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Aim: This study aimed to evaluate the effects of uncoated paper on skin moisture, pressure injury risk and pressure injury incidence in neurological intensive care unit patients. Methods: A randomized controlled design was used. The experimental group (n = 68) received usual care (repositioning every 2 h and use of an air mattress) and application of uncoated paper on the sacral area for 5 days, whereas the control group (n = 67) received only usual care. A repeated measures analysis of variance was used to determine changes in the skin moisture and risk of pressure injury between the groups. A chi‐squared test was used to determine the change in the incidence of pressure injuries for sacral area. Data were collected from 20 October 2017 to 6 March 2018. Results: There were statistically significant differences in the skin moisture and risk of pressure injuries between the experimental and control groups. However, a significant difference was not observed in the incidence of pressure injuries between the groups. Conclusion: The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients. SUMMARY STATEMENT: What is already known about this topic? The neurological intensive care unit patients with motor deficits, loss or deterioration of sensory function and decreased consciousness have high risk of pressure injuries.Although various guidelines consider excessive skin moisture as an important cause of pressure injuries, few targeted interventions exist to manage excessive skin moisture. What this paper adds? The uncoated paper application was effective in reducing skin moisture in neurologic intensive care unit patients.In addition, application of uncoated paper application has an effect on risk of pressure injury in neurologic intensive care unit patients. The implications of this paper: The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients.Nurses should recognize that pressure injuries are potentially preventable adverse events and use various preventive interventions including skin moisture management. [ABSTRACT FROM AUTHOR]

• The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. • Improvements on severity of symptoms in both groups suggest that the self-care program using a mobile app or a paper book may be beneficial in individuals with fibromyalgia. • The Sleep Strategies was the most used function of the ProFibro app, followed by the Exercise Program, and the diary for the practice of gratitude. The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale – Revised. No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia. [ABSTRACT FROM AUTHOR]

The recent Typhoid Fever Surveillance in Africa Program demonstrated an overall adjusted incidence of typhoid fever 2–3 times higher than previous estimates in Africa. Recently, a single-dose typhoid conjugate vaccine that allows infants as young as 6 months old to be vaccinated was prequalified by the World Health Organization (WHO). This Vi-based conjugate vaccine demonstrated robust immunogenicity after 1 dose in infants and children 6 through 23 months of age in India with no safety signal, and is currently being tested for the first time on the African continent in Malawi. The WHO Strategic Advisory Group of Experts recommends studies to evaluate co-administering Vi-typhoid conjugate vaccine (Vi-TCV) with routine childhood vaccines in typhoid-endemic countries. The Burkina Faso immunization schedule includes yellow fever vaccine (YFV) at 9 months and meningococcal A conjugate vaccine (MCV-A) at 15 months, in addition to measles-rubella vaccine at both 9 and 15 months. Co-administration testing of Vi-TCV with these routine vaccinations will provide the data needed to support large-scale uptake of Vi-TCV in sub-Saharan Africa. A randomized, controlled, Phase II trial of Vi-TCV co-administration with the vaccinations routinely given at 9 and 15 months of age is planned in Burkina Faso. The overall aim is to assess the safety and immunogenicity of Vi-TCV when co-administered with YFV at 9 months of age and with MCV-A at 15 months of age. A total of 250 participants (100 infants aged 9–11 months and 150 children aged 15–23 months) will be enrolled. Clinical Trials Registration. NCT03614533. [ABSTRACT FROM AUTHOR]

Objective: To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Design: Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. Setting: A community rehabilitation programme within a large metropolitan health service. Subjects: Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Interventions: Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. Main measures: The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. Results: A total of 62 participants were allocated to the intervention (n = 30) and control groups (n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI −12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI −0.1 to 0.1). There were no between-group differences in how participants found instructions (p = 0.452), whether they remembered to do their exercises (p = 0.485), or whether they enjoyed doing their exercises (p = 0.864). Conclusions: The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx [ABSTRACT FROM AUTHOR]

For a geography bachelor course about climate change, we replaced the end-of-course exam with one term paper and three term-paper peer reviews. Our objectives were to design a learning environment where students read continuously throughout the semester, develop their writing skills, become familiar with quality criteria for academic texts, and get trained in applying these. To support students in their term-paper writing and term-paper peer reviews, we arranged two annotated-bibliography exercises as optional learning activities. A t-test demonstrated a statistically significant increase in performance for those who participated in these exercises compared to those who did not. A survey confirmed that students still doubt their own and their peer students' capability to provide authoritative reviews, but qualitative interviews supported the findings that a majority of students found the peer-review process valuable for their reading behaviours and the development of their writing skills. The improvements, however, were mostly related to form (such as structure, grammar, and how to set up a proper reference list) and less related to academic content. [ABSTRACT FROM AUTHOR]

Background: The internet can provide evidence-based patient education to overcome time constraints of busy ambulatory practices. Health informationprescriptions (HIPs) can be effectivelyintegrated into clinic workflow, but compliance to visit health information sites such as Medline Plus is limited.Objective: Compare the efficacy of paper (pHIP)and email (eHIP) links to deliver HIPs; evaluate patient satisfaction with the HIP process and MedlinePlus information; assess reasons for noncompliance to HIPs.Method: Of 948 patients approached at two internal medicine clinics affiliated with an academic medical centre, 592 gave informed consent after meeting the inclusion criteria. In this randomised controlled trial, subjects were randomised to receive pHIP or eHIP for accessing an intermediate website that provided up to five MedlinePlus links for physician-selected HIP conditions. Patients accessing the intermediate website were surveyed by email to assess satisfaction with the health information.Survey non-responders were contacted by telephone to determine the reasons for no response.Results: One hundred and eighty-one patients accessed the website, with significantly more 'filling' eHIP than pHIP (38% vs 23%; P < 0.001). Most(82%) survey respondents found the website information useful, with 77% favouring email for future HIPs delivery. Lack of time, forgot, lost instructions or changed mind were reasons given for not accessing the websites.Conclusions: Delivery of MedlinePlus-based HIPs in clinic is more effective using email prescriptions than paper. Satisfaction with the HIP information was high, but overall response was low and deserves further investigation to improve compliance and related outcomes. [ABSTRACT FROM AUTHOR]

