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Proof of Carrier Concentration-Dependent Actions within Water-Infiltration-Induced Energy Era by Ionovoltaic Influence.
OBJECTIVE To explore potential synergy in effectiveness between metformin and everolimus, 2 inhibitors of the mTOR pathway, for neuroendocrine tumours (NET). DESIGN AND METHODS A cohort of patients with advanced gastroenteropancreatic or lung NETs treated by everolimus were stratified in to those without diabetes, those with diabetes and without metformin, and those with diabetes with metformin. The primary endpoint was the median progression-free survival (PFS). RESULTS A total of 213 patients were included, 165 of which were non-diabetic; among diabetic patients, 19 were treated with metformin and 29 with others anti-diabetic drugs. No significant difference in median PFS [95%CI] was found between the three groups 10.05 months [8.27;11.83] for non-diabetic patients, 15.24 [19.88;49.43] for diabetic w/metformin, and 9.03 months [4.01;14.06] for diabetic w/o metformin group. In univariate analysis, factors significantly associated with longer PFS was a functioning NET, a number of metastatic sites less then 3, the absence of lung metastasis, and an uptake on Octreoscan®, but not the absence of metformin use; only uptake on Octreoscan® remained significant in multivariate analysis. CONCLUSIONS In contrast with the literature, we did not find a synergy between everolimus and metformin in NET. Prospective studies are underway to improve the comprehension of the potential synergy regarding population and tumour type. PROBLEM AND BACKGROUND Although the number of Muslim women in Canada and northwestern Ontario (NWO) is increasing, few studies have focused on their experiences of perinatal health care. https://www.selleckchem.com/products/valemetostat-ds-3201.html Extant research has highlighted discrimination and care that lacks respect for cultural and religious norms. These factors may limit access to health services and increase unfavorable maternal and child health outcomes. AIM To explore the perinatal health care experiences of Muslim women in NWO. METHODS A qualitative, descriptive study used purposive and snowball sampling to recruit a sample of 19 Muslim mothers. Ssemistructured interviews were conducted, audio recorded, transcribed verbatim, and analyzed thematically. FINDINGS The mothers' experiences were categorized into four themes women's choices and preferences of health care providers (HCPs); attitudes toward prenatal classes and education; husbands' involvement and support in the birthing process; and challenges to optimal care. DISCUSSION AND CONCLUSION The findings show that NWO Muslim women's experiences were generally positive and their care choices and preferences were shaped by their religious beliefs and cultural practices. Factors that enhanced their experiences were HCPs' awareness of and respect for the women's religious and cultural beliefs and practices. However, the women lacked personal knowledge of a range of care options and services. Respecting Muslim women's religious and cultural beliefs and practices will enhance their experience of care. Equity in access to quality services, care, and outcomes can be further enhanced if Muslim women are informed about the range of care options and services as early in their pregnancies as possible. PROBLEM Lactational mastitis is a common condition amongst breastfeeding women. It is associated with decreased breastfeeding rates and often treated with antibiotics. BACKGROUND The anti-inflammatory effects of probiotics have been identified as a potential treatment or prevention strategy for lactational mastitis leading to increased commercial and public interest. Despite the marketing of probiotics to women, evidence is still emerging as to its efficacy. AIM/METHODS This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to identify and examine the evidence around probiotic consumption and lactational mastitis. The review addressed the question; what is the evidence regarding probiotic consumption and human lactational mastitis? Studies were critically appraised using the Joanna Briggs Institute checklist for randomised control trials (RCTs). FINDINGS Five RCTs met the inclusion criteria; three concerned probiotic consumption for the treatment of mastitis, two for the prevention of mastitis. All reported a lower incidence of mastitis in the probiotic groups. DISCUSSION Although potentially promising results were reported across all studies there were significant methodological limitations concerning; appropriately described baseline characteristics, study hypotheses, lack of power calculations, definitional issues, and potential conflicts of interest. CONCLUSION Probiotics may have utility for the treatment or prevention of lactational mastitis. However only a few studies with significant limitations have been published to date. Well designed and conducted studies are needed before evidence-based recommendations can be made for use of probiotics in the treatment or prevention of lactational mastitis. BACKGROUND Rates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study was to identify women's mode of birth preferences and experiences of shared decision-making for induction of labour. METHOD An antenatal survey of women booked for an induction at eight Sydney hospitals was conducted. A bespoke questionnaire was created assessing women's demographics, indication for induction, pregnancy model of care, initial birth preferences, and their experience of the decision-making process. RESULTS Of 189 survey respondents (58% nulliparous), major reported reasons for induction included prolonged pregnancy (38%), diabetes (25%), and suspected fetal growth restriction (8%). Most respondents (72%) had hoped to labour spontaneously. Major findings included 19% of women not feeling like they had a choice about induction of labour, 26% not feeling adequately informed (or uncertain if informed), 17% not being given alternatives, and 30% not receiving any written information on induction of labour. Qualitative responses highlight a desire of women to be more actively involved in decision-making. CONCLUSION A substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated.
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