End Of The Study Research Articles

Sustained Euthyroidism during Thionamide Antithyroid Drug Treatment: Comparison of Short- and Long-term Methimazole Therapy

Background: Extended low serum thyrotropin (TSH) levels may increase the risk of cardiovascular events in patients with hyperthyroidism. Objectives: This study aimed to compare the time spent with sustained normal TSH concentration following short- and long-term methimazole treatment. Methods: A total of 258 patients with Graves’ hyperthyroidism completed 18 - 24 months of methimazole therapy and were randomized to discontinue treatment (n = 128, short-term group) or continue an additional 36 - 102 months of methimazole therapy (n = 130, long-term group). Clinical and laboratory evaluations were performed every 6 months for 132 months after randomization. Results: There was no difference in serum-free thyroxine, triiodothyronine, and TSH concentrations between the 2 groups at the time of randomization. Of 128 patients in the short-term group, 5 left in follow-up, 2 became hypothyroid, 67 (54%) had a relapse of hyperthyroidism, and only 54 (44%) were euthyroid at the end of the study. Among 130 patients on the long-term methimazole therapy, 4 were left in follow-up, 24 developed hyperthyroidism, 4 developed hypothyroidism, and 98 (78%) were euthyroid 132 months post-randomization. Total time spent on euthyroidism was 90.4% ± 8.1% of the study period in the short-term and 95.8% ± 7.0% in the long-term treatment groups (P < 0.001). The lowest time spent in euthyroidism (74.6% ± 6.4% of the study period) belonged to 29 (24%) patients in the short-term group under levothyroxine therapy because of fluctuation in serum TSH. Patients in both groups with hyperthyroidism relapse who chose methimazole therapy spent >90% of the study time in euthyroidism. Conclusions: In patients with Graves' hyperthyroidism, sustained normal serum TSH levels were more common in the long term as compared to the short-term methimazole treatment.

Effect of probiotic supplementation on lipoprotein-associated phospholipase A2 in type 2 diabetic patients: a randomized double blind clinical controlled trial

BackgroundIt has been recently reported that lipoprotein-associated phospholipase A2 (Lp-PLA2) may predict the risk of cardiovascular disease. The effect of multi-strain probiotics on Lp-PLA2 in patients with type 2 diabetes is still not clear.AimsThis study aimed to determine the effect of multi-strain probiotic supplementation on lipoprotein-associated phospholipase A2, and glycemic status, lipid profile, and body composition in patients with type 2 diabetes.MethodsIn this randomized double-blind placebo-controlled clinical trial, 68 participants with type 2 diabetes, in the age group of 50–65 years, were recruited and randomly allocated to take either probiotic (n = 34) or placebo (n = 34) for 12 weeks. The primary outcome was lipoprotein-associated phospholipase A2, and secondary outcomes were glycemic parameters, lipid profile, anthropometric characters, and body composition (fat mass and fat-free mass).ResultsThere was a significant reduction in serum lipoprotein-associated phospholipase A2, in the probiotic group, it dropped by 6.4 units at the end of the study (p < 0.001) compared to the placebo group. Probiotic supplementation also resulted in a significant improvement in the hemoglobin A1c and high-density lipoprotein cholesterol 1.5% (p < 0.001) and 6 mg/dl (p 0.005), respectively. There were no significant changes in other outcomes.ConclusionProbiotic supplementation was beneficial for reducing Lp-PLA2 and hemoglobin-A1c and improving high-density lipoprotein cholesterol, which may suggest an improvement in the prognosis in patients with type 2 diabetes.

Enhancing the Functional Performance of Patients with Late-Stage Age-Related Macular Degeneration Implanted with a Miniature Telescope using Rehabilitation Training.

