Digital Commons Network^™

Embedding Health And Wellbeing Opportunities For People Experiencing Homelessness In A Wider Support System, M. Paisi, L. Withers, J. Erwin, J. Horrell, R. Witton, J. Shawe, R. Byng

School of Nursing and Midwifery

IntroductionHomelessness impacts negatively on health, wellbeing and life expectancy. People experiencing homelessness are likely to suffer physical and mental health problems, be heavy users of emergency services, and die 30 years earlier than the general population.1–3 Their severe and multiple disadvantages raise personal and institutional barriers to using health, social and housing services.4In late 2021, a grass-roots initiative in Plymouth began offering a Saturday morning drop-in service for rough sleepers and those in emergency accommodation. The service responded to the bleakness, loneliness and lack of support imposed by Monday-Friday service patterns. This effort was strengthened in February 2022 by a …

Evaluation Of A Complex Intervention For Prisoners With Common Mental Health Problems, Near To And After Release: The Engager Randomised Controlled Trial, Richard Byng, Tim Kirkpatrick, Charlotte Lennox, Fiona C. Warren, Rob Anderson, Sarah Louise Brand, Lynne Callaghan, Lauren Carroll, Graham Durcan, Laura Gill, Sara Goodier, Jonathan Graham, Rebecca Greer, Mark Haddad, Tirril Harris, William Henley, Rachael Hunter, Sarah Leonard, Mike Maguire, Susan Michie, Christabel Owens, Mark Pearson, Cath Quinn, Sarah Rybczynska-Bunt, Caroline Stevenson, Amy Stewart, Alex Stirzaker, Roxanne Todd, Florian Walter, Lauren Weston, Nat Wright, Rod S. Taylor, Jenny Shaw

Peninsula Medical School

Background Many male prisoners have significant mental health problems, including anxiety and depression. High proportions struggle with homelessness and substance misuse. Aims This study aims to evaluate whether the Engager intervention improves mental health outcomes following release. Method The design is a parallel randomised superiority trial that was conducted in the North West and South West of England (ISRCTN11707331). Men serving a prison sentence of 2 years or less were individually allocated 1:1 to either the intervention (Engager plus usual care) or usual care alone. Engager included psychological and practical support in prison, on release and for 3–5 months in …

Inhibition Of Yap/Taz-Driven Tead Activity Prevents Growth Of Nf2-Null Schwannoma And Meningioma, Liyam Laraba, Lily Hillson, Julio Grimm De Guibert, Amy Hewitt, Maisie R Jaques, Tracy T Tang, Leonard Post, Emanuela Ercolano, Ganesha Rai, Shyh-Ming Yang, Daniel J Jagger, Waldemar Woznica, Philip Edwards, Aditya G Shivane, C Oliver Hanemann, David B Parkinson

Peninsula Medical School

Schwannoma tumours typically arise on the eighth cranial nerve and are mostly caused by loss of the tumour suppressor Merlin (NF2). There are no approved chemotherapies for these tumours and the surgical removal of the tumour carries a high risk of damage to the eighth or other close cranial nerve tissue. New treatments for schwannoma and other NF2-null tumours such as meningioma are urgently required. Using a combination of human primary tumour cells and mouse models of schwannoma, we have examined the role of the Hippo signalling pathway in driving tumour cell growth. Using both genetic ablation of the Hippo …

Assessing The Effect Of Temperate Mpas On Elasmobranch Communities, Chloe Renn

School of Biological and Marine Sciences Theses

Global chondrichthyan (sharks, skates, rays and chimaeras) populations are experiencing alarming declines, driven by intense targeted and incidental extraction. Marine Protected Areas (MPAs) represent one potential solution, which has gained traction in recent years. When implemented effectively, MPAs demonstrate potential to rebuild populations and enable ecosystem recovery. However, their value as an elasmobranch conservation tool remains contested, particularly in temperate waters such as the UK. One essential component of MPA efficacy is the implementation of robust ecological monitoring regimes that allow species trajectories to be characterised and responded to, in real-time. However, several challenges, inherent to both elasmobranchs and temperate …

Personality And Parental Care In The Corkwing Wrasse (Symphodus Melops), Benjamin Ellis

