Displaying publications 61 - 80 of 353 in total

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  1. Sulaiman S, Leelavathi M, Norasyikin AW
    Med J Malaysia, 2020 11;75(6):655-659.
    PMID: 33219173
    INTRODUCTION: The rapid increase in Type 2 Diabetes Mellitus (T2DM) among the younger age groups is a growing concern worldwide. Thus, assessing the perception of risk and knowledge among those at risk may provide an opportunity for early intervention, delay or even prevent the onset.
    OBJECTIVE: The aim of this study was to determine the perceived risk of developing T2DM and its knowledge among the offspring of diabetic patients.
    METHODS: A cross sectional study using a self-administered questionnaire was conducted among university students whose parents had type 2 diabetes to determine their perceived risk and knowledge on T2DM.
    RESULTS: A total of 336 university students participated in this study and 56.5% of them correctly identified themselves at risk of developing T2DM. About half of them (52.7%) had higher knowledge of T2DM. Male students appeared to have better risk perception (p=0.024) compared to females while those with mothers affected by T2DM appear to have higher knowledge regarding diabetes (p=0.007). Most of their information regarding T2DM was obtained from the internet (87.5%) and other family members (77.9%).
    CONCLUSION: The students whose mothers had T2DM appear to have better knowledge and information regarding T2DM and this was mostly obtained from the internet and family members. Awareness regarding diabetes and healthy lifestyles advice through primary patients may be beneficial for their offspring.
    Study site: Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Internet
  2. Sreeramareddy CT, Majeed Kutty NA, Razzaq Jabbar MA, Boo NY
    Biosci Trends, 2012 Jun;6(3):103-9.
    PMID: 22890157 DOI: 10.5582/bst.2012.v6.3.103
    The burden of non-communicable diseases is increasing in Malaysia. Insufficient Physical Activity, which is an important risk factor for non-communicable diseases, is less researched in Malaysia. We aimed to assess the level of physical activity and identify its correlates. An online survey was carried out during October, 2011 in the University Tunku Abdul Rahman by the opinion poll research committee. Young adults answered the Short International Physical Activity Questionnaire and a questionnaire about factors according to a socio-ecological model which was adapted from published studies. Metabolic equivalent (MET)-hours and MET-minutes were calculated. Physical activity was classified as sufficient when MET-minutes were > 840. The mean age of the 474 participants was 22.4 years (S.D. = 4.7), and 253 (53.4%) were females. Their mean and median of MET-hours of PA done during the previous seven days were 31.36 (S.D., 52.19) and 14.7 (IQR, 5.77-32.07), respectively. Physical activity done was sufficient among 242 (51.1%) participants. Using univariate analysis, being male, good self-rated health, positive intention, self-efficacy, perceived benefits, social support, and availability of facilities were associated with sufficient physical activity. Using multivariate analysis sufficient physical activity was associated with participants' intention (OR 0.75, 95% CIs 0.64, 0.88), self-efficacy (OR 0.91, 95% CIs 0.85, 0.97) and facility availability (OR 0.81, 95% CIs 0.73, 0.91). The proportion of participants with sufficient physical activity was low. Positive intention and self-efficacy associated with sufficient physical activity should be supported by availability of facilities and a safely-built environment. A nationwide survey about physical and associated socialecological factors is needed to design rational health promotion strategies.
    Matched MeSH terms: Internet
  3. Sivalingam N, Rampal L
    Med J Malaysia, 2021 03;76(2):119-124.
    PMID: 33742616
    Sharing of knowledge through Continuing Medical Education (CME) contribute immensely to professional development of skills in clinical medical practice. Thus, the writing of CME articles should adopt an approach that addresses the needs of the readers by attempting to fill gaps in their knowledge, skills, and ethics about clinical care. As such CME articles should be comprehensive and focused on specific areas. The specific learning outcomes should be well defined. In designing and development of such articles, pedagogic principles are to be borne in mind. In this article we outline a guide to writing a CME article, incorporating both the principles of instructional design and directed selflearning. The ideal CME articles will transit through multimedia-enhanced interactive online learning, with greater use of connectivity through the internet. Synchronous and asynchronous learning is in greater need, as distance and online learning are increasingly popular. Authors of CME articles will need to eventually design CME articles to be interactive, enriched with multimedia to engage their readers. Lesson plans employing instructional design principles should aim to promote both instructions for learning and formative assessment ensuring learning have taken place, and outcomes have been achieved. This article describes on how to write effective CME articles for medical journals.
