Notes

Molecular procedure involving DLBS3733, any bioactive portion regarding Lagerstroemia speciosa (D.) Pers., upon ameliorating hepatic lipid accumulation throughout HepG2 cellular material.
The study protocol has been approved by the French Agency for the Safety of Health Products (ANSM registration no. ID RCB 2020-A02428-31) and by a French ethics committee (CPP OUEST I-TOURS-2020T1-30 DM at 30 October 2020). Results will be published in peer-reviewed journals, at scientific conferences and through press releases.

NCT04660318.
NCT04660318.
The pathophysiology of type 2 diabetes (T2D) in youth differs from adults and conventional medical treatment approaches with lifestyle change, metformin, thiazolidinediones or insulin are inadequate. Metabolic bariatric surgery (MBS) improves multiple health outcomes in adults with T2D. Initial small, uncontrolled studies of Roux-en-Y gastric bypass have also suggested beneficial effects in adolescents. Definitive studies in youth with T2D are lacking, especially with the now more common form of MBS, vertical sleeve gastrectomy (VSG). The surgical or medical treatment for paediatric type 2 diabetes (ST
OMP) clinical trial was designed to test the hypothesis that VSG will more effectively reduce hyperglycaemic and diabetes comorbidities than the best currently available medical treatment incorporating state of the art pharmacotherapies. ST
OMP is also designed to better understand the pancreatic and enterohepatic mechanisms by which MBS improves diabetes and its associated comorbidities.

ST
OMP is a prospective, open-label, controlled clinical trial that will recruit 90 postpubertal participants, age range 13-19.9 years, with body mass index ≥35 kg/m
or >120% of 95th percentile and youth-onset T2D. The primary outcome is the per cent of youth achieving haemoglobin A1c <6.0% at 12 months postgroup allocation (post-VSG vs postmedical group allocation). Secondary outcomes include remission of comorbidities and measures of β-cell and incretin responses at 12 and 24 months post VSG versus AMT.

The ST
OMP protocol was approved by the Cincinnati Children's Hospital Medical Center and the University of Colorado Institutional Review Boards. Written informed consent is obtained prior to study enrolment. find more Study findings will be widely disseminated through peer-reviewed publications and conference presentations.

Clinical Trials.Gov NCT04128995.
Clinical Trials.Gov NCT04128995.
Preventive interventions to reduce overweight and obesity in childhood and adolescence are studied on their effectiveness worldwide. A number with positive results. However, long-term effects of these interventions and their potentially wider influence on well-being and health have been less studied. This study aims to evaluate the long-term effects of a multicomponent intervention in elementary school children targeting individual behaviour as well as environment (Lekker Fit!). The primary outcomeis body mass index and the secondary outcomes are waist circumference, weight status, physical fitness, lifestyle, psychosocial health and academic performance.

In a naturalistic effect evaluation with a retrospective, controlled design adolescents in secondary schools, from intervention and non-intervention elementary schools, will be compared on a wide set of outcome variables. Data will be collected by questionnaires and through anthropometric and fitness measurements by trained physical education teachers and research assistants. Baseline data consist of measurements from the adolescents at the age of 5 years old and are gathered from preventive youth healthcare records, from before the intervention took place. Multilevel regression models will be used and adjusted for baseline measurements and potential confounding variables on the individual and environmental level. Furthermore, propensity scores will be applied.

The study has been approved by the Medical Research Ethics Committee of the Erasmus Medical Centre, Rotterdam, The Netherlands (permission ID MEC-2020-0644). Study findings will be disseminated in peer-reviewed journals and by conference presentations.

NL8799. Pre-results.
NL8799. Pre-results.
Preschool aged children with cerebral palsy (CP) and like conditions are at risk of performing below their peers in key skill areas of school readiness. Kindy Moves was developed to support school readiness in preschool aged children with CP and like conditions that are dependent on physical assistance and equipment throughout the day. The primary aims are to determine the feasibility of motor-based interventions that are functional and goal directed, adequately dosed and embedded into a play environment with interdisciplinary support to optimise goal-driven outcomes.

Forty children with CP and like conditions aged between 2 and 5 years with a Gross Motor Function Classification System (GMFCS) level of III-V or equivalent, that is, dependent on physical assistance and equipment will be recruited in Western Australia. Participants will undertake a 4-week programme, comprised three, 2-hour sessions a week consisting of floor time, gross motor movement and play (30 min), locomotor treadmill training (30 min)stralian New Zealand Clinical Trials Registry (ACTRN12619000064101p).
Australian New Zealand Clinical Trials Registry (ACTRN12619000064101p).
To validate an existing clinical decision support tool to risk-stratify patients with acute kidney injury (AKI) for hydronephrosis and compare the risk stratification framework with nephrology consultant recommendations.

Cross-sectional study of hospitalised adults with AKI who had a renal ultrasound (RUS) ordered at a large, tertiary, academic medical centre.

Two hundred and eighty-one patients were included in the study cohort. Based on the risk stratification framework, 111 (40%), 76 (27%) and 94 (33%) patients were in the high-risk, medium-risk and low-risk groups for hydronephrosis, respectively.

