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Statistical analyses
A power analysis was conducted to determine the sample size needed to detect a mean difference of 6 mmol/mol (standard deviation [SD] = 9) in HbA1c. To achieve a power of 80% with a significance level of 0,05 in a two-sided test. It determined that a minimum of 37 participants should be included in each group. Consider...
PMC10664359
Ethics
Prior to their inclusion in the study, informed consent was obtained from all participants. The study was conducted in accordance with the principles and all the subsequent amendments of the declaration of Helsinki. The Swedish Ethical Review Authority in Uppsala approved this study with diary number 2018–568 and diary...
PMC10664359
Results
Baseline characteristics for the intervention and control groups are given in Table  Baseline characteristics of the intervention (n = 35) and control (n = 44) groupsNote: NS, non-significant; SD, standard deviation. Missing value: Glucose monitoring intervention group n = 34, Time in range: intervention group n = 33 a...
PMC10664359
Follow-up after 6 months
SECONDARY
At the 6-months follow-up, 71 participants remained in the study, with 7 dropping out due to relocation for studies or work elsewhere and 1 for unknown reasons (2 in the intervention-, and 6 in the control group). Among the 33 individuals in the intervention group, 29 participants actively used one or more functions of...
PMC10664359
Glycaemic control
The baseline HbA1c levels were comparable between the intervention group and the control group, with mean (± SD) values of 63.5 (± 15.0) mmol/mol and 59.6 (± 11.5) mmol/mol, respectively, and no significant differences. The same pattern was observed for the TIR (45.3% vs. 49.7%) and TBR (8.0% vs. 5.7%), again with no s...
PMC10664359
Perceived hyper- and hypoglycaemia
hyperglycaemia, hypoglycaemia
HYPERGLYCAEMIA, HYPOGLYCAEMIA
At baseline, there were no significant differences between the intervention and control groups in terms of perceived hyperglycaemia (2.8 ± 1.4 vs. 3.4 ± 1.3) or hypoglycaemia (1.6 ± 1.1 vs. 1.8 ± 1.3). After six months, no significant differences were observed within or between the groups for these parameters (Table 
PMC10664359
Diabetes treatment satisfaction
diabetes
DIABETES
The study confirmed that there was no significant difference in diabetes treatment satisfaction between the intervention group (29.9 ± 4.1) and the control group (28.8 ± 3.9) at baseline, as measured by the DTSQ. Table 
PMC10664359
Quality of life and check your health questionnaire
The study revealed that the intervention group demonstrated a significant decrease in the physical burden from baseline to 6 months. Thus, in the within-group analysis, the score decreased with 3.23 points, from a mean (± SD) score of 10.5 (± 8.6) points to 7.3 (9.2) points (p = 0.03). Moreover, the change in physical ...
PMC10664359
Discussion
diabetes
DIABETES, HYPOGLYCAEMIA
The present study found that the intervention had not significantly improved glycaemic control, perceived hyper- and hypoglycaemia, or diabetes treatment satisfaction compared with the control condition at the 6-month follow-up. In terms of this result, virtual diabetes care is thus neither better nor worse than usual ...
PMC10664359
Results in perspective
PROM, Diabetes, diabetes type 1.Overall, diabetes
DIABETES TYPE 1, TYPE 1 DIABETES, DIABETES, DIABETES
The study results are consistent with those of prior research in the area of virtual health interventions for individuals with type 1 diabetes [The present study included 79 participants, 35 in the intervention group and 44 in the control group. There were no significant differences between the two groups in terms of a...
PMC10664359
Strengths and limitations
diabetes
HYPOGLYCAEMIA, RECRUITMENT, ADVERSE EFFECTS, HYPERGLYCAEMIA, DIABETES
In addition to the findings discussed above, this study highlights the challenges of implementing interventions in real-world settings. Originally, our intention was to include 100 participants in the study. However, the widespread development of Covid-19 within society presented obstacles that hindered the recruitment...
PMC10664359
Acknowledgements
Our deepest gratitude to the patients whose dedication made this study possible. Without their participation, this study would not have been possible.
