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Background: Pregestational diabetes mellitus (PGDM) is associated with adverse pregnancy outcomes. Studies assessing interventions to improve maternal and infant outcomes have increased exponentially over recent years. Several outcomes in this field of maternal diabetes are rare, making it difficult to synthesise evidence. Objectives: To collect outcomes reported in studies assessing treatment interventions in pregnant women with PGDM. Search strategy: CENTRAL, Web of Science, Medline, CINAHL, Embase and ClinicalTrials.gov from their inception until 27 January 2020. Selection criteria: Any randomised controlled trial assessing treatment interventions in pregnant women with PGDM reported in English. Data collection and analysis: Two independent reviewers assessed the suitability of articles and retrieved the data. Outcomes extracted from the literature were broadly categorised into maternal, fetal/infant or other outcomes by the study advisory group. Main results: Sixty‐seven of the 1475 studies identified fulfilled the inclusion criteria. The median number of outcomes reported per study was 15 (range 1–46). The majority of studies were from North America and Europe. Insulin and metformin were the most commonly investigated pharmacological interventions. Glucose monitoring was the most assessed technological intervention. In all, 131 unique outcomes were extracted: maternal (n = 69), fetal/infant (n = 61) and other (n = 1). Conclusions: Outcome reporting in treatment interventions trials of pregnant women with PGDM is varied, making it difficult to synthesise evidence, especially for rare outcomes. Systems are needed to standardise outcome reporting in future clinical trials and so facilitate evidence synthesis in this area of maternal diabetes. Registration: The systematic review was registered prospectively with the International Prospective Register of Systematic Reviews (PROSPERO) database (Registration number CRD42020173549). Outcome reporting is heterogeneous in intervention trials of pregnant women with diabetes existing before pregnancy. Outcome reporting is heterogeneous in intervention trials of pregnant women with diabetes existing before pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To develop a core outcome set (COS) for randomised controlled trials (RCTs) evaluating the effectiveness of interventions for the treatment of pregnant women with pregestational diabetes mellitus (PGDM). Design: A consensus developmental study. Setting: International. Population: Two hundred and five stakeholders completed the first round. Methods: The study consisted of three components. (1) A systematic review of the literature to produce a list of outcomes reported in RCTs assessing the effectiveness of interventions for the treatment of pregnant women with PGDM. (2) A three‐round, online eDelphi survey to prioritise these outcomes by international stakeholders (including healthcare professionals, researchers and women with PGDM). (3) A consensus meeting where stakeholders from each group decided on the final COS. Main outcome measures: All outcomes were extracted from the literature. Results: We extracted 131 unique outcomes from 67 records meeting the full inclusion criteria. Of the 205 stakeholders who completed the first round, 174/205 (85%) and 165/174 (95%) completed rounds 2 and 3, respectively. Participants at the subsequent consensus meeting chose 19 outcomes for inclusion into the COS: trimester‐specific haemoglobin A1c, maternal weight gain during pregnancy, severe maternal hypoglycaemia, diabetic ketoacidosis, miscarriage, pregnancy‐induced hypertension, pre‐eclampsia, maternal death, birthweight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, mode of birth, shoulder dystocia, neonatal hypoglycaemia, congenital malformations, stillbirth and neonatal death. Conclusions: This COS will enable better comparison between RCTs to produce robust evidence synthesis, improve trial reporting and optimise research efficiency in studies assessing treatment of pregnant women with PGDM. 165 key stakeholders have developed #Treatment #CoreOutcomes in pregnant women with #diabetes existing before pregnancy. 165 key stakeholders have developed #Treatment #CoreOutcomes in pregnant women with #diabetes existing before pregnancy. [ABSTRACT FROM AUTHOR]

In this work we present a centrifugal microfluidic system enabling highly efficient collective trapping and alignment of particles such as microbeads and cells, their multi-colour fluorescent detection and subsequent manipulation by optical tweezers. We demonstrate array-based capture and imaging followed by "cherry-picking" of individual particles, first for fluorescently labelled polystyrene (PS) beads and then for cells. Different cell lines are discriminated based on intracellular as well as surface-based markers. [ABSTRACT FROM AUTHOR]

