Trial Period Research Articles

A randomized, double-blind clinical trial of poly-herbal traditional decoction for the management of type 2 diabetes in comparison with standard Western treatments

Abstract Introduction: Type 2 diabetes mellitus (T2DM) known as Mathumegam is a significant health concern in the twenty-first century. Despite great advances in contemporary science, there is a lack of moderately safe and effective drugs for treatment. The purpose of this study was to evaluate the efficacy of a poly herbal traditional decoction containing 10 herbs such as Senna auriculata (root & bark), Cissampelos pareira (root), Ficus racemosa (bark), Terminalia arjuna (bark), Acacia arabica (bark), Syzygium cumini (bark), Curcuma longa (rhizome), Terminalia chebula (fruit pulp), Phyllanthus emblica (dry fruit), and Terminalia bellirica (fruit pulp) in the management of T2DM. Materials and Methods: It was a double-blind, randomized controlled trial involving 100 T2DM patients who were not well managed by diet or exercise. For a period of 12 weeks, 50 patients in group A were administered 5g of the test medication mixed with 100ml (one tumbler) of hot water for 10 to 15 min, as well as standard Western therapy. Group B patients (n=50) received a placebo in addition to normal Western therapy. The main focus of the study was to achieve a 3-month decrease in glycosylated hemoglobin (HbA1c) levels from the starting point, with additional objectives including lowering fasting blood glucose (FBG) levels and observing changes in diabetic symptoms. Results: At the end of the trial, mean fasting blood glucose levels decreased to 119.04 ± 11.52 and 176.90 ± 13.91 mg/dL in the test and control groups, respectively. Group A showed a more significant decrease in mean fasting blood glucose levels compared to group B. This indicates that the daily use of poly herbal traditional decoction along with standard allopathic medical therapy for 3 months led to notable reductions in FBG levels. Similarly, group A showed greater improvement in the measured signs and symptoms of diabetes, such as polydipsia, polyuria, polyphagia, weariness, and burning sensation in the hands and feet compared to group B throughout the trial. At baseline, the mean HbA1c (%) in group A and group B was 7.47 ± 0.70 and 7.39 ± 0.66, respectively. After 12 weeks of investigation, the levels of glycated hemoglobin were lowered to 5.03 ± 0.53 and 6.79 ± 0.51 respectively. There were no adverse events reported during the trial period. Conclusion: This study found that the experimental medication was beneficial in T2DM, radically lowering FBG and HbA1c levels in diabetic individuals after 12 weeks of treatment.

The regulatory mechanism of garlic skin improving the growth performance of fattening sheep through metabolism and immunity.

Garlic skin (GAS) has been proven to improve the growth performance of fattening sheep. However, the mechanism by which GAS affects fattening sheep is not yet clear. The aim of this study is to investigate the effects of adding GAS to feed on the growth performance, rumen and fecal microbiota, serum and urine metabolism, and transcriptomics of rumen epithelial cells in fattening sheep. GAS with 80 g/kg dry matter (DM) was added to the diet of fattening sheep to study the effects of GAS on gut microbiota, serum and urine metabolism, and transcriptome of rumen epithelial tissue in fattening sheep. Twelve Hu sheep (body weights; BW, 23.0 ± 2.3 kg and ages 120 ± 3.5 d) were randomly divided into two groups. The CON group was the basal diet, while the GAS group was supplemented with GAS in the basal diet. The trial period was 10 weeks, with the first 2 weeks being the pre-trial period. The daily average weight gain of fattening sheep in the GAS group was significantly higher than that in the CON group (p < 0.05), and the serum GSH-Px of the GAS group fattening sheep was significantly increased, while MDA was significantly reduced (p < 0.05). Based on the genus classification level, the addition of garlic peel in the diet changed the intestinal microbial composition, and the relative abundance was significantly upregulated by Metanobrevibater (p < 0.05), while significantly downregulated by Akkermansia, Parasutterella, and Guggenheimella (p < 0.05). Metabolomics analysis found that there were 166 significantly different metabolites in serum and 68 significantly different metabolites in urine between the GAS and CON groups (p < 0.05). GAS had an impact on amino acid metabolism, pyrimidine metabolism, methane metabolism, riboflavin metabolism, and unsaturated fatty acid synthesis pathways (p < 0.05). Transcriptome sequencing showed that differentially expressed genes were mainly enriched in immune regulatory function, improving the health of fattening sheep. Adding GAS can improve the energy metabolism and immune function of fattening sheep by altering gut microbiota, metabolome, and transcriptome, thereby improving the growth performance of fattening sheep.