PMC10664359
Authors’ contributions
JL, ET, JR, JWE, JF, ALO, AR and EN contributed with: Conception, design, or analysis and interpretation of data. Drafting the article or revising it and providing intellectual content of critical importance to the work described. JL, ET, JF and EN: Responsible for ensuring that issues related to the accuracy of any pa...
PMC10664359
Funding
Diabetes
DIABETES
Funding for this study has been provided to J Leksell by the Swedish Diabetes Foundation and The Child Diabetes Foundation, Sweden. The researcher has not received financial support from either commercial entities or non-profit organizations.Open access funding provided by Uppsala University.
PMC10664359
Data Availability
The datasets generated and/or analysed during the current study are not publicly available due to personal data protection legislation but are available from the corresponding author on reasonable request.
PMC10664359
Declarations
PMC10664359
Ethics approval and consent to participate
Informed consent was obtained from all participants prior to inclusion in the study. The study was conducted in accordance with the principles and all the subsequent amendments of the declaration of Helsinki. The manuscript does not contain any identifiable information or images. The Swedish Ethical Review Authority in...
PMC10664359
Consent for publication
Not Applicable.
PMC10664359
Competing interests
We confirm that the authors have no competing interests as defined by BMC or any other interests that could potentially influence the results and/or discussion presented in this paper.
PMC10664359
List of abbreviations
Body mass indexContinuous glucose monitoringContinuous glucose monitoring with intermittent scanning/ flash glucose monitoringContinuous subcutaneous insulin infusionDiabetes Treatment Satisfaction QuestionnaireFlash Glucose MonitoringGlycosylated haemoglobinHealthcare professionalsMultiple daily injectionsPatient-repo...
PMC10664359
References
PMC10664359
1. Introduction
VLBW, Neurodevelopmental, cognitive and motor function, CF and neurodevelopmental outcomes
SECONDARY
Polyunsaturated fatty acids (PUFAs) are vital for brain development, yet limited knowledge exists regarding PUFA intake during complementary feeding (CF) and its impact on neurodevelopmental outcomes in very low birth weight (VLBW) infants. This secondary analysis of a randomized intervention trial, aimed to investigat...
PMC10385005
2. Materials and Methods
PMC10385005
2.1. Study Design and Subgroup
inflammatory bowel syndrome, birth defect, congenital heart disease
NECROTIZING ENTEROCOLITIS, SHORT BOWEL SYNDROME, SECONDARY, HIRSCHSPRUNG DISEASE, CHROMOSOMAL ABERRATION, DISEASES
This is a secondary analysis of nutritional data collected during a prospective, randomized, two arm intervention trial and the association with neurodevelopmental outcome in infants born with a birth weight <1500 g. The initial study was designed to investigate the introduction of CF in VLBW infants at two different t...
PMC10385005
2.2. Standardized Feeding Concept and Dietary Intake Analysis
Study participants had to follow a standardized feeding concept that was ready-to-use, commercially available baby jar food provided for free by NestleWithin this paper, we analyzed single component dietary intake (DHA, AA) as well as total PUFA intake, defined as all fatty acids with a minimum of 2 double bonds. PUFAs...
PMC10385005
2.3. Neurodevelopmental Assessment
Neurodevelopmental
Neurodevelopmental assessment was conducted using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; Harcourt Assessment, San Antonio, TX, USA, 2006) [
PMC10385005
2.4. Outcome Parameters
SECONDARY
The primary outcome of this study was to assess the effect of dietary mean total PUFA intake during the first year of life on neurodevelopmental outcome (cognition, motor, language) at 12 months CA. One secondary outcome was the association between dietary mean total PUFA intake and cognition, motor and language develo...
PMC10385005
2.5. Statistical Analysis
INTRAVENTRICULAR HEMORRHAGE
Statistical analysis was performed on the intention-to-treat analysis set (all randomized patients were included), with the exclusion of subjects that were lost for follow-up, moved, no dietary records or withdrawn informed consent. As the number of participants in this analysis was smaller compared to the initial rand...