    Matched MeSH terms: Internet
  4. Singh D, Brown PN, Cinosi E, Corazza O, Henningfield JE, Garcia-Romeu A, et al.
    Front Psychiatry, 2020;11:574483.
    PMID: 33324252 DOI: 10.3389/fpsyt.2020.574483
    Kratom (Mitragyna speciosa Korth., Rubiaceae) is native to and has traditional use in Southeast Asia. The number of kratom users outside of Southeast Asia has increased significantly in recent decades with use spreading to the Unites States (US) and Europe. Because of its reputed opioid-like psychoactive effects at higher doses, kratom has been regulated in several countries and is subject to an import ban by the US Food and Drug Administration. Nonetheless, in the US it is estimated that 10-15 million people consume kratom primarily for the self-treatment of pain, psychiatric disorders, to mitigate withdrawal from or dependence on opioids, and to self-treat opioid use disorder or other substance use disorders (SUDs). Due to the global COVID-19 pandemic, a shortage in the supply of kratom products may place unexpected burdens on kratom users, potentially influencing some who use kratom for SUD self-treatment to regress to harmful drug use, hence increasing the likelihood of adverse outcomes, including overdose. Inadequate treatment, treatment barriers, and increases in the sales of adulterated kratom products on the internet or in convenience stores could exacerbate circumstances further. Although there are currently no verified indications of kratom scarcity, researchers and clinicians should be aware of and remain vigilant to this unanticipated possibility.
    Matched MeSH terms: Internet
  5. Sillitoe I, Bordin N, Dawson N, Waman VP, Ashford P, Scholes HM, et al.
    Nucleic Acids Res, 2021 Jan 08;49(D1):D266-D273.
    PMID: 33237325 DOI: 10.1093/nar/gkaa1079
    CATH (https://www.cathdb.info) identifies domains in protein structures from wwPDB and classifies these into evolutionary superfamilies, thereby providing structural and functional annotations. There are two levels: CATH-B, a daily snapshot of the latest domain structures and superfamily assignments, and CATH+, with additional derived data, such as predicted sequence domains, and functionally coherent sequence subsets (Functional Families or FunFams). The latest CATH+ release, version 4.3, significantly increases coverage of structural and sequence data, with an addition of 65,351 fully-classified domains structures (+15%), providing 500 238 structural domains, and 151 million predicted sequence domains (+59%) assigned to 5481 superfamilies. The FunFam generation pipeline has been re-engineered to cope with the increased influx of data. Three times more sequences are captured in FunFams, with a concomitant increase in functional purity, information content and structural coverage. FunFam expansion increases the structural annotations provided for experimental GO terms (+59%). We also present CATH-FunVar web-pages displaying variations in protein sequences and their proximity to known or predicted functional sites. We present two case studies (1) putative cancer drivers and (2) SARS-CoV-2 proteins. Finally, we have improved links to and from CATH including SCOP, InterPro, Aquaria and 2DProt.
    Matched MeSH terms: Internet
  6. Shitu, Zayyanu, Isyaku Hassan, Aung, Myat Moe Thwe, Musa, Rabiu Muazu, Tuan Hairulnizam Tuan Kamaruzaman
    Movement Health & Exercise, 2018;7(1):115-128.
    MyJurnal
    One of the major problems causing medication errors is ineffective
    communication between patients and health personnel. This paper discusses
    the communication issues in the healthcare environment and how
    medication errors can be avoided through effective communication. An
    internet-based search was conducted to locate relevant articles published
    between 2004 and 2017. Only articles that touch upon communication and
    health-related issues were selected. Online sources such as PubMed,
    ScienceDirect, and Google Scholar were utilized. The importance of good
    communication practices for effective health and improved patient safety in