School of Biological and Marine Sciences Theses

Parental care in many species is a repeatable aspect of the behavioural phenotype, in some cases covarying with other behavioural traits within wider behavioural syndromes. It is well understood that in several freshwater fishes, recreational and commercial fisheries often (directly or indirectly) impact traits concerning parental care adversely, in some cases through selection on covarying behavioural traits. In contrast, studies on commercially fished marine species that exhibit parental care are scarce. The corkwing wrasse (Symphodus melops) is a marine fish with complex reproductive behaviour, with parental males exhibiting nest building and parental care behaviours. This species is also subject to …

Investigating The Diversity And Distribution Of Mesophotic Coral Ecosystems In The Chagos Archipelago, Clara Diaz

School of Biological and Marine Sciences Theses

Mesophotic coral ecosystems (MCEs, 30-150 m) have received increasing attention from the scientific community over the past two decades, as their significance has been recognised in terms of biodiversity, distribution, and ecological value. However, MCEs remain relatively unexplored compared to their shallow-water counterparts. They are also under-protected and under-represented in marine spatial planning, despite meeting the international criteria used to identify priority areas for conservation policies. One reason for the imbalance between their high ecological value and their low level of protection is that baseline data on MCEs is largely missing to date. Furthermore, research efforts have been unevenly distributed, …

Dietary Patterns And Practices And Leucocyte Telomere Length: Findings From The Uk Biobank, Vasiliki Bountziouka, Christopher P. Nelson, Qingning Wang, Crispin Musicha, Veryan Codd, Nilesh J. Samani

Peninsula Medical School

BACKGROUND: Shorter telomere length (TL) is associated with risk of several age-related diseases and decreased life span, but the extent to which dietary patterns and practices associate with TL is uncertain. OBJECTIVE: This study aimed to investigate the association of dietary patterns and practices and leucocyte TL (LTL). DESIGN: This was a cross-sectional study. PARTICIPANTS AND SETTING: Data collected voluntarily from up to 422,797 UK Biobank participants, during 2006-2010. MAIN OUTCOME MEASURES: LTL was measured as a ratio of the telomere repeat number to a single-copy gene and was loge-transformed and standardized (z-LTL). STATISTICAL ANALYSES PERFORMED: Adherence a priori to …

Metabolism, Swimming Performance, And A Behavioural Syndrome In Schoolmaster Snapper (Lutjanus Apodus), Peter Malorey

School of Biological and Marine Sciences Theses

Commercial overexploitation and climate change can alter the physiology and behaviour of affected marine organisms, although depending on the environment, species, and severity, intraspecific phenotypic response to such changes can vary greatly. Under the Pace-Of-Life Syndrome (POLS) hypothesis, behaviour, physiology, and life history traits can be linked and thus affected both directly and indirectly by selection targeting any aspect of behavioural physiology. However, such links are often understudied in tropical marine fish, with work needed to better understand the impacts of fisheries and climate change on fish stocks. Moreover, tropical regions have greater reliance on fisheries, thus investigations should focus …

Impact Of Digital Technologies On Self-Efficacy In People With Parkinson’S: A Scoping Review Protocol, Andrew Michael Hall, S. Aroori, Camille B. Carroll, Edward Meinert, Victoria Allgar

Peninsula Medical School

Introduction Parkinson’s disease (PD) is the second most common neurological disease globally, for which currently no one definitive cause or cure exists. Estimates suggest that 145 000 people with Parkinson’s (PwP) live in the UK. PD presents with motor and non-motor symptoms fluctuating significantly in and between individuals continually throughout the day. PD adversely affects activities of daily living, quality of life and well-being. Self-efficacy is an important belief to improve for PwP as it enables the individual to develop confidence in their ability to exert control over their own motivation, behaviour and social environment. This scoping review aims to …

Drugless And Radiographer Led: The Start Of A New Era For Ct Coronary Angiography, Gareth Morgan-Hughes, Rebecca Mcnally, Christopher Gibbs Gibbs, Stelios Iacovides, Prabesh Kirat-Rai, Nang Thiriphoo, Alison Powell, Colin Stuckey, Ross Thorpe, Louisa Mayo, Carl Roobottom

Peninsula Medical School

Objective. Since inception CT coronary angiography (CTCA) has required facilitating beta blockers (BB). However, CT technology has improved rapidly as has radiographer and reporter expertise. Using these factors, we instituted a radiographer led cardiac CT service (RLCCTS), without routine BB, which we studied for quality control (QC). Methods. RLCCTS started October 2021 using a wide detector array CT system, with 20 min slots. QC study was registered with the clinical audit team, University Hospitals Plymouth, CA_2020-21-118. Uniform reporting was agreed including indication, BB administration, demographics, dose length product (DLP) and the coronary artery disease—reporting and data system (CAD-RADS) score. Uncertain …

