Health education interventions are considered critical for the prevention and management of conditions of public health concern. Although the burden of these conditions is often greatest in ...socio-economically disadvantaged populations, the effectiveness of interventions that target these groups is unknown. We aimed to identify and synthesize evidence of the effectiveness of health-related educational interventions in adult disadvantaged populations.
We pre-registered the study on Open Science Framework https://osf.io/ek5yg/ . We searched Medline, Embase, Emcare, and the Cochrane Register from inception to 5/04/2022 to identify studies evaluating the effectiveness of health-related educational interventions delivered to adults in socio-economically disadvantaged populations. Our primary outcome was health related behaviour and our secondary outcome was a relevant biomarker. Two reviewers screened studies, extracted data and evaluated risk of bias. Our synthesis strategy involved random-effects meta-analyses and vote-counting.
We identified 8618 unique records, 96 met our criteria for inclusion - involving more than 57,000 participants from 22 countries. All studies had high or unclear risk of bias. For our primary outcome of behaviour, meta-analyses found a standardised mean effect of education on physical activity of 0.05 (95% confidence interval (CI) = -0.09-0.19), (5 studies, n = 1330) and on cancer screening of 0.29 (95% CI = 0.05-0.52), (5 studies, n = 2388). Considerable statistical heterogeneity was present. Sixty-seven of 81 studies with behavioural outcomes had point estimates favouring the intervention (83% (95% CI = 73%-90%), p < 0.001); 21 of 28 studies with biomarker outcomes showed benefit (75% (95%CI = 56%-88%), p = 0.002). When effectiveness was determined based on conclusions in the included studies, 47% of interventions were effective on behavioural outcomes, and 27% on biomarkers.
Evidence does not demonstrate consistent, positive impacts of educational interventions on health behaviours or biomarkers in socio-economically disadvantaged populations. Continued investment in targeted approaches, coinciding with development of greater understanding of factors determining successful implementation and evaluation, are important to reduce inequalities in health.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Passive FMT by coprophagia attenuates paclitaxel-induced inflammation.•Gut microbes associate with chemotherapy-induced inflammation and behavior.•Gut microbial transplants from paclitaxel-treated ...mice cause anxiety-like behavior.•Chemotherapy GMT causes neuroinflammation in germ-free recipient mice.
Chemotherapy treatment is associated with acute behavioral side effects (fatigue, anorexia) that significantly reduce patient quality of life and are dose-limiting, thereby increasing mortality (Kidwell et al., 2014). Disruptions to gut homeostasis (diarrhea, constipation, microbial dysbiosis) are also observed in patients receiving chemotherapy. In non-oncological patients, facets of mental health (fatigue, anxiety, depression) correlate with alterations in the gut microbiome, suggestive of a contribution of the gut in CNS disease etiology. The potential gut-to-brain pathway is poorly understood in patients receiving chemotherapy. Our prior studies have demonstrated a correlation between chemotherapy treatment, gut changes, peripheral and central inflammation, and behavioral symptoms in mice. Here we aimed to determine the extent to which chemotherapy-associated gut manipulations modulate the behavioral and biological consequences of chemotherapy. We measured sickness behaviors, peripheral and central inflammatory mediators, and anxiety in conventional or germ-free female mice: 1) cohabitating with mice of the opposite treatment group, 2) pre-treated with broad-spectrum antibiotics, or 3) given an intra-gastric gavage of gut content from chemotherapy-treated mice. In cohabitation studies, presumed coprophagia promoted body mass recovery, however strong associations with inflammation and behavior were not observed. Reduction of gut microbial alpha diversity via antibiotics did not prevent chemotherapy-associated side effects, however the relative abundances of the genera Tyzzerella, Romboutsia, and Turicibacter correlated with circulating inflammatory (IL-1β) and behavioral outcomes (lethargy, anxiety-like behavior). A gut microbiota transplant from chemotherapy-treated mice decreased central locomotion in open field testing, increased circulating CXCL1, and increased hippocampal Il6 and Tnfa in germ-free mice compared to germ-free mice that received a transplant from vehicle-treated mice. Taken together, these data provide further evidence that the gut microbiota likely contributes to the development of chemotherapy-associated side effects. This work has significant implications in the future treatment of anxiety in patients, and warrants future studies using microbe-based treatment options.