There is increasing interest in the use of nanoparticles (NPs) for biomedical applications. In particular, nanobiophotonic approaches using fluorescence offers the potential of high sensitivity and selectivity in applications such as cell imaging and intracellular sensing. In this review, we focus primarily on the use of fluorescent silica NPs for these applications and, in so doing, aim to enhance and complement the key recent review articles on these topics. We summarize the main synthetic approaches, namely the Stöber and microemulsion processes, and, in this context, we deal with issues in relation to both covalent and physical incorporation of different types of dyes in the particles. The important issue of NP functionalization for conjugation to biomolecules is discussed and strategies published in the recent literature are highlighted and evaluated. We cite recent examples of the use of fluorescent silica NPs for cell imaging in the areas of cancer, stem cell and infectious disease research, and we review the current literature on the use of silica NPs for intracellular sensing of oxygen, pH and ionic species. We include a short final section which seeks to identify the main challenges and obstacles in relation to the potential widespread use of these particles for in vivo diagnostics and therapeutics. [ABSTRACT FROM AUTHOR]

This paper describes the synthesis and characterization of sol-gel silica nanoparticles (NPs) derived from tetraethoxysilane (TEOS) and from tetraethoxysilane and methyltriethoxysilane (TEOS-MTEOS) in which is encapsulated, an in-house synthesized, stable oxygen-sensitive ruthenium complex, ruthenium (II) (bis-2,2-bipyridyl)-2(4-carboxylphenyl) imidazo[4,5-f][1,10]phenanthroline. These NPs were characterized using dynamic light scattering, transmission electron microscopy, scanning electron microscopy, Fourier transform infrared spectroscopy and Brunauer-Emmett-Teller analysis. The spherical, stable and monodispersed NPs have been prepared using the Stöber method. It was found that the addition of prehydrolyzed MTEOS-based sol prepared in an acidic environment to the reaction mixture containing TEOS NPs synthesized for 6 h produced material with increased porosity when compared to pure silica NPs. Oxygen sensitivity, stability, photobleaching and leaching have been characterized. The hybrid NPs exhibit enhanced O2 sensitivity but a high degree of leaching when compared to pure silica NPs, which have minimum O2 sensitivity and no leaching. [ABSTRACT FROM AUTHOR]

Platelets are central in maintaining normal haemostasis and are responsible for the cessation of blood loss following vascular injury. Platelet adhesion, leading to thrombus formation, involves rapid and distinct morphological changes culminating in cell aggregation. Rapid and highly specific platelet diagnostic tests are currently being developed to enable monitoring of drug response in patients with cardiovascular diseases. For a diagnostic device to be effective it needs to be rapid and simple, requiring minimal user interaction and providing results with minimal delay. This study describes the development of a rapid, label free platform for assay platelet function and demonstrates its use to monitor the influence of anti-thrombotic drugs. A rapid, single-step cell purification surface immobilises platelets from whole blood onto a protein array at specific locations used to define the assay site. Morphological changes and cell aggregation properties of activated platelets are exploited and combined within a label free, rapid, dye displacement chamber to determine cell morphology. Stimulation-dependent changes in cell morphology are described using both high resolution AFM imaging and a dye displacement platform. [ABSTRACT FROM AUTHOR]

