based exercises, and stability and mobility activities. The first 6 weeks of the programme were conducted remotely, whereas the second 6 weeks incorporated face-to-face rehabilitation sessions in a community setting. A weekly telephone call with a rehabilitation specialist was also provided to support queries and advise on exercise selection, symptom management and emotional wellbeing. Results: The 12-week rehabilitation programme significantly improved Dyspnea-12 (D-12), Duke Activity Status Index (DASI), World Health Orginaisation-5 (WHO-5) and EQ-5D-5L utility scores (all p < 0.001), with the 95% confidence intervals (CI) for the improvement in each of these outcomes exceeding the minimum clinically important difference (MCID) for each measure (mean change [CI]: D-12: -3.4 [-3.9, -2.9]; DASI: 9.2 [8.2, 10.1]; WHO-5: 20.3 [18.6, 22.0]; EQ-5D-5L utility: 0.11 [0.10, 0.13]). Significant improvements exceeding the MCID were also observed for sit-to-stand test results (4.1 [3.5, 4.6]). On completion of the rehabilitation programme, participants also reported significantly fewer GP consultations (p < 0.001), sick days (p = 0.003) and outpatient visits (p = 0.007) during the previous 3 months compared with baseline. Discussion: The blended and community design of this rehabilitation model makes it scalable and meets the urgent need for an effective intervention to support patients experiencing LC. This rehabilitation model is well placed to support the NHS (and other healthcare systems worldwide) in its aim of controlling the impacts of COVID-19 and delivering on its long-term plan. Clinical trial registration: https://www.isrctn.com/ISRCTN14707226, identifier 14707226.

Patient-rated satisfaction and improvement following hip and knee replacements: Development of prediction models.

RATIONALE: Effective preoperative assessments of determinants of health status and function may improve postoperative outcomes. AIMS AND OBJECTIVES: We developed risk scores of preoperative patient factors and patient-reported outcome measures (PROMs) as predictors of patient-rated satisfaction and improvement following hip and knee replacements. PATIENTS AND METHODS: Prospectively collected National Health Service and independent sector patient data (n = 30,457), including patients' self-reported demographics, comorbidities, PROMs (Oxford Hip/Knee score (OHS/OKS) and European Quality of Life (EQ5D index and health-scale), were analysed. Outcomes were defined as patient-reported satisfaction and improvement following surgery at 7-month follow-up. Univariable and multivariable-adjusted logistic regressions were undertaken to build prediction models; model discrimination was evaluated with the concordance index (c-index) and nomograms were developed to allow the estimation of probabilities. RESULTS: Of the 14,651 subjects with responses for satisfaction following hip replacements 564 (3.8%) reported dissatisfaction, and 1433 (9.2%) of the 15,560 following knee replacement reported dissatisfaction. A total of 14,662 had responses for perceived improvement following hip replacement (lack of improvement in 391; 2.7%) and 15,588 following knee replacement (lack of improvements in 1092; 7.0%). Patients reporting poor outcomes had worse preoperative PROMs. Several factors, including age, gender, patient comorbidities and EQ5D, were included in the final prediction models: C-indices of these models were 0.613 and 0.618 for dissatisfaction and lack of improvement, respectively, for hip replacement and 0.614 and 0.598, respectively, for knee replacement. CONCLUSIONS: Using easily accessible preoperative patient factors, including PROMs, we developed models which may help predict dissatisfaction and lack of improvement following hip and knee replacements and facilitate risk stratification and decision-making processes.

VOC-DL: Deep learning prediction model for COVID-19 based on VOC virus variants.

BACKGROUND AND OBJECTIVE: The ever-mutating COVID-19 has infected billions of people worldwide and seriously affected the stability of human society and the world economic development. Therefore, it is essential to make long-term and short-term forecasts for COVID-19. However, the pandemic situation in different countries and regions may be dominated by different virus variants, and the transmission capacity of different virus variants diversifies. Therefore, there is a need to develop a predictive model that can incorporate mutational information to make reasonable predictions about the current pandemic situation. METHODS: This paper proposes a deep learning prediction framework, VOC-DL, based on Variants Of Concern (VOC). The framework uses slope feature method to process the time series dataset containing VOC variant information, and uses VOC-LSTM, VOC-GRU and VOC-BILSTM prediction models included in the framework to predict the daily newly confirmed cases. RESULTS: We analyzed daily newly confirmed cases in Italy, South Korea, Russia, Japan and India from April 14th, 2021 to July 3rd, 2021. The experimental results show that all VOC-DL models proposed in this paper can accurately predict the pandemic trend in the medium and long term, and VOC-LSTM model has the best prediction performance, with the highest average determination coefficient R2 of 96.83% in five nations' datasets. The overall prediction has robustness. CONCLUSIONS: The experimental results show that VOC-LSTM is the best predictor for such a series of data and has higher prediction accuracy in the long run. At the same time, our VOC-DL framework combining VOC variants has reference significance for predicting other variants in the future.

SIRVD-DL: A COVID-19 deep learning prediction model based on time-dependent SIRVD.

COVID-19 is one of the biggest challenges that human beings have faced recently. Many researchers have proposed different prediction methods for establishing a virus transmission model and predicting the trend of COVID-19. Among them, the methods based on artificial intelligence are currently the most interesting and widely used. However, only using artificial intelligence methods for prediction cannot capture the time change pattern of the transmission of infectious diseases. To solve this problem, this paper proposes a COVID-19 prediction model based on time-dependent SIRVD by using deep learning. This model combines deep learning technology with the mathematical model of infectious diseases, and forecasts the parameters in the mathematical model of infectious diseases by fusing deep learning models such as LSTM and other time prediction methods. In the current situation of mass vaccination, we analyzed COVID-19 data from January 15, 2021, to May 27, 2021 in seven countries - India, Argentina, Brazil, South Korea, Russia, the United Kingdom, France, Germany, and Italy. The experimental results show that the prediction model not only has a 50% improvement in single-day predictions compared to pure deep learning methods, but also can be adapted to short- and medium-term predictions, which makes the overall prediction more interpretable and robust.

TW-SIR: time-window based SIR for COVID-19 forecasts.

Since the outbreak of COVID-19, many COVID-19 research studies have proposed different models for predicting the trend of COVID-19. Among them, the prediction model based on mathematical epidemiology (SIR) is the most widely used, but most of these models are adapted in special situations based on various assumptions. In this study, a general adapted time-window based SIR prediction model is proposed, which is characterized by introducing a time window mechanism for dynamic data analysis and using machine learning method predicts the basic reproduction number and the exponential growth rate of the epidemic. We analyzed COVID-19 data from February to July 2020 in seven countries---China, South Korea, Italy, Spain, Brazil, Germany and France, and the numerical results showed that the framework can effectively measure the real-time changes of the parameters during the epidemic, and error rate of predicting the number of COVID-19 infections in a single day is within 5%.

Engaging Stakeholders in the Design and Usability Evaluation of a Decision Aid to Improve Secondary Stroke Prevention.

Stroke survivors have a nearly 40% risk of recurrent stroke during the first 10 years. Effective secondary stroke prevention strategies are sub-optimally used, and hence, developing interventions to enable healthcare professionals and stroke survivors to manage risk factors more effectively are required. In this paper we describe the usability evaluation of a decision aid designed in collaboration with stakeholders to reduce the risk of a recurrent stroke. The decision aid was found usable and acceptable by both general practitioners and stroke survivors. Concerns and suggestions for improving the decision aid are discussed.