Effectiveness of Comprehensive Intervention Programme on Quality of life, fatigue, self-efficacy, and psychosocial distress among head and neck cancer patients receiving radiotherapy.

PURPOSE: The study aimed at evaluating the Effectiveness of Comprehensive Intervention Programme (CIP) on Quality of life (QOL), fatigue, self-efficacy, and psychosocial distress among Head and Neck Cancer (HNC) patients receiving radiotherapy treatment. METHODS: Single-centre non-RCT time series study was conducted among 134 HNC patients (67 observed, followed by 67 subjected to CIP). FACT- H&N, FACT-F, Cancer Behavior Inventory and psychosocial distress scales were used to assess QOL, fatigue, self-efficacy, and psychosocial distress respectively. CIP was provided to the intervention arm twice a week during the course of radiation therapy along with the standard care; the control arm received only standard care. Data were collected before commencing radiotherapy, and post-test assessments were carried out at the end of radiotherapy treatment, and at 3 and 6 months after completion of radiotherapy. RESULTS: Repeated measures ANOVA revealed a statistically significant improvement with CIP in QOL (F (1.917) = 454.103, p = 0.001), fatigue (F (2.106) = 183.775, p = 0.001), self-efficacy (F (2.429) = 190.861, p = 0.001), and psychosocial distress (F (2.288) = 290.105, p = 0.001) in the intervention arm. CONCLUSION: The CIP implemented to address multitude of issues in HNC patients receiving radiotherapy, proved to be effective in reducing the impact of treatment on QOL, fatigue, self-efficacy and psychosocial distress in HNC patients receiving radiotherapy.

Pulmonary Function and Diffusing Capacity of Carbon Monoxide in Hypersensitivity Pneumonitis: An Observational Study of 152 Patients.

OBJECTIVE: Hypersensitivity pneumonitis (HP) is an inflammatory and/or fibrotic lung disease. The restrictive lung function with low diffusing capacity of carbon monoxide (DLCO) is common in interstitial lung diseases (ILD). There are limited data on pulmonary function test (PFT) in HP and its role for diagnosis is questionable. We analyzed the data of 152 HP patients for type of defect, lung volume, and DLCO. MATERIAL AND METHODS: The present study is a retrospective analysis of 152 patients at one of the tertiary chest institutes in India. All diagnosed cases with at least spirometry were included. PFT findings were classified and graded as obstructive, restrictive, and mixed patterns. The correlation of PFT was calculated with disease duration and 6MWT distance. RESULTS: The majority were female [106 (70%)], with a mean age of 47.8 ± 12.3 years. Spirometry with lung volume data were available for 97% patients. PFT was abnormal in 118 (80%) cases. Among the patterns of abnormality, the most common type was restrictive (74%) followed by mixed (15%) and obstructive (11%) with the majority in the severe to very severe grade. The mean total lung capacity (TLC) and residual volume (RV) were reduced, with the grade more severe when the pattern of abnormality was restrictive while the RV/ TLC was higher suggestive of air tapping. DLCO data were available for 132 (87%) cases, with levels decreased in 67%. The severity of DLCO was highest when the pattern of abnormality was restrictive. One of the PFT parameters was abnormal in 137 (90%) cases, with isolated decreased DLCO levels seen in 16 (10%) cases. Forced vital capacity (FVC), TLC, and DLCO showed positive correlation with 6MWT distance (FVC r = .22, P = .02; TLC r = .28, P = .003; DLCO r = .30, P = .002). CONCLUSION: The PFT abnormality is seen in >80% of HP patients. All types of abnormality were seen, with the restrictive pattern being the most common. Isolated decreased DLCO levels were seen in 10% of cases. We advised to do full PFT for diagnosis and followup of HP.

Epitaxial Heterostructures of CsPbBr3 Perovskite Nanocrystals with Post-transition Metal Bismuth.

