Declaration Of Helsinki Research Articles

Critical current characteristics and ampere force distribution of a novel HTS cable with different transposition lengths

Abstract Distribution characteristics of the current, ampere force and magnetic flux density (B [T]) of a novel high temperature superconducting (HTS) cable woven by transposed REBCO tapes under different transposition lengths are proposed, and these characteristics of the cable stacked with 3 REBCO tapes are also carried out in this paper for comparison. The objective is to enhance the current density and the compactness of the HTS tapes combination, and uniform the current, ampere force and magnetic flux density (B [T]) distributions. A 3D finite element model (FEM), based on Maxwell's equations without consideration of the displacement current, is established to describe the state of the system in the liquid nitrogen condition. The distributions characteristics, maximum and minimum values of current, ampere force and magnetic flux density (B [T]) show significant differences in the simulation results between the novel HTS cable woven by 3 transposed REBCO tapes and the cable stacked with 3 REBCO tapes. The simulated results show that the distribution characteristics are improved, with a more uniform distribution characteristic than that of the cable stacked with REBCO tapes. This is due to fully transposed REBCO tapes. In addition, the experimental E-I curve was also reached. The experimental results show that using a shorter transposition length in the cable can improve the critical current. However, A too small transposition length can cause significant damage to the HTS tape, resulting in deformation of the HTS tape and a reduction in the electromagnetic properties of the HTS tape. This affects the critical current of the HTS tape and, ultimately, the critical current of the cable. From the point of view of whether the production process is convenient, meets the requirements of economy and reduces costs, we need to find a suitable transposition length. The measured optimal transposition length is 95 mm for the cable woven by 3 REBCO tapes.
Ethical Compliance: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Microbiota Transplantation in Individuals with Type 2 Diabetes and a High Degree of Insulin Resistance.

The objective of this study was to determine the results of fecal microbiota transplantation (FMT) from healthy lean subjects in patients with type 2 diabetes (T2D); Methods: We designed a phase II, randomized, single-blind, parallel-arm clinical trial. Twenty-one subjects (12 men [57.1%] and 9 women [42.9%]), who had previously signed an informed consent were randomized to FMT from lean donors, a probiotic (Lactobacillus delbrueckii spp. bulgaricus LB-14), or placebo. Mean age at baseline was 62.5 ± 5.8 years and mean body mass index (BMI) at baseline was approximately 32.4 ± 2.4 kg/m2. Anthropometric measures, biochemical variables, oral glucose tolerance test (OGTT), and a stool microbiota analysis were performed (baseline, 4 and 12 weeks). The trial was conducted following the Declaration of Helsinki, Good Clinical Practice Guides (CPMP/ICH/135/95) and the current Spanish legislation regarding clinical trials (RD 223/2004).; Results: FMT changes occurred at the expense of the species found in the donor. No differences in weight, body mass index, HbA1c, or the results of the OGTT for glucose and insulin were found between groups after the intervention, although a decrease in uric acid was observed in the probiotic group (-0.5 mg/dL; p = 0.037) and a mild increase in HbA1c in the FMT group (+0.25%; p = 0.041); Conclusions: In our sample, neither FMT from healthy and lean donors nor a probiotic were effective in improving insulin sensitivity and HbA1c in patients with T2D.

Stimulating ambulance specialist nurse students' ethical reflections by high-fidelity simulation.