Due to their lack of periodontal ligaments (PLs) and the differences between dental implants and natural teeth, it is necessary to improve and generate a new occlusal scheme to prolong the life of implants and prostheses. The age and the sex of patients must be considered because of their effects on the stomatognathic system's physiology. Operators must manage all the changes to obtain good sensations during mastication and a better occlusal scheme for implanting fixed partial prostheses. Dentists should try to protect this type of prosthesis using adjacent teeth and the PL. This is why new digital systems were created. The combination of T-Scan® (digital software for occlusal analysis) and electromyography (EMG) could allow doctors to find areas where it is necessary to act and to find suitable solutions for the problems generated by using conventional methods of occlusal analysis (such as articulating paper). In this study, a new method for establishing occlusion on fixed partial implant prostheses has been created, combining digital systems with conventional articulating paper. This method consists of asking the patient to bite down with different forces and situations in an attempt to achieve Implant-Protected Occlusion (IPO). The use of digital systems has been shown to be more effective than using only conventional systems. This new method allows a safer mode of occlusion which protects implants and prostheses, saving all the differences between them and natural teeth, and increasing the satisfaction of patients. This method also helps to overcome the changes in the stomatognathic system as age increases, adjusting the occlusion to changes in PLs with age. [ABSTRACT FROM AUTHOR]

The article presents the discussion on assessing the quality of quantitative research with reference to a randomised controlled trial. Topics include entering into the intervention and control arm of the study showing a little chance of selection bias; and reader making an appraisal about the quality of the research methodology and methods employed.

Aim: This study aimed to identify the effects of a web‐based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self‐efficacy and the labour process in primigravida women. Methods: The study was conducted in a single‐blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A‐B, the Childbirth Self‐efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education. Results: Fear of birth was lower, and the birth self‐efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery. Conclusion: Health Belief Model‐based web‐based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self‐efficacy and positively affect the birth process in primigravida women. Summary statement: What is already known about this topic? Caesarean delivery is an important health problem that is common all over the world.Fear of childbirth and low self‐efficacy are two important reasons for the increase in the frequency of caesarean section rates.Nurses can make important contributions to the prevention of optional caesarean birth by providing women with health education.What this paper adds? The web‐based birth preparation programme based on the Health Belief Model and motivational interview decreased fear of birth and improved attitudes and behaviours towards vaginal delivery by increasing health beliefs and birth self‐efficacy.The implications of this paper: This study brings a new perspective, indicating that a birth preparation programme based on the Health Belief Model and supported by motivational interviews with primigravida women is an effective method of preventing elective caesarean delivery.It is recommended that nurses use web‐based training tools and conduct cognitive behavioural strategies in antenatal classes. [ABSTRACT FROM AUTHOR]

Background: Pain and anxiety management in patients undergoing medical and surgical procedures is an important competence area for nurses. Aim: This study aimed to determine and compare the effects of virtual reality and acupressure interventions on pain, anxiety, vital signs and comfort levels in the process of femoral catheter extraction for patients undergoing coronary angiography. Methods: The study was a single‐blind, three‐group, randomized controlled trial conducted in the cardiology clinics of a university hospital in 2021. A total of 153 patients (51 virtual reality, 51 acupressure, 51 control) participated in the study. Data were collected using a Visual Analogue Scale, the State–Trait Anxiety Inventory, a vital signs follow‐up form and the Perianesthesia Comfort Scale. Results: Both intervention groups had significantly lower pain and anxiety scores, as well as higher comfort scores, compared to the control group (p < 0.001). The virtual reality group had lower systolic blood pressure, respiratory rate and pulse rate than the control group (p < 0.05). The acupressure group had lower systolic and diastolic blood pressure and respiratory rate than the control group (p < 0.05). Conclusions: While neither intervention group was found to be superior to the other, both interventions improved vital signs and comfort levels by reducing pain and anxiety. Summary statement: What is already known about this topic? Uncontrolled pain and anxiety during medical and surgical procedures may increase the risk of complications and have negative effects on the pulmonary and cardiovascular systems, leading to changes in vital signs and compromising patients' hemodynamics.Virtual reality has demonstrated its potential to restore cognitive attention capacities, enabling patients to remain engaged and mentally focused during procedures, and thus reducing pain and anxiety.Acupressure, as a non‐pharmacological intervention, involves applying pressure to specific points on the body to alleviate pain and anxiety. It constitutes a safe, side‐effect‐free and cost‐effective option for improving patient outcomes.What this paper adds? This paper contributes to the knowledge of virtual reality and acupressure interventions as non‐pharmacological approaches that nurses can safely incorporate within their independent professional roles.The study evaluates the effects of traditional acupressure and technological virtual reality interventions on patients, comparing the two interventions for the first time to the best of our knowledge. Furthermore, to the best of our knowledge, these procedures were applied for the first time in femoral catheter extraction after coronary angiography.The implications of this paper: This study emphasizes the positive impacts of virtual reality and acupressure interventions administered by nurses for patients undergoing medical procedures.Overall, the findings suggest that non‐pharmacological techniques such as virtual reality and acupressure can contribute to a similar degree in improving patient outcomes during medical procedures. [ABSTRACT FROM AUTHOR]