The facet chemistry of halide perovskite nanocrystals plays a key role in designing nanoscale epitaxial heterostructures. However, despite significant successes achieved in designing these nanocrystals, their heterostructures with several leading transition metals could not be established yet. Herein, the possible heterostructures of metals beyond transition metals are explored and the epitaxial combinations of soft CsPbBr3 nanocrystals with the post-transition metal Bi(0) are reported. These heterostructures are built with interfacing facets having hexagonal atomic configurations of both the rhombicuboctahedron CsPbBr3 and octahedral Bi(0). A high reaction temperature and the presence of alkylamine kept Bi(III) in reduced form and helped in sustaining these CsPbBr3-Bi(0) heteronanocrystals. Since understanding of and synthesis optimization of metal-halide perovskite heterostructures are limited, this finding adds a new fundamental insight in designing ionic and nonionic materials heterojunctions. Furthermore, oxidation and sulfidation of Bi(0) are studied, and the possible oxide/sulfide heterostructures with CsPbBr3 are discussed.

Thirty years of emotional intelligence: A scoping review of emotional intelligence training programme among nurses.

The stressful environment of any healthcare setting can be detrimental to nurses' mental and emotional health. In recent years, emotional intelligence (EI) has emerged as a vital psychological resource that positively impacts mental and emotional health and improves organizational functioning and success. This scoping review aimed to collate, synthesize and outline the research conducted on EI training programmes among nurses to assess their effectiveness in improving staff nurses' EI. Electronic databases of MEDLINE via PubMed, CINAHL, Scopus, Cochrane, ProQuest, Embase and Web of Science were comprehensively searched for related studies published between 1990 and 2021 (updated in May 2022). Two investigators independently screened the abstracts of the retrieved studies against the inclusion and exclusion criteria. Out of 728 initially retrieved studies, only 7 were included in the final synthesis. The PRISMA-ScR (2018) checklist was used to report the study findings. All the studies included in the review reported a significant improvement in nurses' EI after a training programme. The results also indicate that EI interventions are an effective way to improve nurses' psychological resources (improve resilience and coping skills; reduce anxiety and stress), leadership qualities, job performance and patient experience of nursing care. As nurses are exposed to a wide range of emotions, human pain and suffering, the results of this review suggest that improving the EI skills of nurses through short training programmes is an effective way to maintain their emotional and mental well-being. This scoping review is preregistered in Prospero (CRD42020161084).

Effectiveness of health literacy and relaxing music on quality of sleep and risk for antenatal depression.

Background: Pregnant women experience increased sleep disturbances during the third trimester of their pregnancy, which may result in the development of psychological issues in the perinatal period. There is a dearth of interventional studies that combine health literacy and the provision of music for the benefit of pregnant women in South Asia. Aim: To determine the effectiveness of a combination of Comprehensive Health literacy And Relaxing Music (CHARM) interventions on quality of sleep and risk for antenatal depression among women visiting antenatal outpatient departments of a tertiary hospital in South India. Methods: A four-arm parallel-group randomized controlled trial was adopted; 128 low-risk primigravid women were recruited and randomly assigned to the four groups using block randomization. The interventions included relaxing music interventions, comprehensive health-literacy interventions, combinations of both as CHARM interventions, and standard antenatal care. All the interventions were provided for four weeks. The quality of sleep among pregnant women was assessed using the Pittsburgh Sleep Quality Index Scale at baseline and after four weeks of intervention. Women at risk of developing antenatal depression were screened using the Edinburgh Postnatal Depression Scale-Antenatal Version. Results: Pregnant women who received CHARM interventions had significant improvement in quality of sleep when compared with other interventions (F(3,124) =15.0, P < .001, effect size η p2= 0.27). Also, 38 (29.6%) of the included pregnant women were at risk of developing antenatal depression, which was reduced to 21 (16.4%) following the intervention. Conclusion: CHARM intervention could promote quality sleep and reduce the risk of developing antenatal depression, thereby improving perinatal mental health.

