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PPG measurement method
inferior vena cava, TIPS
TIPS was established under local anesthesia using a transjugular approach. 4-Fr pigtail catheters were placed in the right atrium, inferior vena cava (at the level of the hepatic vein), and portal vein (where the spleen and superior mesenteric vein converge) to measure the pressure before and after stent placement. For...
PMC10502141
Statistical analysis
OHE
REGRESSION
The statistical analysis was performed by SPSS 26.0 (SPSS Inc, Chicago, USA) and R 4.0.3 (Institute of Statistics and Mathematics). The univariate or multivariate analysis was conducted at a test level of 0.01 or 0.05, respectively. Means of continuous variables were calculated and compared using Mann–Whitney U tests o...
PMC10502141
Ethical approval
The clinical data were approved by the Ethics Committee of Beijing Shijitan Hospital Affiliated to Capital Medical University. Patients sign informed consent.
PMC10502141
Results
PMC10502141
Constructing a nomogram prediction model for OHE after TIPS
OHE
Based on multivariate analysis, age, ICG-R15, percentage of PPG decline, creatinine, and blood ammonia were identified as independent risk factors for OHE after TIPS. By using rms package of R software, independent factors were incorporated into a nomogram prediction model for OHE after TIPS. The expected probability o...
PMC10502141
The nomogram had a higher predictive power for OHE after TIPS in the training cohort
OHE
In the training cohort, this nomogram model achieved higher prediction accuracy than other conventional models. The C-index of our nomogram was 0.828 (95% CI 0.761–0.896), significantly higher than that of Child–Pugh score (0.665; 95% CI 0.576–0.755) or MELD score (0.657, 95% CI 0.559–0.755) (Fig. Prediction accuracy o...
PMC10502141
The nomogram had a higher predictive power for OHE after TIPS in the validation cohort
OHE
Our nomogram model was accurate in predicting OHE after TIPS in the validation cohort, with a C-index of 0.8464 (95% CI 0.7404–0.9524), higher than that of Child–Pugh score (0.6569, 95% CI 0.5129–0.8009) or MELD score (0.6616, 95% CI 0.5156–0.8076) (Fig. 
PMC10502141
DCA curve comparison of nomogram and conventional models for OHE after TIPS prediction accuracy
The DCA curves indicated that our nomogram prediction model was more valuable than MELD score or Child–Pugh score (Fig. In (
PMC10502141
Discussion
TIPS, OHE, liver function injury
REGRESSION, POSTOPERATIVE COMPLICATIONS
With continuous improvement of hardware facilities and technical concepts, effects of TIPS on PHT therapy have becoming more and more remarkable, however, its postoperative complications remain challenging. For example, HE caused by biochemical disturbance of brain functions as a result of liver function injury and por...
PMC10502141
Acknowledgements
We wish to particularly acknowledge the patients enrolled in this study for their participation.
PMC10502141
Author contributions
All authors contributed to the study conception and design. Data collection and analysis were performed by L.Z., J.-t.W., Z.-d.Y., Z.-h.F., Y.-f.W., Y.Z., C.-b.D., X.-q.W., T.C., M.-m.M., L.B., S.-b.C., F.-q.L., L.W. The first draft of the manuscript was written by Y.L. and all authors commented on previous versions of...
PMC10502141
Funding
This work was supported by the National Natural Science Foundation of China General Program (Grant no. 81871461).
PMC10502141
Data availability
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
PMC10502141
Competing interests
The authors declare no competing interests.
PMC10502141
References
PMC10502141
Background
mental disorders, depression, anxiety, Common mental disorders
Common mental disorders are the leading cause of workplace absences. The Prevail intervention programme aims to reduce stigma and to educate staff and managers about evidence-based low intensity psychological interventions for common mental disorders (depression, anxiety, stress, and distress). Prevail is innovative in...
PMC10334530
Methods
A two-armed cluster randomised control trial (RCT) evaluated the effectiveness of Prevail. Employees (
PMC10334530
Results
Prevail was evaluated highly favourably by both the staff and their managers. Prevail produced significant reductions in self-stigma and anticipated stigma due to mental health difficulties. Crucially, sickness absence was significantly reduced by the Prevail Intervention.
PMC10334530
Discussion
Prevail achieved its goals of producing a palatable and engaging intervention that altered staff’s attitudes and stigmatic beliefs related to mental health and, crucially, produced a strong reduction in work-pace absenteeism. As the Prevail programme is aimed at common mental health problems and was not specialised to ...
