Negative Treatment Effects Research Articles

Short-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: a randomized controlled trial

BackgroundPhysical activity (PA) is beneficial in improving negative physical and psychological effects of cancer and cancer treatment, but adherence to PA guidelines is low. Computer-tailored PA interventions can reach large populations with little resources. They match with patients’ preference for home-based, unsupervised PA programs and are thus promising for the growing population of cancer survivors. The current study assessed the efficacy of a computer-tailored PA intervention in (four subgroups of) prostate and colorectal cancer survivors.MethodsProstate and colorectal cancer patients and survivors were randomized to the OncoActive intervention group (N = 249), or a usual-care waiting-list control group (N = 229). OncoActive participants received a pedometer and computer-tailored PA advice, both Web-based via an interactive website and with printed materials. Minutes moderate-to-vigorous PA (MVPA) and days ≥30 min PA were assessed with an accelerometer (ActiGraph) at baseline and 6 months. Further, questionnaires were used to assess self-reported PA, fatigue, distress, and quality of life at baseline, 3 and 6 months. Differences between both groups were assessed using linear regression analyses (complete cases and intention-to-treat). In addition, efficacy in relation to age, gender, education, type of cancer, and time since treatment was examined.ResultsThree months after baseline OncoActive participants significantly increased their self-reported PA (PA days: d = 0.46; MVPA: d = 0.23). Physical functioning (d = 0.23) and fatigue (d = − 0.21) also improved significantly after three months. Six months after baseline, self-reported PA (PA days: d = 0.51; MVPA: d = 0.37) and ActiGraph MVPA (d = 0.27) increased significantly, and ActiGraph days (d = 0.16) increased borderline significantly (p = .05; d = 0.16). Furthermore, OncoActive participants reported significantly improvements in physical functioning (d = 0.14), fatigue (d = − 0.23) and depression (d = − 0.32). Similar results were found for intention-to-treat analyses. Higher increases in PA were found for colorectal cancer participants at 3 months, and for medium and highly educated participants’ PA at 6 months. Health outcomes at 6 months were more prominent in colorectal cancer participants and in women.ConclusionsThe OncoActive intervention was effective at increasing PA in prostate and colorectal cancer patients and survivors. Health-related effects were especially apparent in colorectal cancer participants. The intervention provides opportunities to accelerate cancer recovery. Long-term follow-up should examine further sustainability of these effects.Trial registrationThe study was registered in the Dutch Trial Register (NTR4296) on October 17 2018.

Patients\u2019 reasoning regarding the decision to participate in clinical cancer trials: an interview study

BackgroundClinical cancer trials are crucial for the implementation of new treatments in the clinical setting, but it is equally crucial that patients are given the opportunity to make a well-informed decision about participation. The inclusion process is complex, including both oral and written information about the trial. The process of patients’ decision-making regarding clinical cancer trials has not yet been sufficiently studied. This interview study aims to explore the process of patients’ reasoning regarding the decision to participate in a clinical cancer trial.MethodsThe study is based on 27 individual face-to-face interviews with patients who had decided to participate in a clinical cancer trial. The interviews were audio-recorded and transcribed verbatim and then analysed using inductive content analysis.ResultsContent analysis revealed 17 subthemes grouped into five themes: (1) an unhesitating decision to participate; (2) a decision based on flimsy grounds and guided by emotion; (3) feeling safe and secure with my decision; (4) faced with a choice versus what choice do I have? and (5) hoping for help while helping others. The decision to participate in a clinical cancer trial was often immediate and guided by emotions, based on a trusting relationship with healthcare personnel rather than on careful reading of written information. Palliative patients, in particular, sometimes had unrealistic beliefs about the effectiveness of the trial treatment.ConclusionsIt is vital that the decision to participate in a clinical cancer trial is preceded by an honest dialogue about possible positive and negative effects of the trial treatments, including other options such as supportive care in the palliative setting. Our findings also raise the questions of how important written information is for the decision-making process and also whether genuine informed consent is possible. To reach a higher degree of informed consent, it is most important that the oral information is given in a thorough and unbiased manner.

