bluuebunny/crossref_metadata_2025 huggingface dataset:
Intratumoral administration of astatine-211-labeled gold nanoparticle for alpha therapy
Authors: Kato Hiroki , Huang Xuhao , Kadonaga Yuichiro , Katayama Daisuke , Ooe Kazuhiro , Shimoyama Atsushi , Kabayama Kazuya , Toyoshima Atsushi , Shinohara Atsushi , Hatazawa Jun , Fukase Koichi
Published: July 2021

Background

211At is a high-energy α-ray emitter with a relatively short half-life and a high cytotoxicity for cancer cells. Its dispersion can be imaged using clinical scanners, and it can be produced in cyclotrons without the use of nuclear fuel material. This study investigated the biodistribution and the antitumor effect of 211At-labeled gold nanoparticles (211At-AuNP) administered intratumorally.

Results

AuNP with a diameter of 5, 13, 30, or 120 nm that had been modified with poly (ethylene glycol) methyl ether (mPEG) thiol and labeled with 211At (211At-AuNP-S-mPEG) were incubated with tumor cells, or intratumorally administered to C6 glioma or PANC-1 pancreatic cancers subcutaneously transplanted into rodent models. Systemic and intratumoral distributions of the particles in the rodents were then evaluated using scintigraphy and autoradiography, and the changes in tumor volumes were followed for about 40 days. 211At-AuNP-S-mPEG was cytotoxic when it was internalized by the tumor cells. After intratumoral administration, 211At-AuNP-S-mPEG became localized in the tumor and did not spread to systemic organs during a time period equivalent to 6 half-lives of 211At. Tumor growth was strongly suppressed for both C6 and PANC-1 by 211At-AuNP-S-mPEG. In the C6 glioma model, the strongest antitumor effect was observed in the group treated with 211At-AuNP-S-mPEG with a diameter of 5 nm.

Conclusions

The intratumoral single administration of a simple nanoparticle, 211At-AuNP-S-mPEG, was shown to suppress the growth of tumor tissue strongly in a particle size-dependent manner without radiation exposure to other organs caused by systemic spread of the radionuclide.

Graphic Abstract
Substance use and overdose risk: documenting the perspectives of formerly incarcerated persons in the Fraser East region of BC
Authors: McCaughran-Contreras Celine , Fernando Saranee , Sikora Mike , Hawkins Jennifer , Kniseley Marinel , Snyder Daniel , Long Connie , Robson James , Slaunwhite Amanda , Salmon Amy
Published: July 2021

Background

The relationship between incarceration and risk of overdose has been well-documented in the literature, but few studies document the perspectives of persons at risk of overdose who were incarcerated. This sub-inquiry aimed to understand the experiences of persons with a history of substance use and incarceration in the Fraser East region of BC and how involvement with the criminal justice system affected their drug use and perceived risk of overdose.

Methods

The Fraser East Overdose Response project utilized a community-based participatory action approach that included peer researchers with lived experience in all parts of the research process. This qualitative pilot study aimed to better understand individuals at risk of an unwitnessed overdose in order to prevent deaths and identify effective local responses. A snowball sampling technique was used to recruit persons aged 19 and over who used illicit drugs over the past 3 years in the Fraser East since 2016. In total, 22 participants were interviewed. Of these, 13 participants identified a history of incarceration. Interviews were analyzed using a framework analysis approach.

Results

The perspectives that participants shared revealed that impacts from incarceration are influenced by policies but also highly individualized. Our inquiry found three broader themes, within which were situated differing and sometimes conflicting interpretations and experiences of systemic environments: (1) incarceration was associated with harms and was perceived to increase risk of overdose following release, (2) incarceration was perceived to have limited impact on substance use and overdose risk, and (3) incarceration was associated with a perceived reduction of substance use and overdose risk.

Conclusions

Understanding the complexities of the perceptions of those with lived experience of substance use and incarceration is of importance to better inform interventions in this population. The existing knowledge base urgently requires further inquiry into the intersections between qualitative perspectives, environments and policies, and quantitative outcomes of overdose vís-a-vís correctional institution.
Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study
Authors: Maruf Farzana , Tappis Hannah , Lu Enriquito , Yaqubi Ghutai Sadeq , Stekelenburg Jelle , van den Akker Thomas
Published: July 2021

Background

Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessmentevaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services.

Methods

Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions.

Results

Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage.