Neonatal Outcomes in Pregnant Women Complicated with Immune Thrombocytopenic Purpura

Background: Maternal antibodies that interact with both maternal and fetal platelets cause autoimmune thrombocytopenia. This happens in autoimmune diseases of the mother, such as immune thrombocytopenia purpura (ITP). Objective: The aim of the study was to evaluate the treatment and prognosis of newborns whose mothers had ITP. Methods: A multi center prospective study was carried out at the Duhok Obstetrics and Gynaecology Teaching Hospital and Kurdistan Private Hospital in Iraqi Kurdistan between November 2016 and November 2022. The requirements for inclusion were all expectant mothers with verified ITP diagnoses. Every newborn was monitored in the neonatal intensive care unit and had their thrombocytopenia assessed on their first day of life. Maternal age, parity, diagnosis time, history of previous splenectomy, platelet count at delivery and in the early stages of pregnancy, propensity for bleeding throughout pregnancy, treatment for ITP, and method of delivery based on obstetric circumstances were all noted. the baby's gender, gestational age at delivery, the neonatal platelet count at birth, haemorrhage, and thrombocytopenia therapy. Nominal variable statistics were expressed. Results: 25 neonates delivered by pregnant mothers with ITP during the trial period were all included in the analysis. The ITP patients' mothers were between 23 and 33 years old. There were 14 (56%) multigravida cases and 11 (44%) primigravida cases. Prior to three years of pregnancy, just one (4%) instance had a history of splenectomy. The mother's platelet count at delivery was less than 50 × 109/L in 7 (28%) cases. Thirteen (52%), utilised corticosteroids. Ten (40%) of the deliveries were caesarean sections. Two (8%) cases had gestational ages between 33 and 36.6 weeks, whereas 23 (92% of cases) had gestational ages between 37 and 38 weeks. In 12 (48%) cases, the birth weight ranged from 1200 to 2500 kg, whereas in the other cases, it was between 250 and 3300) kg in 13(52%) cases the new-born baby's gender was male. Twelve (48%) of the newborns had thrombocytopenia. Just three cases (about 25%) needed medical attention. Conclusion: Pregnancy counselling is necessary for a woman with a history of ITP in order to maximise her platelet count. While serious bleeding is uncommon in neonates with maternal ITP. Corticosteroids are an effective therapeutic option for both the mother and the new-born

Mama Gabrieli, the Contemporary Confessor of Georgia

Saint Gabriel the Holy Fool or the fool for Christ sake is a contemporary saint and wonderworker about whom generations to come will testify his miracles. He was born near Tblisi in a troublesome period of atheistic denial and great trial for the Georgian people. Like all the great holy fools for Christ, all his lifetime was despised, considered crazy, abnormal, judged by people and even by his own members of family, but he never ceased to confess his steadfast belief in the only one and true God.

Effect of probiotics supplementation on giblet and dressing percentage in caged broilers

The present investigation was conducted to evaluate the effects of probiotics supplementation on giblet weight and dressing percentage of caged broilers. A total of 96, day-old chicks were randomly divided into four groups (T0, T1, T2, and T3) with 8 replicates i.e., 24 chicks in each group. The control (untreated) group was fed the basal diet, T1 was supplemented with Bacillus coagulans @40ppm along with basal diet, T2 was given Bacillus subtilis @50ppm mixed in basal diet whereas T3 was given basal diet + Bacillus licheniformis &amp; Bacillus coagulans @20ppm. After 35 days of the trial period, weighing of the giblet and dressing percentage of four at random selected birds from each group were calculated. The mean value of liver weight recorded T0-46.420g, T1- 42.352g, T2-45.275g, and T3-40.521g, respectively. However, the analysis revealed that the variations in these values were not statistically significant. The mean value of Heart weight recorded was T0-14.445g, T1- 9.557g, T2-10.999g, and T3-12.940g, respectively. However, the investigation unveiled that the discrepancies in these values exhibited statistical significance (P&lt;0.05). The mean value of Gizzard weight recorded was T0-24.017g, T1-25.327g, T2-28.088g, and T3-31.040g, respectively. However, the analysis revealed that the variations in these values were not statistically significant. The mean value of dressing percentage weight recorded was T0-58.38 %, T1-57.57 %, T2-58.64 %, and T3-59.06 % respectively which were not statistically significant.