Responses of soil N-fixing bacterial communities to redroot pigweed (Amaranthus retroflexus L.) invasion under Cu and Cd heavy metal soil pollution

Soil nitrogen (N) availability is generally considered as the mainly driving force of successful colonization of many kinds of invasive plant species. Meanwhile, the vast majority of biologically available N in ecosystems mainly originates from soil N-fixing bacterial communities (SNB) primarily via biological N-fixation. The progressive shifts in the components of heavy metal pollution (HMP) can cause obvious changes in soil microbial communities (especially SNB). This study aims to comprehensively analyze the effects of redroot pigweed (Amaranthus retroflexus L.) invasion on the community structure of SNB under Cu and Cd heavy metal soil pollution (independent copper (Cu), independent cadmium (Cd), and combined Cu and Cd) by using high-throughput sequencing. The positive effects of redroot pigweed invasion on the total number of all species, the number of species, the diversity, and the richness of SNB may be that redroot pigweed can trigger obvious variation in soil nutrient content (especially N), a key driver of the community structure of SNB, via the root exudates and/or leaf litters. The negative effects of HMP on the number of species and the richness of SNB may be attributed to the additional energy cost to SNB and/or the decreased soil pH under HMP. The effects of the combined Cu and Cd on the total number of all species and the richness of SNB were higher than those under the independent Cu and Cd. This may be due to the stronger oxidative stress under the combined heavy metals. The negative effects of redroot pigweed invasion treatment with all types of HMP on the total number of all species and the richness of SNB may be ascribed to the shifts in soil physicochemical properties (especially the stronger acidification) and the additional energy cost which can wave remarkably effects on the abundance of the nifH gene. Accordingly, the invasion of redroot pigweed may be inhibited under HMP as a result of the shifts in certain species of SNB and the decreased the total number of all species and the richness of SNB.

Hemodynamic Mechanisms Underlying Initial Orthostatic Hypotension, Delayed Recovery and Orthostatic Hypotension

ObjectivesContinuous noninvasive blood pressure (BP) measurement enables us to observe rapid changes in BP and to study underlying hemodynamic mechanisms. This study aimed to gain insight into the pathophysiological mechanisms underlying short-term orthostatic BP recovery patterns in a real-world clinical setting with (pre)syncope patients. Setting and ParticipantsIn a prospective cohort study, the active lying-to-standing test was performed in suspected (pre)syncope patients in the emergency department with continuous noninvasive finger arterial BP measurement. MeasuresChanges in systolic BP, cardiac output (CO), and systemic vascular resistance (SVR) were studied in normal BP recovery, initial orthostatic hypotension, delayed BP recovery, and sustained orthostatic hypotension. ResultsIn normal recovery (n = 47), ΔBP at nadir was −24 (23) mmHg, with a CO change of +10 (21%) and SVR of −23 (21%). In initial orthostatic hypotension (n = 7) ΔBP at nadir was −49 (17) mmHg and CO and SVR change was −5 (46%) and −29 (58%), respectively. Delayed recovery (n = 12) differed significantly from normal recovery 30 seconds after standing, with a ΔBP of −32 (19) vs 1 (16) mmHg, respectively. Delayed recovery was associated with a significant difference in SVR changes compared to normal recovery, −17 (26%) vs +4 (20%), respectively. There was no difference in CO changes. In sustained orthostatic hypotension (n = 16), ΔBP at 180 seconds after standing was −39 (21) mmHg, with changes in CO of −16 (31%) and SVR of −9 (20%). Conclusions/ImplicationsHemodynamic patterns following active standing are heterogeneous and differ across orthostatic BP recovery patterns, suggesting that volume status, medication use, and autonomic dysfunction should all be taken into account when evaluating these patients. Moreover, results suggest that a delayed BP recovery is associated with an impaired increase in SVR in a significant proportion of individuals, implying that physicians treating older adults with hypertension should consider the possible negative effect of intensive hypertension treatment on initial orthostatic blood pressure control.

Does Inducing Students to Schedule Lecture Watching in Online Classes Improve Their Academic Performance? An Experimental Analysis of a Time Management Intervention

Time management skills are an essential component of college student success, especially in online classes. Through a randomized control trial of students in a for-credit online course at a public 4-year university, we test the efficacy of a scheduling intervention aimed at improving students’ time management. Results indicate the intervention had positive effects on initial achievement scores; students who were given the opportunity to schedule their lecture watching in advance scored about a third of a standard deviation better on the first quiz than students who were not given that opportunity. These effects are concentrated in students with the lowest self-reported time management skills. However, these effects diminish over time such that we see a marginally significant negative effect of treatment on the last week’s quiz grade and no difference in overall course scores. We examine the effect of the intervention on plausible mechanisms to explain the observed achievement effects. We find no evidence that the intervention affected cramming, procrastination, or the time at which students did work.