Adding Web-Based Support To Exercise Referral Schemes Improves Symptoms Of Depression In People With Elevated Depressive Symptoms: A Secondary Analysis Of The E-Coacher Randomised Controlled Trial, Jeffrey Lambert, Adrian Taylor, Adam Streeter, Colin Greaves, Wendy M. Ingram, Sarah Dean, Kate Jolly, Nanette Mutrie, Lisa Price, John Campbell

Peninsula Medical School

Background: Exercise referral schemes (ERS) reduce depression but the additional effect on mental health from web-based behavioural support is unknown. The e-coachER trial reported no effect of augmenting usual ERS with theory-driven web-based behavioural support on moderate to vigorous physical activity (MVPA) at 12 months for patients with chronic physical and mental health conditions. The present study reports the effects of the e-coachER intervention on depression, anxiety and MVPA only among participants with elevated depressive symptoms and investigates whether these were mediated by changes in MVPA and hypothesised cognitive and behavioural processes. Methods: Of the original 450 adults recruited into …

Post-Covid Syndrome And Adults With Intellectual Disability: Another Vulnerable Population Forgotten?, R Shankar, B Perera, A Roy, Et Al

Peninsula Medical School

An area of interest presently is the lingering symptoms after COVID-19, i.e. post-COVID-19 syndrome (PCS). Specifics of diagnosis and management of PCS are emerging. However, vulnerable populations such as those with intellectual disabilities, who were disproportionately affected by the pandemic, risk being ‘left behind’ from these considerations.

Awareness Of Social Care Needs In People With Epilepsy And Intellectual Disability, A. Gabrielsson, S. Tromans, H. Newman, P. Triantafyllopoulou, A. Hassiotis, P. Bassett, L. Watkins, I. Sawhney, M. Cooper, L. Griffiths, A. Pullen, A. Roy, H. Angus-Leppan, Rh Thomas, M. Kinney, P. Tittensor, R. Shankar

Peninsula Medical School

Background: Nearly a quarter of people with intellectual disability (ID) have epilepsy with large numbers experiencing drug-resistant epilepsy, and premature mortality. To mitigate epilepsy risks the environment and social care needs, particularly in professional care settings, need to be met. Purpose: To compare professional care groups as regards their subjective confidence and perceived responsibility when managing the need of people with ID and epilepsy. Method: A multi-agency expert panel developed a questionnaire with embedded case vignettes with quantitative and qualitative elements to understand training and confidence in the health and social determinants of people with ID and epilepsy. The cross-sectional …

An Evidence-Based Approach To Provide Essential And Desirable Components To Develop Surveys On Sudden Unexpected Death In Epilepsy (Sudep) For Doctors: A Focused Review, L. V. Watkins, S. Ashby, J. Hanna, W. Henley, R. Laugharne, R. Shankar

Peninsula Medical School

Sudden Unexpected Death in Epilepsy (SUDEP) is a major concern for people with epilepsy, their families, their care givers, and medical professionals. There is inconsistency in the SUDEP counselling doctors provide, compared to what is recommended in clinical guidelines. Numerous national and international surveys have highlighted how epilepsy professionals, usually doctors, deliver SUDEP risk counselling, particularly, when they deliver it and to whom. These surveys help understand the unmet need, develop suitable strategies, and raise awareness among clinicians with the eventual goal to reduce SUDEPs. However, there is no standardised survey or essential set of questions identified that can be …

Cardiovascular Risk Factors In Secondary Progressive Multiple Sclerosis: A Cross‐Sectional Analysis From The Ms‐Stat2 Randomized Controlled Trial, Thomas Williams, Nevin John, Alberto Calvi, Alessia Bianchi, Floriana De Angelis, Anisha Doshi, Sarah Wright, Madiha Shatila, Marios C. Yiannakas, Fatima Chowdhury, Jon Stutters, Antonio Ricciardi, Ferran Prados, David Macmanus, Marie Braisher, James Blackstone, Olga Ciccarelli, Cam Gandini Wheeler‐Kingshott, Frederik Barkhof, Jeremy Chataway, Jeremy Hobart