    hospital settings has been highlighted. It is evident from this review that
    poor communication most frequent causes adverse effects, delay in
    treatment, medication errors, and wrong-site surgery. The major
    communication issues in healthcare environment include language barriers,
    the medium of communication, physical setting, and social setting.
    Healthcare workers tend to use technical language in the workplace because
    they consider the tone of communication to be always professional. It has
    been established that knowledge on professional-patient communication is
    essential and valuable in improving therapeutic outcomes. Patients need
    knowledge and support in order to be able and motivated to undergo
    medicine therapy. Health practitioners need to take responsibility for
    demanding and creating an environment where high-quality healthcare
    counselling is routinely practiced. To promote safe and effective practice in hospitals and avoid medication errors, clinicians should adhere to teamwork
    and effective communication with the patients. There is a need for designing
    strategies such as effective communication and teamwork amongst
    healthcare professionals, which can consequently influence the quality of
    healthcare services and patient outcomes.
    Matched MeSH terms: Internet
  7. Shiraz M, Gani A, Ahmad RW, Adeel Ali Shah S, Karim A, Rahman ZA
    PLoS One, 2014;9(8):e102270.
    PMID: 25127245 DOI: 10.1371/journal.pone.0102270
    The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC.
    Matched MeSH terms: Internet*
  8. Shin W, Ismail N
    Cyberpsychol Behav Soc Netw, 2014 Sep;17(9):578-83.
    PMID: 25126969 DOI: 10.1089/cyber.2014.0095
    This study investigated the role of parental and peer mediation in young adolescents' engagement in risk-taking in social networking sites (SNSs). A survey conducted in Malaysia with 469 SNS users aged 13-14 revealed that control-based parental mediation can cause boomerang effects, making young adolescents more inclined to taking risks in SNSs. While discussion-based parental mediation was found to be negatively related to young adolescents' befriending strangers in SNSs, it did not reduce privacy risks. Findings also suggested that peer influence could result in undesirable outcomes. In particular, the more young adolescents talked about Internet-related issues with peers, the more likely they were to disclose personally identifiable information on SNSs.
    Matched MeSH terms: Internet
  9. Sherina MS, Azlan HS
    Family Physician, 2003;12:12-14.
    The need to deliver teaching material in medical education using the internet is compelling in view of the many advantages that the internet provides. The internet has enabled organizations, in particular institutions of higher education to conduct various courses entirely electronically and without regard to physical geographical boundaries. The term CAL is used to denote the employment of the Internet for the delivery of teaching material, conduct of discussion, as;sessment of performance and interaction between students and teachers. This study reviews reports of the use and evaluation of Computer-Aided-Learning (CAL) in teaching various major disciplines in medicine.
    Matched MeSH terms: Internet
  10. Shekhawat KS, Chauhan A
    Indian J Dent Res, 2019 3 23;30(1):125-126.
    PMID: 30900670 DOI: 10.4103/ijdr.IJDR_27_17
    Counting citations have been the usual norm to determine the impact of any research and/or scholar. However, with majority of the scholarly activities happening on the World Wide Web, traditional counting of citations is now being termed "slower." The recent explosion of online data storage for many articles may serve as a pool which uses social media sites to navigate. Altmetrics has been proposed as the new entity which aims to change the focus of the scholarly reward system to value and encourage web-native scholarship. This paper makes an attempt to understand altmetrics.
    Matched MeSH terms: Internet
  11. Sharko F, Rbbani G, Siriyappagouder P, Raeymaekers JAM, Galindo-Villegas J, Nedoluzhko A, et al.
    BMC Bioinformatics, 2023 May 19;24(1):205.
    PMID: 37208611 DOI: 10.1186/s12859-023-05331-y
    BACKGROUND: Circular RNAs (circRNAs) are covalently closed-loop RNAs with critical regulatory roles in cells. Tens of thousands of circRNAs have been unveiled due to the recent advances in high throughput RNA sequencing technologies and bioinformatic tools development. At the same time, polymerase chain reaction (PCR) cross-validation for circRNAs predicted by bioinformatic tools remains an essential part of any circRNA study before publication.