KELOIDS TREATMENT USING TRIPLE MEDICINE COMBINATION

Relevance. A lot of conservative approaches have been proposed to the management of keloids, but none of them provides a guaranteed positive result and a stable absence of relapse.
 Objective: to evaluate the effectiveness and side effects of triple keloid scar therapy.
 Materials and methods. Thirty-three patients aged 18-69 years, who received treatment of keloids by triple medicine combination therapy, were investigated retrospectively. All patients were divided into two groups. In first one (16 patients) intralesional injections of mixture of 5-fluorouracil, triamcinolone acetonide and bovine origin hyaluronidase were performed. In the second group (17 patients) instead of triamcinolone betamethasone suspension was used. Four sessions of therapy were performed with a monthly interval. Results were assessed 1 month and 6 months after the last session. The planimetric investigation and measurement of scars’ volume were performed. The influence of treatment on the number of telangiectasias within the scar was performed with the help of our method of computer processing of its digital photographs.
 Results. There was not statistically significant difference in linear size, area and volume of the scars in patients of two groups before beginning of the treatment. One month after the fourth session scars’ width increased statistically significantly. Their length and area also increased but difference did not reach statistically significant level. At the same time maximal height of the scars over surrounding tissues (p<0.001) and their volume (p=0.012 та 0.001) reduced significantly in both groups. There was not difference in percentage of scar volume reduction ((67.4±18.01) % and (74.3±14.71) % correspondingly, p=0.308) in different groups. The main negative effect of treatment was redness of the scars due to purpura and increase of telangiectasias number. Reliable increase of the part of the scars’ surface taken by the telangiectasias was registered in both groups without difference between them. Despite the overall improvement in self-esteem, the patients noted that the change in the color of the scar after the treatment came into the first plane among the factors causing aesthetic dissatisfaction. Supplementary methods of telangiectasias and hyperemia correction were used in 12 patients of the first and 11 patients of the second group. Pain syndrome and itching were eliminated in 11 out of 14 (78.6%) patients in the first group and in 11 out of 15 (73.3%) patients in the second group (p = 0.753). Performed treatment positively influenced patients’ quality of life. Their self-esteem increased essentially ((3.4±2.16) points, p=0.005 and (3.2±1.92) points, p=0.001 correspondingly). At re-examination 6 months after the termination of triple therapy, no statistically significant changes in the size of scars were found, pain and itching did not restore. The quality of life self-esteem remained unchanged.
 Conclusion. The combined use of 5-fluorouracil, glucocorticoid, and hyaluronidase reduced the protrusion and volume of not-burn keloids in patients of both groups (by (67.4 ± 18.01) % and (74.3 ± 14.71) % respectively (p = 0.308)). Triple medicine therapy permitted to eliminate the pain syndrome and itching in 78.6 % of patients of group where triamcinolone acetonide was used, and in 73.3% of patients who received mixture that included betamethasone suspension (p=0.753). Triple medicine therapy effectiveness, both in term scars’ resizing, and eliminating clinical symptoms and improving the quality of life, was the same for both variants of the combination of drugs. The main side effect, that somewhat worsened the aesthetic result of treatment, was the increase of telangiectasias number. The part of the scar area taken by telangiectasias increased from the (3.4±1.16) % to the (9.7±3.51) %, p<0.001 in the first group and from the (3.3±1.31) % to the (9.7±3.05) %, p<0.001 in the second one. The use of glucocorticoid in triple therapy, which to a lesser extent will stimulate the formation of telangiectasias, will improve the cosmetic result of the treatment.

