Informed consent and placebo effects: a content analysis of information leaflets to identify what clinical trial participants are told about placebos

BackgroundPlacebo groups are used in randomised clinical trials (RCTs) to control for placebo effects, which can be large. Participants in trials can misunderstand written information particularly regarding technical aspects of trial design such as randomisation; the adequacy of written information about placebos has not been explored. We aimed to identify what participants in major RCTs in the UK are told about placebos and their effects.Methods and FindingsWe conducted a content analysis of 45 Participant Information Leaflets (PILs) using quantitative and qualitative methodologies. PILs were obtained from trials on a major registry of current UK clinical trials (the UKCRN database). Eligible leaflets were received from 44 non-commercial trials but only 1 commercial trial. The main limitation is the low response rate (13.5%), but characteristics of included trials were broadly representative of all non-commercial trials on the database. 84% of PILs were for trials with 50:50 randomisation ratios yet in almost every comparison the target treatments were prioritized over the placebos. Placebos were referred to significantly less frequently than target treatments (7 vs. 27 mentions, p<001) and were significantly less likely than target treatments to be described as triggering either beneficial effects (1 vs. 45, p<001) or adverse effects (4 vs. 39, p<001). 8 PILs (18%) explicitly stated that the placebo treatment was either undesirable or ineffective.ConclusionsPILs from recent high quality clinical trials emphasise the benefits and adverse effects of the target treatment, while largely ignoring the possible effects of the placebo. Thus they provide incomplete and at times inaccurate information about placebos. Trial participants should be more fully informed about the health changes that they might experience from a placebo. To do otherwise jeopardises informed consent and is inconsistent with not only the science of placebos but also the fundamental rationale underpinning placebo controlled trials

Lithostratigraphy of the Elliot Formation (Karoo Supergroup), South Africa

The Late Triassic to Early Jurassic Elliot Formation is part of the Stormberg Group (Karoo Supergroup) of South Africa. The unit is significant palaeontlologically, because it preserves not only a range of vertebrate fossils, but also a plethora of ichnofossil and encompasses the boundary of Triassic and Jurassic in Southern Africa. The Formation is considered a stratigraphic equivalent of the Upper Omingonde Formation, Etjo Basin, Namibia, with the Bodibeng Sandstone Formation, Tuli Basin, Botswana, with the upper Mosolotsane Formation, Kalahari Karoo Basin. All Upper Triassic-Lower Jurassic continental red beds of South Africa, irrespective of their geographic locality relative to the main Karoo Basin are now termed Elliot Formation due to their very similar lithologic character and stratigraphic position.http://sajg.geoscienceworld.orgam2016Geolog

TeleMed: Wide-area, secure, collaborative object computing with Java and CORBA for healthcare

Distributed computing is becoming commonplace in a variety of industries with healthcare being a particularly important one for society. The authors describe the development and deployment of TeleMed in a few healthcare domains. TeleMed is a 100% Java distributed application build on CORBA and OMG standards enabling the collaboration on the treatment of chronically ill patients in a secure manner over the Internet. These standards enable other systems to work interoperably with TeleMed and provide transparent access to high performance distributed computing to the healthcare domain. The goal of wide scale integration of electronic medical records is a grand-challenge scale problem of global proportions with far-reaching social benefits

Advanced telemedicine development

This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The objective of this project was to develop a Java-based, electronic, medical-record system that can handle multimedia data and work over a wide-area network based on open standards, and that can utilize an existing database back end. The physician is to be totally unaware that there is a database behind the scenes and is only aware that he/she can access and manage the relevant information to treat the patient

Calcification, Dissolution and Test Properties of Modern Planktonic Foraminifera From the Central Atlantic Ocean