PMC10334530
Trial Registration
mental disorder
ISRCTN12040087. Registered 04/05/2020. 10.1186/ISRCTN12040087. A full protocol for the randomised control trial was published: Gray NS, Davies H, Snowden RJ: Reducing stigma and increasing workplace productivity due to mental health difficulties in a large government organization in the UK: a protocol for a randomised ...
PMC10334530
Keywords
PMC10334530
Background
CMDs, depression, anxiety, Common mental disorders
ADULT DISEASE
Common mental disorders (CMDs, i.e. anxiety and depression) contribute around 16–17% of the burden of adult disease in the UK [
PMC10334530
Previous intervention programmes
cognitive behavioural therapies
Most previous work aiming to look at the effects of therapies for CMDs on employment-related variables (e.g., sickness absence, return to work) have looked at standard treatments for CMDs such as cognitive behavioural therapies or medication. While such treatments have the expected (positive) effect on symptom reductio...
PMC10334530
Prevail
CMD, presenteeism
Prevail is a multi-faceted programme aimed at reducing sickness absence and presenteeism due to CMDs. It involves two psychological interventions, both provided via group based intervention programmes. The first (Prevail Staff Intervention) is for all employees within the organization and its aims are to improve knowle...
PMC10334530
Aims and hypotheses
Our original aims were to: (1) measure mental health literacy (and mental health stigma in particular) before and after the intervention, (2) compare sick leave in the 12 months pre- and post-intervention, and (3) to measure quality of life, presenteeism, and current mental health 12 months post intervention [
PMC10334530
Methods
The setting was the Driver and Vehicle Licencing Agency (DVLA). The DVLA is the executive agency part of the Department for Transport. DVLA maintain the registration and licensing of drivers and vehicles in Great Britain. It employs around 6,000 people mainly at its head office in Swansea, Wales, UK. All participants i...
PMC10334530
Participants
Sixty-seven managers across four divisions of the DVLA, stratified by division [Information Technology Services (ITS), the Contact Centre (CC), Casework and Enforcement Group (CAEG), and Input Services Group (ISG)] were chosen for the study. These were then randomised (using a random number sequence) into the two arms ...
PMC10334530
Power and statistical analysis
Our initial aim (see [A
PMC10334530
Prevail intervention
depression, CMD, anxiety
DISORDER, DISORDERS
The Prevail intervention programmes were conceptualised and written by two of the authors (NSG, RJS) who also served to train the trainers that delivered the Prevail Staff Intervention and to deliver the Prevail Managers intervention. NSG is a Consultant Clinical and Forensic Psychologist with over 25 years of experien...
PMC10334530
Delivery of prevail
The Prevail Intervention programme consists of a series of nine modules taking a mainly didactic approach to learning, but with many interactive components and case study discussions to enhance participant engagement. The modules consist of lectures on specific topics (e.g. Module 5 “Stress and Emotional Stress”) that ...
PMC10334530
Results
PMC10334530
Part 1. Perceptions of the prevail training
depression, anxiety
Overall, 492 people completed the evaluation of the Prevail intervention. No demographic information was taken. A summary of the quantitative results for the Prevail Staff Intervention is given in Fig. Importantly, three questions in the quantitative evaluation aimed to examine if participants felt the intervention had...
PMC10334530
Part two. Changes in mental health literacy
The descriptive statistics for the sample, stratified by condition (active vs. control) and wave (pre-assessment or Wave 1 vs. post-assessment or Wave 2) are presented in Table  Demographic Information on RCT participantsThe psychometric properties for the SASS scales were highly similar to a previous report of the pro...
PMC10334530
Part three. Sickness absence
PMC10334530
Statistical methods
mental disorder
Chi-square analysis was performed to compare the active and control arms on demographic characteristics including age, gender, and directorate. Chi-square analysis and unadjusted odds ratios (OR) with 95% confidence intervals (95% CI) were used to compare the treatment arms on the number of “all sickness” and “mental d...
PMC10334530
Statistical results
The results of the demographic variable comparisons are presented in Table  Demographics and chi-square analysis for the participants in the RCT for sickness absenceFor the analysis of summary sickness absences, there was a significantly higher proportion of “all sickness” absence days in the control group during the s...
PMC10334530
Discussion
In order to evaluate the Prevail intervention we assessed, (1) whether the people who underwent Prevail thought that the intervention achieved its aims, (2) whether Prevail produced changes in people’s mental health literacy (including stigma reduction), and (3) whether Prevail changed their ability to work (reduced ab...
