Objective
Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health ...centres in resource‐limited countries.
Design
Cluster randomised trial.
Setting
Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia)
Methods
Clusters were randomised to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds.
Main outcome measures
The primary outcome was a composite of maternal mortality, maternal near‐miss mortality, stillbirth, and neonatal mortality.
Results
During the 24‐month trial, 28 intervention and 28 control clusters had 24 263 and 23 160 births, respectively; 78% in the intervention clusters received at least one study ultrasound; 60% received two. The prevalence of conditions noted including twins, placenta previa, and abnormal lie was within expected ranges. 9% were referred for an ultrasound‐diagnosed condition, and 71% attended the referral. The ANC (RR 1.0 95% CI 1.00, 1.01) and hospital delivery rates for complicated pregnancies (RR 1.03 95% CI 0.89, 1.20) did not differ between intervention and control clusters nor did the composite outcome (RR 1.09 95% CI 0.97, 1.23) or its individual components.
Conclusions
Despite availability of ultrasound at ANC in the intervention clusters, neither ANC nor hospital delivery for complicated pregnancies increased. The composite outcome and the individual components were not reduced.
Tweetable
Antenatal care ultrasound did not improve a composite outcome that included maternal, fetal, and neonatal mortality.
Tweetable
Antenatal care ultrasound did not improve a composite outcome that included maternal, fetal, and neonatal mortality.
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Technology Mediated Service Encounters Garcés-Conejos Blitvich, Pilar; Fernández-Amaya, Lucía; de la O Hernández-López, María
2019, 2019-01-10, Volume:
300
eBook
The chapters in this collection, authored by renowned scholars, address a gap in the literature by focusing on the consequences that outsourcing, among other globalized economic practices, and ...remediation by new technologies have had on the service encounters genre (SE). From both a multilingual and a multidisciplinary perspective, this collection explores the development of technological applications and professional best practices as well as call centre interaction, e-commerce, and e-word of mouth. More specifically, the papers in this volume report on technology developed to support SEs and how this technology influences service providers and their allowable linguistic contributions. Further, this collection provides valuable insights on the language and strategic behaviour deployed in less researched kinds of SEs, gives special attention to how technology impacts the interface between the transactional and interactional goals of SEs, and thus has real world applications.
The scope of the proposed book is to identify and emphasize the successful link between computational materials modeling as a simulation and design tool and its synergistic application to ...experimental research and alloy development. Hence, the purpose of this book is to provide a more balanced perspective of the role that computational modeling can play in every day research and development efforts. This will be done by presenting a series of examples of the successful application of various computational modeling procedures (everything from first principles to quantum approximate to CALPHAD methods) to real life surface and bulk alloy problems.
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FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Thymoquinone (TQ) is the main biologically active constituent of Nigella sativa. Many studies have confirmed its anticancer actions. Herein, we investigated the different anticancer activities of, ...and considered resistance mechanisms to, TQ. MTT and clonogenic data showed TQ’s ability to suppress breast MDA-MB-468 and T-47D proliferation at lower concentrations compared to other cancer and non-transformed cell lines tested (GI50 values ≤ 1.5 µM). Flow-cytometric analyses revealed that TQ consistently induced MDA-MB-468 and T-47D cell-cycle perturbation, specifically inducing pre-G1 populations. In comparison, less sensitive breast MCF-7 and colon HCT-116 cells exhibited only transient increases in pre-G1 events. Annexin V/PI staining confirmed apoptosis induction in MDA-MB-468 and HCT-116 cells, which was continuous in the former and transient in the latter. Experiments revealed the role of reactive oxygen species (ROS) generation and aneuploidy induction in MDA-MB-468 cells within the first 24 h of treatment. The ROS-scavenger NAD(P)H dehydrogenase (quinone 1) (NQO1; DT-diaphorase) and glutathione (GSH) were implicated in resistance to TQ. Indeed, western blot analyses showed that NQO1 is expressed in all cell lines in this study, except those most sensitive to TQ-MDA-MB-468 and T-47D. Moreover, TQ treatment increased NQO1 expression in HCT-116 in a concentration-dependent fashion. Measurement of GSH activity in MDA-MB-468 and HCT-116 cells found that GSH is similarly active in both cell lines. Furthermore, GSH depletion rendered these cells more sensitive to TQ’s antiproliferative actions. Therefore, to bypass putative inactivation of the TQ semiquinone metabolite, the benzylamine analogue was designed and synthesised following modification of TQ’s carbon-3 atom. However, the structural modification negatively impacted potency against MDA-MB-468 cells. In conclusion, we disclose the following: (i) The anticancer activity of TQ may be a consequence of ROS generation and aneuploidy; (ii) Early GSH depletion could substantially enhance TQ’s anticancer activity; (iii) Benzylamine substitution at TQ’s carbon-3 failed to enhance anticancer activity.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Inclusive education in the United Arab Emirates (UAE) is evolving with ambitious policies and strategic plans. The extent to which these policies and plans are being embedded into practice in ...mainstream schools across the country has not been fully captured. This research used an online survey to investigate teachers' perceived competence in implementing inclusive education practices with students with disabilities in mainstream schools and explore its relationship with demographic variables. Participants included 999 teachers from public and private schools across the seven Emirates of the UAE. Greater competence was reported in implementing practices that create an environment conducive to effective learning and less competence in implementing practices that use knowledge of the student. Differences were found between demographic variables and teachers' perceived competence in implementing inclusive education practices with recent professional development in inclusive and/or special education emerging as the most significant predictor. Implications for practice and further research are considered.