Introduction: Ethical competence in professional practice can be considered essential among nurses and nurses in ambulance care encounter ethical dilemmas frequently. To enhance ethical competence among students in the ambulance specialist nursing program, high-fidelity simulation scenarios including ethical dilemmas were introduced as a learning activity. Research aim: The research aim was to investigate the usefulness of high-fidelity simulation in ambulance specialist nurse education to teach ethical reasoning when caring for children. Research design: This study was conducted as a qualitative interview study, complemented with observations and using field notes and qualitative interviews for data collection. Data was analysed using deductive qualitative content analysis based on a care ethical model. Participants and research context: Participants (n = 35) were recruited from an ambulance nurse educational program at a Swedish university. Data was collected after the students took part in two high-fidelity simulations involving children in an ambulance care setting. Ethical considerations: The study has been vetted and approved by the ethical council at the University of Borås, Sweden. The study follows the Helsinki Declaration's advice on ethical principles. Results: The results showed that most of the students expressed some form of ethical reasoning during the simulation sessions, which were elaborated and reflected upon during the debriefing part of the sessions. The simulation design seemed to have a great impact on the outcome of the student's ethical reasoning, where increased immersion led to deeper emotional engagement among the students which increased awareness of their personal preconceptions. Conclusions: This study aimed to investigate whether high-fidelity simulations could be useful to stimulate ethical reflections and contribute to increased ethical competence among students. In conclusion, a well-designed high-fidelity simulation can be useful as an educational tool to learn and enhance ethical competence among specialist ambulance nursing students.

FEATURES OF THE PAPILLARY PATTERN OF THE MIDDLE AND PROXIMAL PHALANGES OF THE FINGERS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Cardiovascular diseases remain the most pressing healthcare problem in most countries of the world in the 21st century, despite the continuous improvement of diagnostic and treatment methods for cardiac patients. Today, the mortality rate for patients within a year after myocardial infarction remains quite high at 9.1%. Despite the large number of scientific papers, most of the available information sources reflect the possibility of using dermatoglyphs of the palms and distal phalanges as diagnostic markers for predicting the susceptibility to AMI and practically do not cover the possibility of using dermatoglyphs of the middle and proximal phalanges, although they also have a powerful prognostic potential. The material of our study were dermatoglyphs of the middle and proximal phalanges of the fingers obtained from 167 male subjects aged 35-69 years. The subjects were divided into 2 groups. Group 1 (83) included men with a history of AMI by questionnaire; Group 2 (84) included men who had never had AMI. The criteria for inclusion in the study groups were voluntary consent, absence of genetic pathology, endocrine and musculoskeletal system pathology, age over 35 and under 69 years. Exclusion criteria were refusal to participate in the study at any stage, presence of genetic pathology, endocrine and musculoskeletal system pathology, age under 35 and over 69 years. The scope and methods of the research do not contradict the basic principles of the Helsinki Declaration on Biometric Research (1974), adapted at the 41st International Assembly in Hong Kong (1989), in which a person is the subject of research. The research was conducted in compliance with the following basic principles: respect for the individual, information of the individual, and assessment of the risk of harm and benefit. Results and discussion. The dermatoglyphic parameters on the middle phalanges that determine the susceptibility to AMI in men with a high level of reliability are: Lu, Lr, Hdu, Hdr, Adu, Adsr, ApNu, ApNr, ApLr, DaN, Vu, Vr, Vm, Dhu, Fu, Fr, NdNu, Lsr, на PPh: Hdu, Adu, Adsu, Adsr, ApNr, ApNsu, Ladu, Ladr, ApLu, ApLr, DaN, DaLu, DaLr, Vu, Vr, Vm, Dhu, Dhr, Fu, Fr, Cl, NdNr, Npu, Dn, ApNpu, ApNpr, Vms, Lsu, Lsr; on the proximal phalanges are present: Ladr, Dhr, Ladu, ApNpr, Dn, Cl, ApLu, Vm, DaN, ApLr, Fr, ApNpu, Lsu, Adsr, Dhu, Hpu, ApNr, NdAdu. The result of the analysis was the construction of a model that allowed us to predict the susceptibility of men to AMI based on the use of dermatoglyphic parameters of the middle phalanges of the fingers with a probability of more than 68 % and dermatoglyphs located on the proximal phalanges with a probability of about 79 %. Conclusion. The incidence of AMI is a medical and social problem. The incidence of this disease among young working-age population is increasing every year and entails a number of negative consequences, including high mortality, disability and others. Therefore, the search for new diagnostic criteria for predicting the susceptibility to AMI, which can form the basis of screening tests, remains relevant. We have established prognostic markers (dermatoglyphs of the middle and proximal phalanges of the fingers): Vu, Vm, Hdr, Lr, Adsr, ApNu, Vr, NdNu, Hdu, Lsr, S, ApNr, Adu, Adr, Lsu, Npr, Lu, Dhu. The obtained results may play a significant role in the future as one of the factors of prevention of AMI development.

