Notes

Leptin as well as TGF-β1 Downregulate PREP1 Expression inside Human Adipose-Derived Mesenchymal Stem Tissues as well as Mature Adipocytes.
Carotid near-occlusion is a frequently overlooked diagnosis when CTA examinations are assessed in routine practice. To evaluate the potential value of phase-contrast MR imaging in identifying near-occlusion, we examined 9 carotid near-occlusions and 20 cases of conventional ≥50% carotid stenosis (mean stenosis degree, 65%) with phase-contrast MR imaging. Mean ICA flow was lower in near-occlusions (52 mL/min) than in conventional ≥50% stenosis (198 mL/min, P less then .001). ICA flow of ≤110 mL/min was 100% sensitive and specific for near-occlusion. Phase-contrast MR imaging is a promising tool for diagnosing carotid near-occlusion.
Radial artery access for cerebral angiography is traditionally performed in the wrist. Distal transradial access in the anatomic snuffbox is an alternative with several advantages.

Our aim was to review the safety and efficacy of distal transradial access for diagnostic cerebral angiography and neurointerventions.

We performed a comprehensive search of the literature using PubMed, Scopus, and EMBASE.

The study included all case series of at least 10 patients describing outcomes associated with distal transradial access for diagnostic cerebral angiography or a neurointervention.

Random-effects models were used to obtain pooled rates of procedural success and complications.

A total of 7 studies comprising 348 (75.8%) diagnostic cerebral angiograms and 111 (24.2%) interventions met the inclusion criteria. The pooled success rate was 95% (95% CI, 91%-98%; I
= 74.33). The pooled minor complication rate was 2% (95% CI, 1%-4%; I
= 0. No major complications were reported. For diagnostic procedures, the combined mean fluoroscopy time was 13.53 [SD, 8.82] minutes and the mean contrast dose was 74.9 [SD, 35.6] mL.

A small number of studies met the inclusion criteria, all of them were retrospective, and none compared outcomes with proximal transradial or femoral access.

Early experience with distal transradial access suggests that it is a safe and effective alternative to proximal radial and femoral access for performing diagnostic cerebral angiography and interventions. Additional studies are needed to establish its efficacy and compare it with other access sites.
Early experience with distal transradial access suggests that it is a safe and effective alternative to proximal radial and femoral access for performing diagnostic cerebral angiography and interventions. Additional studies are needed to establish its efficacy and compare it with other access sites.
The quick Sequential Organ Failure Assessment (qSOFA) is developed as a tool to identify patients with infection with increased risk of dying from sepsis in non-intensive care unit settings, like the emergency department (ED). An abnormal score may trigger the initiation of appropriate therapy to reduce that risk. This study assesses the risk of a treatment paradox the effect of a strong predictor for mortality will be reduced if that predictor also acts as a trigger for initiating treatment to prevent mortality.

Retrospective analysis on data from a large observational cohort.

ED of a tertiary medical centre in the Netherlands.

3178 consecutive patients with suspected infection.

To evaluate the existence of a treatment paradox by determining the influence of baseline qSOFA on treatment decisions within the first 24 hours after admission.

226 (7.1%) had a qSOFA ≥2, of which 51 (22.6%) died within 30 days. Area under receiver operating characteristics of qSOFA for 30-day mortality was 0.68 (95% CI 0.61 to 0.75). Patients with a qSOFA ≥2 had higher odds of receiving any form of intensive therapy (OR 11.4 (95% CI 7.5 to 17.1)), such as aggressive fluid resuscitation (OR 8.8 95% CI 6.6 to 11.8), fast antibiotic administration (OR 8.5, 95% CI 5.7 to 12.3) or vasopressic therapy (OR 17.3, 95% CI 11.2 to 26.8), compared with patients with qSOFA <2.

In ED patients with suspected infection, a qSOFA ≥2 was associated with more intensive treatment. This could lead to inadequate prediction of 30-day mortality due to the presence of a treatment paradox.

6916.
6916.
In the context of a highly contagious virus with only recently approved vaccines and no cure, the key to slowing the spread of the COVID-19 disease and successfully transitioning through the phases of the pandemic, including vaccine uptake, is public adherence to rapidly evolving behaviour-based public health policies. The overall objective of the iCARE Study is to assess public awareness, attitudes, concerns and behavioural responses to COVID-19 public health policies, and their impacts, on people around the world and to link behavioural survey data with policy, mobility and case data to provide behavioural science, data-driven recommendations to governments on how to optimise current policy strategies to reduce the impact of the COVID-19 pandemic.