A Pilot Test of Olive Weevil Repellents in an Olive Orchard

Recently, feeding damage by the olive weevil Pimelocerus (Dyscerus) perforatus Roelofs, which utilizes olive trees (Olea europaea Linne) as a host plant, has become the biggest obstacle to olive cultivation in Japan. We previously identified several volatile plant-derived natural products that exhibit repellent activity against olive weevils. In this study, we conducted a pilot test of repellents in an olive orchard along with the use of insecticide. During three consecutive years from 2021 to 2023, the first year was the observation period, and the second and third years were set aside for a trial period for o-vanillin and geraniol as repellents, respectively. Using o-vanillin, the number of adult olive weevil outbreaks decreased to almost half a year in the experimental area, the use of geraniol then resulted in a drastic reduction of the number of individual olive weevils in the experimental area. In contrast, adults and larvae outbreaks increased in the control area without a repellent, despite the use of insecticide. These results indicate that the volatile repellents drove the olive weevils away and kept them at bay in the field. Based on the observations, we will be able to provide a new approach for the control of olive cultivation, including fruit and leaves used for commercial purposes, following integrated pest management (IPM) practices, such as reducing environmental poisoning from intense insecticides, and returning olive weevils to their original habitat outside of olive orchards.

Silk-derived sericin/fibroin mixture drink fermented with plant-derived Lactococcus lactis BM32-1 improves constipation and related microbiota: a randomized, double-blind, and placebo-controlled clinical trial.

We previously showed through clinical trials that one plant-derived lactic acid bacteria (LAB) can improve constipation. We preliminarily found that the plant-derived LAB Lactococcus lactis BM32-1 can grow in a mixture of sericin and fibroin, which are extracted from silk and have been reported to help promote health. Thus, in the present study, we evaluated the favorable effect of a sericin/fibroin mixture (S/F-M), which was extracted from silk prepared from cocoons reared in an aseptic rearing system using an artificial diet, fermented with the BM32-1 strain through a clinical trial. The trial was conducted at Hiroshima University from June to October 2022 as a double-blind, placebo-controlled, randomized parallel-group comparative study with 50 eligible subjects (aged 23-71) who had an average defecation frequency of less than 5 times per week. The subjects were instructed to drink 100 mL of fermented S/F-M or placebo every day. After the 12 weeks of the clinical trial period, the average defecation frequency increased significantly-1.4 times higher than that at baseline in the test group-as compared with the placebo group. Furthermore, the fecal microbiota was also compared before and after treatment, revealing that intake of the fermented S/F-M significantly multiplied the relative abundance of the genera Enterococcus and Clostridium, which have been reported to contribute to the amelioration of constipation by improving the gut microbiota and producing butyric acid, respectively. In conclusion, the S/F-M fermented using the BM32-1 strain improves defecation frequency through alteration of the gut microbiota.

A double ovulation protocol for Xenopus laevis produces doubled fertilisation yield and moderately transiently elevated corticosterone levels without loss of egg quality.

The African claw-toed frog, Xenopus laevis, is a well-established laboratory model for the biology of vertebrate oogenesis, fertilisation, and development at embryonic, larval, and metamorphic stages. For ovulation, X. laevis females are usually injected with chorionic gonadotropin, whereupon they lay typically hundreds to thousands of eggs in a day. After being rested for a minimum of three months, animals are re-used. The literature suggests that adult females can lay much larger numbers of eggs in a short period. Here, we compared the standard "single ovulation" protocol with a "double ovulation" protocol, in which females were ovulated, then re-ovulated after seven days and then rested for three months before re-use. We quantified egg number, fertilisation rate (development to cleavage stage), and corticosterone secretion rate as a measure of stress response for the two protocol groups over seven 3-month cycles. We found no differences in egg number-per-ovulation or egg quality between the groups and no long-term changes in any measures over the 21-month trial period. Corticosterone secretion was elevated by ovulation, similarly for the single ovulation as for the first ovulation in the double-ovulation protocol, but more highly for the second ovulation (to a level comparable to that seen following shipment) in the latter. However, both groups exhibited the same baseline secretion rates by the time of the subsequent cycle. Double ovulation is thus transiently more stressful/demanding than single ovulation but within the levels routinely experienced by laboratory X. laevis. Noting that "stress hormone" corticosterone/cortisol secretion is linked to physiological processes, such as ovulation, that are not necessarily harmful to the individual, we suggest that the benefits of a doubling in egg yield-per-cycle per animal without loss of egg quality or signs of acute or long-term harm may outweigh the relatively modest and transient corticosterone elevation we observed. The double ovulation protocol therefore represents a potential new standard practice for promoting the "3Rs" (animal use reduction, refinement and replacement) mission for Xenopus research.