Conclusions

This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.
Coping with dyspareunia, the importance of inter and intrapersonal context on women’s sexual distress: a population-based study
Authors: Alizadeh Ameneh , Farnam Farnaz
Published: July 2021

Background

Recently known as the genito-pelvic pain/penetration disorder (GPPPD), Dyspareunia is considered a negative factor affecting a couple’s sexual health. This paper analyzes pain in Dyspareunia cases and determines protective factors causing lower levels of sexual distress among patients.

Methods

In a population-based cross-sectional study conducted in 2017, the cluster quota sampling technique was adopted to randomly select 590 Iranian married women aged 18–70 years from 30 health centers. The research tools included demographic data, a sexual distress scale, and Binik’s GPPPD questionnaire.

Results

In this study, the prevalence of self-report Dyspareunia, confirmed moderate Dyspareunia, and confirmed severe Dyspareunia (based on Binik’s proposed criteria) were 33 %, 25.8 %, and 10.5 %, respectively. Interestingly, 32 (34 %) out of 94 women who experienced severe pain based on Binik’s criteria reported no sexual distress. Compared to women with distress, they also had more positive body images, higher self-confidence, higher levels of sexual satisfaction, and more intimacy in their relationships (P = 0.000). In contrast, 8.5 % of the participants reported significant sexual distress even without confirmed Dyspareunia.

Conclusions

Improving intrapersonal characteristics such as self-confidence and body image as well as interpersonal factors such as sexual satisfaction and intimacy with a spouse can effectively treat Dyspareunia by alleviating sexual distress. The partner’s role in female pain and distress management would be more critical than previously thought.
The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis
Authors: Bedaso Asres , Adams Jon , Peng Wenbo , Sibbritt David
Published: July 2021

Background

Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy.

Methods

The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle–Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I2 statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis.

Result

From the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety.

Conclusion

Low social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.
A human rights-based approach to non-communicable diseases: mandating front-of-package warning labels
Authors: Constantin Andrés , Cabrera Oscar A. , Ríos Belén , Barbosa Isabel , Ramírez Ariadna Tovar , Cinà Margherita M. , Serrano Guzmán Silvia
Published: July 2021

Across the globe, the consumption of energy-dense and nutrient-poor foods and beverages has escalated rates of diet-related non-communicable diseases (NCDs), driven by deceptive marketing tactics from the food and beverage industry. The international community has increasingly recognized the need to provide consumers with accurate health information on food and beverage products as part of their right to health. In July 2020, the U.N. Special Rapporteur on the right to health released a powerful Statement calling for the adoption of front-of-package warning labeling to tackle NCDs. Just a few weeks after the Statement’s release, the Pan American Health Organization published a report highlighting the relevance of front-of-package labeling as a policy tool for the prevention of NCDs in the Americas, demonstrating further support to this regulatory intervention.

In this piece, we explain why front-of-package warning labeling should be part of a comprehensive strategy to promote healthier lives, delving into the human-rights aspects of front-of-package labels. In particular, we explore the role the food and beverage industry play in increasing the consumption of unhealthy foods and beverages, and the relevance of scientific evidence free from conflicts of interest to adequately protect the right to health and health-related rights.
Associations of environment and lifestyle factors with suboptimal health status: a population-based cross-sectional study in urban China
Authors: Xue Yunlian , Huang Zhuomin , Liu Guihao , Zhang Zicheng , Feng Yefang , Xu Mengyao , Jiang Lijie , Li Wenyuan , Xu Jun
Published: July 2021

Introduction

Suboptimal health status (SHS), an intermediate state between chronic disease and health, is characterized by chronic fatigue, non-specific pain, headaches, dizziness, anxiety, depression, and functional system disorders with a high prevalence worldwide. Although some lifestyle factors (e.g. smoking, alcohol consumption, physical exercise) and environmental factors (e.g. air quality, noise, living conditions) have already been studied, few studies can comprehensively illustrate the associations of lifestyle and environment factors with general, physical, mental, and social SHS.

Methods

A cross-sectional study was conducted among 6750 urban residents aged 14 years or over in five random cities from September 2017 to September 2018 through face-to-face questionnaires. There were 5881 valid questionnaires with a response rate of 87%. A general linear model and structural equation model were developed to quantify the effects of lifestyle behaviors and environment factors on SHS.

Results

The detection rates of general, physical, mental, and social SHS were 66.7, 67.0, 65.5, and 70.0%, respectively. Good lifestyle behaviors and favorable environment factors positively affected SHS (P < 0.001). Lifestyle behaviors had the largest effect on physical SHS (β = − 0.418), but the least on social SHS (β = − 0.274). Environment factors had the largest effect on mental SHS (β = 0.286), but the least on physical SHS (β = 0.225).