A Feasibility Study of a Music Enrichment Program on Relative Reinforcing Value of Food and Home Environmental Enrichment among Families of Low Socioeconomic Status.

Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES-related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy. In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus a play date control in a group of 9-24-month-old healthy infants (N = 16). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Children's Mercy Hospital Kansas City. This study is registered with clinicaltrials.gov (NCT05868811). Overall, we found some intervention effects on the relative reinforcing value of food (RRVfood) and the home environmental enrichment measures (i.e., increased music use at home and the home language environment). Our intervention demonstrated large effects on the increased use of music at home. We did not find significant group differences in the RRVfood and home language environment, but some of the effect sizes were medium-to-large. Results also suggest that our intervention is feasible and acceptable. Parent feedback indicated that the intervention was well-liked and that the steps we took to help reduce barriers worked. Music enrichment programs may be a high-impact, low-cost strategy to address socioeconomic disparities.

The state of the hypothalamic-pituitary-adrenal system in workers exposed to electric and magnetic fields of industrial frequenc

Introduction. Electric and magnetic fields of industrial frequency are an integral part of production processes, and their effect on the human body is of increasing interest both among scientists and among specialists in the field of medicine and occupational safety. In recent decades, there has been growing concern about the potential impact of these areas on the health of workers, especially those who are exposed to prolonged exposure in the course of their professional activities. In this context, we pay special attention to the neuroendocrine system, which plays a key role in regulating many physiological processes, including metabolism, stress reactions and maintaining homeostasis. The study of the fundamentals of the neuroendocrine system and the mechanisms of the effect of electromagnetic fields on the body not only contributes to the deepening of scientific knowledge in the field of biomedical research, but also has practical significance in ensuring occupational safety and improving working conditions in industrial enterprises, allowing to identify possible health consequences and develop effective measures to protect workers from negative bioeffects. The study aims to research the effects of electric and magnetic fields of industrial frequency on the functional state of the hypothalamic-pituitary-adrenal system of employees of electric grid facilities. Materials and methods. Specialists examined 144 employees of the main group engaged in the repair and operation of electric grid facilities and 40 employees of the control group who were not exposed to electromagnetic fields of industrial frequency. We determined the concentration of adrenocorticotropic hormone, cortisol and dehydroepiandrosterone sulfate in blood serum samples and calculated the ratio of dehydroepiandrosterone sulfate to cortisol. Results. Workers exposed to the combined effects of electric and magnetic fields of industrial frequency had a lower (p<0.05) level of adrenocorticotropic hormone (1.9 [0.5; 3.9] pg/ml) and dehydroepiandrosterone sulfate (5.8 [3.7; 8.4] mmol/l) in the blood compared with the group of workers exposed to magnetic fields industrial frequency fields (4.4 [2.1; 12.9] pg/ml; 9.8 [6.3; 14.5] mmol/l) and to the control group (6.4 [4.0; 19.8] pg/ml; 7.8 [4.7; 13.3] mmol/l), respectively. The scientists also revealed in the group of workers exposed to combined exposure in the field, the association of a low ratio of dehydroepiandrosterone sulfate and cortisol with the development of cardiovascular diseases and feedback from work experience (p<0.05). Limitations. The study is limited by the number of people surveyed (144 employees). Conclusion. The results of the study indicate the hypoactivity of the hypothalamic-pituitary-adrenal system induced by exposure to electric and magnetic fields of industrial frequency, manifested by a decrease in the level of adrenocorticotropic hormone, dehydroepiandrosterone sulfate and its relationship to cortisol in workers exposed to combined effects of electric and magnetic fields of industrial frequency. Ethics. The work complies with ethical standards developed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting Scientific medical research with human participation" as amended in 2000 and the "Rules of Clinical Practice in the Russian Federation" approved by Order of the Ministry of Health of the Russian Federation dated 04/01/2016 No. 200n. We received informed consent from each examined person to participate in the study, approved in accordance with the established procedure by the local Ethics Committee of Izmerov Research Institute of Occupational Health (minutes of the meeting of the Ethics Committee No. 17 dated 12/16/2015).