    RESULTS: Here, we present the CircPrime web-based platform, providing a user-friendly solution for DNA primer design and thermocycling conditions for circRNA identification with routine PCR methods.

    CONCLUSIONS: User-friendly CircPrime web platform ( http://circprime.elgene.net/ ) works with outputs of the most popular bioinformatic predictors of circRNAs to design specific circular RNA primers. CircPrime works with circRNA coordinates and any reference genome from the National Center for Biotechnology Information database).

    Matched MeSH terms: Internet
  12. Sharif SP, Khanekharab J
    Cyberpsychol Behav Soc Netw, 2017 Aug;20(8):494-500.
    PMID: 28806123 DOI: 10.1089/cyber.2017.0162
    This study investigates the mediating role of identity confusion and materialism in the relationship between social networking site (SNS) excessive usage and online compulsive buying among young adults. A total of 501 SNS users aged 17 to 23 years (M = 19.68, SD = 1.65) completed an online survey questionnaire. A serial multiple mediator model was developed and hypotheses were tested using structural equation modeling. The results showed that excessive young adult SNS users had a higher tendency toward compulsive buying online. This was partly because they experienced higher identity confusion and developed higher levels of materialism. Targeted psychological interventions seeking to gradually increase identity clarity to buffer the detrimental effects of SNS usage and identity confusion in young adults are suggested.
    Matched MeSH terms: Internet
  13. Shamsul Azhar Shah, Azura Abdullah, Azimatun Noor Aizuddin, Mohd Rohaizat Hassan, Nazarudin Safian, Rozita Hod, et al.
    ASEAN Journal of Psychiatry, 2012;13(2):128-137.
    MyJurnal
    Objective: Truancy is a disciplinary problem, which frequently occurs among school students and it has many contributory as well as inter-related factors. It is a growing problem in this country and it often becomes a prelude to other delinquent behaviours. The study objective is to determine the prevalence of truancy as well as factors related to it including psycho-behavioural factors. Methods: A cross-sectional study involving 556 Malay student’s selected using multi-stage sampling was conducted. Results: The overall prevalence of truancy is 30.2%. The predictors to truancy are age, students who frequenting entertainment centre, students who have not completed Quran recital, coping strategies using problems solving methods and time spent watching television/video. There is a significant association between truancy and psycho-behaviour such as watching video/internet pornography, frequenting entertainment centre, smoking, motorcycle racing and dating a special friend. Conclusion: Truancy is a social issue, which must be given serious attention by all concerned components of the society.
    Matched MeSH terms: Internet
  14. Shahar S, Shirley N, Noah SA
    Inform Health Soc Care, 2013 Jan;38(1):15-26.
    PMID: 22957981 DOI: 10.3109/17538157.2012.710684
    This study aimed to assess the quality and accuracy of nutrition information about cancer prevention available on the Web. The keywords 'nutrition  +  diet  +  cancer  +  prevention' were submitted to the Google search engine. Out of 400 websites evaluated, 100 met the inclusion and exclusion criteria and were selected as the sample for the assessment of quality and accuracy. Overall, 54% of the studied websites had low quality, 48 and 57% had no author's name or information, respectively, 100% were not updated within 1 month during the study period and 86% did not have the Health on the Net seal. When the websites were assessed for readability using the Flesch Reading Ease test, nearly 44% of the websites were categorised as 'quite difficult'. With regard to accuracy, 91% of the websites did not precisely follow the latest WCRF/AICR 2007 recommendation. The quality scores correlated significantly with the accuracy scores (r  =  0.250, p  
    Matched MeSH terms: Internet*
  15. Shah PA, Hasbullah HB, Lawal IA, Aminu Mu'azu A, Tang Jung L
    ScientificWorldJournal, 2014;2014:506028.
    PMID: 24688398 DOI: 10.1155/2014/506028
    Due to the proliferation of handheld mobile devices, multimedia applications like Voice over IP (VoIP), video conferencing, network music, and online gaming are gaining popularity in recent years. These applications are well known to be delay sensitive and resource demanding. The mobility of mobile devices, running these applications, across different networks causes delay and service disruption. Mobile IPv6 was proposed to provide mobility support to IPv6-based mobile nodes for continuous communication when they roam across different networks. However, the Route Optimization procedure in Mobile IPv6 involves the verification of mobile node's reachability at the home address and at the care-of address (home test and care-of test) that results in higher handover delays and signalling overhead. This paper presents an enhanced procedure, time-based one-time password Route Optimization (TOTP-RO), for Mobile IPv6 Route Optimization that uses the concepts of shared secret Token, time based one-time password (TOTP) along with verification of the mobile node via direct communication and maintaining the status of correspondent node's compatibility. The TOTP-RO was implemented in network simulator (NS-2) and an analytical analysis was also made. Analysis showed that TOTP-RO has lower handover delays, packet loss, and signalling overhead with an increased level of security as compared to the standard Mobile IPv6's Return-Routability-based Route Optimization (RR-RO).
