Effects Of Different Strategies Research Articles

Effectiveness of different strategies to teach empathy among medical students: A randomized controlled study

ObjectivesTo explore the effectiveness of two educational strategies for teaching empathy to medical students, focusing on their skills and on the theoretical knowledge and self-perception of empathy by patients, professors, and observers. MethodsThis is a randomized controlled study. Clerkship students were divided into two groups: an active group - Role Play and Reflection Group(RRG), and a more traditional group - Lecture Presentation Group(LPG). They were assessed pre- and post-intervention using the Jefferson Empathy Scale(JSPE), ESWIM Empathy Scale, CARE, empathic skills through simulated patient encounters, and a theoretical knowledge test. ResultsA total of 169 students were included. The RRG had higher scores (d=0.81) and greater gains (d=0.82) in empathic skills than the LPG. However, there were no significant differences in knowledge or other scales. Upon assessing skill acquisition (Post–Pre gains), there was a significant increase in both groups for all outcomes, except for JSPE in the LPG group and ESWIM for both groups. ConclusionMedical empathy can be taught, and active learning methodologies can lead to better outcomes, especially on the ability to provide empathic care. Practice implicationsThese findings reinforce existing literature and helps medical schools make informed decisions regarding their teaching methodologies. Trial registryhttps://ensaiosclinicos.gov.br/rg/RBR-8rwx89c.

The Triple E project: a factorial randomised controlled trial to enhance engagement with eHealth approaches to improve health risk behaviours among adolescents

BackgroundDigital, or eHealth, interventions are highly promising approaches to help adolescents improve their health behaviours and reduce their risk of chronic disease. However, they often have low uptake and retention. There is also a paucity of high-quality research into the predictors of eHealth engagement, and a lack of studies that have systematically evaluated existing engagement strategies in adolescent populations. This paper describes the protocol for a randomised controlled trial which primarily aims to assess the effectiveness of different strategies in increasing engagement with a healthy lifestyles app, Health4Life. Associations between the engagement strategies and improvements in adolescent health behaviours (healthy eating, physical activity, sleep, recreational screen time, smoking, alcohol use) will also be examined, along with potential predictors of adolescents’ intentions to use health apps and their use of the Health4Life app.MethodsThe current study will aim to recruit 336 adolescent and parent/guardian dyads (total sample N = 672) primarily through Australia wide online advertising. All adolescent participants will have access to the Health4Life app (a multiple health behaviour change, self-monitoring mobile app). The trial will employ a 24 factorial design, where participants will be randomly allocated to receive 1 of 16 different combinations of the four engagement strategies to be evaluated: text messages, access to a health coach, access to additional gamified app content, and provision of parent/guardian information resources. Adolescents and parents/guardians will both complete consent processes, baseline assessments, and a follow-up assessment after 3 months. All participants will also be invited to complete a qualitative interview shortly after follow-up. The primary outcome, app engagement, will be assessed via an App Engagement Index (Ei) using data collected in the Health4Life app and the Mobile App Rating Scale – User version.DiscussionThis research will contribute significantly to building our understanding of the types of strategies that are most effective in increasing adolescents’ engagement with health apps and which factors may predict adolescents’ use of health apps.Trial registrationThe trial is registered at the Australian New Zealand Clinical Trials Registry (ACTRN12623000399695). Date registered: 19/04/2023.

Leveraging Multi-Sectoral Partnership for Colorectal Cancer Education and Screening in the African American Community: A Protocol and Preliminary Results.