KELOIDS TREATMENT USING TRIPLE MEDICINE COMBINATION

Relevance. A lot of conservative approaches have been proposed to the management of keloids, but none of them provides a guaranteed positive result and a stable absence of relapse.
 Objective: to evaluate the effectiveness and side effects of triple keloid scar therapy.
 Materials and methods. Thirty-three patients aged 18-69 years, who received treatment of keloids by triple medicine combination therapy, were investigated retrospectively. All patients were divided into two groups. In first one (16 patients) intralesional injections of mixture of 5-fluorouracil, triamcinolone acetonide and bovine origin hyaluronidase were performed. In the second group (17 patients) instead of triamcinolone betamethasone suspension was used. Four sessions of therapy were performed with a monthly interval. Results were assessed 1 month and 6 months after the last session. The planimetric investigation and measurement of scars’ volume were performed. The influence of treatment on the number of telangiectasias within the scar was performed with the help of our method of computer processing of its digital photographs.
 Results. There was not statistically significant difference in linear size, area and volume of the scars in patients of two groups before beginning of the treatment. One month after the fourth session scars’ width increased statistically significantly. Their length and area also increased but difference did not reach statistically significant level. At the same time maximal height of the scars over surrounding tissues (p<0.001) and their volume (p=0.012 та 0.001) reduced significantly in both groups. There was not difference in percentage of scar volume reduction ((67.4±18.01) % and (74.3±14.71) % correspondingly, p=0.308) in different groups. The main negative effect of treatment was redness of the scars due to purpura and increase of telangiectasias number. Reliable increase of the part of the scars’ surface taken by the telangiectasias was registered in both groups without difference between them. Despite the overall improvement in self-esteem, the patients noted that the change in the color of the scar after the treatment came into the first plane among the factors causing aesthetic dissatisfaction. Supplementary methods of telangiectasias and hyperemia correction were used in 12 patients of the first and 11 patients of the second group. Pain syndrome and itching were eliminated in 11 out of 14 (78.6%) patients in the first group and in 11 out of 15 (73.3%) patients in the second group (p = 0.753). Performed treatment positively influenced patients’ quality of life. Their self-esteem increased essentially ((3.4±2.16) points, p=0.005 and (3.2±1.92) points, p=0.001 correspondingly). At re-examination 6 months after the termination of triple therapy, no statistically significant changes in the size of scars were found, pain and itching did not restore. The quality of life self-esteem remained unchanged.
 Conclusion. The combined use of 5-fluorouracil, glucocorticoid, and hyaluronidase reduced the protrusion and volume of not-burn keloids in patients of both groups (by (67.4 ± 18.01) % and (74.3 ± 14.71) % respectively (p = 0.308)). Triple medicine therapy permitted to eliminate the pain syndrome and itching in 78.6 % of patients of group where triamcinolone acetonide was used, and in 73.3% of patients who received mixture that included betamethasone suspension (p=0.753). Triple medicine therapy effectiveness, both in term scars’ resizing, and eliminating clinical symptoms and improving the quality of life, was the same for both variants of the combination of drugs. The main side effect, that somewhat worsened the aesthetic result of treatment, was the increase of telangiectasias number. The part of the scar area taken by telangiectasias increased from the (3.4±1.16) % to the (9.7±3.51) %, p<0.001 in the first group and from the (3.3±1.31) % to the (9.7±3.05) %, p<0.001 in the second one. The use of glucocorticoid in triple therapy, which to a lesser extent will stimulate the formation of telangiectasias, will improve the cosmetic result of the treatment.

Differential influence of molybdenum and tungsten on the growth of barley seedlings and the activity of aldehyde oxidase under salinity

The influence of molybdenum, tungsten on germination and growth of barley Hordeum vulgare L. was studied. Results of this study revealed the differential effect of heavy metals on seedlings growth. Exogenous molybdenum treatment stimulated the growth of seedlings. The addition of the metal significantly stimulated root elongation. Contrastingly, the addition of tungsten resulted in increased seed germination and inhibits the growth of seedlings. The negative effect of tungsten on the growth of barley was more profound for roots of plants. In addition, the influence of metals on the growth of plants was also tested in saline conditions. It is shown that under salinity stress plant growth drastically decreased in presence of tungsten. Results of this study showed that activity of molybdenum-containing aldehyde oxidase (AO; EC 1.2.3.1) was also significantly affected by metals. The activity of AO in leaves and roots enhanced with increasing concentrations of molybdate, while tungstate treatment inhibited the enzyme activity. Perhaps, the differential influence of molybdenum and tungsten on the growth of barley is a direct effect of metals on aldehyde oxidase activity in plants. Moreover, the intense negative effect of tungsten treatment on barley growth under salinity conditions emphasizes an important role of aldehyde oxidase in plant resistance to stress factors.

Placebo and nocebo effects on itch : Methodological and clinical implications

Patients often experience positive (placebo) or negative (nocebo) treatment effects due to the positive or negative expectations they have about the treatment. Placebo and nocebo effects have only relatively recently received attention for itch. Experimental studies indicate that, in line with research in other areas, such as pain, learning via verbal suggestion and conditioning plays akey role in placebo and nocebo effects on itch. Results on contagious itch emphasize the role of observational learning and suggest that itch sensations might be particularly susceptible to suggestion and therefore placebo and nocebo effects. Substantial itch reductions in the placebo arms of clinical trials suggest that placebo effects are also important for clinical practice. In this article, an overview is given of how placebo and nocebo effects on itch can optimally be used in research and for the treatment of itch.

The impact of two different hormonal growth promotants (HGPs) on the eating quality of feedlot-finished steer carcasses

The Meat Standards Australia beef-grading model applies a variable adjustment for different cuts of hormonal growth promotant (HGP)-treated carcasses, but does not differentiate between different HGP types. Using 300 non-implanted Bos indicus–Bos taurus composite steers, an experiment was conducted to compare the effects of an oestradiol only (OES) and a combination trenbolone acetate and oestradiol (TBA+OES) implant with non-implanted animals (CON) fed a concentrate ration for 73 days before slaughter, on eating quality of the mm. longissimus lumborum (LL) and gluteus medius (GM) muscles. Sensory and objective LL and GM samples were aged for either 5 or 35 days before freezing at −20°C. Carcass weights from each group were significantly (P < 0.05) different. Corrected for carcass weight, HGP treatment had a significant effect on hump height, ossification score, marble score, P8 fat depth and eye-muscle area. The TBA+OES treatment resulted in significantly (P < 0.05) tougher meat than the OES and CON treatments as assessed by shear force, although this difference was reduced with aging. Sensory scores (tenderness, juiciness, like flavour, overall liking and a composite MQ4 score) confirmed a negative HGP treatment effect, whereby TBA+OES was significantly lower than the CON and OES treatments after 5 days of aging, and these differences were reduced through aging. TBA+OES had a greater impact on sensory scores in the LL when compared to the GM. Both HGP treatments increased calpastatin activity, and the TBA+OES treatment was significantly (P < 0.05) different from the CON and OES treatments. It was concluded that OES and TBA+OES implants have different impacts on meat eating-quality measurements, which could have important implications for the Australian and international beef industry.

