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Background: Deep vein thrombosis (DVT) is a leading cause of death disability. DVT can be classified based on the location and extent of the clot into isolated distal DVT (iDDVT), isolated proximal DVT (iPDVT), or mixed DVT. The aim of this study is to explore the baseline characteristics and clinical outcomes of patients with different types of DVT. Methods: This was a retrospective study of patients who experienced their first DVT event and received an anticoagulant for management. The outcomes of this study include evaluating patients’ characteristics for patients with DVT and assessing the incidence of recurrent DVT, major bleeding (MB), VTE-related rehospitalization, and DVT-related inpatient mortality across different types of DVT. Results: A total of 493 patients were included in the study. Of those, 273 (55.4%) had iPDVT, 25 (5.1%) had iDDVT, and 195 (39.6%) had mixed DVT. The VTE etiology was similar across the groups except for the leg injury, which was significantly higher in patients with iDDVT (24%) compared to iPDVT (6.2%) and mixed DVT (5.6%) ( P = .002). At 12 months, a total of 49 patients (9.9%) had a recurrent DVT event; 25 (9.2%) in the iPDVT group, 3 (12.0%) in the iDDVT group, and 21 (10.8%) in the mixed DVT group ( P = .797). Rates of MB, re-hospitalization, and death from DVT were similar between the groups. Conclusion: Baseline characteristics were not significantly linked to the risk of developing a specific type of lower extremity DVT. Long-term outcomes were similar across all DVT types.

Abstract The decision of the UK to leave the EU has far‐reaching, and often shared, implications for agriculture and fisheries. To ensure the future sustainability of the UK’s agricultural and fisheries systems, we argue that it is essential to grasp the opportunity that Brexit is providing to develop integrated policies that improve the management and protection of the natural environments, upon which these industries rely. This article advances a stakeholder informed vision of the future design of UK agriculture and fisheries policies. We assess how currently emerging UK policy will need to be adapted in order to implement this vision. Our starting point is that Brexit provides the opportunity to redesign current unsustainable practices and can, in principle, deliver a sustainable future for agriculture and fisheries. Underpinning policies with an ecosystem approach, explicit inclusion of public goods provision and social welfare equity were found to be key provisions for environmental, agricultural and fishery sustainability. Recognition of the needs of, and innovative practices in, the devolved UK nations is also required as the new policy and regulatory landscape is established. Achieving the proposed vision will necessitate drawing on best practice and creating more coherent and integrated food, environment and rural and coastal economic policies. Our findings demonstrate that “bottom‐up” and co‐production approaches will be key to the development of more environmentally sustainable agriculture and fisheries policies to underpin prosperous livelihoods. However, delivering this vision will involve overcoming significant challenges. The current uncertainty over the nature and timing of the UK’s Brexit agreement hinders forward planning and investment while diverting attention away from further in‐depth consideration of environmental sustainability. In the face of this uncertainty, much of the UK’s new policy on the environment, agriculture and fisheries is therefore ambitious in vision but light on detail. Full commitment to co‐production of policy with devolved nations and stakeholders also appears to be lacking, but will be essential for effective policy development and implementation. A free Plain Language Summary can be found within the Supporting Information of this article.

Background: Increase in presentations of self-harm to primary care, a risk factor of suicide, has led to a growing interest in identifying at-risk populations. Aim: To examine whether osteoporosis or fractures are risk factors for self-harm, suicidal ideation, and suicide. Design and setting: This was a systematic review of observational studies in adults (>18 years) that had examined the role of osteoporosis and/or fractures in subsequent self-harm, suicidal ideation, and/or suicide. Method: Six databases were searched from inception to July 2019. Additional citation tracking of eligible studies was undertaken in November 2022. Screening, data extraction, and quality assessment of full-text articles were performed independently by at least two authors. Where possible, meta-analysis was run on comparable risk estimates. Results: Fifteen studies were included: two examined the outcome of self-harm, three suicidal ideation, and 10 suicide. In approximately half of studies on osteoporosis, the risk of suicidal ideation and suicide remained significant. However, pooling of adjusted odds ratios from three studies indicated no association between osteoporosis and suicide (1.14, 95% confidence interval = 0.88 to 1.49). Nine studies examined the risk of a mixture of fracture types across different outcomes, limiting comparisons. However, all studies examining vertebral fracture (n = 3) reported a significant adjusted negative association for self-harm and suicide. Conclusion: Patients with vertebral fractures, a risk potential factor for suicide, may benefit from clinical case finding for mood disorders with personalised primary care management. However, because of the limited number and quality of studies and mixed findings, further examination of these associations is warranted. [ABSTRACT FROM AUTHOR]