PMC10385005
3. Results
PMC10385005
3.1. Screening and Participants
Out of the 177 patients that were randomized, neurodevelopmental outcome data at 12 months CA and at least one dietary record were available for analysis in 140 patients, accounting for 79% of the total sample size (
PMC10385005
3.2. Baseline Characteristics and Neonatal Morbidity
Neonatal and obstetric parameters are shown in
PMC10385005
3.3. Dietary Total PUFA, DHA and Intake during the First Year of Life
SECONDARY
Although individual mean intakes were considered for primary and secondary outcome analyses, we herein report median dietary intakes and interquartile range across the first year of life of the PUFA subgroup. The median dietary intakes of total PUFAs, DHA and AA throughout the first year of life were 4.55 g/d (IQR: 3.6...
PMC10385005
3.4. Fatty Acid Intake from 3 to 12 Months CA and Comparison with Current Dietary Intake Recommendations
Median monthly dietary PUFA intake (% of energy) from M3 to M12 is shown in
PMC10385005
3.5. Bayley-III: Cognition, Motor, Language
Results of Bayley-III assessment are shown in
PMC10385005
3.6. Total PUFA Intake and Neurological Development
Results of the primary outcome are shown in To evaluate whether the observed relation between total PUFA intake and neurodevelopmental outcome resulted from DHA or AA intake, we further evaluated the association between DHA and AA intake during the first year of life and neurodevelopment at 12 and 24 months CA.
PMC10385005
3.7. DHA Intake and Neurological Development
Higher dietary DHA intake throughout the first year of life was associated with significantly better cognitive function at 12 months CA (
PMC10385005
3.8. AA Intake and Neurological Development
Infants who had a higher dietary AA intake throughout the first year of life had significantly better motor scores at 12 months CA (
PMC10385005
4. Discussion
PMC10385005
4.1. Dietary Intake of Total PUFAs and Neurodevelopmental Outcome
VLBW, cognitive and motor scores
SECONDARY
This is a secondary outcome analysis of a randomized intervention trial investigating the dietary intake of total PUFAs, DHA and AA during the first year of life and its associations with neurodevelopmental outcome. To the best of our knowledge, there are no published data on dietary intakes of PUFAs during the complem...
PMC10385005
4.2. Dietary Intakes of DHA and AA and Neurodevelopmental Outcome
In the present study, we found that higher DHA and AA intakes during the first year of life were significantly associated with better neurodevelopmental outcomes at 12 months CA, but not at 24 months CA. So far, only one study investigated the association between DHA intake during CF and neurodevelopmental outcome; how...
PMC10385005
4.3. Dietary Intakes of LA, ALA and LA/ALA Ratio
We further conducted a detailed analysis of the dietary LA and ALA intake, as they are essential fatty acids that cannot be synthetized in the human body and must, therefore, be obtained through the diet. Moreover, ALA and AA are precursors for DHA and AA. It is well-established that not only fatty acid quantity, but a...
PMC10385005
4.4. How to Improve Dietary PUFA Intake to Meet a Guideline Diet?
Breast milk
Based on the findings of this study, it is desirable to increase the dietary intake of PUFAs in order to meet nutritional requirements and promote better neurological development in VLBW infants during their first year of life. Breast milk is considered the optimal choice for infant feeding and naturally contains both ...
PMC10385005
4.5. Study Strength and Limitations
breast milk
SECONDARY
This study has several notable strengths. Firstly, the implementation of a standardized CF concept ensured consistency and accuracy in assessing PUFA intake, which allowed for precise calculations during the CF period. Additionally, the inclusion of monthly dietary records throughout the first year of life provided com...
PMC10385005
5. Conclusions
The findings of this study demonstrate that higher dietary intakes of total PUFAs, DHA and AA during the first year of life are associated with better neurodevelopmental outcome in terms of motor and cognitive function at 12 months CA. Additionally, the study highlights the need for improvement in dietary DHA and AA in...
PMC10385005
Supplementary Materials
The following supporting information can be downloaded at: Click here for additional data file.
PMC10385005
Author Contributions
N.H. and B.J., N.H.
Conceptualization, N.H.; Methodology, N.H., M.T. and M.G.; Formal Analysis, M.G. and F.E.; Investigation, M.G. and M.T.; Resources, N.H., B.J. and A.B.; Data Curation, M.G., M.T., R.F. and S.B.; Writing—Original Draft Preparation, M.G.; Writing—Review and Editing, N.H., M.T., B.J., F.E., R.R. and R.F.; Visualization, M...