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The intestinal lymphatic system plays an important role in the pathophysiology of multiple diseases including lymphomas, cancer metastasis, autoimmune diseases, and human immunodeficiency virus (HIV) ...infection. It is thus an important compartment for delivery of drugs in order to treat diseases associated with the lymphatic system. Lipophilic prodrug approaches have been used in the past to take advantage of the intestinal lymphatic transport processes to deliver drugs to the intestinal lymphatics. Most of the approaches previously adopted were based on very bulky prodrug moieties such as those mimicking triglycerides (TG). We now report a study in which a lipophilic prodrug approach was used to efficiently deliver bexarotene (BEX) and retinoic acid (RA) to the intestinal lymphatic system using activated ester prodrugs. A range of carboxylic ester prodrugs of BEX were designed and synthesised and all of the esters showed improved association with chylomicrons, which indicated an improved potential for delivery to the intestinal lymphatic system. The conversion rate of the prodrugs to BEX was the main determinant in delivery of BEX to the intestinal lymphatics, and activated ester prodrugs were prepared to enhance the conversion rate. As a result, an 4-(hydroxymethyl)-1,3-dioxol-2-one ester prodrug of BEX was able to increase the exposure of the mesenteric lymph nodes (MLNs) to BEX 17-fold compared to when BEX itself was administered. The activated ester prodrug approach was also applied to another drug, RA, where the exposure of the MLNs was increased 2.4-fold through the application of a similar cyclic activated prodrug. Synergism between BEX and RA was also demonstrated in vitro by cell growth inhibition assays using lymphoma cell lines. In conclusion, the activated ester prodrug approach results in efficient delivery of drugs to the intestinal lymphatic system, which could benefit patients affected by a large number of pathological conditions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Employing social media applications for instructional activities has become a trendy topic, with a relatively large number of studies published yearly. However, identifying the factors influencing ...social media adoption and having a clear taxonomy that guides further research are neglected in the extant literature. Understanding which specific disciplines use specific social media applications also requires further investigations. Therefore, this systematic review retrieved and analyzed 713 studies published on social media adoption that relied on “Technology Acceptance Model” (TAM) as the basic model. After critically evaluating the collected publications against the inclusion and exclusion criteria, 45 studies were eventually shortlisted for in-depth analysis. The main findings indicated that most of the analyzed studies collected data from students enrolled in the business discipline. Facebook is found to be the primary application used in most of the analyzed studies for educational purposes. The influential factors affecting social media adoption were classified into three distinct groups, including external factors, behavioral intention antecedents, and moderating factors. We have also classified the behavioral intention antecedents into three distinct clusters, including user, social, and technology aspects. The majority of the existing literature was conducted in individualistic settings with limited exposure to collectivistic societies. This review is believed to provide a quick grasp of the disciplines, applications, and determinants influencing social media adoption in higher education.
•Systematic review retrieved and analyzed 713 studies.•Bibliometric analysis.•External factors, behavioral intention antecedents, and moderating factors are at play.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Parenting children with disabilities has consistently been reported to be associated with stress, and even more so among mothers who are primary caregivers. In non-Western contexts such as the United ...Arab Emirates (UAE), there is a dearth of research on maternal mental health in relation to raising children with disabilities and related mitigation strategies. During the COVID-19 pandemic (2020-2021), the Federal Government of the UAE used the Save the Child's Stress Checklist to assess the stress levels of 635 mothers who were raising children with disabilities in the northern part of the country. In the pre-test, an estimated 6% (36/635) of the mothers were found to be experiencing high levels of stress. Consequently, virtual stress management training was conducted, and 12 of the 36 mothers completed the full training. Wilcoxon's ranked test showed a reduction in their total, physical, emotional and cognitive stress at the end of the training. This study demonstrates the pressing need for ongoing training programmes to improve the mental health of mothers of children with disabilities in the UAE and similar contexts.
We report on the synergistic effect of PI3K inhibition with ALK inhibition for the possible treatment of EML4-ALK positive lung cancer. We have brought together ceritinib (ALK inhibitor) and ...pictilisib (PI3K inhibitor) into a single bivalent molecule (a codrug) with the aim of designing a molecule for slow release drug delivery that targets EML4-ALK positive lung cancer. We have joined the two drugs through a new, pH-sensitive linker where the resulting codrugs are hydrolytically stable at lower pH (pH 6.4) but rapidly cleaved at higher pH (pH 7.4). Compound (19), which was designed for optimal lung retention, demonstrated clean liberation of the drug payloads in vitro and represents a novel approach to targeted lung delivery.
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