Purpose Following the Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) trial, sorafenib has become the standard of care for patients with advanced unresectable hepatocellular ...carcinoma, but the relation between survival advantage and disease etiology remains unclear. To address this, we undertook an individual patient data meta-analysis of three large prospective randomized trials in which sorafenib was the control arm. Methods Of a total of 3,256 patients, 1,643 (50%) who received sorafenib were available. The primary end point was overall survival (OS). A Bayesian hierarchical approach for individual patient data meta-analyses was applied using a piecewise exponential model. Results are presented in terms of hazard ratios comparing sorafenib with alternative therapies according to hepatitis C virus (HCV) or hepatitis B virus (HBV) status. Results Hazard ratios show improved OS for sorafenib in patients who are both HBV negative and HCV positive (log hazard ratio, -0.27; 95% CI, -0.46 to -0.06). Median unadjusted survival is 12.6 (11.15 to 13.8) months for sorafenib and 10.2 (8.88 to 12.2) months for "other" treatments in this subgroup. There was no evidence of improvement in OS for any other patient subgroups defined by HBV and HCV. Results were consistent across all trials with heterogeneity assessed using Cochran's Q statistic. Conclusion There is consistent evidence that the effect of sorafenib on OS is dependent on patients' hepatitis status. There is an improved OS for patients negative for HBV and positive for HCV when treated with sorafenib. There was no evidence of any improvement in OS attributable to sorafenib for patients positive for HBV and negative for HCV.
This paper proposes a SIR epidemic model with vital dynamics to control or eliminate the spread of the COVID-19 epidemic considering the constant population, saturated treatment, and direct–indirect ...transmission rate of the model. We demonstrate positivity, boundness and calculate the disease-free equilibrium point and basic reproduction number from the model. We use the Jacobian matrix and the Lyapunov function to analyze the local and global stability, respectively. It is observed that indirect infection increases the basic reproduction number and gives rise to multiple endemic diseases. We perform transcritical, forward, backward, and Hopf bifurcation analyses. We propose two control parameters (Use of face mask, hand sanitizer, social distancing, and vaccination) to minimize the spread of the coronavirus. We use Pontryagin’s maximum principle to solve the optimal control problem and demonstrate the results numerically.
Since its inception in 1997, the Muslim Council of Britain (MCB) has evolved to become one of the most enduring British Muslim organisations. It is a representative body for over 500 member bodies ...(‘affiliates’) including mosques, schools and charities. During the course of the last two decades, it has been subject to external comment and sometimes critique by academics, media commentators, policy-makers, and others. This special issue of the journal Religions has provided a welcome opportunity for the current leadership of the MCB to write about the organisation from ‘within’, based on their long-standing time volunteering with it. This paper is based on an oral history methodology involving extended interviews with the oversight of a research director, supplemented by reference to existing academic and other sources. Therefore this paper is essentially a type of ‘edited transcript’ aggregated wholly from a series of first person interviews undertaken with the current senior elected leaders of MCB; reorganised for clarity and drafted out with added ‘prose’ allowing for it to be presented in essay form. The result is the first documented ‘insider’ perspective on the ways in which the MCB has tackled issues such as internal governance, the challenge of ‘representation’ in view of the diversity of British Muslim communities, changing relationships with government, and policy work. It becomes apparent through the paper that the MCB has matured into a constructively self-critical, pro-active, and more strategically professional body, that contributes to the flourishing of Muslim communities and the place of Islam in British society. The production of the paper is itself an indicator of the growing confidence and capacity of the MCB, and its ability to contribute positively to academic discourse and debate about Muslims in Britain.
Feral pigs are an invasive exotic pest that damage habitat and compete with native species. Trapping feral pigs using a variety of baits or lures is the primary method for eradication, with little ...success. The purpose of this study was to use a variety of lures, with and without the presence of a mock corral trap, to determine if there was a preferred lure selected even in the presence of a trap. We also identified non-target species attraction to the lures, to identify a preferred choice by feral pigs that minimized these non-target species. We deployed 10 stations from July 2017 to March 2018 and used trail cameras to assess feral pig visitation frequency. The majority of feral pig visitation events occurred at the orange flavored corn without a mock corral trap present (43.20%). There was no significant difference in feral pig visitation rates to stations based on presence or absence of corral, but there were differences based on lure: orange corn had a significantly higher visitation rate than any other lure type. The plain corn station without a corral had only 15% of the feral pig visitation events, while the majority of non-target species (i.e., axis - 45.93%, white-tailed deer - 39.42%, and raccoon - 85.38% of visitation events) were associated with this bait. For these reasons, we suggest that orange flavored corn may be the better primary attractant in feral pig management activities in south Texas.
Suicide by sodium nitrite may be an emerging trend in the United States. Our mixed-methods study aims to: (1) describe the rates of suicides secondary to sodium nitrite self-poisoning in the United ...States between 2018 and 2020 and (2) characterize the use of sodium nitrite as a suicide method.