PMC10385005
Institutional Review Board Statement
The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the Medical University of Vienna (EK:1744/2012, date of approval: 10 January 2013) and registered on
PMC10385005
Informed Consent Statement
Written informed consent was obtained from at least one parent.
PMC10385005
Data Availability Statement
The study protocol and the individual participant data that underlie the results reported in this article, after de-identification, are available upon request from the corresponding author 6 months after publication. Researchers will need to state the aims of any analyses and provide a methodologically sound proposal. ...
PMC10385005
Conflicts of Interest
Nadja Haiden reports consulting fees from Medis, MAM, Baxter and Nestle and honoraria for lectures from Nestle, Baxter, Danone and Hipp outside the submitted work.
PMC10385005
References
intraventricular hemorrhage, Bell’s stage ≥ Ila) or after exploratory surgery, Dietary fatty acid
NECROTIZING ENTEROCOLITIS, INTRAVENTRICULAR HEMORRHAGE, SECONDARY, PERIVENTRICULAR LEUKOMALACIA, REGRESSION, RETINOPATHY OF PREMATURITY
Flow chart of study profile.Dietary fatty acid intake from 3 to 12 months of life CA in comparison with dietary intake recommendations. (Bayley-III composite scores at 12 and 24 months corrected for term.Main fatty acids of the Baseline characteristics of the PUFA subgroup—obstetric parameters and neonatal outcome.Cate...
PMC10385005
Methods
Three hundred and eleven adults (median age of 44 years, IQR 34–54 years) were randomly assigned to a salt reduction (
PMC10679749
Results
−2.6, hypertension, −3.8, DBP [mean change of −1.5 mm Hg
SECONDARY, HYPERTENSION
There were no significant differences in primary and secondary outcomes between the two program groups. When comparing each program to baseline, the program focused on salt reduction was effective in lowering BP following a 12-week intervention with a mean change of −2.5 mm Hg in SBP (95% CI, −4.1 to −0.8) and − 2.7 mm...
PMC10679749
Conclusion
HYPERTENSION
Salt-focused programs are effective public health tools mainly in managing individuals at high risk of hypertension. Nevertheless, in general, empowerment-based approaches are important strategies for lowering BP, by promoting health literacy that culminates in adherence to the Mediterranean diet and weight reduction.
PMC10679749
Introduction
Hypertension, CVD
CARDIOVASCULAR DISEASES, CVD, HYPERTENSION, HYPERTENSION, HIGH BLOOD PRESSURE
Changing unhealthy lifestyle behaviors can decrease the prevalence of individuals with high blood pressure (BP) and cardiovascular diseases (CVD), contributing greatly to the sustainability of healthcare systems worldwide (Several dietary approaches have been proposed to reduce BP, including the Dietary Approaches to S...
PMC10679749
Materials and methods
PMC10679749
Study design
This study is a multicenter, randomized, comparative effectiveness trial comparing the outcomes of two different 12-week empowerment-based approaches to promote healthy habits in the general population. The trial was conducted between March 2019 (the first candidate screened for eligibility) and September 2019 (the end...
PMC10679749
Participants
peripheral arteriosclerosis, cancer, liver or kidney diseases, ischemic cardiovascular disease, substance abuse
MYOCARDIAL INFARCTION, STROKE, CARDIOVASCULAR DISEASE, CANCER, UNSTABLE ANGINA, PERIPHERAL ARTERIOSCLEROSIS, HYPERTENSION
The study enrolled adult participants aged 20 to 70, who were responsible for acquiring and preparing their own meals, normal or with hypertension. Medicated hypertense individuals were included if medication and diet was stable for at least 3 weeks before the study. Eligible participants had to be willing and able to ...
PMC10679749
Recruitment
RECRUITMENT
Participants were recruited from the Lisbon Metropolitan Area through public advertisements in online newspapers and social media. Participants underwent eligibility screening and assessment at the study centers, which included the Hospital CUF Descobertas and Hospital CUF Infante Santo. Eligible participants were rand...