Background: Although existing studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and music therapy have advantages in the treatment of non‐fluent aphasia, the efficacy of the combination of these two methods remains to be investigated. Aims: To investigate the clinical efficacy of low‐frequency rTMS combined with music therapy on language function and depression in patients with non‐fluent aphasia after stroke. Methods & Procedures: A single‐blind parallel randomised controlled trial was conducted. Sixty patients (mean duration = 93.78 days) with non‐fluent aphasia after stroke were randomly divided into a traditional therapy group (n = 20), a music therapy group (n = 20) and a combined therapy group (n = 20, 1 Hz). The language function and depression were evaluated before and 3 weeks after treatment with the Chinese version of the Western Aphasia Battery scale, Boston Diagnostic Aphasia Examination scale and Stroke Aphasic Depression Questionnaire Hospital Version scale. Outcomes & Results: The combined therapy group was significantly better in all outcomes than the traditional therapy group and was significantly better in depression than the music therapy group. The music therapy group was significantly better in repetition and depression than the traditional therapy group. Language improvement was positively correlated with depression improvement. For adverse events, only two patients in the combined therapy group showed slight dizziness during rTMS treatment and their symptoms improved after rest. Conclusions & Implications: Our preliminary randomised controlled study indicates that low‐frequency rTMS combined with music therapy is feasible and safe in improving language function and depression in non‐fluent aphasia patients after stroke. WHAT THIS PAPER ADDS: What is already known on this subject: Repetitive transcranial magnetic stimulation (rTMS) and music therapy respectively have advantages in the treatment of non‐fluent aphasia after stroke, but whether the combination of the two methods is more effective is still unknown. What this paper adds to the existing knowledge: This is one of the first randomised control trials to investigate whether the clinical efficacy of low‐frequency rTMS combined music therapy for non‐fluent aphasia is better. The findings show that low‐frequency rTMS combined music therapy is superior to traditional therapy in spontaneous speech, auditory comprehension, repetition, naming, aphasia quotient, functional language level and depression, and superior to music therapy in depression, while music therapy is superior to traditional therapy in repetition and depression. What are the potential or actual clinical implications of this work?: Low‐frequency rTMS combined music therapy may be a better method for treatment of non‐fluent aphasia. [ABSTRACT FROM AUTHOR]

Background: Early intervention is recommended for pre‐school children with low language. However, few robustly evaluated language interventions for young children exist. Furthermore, in many interventions the theoretical underpinnings are underspecified and the 'active ingredients' of the interventions not tested. This paper presents a quasi‐experimental study to test the efficacy and examine the active ingredients of Building Early Sentences Therapy (BEST): an intervention based on usage‐based theory designed to support young children to understand and produce two‐, three‐ and four‐clause element sentences. BEST manipulates the input children hear to support them to harness the cognitive mechanisms hypothesized in usage‐based theories to promote the development of abstract linguistic representations. One such input manipulation is the use of signing alongside verbal input signalling both content and morphology of target sentences. Aims: To examine whether (1) BEST is more efficacious than treatment as usual (TAU); and (2) signing of content and morphology is an active ingredient of the intervention. Methods & Procedures: A quasi‐experimental study recruited children aged 3;5–4;5 years from 13 schools. Schools were assigned to receive either BEST with sign, BEST without sign or TAU. The TAU group received their usual classroom provision. Across arms schools were matched with respect to classroom oral language environment and indices of deprivation. Participants were 48 children (28 boys) with expressive and/or receptive language abilities ≤ 16th centile measured using the New Reynell Developmental Language Scales (NRDLS). Outcomes gathered by researchers blind to treatment arm were NRDLS production and comprehension standard scores and measures of production of targeted sentence structures. Outcomes & Results: Primary outcomes indicate that BEST with sign was significantly more efficacious than TAU with respect to NRDLS production standard score, but not comprehension. The advantage for production was maintained at follow‐up. BEST without sign was significantly more efficacious than TAU on measures of targeted vocabulary, sentence structure and morphology. The results from this quasi‐experimental study provide evidence for the efficacy of a usage‐based intervention on expressive language outcomes for preschool children with low language abilities. There is also evidence to support the inclusion of sign as an active ingredient, and so efforts to train interventionists in its use are worthwhile. Conclusions & Implications: Patterns of findings across outcomes suggest signing of content and morphology may support the development of abstract linguistic representations and accelerate language learning. Given these positive results and the scale of this study, a fully powered randomized controlled trial is warranted. WHAT THIS PAPER ADDS: What is already known on the subject: Robust language skills are crucial for positive social, emotional, academic and economic outcomes across the lifespan. There is a paucity of robustly evaluated interventions for preschool children with language difficulties. The development of such interventions is crucial for ameliorating language difficulties and promoting positive educational and psychosocial outcomes. What this study adds to the existing knowledge: This paper evaluates BEST, a novel usage‐based language intervention targeting children with language difficulties in the early years. Findings indicate that a usage‐based intervention is efficacious for treating language difficulties. In particular, BEST benefited expressive language development, bringing benefits to both treated and untreated language structures and improving standard scores. The role of sign as an active ingredient is also supported. Further evaluation is warranted. What are the practical and clinical implications of this work?: Findings suggest that BEST may be effective for targeting children who have been identified as having language difficulties. In particular, expressive language may be improved when the intervention is delivered as it was originally manualized, including a signing system to represent content and grammatical morphology. More broadly, these findings also provide preliminary evidence that the use of a signing system does not hinder oral language development in children with language difficulties and may conversely support their expressive language. Future research exploring the role and underpinning mechanisms of sign in language intervention is warranted. [ABSTRACT FROM AUTHOR]

The author discuses a confidential agreement which has been signed between researchers and different journals where by not all papers fro dissertation or other scientific research can be reproduced by students. The author has to overcome this problem suggested some ways for scholars to check before they go ahead with their paper writing. Author suggests checking whether the experiments were perfumed blinded or not, the reagents used are validated and the statistical analysis is adequate.

Background: The role of pro-resolving mediators in inflammation is a new concern in research. The effect of low-dose aspirin on production of a special kind of these mediators named aspirin triggered lipoxin (ATL) has been studied on different tissues. This randomized clinical trial evaluated the effect of low-dose aspirin on ATL and pro-inflammatory mediators' level in periapical fluid of necrotic teeth with large lesions. Methods: Twenty-four patients with necrotic pulp and periapical lesion were randomly assigned to low-dose aspirin and placebo groups. In the first appointment, canals were shaped up to F3 size and #40 K-file and cleaned with 10 milliliters 2.5% sodium hypochlorite and 17% Ethylenediaminetetraacetic acid. Periapical fluid was sampled by a paper cone. The tooth was temporized without any intracanal medication. Tablets were administered for 7 days, then the teeth were re-opened and the sampling were repeated. Interleukin-1 beta (IL-1β), prostaglandin E2 (PGE2) and ATL were analyzed by enzyme-linked immunosorbent assay. Data were analyzed with paired t-test using SPSS statistical software, version 21 (α = 0.05). Results: A significant reduction in PGE2 and IL-1β was noted in the aspirin-treated group while an increase in ATL was observed (P < 0.001). There was no significant difference in the mediator scores before and after in the placebo-treated group (P > 0.05). Conclusion: Low-dose aspirin can influence the inflammatory process by reducing pro-inflammatory mediators such as PGE2 and IL-1β, as well as increasing the pro-resolving mediators such as ATL. Trial registration: IRCT20191211045702N1. [ABSTRACT FROM AUTHOR]