Conclusions

Lifestyle behaviors and environment factors were important influencing factors of SHS. Physical SHS was more associated with lifestyle. Lifestyle and environment were similarly associated with mental and social SHS.
Leaf infiltration in plant science: old method, new possibilities
Authors: Chincinska Izabela Anna
Published: July 2021

The penetration of substances from the surface to deep inside plant tissues is called infiltration. Although various plant tissues may be effectively saturated with externally applied fluid, most described infiltration strategies have been developed for leaves. The infiltration process can be spontaneous (under normal atmospheric pressure) or forced by a pressure difference generated between the lamina surface and the inside of the leaf. Spontaneous infiltration of leaf laminae is possible with the use of liquids with sufficiently low surface tension. Forced infiltration is most commonly performed using needle-less syringes or vacuum pumps.

Leaf infiltration is widely used in plant sciences for both research and application purposes, usually as a starting technique to obtain plant material for advanced experimental procedures. Leaf infiltration followed by gentle centrifugation allows to obtain the apoplastic fluid for further analyses including various omics. In studies of plant-microorganism interactions, infiltration is used for the controlled introduction of bacterial suspensions into leaf tissues or for the isolation of microorganisms inhabiting apoplastic spaces of leaves. The methods based on infiltration of target tissues allow the penetration of dyes, fixatives and other substances improving the quality of microscopic imaging. Infiltration has found a special application in plant biotechnology as a method of transient transformation with the use ofAgrobacteriumsuspension (agroinfiltration) enabling genetic modifications of mature plant leaves, including the local induction of mutations using genome editing tools. In plant nanobiotechnology, the leaves of the target plants can be infiltrated with suitably prepared nanoparticles, which can act as light sensors or increase the plant resistance to environmental stress. In addition the infiltration has been also intensively studied due to the undesirable effects of this phenomenon in some food technology sectors, such as accidental contamination of leafy greens with pathogenic bacteria during the vacuum cooling process.

This review, inspired by the growing interest of the scientists from various fields of plant science in the phenomenon of infiltration, provides the description of different infiltration methods and summarizes the recent applications of this technique in plant physiology, phytopathology and plant (nano-)biotechnology.
Clinical outcomes and patterns of failure of head and neck mucosal melanoma treated with multiple treatment modalities
Authors: Xu Qing-Qing , Lai Yan-Zhen , Huang Zi-Lu , Zeng Zi-Yi , Zhang Ya-Ni , Ou Rui-Yao , Wu Wen-Min , Chen Lei , Lu Li-Xia
Published: July 2021

Objectives

The study aims to analyze the clinical characteristics of head and neck mucosal melanoma (MMHN) and the effects of multiple treatment modalities on distant metastasis, recurrence and survival rates to provide a reference for the individualized treatment of MMHN.

Methods

We retrospectively reviewed 262 patients with stage III–IVb MMHN treated from March 1986 to November 2018 at our cancer center.

Results

The median follow-up time was 34.0 months (range 1–262 months). The 5-year overall survival (OS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) probabilities were 37.7%, 30.2%, and 20.3%, respectively. The 5-year OS rates for patients with stage III, stage IVA, and stage IVB MMHN were 67.0%, 24.1% and 8.3%, respectively (P < 0.001). A total of 246 (93.9%) patients received surgery, 149 (56.9%) patients received chemotherapy, and 69 (26.3%) patients received immunologic/targeted therapy. A total of 106 (40.5%) patients were treated with radiotherapy: 9 were treated with preoperative radiotherapy, 93 were treated with postoperative radiotherapy, and 4 were treated with radiotherapy alone. In the multivariate Cox regression analysis, primary tumor site, T stage, and immunologic/targeted therapy were independent factors for OS (all P < 0.05). Irradiation technique, T stage, and N stage were independent prognostic factors for DMFS (all P < 0.05). T stage, N stage, and surgery were independent prognostic factors for DFS (all P < 0.05). Distant metastasis was observed in 107 of 262 patients (40.8%), followed by local [74 (28.2%)] and regional [52 (19.8%)] recurrence.