Colorectal cancer (CRC) awareness and screening rates are still low in African Americans (AAs), especially for those who do not have regular access to health care. We established a multi-sector community partnership between academia, health system, cancer advocacy, and local county treasurer's office (CTO), to test a pilot CRC screening intervention using a tailored educational brochure and fecal immunochemical test (FIT). Participants were recruited at a local CTO in an urban midwestern region. Once eligible, participants were assigned to 2-by-2 intervention arms by educational strategy (brochure vs. no brochure) and FIT provision strategy (direct provision by onsite staff vs. indirect provision via phone/online request). We compared the effect of different strategies on FIT return rates. Of 1500 individuals approached, 212 were eligible for the study. The final sample consisted of 209 participants who were predominantly men (57%) and AAs (85%). No differences were found in the return rates by educational brochure (24% [brochure] vs. 23% [no brochure]; p = 0.82). In regard to FIT provision strategy, direct FIT provision yielded higher return rates than indirect provision (31% vs. 15%; p = 0.01). When the four groups were compared, direct provision with education brochure yielded the highest return rates (33.9%), followed by direct provision only (27.5%), indirect provision only (18%), and indirect provision with a brochure (12.2%). For community-based CRC screening intervention using stool-based test, the direct provision of FIT kits with educational brochure outperforms the other three strategies.

A Critical Review of Anti-Bullying Strategies: Analyzing Survey Results Across Regions

Survey participants were asked to rate the effectiveness of different strategies for dealing with bullying on a scale from 1 to 5. The results of the survey, which were checked for reliability and accuracy, indicate that social support and avoidance of aggression are the preferred methods. An analysis of responses from adolescents between the ages of 12 and 17 shows that many of them turn to their friends for comfort and support. The correlation coefficient is highest at age 14 (13.044), while the coefficients for ages 12, 15, and 16 (7.593, 12.497, 12.167 respectively) are closer to the average and suggest a moderate relationship between the variables. The lowest correlation coefficient is at age 17 (8.308), indicating a weaker connection between that age group and the ability to seek comfort and support. People have different ways of responding to bullying and defending themselves. Not everyone chooses to confront the bully directly; some seek support and try to avoid conflict. Adolescents who are 14 years old (7.598) seem to be the most willing and able to respond to bullying, likely due to their stronger sense of social support and conflict avoidance strategies. On the other hand, those who are 12, 16, and 17 years old (4.438, 6.021, 5.029) may struggle more with showing empathy and support, possibly because they are more inclined to avoid conflict or lack the necessary skills in this area.

The “Latines Lideres En Salud (LaLiSa)” study: Rationale and design

BackgroundLatines suffer from breast cancer (BC), due to elevated biological and social determinants of health (SDOH) risks. This study compares the effects of different strategies on uptake of cancer genetic services, specifically hereditary cancer risk assessment, genetic counseling, and genetic testing, and risk-based BC care. Design/methodsIn Chicago, Illinois, Aim 1 participants are recruited from a federally qualified health center (FQHC) and community venues. For Aim 1, eligible participants: (1) are female; (2) are Latine; (3) are 30+ years old; (4) have personal or family history of BC or cancers with shared hereditary mutations; (5) have at least one SDOH risk; and (6) have not received any cancer genetic services. Participants are randomly assigned to different study arms. Both arms include phone-based sessions, FQHC-based navigation for SDOH, and low- or no-cost cancer genetic services. The educate sessions focus on risk assessment and prevention. The empower sessions focus on risk assessment and equip participants with the skills to share information about FQHC-based cancer genetic services. For Aim 2, eligible participants are: (1) female; (2) network members of Aim 1 participants; and (3) eligible for BC screening based on guidelines recommended by the American Cancer Society (ACS). Primary outcomes include uptake of any cancer genetic services. Analyses will also explore intervention differences by neighborhood context. DiscussionThis is one of the first trials focused on Latines' participation in cancer genetic services and risk-based BC care within the context of SDOH - which has major implications for equity in precision cancer prevention.