Alcohol use disorder is a significant global burden. Stress has been identified as an etiological factor in the initiation and continuation of ethanol consumption. Understanding adaptations within ...stress circuitry is an important step toward novel treatment strategies. The effects of protracted abstinence following long-term ethanol self-administration on the central nucleus of the amygdala (CeA) and the hypothalamic paraventricular nucleus (PVN) were evaluated in male rhesus monkeys. Using whole-cell patch-clamp electrophysiology, inhibitory GABAergic transmission in the CeA and excitatory glutamatergic transmission in the PVN were measured. CeA neurons from abstinent drinkers displayed an elevated baseline spontaneous inhibitory postsynaptic current (sIPSC) frequency compared with controls, indicating increased presynaptic GABA release. Application of acute ethanol significantly increased the frequency of sIPSCs in controls, but not in abstinent drinkers, suggesting a tolerance to ethanol-enhanced GABA release in abstinent rhesus monkeys with a history of chronic ethanol self-administration and repeated abstinence. In the PVN, the frequency of spontaneous excitatory postsynaptic currents (sEPSC) was elevated in abstinent drinkers compared with controls, indicating increased presynaptic glutamate release. Notably, acute ethanol decreased presynaptic glutamate release onto parvocellular PVN neurons in both controls and abstinent drinkers, suggesting a lack of tolerance to acute ethanol among PVN neurons. These results are the first to demonstrate distinct synaptic adaptations and ethanol sensitivity in both the extrahypothalamic and hypothalamic stress circuits in abstinent rhesus males. Importantly, our findings describe adaptations in stress circuitry present in the brain at a state during abstinence, just prior to relapse to ethanol drinking.
•Optical properties of titanium nitride nanocrystalline films are probed using ellipsometry.•Models were constructed and analyzed to account for TiN nano-structure.•TiN films at low nitrogen flow ...rates have the highest absorption at E<2eV.•A correlation between microstructure and optical properties is established.
Titanium nitride (TiNx) thin films were grown by radio-frequency (RF) magnetron sputter deposition by varying the nitrogen content in the reactive gas mixture over a wide range. The effect of nitrogen gas flow rate on the surface and interface morphology, chemical composition and optical properties of TiN thin films was studied employing atomic force microscopy (AFM), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and spectroscopic ellipsometry (SE). Analysis of the optical properties probed with SE has shown that films deposited at low (0–5sccm) nitrogen flow rates have the highest absorption at energies <2eV. It was also shown that Lorentz oscillators with energy positions lower than 2eV can be distinguished from the Drude oscillator function during parameter fitting. AFM imaging analysis indicates that the roughness decreases and plateaus at approximately 1.5nm with the introduction of a small N2 flow rate, remaining consistent thereafter. SEM cross-sectional imaging analysis indicates the dense, columnar structure for the films grown at lower nitrogen flow rates. XPS analysis of atomic composition and the chemical states indicate that the atomic composition remained nearly constant while the chemical states varied significantly among the samples as a function of N2 flow rate. XPS analyses confirm the presence of TiNx, TiO2 and TiOxNy. These process–property relationships derived could be useful for defining and expanding the range of optical and electronic applications of titanium nitrides and (oxy)nitrides.