Cladribine tablets after treatment with natalizumab (CLADRINA) - rationale and design.

Individual disease modifying therapies approved for multiple sclerosis (MS) have limited effectiveness and potentially serious side effects, especially when administered over long periods. Sequential combination therapy is a plausible alternative approach. Natalizumab is a monoclonal therapeutic antibody that reduces leukocyte access to the central nervous system that is associated with an increased risk of progressive multifocal leukoencephalopathy and disease reactivation after its discontinuation. Cladribine tablets act as a synthetic adenosine analog, disrupting DNA synthesis and repair, thereby reducing the number of lymphocytes. The generation of prospective, rigorous safety, and efficacy data in transitioning from natalizumab to cladribine is an unmet clinical need. To test the feasibility of transitioning patients with relapsing forms of MS natalizumab to cladribine tablets. Cladribine tablets after treatment with natalizumab (CLADRINA) is an open-label, single-arm, multicenter, collaborative phase IV, research study that will generate hypothesis regarding the safety, efficacy, and immunological impact of transition from natalizumab to cladribine tablets in patients with relapsing forms of MS. Participants will be recruited from three different sites. The primary endpoint is the absolute and percent change from baseline of lymphocytes and myeloid cell subsets, as well as blood neurofilament light levels. The secondary endpoint is the annualized relapse rate over the 12- and 24-month trial periods. Exploratory endpoints include the expanded disability status scale, and magnetic resonance imaging outcomes. The CLADRINA trial will generate data regarding the safety, efficacy, and immunological impact of the transition from natalizumab to cladribine. As the pace of immunological knowledge of MS continues, insight into disease modifying therapy transition strategies is needed.

A pilot project for energy retrofit of educational buildings - The engineering campus of the University of L’Aquila

The engineering campus of the University of L’Aquila represents a complex use case in the context of energy efficiency, mainly due to its size, the high thermal power, the hybrid hydronic and ventilation system, the absence of a room’s thermal control, and the progressive obsolescence of the heating plant. An in-depth recognition and study of the campus’ HVAC system made it possible to assess the main energy inefficiencies and define interventions to improve its performance. The energy retrofit, carried out by the University’s “Energy Commission Workgroup”, highlighted the main criticalities and potentials of the HVAC system providing viable paths for energy optimization. Among them, one of the hypothesized interventions concerned the thermal regulation of the heating plant, which is, to date, substantially absent. This work presents the results of a Pilot Project to quantitatively evaluate the effectiveness of the closed-loop control on a thermal system. Two classrooms in the Engineering Campus, similar in geometry, orientation, and occupancy, were selected. One of them has been equipped with a control system. The results of the monitoring campaign showed that the proposed system achieved more than 30% energy savings over a three-month trial period.