In this work, our aim is to report the functional outcomes of cataract surgery with smaller-incision new-generation miniature telescope (SING IMT) implantation followed by rehabilitation training in patients with central visual loss due to late-stage age-related macular degeneration (AMD). This retrospective study included patients who were monocularly implanted with SING IMT and then followed a rehabilitation program based on 6 biweekly sessions focused on visual abilities, reading, writing, visual motor integration and mobility. A total of 11 participants were included in this study. Reading acuity (RA), reading speed (RS), and fixation stability (FS) were assessed biweekly at 6-, 8-, 10-, 12-, 14-, and 16-week follow-up visits after SING IMT implantation and at a final assessment at 24weeks. Best-corrected distance visual acuity (BCDVA) was also measured at baseline and at the same postoperative timepoints. Mean baseline BCDVA was 12.5 ± 8.6 letter score. Both RA and RS were found to be significantly improved from the first rehabilitation session (6weeks after surgery) to the last session (24weeks after surgery). At the end of the rehabilitation program, mean RA was 0.45 ± 0.19 LogMAR and mean RS was 30.9 ± 17.6 words per minute. Moreover, all patients achieved a FS of 15s or more after the last rehabilitation session. Most patients (55%) achieved an improvement of 15 letters in BCDVA at the end of the study. This study suggests that rehabilitation training can improve visual functions of patients with late-stage AMD implanted with SING IMT in real-world tasks such as reading skills.

A sports‐related injury prevention program for Dutch youth volleyball players: Process evaluation alongside a quasi‐randomized controlled trial

AbstractObjectiveThis process evaluation aimed to gain insight into the implementation of the VolleyVeilig Youth program by Dutch volleyball clubs within the context of an effectiveness trial.MethodsWe applied the UK Medical Research Council framework for process evaluations and assessed the context, implementation and mechanisms of impact. Trainers participating in the effectiveness trial were asked to complete a questionnaire at the end of the study. A subsample of the trainers based on the self‐reported adherence score was invited to participate in an interview accordingly. We used a thematic analysis to present the data.ResultsThirty‐one trainers (100%) completed the questionnaire, and seven agreed to participate in an interview. Although adherence gradually decreased over the volleyball season, most trainers reported partially adhere with the program until the end of the study. The main themes included factors associated with the (1) VolleyVeilig Youth program, (2) trainer, (3) players, and (4) volleyball club.ConclusionAlthough (partial) adherence to the VolleyVeilig Youth program was high in this study, implementation strategies must be developed to target the barriers reported by the trainers before the program can be successfully implemented nationwide in the Netherlands.

Exploring senior high-school students’ understanding of electrochemical concepts: patterns of thinking across Turkish and Indonesian contexts

This study focuses on examining senior high-school students’ conceptual understanding and difficulties concerning electrochemistry and comparing patterns of thinking across Turkish and Indonesian contexts. The Electrochemistry Concept Questionnaire (ECQ) was applied to 516 Indonesian and 516 Turkish high school students right after the teaching of the electrochemistry topics. The ECQ contains 18 multiple-choice questions and these questions belong to five different categories: reactions occurring during electrolysis, differences between electrolytic and voltaic cells, movement of ions in voltaic cells, poles in voltaic cells, and voltaic cell reactions. At the end of the study, it was determined that both Indonesian and Turkish senior high-school students’ understanding of electrochemistry concepts was relatively weak and they shared common difficulties concerning electrochemical concepts. While there was no significant difference between the average scores of the students from both countries on the test, it was determined that there were some significant differences on the basis of questions. It has been concluded that students from both countries have alternative conceptions similar to those determined in previous studies such as “during electrolysis, the electric current produces ions” and “electrons migrate through the solution from one electrode to the other”. At the end of the study, the reasons for the similar results and the significantly different results for the students of the two countries to comprehend electro-concepts were discussed.

Responsiveness to Tocilizumab in Anti-Acetylcholine Receptor-Positive Generalized Myasthenia Gravis.