Peninsula Medical School

Background and purpose.There is increasing evidence that cardiovascular risk (CVR) contributes to disability progression in multiple sclerosis (MS). CVR is particularly prevalent in secondary progressive MS (SPMS) and can be quantified through validated composite CVR scores. The aim was to examine the cross‐sectional relationships between excess modifiable CVR, whole and regional brain atrophy on magnetic resonance imaging, and disability in patients with SPMS. Methods. Participants had SPMS, and data were collected at enrolment into the MS‐STAT2 trial. Composite CVR scores were calculated using the QRISK3 software. Prematurely achieved CVR due to modifiable risk factors was expressed as QRISK3 premature CVR, …

Poo Matters! A Scoping Review Of Impact Of Constipation On Epilepsy, Alexandra Gabrielsson, Samuel Tromans, Lance Watkins, Lisa Burrows, Richard Laugharne, Rohit Shankar

Peninsula Medical School

BACKGROUND: Epilepsy is a common neurological disorder which frequently presents with co-morbid physical health conditions, including constipation. However, the nature of the relationship between the two conditions has not been well defined. AIM: To quantify constipation's relationship with epilepsy and anti-seizure medication (ASM). METHOD: A scoping review registered on PROSPERO (CRD42022320079) with suitable search terms was conducted and reported in accordance with PRISMA guidance. CINAHL, Embase, PsycInfo and MEDLINE electronic databases were searched by an information specialist. The Joanna Briggs Institute (JBI) critical appraisal tools alongside the Oxford Centre for Evidence Based Medicine (OCEBM) levels of evidence were used to …

Goal-Directed Haemodynamic Therapy Improves Patient Outcomes In Kidney Transplantation, J Fabes, Midani A Al, As Sarna, Dh Hadi, Sa Naji, Nr Banga, Gl Jones, Pd Berry, Md Wittenberg

Peninsula Medical School

Introduction: Kidney transplant graft function depends on optimised haemodynamics. However, high fluid volumes risk hypervolaemic complications. The Edwards Lifesciences ClearSight™ device permits fluid titration through markers of preload and beat-to-beat blood pressure monitoring. We evaluated the implementation of a novel goal-directed haemodynamic therapy protocol to determine whether patient outcomes had improved. Design: A retrospective evaluation of standard care versus goal-directed haemodynamic therapy in adults undergoing kidney transplantation was performed in a single centre between April 2016 and October 2019. Twenty-eight standard-of-care patients received intraoperative fixed-rate infusion and 28 patients received goal-directed haemodynamic therapy. The primary outcome was volume of fluid …

Fast-Track Extubation After Orthotopic Liver Transplant Associates With Reduced Incidence Of Acute Kidney Injury And Renal Replacement Therapy: A Propensity-Matched Analysis, J Fabes, G Wells, Z Abdi, R Bhatia, P Muehlschlegel, M Fortune-Ely, D Krzanicki, S Rahman, M Spiro

Peninsula Medical School

Introduction Liver transplantation is the only available definitive treatment for end-stage liver disease and subtypes of hepatocellular carcinoma. Patient outcomes have significantly improved alongside developments in surgical technique, peri-operative patient optimisation and post-transplantation management [1]. However, it remains a high risk procedure with significant morbidity and mortality attributable in the short term largely to surgical complications and rejection, and in the longer term to organ dysfunction and malignancy, often related to immunosuppressive medication [2,3]. Due to the challenges inherent to the surgical procedure, traditional post-operative management has been to maintain a period of clinical observation while the patient remains mechanically …

Understanding Coastal Change From Noisy Satellite-Derived Shoreline Datasets: Influence Of Tide And Runup Correction And Spatial Averaging, B Castelle, V Marieu, A Ritz, G Masselink, Tim Scott, C Stokes, A Konstantinou, An Lerma, M Vandenhove, S Bujan

School of Biological and Marine Sciences

Free-of-charge publicly available optical satellite imagery can now be used to provide short-term to multi-decadal shoreline satellite-derived shoreline(SDS) data, with errors typically under 10 m on microtidal beaches. However, SDSaccuracy dramatically worsens at high-energy and/or meso to macrotidal lowgradient beaches, which challenges a robust assessment of shoreline variability and trends. In this contribution we demonstrate that, on such beaches, water level (tide + runup) correction and/or an adapted space-averaging of uncorrected (noisy) SDS dataset can substantially reduce uncertainties and thus allow addressing the timeand space variability of shoreline change and their primary drivers.

