protocol of a randomized trial

H4A Primary Healthcare Research Network scholars programme for support of research in the protocol design phase. This article will also be supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020).BACKGROUND: Screening with prostate-specific antigen (PSA) test for prostate cancer is considered a preference sensitive decision; meaning it does not only depend on what is best from a medical point of view, but also from a patient value standpoint. Decision aids are evidence-based tools which are shown to help people feel clearer about their values; therefore it has been advocated that decision aids should contain a specific values clarification method (VCM). VCMs may be either implicit or explicit, but the evidence concerning the best method is scarce. We aim to compare the perceived clarity of personal values in men considering PSA screening using decision aids with no VCM versus an implicit VCM versus an explicit VCM. METHODS: Male factory employees from an industrial facility in the Northern region of Portugal aged 50 to 69 years old will be randomly assigned to one of three decision aid groups used to support prostate cancer screening decisions: (i) decision aid with information only (control), (ii) decision aid with information plus an implicit VCM, (iii) decision aid with information plus an explicit VCM. Men will be allowed release time from work to attend a session at their workplace. After a brief oral presentation, those willing to participate in the study will fill the baseline questionnaire, plus a 5 point-Likert scale question about intentions to undergo screening, and will then receive the intervention materials to complete. We estimated a total sample size of 276 participants; with 92 in each group. The primary outcome will be the perceived clarity of personal values assessed by the Portuguese validated translation of the three subscales of the Decisional Conflict Scale. Secondary outcomes will be intention to be screened (before and after the intervention), the total score from the Decisional Conflict Scale and the self-report of having or not undergone screening at 6 months. DISCUSSION: This study will add to the body of evidence on the role of decision aids to support health preference-sensitive choices and provide further insight on the impact of different methods for eliciting people's values embedded within a decision aid. TRIAL REGISTRATION: NCT03988673 - clinicalTrials.gov (2019/06/17).publishersversionpublishe

Observational Constraints on Interstellar Grain Alignment

We present new multicolor photo-polarimetry of stars behind the Southern Coalsack. Analyzed together with multiband polarization data from the literature, probing the Chamaeleon I, Musca, rho Opiuchus, R CrA and Taurus clouds, we show that the wavelength of maximum polarization (lambda_max) is linearly correlated with the radiation environment of the grains. Using Far-Infrared emission data, we show that the large scatter seen in previous studies of lambda_max as a function of A_V is primarily due to line of sight effects causing some A_V measurements to not be a good tracer of the extinction (radiation field strength) seen by the grains being probed. The derived slopes in lambda_max vs. A_V, for the individual clouds, are consistent with a common value, while the zero intercepts scale with the average values of the ratios of total-to-selective extinction (R_V) for the individual clouds. Within each cloud we do not find direct correlations between lambda_max and R_V. The positive slope in consistent with recent developments in theory and indicating alignment driven by the radiation field. The present data cannot conclusively differentiate between direct radiative torques and alignment driven by H_2 formation. However, the small values of lambda_max(A_V=0), seen in several clouds, suggest a role for the latter, at least at the cloud surfaces. The scatter in the lambda_max vs. A_V relation is found to be associated with the characteristics of the embedded Young Stellar Objects (YSO) in the clouds. We propose that this is partially due to locally increased plasma damping of the grain rotation caused by X-rays from the YSOs.Comment: Accepted for publication in the Astrophysical Journa

Development of a Novel \u3cem\u3ein vivo\u3c/em\u3e Corneal Fibrosis Model in the Dog

The aim of this study was to develop a novel in vivo corneal model of fibrosis in dogs utilizing alkali burn and determine the ability of suberanilohydroxamic acid (SAHA) to inhibit corneal fibrosis using this large animal model. To accomplish this, we used seven research Beagle dogs. An axial corneal alkali burn in dogs was created using 1 N NaOH topically. Six dogs were randomly and equally assigned into 2 groups: A) vehicle (DMSO, 2 μL/mL); B) anti-fibrotic treatment (50 μM SAHA). The degree of corneal opacity, ocular health, and anti-fibrotic effects of SAHA were determined utilizing the Fantes grading scale, modified McDonald-Shadduck (mMS) scoring system, optical coherence tomography (OCT), corneal histopathology, immunohistochemistry (IHC), and transmission electron microscopy (TEM). The used alkali burn dose to produce corneal fibrosis was well tolerated as no significant difference in mMS scores between control and treatment groups (p=0.89) were detected. The corneas of alkali burned dogs showed significantly greater levels of α-smooth muscle actin, the fibrotic marker, than the controls (p=0.018). Total corneal thickness of all dogs post-burn was significantly greater than baseline OCT images irrespective of treatment (p=0.004); TEM showed that alkali burned corneas had significantly greater minimum and maximum interfibrillar distances than the controls (p=0.026, p=0.018). The tested topical corneal alkali burn dose generated significant opacity and fibrosis in dog corneas without damaging the limbus as evidenced by histopathology, IHC, TEM, and OCT findings, and represents a viable large animal corneal fibrosis in vivo model. Additional in vivo SAHA dosing studies with larger sample size are warranted