Prognostic value of troponins in acute coronary syndrome depends upon patient age

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A Framework for Elder-Friendly Public Open Spaces from the Iranian Older Adults' perspectives : A Mixed-Method Study

Authors' contributions All of the authors have made great contributions to the research design, field survey, data collection, data analysis, and drafting of the manuscript. Funding There are no funding resources for this research. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.Peer reviewedPostprin

The usefulness of confusion, urea, respiratory rate, and shock index or adjusted shock index criteria in predicting combined mortality and/or ICU admission compared to CURB-65 in community-acquired pneumonia

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A systematic review of tranexamic acid in hip fracture surgery

Aim: To systematically examine and quantify the efficacy and safety of Tranexamic acid in hip fracture surgery.  Methods: A systematic literature search was conducted using Medline, EMBASE, AMED, CiNAHL, and the Cochrane Central Registry of Controlled Trials. Two assessors independently screened search outputs for potentially relevant articles which met the eligibility criteria. The primary outcome measure was requirement of post-operative blood transfusion. Risk of bias assessment was performed using the Cochrane Collaboration’s risk of bias tool for RCT’s and the ROBINS-I tool for observational studies. Meta-analysis was performed to estimate risk ratio (RR), risk difference (RD) and mean difference (MD) values for dichotomous and continuous data outcomes respectively. The interpretation of each outcome was made using the GRADE approach.  Results: Of 102 studies identified, seven met the inclusion criteria including a total of 770 participants (TXA: 341; Control: 429). On meta-analysis, intra-venous TXA resulted in a 46% risk reduction in blood transfusion requirement compared to a placebo/control group (RR:0.54; 95% CI: 0.35 to 0.85; I2: 78%; Inconsistency (Chi2) p=<0.0001; N=750). There was also a significantly higher post-operative haemoglobin for TXA versus placebo/control (MD:0.81; 95% CI: 0.45 to 1.18; I2: 46%; Inconsistency (Chi2) p=0.10; N=638). There was no increased risk of thromboembolic events (RD:0.01; 95% CI: -0.03, 0.05; I2: 68%; Inconsistency (Chi2) p=0.007, N=683).  Conclusion: There is moderate quality evidence that TXA reduces blood transfusion in hip fracture surgery, with low quality evidence suggesting no increased risk of thrombotic events. These findings are consistent with TXA use in other orthopaedic procedures

The Ageing Gut-Brain Study : Exploring the role of the gut microbiota in dementia

Alex Johnstone, Alison Donaldson, Karen Scott and Phyo Myint all contributed equally to the writing and preparation of the manuscript. This study is funded by Tenovus Scotland Research Project No. G16‐08 (start 1 June 2017, end date 31 January 2019) and NHS‐Grampian Research and Development Endowment Research Grants Project No: 16/11/043 (start date 1 April 2017, end date 31 January, 2019) and the Scottish government as part of the Strategic Research Programme at the Rowett Institute (start date 1 April 2016–31 March 2021).Peer reviewedPostprin

Non-steroidal anti-inflammatory agents and anastomotic leak rates across colorectal cancer operations and anastomotic sites : A systematic review and meta-analysis of anastomosis specific leak rate and confounding factors.

Funding Authors have nothing to disclose. No funding was received for the present study. All crude data available upon request.Peer reviewedPostprin

Comparison of the Clinical Frailty Score (CFS) to the National Emergency Laparotomy Audit (NELA) Risk Calculator in all patients undergoing emergency laparotomy.

Acknowledgments We wish to thank David McDonald, Jennifer Edwards and Neil Pekins of ELLSA for their support of this work. We also want to highlight the enthusiasm from all participating Scottish sites in supporting the ELLSA initiative.Peer reviewedPublisher PD

Sex Differences in Ischemic Stroke Outcomes in Patients With Pulmonary Hypertension

Acknowledgments To the authors thank Dr Jesus A Perdomo‐Lampignano, MBChB for his assistance with the figures and also acknowledge the Healthcare Cost and Utilization Project Data Partners (https://www.hcup‐us.ahrq.gov/db/hcupdatapartners.jsp). Supplementary Material for this article is available at https://www.ahajournals.org/doi/suppl/10.1161/JAHA.120.019341 Open Access via the Jisc Wiley AgreementPeer reviewedPublisher PD

Frailty predicts mortality in all emergency surgical admissions regardless of age : An observational study

Acknowledgements: Cardiff and Vale University Health Board: Aimee Browning, Svetlana Kulikouskaya, Rebecca Best, Andrew Forrester, Joseph Ereaut, James Moore, Dominic Hampson, Stephanie Owen, Shaanjan Islam, Nicolas Gill, Stephan Merrix, Jack Topham, Pip Killingworth, Syed Rahman and Nurulaida Mohd Darus. North Bristol NHS Trust: Emily Benson, Tom Wright, Sarah Blake, Calum Honeyman, Simon Huf, Anni Dong, Indira Garaeva, Manuk Wijeyaratne, Michael Campbell and Eng Hean Teh. Royal Alexandra Hospital: Adam Tay and Nurwasimah Haj Asnan. NHS Grampian: Matthew Greig, Vincent Quan. Central Manchester University Hospitals: Elizabeth Norr. Declaration of Conflict of Interest None. Declaration of Sources of Funding: We acknowledge the support of the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London (B.C.).Peer reviewedPostprintPostprin

Temporal trends in pregnancy-associated stroke and its outcomes among women with hypertensive disorders of pregnancy

Funding PW is funded by a NIHR Transitional Research Fellowship. CCG is part-funded by West Midlands ARC. LCC is funded by a NIHR Professorship (RP-2014-05-019). This paper presents independent research funded by the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders had no involvement in the conduct of this research.Peer reviewedPublisher PD