Getting around with the trial period regime

A Lei n.o 93/2019, de 4 de setembro, subtraiu ao elenco de motivos justificativos subjacentes à contratação a termo certo os trabalhadores à procura de primeiro emprego e os desempregados de longa duração. O impulso legislativo assentou no desiderato de promover a contratação sem termo das referidas categorias de trabalhadores o que implicou a ampliação do período experimental para 180 dias. A medida, desde logo, gerou um profícuo debate doutrinário e conduziu à intervenção do TC, em sede de fiscalização sucessiva abstrata da constitucionalidade. Pese embora o TC tenha declarado a inconstitucionalidade parcial da norma relativa à ampliação do período experimental, a decisão não foi isenta de críticas. Por sua vez, na sequência da decisão do douto Tribunal, o legislador lançou mão de uma solução que não só vai além do postulado pelo TC, como contraria a primitiva intenção subjacente ao alargamento do período experimental, tendente a diminuir a resistência das entidades empregadoras em celebrarem contratos de trabalho sem termo. Ora, por nos parecer que se justifica um conjunto de considerações a tecer a respeito, o presente artigo tem por objeto, por um lado, a dissecção dos aspetos gerais do período experimental e, por outro, a análise, em moldes reflexivos, das temáticas mais específicas do regime que geram questões controvertidas.

The effects of a mixture of small peptide chelating minerals and inorganic minerals on the production performance and tissue deposition of broiler chickens.

Due to the limited bioavailability of inorganic trace minerals, their utilization in poultry production has led to problems such as environmental contamination and inefficient resource utilization. It was investigated whether replacing inorganic trace minerals (ITM) with a blend of organic small peptide-chelated trace minerals (MIX) would improve production performance, selected biochemical parameters, antioxidant capacity, mineral deposition in liver, heart, and tibia, as well as mineral content in feces of broilers. A total of 432 healthy 21-day-old 817 broilers were randomly divided into 4 groups with 6 replicates per group and 18 chickens per replicate. The control group received a basal diet supplemented with 1,000 mg/kg of inorganic trace minerals as sulfate. The experimental groups received basal diets supplemented with 200, 400, and 600 mg/kg of mixed trace mineral elements (50% sulfate +50% small peptide-chelate) for a trial period of 30 days, divided into two stages: 21-35 days and 36-50 days. The results indicate that on the 50th day, compared with the 1,000 mg/kg ITM group, the levels of serum cholesterol, urea nitrogen, and malondialdehyde in the 200, 400, and 600 mg/kg MIX groups decreased (p < 0.01), while the levels of serum glutathione peroxidase in the 200, 400, and 600 mg/kg MIX groups increased (p < 0.05). Compared to the ITM group, the addition of organic small peptide chelated trace minerals mixed with inorganic trace minerals can reduce the levels of zinc and manganese in feces (p < 0.01). Furthermore, the iron content in the heart and tibia of the 600 mg/kg MIX group also significantly decreased (p < 0.05). There were no differences in growth performance and slaughter performance among the groups (p > 0.05). This study shows that replacing inorganic minerals with low-dose MIX (200, 400, and 600 mg/kg) can reduce the levels of zinc and manganese in feces, with no negative impact on growth and slaughter performance.

Combatting Malaysia's Dengue Outbreaks with Auto-Dissemination Mosquito Traps: A Hybrid Stochastic-Deterministic SIR Model

Classical mosquito control methods (e.g. chemical fogging) struggle to sustain long-term reductions in mosquito populations to combat vector-borne diseases like dengue. The Mosquito Home System (MHS) is an auto-dissemination mosquito trap, that kills mosquito larvae before they hatch into adult mosquitoes. A novel hybrid stochastic-deterministic model is presented, that successfully predicts the effect of deploying MHSs within high-rise flats in Selangor, Malaysia. Stochastic SIR (Susceptible-Infected-Recovered) equations (flats) are paired with an existing deterministic SIR model (wider Kuala Lumpur population). Model predictions provide excellent agreement with data from a 44 week MHS trial within the flats. The stochastic model is validated as a powerful tool for predicting short- and long-term impacts of deploying this style of trap within similar environments. Significant, sustainable reductions in mosquito populations are predicted when the MHS is active: with a mean of 9 (95% Uncertainty Range (UR): 1; 30) during the 44 week trial period, compared to 35 (95% UR: 1; 234) dengue cases with no MHSs. Long-term predictions for endemic equilibrium show MHSs significantly narrow the mosquito population distribution and reduce dengue prevalence: from a mean of 5 (95% UR: 0; 52) (no MHS), to 1 (95% UR: 0; 8) dengue cases annually (with MHS).