The mass of well-preserved calcite in planktonic foraminifera shells provides an indication of the calcification potential of the surface ocean. Here we report the shell weight of 8 different abundant planktonic foraminifera species from a set of core-top sediments along the Mid-Atlantic Ridge. The analyses showed that near the equator, foraminifera shells of equivalent size weigh on average 1/3 less than those from the middle latitudes. The carbonate preservation state of the samples was assessed by high resolution X-ray microcomputed tomographic analyses of Globigerinoides ruber and Globorotalia truncatulinoides specimens. The specimen preservation was deemed good and does not overall explain the observed shell mass variations. However, G. ruber shell weights might be to some extent compromised by residual fine debris internal contamination. Deep dwelling species possess heavier tests than their surface-dwelling counterparts, suggesting that the weight of the foraminifera shells changes as a function of the depth habitat. Ambient seawater carbonate chemistry of declining carbonate ion concentration with depth cannot account for this interspecies difference. The results suggest a depth regulating function for plankton calcification, which is not dictated by water column acidity

Bioethanol Production from Low-Value Feedstocks: Wild Cocoyam, Waste Cassava Peels, and Waste Sugar Cane Molasses

Abstract: Bioethanol, produced by the anaerobic fermentation of carbohydrates, can be used as a renewable fuel, as vital ingredient in the production of beer, wine, or high-valued distillate alcoholic drink. Different plants have been installed in different parts of the world as carbon source to produce bioethanol. Feedstocks is a fundamental requirement for successful and efficient operations of these bioethanol manufacturing plants. One major challenge in choosing suitable feedstock is food versus fuel debate, that is, reducing to the barest minimum food crops serving as main source of food for human consumption. Thus, the focus of this review is to explore some crops rich in carbohydrate but less commonly consumed as food such as wild cocoyam, cassava peels and waste product of sugar refinery, sugar cane molasses as alternative feedstocks. In this review, the harvested wild cocoyam corms and cassava peels were washed, dried, ground and then made into a gelatinized solution to increase the surface area. The starch present in the slurry mixtures was then saccharified by the action of different hydrolytic enzymes, like alpha-amylase, protease, amylitic-TS, and amyloglucosidase. It was reported that the enzymatic hydrolysis of ground cocoyam and cassava was effective in yielding favorable levels of fermentable glucose. The saccharified wort was then inoculated with viable yeast strains to begin the fermentation process. On the other hand, sugar cane molasses considered highly rich in sugar content was converted to bioethanol using a gram negative, facultative anaerobic, rod shaped strain’’ Zymomonas mobilis’’ as the microorganism under anaerobic fermentation condition. The fermentation process varied for several days from 48 h to 168 h depending on the feedstock. Percent alcohol concentration produced from wild cocoyam sample was 12.90 % after 168 h of anaerobic fermentation, whilst sugar cane molasses recorded 9.3 % bioethanol content after 48 h of fermentation process. The percent alcohol recovered from waste cassava peel was 8.5 % after 96 h of fermentation. Keywords: Bioethanol, Anaerobic fermentation, wild cocoyam, molasses, and cassava peels. Title: Bioethanol Production from Low-Value Feedstocks: Wild Cocoyam, Waste Cassava Peels, and Waste Sugar Cane Molasses Author: Isah S., Ahiakwo J, Odusina A., Equere-Obong A., George J., Ojo E.M., Udoh S., Anwuchughum C., Edward A., Enahoro E., Salami A International Journal of Novel Research in Physics Chemistry & Mathematics ISSN 2394-9651 Vol. 10, Issue 3, September 2023 - December 2023 Page No: 1-19 Novelty Journals Website: www.noveltyjournals.com Published Date: 18-September-2023 DOI: https://doi.org/10.5281/zenodo.8355346 Paper Download Link (Source) https://www.noveltyjournals.com/upload/paper/Bioethanol%20Production-18092023-4.pdfInternational Journal of Novel Research in Physics Chemistry & Mathematics, ISSN 2394-9651, Novelty Journals, Website: www.noveltyjournals.co