It is poorly understood how solid peripheral tumors affect brain neuroimmune responses despite the various brain-mediated side effects and higher rates of infection reported in cancer patients. We ...hypothesized that chronic low-grade peripheral tumor-induced inflammation conditions microglia to drive suppression of neuroinflammatory responses to a subsequent peripheral immune challenge. Here, Balb/c murine mammary tumors attenuated the microglial inflammatory gene expression responses to lipopolysaccharide (LPS) and live Escherichia coli (E. coli) challenges and the fatigue response to an E. coli infection. In contrast, the inflammatory gene expression in response to LPS or a toll-like receptor 2 agonist of Percoll-enriched primary microglia cultures was comparable between tumor-bearing and -free mice, as were the neuroinflammatory and sickness behavioral responses to an intracerebroventricular interleukin (IL)-1β injection. These data led to the hypothesis that Balb/c mammary tumors blunt the neuroinflammatory responses to an immune challenge via a mechanism involving tumor suppression of the peripheral humoral response. Balb/c mammary tumors modestly attenuated select circulating cytokine responses to LPS and E. coli challenges. Further, a second mammary tumor/mouse strain model (E0771 tumors in C57Bl/6 mice) displayed mildly elevated inflammatory responses to an immune challenge. Taken together, these data indicate that tumor-induced suppression of neuroinflammation and sickness behaviors may be driven by a blunted microglial phenotype, partly because of an attenuated peripheral signal to the brain, which may contribute to infection responses and behavioral side effects reported in cancer patients. Finally, these neuroimmune effects likely vary based on tumor type and/or host immune phenotype.
•Measurement of refractive index and extinction coefficient of GeOx (0<x<2).•Spectral refractive index for GeO2 ranges from 1.66 to 1.60.•GeO2 obtained at oxygen fractions of 50% and above.•Compounds ...obtained include Ge, GeO, and GeO2.•Correlation shown between oxygen fraction, optical constants, and chemical composition.
Germanium oxide (GeOx) films were grown on (100) Si substrates by reactive Direct-Current (DC) magnetron sputter-deposition using an elemental Ge target. The effects of oxygen gas fraction, Г=O2/(Ar+O2), on the deposition rate, structure, chemical composition and optical properties of GeOx films have been investigated. The chemistry of the films exhibits an evolution from pure Ge to mixed Ge+GeO+GeO2 and then finally to GeO2 upon increasing Г from 0.00 to 1.00. Grazing incidence X-ray analysis indicates that the GeOx films grown were amorphous. The optical properties probed by spectroscopic ellipsometry indicate that the effect of Г is significant on the optical constants of the GeOx films. The measured index of refraction (n) at a wavelength (λ) of 550nm is 4.67 for films grown without any oxygen, indicating behavior characteristic of semiconducting Ge. The transition from germanium to mixed Ge+GeO+GeO2 composition is associated with a characteristic decrease in n (λ=550nm) to 2.62 and occurs at Г=0.25. Finally n drops to 1.60 for Г=0.50–1.00, where the films become GeO2. A detailed correlation between Г, n, k and stoichiometry in DC sputtered GeOx films is presented and discussed.
Water has supposedly marked the surface of Mars and produced characteristic landforms. To understand the history of water on Mars, we take a close look at key locations with the High-Resolution ...Imaging Science Experiment on board the Mars Reconnaissance Orbiter, reaching fine spatial scales of 25 to 32 centimeters per pixel. Boulders ranging up to ~2 meters in diameter are ubiquitous in the middle to high latitudes, which include deposits previously interpreted as finegrained ocean sediments or dusty snow. Bright gully deposits identify six locations with very recent activity, but these lie on steep (20° to 35°) slopes where dry mass wasting could occur. Thus, we cannot confirm the reality of ancient oceans or water in active gullies but do see evidence of fluvial modification of geologically recent mid-latitude gullies and equatorial impact craters.