A range of both sol-gel and polymer derived sensor films have been developed for optical oxygen and pH sensing. Oxygen sensing is based on the luminescence quenching of the ruthenium complex [Ru(II)-tris( 4,7-diphenyl-l,10-plenanthroline)]dichloride, ([Ru(dpp)3]2+), which is entrapped in the sol-gel matrix. The oxygen-dependent luminescence is detected using the principle of phase fluorometry, which facilitates indirect monitoring of the luminescence lifetime. The pH sensor uses excitation ratiometric detection of the fluorescence from the pH sensitive dye, 1-hydroxypyrene-3,6,8-trisulfonic acid, ion-paired with cetyl trimethyl ammonium bromide (HPTS_IP). The phase-based detection scheme, dual lifetime referencing (DLR), was also examined as an alternative sensing strategy. ORMOSIL oxygen sensor films were fabricated using a range of organosilicon precursors including methyltriethoxysilane (MTEOS), ethyltriethoxysilane (ETEOS), n-propyltriethoxysilane (PTEOS) and phenyltriethoxysilane (PhTEOS). In addition to optimising the sensor performance, issues such as the influence of humidity on oxygen sensing were addressed. By varying the processing parameters, the surface characteristics and microstructure were tailored to suit applications such as breath gas analysis and bioprocess monitoring. pH sensor films were prepared by hydrolyzing and co-condensing (3-aminopropyl) trimethoxysilane (APTMS) with an organosilicon monomer such as ETEOS or PTEOS or the polymer, ethyl cellulose (EC). Optimised pH sensors showed good reproducibility, reversibility and short response times. The dynamic range for these sensor films extends from pH 6.00 to 8.50 which is relevant for bioprocess monitoring applications. The spectral compatibility of the luminophores and the printability of the sol-gels present the possibility of simultaneous oxygen and pH sensing using low-cost LEDs as excitation sources along with common detection electronics. [ABSTRACT FROM AUTHOR]

Pale, soft, exudative (PSE) pork poses many problems for ham processors with the colour and texture of the final product being of major concern. As visual assessment is the primary, and often the only, method used by these producers, they require objective methods of assessing the quality of the raw material prior to production of hams. This study was conducted to establish the relationship between objective colour measurements and subjective (visual) methods of assessing pork meat quality and to ascertain the ability of objective colour measurements (CIE L* and percentage reflectance) to accurately segregate porcine muscles according to quality, prior to ham production. Pork topsides (M. semi-membranosus and M. adductor) were visually assessed by experienced industry personnel, from a large ham producing company, as being `pale' (n 489) or `good' (n = 625) in colour. CIE L* and percentage reflectance (%R) were then recorded on all muscles. Pearson's correlation coefficients confirmed a significant relationship between visually assessed meat and both L* (r = -0.71) and reflectance (r = 0.71). CIE L* above 57 and %R below 43% correctly classified 75% of the `pale' topsides. CIE L* below 53 and %R above 53% correctly classified 75% of the `good' topsides. Muscles were processed and colour, texture, sliceability and water holding capacity of the resulting ham products were determined. Hams produced using `pale' topsides had significantly higher (p C 0.001) CIE L* and b* values and lower %R (p C 0.001), moisture content (p <0.001) and water holding capacity (p < 0.05). The textural characteristics of the hams were significantly different (p < 0.05) and those produced using `good' meat had greater cohesiveness, chewiness, gumminess and springiness. This study indicates that these objective methods may have potential in the classification of topsides prior to ham processing. [ABSTRACT FROM AUTHOR]

In recent years, sol–gel-derived films have played a significant role in optical sensor development. This paper focuses on the characterisation of oxygen-sensitive tetraethoxysilane (TEOS) and methyltriethoxysilane (MTEOS)-based films. Film porosity and sensor response times are reported for a range of films fabricated under different conditions. Porosity data are correlated with predicted film behaviour and also with previous characterisation studies. Oxygen diffusion coefficients are estimated from the response times. The enhanced diffusion coefficient of MTEOS films compared to TEOS films is discussed in terms of the relative oxygen solubility of the films. Comparisons are made with data for oxygen-sensitive polymer films, indicating an enhanced solubility for sol–gel films compared with typical polymer films. [Copyright &y& Elsevier]

Provides information on the development the sol-gel-based optical sensors for both gas-phase and dissolved oxygen. Investigation of the optimal film-processing parameters for both environments; Background information on these optical sensors; Details on film hydrophobicity in relation to this topic.