Expression of DNA repair genes in workers producing lead from recycled materials

Working conditions at lead production plants, where a large number of harmful chemicals are present in the air of the work area, among which lead is the leading risk factor, have a negative impact on the health of workers. This xenobiotic disrupts numerous biochemical processes and affects many body systems. Of particular interest is the understanding of the action of lead at the molecular level, since in addition to the general mechanisms of damage to molecules and ultrastructures as a result of oxidative stress, lead is able to bind to a large DNA groove. A change in the level of gene expression in response to toxic exposure is considered as one of the biomarkers of the effect and can serve to develop measures for the early diagnosis of health disorders in exposed populations, including those working in harmful conditions. The study aims to consider the expression of DNA repair genes in workers of lead processing from secondary raw materials. The researchers examined the interned men working at the enterprise for the production of lead from secondary raw materials in the profession of a smelter (n=11) of the rough lead department, a dryer (n=10) of the rough lead department. The comparison group included men (n=20) who work at the same enterprise and have no contact with harmful factors of production. We have performed amplification of the studied genes (ATM, CDKN1A and MDM) in real time using the QuantStudio 3 amplifier (Thermo Fisher Scientific, USA). It was found that the expression level of the ATM gene was statistically significantly different in all three study groups from the comparison group. The expression of the CDKN1A gene increased in comparison with the comparison group only in the smelters of the refining department. Also, the expression of this gene was increased in the smelters of the refining department compared with the smelters of the rough lead department. In this study, an increase in the expression level of CDKN1A in smelters of the refining department was demonstrated, which may be an adaptive mechanism of the repair system. Also, in all exposed groups, the researchers found a decrease in the expression level of the ATM gene, which is important for maintaining cellular homeostasis. Further studies of the mechanisms of the influence of lead on the expression of these two genes in experimental models will allow the use of expression levels as early biomarkers of the effect of both total Pb exposure (ATM gene) and dose-dependent (CDKN1A gene). Limitations. Ethnicity was not determined in this study. Ethics. The studies were conducted in accordance with the ethical principles set out in the Helsinki Declaration of the World Medical Association and approved by the local Ethics committee of the Federal State Budgetary Institution of the Russian National Research Center of Rospotrebnadzor (Protocol No. 1 of 02/26/2021).

Atherosclerotic vascular lesion in the coal industry workers of average and high fatal risk groups

Introduction. Experts do not take into account the presence of subclinical atherosclerosis when stratifying risk on the SCORE scale, however, it is the main substrate for the occurrence of cardiovascular disasters. Most primary cardiovascular events occur in low cardiovascular risk groups, which requires timely detection of atherosclerosis and preventive measures to preserve the working population's ability to work and reduce the economic burden of treatment of cardiovascular diseases. The study aims to research the incidence of atherosclerosis in workers of the main professions of the coal industry in the South of Kuzbass in groups of medium and high risk of fatal events on the SCORE scale. Materials and methods. We divided the subjects into two groups using the SCORE scale: high-risk (main) — from 5 to 9%, which included 60 people, and moderate-risk group — from 2 to 4% (comparison) — 70 employees. The average age of the first was 50.98±0.43 years, the comparison group was 49.96±0.35 years (p=0.070). The scientists examined the indicators of blood pressure, lipid, carbohydrate and purine metabolism, and performed an ultrasound examination of the main arteries. Results. The incidence of atherosclerotic plaques in at least one vascular basin was 80.0% in the main group and 78.6% in the comparison group, p=0.845. The frequency of carotid artery atheromas in the high-risk group on the SCORE scale (52.7%) did not significantly differ from the comparison group (54.3%), p=0.862; a similar pattern in the arteries of the lower extremities: 80.0% vs. 70.0%, respectively, p=0.203. The frequency of carotid artery atheromas in the high-risk group on the SCORE scale (52.7%) did not significantly differ from the comparison group (54.3%), p=0.862; a similar pattern in the arteries of the lower extremities: 80.0% vs. 70.0%, respectively, p=0.203. The combination of thickening of the intima of vessels and the presence of atheromas tended to be more frequent in the main group — 83.6% compared with those in the comparison group — 70.1%, p=0.076 Limitations. The study is limited by the number of examined patients who underwent periodic medical examination at the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases. Conclusion. The incidence of atherosclerosis among employees of coal enterprises turned out to be very high and did not statistically differ in the groups of medium and high fatal risk stratified on the SCORE scale, which requires more thorough screening and measures of enhanced angioprotective prevention, even in people with a low risk of fatal cardiovascular disasters. Ethics. All the subjects signed an informed consent to participate in the study, the Protocol of which corresponded to the requirements of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, executed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical research with human participation as a subject" as amended in 2013 and the "Rules of Good Clinical Practice" approved by the order Ministry of Health of the Russian Federation No. 200n dated April 1, 2016.