Effect of Lifestyle Modification Intervention Programme on Bone Mineral Density among Postmenopausal Women with Osteoporosis.

Objectives: Osteoporosis is one of the major public health problems worldwide among postmenopausal osteoporotic women. Lifestyle modification interventions along with pharmacotherapy help to revert bone loss and prevent complications. Methods: A randomised controlled trial was conducted at Kasturba Hospital, Manipal from January 2019 to December 2021 among postmenopausal women with osteoporosis. The postmenopausal women who attended the osteoporosis clinic and were within the age group of 45-65 years, could speak and understand English or Kannada and whose bone mineral density (BMD) score was between -1 and -3 were included in the study. The total sample size of the study was 120 with 60 in each of the experimental and control groups. After obtaining informed consent, a stratified block randomisation method was used to allocate the participants to intervention and control groups. The BMD was monitored by the portable ultrasound densitometer by a technician at the outpatient departments. The baseline information was collected by a structured demographic questionnaire. Intervention group participants received a lifestyle modification intervention program (LMIP) whereas the control group received standard regular care from the physician. Follow-up was done at three and six months. Results: The results revealed that the increase in the BMD median score among the experimental group was from -2.2 (-2.5- -1.8) to -1.5 (-1.8- -0.65) whereas in the control group, it was from -2.3 (-2.6- -1.9) to -2.0 (-2.4- -1.5). The results of the Mann Whitey U test showed a statistical significance between the intervention and control groups in the post-test after six months (U = 505.5; P <0.05). Wilcoxon signed rank test showed a significant change in both the intervention and control groups from pre-test to post-test I (3 months) and post-test II (6 months; P <0.001). Conclusion: The lifestyle modification intervention was found to be effective in improving the bone health status of postmenopausal women. Hence it is very important to integrate it into regular therapy.

Role of sleep questionnaires in predicting obstructive sleep apnea amongst interstitial lung diseases patients.

Introduction: The co-existence of obstructive sleep apnea (OSA) and interstitial lung diseases (ILD) results in significant morbidity and mortality. So screening for OSA is important for its early diagnosis among ILD patients. The commonly used questionnaires for screening of OSA are Epworth sleep score (ESS) and STOP-BANG. However, the validity of these questionnaires among ILD patients is not well studied. The aim of this study was to assess the utility of these sleep questionnaires in detection of OSA among ILD patients. Methods: It was a prospective observational study of one year in a tertiary chest centre in India. We enrolled 41 stable cases of ILD who were subjected to self-reported questionnaires (ESS, STOP-BANG, and Berlin questionnaire). The diagnosis of OSA was done by Level 1 polysomnography. The correlation analysis was done between the sleep questionnaires and AHI. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for all the questionnaires. The cutoff values of STOPBANG and ESS questionnaire were calculated from the ROC analyses. P value of <0.05 was considered to be significant. Results: OSA was diagnosed in 32 (78%) patients with mean AHI of 21.8 ± 17.6.The mean age was 54.8 ± 8.9 years with majority being female (78%) and mean body mass index (BMI) was 29.7 ± 6.4 kg/m2. The mean ESS and STOPBANG score were 9.2 ± 5.4 and 4.3 ± 1.8, respectively, and 41% patients showed high risk for OSA with Berlin questionnaire. The sensitivity for detection of OSA was highest (96.1%) with ESS and lowest with Berlin questionnaire (40.6%). The receiver operating characteristics (ROC) area under curve for ESS was 0.929 with optimum cutoff point of 4, sensitivity of 96.9%, and specificity of 55.6%, while ROC area under curve for STOPBANG was 0.918 with optimum cutoff point of 3, sensitivity of 81.2% and specificity of 88.9%.The combination of two questionnaires showed sensitivity of >90%. The sensitivity also increased with the increasing severity of OSA. AHI showed positive correlation with ESS (r = 0.618, P < 0.001) and STOPBANG (r = 0.770, P < 0.001). Conclusion: The ESS and STOPBANG showed high sensitivity with positive correlation for prediction of OSA in ILD patients. These questionnaires can be used to prioritize the patients for polysomnography (PSG) among ILD patients with suspicion of OSA.