Tocilizumab, a humanized IL-6R monoclonal antibody, has been used in autoimmune diseases closely related to humoral immunity. This report aims to evaluate the efficacy and safety in patients with anti-acetylcholine receptor-positive (AChR+) generalized myasthenia gravis (gMG). We performed a prospective, open-label, single-arm study in patients with gMG in a 48-week follow-up. All patients were AChR+ and were given tocilizumab by intravenous infusion at a dose of 8 mg/kg at intervals of 4 weeks. The primary endpoint was mean change from baseline in quantitative MG (QMG) score at week 12. The secondary endpoints were mean changes from baseline in MG activities of daily living (MG-ADL) score, AChR-ab titers, and the dosage of oral prednisone at week 12. At week 48, QMG, MG-ADL, and the use of prednisone were also evaluated. Fourteen gMG patients were enrolled and all of them completed the study. Tocilizumab treatment started 8 (4-192) months after the onset of gMG. During tocilizumab treatment, the QMG score was significantly decreased from 15.5 (interqualile range, 9-26) at baseline to 4 (0-9) at week 12 (p < 0.001). The change of ADL was decreased from 14.5(11-19) at baseline to 4 (0-19) at week 12 (p < 0.001) and the change of AChR-ab titers from 15 (7.5-19) at baseline to 6.8 (11.6-4.3) at week 12 (p < 0.001). The dosage of prednisone decreased from baseline 60 (20-65) mg/d to 30 (30-50) mg/d at week 12 (p < 0.001). By the end of the study, the QMG score was 2 (0-7) and MG-ADL score was 1.5 (0-6). 12 (85.7%) patients achieved minimal manifestations. 4 (28.6%) patients were able to discontinue prednisone. No patients experienced exacerbation at the end of the study. No serious adverse events were observed during follow-up. Tocilizumab treatment was associated with a good clinical response and safety over a 48-week observation period, as evidenced by significant improvements in QMG and MG-ADL.

Impact of combined pulmonary fibrosis and emphysema on lung cancer risk and mortality in rheumatoid arthritis: A multicenter retrospective cohort study.

Combined pulmonary fibrosis and emphysema (CPFE) is a syndrome characterized by the coexistence of emphysema and fibrotic interstitial lung disease (ILD). The aim of this study was to examine the effect of CPFE on lung cancer risk and lung cancer-related mortality in patients with rheumatoid arthritis (RA). We conducted a multicenter retrospective cohort study of patients newly diagnosed with lung cancer at five community hospitals between June 2006 and December 2021. Patients were followed until lung cancer-related death, other-cause death, loss to follow-up, or the end of the study. We used the cumulative incidence function with Gray's test and Fine-Gray regression analysis for survival analysis. A total of 563 patients with biopsy-proven lung cancer were included (82 RA patients and 481 non-RA patients). The prevalence of CPFE was higher in RA patients than in non-RA patients (40.2% vs.10.0%) at lung cancer diagnosis. During follow-up, the crude incidence rate of lung cancer-related death was 0.29 and 0.10 per patient-year (PY) in RA and non-RA patients, and 0.32 and 0.07 per PY in patients with CPFE and patients without ILD or emphysema, respectively. The estimated death probability at 5 years differed between RA and non-RA patients (66% vs. 32%, p<0.001) and between patients with CPFE and patients without ILD or emphysema (71% vs. 24%, p<0.001). In addition to clinical cancer stage and no surgery within 1 month, RA and CPFE were identified as independent predictive factors for increased lung cancer-related mortality (RA: adjusted hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.65-4.76; CPFE: adjusted HR 2.01; 95% CI 1.24-3.23). RA patients with lung cancer had a higher prevalence of CPFE and increased cancer-related mortality compared with non-RA patients. Close monitoring and optimal treatment strategies tailored to RA patients with CPFE are important to improve the poor prognosis of lung cancer.

Effectiveness of next-generation sequencing for patients with advanced non-small-cell lung cancer: a population-based registry study

Despite the growing use of next-generation sequencing (NGS) in the management of advanced non-small-cell lung cancer (NSCLC), there is little evidence that its use leads to improved clinical outcomes. This study aimed to compare the effectiveness of NGS with that of single-gene testing (SGT) alone in patients with advanced NSCLC. This was a retrospective cohort study conducted on patients diagnosed with advanced lung adenocarcinoma between 2017 and 2018 from a nationwide, population-based database. We identified patients who had SGT exclusively (SGT group) or underwent upfront NGS or NGS following SGT as an initial evaluation (NGS group). Patients were followed up until death or the end of the study (31 December 2019). The adjusted hazard ratio (aHR) for death was estimated using the Cox proportional hazards model. The factors affecting the adoption of NGS were identified. Of 8566 patients diagnosed with advanced lung adenocarcinoma, 402 and 6932 patients were assigned to the NGS and SGT groups, respectively. More NGS was carried out in younger patients, those with higher incomes, and those living in urban areas. After balancing these confounders through matching, no difference was observed in the median overall survival and risk of death between the NGS and SGT groups [18.5 versus 19.7 months, log-rank P= 0.783; aHR 0.98, 95% confidence interval (CI) 0.84-1.14, respectively]. Only in a subgroup for whom epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) inhibitors were not indicated, NGS was associated with better survival outcomes (14.1 versus 9.0 months, log-rank P= 0.006; aHR 0.82, 95% CI 0.69-0.97). In the real world, NGS for all-comers in patients with advanced NSCLC did not increase survival outcomes. When health care resources to support equal access to NGS are limited, upfront SGT followed by NGS may be a more efficient strategy.