PMC10334530
Evaluation of the prevail intervention
Prevail Staff Intervention was administered to staff via a one-day group intervention. Most participants evaluated the duration and pace of the intervention as appropriate and that they were able to understand the Prevail content. Crucially, they also thought that they would be able to improve their own mental health, ...
PMC10334530
Changes in mental health literacy
The Prevail Intervention led to clear reductions in levels of self-stigma and anticipated stigma. These two scales are those most strongly associated with mental health [
PMC10334530
Changes in sickness absence
anxiety
DISORDERS, DISEASE, FLU
Producing an intervention that is valued by the workforce and which is able to change people’s attitudes and intentions to seek help is a good achievement. However, actually being able to change people’s future behaviour is a far more difficult task [While the results of the Prevail intervention appear robust there are...
PMC10334530
Limitations to the RCT
LEAKAGE
The main limitation to the study were the unexpected differences in baseline levels of sickness absence between the two arms of the study (see discussion above). The study was also curtailed in some of its aims due to the onset of restrictions due to the COVID-19 pandemic that severely altered work practices and limite...
PMC10334530
Acknowledgements
Thanks to all members of the project team at the DVLA for their help with this project and for the support we received from the DVLA Executive Board who approved and supported the Prevail Intervention programme and three-stage evaluation. We are particularly grateful to Louise White and Andrew Falvey as Executive Direc...
PMC10334530
Authors’ contributions
The conception of the Prevail programme was completed by NSG in collaboration with HD. NSG and RJS wrote the Prevail intervention programme. HD arranged for a cross-section of DVLA staff to give feedback on draft versions of the psychological intervention and gave advice on practical implementation of the programme to ...
PMC10334530
Funding
The development of Prevail, its implementation to the DVLA, and the costs of the RCT were funded by the DVLA via a research grant to Swansea University (Ref number: PSC1046). The funders helped in the implementation of the RCT via selecting appropriate managers and their teams, randomising these managers/teams to the a...
PMC10334530
Data Availability
mental disorder
The datasets generated during this research and/or analysed following completion of the current study are stored in a publicly available repository (Mendeley). Snowden, Robert (2022), “Reducing stigma and increasing workplace productivity due to mental health difficulties: A randomised control treatment trial (RCT) of ...
PMC10334530
Declarations
PMC10334530
Ethical approval and consent to participate
All methods were carried out in accordance with relevant guidelines and regulations (e.g., the Declaration of Helsinki). This trial has received ethical approval by Ethics committee of Swansea University, 25/09/2019 Ref: 1521. Participants selected for the Prevail intervention programme undertook this programme as part...
PMC10334530
Consent for publication
Not applicable.
PMC10334530
Competing interests
NSG and RJS are the authors of the Prevail intervention and may receive commission or financial reward for the future use of this programme. The other authors have no competing interests.
PMC10334530
References
PMC10334530
The present study
personality traits
SECONDARY
The goal of this study was to test the effects of a 7-week digital self-control intervention to increase physical activity using a two-arm randomized controlled trial. The self-control treatment group showed greater increases in self-reported physical activity (MET’s) than the comparison group. Both groups significantl...
PMC10466994
Method
This study has been approved by the University’s Institutional Review Board at Brandeis University and the protocol has been registered at ClinicalTrials.gov (CT04522141) and is published (
PMC10466994
Participants
A total of 86 middle-aged adults were enrolled in the study between October 2020 and April 2021. Participants were recruited from across the US, with a majority in the Northeast, by posting advertisements on public boards and online. Advertisements specified: “Do you want to be more active, but find yourself making exc...
PMC10466994
Study design and procedure
BLIND
This study used a two-arm randomized controlled trial design with a pretest (baseline), weekly assessments at the end of every week (weeks 1–7), a posttest (week 8), and a follow-up assessment (week 12). Participants were randomly assigned to one of the two conditions: the treatment group or the comparison group. The a...
PMC10466994
Self-control treatment group
The treatment group used the MindHike coaching application, which supports and guides people who would like to train their self-control with the help of a digital coach. The app delivered the same dialogs to all participant in the treatment group. There was no bi-directional communication, but participants clicked on p...
PMC10466994
Comparison group
The comparison group used a minimal app version across the eight study weeks, which sent them two daily reminders. At customized times in the morning, they were reminded to wear the Fitbit and at customized times in the evening, they were reminded to sync their step data with the Fitbit app and to charge their Fitbit d...