Aim: The anxiety of nursing students about the administration of intramuscular injection reduced nursing skill performance. The research was conducted in order to evaluate the effect of touching among the students who performed the administration of intramuscular injection on a model for the first time upon the level of anxiety and success. Design: Single blind experimental study. Methods: The study was conducted with the first year nursing students (n=49). The students whose school numbers were even number were assigned to the intervention group (n=24) whereas the students whose school numbers were odd numbers were assigned to the control group (n=25). The shoulders of the students in the intervention group who administered injection were touched for averagely 3-5 minutes while the students in the control group were not done anything. The data of the research were collected using a personal information form, guide for intramuscular injection administration skills and state-trait anxiety inventory. The necessary official permissions for the research and informed consents of the students were obtained. The data were evaluated using Wilcoxon, Kruskal-Wallis and Man-Whitney U test. Results: The level of anxiety of the students who were touched was significantly lower than that of control group. The level of stress had a dealing tendency and the nursing skill performance level was significantly higher than that of control group. Conclusions: Touching suggested as an effective nursing intervention did reduce the anxiety and promoted nursing skill performance of nursing students. Touching may be used by the academic personnel so that nursing students can get psycho-motor skills during the intramuscular injection administration. [ABSTRACT FROM AUTHOR]

The article presents abstracts on paediatric anesthesia which include "Audit on evaluation of pediatric anesthesia emergence delirium," by N. Kirodian, S. Campbell, and T. Engelhardt, "Assessment of a noninvasive hemoglobin monitor (Masimo SpHb) in infants and small children undergoing craniofacial surgery," by M. Naik and colleagues, and "Emergence delirium in children, a randomized, double-blind trial of total intravenous anesthesia vs sevoflurane," by D. Myers and colleagues.

Aim: This study aimed to evaluate the effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery. Methods: This randomized controlled study was conducted with 132 participants at a public hospital between June 2017 and 2018. The Kinesio taping method was applied once, immediately after the surgery during the hospital stay and breathing exercises were performed three times a day for 30 min on the first, second and third post‐operative days. Results: The median age of the women was 47 years. The mean body mass index was 27.6 ± 5.0 kg/m2. When the intervention and control groups were compared, the level of women's pain in the Kinesio taping group was significantly reduced. There was also a statistically significant difference in terms of the passage of gas and defecation time and wound healing in groups with Kinesio taping. Conclusions: Kinesio taping has been shown to be an effective intervention in the management of acute pain after surgery. The results of this study suggest that future studies may be indicated to study taping in other surgical conditions. Summary statement: What is already known about this topic? Standard surgical procedures performed in gynaecology and obstetrics can be associated with severe post‐operative pain.Post‐operative pain following gynaecological abdominal surgery is a common symptom, and nurses play a key role in ensuring that it is properly and adequately managed. What this paper adds? Kinesio taping is a more effective method than the standard analgesia control group and for the groups with combined or sole application of breathing exercises.This randomized controlled trial showed that Kinesio taping used in the intervention was more effective in pain management, reduction of time to passage of gas and defecation and wound healing after gynaecological abdominal surgery. The implications of this paper Kinesio taping can contribute to reducing pain, reduction of time to passage of gas and defecation and wound healing after gynaecological abdominal surgery.Nurses can be trained on Kinesio taping after gynaecological abdominal surgery and encouraged to use this method because of its effectiveness. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the effectiveness of an instant message‐based lifestyle and stress management intervention delivered by nurses on cardiovascular disease risk reduction. Methods: In this nonrandomized concurrent controlled trial conducted from March 2013 to September 2013, 164 eligible employees in two companies were assigned to the intervention (n = 83) and control (n = 81) groups based on their worksites. Only participants were blinded to group assignment. All participants received two education sessions during 1 month, and the intervention group also received an instant message‐based lifestyle and stress management intervention for 5 months. The primary outcome was the Framingham Risk Score, and the data were collected at the first month and the sixth month. Results: The final analysis included 80 participants in the intervention group and 76 in the control group. After the intervention, significant intervention effects were found for the mean value and the changes of the Framingham Risk Score and the proportion of participants who improved their diet and exercise (P < 0.05). There were trends for improvement in the proportion of smoking and levels of stress, but statistically significant levels (P > 0.05) were not met. Conclusion: An instant message‐based lifestyle and stress management intervention can reduce cardiovascular disease risk in high‐risk individuals. Summary statement: What is already known about this topic? Cardiovascular disease is the leading cause of death globally and causes a heavy economic burden, while lifestyle changes and stress management are modifiable and cost‐effective ways to reduce the risk of cardiovascular disease in high‐risk individuals.The widespread use of mobile phones facilitates the implementation of health education to improve lifestyle and is well adapted for use in the developing world.Instant messaging tools are widely used for daily and work communication because of convenience and free access. These tools have also been used to improve health knowledge and self‐management. What this paper adds? More than half of participants had unhealthy diets and insufficient exercise, which contributed to abnormal body mass index and cholesterol levels.Lifestyle‐related health education that provided tailored strategies for improving lifestyle and stress reduction, as well as timely feedback and peer support, can reduce cardiovascular disease risk in high‐risk individual.Instant messaging tools provide a cost‐effective and feasible platform for health education on prevention of cardiovascular disease. The implications of this paper: Improving unhealthy diet and levels of exercise, which can decrease the prevalence of obesity and dyslipidemia, are two main aspects for prevention of cardiovascular disease that require continued focus.Using instant messaging tools as a platform to deliver health education, nurses can more easily manage high CVD risk individuals and provide guidance on healthy lifestyle. These tools should be used more widely, especially in developing countries with limited resources and heavy economic burdens. [ABSTRACT FROM AUTHOR]