Ultrafast time-resolved carrier dynamics in tellurium nanowires using optical pump terahertz probe spectroscopy.

We report carrier relaxation dynamics in semiconducting tellurium nanowires (average diameter ∼ 10 nm) using ultrafast time-resolved terahertz spectroscopy. After photoexcitation using an 800 nm pump pulse, we observed an initial increase in the THz conductivity due to the absorption of THz radiation by photoexcited carriers. The time evolution of the differential conductivity (Δσ(τpp) = σpump on(τpp) - σpump off) shows a bi-exponential relaxation with the initial fast decay time scale of τ1 ∼ 25 ps followed by a longer relaxation time constant of τ2 ∼ 100 ps. Interestingly, the two time scales depend on the amount of the capping agent present on the surface of TeNWs, showing a faster relaxation of the photoexcited carriers as the percentage of capping decreases. This is physically interpreted as the surface state mediated relaxation mechanism of the photo-pumped carriers depending on the density of available surface states. A quantitative understanding is obtained using a coupled rate equation model taking into account the decay mechanisms determined from the surface mediated relaxation rate (DS) and direct recombination rate (DR) of the electron-hole pairs. Furthermore, the measured lattice temperature (TL) dependent dynamics, showing a faster relaxation at lower temperature, is understood using the same rate equation model, giving a power law dependence of the electron-hole recombination rate (DR) on TL as DR ∝ TL-1/2. This is explained by estimating DR using the van Roosbroeck-Shockley theory taking into account the density of states () of one-dimensional nanowires. Furthermore, to understand the measured frequency-dependent THz photoconductivity, we model Δσ(ω) using the Boltzmann transport equation taking into account the energy-dependent scattering rates showing the dominant role of short range (Γsr) and Coulomb scattering (ΓC) rates in the relaxation process, which further provides a measure of the charged and neutral impurity concentrations.

A Qualitative Study of Decision-making (DM) in Surgery and Cancer Care: an Indian Perspective.

Cancer psychology is a vitally important part of cancer management. Qualitative research is a gateway to exploring this. Weighing the treatment options in terms of quality of life and survival is important. Given the globalization of healthcare seen in the last decade, the exploration of the decision-making process in a developing nation was deemed highly appropriate. The aim is to explore the thoughts of surgical colleagues and care providing clinicians about patient decision-making in cancer care in developing countries, with special reference to India. The secondary objective was to identify factors that may have a role to play in decision-making in India. A prospective qualitative study. The exercise was carried out at Kiran Mazumdhar Shah Cancer Center. The hospital is a tertiary referral center for cancer services in the city of Bangalore, India. A qualitative study by methodology, a focus group discussion was undertaken with the members of the head and neck tumor board. The results showed, in India, decision-making is predominantly led by the clinicians and the patient's family members. A number of factors play an important role in the decision-making process. These include as follows: health outcome measures (quality of life, health-related quality of life), clinician factors (knowledge, skill, expertise, judgment), patient factors (socio-economic, education, cultural), nursing factors, translational research, and resource infrastructure. Important themes and outcomes emerged from the qualitative study. As modern healthcare moves towards a patient-centered care approach, evidence-based patient choice and patient decision-making clearly have a greater role to play, and the cultural and practical issues demonstrated in this article must be considered. Supplementary Information: The online version contains supplementary material available at 10.1007/s13193-022-01521-x.

Effect of task-based bilateral arm training on upper limb recovery after stroke: A systematic review and meta-analysis.