Efficacy of Metamifop against grassy weeds in direct-sown rice (Oryza sativa) and its impact on succeeding crop

Metamifop is an aryloxyphenoxypropionate herbicide that controls grassy weeds. Insufficient information is available on the dose of application of metamifop for post-emergence weed control. A field experiment was conducted during 2014-15 and 2015-16 at ICAR-National Rice Research Institute to determine the most effective dose of metamifop in direct-sown rice (Oryza sativa L.) and its impact in rice-rice cropping sequence. The treatments consisted of 4 doses of metamifop 10% EC at 75, 100, 150 and 200 g/ha along with oxyfluorfen 23.5% EC at 240 g/ha as standard check. Application of metamifop at 200 g/ha effectively controlled all the grassy weeds (weed control efficiency, 80-84%) except Leptochloa chinensis. Similar trend was observed with metamifop at 150 g/ha (weed control efficiency, 76-82%). Metamifop at 150 g/ha recorded 4.59 tonnes/ha grain yield and it was at par with metamifop applied at 200 g/ha (4.84 tonnes/ha). There was no negative effect of the herbicide treatments on the germination percentage, growth and yield of the succeeding rice crop in rice-rice cropping sequence. Therefore, metamifop 10% EC at 150 g/ha would be optimum recommendation for the control of grassy weeds in rice crop, considering the lower dose for reducing the herbicide load in the environment.

Next-of-kin involvement in improving hospital cancer care quality and safety \u2013 a qualitative cross-case study as basis for theory development

BackgroundNext-of-kin are an extension of healthcare professionals in all stages of cancer care. They offer care activities such as interpretations of symptoms, and reporting of negative or adverse effects of treatment, without any professional knowledge or skills. Their participation is often expected from healthcare professionals, managers, or the patient. However, there is limited knowledge of next-of-kin’s role in and contribution to quality and safety improvement in hospital cancer care. The aim of this study was to explore how managers and healthcare professionals understand the role of next-of-kin in cancer care, and what methods they use for next-of-kin involvement.MethodsThe study design was a comparative multiple embedded case study of cancer departments in two Norwegian university hospitals. Data collection methods consist of qualitative interviews with managers (13) and healthcare professionals (19) collected in 2016, and document analysis of policy documents and regulation. The interviews were analyzed according to a directed content analysis approach guided by the theoretical framework ‘Organizing for Quality’.ResultsBoth hospitals have a strategy to involve next-of-kin in treatment and care but have no formal way of doing so. Managers and healthcare professionals in the two hospitals illuminated nine areas where next-of-kin are important stakeholders in improving quality and safety. These nine areas (e.g. nutrition, observations, transitions, pain treatment, information, palliative and terminal care) are common across the two hospitals. Key challenges in the next-of-kin involvement pertain to insufficient physical working conditions and room facilities, and lack of continuity of experienced nurses and consultants.ConclusionHospital employees and managers regard next-of-kin as a safety net or a buffer that cannot be replaced by other stakeholders. This study shows a close collaboration between patient, next-of-kin and healthcare professionals in cancer care, but more effort should be invested in more systematic approaches for next-of-kin involvement in quality and safety improvement such as a guide for managers and healthcare professionals on methods and areas of involvement.

Aerobic and strength training exercise programme for cognitive impairment in people with mild to moderate dementia: the DAPA RCT.