Tensile Property of Carbon Reinforced Epoxy Composites for Different Directions

Due to higher chemical stability, higher strength/stiffness, lower density, and good corrosion resistance, carbon fiber-reinforced polymeric composites (CFRPs) have been increased numbers of areas such as aircraft industry, automotive industry, ship making and packing industry, turbines, compressors, wind blades besides implant applications. Epoxy based composites are developed using carbon fiber reinforcements by vacuum controlled resin transfer (VARTM) molding method by Twill carbon fiber [K3T] with 200 gr and Plain carbon fiber [K3P] with 200 gr. Composite plates are produced in the dimension of 500 mm x 500 mm with 0.8 mm thickness. According to the ASTM D3039, standard test samples are cut with CNC machine. Tensile tests are conducted at three different fiber directions like 00-450- 90o, respectively. Their mechanical properties are determined. Experimental results indicated that fiber direction significantly affected the tensile behavior of tested samples. Average tensile strength of CFRPs was obtained around 470 MPa for 0 degree to x-axis, and testing lasted about 44 s. For 90o direction, tensile strength of carbon fiber composites reached to 520 MPa, which is slightly higher than the previous one while trial period was around 50 s. For 45o tested samples, a completely different behavior was observed because stress-strain curve showed the elastic-plastic behavior. Its tensile strength measured was about 120 MPa average value while the trial lasted about 145 s.

Культ святых и генерирование этнической идентичности казахов в Северо-Казахстанской области

Introduction. The formation and maintenance of Kazakh identity in the northern regions of Kazakhstan was largely associated with the specificity of historical, cultural, linguistic resources, and the religious factor played an important role therein. The shaping of ‘Kazakhness’ in the pre-Soviet period was based not only on the self-image as free nomads and language community but also on belonging to the world of Islam. Such local resources of the Kazakh ethnic identity comprise the cult of holy warriors and seers — batyr, auwliye and zhyrau, i.e. true historical heroes from the period of fierce struggle for the region throughout the seventeenth–eighteenth centuries. Goals. The study attempts an insight into the specifics of the saints’ cult among Kazakhs of Northern Kazakhstan. Real supporters of Khan Abylai and active participants of steppe wars — batyrs Kozhabergen, Kulsary and Kuleke — were included in the pantheon of saints across the designated region. Materials and methods. The work examines a wide range of sources, both published archival documents and pre-revolutionary statistical collections, as well as ethnographic material collected by the authors in the form of family trees (shezhire) and ethno-genealogical legends about the deeds of cultural heroes. The documents introduced into scientific turnover have made it possible to verify the relevance of data articulated by oral shezhire narratives and legends, which together constitute a valuable layer of sources yielding insights into the mentality and spiritual world of nomads. Results. The ethnic history of the northern Kazakh clans and tribes and the emergence of the local cult of holy warriors show a close connection between lifestyle and religious factor for the reproduction of ethnic identity. Under the conditions of constant hostilities and distrust toward alien neighbors across northern steppes, those were Genghisids — famous warlords/batyrs and charismatic leaders of mighty tribes — that became objects of veneration, rather than Muslim righteous men or descendants of the Kozha clan. The informal alliance of Genghisids and batyrhood did facilitate the preservation of “Kazakhness’ during the period of heavy defeats and severe trials in the sixteenth–eighteenth centuries. The lives of heroes served as examples to all Kazakhs regardless of tribal affiliation and as models of ideal behavior. Later, descendants would endow their ancestors with the traits of Muslim saints and pass on narratives claiming their gifts of soothsaying and healing from generation to generation. Being a local Muslim variant of saints’ worship practices which incorporated elements of pre-Islamic beliefs, the cult of the northern batyr-auwliye performed an important integrative function and contributed to the deep ethnicization of clan/tribal roots among local Kazakhs.

Hearing Care, as part of basic care in a senior home.