OBJECTIVE: Upper limb recovery is a crucial component of stroke rehabilitation aimed to maximize functional activities and reduce disability. Using both arms post stroke is essential to carry out many functional activities but the evidence on bilateral arm training (BAT) is understudied. To investigate the evidence for efficacy of task-based BAT on upper limb recovery, function, and participation post stroke. METHODS: We included 13 randomized controlled trials, and methodological quality was assessed using Cochrane risk of bias tool and the PEDro scale. The outcome measures such as Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), Box and Block Test (BBT), Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Stroke Impact Scale (SIS) were synthesized and analysed based on ICF. RESULTS: When comparing BAT with control group, BAT showed improvement in the pooled standard mean difference (SMD) of FMA-UE (SMD= 0.62, 95% confidence interval (CI), 0.12 to 1.12, p = 0.01; I2=83%). The control group showed significant improvement in MAL-QOM (SMD= -0.10, 95%CI, -0.77 to 0.58, p = 0.78; I2=89%). Compared to conventional group, BAT showed a significant improvement in BBT (SMD= 0.52, 95%CI, 0.04 to 1.00, p = 0.03; I2=0%). When compared with BAT, unimanual training yielded a significant improvement (SMD= -0.60, 95%CI, -0.98 to -0.22, p = 0.002; I2=0%) in MAL-QOM. In real-life participation, the control group showed improvement in SIS (SMD= -0.17, 95% (CI), -0.70 to 0.37, p = 0.54; I2=48%) over BAT. CONCLUSIONS: Task-based BAT appears to improve upper limb motor function post stroke. The benefits of task-based BAT on activity performance and participation in real life are not statistically significant.

Physical activity interventions for glycaemic control in African adults - A systematic review and meta-analysis.

BACKGROUND AND AIM: Growing evidence indicates that increasing physical activity may aid in regulating altered glycaemic control, thereby mitigating the risk of diabetes. However, the evidence summarising the efficacy of physical activity on glycaemic control among African adults remains unconsolidated. Our objective was to provide an amalgamated summary of the empirical evidence that explored the effectiveness of physical activity interventions on glycaemic control among African adults. METHODS: A systematic search of six journal databases for the studies exploring the efficacy of physical activity on glycaemic control among African adults until March 21, 2022, was administered. Two independent reviewers screened the citations based on a priori set eligibility criteria. Data were analysed using inverse variance method and a summary of findings was synthesised using the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS: Of the 14,624 citations retrieved, 26 articles with 1474 participants were included for final analysis. Most of the included trials had a high risk of bias (N = 20; 76.92%). Our review found a significant reduction in fasting blood glucose (FBG, -2.18 [ 95% CI -3.18, -1.18] mmol/L), insulin (-0.99 [-2.71, 0.74] µU/L), Glycosylated haemoglobin (HbA1C) (-0.53% [-0.88, -0.19]), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (-0.74% [-1.10, -0.38]) and insulin sensitivity (-0.90 µU/l/min [-1.75, -0.06]) following physical activity interventions. The review reports low certainty of evidence across all outcome measures. DISCUSSION AND CONCLUSION: Physical activity interventions were found to improve glycaemic control among African adults. However, the optimal physical activity dose for demonstrating meaningful benefits on glucose tolerance still remains unclear due to the limited number of primary studies available.

Tuning Catalytic Activity in Ultrathin Bimetallic Nanowires via Surface Segregation: Some Insights.

The efficiency of heterogeneous catalysts critically depends on the nature of the surface. We present results on controlling the composition in ultrathin bimetallic AuPd. AuPd wires were grown using Au nanowire templates; the surface composition could be tuned by increasing the amount of Pd. Further, segregation of Pd to the surface could be induced in alloyed nanowires by annealing under a controlled CO atmosphere. Electrocatalytic activity of these bimetallic systems is assessed for the methanol oxidation reaction (MOR). While the MOR potential shows a monotonic increase with Pd content, the specific activity displays a typical volcano-type behavior. The CO-annealed nanowires show a lowering of potential owing to a higher Pd content on the surface while still maintaining the specific activity. These findings provide clear strategies to independently control the reaction potential and the activities of nanocatalysts. The experimental findings are well supported by the theoretical investigations using density functional theory (DFT) calculations.