Conclusions

The main reason for treatment failure in MMHN is distant metastasis. Immunologic/targeted therapy and surgery are recommended to improve the survival of MMHN. The American Joint Committee on Cancer (AJCC) 8th edition staging system for MMHN does stage this disease effectively.
Stanford type A acute aortic dissection with proximal intimo-intimal intussusception: a case report and literature review
Authors: Pan Hao , Sun Wei
Published: July 2021

Background

Acute aortic circumferential dissection with proximal intimo-intimal intussusception is a rare and potentially lethal occurrence. We here report a case and review previous works to better understand this particular condition and help surgeons to determine accurate diagnosis and optimal intervention strategies by intraoperative transesophageal echocardiography (TEE).

Case presentation

We report a case of a 46-year-old male who complained of sudden substernal chest pain. Stanford type A acute aortic dissection with proximal intimo-intimal intussusception was confirmed by contrast-enhanced computed tomography (CECT), transthoracic echocardiography (TTE), and TEE. We found the intimal flap prolapsed into the left ventricle outflow tract (LVOT), which caused severe aortic regurgitation (AR) and obstructed the ostia of the coronary arteries. Given the preexisting aneurysmal dilatation of aortic sinus and severity of aortic root and arch dissection, Bentall procedure and Sun’s procedure were performed for our patient.

Conclusions

Intraoperative TEE used by anesthesiologists here played an increasingly valuable role in the determination of acute aortic dissection. Hence, it is necessary that TEE screening is routinely performed in patients with acute aortic dissection to provide valuable information for facilitating surgical strategies.
A multidisciplinary team nursing model in the treatment of patients undergoing transapical mitral valve clamping: a prospective study
Authors: Li Sailan , Zhang Haoruo , Chen Meihua , Wang Zhenzhen , Lin Yanjuan
Published: July 2021

Background

As a new surgical method for older adults with cardiac insufficiency, transapical mitral valve clamp surgery requires the cooperation of practitioners across multiple disciplines to ensure appropriate treatment and nursing care. This study aimed to explore the utility of a multidisciplinary team nursing model in the clinical treatment and nursing care of patients undergoing transapical mitral valve clamping.

Methods

Our sample of ten patients included four men (40%) and six women (60%), with a mean age of 71.4 ± 5.2 years. The multidisciplinary team comprised nurses that specialized in severe illness, cardiac health, rehabilitation, psychology, nutrition, and pain. The team engaged in comprehensive discussions regarding problems specific to the patients undergoing transapical mitral valve surgery, allowing them to formulate individualized nursing measures and implement precise policies.

Results

No serious postoperative complications occurred in any of the ten patients included in this study, and a significant improvement was noted in the cardiac status of all the patients. Color ultrasound findings at discharge indicated that the degree of reflux of all the patients was ≤2+. Among the ten patients, the Activity of Daily Living Scale scores at discharge were significantly higher than before the operation (69.0 ± 4.6 vs. 55.0 ± 5.8). In addition, the 6-min walking test results at discharge were significantly better than those observed before the operation (318.0 ± 21.7 m vs. 295.2 ± 18.4 m).

Conclusions

Utilization of a multidisciplinary team allows nurses across various specialties to provide more comprehensive and systematic care for patients undergoing a mitral valve clamping operation, thus promoting patient recovery.
Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest
Authors: Ho Andrew Fu Wah , Tan Timothy Xin Zhong , Latiff Ejaz , Shahidah Nur , Ng Yih Yng , Leong Benjamin Sieu-Hon , Lim Shir Lynn , Pek Pin Pin , Gan Han Nee , Mao Desmond Renhao , Chia Michael Yih Chong , Cheah Si Oon , Tham Lai Peng , Ong Marcus Eng Hock
Published: July 2021

Background

Organ donation after brain death is the standard practice in many countries. Rates are low globally. This study explores the potential national number of candidates for uncontrolled donations after cardiac death (uDCD) amongst out-of-hospital cardiac arrest (OHCA) patients and the influence of extracorporeal cardiopulmonary resuscitation (ECPR) on the candidacy of these potential organ donors using Singapore as a case study.

Methods

Using Singapore data from the Pan-Asian Resuscitation Outcomes Study, we identified all non-traumatic OHCA cases from 2010 to 2016. Four established criteria for identifying uDCD candidates (Madrid, San Carlos Madrid, Maastricht and Paris) were retrospectively applied onto the population. Within these four groups, a condensed ECPR eligibility criteria was employed and thereafter, an estimated ECPR survival rate was applied, extrapolating for possible neurologically intact survivors had ECPR been administered.

Results

12,546 OHCA cases (64.8% male, mean age 65.2 years old) qualified for analysis. The estimated number of OHCA patients who were eligible for uDCD ranged from 4.3 to 19.6%. The final projected percentage of potential uDCD donors readjusted for ECPR survivors was 4.2% (Paris criteria worst-case scenario,n = 532) to 19.4% of all OHCA cases (Maastricht criteria best-case scenario,n = 2428), for an estimated 14.3 to 65.4 uDCD donors per million population per year (pmp/year).