Risk factors of first thrombosis in obstetric antiphospholipid syndrome

ObjectiveThere is limited evidence on long-term thrombosis risk in patients with obstetric antiphospholipid syndrome (OAPS). This study aimed to investigate the clinical features and risk factors associated with the first...

Effects of Homework Policy on EFL Literacy Development in Emergency Remote Learning: A Focus on Academic Self-Regulation

Homework as an essential component of the academic process supports teaching and learning by consolidating what the students learn in class and promoting their study skills and self-paced work capacities. While homework characteristics and its efficacy are reported to be interrelated, there is a lacuna in the research on the effectiveness of homework policy in learning outcomes in online classes, particularly under adverse conditions. As a result, the current study investigated the effects of homework policy (leniency vs. strictness) on EFL learners literacy (reading and writing) development, focusing on their academic self-regulation (ASR) level in a distance learning course amid the COVID-19 pandemic. Data were gathered from 36 K-10 students organized into homework packet and homework leniency groups. Their literacy skills and ASR were assessed before and after the study. Due to schools closure during the COVID-19 pandemic, both groups participated in distance learning courses delivered via the national mobile-based LMS. The results of the two-way Analysis of Variance primarily revealed a significant development in the reading and writing skills of the homework-packet group. Despite the marginal difference between the reading performance of high and low self-regulated participants of both homework conditions at the end of the study, a significant difference in the development of the writing skills of high self-regulated participants of the homework-packet condition was observed. The critical role of homework strictness in online courses and promoting learners’ self-regulation skills to benefit from the assigned homework, particularly in teaching writing, is underscored.

Venipuncture Site Influences Blood-drop Volume in C57BL/6 Mice.

Many experiments require the collection of serial blood samples from mice. However, the size of mice limits the volume of blood that can be safely collected as a survival procedure. In IACUC protocols, investigators may report the amount of blood they collect from mice as a number of drops. Many institutions, including ours, use an anecdotal conversion factor (1 drop of mouse blood = 25 µL) to ensure that blood-collection volumes are compliant with institutional guidelines. To our knowledge, previous work has not experimentally determined the volume of a drop of mouse blood. In this 10-wk crossover experiment, 2 phlebotomists bled 30 C57BL/6J mice from 3 sites (facial, saphenous, and tail) using one or 2 different needle gauge sizes per site. Male and female mice were weighed weekly and divided among 5 groups (n = 6): left and right tail vein, left and right saphenous vein, and facial vein. A single blood drop from each site was weighed, and the volume of each drop was calculated using the average blood density determined from 8 mice terminally bled at the end of the study. Venipuncture site and side significantly influenced blood-drop weight and thus calculated volume. Facial vein puncture produced the largest drop volume (mean: 21.7 µL), followed by the saphenous vein (mean: 9.97 µL) and tail vein (mean: 4.96 µL). Collection from the facial vein was associated with more hemorrhage and morbidity. Left-sided venipuncture was associated with slightly larger-volume blood drops, though the effect size of side was small. The results of this study may be useful in more accurately estimating blood loss via conversion of drops to volume. Our data indicate that blood collection from saphenous and tail veins minimizes blood loss relative to facial vein puncture and may optimize both serial collection of small-volume blood samples and animal welfare.

Prevention of heartworm infection in dogs using a combination of moxidectin, imidacloprid and praziquantel: evidence from a randomized clinical trial.