Preserving system activity while controlling epidemic spreading in adaptive temporal networks

Human behavior strongly influences the spread of infectious diseases: understanding the interplay between epidemic dynamics and adaptive behaviors is essential to improve response strategies to epidemics, with the goal of containing the epidemic while preserving a sufficient level of operativeness in the population. Through activity-driven temporal networks, we formulate a general framework which models a wide range of adaptive behaviors and mitigation strategies, observed in real populations. We analytically derive the conditions for a widespread diffusion of epidemics in the presence of arbitrary adaptive behaviors, highlighting the crucial role of correlations between agents behavior in the infected and in the susceptible state. We focus on the effects of sick leave, comparing the effectiveness of different strategies in reducing the impact of the epidemic and preserving the system operativeness. We show the critical relevance of heterogeneity in individual behavior: in homogeneous networks, all sick-leave strategies are equivalent and poorly effective, while in heterogeneous networks, strategies targeting the most vulnerable nodes are able to effectively mitigate the epidemic, also avoiding a deterioration in system activity and maintaining a low level of absenteeism. Interestingly, with targeted strategies both the minimum of population activity and the maximum of absenteeism anticipate the infection peak, which is effectively flattened and delayed, so that full operativeness is almost restored when the infection peak arrives. We also provide realistic estimates of the model parameters for influenza-like illness, thereby suggesting strategies for managing epidemics and absenteeism in realistic populations. Published by the American Physical Society 2024

Regulations of Bulk and Interfacial Chemistry of Mn-Based Cathode Materials for Sodium Ion Batteries

Sodium ion batteries (SIBs) show the great potential to achieve large-scale energy storage due to their low cost and good safety as well as abundant resources of sodium. Among the cathode materials for SIBs, manganese-based layered oxides with adjustable structure have been attached great interest for the high energy density and low-cost SIBs. . Particularly, P2-type Mn-based materials exhibit anionic redox during charge and discharge processes, which can not only elevate the battery potential but also provide extra capacity, drastically boosting the energy density of the batteries. However, the irreversible phase transition, Jahn-Teller effect of manganese and interphase degradation at high charge cutoff voltage during anionic redox largely affect the cyclic stability of the cathodes. Therefore, it is essential to develop effective strategies to regulate the structural and interfacial chemistry for suppressing the phase transition and voltage hysteresis as well as increasing the cycle life of cathode materials. In this work, various electrochemical inert/active elements have been introduced into Mn-based P2 type cathode materials for regulating the electronic structure of the cathodes to promote more anionic redox and improve the structural stability. In addition, a new type of ionic liquid is introduced to build a stable interphase and improve the high voltage stability of the cathode material. Multi-model synchrotron-based X-ray characterization techniques combined with first-principles calculation are used to reveal the effectiveness of different strategies on the electrochemical properties of SIBs. The results provide valuable information for the development of high-performance cathode materials. Acknowledgement This work at Shanghai Jiao Tong University was financially supported by the National Natural Science Foundation of China (No. 22209106).

Non-visual spatial strategies are effective for maintaining precise information in visual working memory

Visual working memory content is commonly thought to be composed of a precise visual representation of stimulus information (e.g., color, shape). Nevertheless, previous research has shown that individuals represent this visual information in different formats, historically dichotomized into “verbal” and “visual” formats. With growing popular knowledge of aphantasia, or the absence of sensory mental imagery, recent studies have demonstrated that individuals with aphantasia perform similarly to individuals with typical imagery on visual working memory tasks. This suggest that the use of non-visual strategies may be sufficient to perform visual working memory tasks, which were previously thought to be strictly visual. To investigate the effects of different strategies on performance in a visual working memory task, we recruited individuals across the visual imagery spectrum and tested their ability to identify relatively small (3°), medium (6°), or large (10°) changes in the degree of orientation of gratings held in working memory. Subsequently, participants indicated the extent to which they used five different strategies: visual, spatial, verbal, semantic, and sensorimotor. Results revealed that individuals with aphantasia and typical imagery performed similarly to each other across all task difficulty levels. Individuals with typical imagery dominantly used visuospatial strategies, but surprisingly, individuals with aphantasia overwhelmingly preferred the use of non-visual spatial and sensorimotor strategies over verbal strategies. These results suggest that non-visual spatial and sensorimotor strategies can be adopted in visual working memory tasks and these strategies are equally effective as visuospatial strategies. This calls for a rethinking of the “visual” versus “verbal” dichotomy, and provides evidence for the use of other non-visual mental representations in working memory tasks.