Conclusions

In Singapore case study, we demonstrated the potential numbers of candidates for uDCD among resuscitated OHCA cases. This sizeable pool of potential donors demonstrates the potential for an uDCD program to expand the organ donor pool. A small proportion of these patients might however survive had they been administered ECPR. Further research into the factors influencing local organ and patient outcomes following uDCD and ECPR is indicated.
Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
Authors: Groombridge Christopher J , Maini Amit , Mathew Joseph , Kim Yesul , Fitzgerald Mark , Smit De Villiers , O’Reilly Gerard
Published: July 2021

Objective

In the ‘can’t intubate can’t oxygenate’ scenario, techniques to achieve front of neck access to the airway have been described in the literature but there is a lack of guidance on the optimal method for securing the tracheal tube (TT) placed during this procedure. The aim of this study was to compare three different methods of securing a TT to prevent extubation following a surgical cricothyroidotomy.

Methods

A randomised controlled trial was undertaken. The population studied were emergency physicians (EPs) attending a cadaveric airway course. The intervention was securing a TT placed via a surgical cricothyroidotomy by suture. The comparison was securing the TT using fabric tape with two different tying techniques. The primary outcome was the force required to extubate the trachea. The trial was registered with ANZCTR.org.au (ACTRN12621000320853).

Results

17 emergency physicians completed intubations using all three of the securing methods on 12 cadavers for a total of 51 experiments. The mean extubation force was 6.54 KG (95 % CI 5.54–7.55) in the suture group compared with 2.28 KG (95 % CI 1.91–2.64) in the ‘Wilko tie’ group and 2.12 KG (95 % CI 1.63–2.60) in the ‘Lark’s foot tie’ group; The mean difference between the suture and fabric tie techniques was significant (p < 0.001).

Conclusions

Following a surgical cricothyroidotomy in cadavers, EPs were able to effectively secure a TT using a suture technique, and this method was superior to tying the TT using fabric tape.
Educational films for improving screening and self-management of gestational diabetes in India and Uganda (GUIDES): study protocol for a cluster-randomised controlled trial
Authors: Oakley Laura L. , R Deepa , Namara Arthur , Sahu Biswamitra , Nadal Iliatha Papachristou , Ana Yamuna , Coombe Helen , Oteng-Ntim Eugene , Seeley Janet , Nyirenda Moffat , Babu Giridhar , Kinra Sanjay
Published: July 2021

Background

The prevalence of gestational diabetes mellitus (GDM) is rising rapidly in many low- and middle-income countries (LMICs). Most women with GDM in LMICs are undiagnosed and/or inadequately managed due to a lack of knowledge and skills about GDM on the part of both providers and patients. Following contextual analysis, we developed an educational/behavioural intervention for GDM delivered through a package of culturally tailored films. This trial aims to evaluate whether the intervention can improve the timely detection and management of GDM in two LMIC settings.

Methods

Two independent cluster randomised controlled trials, one each to be conducted in Uganda and India. Thirty maternity facilities in each country have been recruited to the study and randomised in a 1:1 ratio to the intervention and control arms. The intervention comprises of three interconnected sets of films with the following aims: to improve knowledge of GDM guidelines and skills of health providers, to raise awareness of GDM screening among pregnant women and their families, and to improve confidence and skills in self-management among those diagnosed with GDM. In facilities randomised to the intervention arm, a GDM awareness-raising film will be shown in antenatal care waiting rooms, and four films for pregnant women with GDM will be shown in group settings and made available for viewing on mobile devices. Short films for doctors and nurses will be presented at professional development meetings. Data will be collected on approximately 10,000 pregnant women receiving care at participating facilities, with follow-up at 32 weeks gestational age and 6 weeks postnatally. Women who self-report a GDM diagnosis will be invited for a clinic visit at 34 weeks. Primary outcomes are (a) the proportion of women who report a GDM diagnosis by 32 weeks of pregnancy and (b) glycaemic control (fasting glucose and HbA1C) in women with GDM at ~34 weeks of pregnancy. The secondary outcome is a composite measure of GDM-related adverse perinatal-neonatal outcome.

Discussion

Screening and management of GDM are suboptimal in most LMICs. We hypothesise that a scalable film-based intervention has the potential to improve the timely detection and management of GDM in varied LMIC settings.

