Type 2 diabetes (T2D) is a complex disease with an elusive link between its molecular aetiology and clinical presentation. Although, the role of visceral adipose tissue in insulin-resistance and T2D is known, limited information is available on the role of peripheral-subcutaneous adipose tissue especially in Asian Indians. In this microarray-based study of diabetic and normal glucose tolerant Asian Indians, we generated the transcriptome of their thigh adipose tissue and analyzed differentially expressed genes (DEGs) using weighted gene co-expression network analysis; further we identified perturbed pathways implicated by these DEGs in relevant co-expression modules. We also attempted to link these pathways with known aspects of T2D pathophysiology in terms of their association with some of their intermediate traits, namely; adipocyte size, HOMA-B, HOMA-R, Hb1Ac, insulin, glucose-level, TNF-α, IL-6, VLDLs, LDLs, HDLs, and NEFAs. It was observed that several modules of co-expressed genes show an association with diabetes and some of its intermediate phenotypic traits mentioned above. Therefore, these findings suggest a role of peripheral subcutaneous adipose tissue in the pathophsiology of T2D in Asian Indians. Additionally, our study indicated that the peripheral subcutaneous adipose tissue in diabetics shows pathologic changes characterized by adipocyte hypertrophy and up-regulation of inflammation-related pathways.

BackgroundIn the UK, poor oral health among children continues to be a major public health concern. Primary care professionals are encouraged to take a proactive approach in engaging parents and carers to develop better oral health practices for their children. Unfortunately, research has shown that patients are often exposed to inconsistent and at worst conflicting advice.AimTo increase the confidence of primary care professionals in their knowledge surrounding preventative oral health and ensure the delivery of consistent and proactive oral health advice.MethodA local dentist and dental health educator were invited to a general practice multidisciplinary meeting to deliver an educational session on oral health advice for children. Qualitative and quantitative data in form of a questionnaire was collected to analyse the impact of the education session.ResultsThe meeting was attended by 15 healthcare professionals including GPs, paediatricians, a community mental health representative, and a school nurse. There were 78% of attendees who reported that they had never received any formal teaching on oral health care prior to this session. Qualitative data highlighted specific gaps in knowledge, while confidence ratings suggest significant improvement in confidence of attendees in their knowledge of oral health in children.ConclusionAchieving good oral health for all children requires the support of a wide range of healthcare professionals. Further education sessions such as this encourages joint learning and relationship building between professionals and influences behaviour to improve child health care as part of making every contact count. The emerging Primary Care Networks provide an excellent setting to deliver this education.

Connecting Care for Children, an integrated care collaborative in northwest London, responded to local child health needs during the start of the COVID-19 pandemic through the co-production of infographics. Here we describe the development and evaluation of co-produced infographics using quality improvement methodology, to highlight their effectiveness in swiftly responding to local community health concerns.

849 of the 992 participants in the first round returned (86%). The median time between initial and follow up collections was 62 days. Of the 849 participants, 65 had positive SARS-CoV-2 antibody tests (7.66% CI 6.05-9.64). Of the 45 participants with positive antibody tests in the first round who attended the follow-up visit mean antibody titres increased. With Roche's Elecsys assay, mean antibody titres increased from 84.7 cutoff index (COI) to 115.8 COI (difference 31.08, 95% CI 13.82-48.34, p=0.0007) and with DiaSorin's LIAI-SON assay. mean antibody titres increased from 67.5 AU/ml to 81.4 AU/ml (13.89, 0.31-27.46;p=0.0452).

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rotas. With increased responsibility and training, imaging staff lead VCs. They also call patients before their appointment to ask and answer questions and explain requirements. Staff survey results now show significant improvement in all stress categories. Patient responses (n=255), also show significantly favourable results with patients indicating an overall good or excellent experience with the service (96%). The switch to a 12-hour day and compressed workweek can be a risk. Fortunately, in our department, it has been beneficial. This improvement is likely due to certain factors, such as task diversification, the autonomy that staff experience in leading VCs, and extended roles. Smaller work teams provide quick and better contact with managers, improvement in teamwork and opportunity for better relationships. Finally, patient phone calls reduce patient anxiety and improve communication, and reduced staff stress undoubtedly impacts quality of patient care.

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