Colonoscopy is an essential method for diagnosing and treating colorectal cancer, relying on effective bowel preparation to thoroughly examine the large intestinal mucosa. Traditional education involves printed instructions and verbal explanations but does not guarantee clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. A mobile medical model using Android devices for bowel preparation education was tested in a single-blind, randomized trial. This trial enrolled outpatients undergoing colonoscopy at the Endoscopy Center for Diagnostic and Treatment between 27 October 2021 and 31 December 2022. This study introduced the ColonClean app alongside traditional methods. After examination, endoscopists rated the preparation quality using the Aronchick scale. A data analysis was conducted using SPSS 25.0 to determine if there was a significant improvement in bowel preparation quality between the control group (traditional method) and the experimental group (traditional method plus the ColonClean app). Forty patients were recruited in each group. In the experimental group, all ratings were "fair", with 75% receiving an "excellent" or "good" rating, showing statistical significance (p = 0.016). The ColonClean app improves bowel preparation quality more effectively than traditional care instructions. [ABSTRACT FROM AUTHOR]

Background: This evaluation emphasizes the main points of the original article 'Position paper: new insights into the immunobiology and dynamics of tumor–host interactions require adaptations of clinical studies' by Sprenger et al. and provides further justification for the use of an alternative approach in the design of human clinical trials for new investigational drugs in the field of immuno-oncology.Objective: Standard trial design utilizing the double blind placebo trial approach, while effective for drugs that directly treat tumors, is too costly, slow, and not effective for drugs and protocols that depend on activation of the immune system for killing of tumors.Methods/results: This paper has proposed through the use of detailed diagnostic profiling, small groups of patients with similar tumor microenvironment characteristics be grouped to determine the clinical benefit of immunological combinations that enter clinical trials. In addition, mega data from larger trials in which patients are subcategorized as above can provide the necessary data as a substitute for current double blind placebo trials which do not take into account the immune status of the host and tumor.Conclusion: There needs to be evolution of the clinical trial landscape so that it matches the exponential growth of the field of immunotherapy. [ABSTRACT FROM AUTHOR]

This paper summarizes the articles of the Special Issue on Government Policies to Support Entrepreneurship. All of them went through double-blind reviews and revisions. These articles contribute to various perspectives of government policies and entrepreneurship in different countries. The papers in this Special Issue cover a variety of topics encompassed within the area of government policies and entrepreneurship. [ABSTRACT FROM PUBLISHER]

The use of virtual reality (VR) content in neurological disorders with cognitive impairment is increasing. We have developed a device that incorporates virtual drum beating content, designed for digit memorization training. This study aimed to investigate the effects of realistic cognitive training on brain activity using functional near-infrared spectroscopy (fNIRS). Thirty healthy individuals were recruited and randomly assigned into two groups: conventional cognitive exercise (CCE) and a realistic cognitive exergame (RCE). Subjects in the CCE group underwent memory training by memorizing numbers displayed on a computer screen and then writing them on paper. The main outcome measure was the oxyhemoglobin level in the dorsolateral prefrontal cortex (DLPFC). As a result, the average number of digits was 7.86 ± 0.63 for the CCE and 7.6 ± 0.82 for the RCE. The mean difference in ΔHbO was 1.417 ± 0.616 μm (p = 0.029) in channel 2, located in the right DLPFC. Channel 7 and channel 10, which measured activations in the hypothesized medial orbitofrontal cortex (OFC), also showed a significant mean difference of ΔHbO. DLPFC and OFC presented higher activation in the RCE group (p < 0.05), attributable to the simultaneous memory training and virtual drum beating, which provided various sensory inputs (visual, auditory, and vibration). Although DLPFC involvement in cognitive processes remains controversial, our findings suggest that realistic memory training using drumming content can lead to safer activation of the DLPFC compared to conventional cognitive training. [ABSTRACT FROM AUTHOR]

Objectives: This study presents results of our randomized clinical trial studying the effect of human probiotics on memory and psychological and physical measures following our study protocol registered at clinicaltrials.gov NCT05051501 and described in detail in our previous paper. Methods: Community dwelling participants aged between 55 and 80 years were randomly assigned to receive a single dose of 106 colony-forming units of human Streptococcus thermophilus GH, Streptococcus salivarius GH NEXARS, Lactobacilus plantarum GH, and Pediococcus pentosaceus GH or placebo. A cross-over design allowed each group to receive probiotics and placebo for 3 months each in reverse order. A small subset of participants was examined online due to the COVID-19 pandemic. After 6 months a small number of volunteers were additionally assessed after 2 months without any intervention. Primary outcome measures included changes in cognitive functions assessed using brief tests and a neuropsychological battery and changes in mood assessed using validated questionnaires. Secondary outcome measures included changes in self-report and subjective measures using depression and anxiety questionnaires, seven visual analog scales of subjective feelings (memory, digestion, etc.), and physical performance. Results: At baseline, the probiotic-placebo group A (n = 40, age 69 ± 7 years, education 16 ± 3 years, 63% females, body mass index 28.5 ± 6, subjective memory complaint in 43%) did not differ from the placebo-probiotic group B (n = 32) in any of the sociodemographic characteristics and evaluated measures including cognitive status. At follow-up visits after 3, 6, and 8 months, no cross-sectional differences in any of the measures were found between the groups except worse sentence recall of the ALBA test after 3 months of probiotic use. Score changes were not observed for all cognitive tests but one in any group between visits 1 and 3 and between visits 3 and 6. The only change was observed for the TMT B test after the first three months but no change was observed after the second three months. Conclusion: The treatment with human probiotics and prebiotics did not improve cognitive, affective, or physical measures in community-dwelling individuals with normal or mildly impaired cognitive functions. [ABSTRACT FROM AUTHOR]