Effectiveness of Integrated Emotional-Self Enhancement (IESE) program among staff nurses: protocol for a quasi-experimental study.

Background: Staff nurses face frequent emotional situations in their work environment. The constant contact with suffering patients, and the busy work environment, pose tremendous stress on nurses' physical and emotional health. The Emotional Intelligence skills of empathy, self-awareness, motivation, self-control, and keeping relationships, can help handle difficult emotions and allow nurses to work in an organized, calm, and professional way. This study aims to implement and assess the effectiveness of a training program developed by the investigator, tailored to the mental and emotional needs of staff nurses who are working in an organization. The study also aims to observe any significant change, correlation, and association in the staff nurses' level of emotional intelligence, intrinsic motivation, self-compassion, emotional labor, and nurse-in-charges' and patients' perception of nursing care after the program. Methods: A quasi-experimental (one-group) study design was used in this study. The study will involve 80 staff nurses working in a selected hospital in India. The staff nurses will be selected from the hospital's general wards using convenience sampling. For the current study, a quasi-experimental design will be used. The investigator will deliver a training program, divided into four sessions of two hours each. Data will be collected from the participants at baseline and 3-months pre-intervention; and post-test data will be collected immediately after the intervention, at 3-month, and 6-month follow-up, to observe any significant change in the study variables before and after the intervention. Results: The current study primarily focuses on the vital aspect of developing emotional needs, for promoting a better work-life balance. Research findings from the study will significantly contribute to the evidence based Emotional Intelligence programs for staff nurses, and if proven effective, could be delivered extensively in the hospitals. Trial registration: The study is registered in June 2019 under the Central Trial Registry of India ( CTRI/2019/08/020592).

A Phantom-based Investigation Into the Influence of Low Tube Potential and Matrix Size on Radiation Dose and Image Quality for a 128 Slice Abdominopelvic Ct Protocol

@#Introduction: Reducing radiation dose for CT examinations has been accompanied by an increase in image noise. Studies have highlighted the application of a higher matrix size for improving image quality when assessing the lungs. This study aims to evaluate the influence of a low kVp and higher matrix size on radiation dose and image quality for abdominopelvic CT. Methods: This experiment was done on a 32 cm body phantom and scanned using a 128 slice CT scanner. The study utilised various combinations of kVp settings (140, 120, 100, 80 & 70) and matrix sizes (1024, 768 & 512). The image obtained was analysed objectively and subjectively. For objective analysis, we calculated SNR, and CNR. For subjective analysis, two radiologists evaluated the image in a 3-point scoring scale. Results: The study reported an increase in SNR (0.8%) and CNR (46%) at 120 kVp when increasing the matrix size from 512 x 512 to 768 x 768. Similarly, there was an increase of 14.5 % and 56.4 % in CNR and SNR using 1024 matrix size. The DLP was reduced by 4.5%, 50% and 70.6 % using 100, 80 and 70 kVp respectively. However, there was no change in DLP with higher matrix sizes. Conclusion: The study reported a combination of 100 kVp and 768 matrix size resulted in an almost similar (↓0.9 %) SNR and improved CNR (↑46.4 %) compared to 120 kVp and 512 matrix size. Qualitative analysis also showed a similar image quality with decreased radiation dose for abdominopelvic CT.

Dirac surface plasmons in photoexcited bismuth telluride nanowires: optical pump-terahertz probe spectroscopy.