Systematic comparison of deep-learning based fusion strategies for multi-modal ultrasound in diagnosis of liver cancer

For the diagnosis of liver cancer, conventional brightness mode (B-mode) can only provide morphological information. Multi-modal ultrasound, including shear-wave elastography (SWE) and contrast enhanced ultrasound (CEUS), can provide comprehensive diagnostic information on tumor microenvironment and tissue perfusion. The challenge is to effectively explore the multi-modal features of ultrasound. Besides, there are many fusion strategies currently available, but there is a lack of systematic comparative research on the various fusion strategies. In this study, we designed 'Lesions Pairing' to construct the dataset, addressing the challenge of small sample sizes in multi-modal learning. We then compared the effectiveness of different strategies and proposed hybrid-fusion strategies based on the combination of conventional layer-level fusion (i.e. early-fusion, mid-fusion and late-fusion), which can efficiently extract intra-/inter- modal information. Specifically, we first systematically compared different deep-learning-based fusion strategies for multi-modal ultrasound in the diagnosis of liver cancer. Secondly, based on the comparison results of a multimodal framework that integrates B-mode, SWE, CEUS ultrasound data, and clinical data simultaneously, we propose a hybrid-fusion strategies for the diagnosis of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. The experimental results showed that the area under the curve of the early-late fusion strategy combined with clinical data was 0.9854, which was superior to other single mode and other fusion strategies, increasing by 13.8–25.88 % and 2.22 %-9.79 %, respectively.

Reducing freeloading in Global Virtual Teams: A quasi-experimental approach

Freeloading, a challenge faced by all workgroups but particularly acute in global virtual teams (GVTs), is an increasing concern as GVTs become increasingly ubiquitous in international business settings. This study employed a quasi-experimental design to evaluate the comparative effectiveness of different strategies grounded in equity theory for mitigating freeloading behavior in GVTs. The study used a sample of 2,022 GVTs comprising 12,536 business students from 43 countries who, for two months, worked on international business consulting projects. The results indicate that freeloading could be significantly reduced if the performance management system promotes a sense of equity and fairness by visible monitoring of individual effort coupled with the threat of reciprocations for insufficient contributions. Importantly, making a lack of individual effort visible through regular peer evaluations but taking no immediate punitive action could reduce perceived fairness and actually increase freeloading. The implications of these findings for practice and future research are discussed.

Developing Ultra‐High Strength Bainitic Steel by Hot Stamping Process and Anisothermal Holding

Hot stamping is a well‐established process in the automotive industry for structural parts to decrease the weight of a vehicle without reducing the safety and stiffness of components. In this work, a bainitic approach during the hot stamping process is studied by anisothermal annealing. The effect of different strategies on the microstructure and mechanical properties of the hot‐stamped parts is investigated. The microstructure is analyzed using light microscopy (LM), scanning electron microscopy (SEM), and electron backscatter diffraction (EBSD) techniques. Tensile and hardness tests are applied to analyze mechanical properties. A microstructure consisting of a carbide‐free bainite matrix containing martensite, fine‐grained ferrite, and retained austenite is obtained. SEM analysis of fracture surfaces from tensile samples reveals that the bainitic microstructure showed mainly a ductile fracture by dimples and voids along with some quasi‐cleavage fracture.

The Strategies of Air Quality Improvement in Urban Governance: A Case Study of Beijing

In recent years, the economy of China has a rapid development. Meanwhile, there are a few problems exposed that are harmful to human health, especially environmental problems and air pollution in Beijing are concerned by all citizens. Since 2013, under the guidance of national governance policy, the Beijing government has been paying high attention to dealing with air pollution and officially launched air pollution control activities. With the cooperation and joint efforts of government, enterprises and academic institutions, air governance has achieved remarkable results, which reduced the index of air pollutants in terms of PM2.5, sulfur dioxide, nitrogen dioxide, and PM10. This paper will summarize the core countermeasures including the policy effect launched by the government, and the promotion effect of shared transportation modes by enterprises. Based on the measurements taken by government and enterprises, this paper analyzes the effects of different strategies. In addition, the suggestions for air quality control will be presented.