    Matched MeSH terms: Internet*
  16. Sgamma T, Masiero E, Mali P, Mahat M, Slater A
    Front Plant Sci, 2018;9:1828.
    PMID: 30619401 DOI: 10.3389/fpls.2018.01828
    Herbal medicines are used globally for their health benefits as an alternative therapy method to modern medicines. The market for herbal products has increased rapidly over the last few decades, but this has in turn increased the opportunities for malpractices such as contamination or substitution of products with alternative plant species. In the 1990s, a series of severe renal disease cases were reported in Belgium associated with weight loss treatment, in which the active species Stephania tetrandra was found to be substituted with Aristolochia fangchi. A. fangchi contains toxic aristolochic acids, which have been linked to kidney failure, as well as cancers of the urinary tract. Because of these known toxicities, herbal medicines containing these compounds, or potentially contaminated by these plants, have been restricted or banned in some countries, but they are still available via the internet and in alternate formulations. In this study, a DNA based method based on quantitative real-time PCR (qPCR) was tested to detect and distinguish Aristolochia subg. Siphisia (Duch.) O.C.Schmidt species from a range of medicinal plants that could potentially be contaminated with Aristolochia material. Specific primers were designed to confirm that Aristolochia subg. Siphisia can be detected, even in small amounts, if it is present in the products, fulfilling the aim of offering a simple, cheaper and faster solution than the chemical methods. A synthetic gBlock template containing the primer sequences was used as a reference standard to calibrate the qPCR assay and to estimate the copy number of a target gene per sample. Generic primers covering the conserved 5.8S rRNA coding region were used as internal control to verify DNA quality and also as a reference gene for relative quantitation. To cope with potentially degraded DNA, all qPCR primer sets were designed to generate PCR products of under 100 bp allowing detection and quantification of A. fangchi gBlock even when mixed with S. tetrandra gBlock in different ratios. All proportions of Aristolochia, from 100 to 2%, were detected. Using standards, associating the copy number to each start quantity, the detection limit was calculated and set to about 50 copies.
    Matched MeSH terms: Internet
  17. Seluakumaran K, Jusof FF, Ismail R, Husain R
    Adv Physiol Educ, 2011 Dec;35(4):369-77.
    PMID: 22139773 DOI: 10.1152/advan.00008.2011
    Educators in medical schools around the world are presently experimenting with innovative ways of using web-based learning to supplement the existing teaching and learning process. We have recently used a popular open-source course management system (CMS) called the modular object-oriented dynamic learning environment (Moodle) to construct an online site (DPhysiol) to facilitate our face-to-face teaching of physiology to a group of first-year students in the Bachelor of Medicine and Bachelor of Surgery program. The integration of the Moodle site into our teaching was assessed using online log activity, student examination marks, and feedback from students. The freely available Moodle platform was simple to use, helped to effectively deliver course materials, and has features that allowed cooperative learning. Students who used the CMS throughout their academic year and commented favorably regarding its use as a complement to the face-to-face classroom sessions. The group of students used the CMS obtained significantly higher scores in the final examination compared with the previous class that did not use the CMS. In addition, there was a significant correlation between student participation and performance in online quizzes and their final examination marks. However, students' overall online usage of the CMS did not correlate with their examination marks. We recommend Moodle as a useful tool for physiology educators who are interested in integrating web-based learning into their existing teaching curriculum.
    Matched MeSH terms: Internet*
  18. Sekaran VC, Ashok L, Kamath VG, Kamath A, Hegde AP, Devaramane V
    Indian J Pediatr, 2020 03;87(3):200-206.
    PMID: 31925719 DOI: 10.1007/s12098-019-03114-z
    OBJECTIVE: To explore the experiences of parents and their adolescent children, specifically the dimension of parental involvement in the lives of their adolescent children and how adolescents perceived it.