Longitudinal Assessment of Ocular Biomarkers in Individuals With Gulf War Illness Symptoms.

Gulf War illness (GWI) is characterized by a constellation of symptoms, including, but not limited to, diarrhea, fatigue, and memory problems that affect Gulf War veterans. Currently, there are no objective biomarkers for GWI. Previous studies have identified differences in optical coherence tomography (OCT) metrics between individuals with GWI symptoms and those without. However, there are limited data on how these metrics change over time. Therefore, in this current study, we conducted a prospective case-control investigation to determine if OCT metrics show longitudinal changes in those affected by GWI. We conducted a prospective study with 100 Gulf War-era veterans at the Miami Veterans Affairs Hospital from November 2018 to February 2022. Inclusion criteria required service during 1990-1991, with both deployed and nondeployed veterans included. Exclusions were based on factors like active infection, unmanaged psychotic disorders, significant head injuries, severe neurological disorders, and eye pathologies affecting OCT imaging. All participants provided informed consent, and the study was institutional review board-approved and conducted per the Declaration of Helsinki and Health Insurance Portability and Accountability Act guidelines. GWI symptoms were assessed using the modified Kansas questionnaire, categorizing veterans into groups based on GWI symptoms presence and deployment status. Data on demographics, comorbidities, medications, and medical and ocular diagnoses were collected. Participants underwent OCT imaging at 2 time points, 1 year apart, with macular, retinal nerve fiber layer, and ganglion cell layer-inner plexiform layer (GCL-IPL) thicknesses measured. Additionally, blood samples were collected and cytokine levels measured at baseline. Data analysis involved descriptive statistics, t-tests, and multivariable regression models. Statistical analyses were performed using SPSS 28.0. Logistic regression demonstrated that post-traumatic stress disorder (odds ratio [OR]: 8.18, 95% confidence interval [CI]: 2.327-28.851, P = .001) and a lower baseline macular thickness in the outer nasal segment (OR: 0.959, 95% CI: 0.924-0.994, P = .023) remained significantly associated with GWI symptoms. The model also found that individuals with GWI symptoms were more likely to have an increase in inner temporal GCL-IPL layer thickness over a 1-year period (OR: 1.187, 95% CI: 0.974-1.447, P = .089). When analysis was conducted only among those deployed, only baseline interleukin (IL) 1a (OR = 1.24, CI = 1.019-1.52, P = .03) and interleukin-10 (OR = 0.95, CI = 0.91-0.99, P = .02) levels remained significantly associated with GWI symptoms. Baseline OCT measures, especially a thinner outer nasal macula, were associated with GWI symptoms. Longitudinally, individuals with GWI symptoms had greater thickening of their inferotemporal GCL compared to those without symptoms. When the model was re-examined in deployed veterans, OCT measures (at baseline and longitudinally) no longer remained significantly related with GWI symptoms and instead baseline levels of plasma inflammatory cytokine markers, IL1a and IL10, were most closely related to symptoms. Our longitudinal study builds on our previous retrospective and cross-sectional work on identifying ocular biomarkers in GWI. Across the studies, macular thinning at baseline and inferotemporal GCL-IPL thickening have been noted between cases and controls. Some of these findings share correlates with OCT biomarkers identified in conditions such as Alzheimer's, Parkinson's and Multiple Sclerosis. This is significant as it may help contextualize future research and help us develop better models of GWI.