The effectiveness of BIM features application strategies for building refurbishment project performance improvement

Abstract This research presents a study that explores the effectiveness of different strategies for implementing Building Information Modelling (BIM) features in enhancing the performance of building refurbishment projects. The study adopts a combined quantitative and qualitative approach to measure the significance of BIM features in relation to building refurbishment project performance improvement. It aims to uncover the correlation between BIM feature application strategies and building refurbishment project performance and provides recommendations on utilizing BIM features to improve project outcomes. The study encompasses a comprehensive review of existing literature on BIM and building refurbishment projects, followed by a mixed-methods approach. This approach involves quantitative analysis of data from refurbishment projects that have implemented BIM, as well as qualitative analysis of expert interviews with industry professionals. The findings of the expert interviews shed light on the factors influencing the effectiveness of BIM in building refurbishment projects, such as the level of BIM adoption, the availability of skilled personnel, and the integration of BIM into project workflows. The research contributes valuable insights to enhance the understanding of BIM utilization in building refurbishment projects, offering guidance to practitioners and decision-makers in leveraging BIM technologies for such endeavourrs.

Energy Transition and Poverty Alleviation in Light of Environmental and Economic Challenges: A Comparative Study in China and the European Union Region

This study aims to compare the effectiveness of renewable energy and circular economy practices in reducing environmental damage and poverty in China and the European Union (EU) by using the Autoregressive Distributed Lag (ARDL) approach and the Vector Error Correction Model (VECM) technique. Analyzing data from 1995 to 2022, we compared the effectiveness of these approaches in both regions. This study offers several fresh perspectives on the fight against environmental damage and poverty, differentiating itself from existing research in a few key ways. In fact, most studies focus on a single region’s approach to sustainability. However, this research directly compares China and the European Union (EU), highlighting how factors like economic structure and development stages influence the effectiveness of renewable energy and circular economy practices. Also, this study shows how renewable energy and circular practices can simultaneously tackle both environmental damage (emissions) and social issues (poverty). Our findings reveal that factors like poverty, fossil fuel reliance, economic growth, and international trade all contribute to rising carbon emissions in both China and the EU, though their influence varies. Interestingly, China experienced greater success in curbing emissions through solar power, circular economy measures, and wind power compared to the EU. Additionally, the impact of these strategies on poverty reduction differed significantly between the two regions. Based on these results, we recommend that policy makers in both regions develop tailored strategies for tackling carbon emissions and poverty. Prioritizing renewable energy sources and circular practices is key, as they can simultaneously reduce emissions and alleviate poverty. However, it is crucial to focus on approaches that work best in each specific region, considering social, economic, and environmental factors. This study suggests that a one-size-fits-all approach will not work for fighting climate change and poverty. While renewable energy and circular economies are effective, China saw greater success with solar and wind power compared to the EU. Policy makers need to design strategies specific to their region’s economic, social, and environmental context. Further research can refine these approaches, and public education is crucial to promote sustainable behavior and empower policy makers. It is also needed to refine and improve the implementation of these strategies. Finally, public awareness and education are essential to promote sustainable behavior and empower policy makers in their fight against climate change and poverty. This study highlights the importance of a region-specific approach to energy transition and poverty alleviation. By comparing China and the EU, we gain valuable insights into the effectiveness of different strategies in tackling these interconnected challenges. The findings provide valuable guidance for policy makers looking to create a more sustainable and equitable future.

Efficacy of different strategies for reducing labor pain: A Bayesian analysis.