The aim of this study was to evaluate the efficacy of a topical combination of moxidectin 3.5%, imidacloprid 10% and praziquantel 10% for the prevention of Dirofilaria immitis (Leidy, 1856) infection in dogs. For this purpose, a randomized and controlled clinical trial was conducted between August 2021 and October 2022, in the municipality of Goiana, state of Pernambuco, north-eastern Brazil, where heartworm is highly prevalent. Of the 213 dogs initially sampled (baseline), 68 (31.9%) were positive for adult antigens (SNAP 4Dx Plus, Idexx) and/or microfilariae (modified Knott's test). On day 0, 140 negative dogs were randomly included in the treatment and control groups, 70 animals each. During the study, 60 dogs (34 treated and 26 untreated) were removed for different reasons. At the end of the study (day 360 ± 2), 36 treated and 44 untreated were sampled and included in the efficacy calculation. The efficacy against the development of adults and microfilariae was 84.7%, with only one treated dog being positive for adult antigens but negative for microfilariae. On the other hand, eight untreated dogs were positive for adultantigens and/or microfilariae, resulting in a significant difference in the number of positives between groups (Chi-square test = 4.706, df = 1, P = 0.0301). Remarkably, the efficacy against the appearance of D. immitis microfilariae was 100% (i.e., all treated dogs negative) and three untreated dogs were positive for microfilariae. The topical combination of moxidectin 3.5%, imidacloprid 10% and praziquantel 10% significantly reduced the risk of D. immitis infection in treated dogs as compared with untreated dogs, in a highly endemic area in north-eastern Brazil.

Melhorando as características reprodutivas e de crescimento em cabras nativas criadas em sistema de pequenas propriedades

ABSTRACT: Goat breeding is an economic activity carried out in the rural areas of the Eastern Mediterranean region of Türkiye. The small ruminants breeding project carried out in extensive farmer conditions was a project which aimed to improve the quality and quantity of meat and milk yields of domestic goat breeds of Anatolia since 2015. The genetic improvement study of indigenous Hair goats was started in 2015 and ended in 2020, using 5985 does and 252 bucks, with the participation of 60 local volunteer farmers in the rural farming system of Eastern Anatolia of Türkiye. At the end of the study, it was found that the birth rate, twinning rate, prolificacy, litter size, and survival rate varied between, 81.88 to 98.18%, 5.26 to 13.54%, 103.00 to 111.00%, 1.11 to 1.27 and 92.67% to 99.06%, by years respectively. As a result of the breeding study, it was determined that the birth weight, weaning weight, and daily body weight gain of the offspring were increased from 2.60 to 3.07 kg, from 8.21 to 10.77 kg, and from 107.74 to 149.15 g, respectively. It was determined that the growth characteristics of kids differed significantly over the years (P &lt; 0.001). As a result of this study, it was determined that production based on local gene resources with improved genetic capacity in rural areas is important for sustainability. Simple recording schemes for the objective assessment of performance traits and planned mating schemes will help enhance animals’ production performances in traditional farming systems.

[Artículo traducido] Aparición temprana de líneas radiolúcidas alrededor de la artroplastia total de rodilla en pacientes con artritis reumatoide. ¿Cuál es su impacto en la tasa de fracaso aséptico y los resultados funcionales a los 13 años de seguimiento?

IntroductionAseptic total knee arthroplasty (TKA) failure has been associated with radiolucent lines. This study aimed to determine the impact of the early appearance of radiolucent lines (linear images of 1, 2, or > 2mm at the cement–bone interface) around the TKA on prosthetic survival and functional outcomes in rheumatoid arthritis (RA) patients during a 2–20 years follow-up. MethodsWe retrospectively analyzed a consecutive series of RA patients treated with TKA between 2000 and 2011. We comparatively analyzed patients with and without radiolucent lines around implants. Clinical outcomes were assessed with the knee society score (KSS) collected before surgery, at years 2, 5, and 10, and at the last postoperative follow-up. The knee society roentgenographic evaluation system was used to analyze the impact of radiolucent lines around the implants at 1, 2, 5, and more than ten years of follow-up. The reoperation and prosthetic survival rates were calculated at the end of the follow-up. ResultsThe study series included 72 TKAs with a median follow-up of 13.2 years (range: 4.0–21.0), of which 16 (22.2%) had radiolucent lines. We did not observe aseptic failure, and prosthetic survival at the end of the study was 94.4% (n=68). The KSS improved significantly (p<0.001) between preoperative values at 2, 5, and 10 years and the end of follow-up, with no differences between patients with and without radiolucent lines. ConclusionsOur study demonstrates that the early appearance of radiolucent lines around a TKA in RA patients does not significantly impact prosthetic survival or long-term functional outcomes at 13 years of follow-up.