PMC10466994
Primary outcome measures
The study included Qualtrics online questionnaires at the pretest, weekly assessments (weeks 1–7), a posttest (week 8), and a follow-up assessment (week 12).
PMC10466994
Self-control
Self-control was assessed in two ways. First, we assessed overall self-control at pretest, at posttest, and follow-up assessment using the Brief Self-control Scale (BSCS; Second, to measure weekly self-control, we asked participants to indicate to what extent the same 13 items from the BSCS applied to them with respect...
PMC10466994
Self-reported physical activity (MET’s)
Self-reported physical activity was assessed at pretest, posttest, and follow-up using the short version of the International Physical Activity Questionnaire (IPAQ;
PMC10466994
Objectively assessed physical activity
Fitbit Charge 4 activity trackers (
PMC10466994
Daily steps
As there were likely times when participants walked without wearing their Fitbit device, we only included days with more than 500 steps as valid days in our analyses. This is in line with prior studies using step data (
PMC10466994
MVPA
Daily steps and MVPA can be correlated, but MVPA can pick up on activity that is more strenuous than regular walking. Fitbit categorizes active time into four categories: sedentary, lightly active, fairly active, and very active. In this study, MVPA was calculated by adding up fairly active and very active minutes each...
PMC10466994
Secondary outcome measures
PMC10466994
Conscientiousness
At pretest, posttest, and follow-up assessment, participants completed the 60-item BFI-2 to assess conscientiousness (
PMC10466994
Covariates
Age, sex (0 = female, 1 = male), education in years, race (0 = White, 1 = Non-White), self-reported functional health (SF-36(
PMC10466994
Data analysis
Details on the power analyses are reported in We used longitudinal multilevel models and the lme4 package in R (To test if participants showed significant changes in our outcome measures, we tested the main effects of time using multilevel models. In additional multilevel models, we tested if there was differential cha...
PMC10466994
Results
Randomization check and attrition analyses are reported in
PMC10466994
Association between changes in self-control and changes in physical activity
We tested a Time by Change in Self-control interaction to examine if participants who showed greater increases in self-control were better able to increase their physical activity across time. The results suggest that participants who showed greater increases in self-control showed greater increases in MET’s (Associati...
PMC10466994
Discussion
Three important findings emerged from the present study. First, the results suggest significant overall increases in physical activity and self-control in both conditions. Also, both groups maintained their levels of physical activity and self-control until 4 weeks after the end of the intervention. Second, participant...
PMC10466994
Limitations and future directions
Based on the present findings, it is not entirely clear which micro interventions are most effective in changing self-control and physical activity. Future research is needed to disentangle the specific active ingredients of the intervention. The results on increasing self-control and physical activity in the compariso...
PMC10466994
Conclusion
This study constitutes the first to test whether a digital self-control coaching intervention has an effect on physical activity. The results suggest that a digital intervention targeting self-control can help people increase their MET levels for physical activity. Also, individuals with higher levels of conscientiousn...
PMC10466994
Supplemental Material
PMC10466994
sj-docx-9-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.Supplemental material, sj-docx-9-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-pdf-1-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.sj-pdf-1-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-pdf-2-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.sj-pdf-2-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-pdf-3-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.sj-pdf-3-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-pdf-4-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.sj-pdf-4-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-sav-5-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.sj-sav-5-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-sav-6-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.sj-sav-6-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
sj-sav-7-hpq-10.1177_13591053231166756 – Supplemental material for Effects of a digital self-control intervention to increase physical activity in middle-aged adults
Click here for additional data file.j-sav-7-hpq-10.1177_13591053231166756 for Effects of a digital self-control intervention to increase physical activity in middle-aged adults by Mirjam Stieger, Mathias Allemand and Margie E Lachman in Journal of Health Psychology
PMC10466994
References
PMC10466994
Methods
Autoimmune and Autoinflammatory Disorders, Sarah Alice, T1D
AUTOIMMUNE DISORDERS, TYPE 1 DIABETES
Edited by: Sarah Alice Long, Benaroya Research Institute, United StatesReviewed by: Howard Davidson, University of Colorado, United States; Helena Reijonen, City of Hope National Medical Center, United StatesThis article was submitted to Autoimmune and Autoinflammatory Disorders: Autoimmune Disorders, a section of the ...