The effect of self‐care levels on erectile dysfunction in Turkish men with heart disease

AbstractFor many years there has been evidence of an association between heart disease and erectile dysfunction (ED). This is a health problem that affects patients both physically and psychologically. Individuals affected by coronary heart disease need a comprehensive care approach to achieve optimal health outcomes. However, there is a gap in nursing research on the sexual life of men with coronary artery disease. This descriptive research will identify the prevalence of self‐care and ED in Turkish men having coronary heart disease and examine potential interactions between them. This descriptive study conducted between March 2022 and March 2023 with 178 men aged 18–70 years who were followed up in the cardiology polyclinic of a hospital with a diagnosis of coronary artery disease. Data collected via face‐to‐face meetings using a Socio‐Demographic Questionnaire Form, Coronary Heart Disease Self‐Care Inventory and International Index of Erectile Function questionnaire. Ethical approval was obtained before starting research. The Declaration of Helsinki was complied with during the research period. Of the participating patients, 52.2% were older than 65 years and 37.6% had high school education or higher. A significant proportion of patients (42.1%) had been married for 20–29 years. The majority of the participants (59%) were still working and 88.8% reported that their income was equal to their expenses. The mean scores of the scales were found to be moderate and when the correlation between the scales was examined, a moderate positive correlation was found (p < 0.05). A regression was performed to determine the causal relationship linking self‐care scores and ED. The results yielded significant findings (F = 46.854; p < 0.05). The change in the level of ED was found to be explained by self‐care at a rate of 43.7% (R2 = 0.437). This study showed that ED levels decreased with improving self‐care levels in men with coronary heart disease. While counselling these patients, health professionals should aim to increase their self‐care competencies related to cardiac rehabilitation and decrease their ED levels by considering the characteristics of the patients.

Reporting ethical approval in case reports and case series in 12 consecutive years: A systematic review.

Our study describes the reported rate of the Institutional Review Board (IRB) approval, declaration of Helsinki (DoH), and informed consent in the case reports and case series and investigates factors associated with the ethical approval report. We searched PubMed for case reports and case series from 2006 to 2017. Annually, we obtained the first 20 articles of a case report cluster from 20 distinct publications. This analysis initially contained at least 2400 papers, with 100 papers each study design and year. Only 26 (5.4%) of 480 included studies reported IRB approval, DoH approval, and participant informed consent; 58 (12.1%) reported two out of three ethical statements (DoH, informed consent, IRB); and 151 (31.5%) reported only one, leading to nearly 245 studies (51.0%) did not report any ethical approval item. Both clusters mentioned the DoH the least. Only years, ages, ethical item types, and cluster types were associated with ethical reporting practices. This study found the serious under-reporting of ethical practices in both case reports and case series.

Efficacy and safety of henagliflozin combined with continuous subcutaneous insulin infusion in the treatment of Chinese inpatients with type 2 diabetes mellitus based on a continuous glucose monitoring system: protocol of a multicentre, open-label, inpatient, randomised, controlled trial

IntroductionThe role of sodium-glucose cotransporter 2 inhibitors (SGLT2is) in diabetes treatment is expanding; however, few studies have investigated the efficacy and safety of combining SGLT2is with insulin pump therapy. Notably,...

Safety and efficacy of personalised versus standard dosing of linezolid in patients with sepsis (SePkLin): a pragmatic, multicentre, randomised, controlled and superiority clinical trial protocol.