The iCARE study (www.icarestudy.com) uses a multiple cross-sectional survey design to capture self-reported information on a variety of COVID-19 related variables from individuals around the globe. Survey data are captured using two data capture methods conveneness of evolving country-level policies and communication strategies to reduce the spread of the COVID-19. Due to the urgency of the pandemic, results will be disseminated in a variety of ways, including policy briefs, social media posts, press releases and through regular scientific methods.
Limited cutaneous systemic sclerosis (lcSSc) is the most frequent subset of systemic sclerosis. Despite this, lcSSc is not the major focus of clinical studies. The lack of interventional studies in lcSSc is due, in part, to a paucity of relevant outcome measures to effectively evaluate this subset. A combined response index dedicated to lcSSc would facilitate development of well-designed trials and approval of new drugs. The objective of this scoping review is to perform a broad and comprehensive identification of the outcome measures (core set items) within relevant domains, which have been used so far to assess lcSSc.

The planned scoping review will be based on the approach proposed by Arksey
and further developed by Levac
. Development and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews checklist and guidelines. The development of the search strategy was guided by the concepts of domains and outcomes based on the Outcome Medicated to lcSSc (the CRISTAL project Combined Response Index for Scleroderma Trial Assessing lcSSc).
Postoperative malnutrition is a major issue in patients with gastric cancer. The European Society for Clinical Nutrition and Metabolism recommends oral nutritional supplements (ONS) as a first-line nutritional therapy to prevent malnutrition in patients with cancer. However, adherence to ONS is unsatisfactory. The overall aim of this study was to evaluate the adherence of patients with gastric cancer to ONS and to explore the promoting and hindering factors.

In this study, we will use mixed methods with an explanatory sequential approach for data collection and analysis. In the first phase, a 12-week longitudinal study will be performed to identify changes in trends of oral nutritional supplementation adherence in 135 patients with gastric cancer, the impact of adherence on nutritional indicators and clinical outcomes and ONS adherence-related factors. The primary endpoints include patient adherence to ONS, weight, body mass index and grip strength followed by 30-day readmission rate, complications and adverse reactions. In the second stage, qualitative research will be implemented to provide in-depth insight into the quantitative results. Finally, quantitative and qualitative results will be combined for analysis and discussion to put forward suggestions for improving patients' ONS adherence.

This research protocol has been approved by the Ethics Committee of the School of Nursing, Jilin University, China (No. 2019101601). Results will be disseminated in peer-reviewed journals and conferences, and sent to participating practices.

ChiTR2000032425.
ChiTR2000032425.
Primary care records have traditionally served the needs and demands of clinicians rather than those of the patient. In England, general practices must promote and offer registered patients online access to their primary care record, and research has shown benefits to both patients and clinicians of doing so. Despite this, we know little about patients' needs and expectations regarding online access to their record. This study explored what patients and carers want from online access to their electronic primary care health record, their experiences of using it, how they would like to interact with their record and what support they may need.

Focus groups and semistructured interviews using purposive sampling to achieve a good sociodemographic spread. Interviews were digitally audiorecorded, transcribed and coded using an established thematic approach.

Focus groups and interviews were conducted in community settings in the UK.

Fifty-four individuals who were either eligible for the National Health Serv patients and carers about their views of accessing online records have provided useful insights into future directions and potential improvements for this service.
To assess the effect of a weather index on in-hospital COVID-19-linked deaths.

Ecological study.

Continental France administrative areas (
; henceforth counties). The study period, from 18 March to 30 May 2020, corresponds to the main first outbreak period in France.

COVID-19-linked in-hospital deaths.

In-hospital deaths and demographics (population, human density, male sex and population percentage >59 years old) were obtained from national and centralised public databases. County weather indexes were calculated by the French National Meteorological Agency.

In this observational ecological study, the relationship between in-hospital COVID-19-related mortality and climate zones in continental French counties were analysed, by comparing the cumulative in-hospital death tolls in France by county to other factors (population density, climate, age and sex). check details The study period lasted from 18 March to 30 May 2020. A multivariate linear-regression analysis of in-hospital mortality included climate zone discern. Weather (mainly cold winter temperatures) was independently associated with mortality and could help explain outbreak dynamics, which began and were initially more severe in the coldest counties of continental France. Weather partly explains fatality-rate discrepancies observed worldwide.
Safety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study of the collection and application of safety data in the care home sector in England, a scoping review of the international literature was conducted.

The aim of the review was to identify measures that could be used as indicators of safety for quality monitoring and improvement in older adult residential or nursing care homes.

Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019.

Inclusion criteria were peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria.
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