Evaluating the suppression of Hydrilla verticillata by manual removal and planting natives for small-scale restoration efforts in a spring-fed river

Hydrilla (Hydrilla verticillata) is an invasive aquatic macrophyte found on every continent except Antarctica. Due to the high number of federally listed species in the San Marcos River, Texas, management options for hydrilla are limited. We examined the ability of the two native macrophytes to suppress hydrilla in plots where 0 to 100% hydrilla was removed. In plots where 100% hydrilla was removed, Texas wild rice exhibited equal or greater coverage to hydrilla. Hydrilla was present in 100% of the plots at the end of the study, regardless of percent removal, while Texas wild rice (Zizania texana) and water stargrass (Heteranthera dubia) were present in 50 and 42% of the plots, respectively. While the overall survival percentage in plots was 50% for Texas wild rice, the mean root and shoot dry weights were significantly greater than hydrilla which occurred in all plots. However, hydrilla coverage was among the highest in plots where 100% of the hydrilla was removed at the start of the study, indicating its ability to quickly invade disturbed sites. The study results indicate morphological differences with hydrilla allocating greater biomass into its shoots while Texas wild rice allocates equal amounts of biomass into its shoots and roots.

The effect of telerehabilitation on clinical stress levels experienced by nursing students during their first clinical experience

AimTo investigate the effect of telerehabilitation on stress levels experienced by nursing students during their first clinical experience. BackroundFor nursing students, the first clinical experience can cause stress and anxiety. As a result, nursing students may lose motivation and desire to learn. Telerehabilitation is used for many conditions, including mental health conditions. MethodSeventy-four nursing students, aged 18-24 years, who volunteered to participate in the study and who were having their first clinical experience, participated in the study. The participants were randomly divided into two groups, the exercise group (n=37) and the control group (n=37). The experimental group received a total of 16 sessions of progressive muscle relaxation exercises with telerehabilitation four times a week for four weeks. The control group received no treatment. ResultsThere was no statistically significant difference in the mean PSSNS scores of the students in the experimental group after the tele-rehabilitation application, but there was a decrease in the mean score levels compared to the experimental group (p>0.05). At the end of the study, the BRSNS mean scores of the exercise group decreased statistically significantly compared to the control group (p<0.05). ConclusionIt was observed that telerehabilitation practice may have a positive effect on clinical stress levels and stress responses of nursing students during their first clinical experience.

Methods of obtaining activated adsorbents based on gossypol tar and local bentonites and analysis of their physical parameters

This article provides information on the methods of obtaining activated adsorbents based on oil-oil waste gossypol tar and local benonites and their various physical properties. In addition, the effect of temperature change on the yield of activated adsorbents from gossypol resin was analyzed. As a result, when Logon bentonite is modified with activated gossypol resin, the hydrophilic properties decrease and the hydrophobic properties increase. Compared to coke obtained from gossypol, it was known that the density of adsorbents obtained as a result of its modification with local bentonite increases. At the end of the study, it was concluded that by adding bentonite as a binder to gossypol resin, its strength increases several times.

A phase 4 multicentre, 2×2 factorial randomised, double-blind, placebo-controlled trial to investigate the efficacy and safety of tobramycin inhalation solution for Pseudomonas aeruginosa eradication in bronchiectasis: ERASE.

Chronic Pseudomonas aeruginosa (PA) infection significantly contributes to morbidity and mortality in bronchiectasis patients. Initiating antibiotics early may lead to the eradication of PA. Here we outline the design of a trial (ERASE; NCT06093191) assessing the efficacy and safety of inhaled tobramycin, alone or with oral ciprofloxacin, in bronchiectasis patients with a new isolation of PA. This multicentre, 2×2 factorial randomised, double-blind, placebo-controlled, parallel-group trial includes a 2-week screening period, a 12-week treatment phase (with a combination of ciprofloxacin or a placebo at initial 2 weeks) and a 24-week follow-up. 364 adults with bronchiectasis and a new PA isolation will be randomly assigned to one of four groups: placebo (inhaled saline and ciprofloxacin placebo twice daily), ciprofloxacin alone (750 mg ciprofloxacin and inhaled saline twice daily), inhaled tobramycin alone (inhaled 300 mg tobramycin and ciprofloxacin placebo twice daily) or a combination of both drugs (inhaled 300 mg tobramycin and 750 mg ciprofloxacin twice daily). The primary objective of this study is to assess the proportion of patients successfully eradicating PA in each group by the end of the study. Efficacy will be evaluated based on the eradication rate of PA at other time points (12, 24 and 36 weeks), the occurrence of exacerbations and hospitalisations, time to first pulmonary exacerbations, patient-reported outcomes, symptom measures, pulmonary function tests and the cost of hospitalisations. To date no randomised trial has evaluated the benefit of different PA eradication strategies in bronchiectasis patients. The ERASE trial will therefore generate crucial data to inform future clinical guidelines.