Linezolid is a broadly used antibiotic to treat complicated infections caused by gram-positive bacteria. Therapeutic drug monitoring of linezolid concentrations is recommended to maximise its efficacy and safety, mainly haematological toxicity. Different pharmacokinetic/pharmacodynamic targets have been proposed to improve linezolid exposure: the ratio of the area under the concentration-time curve during a 24-hour period to minimum inhibitory concentration (MIC) between 80 and 120; percentage of time that the drug concentration remains above the MIC during a dosing interval greater than 85% and the trough concentration between 2 and 7 mg/L. This clinical trial aims to evaluate the safety, efficacy and the clinical and economic utility of personalised dosing of linezolid using Bayesian forecasting methods to attain pharmacokinetic/pharmacodynamic targets, known as model-informed precision dosing. This is a pragmatic, multicentre, randomised, parallel, controlled, phase IV and low intervention trial. Participants will be randomly assigned 1:1 to each group (n=346 per group). Control group will receive the standard dose of linezolid. Intervention group will receive personalised dosage of linezolid based on pharmacokinetic-pharmacodynamic adjustments. The primary outcome will be the incidence of thrombocytopenia in both groups. This protocol was approved by the Ethical Committee of the Investigation with Medicines of Galicia (code 2022/140) and authorised by the Spanish Agency for Medicines and Medical Devices. The trial is implemented in accordance with the Declaration of Helsinki and the international ethical and scientific quality standard, the Good Clinical Practice. The results will be published in peer-reviewed journals. EudraCT registration code: 2022-000144-30.

Effectiveness of using a vibration device to ease pain during upper extremity injections: A randomized controlled trial

Objectives: The current study aimed to evaluate the effectiveness of using a vibration device to ease pain during upper extremity injections. Specifically, the study aims to compare the pain levels of patients who receive the injection with and without the use of vibration therapy. The results of this study may have implications for improving patient outcomes and satisfaction during routine injection procedures. Material and Methods: This randomized controlled trial included patients aged 18 years or older who were scheduled to receive an injection in the upper extremity. A total of 60 patients were enrolled and randomized to either the intervention group or the control group using a computer-generated randomization sequence. The level of satisfaction and pain levels were assessed using a visual analog scale. The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board. Results: The mean pain score immediately after the injection was 4.03 ± 2.11 out of 10 in the vibration group (n = 30), compared to 7.4 ± 1.37 out of 10 in the control group (n = 30) (P < 0.001). Patients in the vibration group also reported higher levels of satisfaction and comfort during the injection (P < 0.001). No adverse events were reported in either group. Conclusion: Our study proves that using a vibration device during upper extremity injections can effectively reduce postinjection pain and improve patient satisfaction. Further research is needed to explore this intervention’s long-term effects and feasibility in different clinical settings.

Anticoagulation Therapy Timing in patients with Atrial Fibrillation after Acute and Chronic Subdural Haematoma (ATTAACH): a pilot randomised controlled trial

IntroductionSubdural haematomas (SDHs), acute or chronic, are common neurosurgical diagnoses. These problems can occur among patients requiring direct oral anticoagulation (DOAC) for atrial fibrillation. There are currently no guidelines regarding...

Photobiomodulation therapy to prevent oral mucositis and functional impairment in adult patients with haematological cancer undergoing haematopoietic stem cell transplantation: randomised trial protocol

IntroductionOral mucositis is a highly prevalent condition in individuals treated for haematological neoplasms, primarily during haematopoietic stem cell transplantation (HSCT). The condition is known to delay recovery processes, increasing the...

Prospectively investigating the impact of AI on shared decision-making in post kidney transplant care (PRIMA-AI): protocol for a longitudinal qualitative study among patients, their support persons and treating physicians at a tertiary care centre

IntroductionAs healthcare is shifting from a paternalistic to a patient-centred approach, medical decision making becomes more collaborative involving patients, their support persons (SPs) and physicians. Implementing shared decision-making (SDM) into...