Coastal Typologies To Support Coastal Change Adaptation Management: A Study Of The South West Coast Of England, Ja Kirby, G Masselink, T Poate, T Scott

School of Biological and Marine Sciences

Sea-level rise, increased coastal erosion and flooding due to climate change is threatening coastal communities across the world. Globally, coastal change management policies include zonation of the coast to restrict development in areas susceptible to coastal change. Defining the extent of the coastal change area can be problematic and is often done using large-scale (>1 km) coastal classifications and estimates of coastal retreat. In this study, we investigate the south west coast of England, using a high-resolution (0.1 km) coastal classification to determine coastal types and their response to sea-level rise. Nine coastal typologies were defined in the study …

Satellite-Based Shoreline Detection For Macro-Tidal Coasts: Impacts Of Morphological And Hydrodynamic Setting, A Konstantinou, T Scott, G Masselink, C Stokes, D Conley, B Castelle

School of Biological and Marine Sciences

Earth observation (EO) coupled with novel image analysis techniques have demonstrated the potential of EO for long-term, local, regional, and even global scale investigations of shoreline change. However, satellite-derived shoreline (SDS) data is associated with large uncertainties relating to environmental factors, tidal range, and wave action among other factors. This contribution investigates the impacts of morphological and hydrodynamic setting on the accuracy of SDS in macrotidal, highenergy coasts. Results revealed significant differences in SDS accuracy between the two morphologically contrasting sites in terms of the level of error and the optimal water level correction. We show that SDS accuracy at …

Ocean Acidification Has A Strong Effect On Communities Living On Plastic In Mesocosms, X Zhang, P Zhang, Zichao Deng, Ruiping Huang, D Zhang, Yang Tian, N Wang, He Li, X Wang, Xiaowen Jiang, Jiazhen Sun, Qianqian Fu, Xiangqi Yi, Liming Qu, Cong Zhou, Yuming Rao, Xiaorong Zeng, Jm Hall‐Spencer, G Gao, K Gao, Xin Lin

School of Biological and Marine Sciences

We conducted a mesocosm experiment to examine how ocean acidification (OA) affects communities of prokaryotes and eukaryotes growing on single-use drinking bottles in subtropical eutrophic waters of the East China Sea. Based on 16S rDNA gene sequencing, simulated high CO2 significantly altered the prokaryotic community, with the relative abundance of the phylum Planctomycetota increasing by 49%. Under high CO2, prokaryotes in the plastisphere had enhanced nitrogen dissimilation and ureolysis, raising the possibility that OA may modify nutrient cycling in subtropical eutrophic waters. The relative abundance of pathogenic and animal parasite bacteria also increased under simulated high CO2. Our results show …

Patients With Low Socio-Economic Status (Ses): What Are Their Perceptions And Experiences Of Mental Health Provision Within Primary Care?, Katy Stevenson

Peninsula Medical School

No abstract provided.

Effects Of Preservation By Ethanol On Δ13c And Δ15n Of Three Tissues Of The Critically Endangered European Eel Anguilla Anguilla, Rose M. Boardman, Adrian C. Pinder, Adam T. Piper, Catherine Gutmann Roberts, Rosalind M. Wright, John Robert Britton

School of Biological and Marine Sciences

The temporal effects of ethanol preservation on the δ13C and δ15N values of tissues excised from European eel Anguilla anguilla were assessed. Preservation significantly enriched 13C values of fin and mucus but not dorsal muscle. The 13C enrichment occurred in the initial 15 days of preservation and was independent of initial eel mass. Tissue preservation effects on δ15N values were negligible. These tissue-specific isotopic shifts should be considered when ethanol-preserved eel samples are used.

Treatment Integrity And Differentiation In The Very Early Rehabilitation In Speech (Verse) Trial, Emily Brogan, Natalie Ciccone, Erin Godecke

Research outputs 2014 to 2021

Background:

Key elements of treatment fidelity include treatment integrity (adherence to the treatment protocol) and treatment differentiation (the difference in treatment ingredients in the control and intervention groups). The Very Early Rehabilitation in SpEech (VERSE) trial established treatment fidelity at the macro level for key components of therapy.

Aims:

To complete a detailed analysis of treatment integrity and differentiation at the utterance level of a therapeutic interaction.