PMC10679749
Interventions
PMC10679749
Salt-reduction program
Participants randomized to the salt reduction program received a multi-component educational program for 12 weeks, consisting of three educational sessions that occurred during clinic visits (baseline, 4-week, and 8-week), five individual practical training sessions at the local supermarket, and 8 telephone counseling ...
PMC10679749
Healthy lifestyle program
Participants randomized to the healthy lifestyle program received a 12-week educational program that consisted of three sessions during clinic visits (at baseline, 4-weeks, and 8-weeks) and 12 telephone counseling calls. The first session focused on the impact of the Mediterranean diet on health, with an emphasis on ca...
PMC10679749
Outcome assessment
We collected 24-h urine samples at baseline and after the 12-week intervention period to estimate NaFlow diagram portraying the study design.
PMC10679749
Statistical analysis
The sample size calculation was based on the estimated difference in salt reduction between the two groups after 12 weeks. Assuming a salt reduction of 1 g/day and a standard deviation of 3.8 g/day (Descriptive statistics were reported as numbers and percentages for categorical variables and as mean and standard deviat...
PMC10679749
Results
PMC10679749
Recruitment and baseline characteristics of the participants
overweight, CVD, dyslipidemia
OBESE, CARDIOVASCULAR DISEASES, CVD, RECRUITMENT, SECONDARY, HYPERTENSION, DYSLIPIDEMIA
From March 29 to June 4, 2019, a total of 352 candidates were screened for eligibility. After an initial assessment, 30 declined to participate and 11 did not meet the inclusion criteria. Thus, 311 participants were enrolled, comprising 224 women and 87 men with a median age of 44 years (IQR 34–54 years), who were rand...
PMC10679749
Impact of intervention on blood pressure
hypertension
HYPERTENSION
After 4 weeks, both the salt reduction and healthy lifestyle programs led to lower SBP compared to baseline: −1.7 mm Hg (95% CI, −3.1 to −0.3) for the salt reduction and − 1.5 mm Hg (95% CI, −2.8 to −0.2) for the healthy lifestyle. Importantly, the salt reduction group maintained lower SBP at 8 and 12 weeks, unlike the...
PMC10679749
Impact of Na
Participants were categorized into quintile groups (Q1 to Q5) based on changes in the 12-week NaChange in office blood pressure (BP) stratified by mean quintiles of changes in NaWhile not reaching statistical significance, these findings suggest that a lower Na
PMC10679749
Impact of weight and adherence to the mediterranean diet on blood pressure
For each program, participants were divided into Q1 to Q5 quintile groups based on weight changes after 12 weeks compared to baseline (lowest to highest change). We then analyzed how changes in SBP and DBP related to these weight quintile groups (shown in Change in office blood pressure (BP) stratified by mean quintile...
PMC10679749
Discussion
weight reduction, intentional behavior, BP decrease, hypertension, weight loss
CVD, MINOR, HYPERTENSION
In the broader effort to address the impact of high BP and CVD across populations, there is a pressing need to establish effective strategies for encouraging behavior changes (Our findings revealed that both interventions were effective in reducing DBP after 12 weeks. However, only the intervention focused on salt redu...
PMC10679749
Conclusion
weight loss, hypertensive
This study shows that empowerment-based approaches, aimed at promoting healthy culinary habits and improved purchasing options, effectively lower BP in the short term. However, an intervention focused on educating participants about salt reduction was found to be more impactful in lowering both systolic and diastolic B...
PMC10679749
Data availability statement
The original contributions presented in the study are included in the article/
PMC10679749
Ethics statement
The studies involving humans were approved by Ethical Committee of the Hospital CUF. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
PMC10679749
Author contributions
JP, CMO, MPS, CM
AM-R: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – original draft. SI: Data curation, Investigation, Writing – review & editing. IB-M: Data curation, Investigation, Writing – review & editing. JM: Data curation, Investigation, Writing –...
PMC10679749
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
PMC10679749
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or ...
PMC10679749
Supplementary material
The Supplementary material for this article can be found online at: Click here for additional data file.
PMC10679749
References
PMC10679749
Supplementary Information
ideation
Despite suicide ideation being one of the most frequently reported health issues impacting tertiary students, there is a paucity of research evaluating the efficacy of preventive interventions aimed at improving mental health outcomes for students studying at two tertiary institutes. The current study evaluated the eff...