In this letter, we report a simple optical strategy designed to significantly enhance the fluorescence collection efficiency of planar substrate-based optical sensors. The strategy involves the use of refractive and reflective optical elements that permit supercritical angle fluorescence to be transmitted through the lower surface of the planar substrate and redirected toward an optical detector. Importantly, this approach facilitates simple integration with existing multianalyte sensor systems and microfluidic platforms by leaving the sensor's upper planar surface unstructured. In comparison to a conventional planar substrate configuration, the proposed approach can provide better than an order of magnitude (factor of 20) enhancement in the fluorescence intensity detected. It is envisaged that this approach will have significant potential in a range of application areas where there is need for low-cost optical sensor technologies. [ABSTRACT FROM PUBLISHER]

In this letter, we report on the development of a novel camera phone-based UV-dosimeter for monitoring the solar disinfection (SODIS) of water. The dosimeter consists of a UV indicator, methylene blue, dispersed in an ethylcellulose-based polymer matrix. To provide quantitative measurement of UV dose, we demonstrate the use of a camera phone to analyze dosimeter color change in response to UV exposure. The dosimeter response exhibits excellent agreement with a polynomial model (R2) >; 0.99) over the UV exposure range tested. A notable advantage of the dosimeter described here is that it can be deposited on a variety of substrates with the potential to be incorporated into water containers. It is envisaged that use of such a dosimeter in conjunction with mobile phone technology will enhance the use of SODIS thereby impacting significantly on the challenge of providing clean drinking water in developing regions of the world. [ABSTRACT FROM PUBLISHER]

This work describes the design and fabrication of a novel multianalyte biosensor platform for medical diagnostic applications. The sensor platform consists of a photonic waveguide-based optical circuit used to deliver excitation light to multiple sensor windows on the platform. The platform is fabricated by UV-photopatterning of photocurable hybrid organic–inorganic sol–gel materials. The sensing mechanism is based upon the detection of fluorescently labelled antibodies, in order to determine the concentration of specific analytes in a test solution. Fluorescence is excited by means of the evanescent wave in each sensor window. It is shown that the sensing properties of the platform can be dramatically enhanced by increasing the intensity of the evanescent field of the light propagating in the optical waveguide by a precise design of a high refractive index layer deposited at the waveguide surface. This work proved the concept of employing a waveguide-based photonic platform for the detection of fluorescently labelled antibodies, with μg/ml detection levels, and as such, we believe this system has immense potential for future applications as a medical diagnostic platform. [ABSTRACT FROM AUTHOR]

Abstract: In this work we report on the so-called plasmonic enhancement effect, whereby the presence of metallic surfaces or particles in the vicinity of a fluorophore can dramatically alter the fluorescence emission and absorption properties of a fluorophore. The effect, which is associated with the surface plasmon resonance of the metallic surface, depends on parameters such as metal type, particle size, fluorophore type, and fluorophore-particle separation. This work focuses on the creation of metal nanoparticle arrays by a lithographic process and on optimisation strategies to maximise the fluorescence enhancement of dyes in the vicinity of the nanoparticles, for important applications such as fluorescence-based biochip platforms. Ordered arrays of metallic nano-islands were fabricated on glass substrates by a process of natural lithography using monodisperse polystyrene nanospheres. The metal particle dimensions were tailored in order to tune the plasmon resonance wavelength to match the spectral absorption of the fluorophore. The fluorophore, Cy5 dye, which is widely used in optical immunoassays and has a medium quantum efficiency (∼0.3), was used in this preliminary study of the plasmonic enhancement effect. The morphology of the metallic arrays was investigated using scanning electron microscopy (SEM) and atomic force microscopy (AFM). Absorption and emission spectroscopies were used to elucidate the enhancement effect and its dependence on metal island morphology. Results were correlated with existing theoretical models. The applicability of this important technique to sensor platforms, such as fluorescence-based biochips, is also discussed. [Copyright &y& Elsevier]