Trial registration

ClinicalTrials.gov NCT03937050, registered on 3 May 2019. Clinical Trials Registry India CTRI/2020/02/023605, registered on 26 February 2020.
Patient and public involvement in numerical aspects of trials (PoINT): exploring patient and public partners experiences and identifying stakeholder priorities
Authors: Goulao Beatriz , Bruhn Hanne , Campbell Marion , Ramsay Craig , Gillies Katie
Published: July 2021

Background and aims

Patient and public involvement is increasingly common in trials, but its quality remains variable in a lot of settings. Many key decisions in trials involve numbers, but patients are rarely involved in those discussions. We aimed to understand patient and public partners’ experiences and opinions regarding their involvement in numerical aspects of research and discuss and identify priorities, according to multiple stakeholders, around the most important numerical aspects in trials to involve patients and the public in.

Methods

The study had two stages: (1) online focus groups with patient and public partners recruited via online platforms and analysed using inductive thematic analysis and (2) online priority setting meeting with UK- and Ireland-based stakeholders and following James Lind Alliance methodology. Pre-selected numerical aspects were introduced prior to the meeting and discussed and prioritised based on a voting system.

Results

In stage 1, we held two focus groups with patient and public partners (n = 9). We identified four themes in the analysis: “Determinants of PPI in numerical aspects”, “Identity and roles”, “Impact of involving patients and the public in numerical aspects”. Patient and public partners believed being involved in numerical aspects of research is important and should be facilitated, but communication about these aspects needs to be clearer. An environment and relationship with researchers that facilitates that will include time for discussion, support to improve knowledge and confidence, clear language and definitions and trust. Patient and public partners perceive their role as bringing an outsider perspective and were mainly interested in involvement in assumptions and dissemination of quantitative research. They believed this can lead to more transparency and improve their experience by making involvement more meaningful.

In stage 2, we identified twelve numerical aspects of trials to be prioritised. We held a priority setting meeting with 14 stakeholders, which led to the selection of three priority numerical aspects in patient and public involvement: target differences, interpretation of results and cost-effectiveness. Participants felt all aspects should be considered for involvement and their communication needs to ensure a shared level of understanding to avoid power imbalances.

Conclusions

Our work shows the importance of involving patient and public partners in numerical aspects of trials by assessing their experiences and motivations for the first time and discussing and prioritising which numerical aspects of trials are the most important for patients and the public to contribute to. Our research provides a platform for future efforts to improve patient and public involvement in trials and a prioritised set of future research foci.
Resiliency Engagement and Care in Health (REaCH): a telephone befriending intervention for upskilled rural youth in the context of COVID-19 pandemic—study protocol for a multi-centre cluster randomised controlled trial
Authors: Devassy Saju Madavanakadu , Allagh Komal Preet , Benny Anuja Maria , Scaria Lorane , Cheguvera Natania , Sunirose I. P.
Published: July 2021

Background

The lockdown associated with the COVID-19 pandemic is likely to impact people’s mental health, especially those from economically disadvantaged and vulnerable sections of society. Mental health can be affected by many factors, including fear of disease transmission, from response measures against the pandemic like social distancing, movement restriction, fear of being in quarantine, loneliness, depression due to isolation, fear of losing work and livelihood and avoiding health care due to fear of being infected. Telephonic befriending intervention by non-specialists will be used to provide social and emotional support to the youth from the Deen Dayal Upadhyaya Grameen Kaushalya Yojana (DDUGKY), an initiative of the Government of India. This study aims to promote mental wellbeing and reduce depressive symptoms by assisting participants to mobilise social support from family, friends and significant others by using the telephonic befriending intervention.

Methods

In this article, we report the design and protocol of a multi-centre cluster randomised controlled trial. In total, 1440 participants aged 18–35 years who have recently completed their course out of the DDU-GKY initiative will be recruited in the study from 12 project-implementing agencies (PIAs) across six geographical zones of India. Participants from 6 of these agencies will be assigned to the telephonic befriending intervention arm, and the other six agency participants will be assigned to the general enquiry phone call arm (control). The primary outcomes of this study are mental wellbeing, depressive symptoms and perceived social support. Baseline assessments and follow-up assessments will be carried out 1 month following the intervention using WHO-5, PHQ and MSPSS-12 questionnaires. The befriending intervention will be provided by DDU-GKY staff, whom a virtual training programme will train.

Discussion

This trial will help assess whether participants who are offered emotional, social and practical support through befriending will experience lesser symptoms of depression and better mental health compared to participants who do not receive this intervention through mobilised social support from friends, family and others.