Collective excitation of Dirac plasmons in graphene and topological insulators has opened new possibilities of tunable plasmonic materials ranging from THz to mid-infrared regions. Using time resolved Optical Pump-Terahertz Probe (OPTP) spectroscopy, we demonstrate the presence of plasmonic oscillations in bismuth telluride nanowires (Bi2Te3 NWs) after photoexcitation using an 800 nm pump pulse. In the frequency domain, the differential conductivity (Δσ = σpump on-σpump off) spectrum shows a Lorentzian response where the resonance frequency (ωp), attributed to surface plasmon oscillations, shifts with photogenerated carrier density (n) as . This dependence establishes the absorption of THz radiation by the Dirac surface plasmon oscillations of the charge carriers in the Topological Surface States (TSS) of Bi2Te3 NWs. Moreover, we obtain a modulation depth, tunable by pump fluence, of ∼40% over the spectral range of 0.5 to 2.5 THz. In addition, the time evolution of Δσ(t) represents a long relaxation channel lasting for more than 50 ps. We model the decay dynamics of Δσ(t) using coupled second order rate equations, highlighting the contributions from surface recombination as well as from trap mediated relaxation channels of the photoinjected carriers.

A mixed-methods systematic review on barriers to exclusive breastfeeding.

INTRODUCTION: The World Health Organization recommends exclusive breastfeeding for every newborn during the first 6 months of life, yet women come across various challenges to continuing it. AIM: This systematic review was intended to identify barriers to exclusive breastfeeding among mothers. METHODS: MEDLINE, Cumulative Index to Nursing and Allied health literature, ProQuest, Web of Science and Scopus databases were searched from January 1990 to October 2017. The systematic review included quantitative, qualitative and mixed-methods studies to identify barriers to exclusive breastfeeding among mothers of reproductive age with an infant aged between 0 and 12 months. All studies were screened based on titles, abstracts and full text by two reviewers independently. The methodological quality of included studies was assessed using appropriate tools. Of the 9737 eligible records, 44 studies were included for analysis. Classification of barriers to exclusive breastfeeding was adopted from the conceptual framework of factors affecting breastfeeding practices given by Hector and colleagues. RESULTS: In total 32 barriers were grouped under individual, group and society level factors. Meta-analysis indicated that mothers who smoked had 2.49 times more odds of not exclusively breastfeeding than non-smoking mothers and mothers who had undergone caesarean section had 1.69 times more risk of cessation of exclusive breastfeeding than mothers who have had a vaginal childbirth. CONCLUSION: The systematic review revealed a complex interplay of various barriers related to exclusive breastfeeding. It is recommended that context-specific strategies should be designed in accordance with barriers existing in a region or country.

Comparison of two self-sampling methods for human papillomavirus (HPV) DNA testing among women with high prevalence rates.

One major advantage of molecular assays for human papillomavirus (HPV) DNA detection is that these assays can be performed on self-collected samples unlike cytology or visual inspection with acetic acid (VIA). This cross-sectional study was carried out between March 2017 and April 2019 to compare the diagnostic performance in self-collected urine and vaginal samples for HPV DNA detection. Viral DNA was extracted from processed samples using a Qiagen viral DNA extraction Kit (QIAamp DNA Mini Kit). To detect four common high-risk HPV types (16, 18, 31, 45), multiplex real-time polymerase chain reaction (PCR) targeting the LCR/E6/E7 region of the HPV genome was performed in ABI 7500 cycler (Applied Biosystems). The negative samples were screened by conventional PCR targeting the L1 capsid region to exclude other HPV types. The overall agreement between the two self-collecting sampling methods was 64.04% with a κ value of 0.29 pointing towards a fair agreement (P < .01). The sensitivity of HPV DNA detection in urine samples was 57.95% (47.52%, 67.72), and specificity was 84.6% (66.47%, 93.85%) when compared with vaginal samples. The study concludes that self-collected vaginal HPV DNA testing is more sensitive than unpreserved-urine samples for HPV DNA detection in a hospital-based setting.

Modulation of the bacterial population in commercial cucumber fermentations by brining salt type.