    METHODS: Following informed consent, a total of nine families with 22 participants took part in the study including nine adolescents, aged between 14 and 16 y, and 13 parents. One-on-one in-depth interviews were conducted at their homes following informed consent. Following transcription, the data was coded and themes were identified using Atlas.ti software. A grounded theory approach was undertaken in analysing the data.

    RESULTS: Two main themes were identified including perceptions of parental involvement in the lives of their adolescent children and family strategies to improve bonding. Adolescents' concerns centered on reduced interaction time with their family members. Concerns were also raised over the adolescents' increasing academic burden and parents particularly emphasized the increasing use of media and mobile technology by adolescents as deterrents to interaction. Though mothers functioned as primary caregivers, fathers also took on more active roles in the rearing of their children, stepping away from the traditionally viewed role of being a distant patriarchal provider. To improve interaction, parents devised creative strategies to increase time spent interacting with family members such as having dinner, performing household chores, playing games, or visiting places together.

    CONCLUSIONS: The increasing academic burden and access to digital media were perceived as factors leading to reduced interaction between the parent-adolescent dyad. Creative parenting strategies to increase interaction were sought as a solution.

    Matched MeSH terms: Internet
  19. Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, et al.
    J Behav Addict, 2017 Sep 01;6(3):271-279.
    PMID: 28816494 DOI: 10.1556/2006.6.2017.039
    Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%-15% among young people in several Asian countries and of 1%-10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.
    Matched MeSH terms: Internet
  20. Sartini C, Lomivorotov V, Pisano A, Riha H, Baiardo Redaelli M, Lopez-Delgado JC, et al.
    J Cardiothorac Vasc Anesth, 2019 Oct;33(10):2685-2694.
    PMID: 31064730 DOI: 10.1053/j.jvca.2019.03.022
    OBJECTIVE: Reducing mortality is a key target in critical care and perioperative medicine. The authors aimed to identify all nonsurgical interventions (drugs, techniques, strategies) shown by randomized trials to increase mortality in these clinical settings.

    DESIGN: A systematic review of the literature followed by a consensus-based voting process.

    SETTING: A web-based international consensus conference.

    PARTICIPANTS: Two hundred fifty-one physicians from 46 countries.

    INTERVENTIONS: The authors performed a systematic literature search and identified all randomized controlled trials (RCTs) showing a significant increase in unadjusted landmark mortality among surgical or critically ill patients. The authors reviewed such studies during a meeting by a core group of experts. Studies selected after such review advanced to web-based voting by clinicians in relation to agreement, clinical practice, and willingness to include each intervention in international guidelines.

    MEASUREMENTS AND MAIN RESULTS: The authors selected 12 RCTs dealing with 12 interventions increasing mortality: diaspirin-crosslinked hemoglobin (92% of agreement among web voters), overfeeding, nitric oxide synthase inhibitor in septic shock, human growth hormone, thyroxin in acute kidney injury, intravenous salbutamol in acute respiratory distress syndrome, plasma-derived protein C concentrate, aprotinin in high-risk cardiac surgery, cysteine prodrug, hypothermia in meningitis, methylprednisolone in traumatic brain injury, and albumin in traumatic brain injury (72% of agreement). Overall, a high consistency (ranging from 80% to 90%) between agreement and clinical practice was observed.

    CONCLUSION: The authors identified 12 clinical interventions showing increased mortality supported by randomized controlled trials with nonconflicting evidence, and wide agreement upon clinicians on a global scale.

    Matched MeSH terms: Internet
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