Homer 2

AIM: The risk of Type 2 Diabetes is 10 times higher after a pregnancy with Gestational Diabetes. Physical activity can independently reduce this risk, yet engagement with physical activity remains low after Gestational Diabetes. Therefore, the present study aimed to explore the barriers and facilitators to the uptake of physical activity after Gestational Diabetes in the United Kingdom, using a socio-ecological approach. METHODS: The paper was written following the Standards for Reporting Qualitative Research...

Cesarean section rates worldwide are rising, driven by medically unnecessary cesarean use. The new World Health Organization Labour Care Guide (LCG) aims to improve the quality of care for women during labor and childbirth. Using the LCG might reduce overuse of cesarean; however, its effects have not been evaluated in randomized trials. We conducted a stepped-wedge, cluster-randomized pilot trial in four hospitals in India to evaluate the implementation of an LCG strategy intervention, compared with routine care...

The building consumes almost 40% of the energy generated in the building. Investigating the photovoltaic system, wind, battery, and diesel generators for residential buildings can reduce energy utilization. In this work, various energy sources are combined to form hybrid energy sources, which are designed based on the load of the residential building. The Hybrid Optimization of Multiple Energy Resources tool optimizes various energy sources such as photovoltaic (PV), wind, diesel generator (DG), and battery...

There is a pressing need for allogeneic chimeric antigen receptor (CAR)-immune cell therapies that are safe, effective and affordable. We conducted a phase 1/2 trial of cord blood-derived natural killer (NK) cells expressing anti-CD19 chimeric antigen receptor and interleukin-15 (CAR19/IL-15) in 37 patients with CD19+ B cell malignancies. The primary objectives were safety and efficacy, defined as day 30 overall response (OR). Secondary objectives included day 100 response, progression-free survival, overall survival and CAR19/IL-15 NK cell persistence...

OBJECTIVE: Endocrine systems are disrupted in acute illness, and symptoms reported following coronavirus disease 2019 (COVID-19) are similar to those found with clinical hormone deficiencies. We hypothesised that people with severe acute COVID-19 and with post-COVID symptoms have glucocorticoid and sex hormone deficiencies. DESIGN/PATIENTS: Samples were obtained for analysis from two UK multicentre cohorts during hospitalisation with COVID-19 (International Severe Acute Respiratory Infection Consortium/World Health Organisation [WHO] Clinical Characterization Protocol for Severe Emerging Infections in the UK study), and at follow-up 5 months after hospitalisation (Post-hospitalisation COVID-19 study)...

BACKGROUND: Physique athletes are ranked by a panel of judges against the judging criteria of the corresponding division. To enhance on-stage presentation and performance, competitors in certain categories (i.e. bodybuilding and classic physique) achieve extreme muscle size and definition aided by implementing acute "peaking protocols" in the days before competition. Such practices can involve manipulating nutrition and training variables to increase intramuscular glycogen and water while minimising the thickness of the subcutaneous layer...

Septic tanks treat wastewater of individual houses and small communities (up to 2000 people in Scotland) in rural and semi-urban areas and are understudied sources of surface water contamination. A multi-analyte methodology with solid phase extraction (SPE), ultra-sonic extraction, and direct injection sample preparation methods was developed to analyse a comprehensive range of emerging contaminants (ECs) including prescription and over-the-counter pharmaceuticals and related metabolites, natural and synthetic hormones, and other human wastewater marker compounds in septic tank influent and effluent, river water, suspended solids, and septic tank sludge by ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS)...

BACKGROUND: The place of tonsillectomy in the management of sore throat in adults remains uncertain. OBJECTIVES: To establish the clinical effectiveness and cost-effectiveness of tonsillectomy, compared with conservative management, for tonsillitis in adults, and to evaluate the impact of alternative sore throat patient pathways. DESIGN: This was a multicentre, randomised controlled trial comparing tonsillectomy with conservative management...

BACKGROUND: The National Health Service Type 2 Diabetes Path to Remission programme in England (known as the NHS Low Calorie Diet programme when piloted) was established to support people living with excess weight and Type 2 Diabetes to lose weight and improve their glycaemic control. A mixed method evaluation was commissioned to provide an enhanced understanding of the long-term cost effectiveness of the pilot programme, its implementation, equity and transferability across broad and diverse populations...

BACKGROUND: Health and wellbeing can be profoundly impacted by both obesity and type 2 diabetes, while the normalisation and equity of care for people living with these non-communicable diseases remain as challenges for local health systems. The National Health Service Low Calorie Diet programme in England, aims to support people to achieve type 2 diabetes remission, while also reducing health inequalities. We have explored the experiences of health care staff who have made a referral to the LCD programme, while identifying effective and equitable delivery of programme referrals, and their normalisation into routine care...