Biopolymer-based packaging films were prepared from pectin (PEC) and sodium alginate (SA), with the incorporation of 10 % MCC and different concentrations of geraniol (GER at 2.5, 5.0, 7.5, and 10.0 %). Rheological properties suggested that film-forming solutions and film-forming emulsions exhibited a shear-thinning or pseudo-plastic non-Newtonian behaviour. The dried films were crosslinked with 2.0 % CaCl 2 . The addition of MCC into PEC/SA film enhanced the TS but reduced it with the impregnation of GER without influencing the EAB and toughness of the film. The water solubility of the films significantly reduced with the rise in the GER levels but enhanced the water vapor and oxygen barrier attributes. TGA demonstrated that incorporating MCC reduced the film's thermal degradation (44.92 % to 28.81 %), but GER had an insignificant influence on the thermal stability. FTIR spectra revealed that hydrogen bond formation was positively linked with the GER addition in the film formulation. X-ray diffractograms showed that prepared films were predominantly amorphous. Antimicrobial studies showed a complete reduction of Escherichia coli and Bacillus cereus in 24 h. Overall, the composite film displayed excellent physical and active properties and PEC/SA/MCC/5.0 %GER/CaCl 2 film was considered the best formulation for food packaging applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The present work investigated the structure-function relationship of dry fractionated oat flour (DFOF) as a techno-functional ingredient using bread as a model system. Mechanically, DFOF fractions (F), that is, F1: <224 µm, F2: 250-280 µm, F3: 280-500 µm, F4: 500-600 µm, and whole oat flour (F5) were blended with white wheat flour at 10%, 30%, and 50% substitution levels for bread making. The blended flours, doughs, and bread samples were assessed for their techno-functional, nutritional, and structural characteristics. The results of Mixolab and the Rapid Visco Analyzer show that the 50% substituted F3 fraction exhibits the highest water absorption properties (69.53%), whereas the 50% F1 fraction exhibits the highest peak viscosity of the past slurry. Analysis of bread samples revealed a lower particle size of DFOF fractions and higher supplementation levels, increased β-glucan levels (0.13-1.29 g/100 bread (db), reduced fermentable monosaccharides, that is, glucose (1.44-0.33 g/100 g), and fructose (1.06-0.28 g/100 g). The effect of particle size surpassed the substitution level effect on bread volume reduction. The lowest hardness value for F1 is 10%, and the highest value for F2 is 50%. The total number of cells in the bread slice decreased from the control to the F4 fraction (50%). Multi-criteria analysis indicated that DFOF fractions produced breads with similar structure and higher nutritional value developed from white wheat flour. PRACTICAL APPLICATION: The use of mechanically fractionated oat flours fractions in white wheat flour breads can improve the nutritional profile without affecting the physical properties of the bread product. Based on the oat flour fractions, bakers and food processing companies can tailor the bread formulations for high β-glucan, high fiber, and low reduced sugar claims., (© 2024 The Authors. Journal of Food Science published by Wiley Periodicals LLC on behalf of Institute of Food Technologists.)

The market has observed a rapid increase in the demand for plant-based foods as an alternative to animal meat products. Technologies such as high-moisture extrusion (HME) have the potential to develop anisotropic structures using alternative protein ingredients. This article discusses the different possible mechanisms responsible for structure formation and the effect of extrusion process parameters and outlines the recent advances in the long cooling dies (LCDs) used for meat alternative development. The role of different protein ingredients and the impact of combining them with other biopolymers were also evaluated. The underlying mechanism behind anisotropic structure formation during HME is a synergistic effect, with substantial dependence on the source of ingredients and their processing background. Formulation including proteins derived from plants, insects, animals, and microalgae with other biopolymers could pave the way to develop structured meat alternatives and fill nutritional interstices. Dynamic or rotating annular gap cooling dies operating at freely controllable shear and static annular gap dies are recent developments and assist to produce layered or fibrous structures. The complex chemical sites created during the HME of plant protein favour flavour and colour retention. This paper summarises the recent information published in the scientific literature and patents, which could further help researchers to fill the present knowledge gaps.