The effectiveness of different medical interventions in managing labor pain has yielded mixed results. Therefore, this systematic review and network meta-analysis aimed to provide a comprehensive summary of the available evidence on the impact of different strategies for reducing labor pain. We systematically searched 3 English databases (Pubmed, Embase and the Cochrane Library) from inception to January 2023. Randomized controlled trials (RCTs) or controlled clinical trials that investigating the effects of different strategies for reducing labor pain were included in this network meta-analysis. Risk of bias (ROB) was assessed using the Cochrane ROB tools. Network meta-analysis was performed using the R software (version 4.2.1) with gemtc package. A total of 9 studies involving 823 patients, including 9 treatments (acupressure, birth ball exercise, Bonapace method, distraction techniques, ice pressure, LI4 acupressure, lidocaine spray, smartphone-based music intervention and placebo). The surface under the cumulative ranking (SUCRA) shows that Bonapace method ranked first (SUCRA, 79.5%), LI4 acupressure ranked second (SUCRA, 65.6%), distraction technique ranked third (SUCRA, 57.6%), birth ball exercise ranked fourth (SUCRA, 51.8%). According to the results of the network meta-analysis, among the different strategies examined, the Bonapace Method stands out as the most effective nonpharmacological intervention for reducing labor pain. The results of this meta-analysis can aid both patients and healthcare professionals in choosing the most effective techniques to reduce labor pain.

Evaluation of Early-Age Compressive Strength in Winter Prefabrication: A Comparative Study

In the field of prefabrication, the timely demolding of concrete elements is crucial to prevent structural failures during panel lifting. This study investigates the early-age compressive strength of different concrete mixtures by simulating various prefabrication plant scenarios. Special attention is given to winter conditions, where concrete hydration tends to be slower, potentially compromising the minimum compressive strength requirement of 10 MPa. The first scenario (reference), set at an ambient temperature of 20 °C with raw materials at room temperature, establishes the baseline for comparison. Two alternative dispositions are explored: Scenario 2, with an external temperature of 8 °C and the water for mixing at 35 °C, and Scenario 3, with the same external temperature but utilizing a heating hood to maintain the concrete at 35 °C. The experimental results shed light on the effectiveness of different strategies in achieving the desired early-age compressive strength under winter conditions. The use of warm mixing water and heating hoods are evaluated as potential measures to counteract the hydration slowdown. The findings contribute valuable insights for optimizing prefabrication processes in cold weather, ensuring the structural integrity of precast concrete elements.

Optimizing Crop Water Productivity in Greenhouse Pepper

Although advanced production systems have been developed in the last 20 years, water scarcity is still a growing problem in agriculture. This study aims to evaluate the effect of different strategies that combine the application of seaweed and microbial biostimulants with regulated deficit irrigation (RDI) strategies on the irrigation water productivity (WPI), fruit quality parameters and soil enzymatic activity in pepper plants (Capsicum annum sp.) under two commercial greenhouse conditions. In each trial, two treatments were applied: (i) irrigation according to Farmer criteria without biostimulant applications and (ii) a combined treatment of RDI and the same biostimulation program, composed of Bacillus paralicheniformis and Ascophillum nodosum extracts. RDI was applied in different phenological stages in each greenhouse after the establishment until the 1st harvest in trial 1 or during the ripening and harvest period in trial 2. On average, the irrigation was reduced by 600 m3 ha−1 compared to the Farmer irrigation schedule. In both trials, biostimulation promoted an increase in fruit numbers, punctually in trial 1, leading to yield precocity, or generally in trial 2, obtaining a higher yield. Globally, WPI was increased when RDI was combined with biostimulation. This combined treatment also enhanced the root water absorption and improved the soil enzymatic activity in both greenhouses, suggesting that nutrients in the soil would become more available to plants. Thus, the combined action of biostimulation under different RDI strategies has been proved to be a useful strategy to improve agricultural sustainability.