Aims: This pilot study aimed to evaluate the effects of motor imagery training on lower limb motor function of stroke patients. Background: Motor imagery training has played an important role in rehabilitation outcomes of stroke patients. Methods: In this pilot randomized controlled trial 32 stroke patients were randomly divided into experimental and control groups from January to June 2017. Patients in both groups received conventional neuro‐rehabilitation five times a week in 3‐h segments for 6 weeks. Patients in the experimental group underwent an additional 20 min of motor imagery training. Measures were evaluated by motor function of the lower extremity, activities of daily living and balance ability. Results: The outcomes significantly improved by motor imagery training were the Fugl‐Meyer Assessment of the lower extremity, the Functional Independence Measure dealing with transfers and locomotion, and the Berg Balance Scale. Conclusion: Motor imagery training could be used as a complement to physical rehabilitation of stroke patients. Our findings may be helpful to develop nursing strategies aimed at improving functional ability of stroke patients and thus enhancing their quality of life. Summary statement: What is already known about this topic? Lower extremity dyskinesia is among the most common complications that significantly limit the patient's activities of daily living. Motor imagery training, a safe and cost‐efficient technique, may be used as a complement to physical rehabilitation of stroke patients.Evidence suggests that motor imagery training is effective in upper limb recovery after stroke.There is limited evidence of the effectiveness of motor imagery training on lower limb motor functions of patients with chronic stroke. What this paper adds? Motor imagery training can be incorporated into conventional therapy among individuals by rehabilitation specialist nurses with sufficient experience of motor imagery training, but substantial resources are needed.Six‐week motor imagery training resulted in a significant improvement in the motor performance of lower limbs in patients with stroke.Further study is needed to modify and optimize the present programme and should be focused on enabling more stroke patients to benefit from motor imagery training. The implications of this paper: The addition of motor imagery training to the conventional neuro‐rehabilitation can significantly promote the recovery of motor performance of lower limbs in stroke patients, thus reducing long‐term disability and associated socio‐economic burden.The findings of this pilot study may be helpful to develop nursing strategies aimed at improving functional ability and consequently the quality of life of stroke patients.Nurses can learn the motor imagery training as a technique for practising psychomotor nursing skills. [ABSTRACT FROM AUTHOR]

Traditional x-ray sources used today for multiple applications, such as medical imaging (computed tomography, radiography, mammography, and interventional radiology) or industrial inspection, are vacuum based electron beam devices that include several key components, such as electron emitters, electron guns/cathodes, and anodes/targets. The associated electronics for electron beam generation, focusing and control, and beam acceleration are located outside the vacuum chamber. The general topology of these tubes has been directionally unchanged for more than 100 years; however, tube design remains a long, inefficient, tedious, and complex process; blind design of experiments do not necessarily make the process more efficient. As a case study, in this paper, we introduce the differential evolution (DE), an artificial intelligence-based optimization algorithm, for the design optimization of x-ray source beam optics. Using a small-scale design problem, we demonstrate that DE can be an effective optimization method for x-ray source beam optics design. [ABSTRACT FROM AUTHOR]

Aim: Study aims were to determine the most effective chlorhexidine concentration to be used in reducing microbial colonization in patients under mechanical ventilation and to examine the effect of oral care using different concentrations on the integrity of the oral mucous membranes. Design This research was a randomized controlled double‐blinded experimental study. Method: The sample of study consisted of the 116 adult patients who remained intubated. Oral care was given to patients 4 times/day as per nurse protocol. Every morning during for 4 days, the intraoral mucosa of all groups of patients was assessed. Microbial colonization samples from oral mucosa were taken in the morning before oral care. A determination of the species of microorganisms in these samples was made. Results: A statistically significant difference was found with regard to the reproduction of microorganisms between the oral mucosa samples taken from patients using 2% and 1% chlorhexidine solutions (P < 0.001). In the cultures taken from patients on the first and fourth days of intubation, a total of 36 different microorganisms were seen to be reproducing. Conclusion: It was concluded that the most effective oral solution for the prevention of microbial colonization in patients under mechanical ventilation was chlorhexidine 1%. Summary statement: What is already known about this topic? Oral hygiene with solutions scientifically proven to be effective in patient care can reduce bacterial colonization in the oral mucosa in patients under mechanical ventilation.Chlorhexidine gluconate is an oral antiseptic solution that is preferred for the reduction of microbial colonization, particularly in patients under mechanical ventilation. However, a concentration of chlorhexidine gluconate solution has not been standardized in the oral care of these patients. What this paper adds? This randomized controlled study will serve as guide to the use of the most suitable and effective solution of chlorhexidine in the oral care of patients under mechanical ventilation.Chlorhexidine 1% was effective to reduce bacterial load in oral mucosa. The implications of this paper: With patients on mechanical ventilation support, correct, effective and regular oral care by nurses is of the utmost importance.Nurses can play an active role in ensuring the integrity of the oral mucosa and increasing comfort with the oral care in patients under mechanical ventilation. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the effect of the methods used in endotracheal tube fixation on haemodynamic parameters (systolic and diastolic blood pressure, heart rate and oxygen saturation) during endotracheal suction. Methods: The sample of this prospective, parallel two‐armed, single‐blind non‐randomized clinical trial study included 86 intubated patients treated in the cardiovascular surgery intensive care unit between September 2016 and December 2017. The endotracheal tube was fixed with tube holders in the intervention group (n = 43), whereas the endotracheal tube was fixed with plasters in the control group (n = 43). The patients' haemodynamic parameters were measured before, during, at the end of suction, and 5 and 15 min after suction. Results: In comparison with the patients with plasters, patients with tube holders had significantly lower systolic blood pressure 15 min after endotracheal suction and significantly lower diastolic blood pressure during and at the end of endotracheal suction. Oxygen saturation of the patients with tube holder during, at the end, and following 5 min after endotracheal suction were higher than patients with plaster. Heart rate was not affected during endotracheal suction in both groups. Conclusion: The study showed the tube holder affected the haemodynamic parameters during endotracheal suction less than the plaster. Summary statement: What is already known about this topic? Endotracheal suction is one of the essential nursing care interventions with mechanically ventilated patients.Nurses are responsible for selecting and using the most secure endotracheal tube fixation.Haemodynamic parameters are affected during endotracheal suction. What this paper adds? Some haemodynamic parameters are affected during endotracheal suction in two endotracheal tube fixation methods.The endotracheal tube holder affects systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation less than plaster fixation during endotracheal suction.The heart rate and oxygen saturation were not affected in both endotracheal tube fixation methods during endotracheal suction. The implications of this paper: The endotracheal tube holder can be used safely in the cardiovascular surgery intensive care patients with unstable haemodynamic parameters.These study findings guide intensive care nurses in preventing some haemodynamic changes caused by endotracheal suction. [ABSTRACT FROM AUTHOR]