Suitable packaging material in combination with high-pressure processing (HPP) can retain nutritional and organoleptic qualities besides extending the product's shelf life of food products. However, the selection of appropriate packaging materials suitable for HPP is tremendously important because harsh environments like high pressure and high temperature during the processing can result in deviation in the visual and functional properties of the packaging materials. Traditionally, fossil-based plastic packaging is preferred for the HPP of food products, but these materials are of serious concern to the environment. Therefore, bio-based packaging systems are proposed to be a promising alternative to fossil-based plastic packaging. Some studies have scrutinized the impact of HPP on the functional properties of biopolymer-based packaging materials. This review summarizes the HPP application on biopolymer-based film-forming solutions and pre-formed biopolymer-based films. The impact of HPP on the key packaging properties such as structural, mechanical, thermal, and barrier properties in addition to the migration of additives from the packaging material into food products were systemically analyzed. HPP can be applied either to the film-forming solution or preformed packages. Structural, mechanical, hydrophobic, barrier, and thermal characteristics of the films are enhanced when the film-forming solution is exposed to HPP overcoming the shortcomings of the native biopolymers-based film. Also, biopolymer-based packaging mostly PLA based when exposed to HPP at low temperature showed no significant deviation in packaging properties indicating the suitability of their applications. HPP may induce the migration of packaging additives and thus should be thoroughly studied. Overall, HPP can be one way to enhance the properties of biopolymer-based films and can also be used for packaging food materials intended for HPP.

Background: Many adolescents meeting diagnostic criteria for social anxiety disorder (SAD) do not seek help or access timely professional supports. The current study investigated two hypothesized barriers to adolescents' seeking help for SAD: stigma and SAD symptoms., Method: Three hundred fifteen adolescents (52% female; mean age = 14.85 years) read a vignette describing a hypothetical peer with symptoms of SAD and completed measures of their own help-seeking intentions, SAD symptoms, stigma awareness and agreement., Results: The majority of adolescents reported that the vignette character needed help. Adolescents with more SAD symptoms, and those with greater stigma awareness, were less likely to indicate they would seek help from an adult they know (e.g., parent or teacher) for similar symptoms., Conclusions: Both SAD symptoms and perceptions of societal stigma may act as barriers to help-seeking for young people indicating the importance of intervention with young people, and the adults with whom they interact regularly., (© 2021 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)

Background: Pregestational diabetes mellitus (PGDM) is associated with adverse pregnancy outcomes. Studies assessing interventions to improve maternal and infant outcomes have increased exponentially over recent years. Several outcomes in this field of maternal diabetes are rare, making it difficult to synthesise evidence., Objectives: To collect outcomes reported in studies assessing treatment interventions in pregnant women with PGDM., Search Strategy: CENTRAL, Web of Science, Medline, CINAHL, Embase and ClinicalTrials.gov from their inception until 27 January 2020., Selection Criteria: Any randomised controlled trial assessing treatment interventions in pregnant women with PGDM reported in English., Data Collection and Analysis: Two independent reviewers assessed the suitability of articles and retrieved the data. Outcomes extracted from the literature were broadly categorised into maternal, fetal/infant or other outcomes by the study advisory group., Main Results: Sixty-seven of the 1475 studies identified fulfilled the inclusion criteria. The median number of outcomes reported per study was 15 (range 1-46). The majority of studies were from North America and Europe. Insulin and metformin were the most commonly investigated pharmacological interventions. Glucose monitoring was the most assessed technological intervention. In all, 131 unique outcomes were extracted: maternal (n = 69), fetal/infant (n = 61) and other (n = 1)., Conclusions: Outcome reporting in treatment interventions trials of pregnant women with PGDM is varied, making it difficult to synthesise evidence, especially for rare outcomes. Systems are needed to standardise outcome reporting in future clinical trials and so facilitate evidence synthesis in this area of maternal diabetes., Registration: The systematic review was registered prospectively with the International Prospective Register of Systematic Reviews (PROSPERO) database (Registration number CRD42020173549)., Tweetable Abstract: Outcome reporting is heterogeneous in intervention trials of pregnant women with diabetes existing before pregnancy., (© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