Outcomes were the presence of unilateral or bilateral hydronephrosis on RUS.

Thirty-five patients (12%) were found to have hydronephrosis. The high-risk group had 86% sensitivity and 67% specificity for identifying hydronephrosis. A nephrology consult was involved in 168 (60%) patients and RUS was recommended by the nephrology service in 95 (57%) cases. Among patients with a nephrology consultation, 9 (56%) of the 16 total patients with hydronephrosis were recommended to obtain an RUS.

We further externally validated a risk stratification framework for hydronephrosis. Clinical decision support systems may be useful to supplement clinical judgement in the evaluation of AKI.
We further externally validated a risk stratification framework for hydronephrosis. Clinical decision support systems may be useful to supplement clinical judgement in the evaluation of AKI.
Hospital readmission is a burden to patients, relatives and society. Older patients with frailty are at highest risk of readmission and its negative outcomes.

We aimed at examining whether follow-up visits by an outgoing multidisciplinary geriatric team (OGT) reduces unplanned hospital readmission in patients discharged to a skilled nursing facility (SNF).

A retrospective single-centre before-and-after cohort study.

Study population included all hospitalised patients discharged from a Danish geriatric department to an SNF during 1 January 2016-25 February 2020. To address potential changes in discharge and readmission patterns during the study period, patients discharged from the same geriatric department to own home were also assessed.

OGT visits at SNF within 7 days following discharge. Patients discharged to SNF before 12 March 2018 did not receive OGT (-OGT). Patients discharged to SNF on or after 12 March 2018 received the intervention (+OGT).

Unplanned hospital readmission between 4 hours and 30 days following initial discharge.

Totally 847 patients were included (440 -OGT; 407 +OGT). No differences were seen between the two groups regarding age, sex, activities of daily living (ADLs), Charlson Comorbidity Index (CCI) or 30-day mortality. The cumulative incidence of readmission was 39.8% (95% CI 35.2% to 44.8%, n=162) in -OGT and 30.2% (95% CI 25.8% to 35.2%, n=113) in +OGT. The unadjusted risk (HR (95% CI)) of readmission was 0.68 (0.54 to 0.87, p=0.002) in +OGT compared with -OGT, and remained significantly lower (0.72 (0.57 to 0.93, p=0.011)) adjusting for age, length of stay, sex, ADL and CCI. For patients discharged to own home the risk of readmission remained unchanged during the study period.

Follow-up visits by OGT to patients discharged to temporary care at an SNF significantly reduced 30-day readmission in older patients.
Follow-up visits by OGT to patients discharged to temporary care at an SNF significantly reduced 30-day readmission in older patients.
This study aimed to determine the relationship between the body mass index (BMI) and short-term mortality of patients with intra-abdominal infection (IAI) using the Medical Information Mart for Intensive Care (MIMIC-III) database.

Retrospective cohort study.

Adult intensive care units (ICUs) at a tertiary hospital in the USA .

Adult IAI ICU patients from 2001 to 2012 in the MIMIC-III database.

In univariate analysis, we compared the differences in the characteristics of patients in each BMI group. Cox regression models were used to evaluate the relationships between BMI and short-term prognosis.

90-day survival.

In total, 1161 patients with IAI were included. There were 399 (34.4%) patients with a normal BMI (<25 kg/m
), 357 (30.8%) overweight patients (25-30 kg/m
) and 405 (34.9%) obese patients (>30 kg/m
) who tended to be younger (p<0.001) and had higher Sequential Organ Failure Assessment scores (p<0.05). The mortality of obese patients at 90 days was lower than that of patients with a normal BMI (20.74% vs 23.25%, p<0.05), but their length of stay in the ICU was higher (4.9 days vs 3.6 days, p<0.001); however, their rate of mechanical ventilation utilisation was higher (61.48% vs 56.86%, p<0.05). In the Cox regression model, we also confirmed that BMI was a protective factor in patients with IAIs, and the adjusted mortality rate of patients with a higher BMI was 0.97 times lower than that of patients with a lower BMI (p<0.001, HR=0.97, 95% CI 0.96 to 0.99).

IAI patients with an overweight or obese status might have lower 90-day mortality than patients with a normal BMI.
IAI patients with an overweight or obese status might have lower 90-day mortality than patients with a normal BMI.
Previous studies suggested mean arterial pressure (MAP) had moderate predictive values in the first and second trimesters for the prediction of preeclampsia. However, the performance of MAP in Asian women is still unclear. The objective of this study was to examine the predictive values of MAP in Asian population throughout gestation, and to compare the performance of MAP, angiogenic factors and uterine artery Doppler in the prediction of preeclampsia.

A prospective cohort study.

KK Women's and Children's Hospital, Singapore.

A total of 926 women with singleton pregnancy less than 14 weeks of gestation were included in the prospective Neonatal and Obstetrics Risks Assessment cohort between September 2010 and October 2014. Maternal blood pressure levels, uterine artery pulsatility index (UtA-PI), serum soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF) and sFlt-1/PlGF ratio were measured at 11-14, 18-22, 28-32 and 34 weeks onward, respectively.

Preeclampsia was the main pregnancy outcome.
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