PMC9933867
Results
Higher GADA, GADA subclasses, GAD
PMC9933867
Conclusion
Patients with DR3DQ2 haplotype had a distinct early cellular immune response to GAD-alum injections into the lymph node, and predominant GAD
PMC9933867
Introduction
T1D, chronic disorder
CHRONIC DISORDER, DISEASE PROGRESSION, ADVERSE EVENTS, DISEASE, TYPE 1 DIABETES
Type 1 diabetes (T1D) is a chronic disorder requiring lifelong treatment. Despite intensive treatment, the disease causes substantial morbidity and mortality. Several clinical intervention trials with different approaches to delay or halt disease progression have shown limited efficacy, sometimes accompanied with adver...
PMC9933867
Materials and methods
PMC9933867
Study design
diabetes
TOLERANCE, DIABETES
DIAGNODE-2 study was a two-arm, multicenter, randomized, double-blind, placebo-controlled trial (NCT03345004) performed at 18 diabetes clinics in the Czech Republic, the Netherlands, Spain, and Sweden as described before (Three intralymphatic injection with 4 μg GAD-alum (Diamyd Medical, Stockholm, Sweden) on days 30, ...
PMC9933867
Blood samples
For the immunological analysis, blood and serum were collected at all visits. Samples were drawn during the morning hours, and peripheral blood mononuclear cells (PBMCs) were isolated within 24 hours using Leucosep (Greiner Bio One), according to the manufacturer’s instructions at Linköping University, Sweden.
PMC9933867
GAD autoantibodies and IgG subclasses
GAD autoantibodies
Serum GAD autoantibodies (GADA) levels were assessed by means of enzyme-linked immunosorbent assay (ELISA) by Synlab Pharma Institute (Munich, Germany).GADA IgG 1, 2, 3, and 4 subclasses were measured by radio-binding assays using IgG subclass-specific biotin-labelled mouse-anti-human monoclonal antibodies bound on Str...
PMC9933867
Lymphocyte proliferation assay
PROLIFERATIVE
Proliferative response was analyzed in PBMCs cultured in triplicates in AIM-V medium with β-mercaptoethanol at 37°C in 5% CO
PMC9933867
Cytokine secretion assay
Cytokines were quantified both in serum samples and in PBMCs supernatants. PBMCs were cultured in AIM-V medium with β-mercaptoethanol for 7 days at 37°C in 5% CO
PMC9933867
Statistics and software analysis
Immunological data was presented as median with 95% CI following non-normal distribution, and nonparametric tests were applied. For determining differences between groups, the Mann-Whitney test was used, and Wilcoxon test was applied for differences within groups. A probability level of < 0.05 was considered statistica...
PMC9933867
Results
PMC9933867
Immune response in GAD-alum treated patients
PROLIFERATION
GADA levels increased in GAD-alum treated patients at 2 months, after the first injection, and remained higher through the study compared to the placebo group (Immune response from day 1 to 15 months in GAD-alum (smooth line, n=56) and Placebo (dashed line, n=52) individuals. GADFurther stratification of the GAD-alum a...
PMC9933867
Changes associated to the DR3DQ2 haplotype
Comparison of the immune response in individuals who received GAD-alum stratified according to the DR3DQ2 haplotype showed that GADImmune response from day 1 to 15 months in GAD-alum treated patients with (black, n=29) and without (light blue, n=27) DR3DQ2 haplotype.
PMC9933867
Immune response in relation to clinical outcome
To search for immune surrogate markers of clinical efficacy, we looked for the association between remaining C-peptide secretion at 15 months (Immune responses in GAD-alum treated patients in relation to Clinical outcome. Patients who received GAD-alum were stratified into Good Responders (GR, n=23, loss < 30% AUC) and...
PMC9933867
Discussion
T1D
DISEASE, TYPE 1 DIABETES, OTHER AUTOIMMUNE DISEASE
The DIAGNODE-2 study constituted the first placebo-controlled trial in which an autoantigen was administrated into the lymph nodes of patients with Type 1 diabetes, and immunological changes observed in GAD-alum treated patients with respect to placebo have not been previously described. Modifications following therapy...
PMC9933867
Data availability statement
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
PMC9933867
Ethics statement
The studies involving human participants were reviewed and approved by the relevant regulatory authorities and research ethics boards of the participating sites and countries. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.
PMC9933867
Author contributions
RC designed the experiments. SP-M, FD, and PA performed experiments. SP-M and HB analyzed the data. SP-M and RC interpreted the results and wrote the manuscript. JL conceived DIAGNODE-2 study, recruited, and followed patients. All authors contributed to the article and approved the submitted version.
PMC9933867