Evaluating mitigation strategies for building stocks against absolute climate targets

With the growing urgency of addressing climate change it is increasingly important that decision makers at all levels are equipped to take efficient mitigation actions. This research evaluates the potential of four mitigation strategies to reduce greenhouse gas emissions from the building stock based on a case study, and these are further evaluated in terms of alignment with the remaining global emission budget and the planetary boundary for global warming. The results cover annual emissions from 2023 to 2050 across 18 impact categories, thus highlighting possible impact burden-shifting that may occur as a result of the mitigation strategies. The results show that decarbonisation of the electricity grid delivers a substantial reduction across impact categories. However, in absolute terms, this is counteracted by the increase in building stock. The results also show that current estimates for mitigation potentials are insufficient to comply with the remaining global emission budget. Thus, mitigation strategies should be even more ambitious: constructing 80% fewer new buildings and reducing operational energy demand by 80%. These findings highlight the urgency of taking multiple actions. The increase in demand for new buildings needs to be challenged. Practice relevance Present urban mitigation strategies are inadequate for meeting the stated GHG targets. To enable informed decisions it is important to quantify the effects of different strategies. Traditional life cycle assessments have static inventories and impacts can therefore not be temporarily differentiated and transparency cannot be provided on long-term potentials. This study suggests combining material flow analysis and life cycle assessment to enable integration of dynamic parameters into the life cycle inventory. This shows how the long-term effectiveness of different mitigation strategies can be evaluated. To ensure unintended burden-shifting does not occur, results cover annual emissions from 2023 to 2050 across 18 impact categories. Furthermore, this study showcases how strategies can be designed to align with global commitments such as those set by the Paris Agreement.

Experimental and New Approaches for Bladder Preservation in Intermediate and High-Risk Non-Muscle-Invasive Bladder Cancer (NMIBC).

About 75% of bladder cancers are detected as non-muscle invasive. High-risk patients have high progression risk. Although the standard is transurethral resection of bladder tumor plus full dose intravesical BCG for one to 3 years, due to the high risk of progression, radical cystectomy may be considered in specific cases. Although radical cystectomy is still the best approach for high-grade NMIBC from an oncological perspective, its high morbidity and impact on quality of life motivate studies of new strategies that may reduce the need for cystectomy. We carried out a mini-review whose objectives were: 1 - to identify bladder-sparing alternatives that are being studied as possible treatment for patients with intermediate and high-risk NMIBC; 2 - understand the evidence that exists regarding success rate, follow-up, and side effects of different strategies. Several studies have sought alternatives for bladder preservation, including immunotherapy, intravesical chemotherapy, chemo-hyperthermia, antibody-drug conjugates, viral genetic therapy, and others with promising results. The selection of an optimal therapy for high-risk NMIBC that can reduce the need for cystectomy, with low toxicity and high efficacy, is of paramount importance and remains an issue, however, several known medications are being tested as bladder-preserving alternatives in this scenario and have shown promise in studies.

Pulmonary Rehabilitation Associated with Noninvasive Ventilation on Physical Capacity and Quality of Life in Post-COVID-19: A Randomized Controlled Double-Blinded Clinical Trial Protocol.

The coronavirus disease-2019 (COVID-19) pulmonary rehabilitation (PR) seems to be a better choice to improve physical and functional capacity after acute infection. However, there is a lack of evidence regarding the effects of different strategies to optimize post-acute phase rehabilitation and reduce long COVID-19 physical deteriorations. To compare the use of a noninvasive ventilation (NIV) plus aerobic exercise strategy during PR program with to a standard PR (without NIV) on physical capacity and quality of life outcomes in post-COVID-19. Double-blinded randomized controlled clinical trial. A total of 100 individuals discharged from hospital in a post-acute phase of severe COVID-19 will be randomized into two groups: PR + NIV (Group 1) and PR (Group 2). Inclusion criteria include participants who present symptomatic dyspnea II and III by the modified Medical Research Council, aged 18 years or older. Both groups will receive aerobic and resistance exercise, and inspiratory muscle training. However, group 1 will perform aerobic training with bilevel NIV. Cardiopulmonary exercise test will assess the O2 peak uptake, 6-minute walk test will assess the walking distance and short-form 36 will assess the quality of life before and after 8 weeks (after 24 PR sessions). Moreover, patients will be contacted by telephone every 3 months for one year to record possible adverse events, hospitalizations, and death. All data will be registered in RedCap, and analyses will be performed in the STATA v13 software. RBR-3t9pkzt.