Approximately 670,000 people in the UK have dementia. Previous literature suggests that physical exercise could slow dementia symptom progression. To estimate the clinical effectiveness and cost-effectiveness of a bespoke exercise programme, in addition to usual care, on the cognitive impairment (primary outcome), function and health-related quality of life (HRQoL) of people with mild to moderate dementia (MMD) and carer burden and HRQoL. Intervention development, systematic review, multicentred, randomised controlled trial (RCT) with a parallel economic evaluation and qualitative study. 15 English regions. People with MMD living in the community. A 4-month moderate- to high-intensity, structured exercise programme designed specifically for people with MMD, with support to continue unsupervised physical activity thereafter. Exercises were individually prescribed and progressed, and participants were supervised in groups. The comparator was usual practice. The primary outcome was the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog). The secondary outcomes were function [as measured using the Bristol Activities of Daily Living Scale (BADLS)], generic HRQoL [as measured using the EuroQol-5 Dimensions, three-level version (EQ-5D-3L)], dementia-related QoL [as measured using the Quality of Life in Alzheimer's Disease (QoL-AD) scale], behavioural symptoms [as measured using the Neuropsychiatric Inventory (NPI)], falls and fractures, physical fitness (as measured using the 6-minute walk test) and muscle strength. Carer outcomes were HRQoL (Quality of Life in Alzheimer's Disease) (as measured using the EQ-5D-3L) and carer burden (as measured using the Zarit Burden Interview). The economic evaluation was expressed in terms of incremental cost per quality-adjusted life-year (QALY) gained from a NHS and Personal Social Services perspective. We measured health and social care use with the Client Services Receipt Inventory. Participants were followed up for 12 months. Between February 2013 and June 2015, 494 participants were randomised with an intentional unequal allocation ratio: 165 to usual care and 329 to the intervention. The mean age of participants was 77 years [standard deviation (SD) 7.9 years], 39% (193/494) were female and the mean baseline ADAS-Cog score was 21.5 (SD 9.0). Participants in the intervention arm achieved high compliance rates, with 65% (214/329) attending between 75% and 100% of sessions. Outcome data were obtained for 85% (418/494) of participants at 12 months, at which point a small, statistically significant negative treatment effect was found in the primary outcome, ADAS-Cog (patient reported), with a mean difference of -1.4 [95% confidence interval (CI) -2.62 to -0.17]. There were no treatment effects for any of the other secondary outcome measures for participants or carers: for the BADLS there was a mean difference of -0.6 (95% CI -2.05 to 0.78), for the EQ-5D-3L a mean difference of -0.002 (95% CI -0.04 to 0.04), for the QoL-AD scale a mean difference of 0.7 (95% CI -0.21 to 1.65) and for the NPI a mean difference of -2.1 (95% CI -4.83 to 0.65). Four serious adverse events were reported. The exercise intervention was dominated in health economic terms. In the absence of definitive guidance and rationale, we used a mixed exercise programme. Neither intervention providers nor participants could be masked to treatment allocation. This is a large well-conducted RCT, with good compliance to exercise and research procedures. A structured exercise programme did not produce any clinically meaningful benefit in function or HRQoL in people with dementia or on carer burden. Future work should concentrate on approaches other than exercise to influence cognitive impairment in dementia. Current Controlled Trials ISRCTN32612072. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full programme and will be published in full in Health Technology Assessment Vol. 22, No. 28. See the NIHR Journals Library website for further project information. Additional funding was provided by the Oxford NIHR Biomedical Research Centre and the Oxford NIHR Collaboration for Leadership in Applied Health Research and Care.

Recycling of P and K in circular horticulture through compost application in sustainable growing media for fertigated strawberry cultivation

Abstract Peat replacement by compost in growing media can increase the sustainability of soilless cultivation. Compost, when mixed into growing media, is a source of fiber, i.e., a rooting medium, as well as an important source of nitrogen (N), phosphorus (P) and potassium (K). Physical properties as well as nutrient levels in growing media are known to affect plant growth and health. Therefore we monitored the evolution of nutrient release in compost-amended growing media for strawberry in greenhouse culture with drip fertigation for a double cropping system of cv. Elsanta, i.e., autumn culture with continued culture in spring. Compost amended and other alternative growing media for strawberry production were tested during four years of trials at full-scale level in a professional greenhouse growing system, in order to optimize the new cropping system with alternative substrates. Compost amended substrates contained 20–100% (v/v) compost, with different compost types tested. We assessed effects on yield and nutrients, i.e. nutrient availability in the substrate, uptake in the plants, and losses with the drainage water, as well as effect on diseases and pests (infection by powdery mildew (Podosphaera aphanis), aphids (Chaetosiphon fragefolii), and the anthracnose pathogen (Colletotrichum acutatum)). Adding compost to growing media has potential to increase the sustainability of soilless strawberry culture. Results show that growing strawberries on alternative substrates is feasible, but the substrate mixtures containing compost required adjusted fertigation due to nutrients supplied by the compost. This study revealed that strawberry plants made highly efficient use of the P and K in the compost when P and K input by fertigation was reduced, and that compost addition results in reduced export and potential losses of nutrients with the drain water and spent growing media. In general, the compost-amended substrates with lower N fertigation performed well as a growing medium during the autumn culture, but in the continued spring culture, these substrates needed an adapted fertigation regime for N, P and K. The N supply by the tested composts during the autumn culture allowed for significant reductions in N supplied by fertigation, i.e., 50% reduction when 100% (v/v) compost was used, and 10% reduction when 20% (v/v) compost was used. Degree of infection with powdery mildew and aphids was strongly positively correlated with the N status of the crop, pointing at the risks of high N supply for the crop. At the end of the autumn culture, no significant positive or negative effect of the compost treatments on the latent survival of C. acutatum on the strawberry leaves was found.