PMC9531217
Keywords
Open Access funding enabled and organized by CAUL and its Member Institutions
PMC9531217
Introduction
deaths, death, ’ mental distress
Young adulthood represents a period of necessary personal growth and development, moving towards mastering the increased demands of adulthood and developing a personal identity [In 2019, a total of 1,609,798 students were studying at the tertiary level in Australia [Suicide is a leading cause of death among young adult...
PMC9531217
Methods
PMC9531217
Design
Following a pre-defined protocol [
PMC9531217
Participants
anxiety
Participants were recruited via flyers sent through the university learning management systems of two universities in Perth, Western Australia (Curtin University and the University of Western Australia) from February to March 2020. Full or part-time students enrolled in health or education degrees from these universiti...
PMC9531217
Intervention
“Talk-to-Me” is an online psychoeducational Suicide prevention program targeting young adults [
PMC9531217
Procedures
Prior to group allocation, a survey link to Qualtrics [
PMC9531217
Statistical analysis
A data frame with 300 participants allocated to intervention and control groups and assessed at three assessment time points was created using RStudio Version 4.2.1 [
PMC9531217
Results
PMC9531217
Primary and secondary outcomes
REGRESSION, SECONDARY
Findings did not demonstrate any significant difference in SIRI-2 scores between ESG and DSG before crossover was applied (Similar to SIRI, no significant difference was observed in any of the secondary outcomes between ESG and DSG before or after the crossover of The effects of time by group (ESG/DSG) on the study’s o...
PMC9531217
Acceptability of “Talk-to-Me” MOOC
Overall, 74 participants from both the ESG and DSG provided insight into how they perceived the program. Findings suggested a high satisfaction with the content and delivery of the “Talk to Me” MOOC [Median = 43.5,
PMC9531217
Discussion
generalised
ADVERSE EVENTS, SECONDARY
This pragmatic crossover RCT evaluated the efficacy of an online psychoeducational Suicide prevention program, “Talk to Me”, firstly in improving university students’ ability to identify and respond to suicidal statements; and, secondly, in improving participants’ knowledge of the program’s content, their ability to re...
PMC9531217
Limitations and areas for further research
The findings of the current study should be viewed as preliminary in the context of its limitations. This study employed a rigorous crossover design approach to explore the superiority of “Talk to Me” to treatment as usual. However, data collected at the end of Period 1 was used to assess change over the second period,...
PMC9531217
Conclusions
This study indicated that receiving the online “Talk to Me” MOOC it is not enough to enable students to develop skills to respond to others in distress. Future suicide prevention interventions among tertiary students may consider using online peer mentoring programs to create user groups where participants can practice...
PMC9531217
Supplementary Information
Below is the link to the electronic supplementary material.Supplementary file1 (DOCX 16 KB)Supplementary file2 (DOCX 18 KB)Supplementary file3 (DOCX 21 KB)Supplementary file4 (DOCX 20 KB)Supplementary file5 (DOCX 27 KB)Dr Afsharnejad and Dr Milbourn contributed equally as first authors to this paper.
PMC9531217
Acknowledgements
We acknowledge the generous support from Nicole David, Patricia Tran and Paulene Tavani who assisted with the delivery of the “TALK-to-Me” MOOC. We would also like to thank all the students who took part in this study.
PMC9531217
Author contributions
MHE
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by BM, EB-Y, BA, MH-E. The first draft of the manuscript was written by BA, MHE, BM and SG. All authors commented on previous versions of the manuscript. All authors read and approved the final ...
PMC9531217
Funding
Deutscher Akademischer, Milbourn
Open Access funding enabled and organized by CAUL and its Member Institutions. The authors would like to acknowledge the following fundings, making this study possible. Dr Black, Dr Thompson, Dr Kacic, Mr Zimmermann, Professor Girdler, and Dr Milbourn received funding from Healthway (Grant 33212). Dr Milbourn and Profe...
PMC9531217
Availability of data and material
There is no public access to the datasets generated and/or analysed during the current study, and they are only available from the corresponding author upon reasonable request.
PMC9531217
Code availability
Not applicable.
PMC9531217
Declarations
PMC9531217