Characterization of bacterial pathogens in rural and urban irrigation water

The study aimed to compare the bacteriological quality of an urban and rural irrigation water source. Bacterial counts, characterization, identification and diversity of aerobic bacteria were determined. Escherichia coli isolated from both sites was subjected to antibiotic susceptibility testing, virulence gene (Stx1/Stx2 and eae) determination and (GTG)5 Rep-PCR fingerprinting. Low mean monthly counts for aerobic spore formers, anaerobic spore formers and Staphylococcus aureus were noted although occasional spikes were observed. The most prevalent bacterial species at both sites were Bacillus spp., E. coli and Enterobacter spp. In addition, E. coli and Bacillus spp. were most prevalent in winter and summer respectively. Resistance to at least one antibiotic was 84% (rural) and 83% (urban). Highest resistance at both sites was to cephalothin and ampicillin. Prevalence of E. coli possessing at least one virulence gene (Stx1/Stx2 and eae) was 15% (rural) and 42% (urban). All (rural) and 80% (urban) of E. coli possessing virulence genes showed antibiotic resistance. Complete genetic relatedness (100%) was shown by 47% of rural and 67% of urban E. coli isolates. Results from this study show that surface irrigation water sources regardless of geographical location and surrounding land-use practices can be reservoirs of similar bacterial pathogens.This study was part of an on-going solicited research project (K5/1875/4) funded by the Water Research Commission and co-funded with the Department of Agriculture, Republic of South Africa.http://jwh.iwaponline.comhb2016Food Scienc

Comment on Intrinsic and dynamically generated scalar meson states

The scalar-meson assignments of Shakin and Wang in a generalized Nambu--Jona-Lasinio model are contradicted by recent experimental information. Also the strict distinction made by these authors between ``intrinsic'' and ``dynamically generated'' states is contested, as well as a number of other statements.Comment: 7 pages, (v2 cosmetics, v3 corrections in one reference), to be published in Phys.Rev.

Symptom burden and lived experiences of patients, caregivers and healthcare professionals on the management of malignant bowel obstruction: A qualitative systematic review

Background: Malignant bowel obstruction occurs in up to 50% of people with advanced ovarian and 15% of people with gastrointestinal cancers. Evaluation and comparison of interventions to manage symptoms are hampered by inconsistent evaluations of efficacy and lack of agreed core outcomes. The patient perspective is rarely incorporated. Aim: To synthesise the qualitative data regarding patient, caregiver and healthcare professionals’ views and experience of malignant bowel obstruction to inform the development of a core outcome set for the evaluation of malignant bowel obstruction. Design: A qualitative systematic review was conducted, with narrative synthesis. The review protocol was registered prospectively (https://www.crd.york.ac.uk/prospero, CRD42020176393). Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO and Scopus databases were searched for studies published between 2010 and 2021. Reference lists were screened for further relevant publications, and citation tracking was performed. Results: Nine papers were included, reporting on seven studies which described the views and experiences of malignant bowel obstruction through the perspectives of 75 patients, 13 caregivers and 62 healthcare professionals. Themes across the papers included symptom burden, diverse experiences of interventions, impact on patient quality of life, implications and trajectory of malignant bowel obstruction, mixed experience of communication and the importance of realistic goals of care. Conclusion: Some of the most devastating sequelae of malignant bowel obstruction, such as pain and psychological distress, are not included routinely in its clinical or research evaluation. These data will contribute to a wider body of work to ensure the patient and caregiver perspective is recognised in the development of a core outcome set

The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

Background: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent.Aim: To identify outcomes evaluating palliative treatment for inoperable malignant bowel obstruction, as part of a four-phase study developing a core outcome set. Design: The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); PROSPERO (ID: CRD42019150648). Eligible studies included at least one subgroup with obstruction below the ligament of Treitz undergoing palliative treatment for inoperable malignant bowel obstruction. Study quality was not assessed because the review does not evaluate efficacy. Data sources: Medline, Embase, the Cochrane Database, CINAHL, PSYCinfo Caresearch, Open Grey and BASE were searched for trials and observational studies in October 2021. Results: A total of 4769 studies were screened, 290 full texts retrieved and 80 (13,898 participants) included in a narrative synthesis; 343 outcomes were extracted verbatim and pooled into 90 unique terms across six domains: physiological, nutrition, life impact, resource use, mortality and survival. Prevalent outcomes included adverse events (78% of studies), survival (54%), symptom control (39%) and mortality (31%). Key individual symptoms assessed were vomiting (41% of studies), nausea (34%) and pain (33%); 19% of studies assessed quality of life. Conclusions: Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment ‘success’ that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population