Hovmandrefsgaard4382

Purpose We studied subcutaneous white adipose tissue (sWAT) of obese mice submitted to intermittent fasting (IF). Methods Twelve-week-old C57BL/6 male mice received the diets Control (C) or high-fat (HF) for eight weeks (n = 20/each). Then, part of each group performed IF (24 h feeding/24 h fasting) for four weeks C, C-IF, HF, and HF-IF (n = 10/each). Results Food intake did not show a difference in feeding and fasting days, but HF groups had a high energy intake. IF led to multilocular adipocytes in sWAT (browning), and improved respiratory quotient on the fed day. IF decreased gene expression of Leptin, but increased Adiponectin, β3ar (beta3 adrenoreceptor), and Ucp1 (uncoupling protein). IF enhanced immunostaining of Caspase 3, Pcna (proliferating cell nuclear antigen), and UCP1 in sWAT. IF attenuated pro-inflammatory markers and pro-apoptotic markers in sWAT. Conclusions IF in obese mice led to browning in sWAT adipocytes, enhanced thermogenesis, an improved adipose tissue pro-inflammatory profile.Purpose Therapeutic misconception is the tendency for a clinical trial participant to overlook the scientific objective and instead believe that an experimental intervention is intended for personal therapeutic benefit. We sought to evaluate this tendency in the setting of a clinical trial of a new radiotherapy technology. Methods Patients with breast cancer enrolled on a randomized clinical trial evaluating intensity modulated radiotherapy with deep inspiration breath hold (IMRT-DIBH) versus 3-dimensional conformal radiotherapy (3DCRT) completed surveys at baseline, after randomization, and upon completion of radiotherapy to evaluate expectations, satisfaction, and experiences. Results Among 35 women surveyed, most endorsed the perception that participation on the trial might result in better treatment than the current standard treatment (77%) and more medical attention than off trial (54%). At baseline, most (74%) believed that a new treatment technology is superior than an established one. Prior to randomization, 43% of participants believed IMRT-DIBH would be more effective than standard treatment with 3DCRT, none felt that 3DCRT would be more effective, 23% felt that they would be the same, and 34% didn't know. None felt that IMRT-DIBH would cause worse long-term side effects, whereas 37% felt that 3DCRT would. Most (71%) reported that they would choose to be treated with IMRT-DIBH; none would have elected 3DCRT if given a choice. Nearly half (44%) in the 3DCRT arm wished that they had been assigned to the IMRT-DIBH arm; none in the IMRT-DIBH arm expressed a wish for crossover. Conclusions Most participants reported the perception that trial participation would result in better treatment and more medical attention than off trial, hallmarks of therapeutic misconception. Our observations provide empirical evidence of a fixed belief in the superiority of new technology and highlight the importance of adjusting expectations through informed consent to mitigate therapeutic misconception.Background As COVID-19 cases continue to rise globally, evidence from large randomized controlled trials is still lacking. Currently, numerous trials testing potential treatment and preventative options are being undertaken all over the world. Objectives We summarized all registered clinical trials examining treatment and prevention options for COVID-19. Additionally, we evaluated the quality of the retrieved studies. Data sources Clinicaltrials.gov, the Chinese Clinical Trial Registry and the European Union Clinical Trials Register were systematically searched. Study eligibility criteria Registered clinical trials examining treatment and/or prevention options for COVID-19 were included. No language, country or study design restrictions were applied. We excluded withdrawn or cancelled studies and trials not reporting therapeutic or preventative strategies for COVID-19. Participants and interventions No restrictions in terms of participants' age and medical background or type of intervention were enforced. Methers to promote patient care and guide future research efforts for COVID-19 pandemic containment.Background As health-care institutions mobilize resources to address the coronavirus disease 2019 (COVID-19) pandemic, palliative care may potentially be underutilized. iCRT14 supplier It is important to assess the use of palliative care in response to the COVID-19 pandemic. Methods This is a retrospective single-center study of patients with COVID-19 diagnosed via reverse transcriptase-polymerase chain reaction assay admitted between March 1, 2020, and April 24, 2020. An analysis of the utilization of palliative care in accordance with patient comorbidities and other characteristics was performed while considering clinical outcomes. Chi-square test was used to determine associations between categorical variables while t-tests were used to compare continuous variables. Results The overall mortality rate was 21.5% (n = 52), and in 48% (n = 25) of these patients, palliative care was not involved. Fifty-nine percent (n = 24) of those who had palliative consults eventually elected for comfort measures and transitioned to hospice care. Among those classified as having severe COVID-19, only 40% (n = 31) had palliative care involvement. Of these patients with severe COVID-19, 68% (n = 52) died. Patients who got palliative care consults were of older age, had higher rates of intubation, a need for vasopressors, and were dead. Conclusion There was a low utilization rate of palliative care in patients with COVID-19. Conscious utilization of palliative care is needed at the time of COVID-19.Context African Americans are less likely to receive hospice care and more likely to receive aggressive end-of-life care than Whites. Little is known about how palliative care consultation to discuss goals-of-care (hereafter "PCC") is associated with hospice enrollment by race. Objectives To compare enrollment in hospice at discharge between propensity-matched cohorts of African Americans with and without PCC, and Whites with and without PCC. Methods Secondary analysis of a retrospective cohort study at a high-acuity hospital; employing stratified propensity-score matching for 35,154 African Americans and Whites age 18+ admitted for conditions other than childbirth or rehabilitation, who were not hospitalized at end of study, and didn't die during index hospitalization (hospitalization during which first PCC occurred). Results Compared to African Americans without PCC, African Americans with PCC were 15 times more likely to be discharged to hospice from index hospitalization (2.4% vs. 36.5%, P less then 0.0001).