Postbariatric hypoglycemia, abdominal pain and gastrointestinal symptoms after Roux-en-Y gastric bypass explored by continuous glucose monitoring.

BackgroundAbdominal pain and postbariatric hypoglycemia (PBH) are common after bariatric surgery. ObjectivesThis study aimed to explore the potential relationship between abdominal pain, gastrointestinal symptoms, and PBH more than a decade after Roux-en-Y gastric bypass (RYGB) and whether continuous glucose monitoring (CGM) with dietary intervention has an educational role in reducing symptoms. SubjectsAt two public hospitals in Norway (one University Hospital) 22 of 46 invited patients who reported abdominal pain more than weekly took part. Recruited from a prospective follow-up study of 546 patients 14.5 years after RYGB. MethodsThey used a CGM for two 14-day periods, with a dietary intervention between periods. The Gastrointestinal Symptom Rating Scale (GSRS) and the Dumping Severity Score (DSS) questionnaires were completed at the start and end of the study. ResultsThe 22 women had preoperative age 39.6 ± 7.7 years and body mass index (BMI) 42.0 ± 4.0 kg/m2, present age 54.6 ± 7.7 years and BMI 29.8 ± 4.8 kg/m2. The total GSRS score and DSS of early dumping decreased after the diet intervention. The number of events with Level 1 (<3.9 mmol/L) or Level 2 (<3.0 mmol/L) hypoglycemia did not change in the second period. Half of the patients had fewer, three had unchanged, and eight had more frequent events with Level 1 hypoglycemia after the intervention. Ten patients had Level 2 hypoglycemia. ConclusionThough inconclusive findings, a personalized dietary intervention reduces GSRS. This intervention was accompanied by lower mean absolute glucose in patients with recurrent abdominal pain after bariatric surgery. However, further studies are needed to explore the benefits of CGM in this setting.

Development of endurance in physical education lessons with the use of outdoor games

Background: Endurance is of great importance for the growth and development of the body of schoolchildren, and is also the foundation for the development of other physical qualities. The low level of endurance of modern schoolchildren requires the search for new ways to improve the system of physical education.&#x0D; The aim of the study: To increase the level of endurance development in schoolchildren using outdoor games in physical education classes at school.&#x0D; Study design: Pedagogical experiment.&#x0D; Research methods: The research was carried out on the basis of secondary school number 30 in the city of Kirov, Russian Federation. The experiment was attended by 3rd grade students aged 9-10 years. The study took place from September 6 to December 26, 2022 during physical education lessons 2 times a week for 45 minutes each lesson. In total, 2 groups of 25 people were formed. Classes in the control group were conducted according to the standard program, and in the experimental group, outdoor games were additionally conducted at each lesson for 6-7 minutes. Tests that were used to determine endurance: flexion and extension of the arms while lying on the floor, running 30 meters, Vis bent arms, lifting the trunk from the supine position, running 1000 m.&#x0D; Results: After the end of the pedagogical experiment, the indicators of school children in both groups became higher. In the control group, the indicators were reliable only in the test for flexion and extension of the arms while lying on the floor. In the experimental group, by the end of the study, the results in all 5 tests showed a significant and reliable result. Flexion and extension of the arms in the prone position from 15,6±0,76 to 19,7±0,76 (p&lt; 0.05); Running 30 meters from 6,25±0,08 to 5,99±0,08 (p&lt; 0.05); Vis bent arms from 21,90±0,97 to 27,10±0,97 (p&lt; 0.05); Lifting the trunk from the supine position from 22,40±0,87 to 28,10±0,76 (p&lt; 0.05); running 1000 m from 337,7±8,01 to 311,9±3,9 (p&lt; 0.05).&#x0D; Conclusion: If outdoor games are used in physical education lessons at school when working with children 9-10 years old, then the indicators of different types of endurance will significantly improve.&#x0D; Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 254-261