3550).

The use of sedation in intensive care units (ICUs) is necessary and ubiquitous. The impact of sedation strategy on outcome, particularly when delivered early after initiation of mechanical ventilation, is unknown. Evidence is increasing that volatile anaesthetic agents could be associated with better outcome. Their use in delirium prevention is unknown.

This study is an investigator-initiated, prospective, multicentre, two-arm, randomised, control, open-trial comparing inhaled sedation strategy versus intravenous sedation strategy in mechanically ventilated patients in ICU. Two hundred and fifty patients will be randomly assigned to the intravenous sedation group or inhaled sedation group, with a 11 ratio in two groups according to the sedation strategy. The primary outcome is the occurrence of delirium assessed using two times a day confusion assessment method for the ICU (CAM-ICU). Secondary outcomes include cognitive and functional outcomes at 3 and 12 months.

The study has been approved by the Regional Ethics Committee (CPP Ouest) and national authorities (ANSM). The results will be submitted for publication in peer-reviewed journals.

NCT04341350.

NCT04341350.

To assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.

Population-based cross-sectional study using a cluster random sampling method to select the study clusters.

Elderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.

1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.

Prevalence of disabilities and NCDs.

Overall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).

Every fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.

Every fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.

Acute kidney injury (AKI) is one of the most common organ dysfunction in sepsis, and increases the risk of unfavourable outcomes. Renal replacement therapy (RRT) is the predominant treatment for sepsis-associated AKI (SAKI). However, to date, no prospective randomised study has adequately addressed whether initiating RRT earlier will attenuate renal injury and improve the outcome of sepsis. The objective of the trial is to compare the early strategy with delayed strategy on the outcomes in patients with SAKI in the intensive care unit (ICU).

This is a large-scale, multicentre, randomised controlled trial about SAKI. In total, 460 patients with sepsis and evidence of AKI stage 2 of Kidney Disease Improving Global Outcomes (KDIGO) will be recruited and equally randomised into the early group and the delay group in a ratio of 11. In the early group, continuous RRT (CRRT) will be started immediately after randomisation. In the delay group, CRRT will initiated if at least one of the following criteria was met 75328.

The prevalence of flight-related neck pain is 70% in UK fast jet pilots; much higher than the general population. The Aircrew Conditioning Programme and direct access physiotherapy exist to minimise the impact on military capability, but a population specific patient-reported outcome measure (PROM) is required to investigate the effectiveness of these. We aimed to explore the experiences of flight-related neck pain to inform the content validity and development of a population specific PROM.

Qualitative semistructured interviews combining phenomenological and grounded theory methods, reported using Consolidated criteria for Reporting Qualitative research guidelines. A purposive sample of 10 fast jet pilots with neck pain was recruited. Concept elicitation interviews were audio recorded, transcribed verbatim along with field notes. Data analysis involved subject and methodological expertise used a concept elicitation approach.

Participants included 10 male fast jet pilots, age 34.7 years. Identified themes included (1) physical symptoms associated with flying activities; (2) occupational effects revealed modifications of flying, or 'suboptimal’ performance owing to neck pain; (3) psychological effects revealed feelings or worry and (4) social and activity effects showed impact on out of work time.

Population-specific occupational, psychological and social factors should be considered alongside physical symptoms when managing neck pain in military aircrew. Findings support the development of a PROM specifically designed for military aircrew with neck pain.

Population-specific occupational, psychological and social factors should be considered alongside physical symptoms when managing neck pain in military aircrew. Findings support the development of a PROM specifically designed for military aircrew with neck pain.

In children, supraventricular tachycardia is the most common form of arrhythmia, and propafenone is an effective class Ic antiarrhythmic agent used in this population. No suitable paediatric-specific, dosing-flexible preparation is available in Taiwan. The objective of this study was to develop a formulation of propafenone oral suspension prepared from commercially available propafenone tablets and commercially available oral syrup vehicles for related patients.

An oral suspension of propafenone hydrochloride at a concentration of 10 mg/mL was prepared by mixing finely grounded propafenone hydrochloride tablets and a 11 mixture of Ora-Plus and Ora-Sweet. The beyond-use date was determined by analysing the samples stored at room temperature or 2-8℃ at time 0 and on days 7, 14, 21, 28, 35, 42, 56, and 90. Parameters to be inspected included appearance, pH measurement, high-performance liquid chromatography analysis, and microbial limit tests.