Public–private wage differential in a post‐transition economy

AbstractIn this study, we estimate the public sector wage premium in a post‐transition economy, a quarter of a century since the collapse of the old regime. Our methodology uses a copula method to estimate the switching regression model, which allows for the relaxation of the restrictive assumption of joint normality. We control for employment selection into both sectors using an instrument based on information regarding learned professions. We use data from the Polish Survey of Earnings by Occupations (2012). Contrary to earlier results for Poland, we found positive selection into employment in both sectors, with positive average treatment effect on the treated and negative average treatment effect on the untreated. The results suggest that both private and public sector employees select themselves into the sector in which they earn more than they would in a counterfactual scenario.

Epidermal barrier and oxidative stress parameters improve during in 311 nm narrow band UVB phototherapy of plaque type psoriasis

BackgroundPsoriasis is a multi-systemic inflammatory disease that results from dysregulation between epidermal keratinocyte homeostasis and both innate and acquired immunity. Epidermal barrier defect has been described in psoriatic lesions. Furthermore an imbalance between pro-oxidative stress and antioxidant defense mechanisms are known in psoriasis patients. AimThe aim of this study was to address the link between disease activity, epidermal barrier and systemic oxidative stress in the course of 311 nm narrow band ultraviolet B (NB-UVB) therapy of psoriasis. The dynamic of systemic oxidative stress parameters as well as local transepidermal water loss (TEWL) and stratum corneum hydration (SCH) was characterized before and after 311 nm NB-UVB therapy on the plaques of psoriasis vulgaris in comparison to untreated non-affected volar forearm sites of the same patients. Material and methods22 patients with plaque type psoriasis vulgaris and 25 gender- and age-matched healthy controls were enrolled. We assessed the psoriasis area and severity index (PASI) and the dermatology life quality index (DLQI) for monitoring disease activity, severity and self-perceived DLQI impact as patient related outcome parameter. We measured non-invasively TEWL (Tewameter TM 300) and SCH (Corneometer CM 825) and the end product of lipid peroxidation – malondialdehyde (MDA), Reactive oxygen species (ROS), ascorbyl radicals (Asc) and detoxifying activity of catalase (CAT) were measured in the peripheral blood with spectrophotometric and EPR spectroscopy methods. ResultsDisease activity improved in all patients compared to baseline witnessed by significant decrease in PASI; (from 14.1 to 10.4; p < 0.0001) and DLQI (from 11.7 to 8.1; p < 0.0001). At baseline TEWL-values were significantly (p < 0.0001) higher on psoriatic plaques (16.8 g/h/m2) in comparison to uninvolved skin (5.3 g/h/m2); with a decrease at both sites after NB-UVB phototherapy. SCH was significantly lower at psoriatic plaque s (4.7AU) compared to uninvolved sskin (42.4AU) and increased after treatment (8.6AU) (p < 0.0001). Interestingly, SCH decrease slightly during therapy at uninvolved skin (40.6AU). ROS and Asc declined during therapy in parallel to a decrease in MDA. A mild decrease in the antioxidative enzyme CAT activity which did not reach the significance was observed. ConclusionThe presented data is shows that a clinical improvement of psoriatic plaques under NB-UVB therapy, shown in with a decreased PASI and reflected by an increase in quality of life has beneficial effects on epidermal barrier function, SCH and improvement of systemic oxidative stress parameters (ROS, MDA and Asc). We assume that the general improvement in the oxidative stress parameters along with epidermal barrier parameters reflects mainly the improvement of disease activity which overwrites the possible negative pro-oxidative effects of the UV treatment.

Quercetin and rutin ameliorates sulphasalazine-induced spermiotoxicity, alterations in reproductive hormones and steroidogenic enzyme imbalance in rats.