Objective: To develop a core outcome set (COS) for randomised controlled trials (RCTs) evaluating the effectiveness of interventions for the treatment of pregnant women with pregestational diabetes mellitus (PGDM)., Design: A consensus developmental study., Setting: International., Population: Two hundred and five stakeholders completed the first round., Methods: The study consisted of three components. (1) A systematic review of the literature to produce a list of outcomes reported in RCTs assessing the effectiveness of interventions for the treatment of pregnant women with PGDM. (2) A three-round, online eDelphi survey to prioritise these outcomes by international stakeholders (including healthcare professionals, researchers and women with PGDM). (3) A consensus meeting where stakeholders from each group decided on the final COS., Main Outcome Measures: All outcomes were extracted from the literature., Results: We extracted 131 unique outcomes from 67 records meeting the full inclusion criteria. Of the 205 stakeholders who completed the first round, 174/205 (85%) and 165/174 (95%) completed rounds 2 and 3, respectively. Participants at the subsequent consensus meeting chose 19 outcomes for inclusion into the COS: trimester-specific haemoglobin A1c, maternal weight gain during pregnancy, severe maternal hypoglycaemia, diabetic ketoacidosis, miscarriage, pregnancy-induced hypertension, pre-eclampsia, maternal death, birthweight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, mode of birth, shoulder dystocia, neonatal hypoglycaemia, congenital malformations, stillbirth and neonatal death., Conclusions: This COS will enable better comparison between RCTs to produce robust evidence synthesis, improve trial reporting and optimise research efficiency in studies assessing treatment of pregnant women with PGDM., Tweetable Abstract: 165 key stakeholders have developed #Treatment #CoreOutcomes in pregnant women with #diabetes existing before pregnancy., (© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

Background: The stigma associated with mental disorders in adolescence has a range of detrimental consequences, negatively impacting help-seeking behaviours and quality of life. Social anxiety typically has its onset during adolescence, but the associated stigma is not well understood. This study was designed to improve understanding of social anxiety and depression stigma in adolescence by examining demographic and personal variables that predict them both., Methods: Three hundred and fifteen adolescents (150 males, 165 females), from 2nd and 4th year of secondary school (mean ages 13.92 and 15.92 years respectively), completed the Peer Mental Health Stigmatization Scale to measure both personal and perceived stigma towards vignettes depicting social anxiety and depression. They also answered demographic questions and completed the Social Anxiety Scale for Adolescents., Results: Hierarchical multiple regression revealed that gender predicted both personal and perceived stigma towards depression and personal stigma towards social anxiety. Males scored higher on measures of personal stigma whereas females had higher scores on perceived stigma. Ability to accurately identify symptoms described in a vignette, predicted lower personal stigma towards social anxiety and higher perceived stigma towards depression. Depression was more stigmatized than social anxiety., Limitations: The study used vignettes to represent individuals with depression and social anxiety so participant responses may not reflect their behaviour towards real peers., Conclusions: Findings emphasise the importance of separately considering personal and perceived stigma for each condition and highlight gender differences in stigma responses that need to be considered in intervention design., (Copyright © 2020. Published by Elsevier B.V.)

A 73-year-old female patient with epilepsy presented to hospital with a progressive, diffuse macular rash over the trunk and limbs with associated mucosal blistering and discharge. Ocular symptoms initially predominated and she was treated for presumed bacterial conjunctivitis by her General Practitioner the previous day. On the acute medical unit supportive management was initiated for suspected adverse drug reaction (ADR) to a recent lamotrigine dose increase. Skin biopsy confirmed a diagnosis of toxic epidermal necrolysis. We present this case to highlight the importance of medication history taking and raise awareness of indolent presentations of life-threatening ADRs. Caution should be applied following dose changes to anti-epileptics, even if previously stable.