Purpose: Postmicturition dribbling (PMD) is a stressful symptom in middle-aged men characterized by urinary leakage after the completion of normal voiding. Appropriate treatments have not yet been introduced. This study assessed the efficacy of treatment of PMD with 75 mg udenafil daily.Materials and Methods: The study included 138 men with regular sexual lifestyles. The Hallym PMD questionnaire (HPMDQ) was used to assess PMD symptoms. After all basic examinations, patients were randomly assigned to either udenafil or placebo. Patients completed the surveys, uroflowmetry (UFM), a bladder scan, and the paper test during the follow-up visit.Results: The mean age of the patients was 57.6 years. PMD with one of every three urinations was experienced by 59 patients (42.8%), whereas 45 patients (32.6%) experienced PMD with two of every three urinations. PMD with every urination was experienced by 34 patients (24.6%). More than half of the patients (89 patients, 65.4%) indicated that persistent PMD symptoms would likely result in moderate to severe discomfort in their daily activities. As time passed, the udenafil group showed significant improvement in PMD symptoms (p = 0.001).Conclusion: Udenafil 75 mg once daily can be an effective treatment for patients with PMD symptoms. [ABSTRACT FROM AUTHOR]

Background: Continuous femoral nerve block (CFNB) is a common procedure used for postoperative analgesia in total knee arthroplasty. Continuous nerve block using a conventional needle (catheter-through-needle/CTN) is complicated by leakage of the anesthetic from the catheter insertion site. A different type of needle (catheter-over-needle/ CON) is now available, which is believed to reduce leakage as the diameter of the catheter is larger than that of the needle. The purpose of this study was to compare the incidence of leakage from the catheter insertion site during CFNB while using CTN and CON for postoperative analgesia after total knee arthroplasty (TKA). Methods: This prospective, randomized, single-blinded controlled study included 60 patients who were scheduled for TKA at our facility between May 2016 and November 2017. Patients were randomly allocated to the CTN or CON groups. All patients in both groups received CFNB and sciatic nerve block for postoperative analgesia. The administration of 0.16% levobupivacaine mixed with 6 mg of indigo carmine (a dye added to easily identify leakage) was started at 6 ml/h at the end of surgery. The primary outcome was the incidence of leakage from the catheter insertion site. We further investigated the degree of leakage, the incidence of catheter migration, pain scores using the numerical rating scale at 48 h postoperatively, and the number of days until the operated knee could be flexed 120 degrees postoperatively in both groups. Results: The CON group had a significantly lower incidence and degree of leakage from the catheter insertion site. There were no significant differences in other measurement outcomes. Conclusions: Use of CON reduces the incidence of leakage from the catheter insertion site during CFNB in the use of postoperative analgesia for total knee arthroplasty. Future research is needed to determine additional benefits of using CON related to decreased leakage. Trial registration: The study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000021537), prospectively registered on 18 March 2016. [ABSTRACT FROM AUTHOR]

Thoracic echocardiography (TTE) can provide sufficient cardiac structure information, evaluate hemodynamics and cardiac function, and is an effective method for atrial septal defect (ASD) examination. This paper aims to study a deep learning method based on cardiac ultrasound video to assist in ASD diagnosis. We chose four standard views in pediatric cardiac ultrasound to identify atrial septal defects; the four standard views were as follows: subcostal sagittal view of the atrium septum (subSAS), apical four-chamber view (A4C), the low parasternal four-chamber view (LPS4C), and parasternal short-axis view of large artery (PSAX). We enlist data from 300 children patients as part of a double-blind experiment for five-fold cross-validation to verify the performance of our model. In addition, data from 30 children patients (15 positives and 15 negatives) are collected for clinician testing and compared to our model test results (these 30 samples do not participate in model training). In our model, we present a block random selection, maximal agreement decision, and frame sampling strategy for training and testing respectively, resNet18 and r3D networks are used to extract the frame features and aggregate them to build a rich video-level representation. We validate our model using our private dataset by five cross-validation. For ASD detection, we achieve 89.33 ± 3.13 AUC, 84.95 ± 3.88 accuracy, 85.70 ± 4.91 sensitivity, 81.51 ± 8.15 specificity, and 81.99 ± 5.30 F1 score. The proposed model is a multiple instances learning-based deep learning model for video atrial septal defect detection which effectively improves ASD detection accuracy when compared to the performances of previous networks and clinical doctors. [ABSTRACT FROM AUTHOR]

Simple Summary: The research paper reported on a newly developed screening technique called Microtube Array Membrane Hollow Fiber Assay (MTAM-HFA) used for determining the most effective medication for breast cancer patients. The study found that the MTAM-HFA approach had a high level of accuracy in predicting the patient's response to the medication therapy, and there was a significant correlation between the screening outcome and the clinical outcome. The findings suggest that the MTAM-HFA technique has great potential for developing customized therapy for cancer care. With its ability to identify precise therapies for breast cancer patients, the MTAM-HFA screening method could transform cancer therapy, resulting in better outcomes for patients. The study provides valuable information for healthcare professionals and researchers working on breast cancer therapy research. Breast cancer is a severe public health problem, and early treatment with powerful anticancer drugs is critical for success. The researchers investigated the clinical results of a novel screening tool termed Microtube Array Membrane Hollow Fiber Assay (MTAM-HFA) in breast cancer patients in this clinical investigation. In all trial participants, the MTAM-HFA was utilized to identify active medicines for the treatment of breast cancer. The MTAM-HFA was shown to be extremely useful in predicting patient response to anticancer medication therapy in this study. Furthermore, the substantial association between the MTAM-HFA screening outcome and the clinical outcome of the respective patients emphasizes the promise of this unique screening technology in discovering effective anticancer medication combinations for the treatment of breast cancer. These findings indicate that the MTAM-HFA has clinical significance and might be a valuable tool in the development of tailored therapy for cancer care. This study provides helpful information for physicians and scientists working on breast cancer therapy research. The potential benefits of employing MTAM-HFA to find accurate therapies for breast cancer patients might lead to enhanced personalized medicine approaches to cancer care, resulting in better patient outcomes. Overall, the MTAM-HFA screening approach has the potential to revolutionize customized cancer therapy, providing hope to both patients and physicians. [ABSTRACT FROM AUTHOR]