On the basis of the physicochemical and microbial stability resprove the accuracy of dosage administration and reduce the risk of medication errors affecting the paediatric population.

The medication safety officer (MSO) role was created following a patient safety alert, with an action for MSOs to be active participants in a national network in England, which included regular online webinar meetings and an online forum. The aim of the study was to assess the effectiveness of digital platforms in facilitating interaction and communication by the MSO network. The objectives were to establish the proportion of MSOs who interact through monthly webinars and the online forum. A secondary objective was to identify barriers and facilitators for engaging digitally within the MSO network.

An online survey was used alongside semistructured interviews. The online survey was disseminated to all 400 MSOs registered with the UK Department of Health Central Alerting System from December 2018 to February 2019. Interviewees were identified purposively through snowball sampling and voluntarily through the survey.

84 MSOs responded to the survey (21% response rate) and 10 participated in the semistructutforms can help the MSO network achieve critical mass and greater interaction, allowing timely access to information.

Around 25% of patients who had a stroke do not present with typical 'face, arm, speech’ symptoms at onset, and are challenging for emergency medical services (EMS) to identify. The aim of this systematic review was to identify the characteristics of acute stroke presentations associated with inaccurate EMS identification (false negatives).

We performed a systematic search of MEDLINE, EMBASE, CINAHL and PubMed from 1995 to August 2020 using key terms stroke, EMS, paramedics, identification and assessment. Studies included patients who had a stroke or patient records; ≥18 years; any stroke type; prehospital assessment undertaken by health professionals including paramedics or technicians; data reported on prehospital diagnostic accuracy and/or presenting symptoms. Data were extracted and study quality assessed by two researchers using the Quality Assessment of Diagnostic Accuracy Studies V.2 tool.

Of 845 studies initially identified, 21 observational studies met the inclusion criteria. Of the 6934 stroke bsequent sensitivity and specificity, training needs and possible overuse of high priority resources.The Ezh2 gene encodes a histone methyltransferase of the polycomb repressive complex 2 that methylates histone H3 lysine 27. In this study, we investigated whether EZH2 has a role in the development of the pharyngeal apparatus and whether it regulates the expression of the Tbx1 gene, which encodes a key transcription factor required in pharyngeal development. To these ends, we performed genetic in vivo experiments with mouse embryos and used mouse embryonic stem cell (ESC)-based protocols to probe endoderm and cardiogenic mesoderm differentiation. Results showed that EZH2 occupies the Tbx1 gene locus in mouse embryos, and that suppression of EZH2 was associated with reduced expression of Tbx1 in differentiated mouse ESCs. Conditional deletion of Ezh2 in the Tbx1 expression domain, which includes the pharyngeal endoderm, did not cause cardiac defects but revealed that the gene has an important role in the morphogenesis of the third pharyngeal pouch (PP). We found that in conditionally deleted embryos the third PP was hypoplastic, had reduced expression of Tbx1, lacked the expression of Gcm2, a gene that marks the parathyroid domain, but expressed FoxN1, a gene marking the thymic domain. Consistently, the parathyroids did not develop, and the thymus was hypoplastic. Thus, Ezh2 is required for parathyroid and thymic development, probably through a function in the pouch endoderm. This discovery also provides a novel interpretational key for the finding of Ezh2 activating mutations in hyperparathyroidism and parathyroid cancer.Mutations in the presenilin genes (PS1, PS2) have been linked to the majority of familial Alzheimer’s disease (AD). Although great efforts have been made to investigate pathogenic PS mutations, which ultimately cause an increase in the toxic form of β-amyloid (Aβ), the intrinsic physiological functions of PS in human neurons remain to be determined. In this study, to investigate the physiological roles of PS in human neurons, we generated PS1 conditional knock-out (KO) induced pluripotent stem cells (iPSCs), in which PS1 can be selectively abrogated under Cre transduction with or without additional PS2 KO. We showed that iPSC-derived neural progenitor cells (NPCs) do not confer a maintenance ability in the absence of both PS1 and PS2, showing the essential role of PS in Notch signaling. We then generated PS-null human cortical neurons, where PS1 was intact until full neuronal differentiation occurred. Aβ40 production was reduced exclusively in human PS1/PS2-null neurons along with a concomitant accumulation of amyloid β precursor protein (APP)-C-terminal fragments CTFs, whereas Aβ42 was decreased in neurons devoid of PS2 Unlike previous studies in mice, in which APP cleavage is largely attributable to PS1, γ-secretase activity seemed to be comparable between PS1 and PS2.