PURPOSE: to determine whether primary trabeculectomy or medical treatment produces better outcomes in term of quality of life (QoL), clinical effectiveness and safety in patients presenting with advanced glaucoma. DESIGN: multicentre randomised controlled trial PARTICIPANTS: between June 3, 2014 and May 31, 2017, 453 adults presenting with newly diagnosed advanced open angle glaucoma in at least one eye (Hodapp Classification) were recruited from 27 secondary care glaucoma departments in the UK, 227 were allocated to trabeculectomy and 226 to medical management...

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are neurodevelopmental conditions with early life origins. Alterations in blood lipids have been linked to ADHD and ASD; however, prospective early life data are limited. This study examined (i) associations between the cord blood lipidome and ADHD/ASD symptoms at 2 years of age, (ii) associations between prenatal and perinatal predictors of ADHD/ASD symptoms and cord blood lipidome, and (iii) mediation by the cord blood lipidome...

BACKGROUND: Existing literature examines barriers to the provision of ethnically diverse dietary advice, however, is not specific to total diet replacement (TDR). There is a lack of literature from the UK, limiting the potential applicability of existing findings and themes to the UK context. This study addresses this gap in research by interviewing participants of South Asian ethnicity who have undertaken the National Health Service (NHS) low-calorie diet programme (LCD) for people with type 2 diabetes living with overweight or obesity...

RATIONALE: Potassium repletion is common in critically ill patients. However, practice patterns and outcomes related to different intensive care unit (ICU) potassium repletion strategies are unclear. OBJECTIVES: (1) Describe potassium repletion practices in critically ill adults, (2) compare the effectiveness of potassium repletion strategies, and (3) compare effectiveness and safety of specific potassium repletion thresholds on patient outcomes Methods: Retrospective analysis of the PINC AI Healthcare Database (2016-2022), including all critically ill adults admitted to an ICU on hospital day 1 and with a serum potassium level measured on hospital day 2...

OBJECTIVE: To study the fertility treatment pathways used by women with and without polycystic ovary syndrome (PCOS) and which pathways were more likely to result in a birth. DESIGN: This retrospective national community-based cohort study used longitudinal self-report survey data (collected 1996-2022; aged 18-49 years) from women born in 1973-1978 who are participants in the Australian Longitudinal Study on Women's Health. The study also used linked administrative data on fertility treatments (1996-2021)...

Occurrence of extraskeletal Ewing sarcoma (ES) in the gastrointestinal (GI) tract is extremely rare. Here, we report 25 cases of ES arising primarily in the GI tract with a focus on the clinicopathological and molecular features, differential diagnosis, and biological behavior. Thirteen patients (52%) were male, and 12 (48%) were female with age ranging from 9 to 59 years (mean: 36.2 years; median: 38 years). Twenty-one tumors (84%) occurred in the small intestine, 3 (12%) in the stomach, and 1 (4%) in the anal canal...

Objective: To investigate the clinicopathological characteristics, pathological diagnosis of Ewing's sarcoma of the central nervous system. Methods: Six cases of Ewing's sarcoma of the central nervous system diagnosed at the First Affiliated Hospital of Nanjing Medical University, Nanjing, China from 2015 to 2022 were collected. The clinical manifestations, histological morphology, immunophenotype and molecular genetics of these cases were analyzed. The related literature was reviewed. Results: There were four males and two females, with a male to female ratio of 2∶1...

BACKGROUND: "Shared decision-making" (SDM) is a cornerstone of prostate cancer (PCa) screening guidelines due to tradeoffs between clinical benefits and concerns for over-diagnosis and over-treatment. SDM requires effort by primary-care-providers (PCP) in an often busy clinical setting to understand patient preferences with the backdrop of patient risk factors. We hypothesized that SDM for PCa screening, given its prominence in guidelines and practical challenges, may be associated with quality preventative healthcare in terms of other appropriate cancer screening and encouragement of other preventative health behaviors...

Primary hyperparathyroidism commonly affects elderly women. When present in the young population, it is usually asymptomatic, most frequently due to a parathyroid adenoma and the definitive management is surgical excision. Uncommonly, 5-10% of patients fail to achieve long-term cure after initial parathyroidectomy and 6-16% of them is due to an ectopic parathyroid adenoma that will require focused diagnostic and surgical approaches. We report a 21-year-old male who had bilateral thigh pain. Work-up revealed bilateral femoral fractures, brown tumors on the arms and multiple lytic lesions on the skull...

The use of renewable energy resources for off-grid electricity production has gained more importance in recent decades for meeting the energy needs of remote areas, even with limited resources. This research aims to provide an optimized and cost-effective approach for generating electricity in rural areas. By using current methodology, a stand alone energy source of PV is designed for development of NZE village. Solar irradiance of the selected location is 6.16 kWh/m2 /day while the estimated electric load data for whole village is 64...