Background: World wide, 1 in 6 people is hearing impaired. Age-related hearing loss is the most frequent cause. The number of deaf and hearing impaired persons increases as the population is getting older.&#x0D; Unfortunately, the impact on quality of life is underestimated. &#x0D; Hearing is an important part of communication. Several studies of the World Health Organization show the consequences of bad hearing s.a. isolation, frustration, loneliness and even acceleration of the dementia process. A hearing disability is invisible and problems are often not recognized.&#x0D; A great part of the elderly people lives in a senior home. The prevalence of hearing problems there is estimated around 80% as average age is about 87 years. The ringing of the telephone, a knock on the door, the radio, the television, the alarm signals are difficult to hear. This absence of familiar sounds produces a feeling of confusion and anxiety instead of safety and recognition. Communication is often done ‘on the job’ ignoring some special needs of the hearing impaired. Facemasks may make things even more difficult. The elderly hearing impaired, their family and caretakers have often little or no knowledge about the risks of untreated hearing loss, about innovative technologies in hearing aids and other hearing devices and about some interactional adaptations to improve their quality of life.&#x0D; Aim: Installing high-quality hearing care in senior homes in order to stimulate the inclusion and participation of hearing impaired elderly.&#x0D; Method: A team of AHOSA vzw, a Flemish interest group for persons with a hearing loss who communicate in spoken language, developed a project to put into the spotlight the importance of hearing care in senior homes.&#x0D; Basic relevant information is given to all the persons who are involved in the care process, but also to the residents themselves and to their family. &#x0D; Physical and digital workshops include a theoretical approach as well as practical information s.a. how wearing a hearing aid, changing a battery, seeing that the person didn’t understand the message… Tips and tricks are given to improve communication.&#x0D; The workshops use tools such as a PowerPointpresentation, an instruction film and leaflets.&#x0D; We started with a pilot study: a partnership between the association AHOSA VZW and the Senior Home Sint-Jozef, Assenede Belgium, with support of the Artevelde Highschool Ghent.&#x0D; During this trial period, the workshops and tools are adjusted by means of feedback of all participants, and the effects are measured by pre- and post questionnaires.&#x0D; Result: This participatory process with co-creation leads to a workable model of hearing care for all senior homes in Flanders, and can be a national or an international policy recommendation in a later stage.&#x0D; The scoop can be more durable by also aiming at integration of this model in the education programs of schools and departments that prepare students to work with elderly people.&#x0D; Conclusion: A well-developed Hearing Care model as part of basic care in a senior home leads to better quality of life.&#x0D; &#x0D; &#x0D;

How to achieve delivery of a cardiovascular health intervention in community mental health settings: a process evaluation of Flinders Program using RE-AIM framework

Background, research problem &amp; context: Globally, it is well recorded that adults with severe mental illness (SMI) die 10-20 years earlier than the general population, with cardiovascular disease being recorded as the key contributor to this health inequity. To address this health gap, the Flinders Chronic Condition Self-Management Program (will be referred to as Flinders Programme from here onward) was delivered within an NHMRC-funded randomised controlled trial (RCT) during 2018-2020 among 130 South Australian community-living adults diagnosed with SMI and CVD risk factors. Intervention design: The Flinders Programme is a person-centred care planning approach designed by Flinders University Behavioural Health Unit’s researchers. For this study, the programme aimed to improve the heart health and quality of life of the study participants. Intervention evaluation methods: This study sat alongside the RCT research and employed a longitudinal qualitative methodology underpinned by Roy Bhaskar’s Critical Realism philosophy and ontology. The aim was to understand why, how, and under which contexts the Flinders Program worked (or not). Alongside an outcome evaluation, this study also investigated how the Flinders Programme was delivered. Reach (R), Effectiveness/Efficacy (E), Adoption (A), Implementation/Delivery (I), Maintenance (M) or RE-AIM framework was used to conduct this qualitative process evaluation. Data were collected from 19 trial team members at multiple time points using multiple methods. In total, ten in-depth interviews, two focus group discussions, ten meeting minutes, and five reflective journals were analysed. Data analysis involved a Critical Realist Analysis (CRA) approach. Results &amp; impact: The key findings were organised within the RE-AIM framework: Reach (low recruitment, strategies taken to increase recruitment), Effectiveness (non-specific effects, ‘invisible’ changes such as enhanced awareness, motivation, hope), Adoption (model of care, work atmosphere, the physical structure of the setting), Implementation (preparation, pilot survey, revising study design, actual trial and adaptations, fidelity), Maintenance (self-management capacity, resources, care continuity). Learning for the international audience: This study described the steps taken in delivering the Flinders Programme within a few South Australian metropolitan community mental health settings between the period November 2017 – September 2020. The trial team faced difficulties in fulfilling the recruitment target for the trial. There were a few critical reasons identified- the South Australian community mental health system went through a significant restructuring during the same time, resulting in enormous workload increases in an already resource-scarce sector. Health system-level politics had a direct negative effect on the trial. Besides, improving the cardiovascular health of SMI was not deemed a priority in a system that was struggling to deal with acute mentally ill patients within a crisis-driven system. There was a clear indication that most sites did not have enough clear communication from the trial team before recruitment and throughout the trial period. The next steps: In the future, more preparation, including education sessions among clinicians, are required before delivering such physical health interventions within mental health settings. &#x0D;