Trial registration

Clinical Trial Registry India (ICMR-NIMS) CTRICTRI/2020/07/026834. Registered on 27 July 2020.
The efficacy of Tuina with herbal ointment for patients with post-stroke depression: study protocol for a randomized controlled trial
Authors: Tao Jiming , Kong Lingjun , Fang Min , Zhu Qingguang , Zhang Shuaipan , Zhang Sicong , Wu Jiajia , Shan Chunlei , Feng Ling , Guo Qingjuan , Wu Zhiwei
Published: July 2021

Background

Post-stroke depression (PSD) is a common complication after stroke which hinders functional recovery and return to social participation of stroke patients. Efficacy of conventional drug therapies for patients with PSD is still uncertain. Therefore, many patients prefer to use complementary and alternative therapies for PSD. Tuina (traditional Chinese manual manipulation) with herbal ointment is an integration of manual therapy, and ointment is an important part of traditional Chinese medicine (TCM) therapy. Preliminary experiments have shown that the Tuina with herbal ointment can improve the mental state of patients with PSD. The purpose of this study is to observe and verify the efficacy of Tuina combined with herbal ointment for patients with post-stroke depression, and to lay a foundation for further research on its mechanism of action.

Methods/design

In this study, a randomized controlled trial will be conducted in parallel, including two intervention groups: Tuina with herbal ointment group and herbal ointment for control group. A total of 84 eligible participants will be randomly assigned to the groups in a 1:1 ratio. All participants will receive conventional antidepressant venlafaxine treatment (75 mg QD), on which they received two different interventions. The interventions for both groups will be carried out 5 times each week for a period of 2 weeks. The primary outcome will be the Hamilton Rating Scale for Depression (HAMD). Secondary outcomes will include transcranial magnetic stimulation (TMS), as well as 36-item Short-Form Health Survey (SF-36) and Treatment Emergent Symptom Scale (TESS). They will be assessed at the baseline, at the end of the intervention (2 weeks), and during the 1 month and 3 months of follow-up by repeated measures analysis of variance. The significance level is 5%. Adverse events will be monitored at each visit to assess safety. All outcomes will be assessed and analyzed by researchers blinded to the treatment allocation. The purpose of this study will focus on observing the efficacy of Tuina with herbal ointment for patients with post-stroke depression, and to explore further the mechanisms of its effects.

Discussion

This study may evaluate clinical application value and safety of Tuina with herbal ointment in PSD patients, which can provide basis for clinical research and mechanism exploration of PSD.

Trial registration

Chinese Clinical Trial RegistryChiCTR2000033887. Registered on 15 June 2020.

Dissemination

The results will be published in peer-reviewed journals and disseminated through the study’s website and conferences.
Addressing the liver progenitor cell response and hepatic oxidative stress in experimental non-alcoholic fatty liver disease/non-alcoholic steatohepatitis using amniotic epithelial cells
Authors: Goonetilleke Mihiri , Kuk Nathan , Correia Jeanne , Hodge Alex , Moore Gregory , Gantier Michael P. , Yeoh George , Sievert William , Lim Rebecca
Published: July 2021

Background

Non-alcoholic fatty liver disease is the most common liver disease globally and in its inflammatory form, non-alcoholic steatohepatitis (NASH), can progress to cirrhosis and hepatocellular carcinoma (HCC). Currently, patient education and lifestyle changes are the major tools to prevent the continued progression of NASH. Emerging therapies in NASH target known pathological processes involved in the progression of the disease including inflammation, fibrosis, oxidative stress and hepatocyte apoptosis. Human amniotic epithelial cells (hAECs) were previously shown to be beneficial in experimental models of chronic liver injury, reducing hepatic inflammation and fibrosis. Previous studies have shown that liver progenitor cells (LPCs) response plays a significant role in the development of fibrosis and HCC in mouse models of fatty liver disease. In this study, we examined the effect hAECs have on the LPC response and hepatic oxidative stress in an experimental model of NASH.

Methods

Experimental NASH was induced in C57BL/6 J male mice using a high-fat, high fructose diet for 42 weeks. Mice received either a single intraperitoneal injection of 2 × 106 hAECs at week 34 or an additional hAEC dose at week 38. Changes to the LPC response and oxidative stress regulators were measured.