For the majority of patients with severe corneal injury or disease, corneal transplantation is the only suitable treatment option. Unfortunately, the demand for donor corneas greatly exceeds the ...availability. To overcome shortage issues, a myriad of bioengineered constructs have been developed as mimetics of the corneal stroma over the last few decades. Despite the sheer number of bioengineered stromas developed , these implants fail clinical trials exhibiting poor tissue integration and adverse effects in vivo. Such shortcomings can partially be ascribed to poor biomechanical performance. In this review, existing approaches for bioengineering corneal stromal constructs and their mechanical properties are described. The information collected in this review can be used to critically analyze the biomechanical properties of future stromal constructs, which are often overlooked, but can determine the failure or success of corresponding implants.
Although numerous stromal constructs have been developed over the last few decades, many approaches display shortcomings, such as poor tissue integration and adverse effects in vivo. A main reason for these shortcomings is the poor mechanical behavior of the developed constructs. In this review, mechanical properties of existing approaches are described, giving an overview of available fabrication techniques and their limitations.
Background. Efavirenz has a long plasma half-life and a low genetic barrier to resistance. Simultaneously stopping treatment with all agents in efavirenz-containing regimens may result in functional ...efavirenz monotherapy that selects for drug-resistant human immunodeficiency virus type 1. Lower plasma efavirenz clearance is associated with a cytochrome P450 2B6 gene (CYP2B6) polymorphism (516G→T) that is more frequent among African American individuals than among European American individuals. Methods. We characterized relationships between this polymorphism and predicted plasma efavirenz concentration-time profiles after discontinuation of therapy with use of data obtained from subjects receiving therapy. Pharmacokinetic parameters were estimated using population-based methods. Concentrations after discontinuation of therapy were predicted from subject-specific estimates. Results. Median estimated efavirenz half-lives were 23, 27, and 48 h for patients with CYP2B6 position 516 GG (78 patients), GT (60), and TT (14) genotypes, respectively (P < .001). After therapy was stopped, plasma efavirenz concentrations in patients with GG, GT, and TT genotypes were predicted to exceed 46.7 ng/mL (the estimated protein-adjusted 95% inhibitory concentration for wild-type virus) for a median of 5.8 days (interquartile range IQR, 4.4–8.3 days), 7.0 days (IQR, 5.0–8.0 days), and 14 days (IQR, 11.1–21.2 days), respectively (P < .001). Plasma efavirenz levels were predicted to exceed 46.7 ng/mL for >21 days in 5% of subjects with GG genotype, 5% of subjects with GT genotype, and 29% of subjects with TT genotype. Conclusions. The CYP2B6 position 516 TT genotype or a prolonged measured elimination half-life may predict increased risk of developing drug resistance among patients who discontinue efavirenz-containing regimens. This has implications for strategies to safely discontinue antiretroviral regimens while avoiding the emergence of drug resistance.
•An approach to fabricate WO3–TiO2 thin films using W–Ti alloy target is presented.•The effect of W–Ti ratio on the surface chemistry of W–Ti–O oxide films is evaluated.•Increasing Ti decreases ...W–Ti–O film thickness drastically due to sputtering kinetics.•Optimum conditions to deposit stoichiometric WO3–TiO2 films are reported.
Tungsten–titanium (W–Ti) mixed oxide thin films were fabricated using reactive sputtering of W–Ti alloy targets with Ti content ranging from 0 to 30wt%. The effect of target composition on film structure, surface/interface chemistry and chemical valence state of the W and Ti cations was investigated in detail. All films were amorphous in nature as confirmed by X-ray diffraction analyses. For growth times of 1h, the thicknesses of the W–Ti–O films decreased significantly from 150 to 35nm with increasing Ti content in the target, confirming that the oxide film growth behavior is dependent on the sputter-target composition. The chemistry and composition of the films probed using X-ray photoelectron spectroscopy (XPS) confirms the existence of W and Ti in their highest oxidation states of 6+ and 4+, respectively. Quantification of binding energy shifts for W and Ti core-level transitions confirms the formation of WO3–TiO2 composite oxide films. Depth profiles confirm and validate film uniformity, as well as film thickness differences and variable oxidation behavior of W and Ti in the films.
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