AIMS: Differences in the bacterial population of cucumber fermentations brined with no salt, 100 mmol l-1 (1·1%) calcium chloride (CaCl2 ) or 1·03 mol l-1 (6%) sodium chloride (NaCl) were studied. METHODS AND RESULTS: Changes in the microbiology and chemistry of commercial and laboratory scale cucumber fermentations occurring as a function of time were monitored using colony counts and metagenetic analysis, and a pH probe and high-performance liquid chromatography analysis respectively. Dissolved oxygen and carbon dioxide content were monitored in commercial fermentations. Fermentations brined with calcium chloride (CaCl2 ) or no salt sustained faster microbial growth and reduction in pH than those brined with 1·03 mol l-1 NaCl. Leuconostoc, Lactococcus and Weissella dominated in fermentations brined with no salt or 100 mmol l-1 CaCl2 on day 1 as compared to Weissella and enterobacteria in fermentations containing 1·03 mol l-1 NaCl. Lactobacilli dominated all fermentations by the third day, regardless of salt type, and was followed, in relative abundance by Pediococcus, Leuconostoc, Lactococcus and Weissella. From 84 to 96% of the population was composed of Lactobacillus by day 7 of the fermentations, except in the no salt fermentations in which a mixed population of LAB remained. The population of LAB found in commercial cucumber fermentations brined with 100 mmol l-1 CaCl2 (n = 18) or 1·03 mol l-1 NaCl (n = 9) mimicked that of laboratory fermentations. A declining population of aerobes was detected in commercial fermentations brined with CaCl2 on day 1. CONCLUSION: A reduced NaCl content in cucumber fermentation enhances microbial diversity. SIGNIFICANCE AND IMPACT OF THE STUDY: This study fills a knowledge gap and aids in the design of improved reduced NaCl cucumber fermentations.

Ultra-sensitive graphene-bismuth telluride nano-wire hybrids for infrared detection.

The myriad technological applications of infrared radiation sensors make the search for ultra-sensitive detectors extremely crucial. Materials such as bismuth telluride (Bi2Te3), having a small bulk band gap of 0.17 eV, are ideal infrared detectors. However, due to the high recombination rate of photo-generated charge carriers in the bulk, the electrical response under optical illumination is typically very weak in these materials. We have circumnavigated this by sensitizing graphene with Bi2Te3 nano-wires. These hybrid devices show an ultra-high sensitivity of ∼106 A W-1, under incident electromagnetic radiation from 940 nm to 1720 nm. The theoretical limit of the noise equivalent power and specific detectivity in these devices are ∼10-18 W Hz-1/2 and ∼1011 Jones respectively, which are comparable to those of some of the best known detectors.

Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND: Insulin resistance is a determining factor in the pathophysiology of type 2 diabetes mellitus (T2DM). Exercise is known to improve insulin resistance, but a systematic review of the literature is lacking. OBJECTIVE: This systematic review and meta-analysis focused on identifying evidence for the effectiveness of a structured exercise intervention program for insulin resistance in T2DM. METHODS: We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane Central Register of Controlled Trials for reports of studies on fasting insulin, homeostatic model assessment for insulin resistance (Homa-IR), fasting blood sugar, glycated hemoglobin and body mass index in patients with T2DM and healthy controls that were published between 1990 and 2017. Data are reported as the standardized mean difference or mean difference with 95% confidence intervals (CIs). RESULTS: Among 2242 records retrieved, only 11 full-text articles were available for meta-analysis. Data for 846 participants were analyzed, 440 in the intervention group, and 406 in the control group. The mean difference for fasting insulin level was-1.64 (95% CI; -3.38 to 0.10), Homa-Ir 0.14 (-1.48 to 1.76), fasting blood sugar-5.12 (-7.78 to-2.45), hemoglobin A1c 0.63 (-0.82 to 2.08) and body mass index-0.36 (-1.51 to 0.79). CONCLUSION: The evidence highlights the effectiveness of a structured exercise intervention program for insulin resistance in T2DM with a moderate level 2 of evidence.