Results

hAEC administration significantly reduced the expansion of LPCs and their mitogens, IL-6, IFNγ and TWEAK. hAEC administration also reduced neutrophil infiltration and myeloperoxidase production with a concurrent increase in heme oxygenase-1 production. These observations were accompanied by a significant increase in total levels of anti-fibrotic IFNβ in mice treated with a single dose of hAECs, which appeared to be independent of c-GAS-STING activation.

Conclusions

Expansion of liver progenitor cells, hepatic inflammation and oxidative stress associated with experimental NASH were attenuated by hAEC administration. Given that repeated doses did not significantly increase efficacy, future studies assessing the impact of dose escalation and/or timing of dose may provide insights into clinical translation.
The geography of body size in cuttlefishes (Cephalopoda, Sepiidae)
Authors: Neige Pascal
Published: July 2021

This study explores body size in sepiids (Cephalopoda, Sepiidae) on the interspecific scale and provides an overview of their geographical distribution. Results reveal a highly skewed distribution of body size variation for raw values and a nearly normal distribution for log-transformed data. However, normality is not statistically validated due to the overrepresentation of small and large species. The geographical distribution of sepiids reveals five main clusters: Atlantic, Cape Basin, Indian Ocean, Asia-Pacific, and Australian. On average, clusters display more or less the same mean body size pattern except the Cape Basin cluster, which is statistically different from the others (smaller interspecific mean body size). The reasons remain unclear but a phylogenetic effect is suspected as southwest African coastal waters concentrate species from the ‘Hemisepius’ complex which is made up of small species. Sepiids do not obey Bergmann’s rule: species from high latitudes do not tend to be larger than species from low latitudes.
Musical note onset detection based on a spectral sparsity measure
Authors: Mounir Mina , Karsmakers Peter , van Waterschoot Toon
Published: July 2021

If music is the language of the universe, musical note onsets may be the syllables for this language. Not only do note onsets define the temporal pattern of a musical piece, but their time-frequency characteristics also contain rich information about the identity of the musical instrument producing the notes. Note onset detection (NOD) is the basic component for many music information retrieval tasks and has attracted significant interest in audio signal processing research. In this paper, we propose an NOD method based on a novel feature coined as Normalized Identification of Note Onset based on Spectral Sparsity (NINOS2). The NINOS2 feature can be thought of as a spectral sparsity measure, aiming to exploit the difference in spectral sparsity between the different parts of a musical note. This spectral structure is revealed when focusing on low-magnitude spectral components that are traditionally filtered out when computing note onset features. We present an extensive set of NOD simulation results covering a wide range of instruments, playing styles, and mixing options. The proposed algorithm consistently outperforms the baseline Logarithmic Spectral Flux (LSF) feature for the most difficult group of instruments which are the sustained-strings instruments. It also shows better performance for challenging scenarios including polyphonic music and vibrato performances.
On some inequalities in 2-metric spaces
Authors: Jleli Mohamed , Samet Bessem
Published: July 2021

In this paper, we establish new inequalities in the setting of 2-metric spaces and provide their geometric interpretations. Some of our results are extensions of those obtained by Dragomir and Goşa (J. Indones. Math. Soc. 11(1):33–38, 2005) in the setting of metric spaces.
Existence criteria via α–ψ-contractive mappings of φ-fractional differential nonlocal boundary value problems
Authors: Iqbal Muhammad Qamar , Hussain Azhar
Published: July 2021

In the existing study, we investigate the criteria of existence of solution for relatively new categories of φ-Caputo fractional differential equations and inclusions problems equipped with nonlocal φ-integral boundary conditions. In order to achieve the desired goal, we use α–ψ-contractive mappings and the theory of approximate endpoint. In the final stage, we exhibit some examples to provide the illustrations of our theoretical findings.
Bivariate Chebyshev polynomials of the fifth kind for variable-order time-fractional partial integro-differential equations with weakly singular kernel
Authors: Sadri Khadijeh , Hosseini Kamyar , Baleanu Dumitru , Ahmadian Ali , Salahshour Soheil
Published: July 2021

The shifted Chebyshev polynomials of the fifth kind (SCPFK) and the collocation method are employed to achieve approximate solutions of a category of the functional equations, namely variable-order time-fractional weakly singular partial integro-differential equations (VTFWSPIDEs). A pseudo-operational matrix (POM) approach is developed for the numerical solution of the problem under study. The suggested method changes solving the VTFWSPIDE into the solution of a system of linear algebraic equations. Error bounds of the approximate solutions are obtained, and the application of the proposed scheme is examined on five problems. The results confirm the applicability and high accuracy of the method for the numerical solution of fractional singular partial integro-differential equations.