Using NVDRS data, descriptive statistics, population-based incident rates/year and incidence estimates across 50 states were calculated. An inductive thematic analysis characterized the use of sodium nitrite as a suicide method on review of medical examiner and law enforcement reports.
260 incidents were identified as suicides secondary to self-poisoning with sodium nitrite/nitrate across 37 states and 1 territory-69% of which occurred in 2020. The typical victim was a white male student with a known depressive disorder and a history of suicidal thoughts (n = 120). The annual suicide rate using sodium nitrite increased from 0.01-0.09/100,000 person-years over the three-year period. Online forums were used to share knowledge on the procurement and preparation of sodium nitrite poisoning.
Sodium nitrite self-poisoning is an increasingly used planned suicide method among young people. Further studies are required to identify the impact of means safety interventions on the incidence of sodium nitrite self-poisoning incidents.
Female genital cutting (FGC) is described by the World Health Organization as ‘all procedures that involve partial or total removal of the female external genitalia or other injury to the female ...genital organs for non-medical reasons’ (1). Its practice is common in at least 29 countries across Africa and the Middle East (2) currently affecting 125 million girls and women worldwide. Due to globalization, specifically increasing trends in migration, instances of FGC are increasingly common in the developed world. For example, 137,000 girls residing in the UK in 2011 were found to have undergone FGC (3). Despite this, the increasing trend of FGC in the developed world has not been uniformly met with suitable mechanisms to support these patients. With increased societal stigma and grave misinformation, funding for FGC support structures has largely ignored sensitive issues surrounding FGC, for example, the social and economic structures that propagate abuse against women, such as poverty (4). Without promoting dialogue and tackling FGC on a broader level, any progress we make to tackle FGC will be stunted. In this article, we aim to briefly summarise methods to tackle FGC and underline any improvements that can help better support those at risk or who have undergone FGC.
One in five fatal police shooting victims may have been experiencing a mental health crisis (MHC) at the time of their death
1
. We use data on fatal police shootings from the National Violent Death ...Reporting System (2014–2015) to (a) identify incidents where the victim is reported to have experienced an MHC at the time of their death, (b) describe the characteristics of these incidents, and (c) compare the characteristics of MHC to fatal police shootings where the victim was not experiencing an MHC at the time of their death. We systematically coded 633 fatal police shootings from 27 states. Descriptive statistics characterized fatal police shootings, including victim characteristics; their mental health status; and contextual information regarding the police encounter (e.g., reason for police call). Overall, 203 of 633 fatal police encounters (32%) involved victims who showed signs of an MHC at the time of their death. Victims were predominantly white, male, and in possession of a firearm. In 3 of 4 cases, the MHC manifested as suicidal ideation despite any relevant documented history among most victims. Among half of suicidal victims, suicidal ideation was expressed verbally and in-person to a family member/intimate partner who subsequently called the police. Dispatch was aware of the MHC in 1 of 4 of total police calls. Overall, fatal police encounters involving those experiencing an MHC accounted for 1 in 3 of our caseloads. Approximately, 3 of 4 mental health calls involved a suicidal person who mainly expressed intent to a loved one in-person.
The development and commercialization of SLRFB is obstructed due to its limited cycle life. The cycle life is prevented due to the formation of Pb dendrites, sluggish kinetics of Pb+2/PbO2 redox ...species, partial reversibility of PbO2, and O2 evolution during charging. SLRFB has common electrolyte reservoir, therefore, it is desirable to add both anode and cathode benefitting additives together in the electrolyte. But, such kind of study is very limited in the literature. By considering this, first time, the present work demonstrates the combined effect of trimethyloctadecylammonium chloride and NaF/LiF as electrolyte additives on the electrochemical performance and cycle life of SLRFB. Compared with the pristine electrolyte, the kinetics and reversibility of Pb2+/PbO2 redox couple are improved in the presence of additives. Both Pb and PbO2 electrodeposits are smooth, compact and uniform in the presence of additives. The lifespan of SLRFB without any additive is limited to 45 charge/discharge cycles due to shorting of the electrodes. The CE has been decreased from 93 % to 74 % in 46th cycles at a charging current density of 20 mA cm2. However, in the presence of additives, the cell has been successfully cycled for over 500 cycles with an average CE, VE and EE of 94 %, 78 % and 74 % respectively. The cell also showed the maximum specific capacity 50 mAh cm−2 over 100 cycles when cycled at 50 mA cm2 current density for 1 h, such high current density operation is very scarce in the literature.
•The effect of TMOAC and NaF/LiF on the SLRFB’s performance has been studied first time.•Additives improve the kinetics and influences the Pb and PbO2 electroplating.•Cycle life of SLRFB extended >500 charge/discharge cycles without requiring maintenance.•The average coulombic and energy efficiency of the cell is 94%, and 74% respectively.•Cell showed the highest areal capacity of 50 mAh cm-2 for >50 cycles @ 50 mA cm2 current density.
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