Methods:

This was an observational study of therapy videos collected as part of the VERSE trial. Participants were people with aphasia in the very early phase of recovery post stroke (n = 44) …

Gender Equity In Early Childhood Picture Books: A Cross-Cultural Study Of Frequently Read Picture Books In Early Childhood Classrooms In Australia And The United States, Helen Adam, Laurie Harper

Research outputs 2014 to 2021

Children’s picture books contribute to children’s development of gender identity and can impact aspirations and expectations of roles in families and society. However, the world represented in children’s books reflects predominantly middle class, heterosexual, male heroes and characters. This paper reports on a cross-cultural study investigating gender representation in frequently read picture books across eight early learning centres in the United States and Australia. Forty-four educators working with 271 children participated. Data were collected from book audits and observations. Unique to this study is the presentation of a new data analysis instrument, Harper’s Framework of Gender Stereotypes Contained in Children’s …

Primary Specialisations In Australia: Graduates’ Perceptions Of Outcome And Impact, Susan Main, Matt Byrne, Joseph Scott, Kevin Sullivan, Annamaria Paolino, Eileen Slater, Jason Boron

Research outputs 2014 to 2021

In 2014, the Australian Government established the Teacher Education Ministerial Advisory Group (TEMAG) to advise on how teacher education programmes could ensure new teachers were adequately prepared for the classroom. Following this, the Australian Government endorsed a key recommendation of the TEMAG Action Now: Classroom Ready Teachers report, the inclusion of specialisations in primary Initial Teacher Education (ITE). This research was conducted at an Australian public university that, in 2016, had embedded specialisations in a revised primary teacher programme structure and was one of the first ITE institutions in Australia to graduate primary teachers with a specialisation. Using a mixed-methods …

Towards The Validation Of Novel Cognitive And Physiological Indicators Of Affective State In Horses (Equus Caballus), Sarah Kappel

School of Biological and Marine Sciences Theses

Assessing animal emotions reliably is crucial for making accurate decisions about animal welfare, but subjective affective (emotional) states are inaccessible for direct measurement. We know that negative affect modulates attention in humans and some animals. The overarching aim of this thesis is to investigate if the preferential attention allocation towards certain information (i.e. attention bias, AB) could be a potential proxy measure of affective valence in horses. First, I provide an overview of the theoretical background to attention and AB by reviewing the literature on AB in humans and animals (Chapter 2). I examine which methodological aspects need consideration when …

Does Connectivity With Nature Alter Consumer Behaviour? Linking Ocean Connectedness And Consumer Views On Single-Use Packaging, Sohvi Katariina Nuojua

School of Biological and Marine Sciences Theses

Single-use packaging items constitute a large proportion of the plastic litter found in the marine environment. Consumer behaviour is a key contributor to the accumulation of this pollution in the environment. This thesis outlines correlational and experimental research on consumer responses to environmentally relevant qualities of single-use packaging. Furthermore, it considers a novel concept of ocean connectedness as a psychological moderator of consumer response. Studies 1 and 2 investigated consumer responses to recyclability of packaging as well as its raw material (plastic, glass, carton and aluminium) in undergraduate students and in a broader UK public sample. Ocean connectedness was assessed …

A Pilot Phase Ib Study To Evaluate Tadalafil To Overcome Immunosuppression During Chemoradiotherapy For Idh-Wild-Type Glioblastoma, Subhajit Ghosh, Tanner M Johanns, Milan G Chheda, Eric Liu, Omar Butt, Christopher Abraham, Shahed Badiyan, Yi Huang, David Denardo, Albert H Kim, Dennis Hallahan, Dinesh Thotala, Jiayi Huang

2020-Current year OA Pubs

BACKGROUND: Myeloid-derived suppressor cells (MDSCs) are critical regulators of immunosuppression and radioresistance in glioblastoma (GBM). The primary objective of this pilot phase Ib study was to validate the on-target effect of tadalafil on inhibiting MDSCs in peripheral blood and its safety when combined with chemoradiotherapy in GBM patients.

METHODS: Patients with newly diagnosed IDH-wild-type GBM received radiation therapy (RT) and temozolomide (TMZ) combined with oral tadalafil for 2 months. A historical cohort of 12 GBM patients treated with RT and TMZ was used as the comparison group. The ratio of MDSCs, T cells, and cytokines at week 6 of RT …