Certain dietary flavonoids exhibit protective potentials against drug-induced male reproductive toxicities. We investigated the protective effects of quercetin and rutin on sulphasalazine-induced alterations in steroidogenic enzyme activity, hormone profile and spermiotoxicity in rats. Sulphasalazine (SASP, 600mg/kg bw) was administered alone or in combination with quercetin (20mg/kg bw) or rutin (10mg/kg bw) for 14days. SASP treatment significantly increased relative weights of the epididymis and seminal vesicles. Also, testicular and epididymal sperm numbers (TSN, ESN), motility, daily sperm production (DSP) and acrosome reaction (AR) significantly decreased. SASP altered plasma testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) levels while testicular cholesterol levels, 3β-hydroxysteroid dehydrogenase (3β-HSD) and 17β-hydroxysteroid dehydrogenase (17β-HSD) activities were decreased. Elevated malondialdehyde levels and concomitant decrease in reduced glutathione, glutathione-S-transferase, peroxidase and superoxide dismutase activities were evident in testis and epididymis of SASP-treated rats. Quercetin or rutin co-treatment with SASP significantly reversed organ weights, preserved sperm integrity, restored plasma hormone levels and increased cholesterol levels, 3β-HSD and 17β-HSD activities in testis. Both flavonoids also prevented oxidative stress in testis and epididymis of SASP-treated rats. Quercetin and rutin protect against the negative effects of SASP treatment on reproductive capacity in male rats.

Effects of Epilepsy on Language Functions: Scoping Review and Data Mining Findings.

This study involved a scoping review to identify possible gaps in the empirical description of language functioning in epilepsy in adults. With access to social network data, data mining was used to determine if individuals with epilepsy are expressing language-related concerns. For the scoping review, scientific databases were explored to identify pertinent articles. Findings regarding the nature of epilepsy etiologies, patient characteristics, tested language modalities, and language measures were compiled. Data mining focused on social network databases to obtain a set of relevant language-related posts. The search yielded 66 articles. Epilepsy etiologies except temporal lobe epilepsy and older adults were underrepresented. Most studies utilized aphasia tests and primarily assessed single-word productions; few studies included healthy control groups. Data mining revealed several posts regarding epilepsy-related language problems, including word retrieval, reading, writing, verbal memory difficulties, and negative effects of epilepsy treatment on language. Our findings underscore the need for future specification of the integrity of language in epilepsy, particularly with respect to discourse and high-level language abilities. Increased awareness of epilepsy-related language issues and understanding the patients' perspectives about their language concerns will allow researchers and speech-language pathologists to utilize appropriate assessments and improve quality of care.

The effect of Tehran metro rail system on residential property values: A comparative analysis between high-income and low-income neighbourhoods

Estimating the effect of rail transit on residential property values has resulted in mixed findings. Some researchers report positive effects on property values while others are negative or insignificant. The current paper argues that the impact of rail transit on property values depends on contextual factors which can influence magnitude and direction of the impact and cause variation in the findings. Tehran’s Metro Rail System is chosen because the neighbourhoods served by the metro to the north side and south side of the city are dramatically different in terms of economic, social and physical circumstances. A comparative analysis of six of Tehran’s metro stations is conducted between the high-income neighbourhoods, which are located primarily on the city’s north side, and lower-income neighbourhoods on the south side to determine the effects of proximity to metro stations on residential property values. The paper uses a mixed-method sequential explanatory design based on a before-and-after estimation strategy, which includes trend analysis, difference-in-differences model and qualitative impact assessment methods. The results show that there are large increases in premiums for residential properties near the lower-income neighbourhoods, the south side parts of the Tehran Metro Rail System, while a negative treatment effect for residential properties lying close to the northern stations in the high-income neighbourhoods. The qualitative survey also suggests that the impact of metro station is affected by a number of contextual factors, including the need for public transportation, land-use planning and management, socio-cultural effect and possible nuisance effects.

Effect of Low-pressure Cold Plasma (LPCP) on the Wettability and the Inactivation of Escherichia coli and Listeria innocua on Fresh-Cut Apple (Granny Smith) Skin

The aim of this study was to investigate the effect of low-pressure cold plasma (LPCP) on the inactivation of Escherichia coli and Listeria innocua on fresh-cut apple skin and its influence on wettability. Cold plasma treatments have shown to be effective to decontaminate foods, but their effect on the wettability has not been well studied. Surface-inoculated apple samples were treated with argon (Ar), nitrogen (N2), oxygen (O2), and argon-oxygen (Ar-O2) cold plasma using a commercial LPCP unit. Three different models were used to fit bacterial survival curves after the LPCP treatments. Changes in surface wettability were also determined by measuring the contact angle. The LPCP treatments using Ar, O2, or Ar-O2 mixture for 20 min were the most effective to inactivate E. coli with O2, while the LPCP treatment with N2 for 20 min reduced L. innocua the most for (p < 0.05). The highest increase in surface wettability was observed in samples treated for 20 min with O2 and Ar-O2. Different LPCP treatments have not great effectivity on the inactivation of E. coli and L. innocua on fresh-cut apple surface, but the all treatments changed the surface wettability of apples, making it more hydrophilic. This can be considered as a negative effect of the LPCP treatment because it can facilitate the adhesion and proliferation of re-contaminating microorganisms. More research should be undertaken to explore the use of other gases and complex surfaces.