Enhancing Dispatch Systems for Out-of-Hospital Cardiac Arrest: A Proposal for Improved Survival Outcomes

Early and effective cardiopulmonary resuscitation (CPR) is critical for survival and neurological recovery in cases of out-of-hospital cardiac arrest (OHCA). This commentary proposes a novel approach involving the use of a CPR instructional video tailored for laypersons. It also recommends a three-phase approach for the implementation of this strategy, including a trial period, agreements with telecom and dispatch system providers, and a public health campaign to raiseawareness and improve compliance with instructions. This proposal aims to enhance the dispatch process for OHCA, ultimately improving survival rates and neurological outcomes.

Holştayn İneklerde Kırmızı Işıkla Gece Aydınlatmasının Melatonin ve Süt Kalite Parametrelerine Etkileri

In this study, it was aimed to investigate the effects of red lighting on blood and milk melatonin levels, and milk quality. The experiment was carried out on 6 lactating Holstein Dairy cows, which were being reared at the Hümeyra Özgen Research and Application Farm, affiliated to Selcuk University Faculty of Veterinary Medicine. After a control period of 15 days in which night lighting was not applied (control group), night lighting was provided by LED bulbs emitting red light with a wavelength of 652 nm during the following 15-day trial period (experimental group). On days 5th, 10th and 15th days of the control and experimental groups, milk and blood samples were taken at the 06:00 am and at 06:00 pm.Serum and milk melatonin concentrations in the morning of the control, on days 5th, 10th and 15th; were 8.64±1.4, 7.02±0.97, 8.71±2.3, and 5.01±0.92, 5.23±0.35 , 3.93±0.81pg/ml, respectively while control evening group were respectively 8.59±1.8,7.53±2.14,8.35±0.94, 6.91±1.73, 6.8±1.27. It was obtained as 3.67±0.97 pg/ml. Serum and milk melatonin levels in the trial morning group were 10.93±2.06, respectively, on the same days; 15.37±2.6; 11.25±1.71 and 2.97±0.64; 5.7±1.06; While it was measured as 3.33±0.73 pg/ml, it was 14.83±3.11 in the trial evening group; 14.5±3.57; 12.95±4.09 and 4.42±0.61; 2.51±0.56; It was obtained as 2.48±0.79 pg/ml.It was observed that serum and milk melatonin levels and milk parameters were not adversely affected in the use of red LED lamps (652 nm) at night for 12h.

A Double-Blind Trial Platform Based on Distributed Ledger Technology

In the pharmaceutical research and development process, the third phase of clinical trials involves double-blind trials to mitigate the influence of human subjective awareness on the experimental results and ensure the efficacy and safety of drugs or vaccines. However, conventional double-blind trials are often overseen by a single institution responsible for the entire trial process. Researchers centrally manage data, introducing risks of data loss and tampering. Furthermore, since researchers have full access to all experimental data, there is a potential for premature unblinding and leakage of results to specific individuals, giving rise to bias and conflicts of interest. To address these problems, this paper proposes a distributed-ledger-based double-blind trial platform called “BlindBox”. This platform leverages the immutability and decentralization of distributed ledgers to enhance the security of experimental data. On the other hand, the platform employs smart contracts to restrict personnel’s access to experimental data, coupled with RFID technology to encode and shuffle the experimental drugs discreetly. This ensures that no one can ascertain the pairing between test subjects and drug groups, preventing collusion and result manipulation. When the trial period concludes, smart contracts automatically unblind the results and publish them on the IOTA platform. By utilizing IOTA’s zero-value transactions, the platform reduces the cost of repeated data access and ensures information openness and transparency. This approach prevents deliberate premature unblinding or insider trading stemming from monopolized information. The platform proposed in this study is expected to enhance the credibility and accuracy of double-blind trials while promoting the willingness and convenience of public participation in experiments.