Evaluation of the Causative Microorganisms and Antibiogram Results in Women with Vaginal Swab Culture Taken with Prediagnosis of Vaginitis

Aim: Vaginitis occurs when the vaginal flora is disturbed. This study aimed to evaluate the demographic data, causative microorganisms, and antibiogram results of women who underwent vaginal swab culture with a prediagnosis of vaginitis. Methods: Vaginal swab samples from 314 women who visited the Kafkas University Department of Obstetrics and Gynecology were included in the study. Women with immunosuppressive diseases, gynecological malignancies, and IUD use were excluded. Vaginal discharge or swab samples were Gram stained and cultured on various media. Microorganisms were identified using conventional and biochemical methods, and antibiotic susceptibility tests were performed using the Kirby-Bauer disk diffusion method, according to the EUCAST guidelines. Statistical analyses were performed using SPSS, with categorical variables assessed using the chi-square test or Fisher's exact test, and continuous variables assessed using the Mann-Whitney U test. The study complied with the recommendations of the Declaration of Helsinki for human biomedical research and was approved by the Non-Interventional Clinical Research Ethics Committee of the Kafkas University Faculty of Medicine. Results: The median age of 314 women included in this study was 39 (20-69) years. . In total, 73.6% (n=231) were premenopausal, 24.5% (n=77) were postmenopausal, and 1.9% (n=6) were pregnant. The most common complaint was abdominal/pelvic pain (142, 45.2%). Vaginal cultures from 123 women (39.1%) showed the growth of different microorganisms. The most common causative microorganism was Escherichia coli (41.5%). According to the antibiogram results, the most sensitive antibiotic was gentamicin (65.9%), and ampicillin (52.8 %) was the most resistant. Conclusion: It is important to quickly and accurately identify microorganisms involved in the etiology of the correct treatment.

Reconciliation in palliative care: A concept analysis.

The aim was to gain a deeper understanding of the meaning of reconciliation as a concept in palliative care. Terminal illnesses affect almost all aspects of life and being close to death may lead to a need for reconciliation. The end of life is stressful on an existential level for both patients and relatives. It can therefore be of relevance for palliative care nurses to understand the meaning of reconciliation. This study used a design for a literature study in accordance with a hybrid model. A deductive qualitative content analysis of autobiographies about being seriously ill and in a palliative stage in life was used to test the meaning of reconciliation. Ethical aspects concerning the use of autobiographies and the ethical principles of the Helsinki Declaration were considered. The theoretical perspective was the caritative theory of caring. The result showed that for patients in palliative care, reconciliation can be described as a strive for acceptance, to live in a truthful way, to forgive and be forgiven. People wish to create meaning in their existence and reconcile as a whole in body, spirit, and soul. By striving to unite suffering, life, and death as well as a peaceful relationship with relatives, people can achieve reconciliation at the end of life. Reconciliation is something ongoing and can be a force in what has been, what is, and what will be. We conclude that reconciliation is a concept of importance when caring for patients in end-of-life care. However, reconciliation can be expressed in different ways without necessarily using the concept itself. A broader and deeper understanding of the concept facilitates conversations about the meaning of reconciliation in palliative care and can enable patients who strive to achieve reconciliation to be more easily identified and supported.

Association of Self-Esteem with Academic Performance of Physiotherapy Students in Rawalpindi/Islamabad

Background: Self-esteem is a critical psychological factor influencing academic performance, especially in demanding educational programs like physiotherapy. Understanding this relationship is essential for enhancing student outcomes.Objective: To examine the correlation between self-esteem levels and academic performance of physiotherapy students in Rawalpindi/Islamabad and to investigate whether the relationship varies based on gender.Methods: A descriptive correlational study was conducted on 313 physiotherapy students selected through non-probability convenience sampling. Data were collected using a self-structured demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Academic Life Assessment Scale (ALAS). The study adhered to the Declaration of Helsinki, and analysis was performed using SPSS version 25. Pearson’s correlation, independent t-tests, and one-way ANOVA were used to evaluate relationships.Results: A weak but significant positive correlation was found between self-esteem and academic performance (r = 0.249, p < 0.01). Female students performed better academically (Mean = 72.46 ± 7.77) compared to males (Mean = 72.53 ± 7.52), but gender differences were not statistically significant (p > 0.05).Conclusion: The study concluded that higher self-esteem is associated with better academic performance, with no significant gender differences.