Simple Summary: Thyroid carcinoma is the most common cancer of the endocrine system and accounts for 12% of all cancer cases in adolescents in the United States. In this paper, we present a double-blind, randomized, placebo-controlled clinical trial aimed at evaluating the effect of probiotics supplementation in reducing the acute side-effects of radioiodine therapy in DTC patients. The probiotics' effectiveness was confirmed for dry mouth and taste loss or change when it was administered prior to the radioiodine treatment. The benefit was not confirmed for other radiation-induced complications such as pain and swelling in the neck, nausea and vomiting, salivary gland swelling, and diarrhea. Further large-scale clinical trials are warranted to improve our knowledge of this quickly evolving field. Thyroid carcinoma is the most common cancer of the endocrine system, accounting for 12% of all cancer cases in adolescents in the United States. Radioiodine therapy plays a key role in differentiated thyroid cancer (DTC) treatment. This double-blind, randomized, placebo-controlled clinical trial was aimed at evaluating the effect of probiotics supplementation in reducing the acute side-effects of radioiodine therapy in PTC patients. Fifty-six patients were randomly divided into four groups: one placebo and three intervention groups. The probiotics product used in this study was LactoCare (ZistTakhmir Co., Tehran, Iran), a multi-strain commercially available symbiotic containing 12 strains of probiotic species including Lactobacillus strains, Bifidobacteria strains, and Streptococcus thermophilus, plus Fructo-oligosaccharides as the prebiotic. Group 0 was our placebo group (no probiotics), while the other three groups received probiotics capsules for 2/4 days, starting only 2 days prior to radioiodine therapy, only 4 days after radioiodine therapy or 2 days prior and 4 days after radioiodine therapy. Six patients were withdrawn during the study because of poor compliance or at their own request. The symptoms reported by patients including data about the incidence and duration of each complication were recorded. The probiotics' effectiveness was confirmed for dry mouth and taste loss or change when it was administered prior to the radioiodine treatment. The benefit was not confirmed for other radiation-induced complications such as pain and swelling in the neck, nausea and vomiting, salivary gland swelling, and diarrhea. Further large-scale clinical trials are warranted to improve our knowledge in this quickly evolving field. [ABSTRACT FROM AUTHOR]

This paper focuses on plaque control and the management of gingivitis in adults and summarizes the evidence of commercially available dentifrices as gathered from existing systematic reviews. Three internet sources were used to search for appropriate papers (up to and including February 2017). The search strategy was designed to include any systematic review published on dentifrices that also included an evaluation of plaque and gingivitis scores. Characteristics of the individual reviews, such as methodological aspects, quantitative data and conclusions, were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Independent screening of 205 unique reviews resulted in 10 published and eligible systematic reviews. One publication evaluated the mechanical contribution of dentifrice to plaque removal. Eight papers were identified that evaluated the efficacy of a proposed single active ingredients, of which two reviewed more than one potentially active ingredient. One study compared two active ingredients. This meta-review appraised the current state of evidence and found that toothbrushing with a standard fluoride dentifrice does not provide an added effect for the mechanical removal of dental plaque. Evidence suggests that compared with a standard dentifrice, those containing triclosan or stannous fluoride have benefits with respect to gingival health and control of dental plaque. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the effect of the exercise programme on the quality of life of prostate cancer (PCa) survivors. Methods: A randomized controlled, parallel trial was conducted from April 2017 to January 2018 on 80 PCa survivors. They were randomly assigned to intervention and control groups (n = 40 in each group). The exercise programme was designed based on the self‐management approach (SMA). The intervention group participated in a 12‐week exercise programme consisting of one session of group exercise and three sessions of individual exercise per week using exercise facilities in the community. Data were collected using the quality of life questionnaires and the follow‐up checklist. Results: In the intervention group, statistically significant improvements in physical, role, emotional, social and sexual functions were reported. Also, the patients in this group reported reduced fatigue, insomnia, constipation, diarrhoea, urinary, bowel and hormonal treatment‐related symptoms in comparison with before the exercise programme (p < 0.05). Conclusions: Nurses are suggested to plan for improving the participation of PCa survivors in exercise programmes using exercise facilities in the community in order to reduce the complications of treatment and improve their quality of life. SUMMARY STATEMENT: What is already known about this topic? Prostate cancer (PCa) is one of the most common types of cancer in men across the globe.Given the increased survival rate of patients with PCa, interventions are required for improving their quality of life.There is a lack of knowledge about the effect of physical activity on the quality of life of PCa survivors. What this paper adds? The exercise programme based on the self‐management approach, use of exercise facilities in the community and group exercise can improve the quality of life of PCa survivors.Participation in the exercise programme can help with the reduction of physical and psychological complications of PCa. The implications of this paper: Nurses should encourage PCa survivors to participate in the exercise programme for reducing treatment complications and improving their quality of life.Nurses can use exercise facilities in the community to improve the participation of PCa survivors in healthcare initiatives aiming at the improvement of their quality of life.The examination of the effect of exercise programmes on well‐being and health‐related quality of life of PCa survivors needs further research. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the effect on health, well‐being and weight loss of a motivational support programme provided for adolescents who were overweight and obese. Methods: This was a randomized controlled trial. Sixty‐four adolescents (39 girls and 25 boys) who were overweight and obese and consulted at our polyclinic from January 2015 to February 2016 comprised the study population. The sociodemographic characteristics, well‐being levels and physical parameters of the adolescents were evaluated. Routine follow‐ups were practiced for both groups. The adolescents in the experimental group had motivational interviews and were sent reminder messages over a 6‐month period, and education programmes were conducted with the parents. Results: After 6 months, the body mass index values had decreased in the experimental group compared with baseline, with no decrease in the controls. Scores for the Paediatric Quality of Life total scale and physical health and psychosocial health subscale points were increased in experimental and control groups, but the quality of life scale points of the experimental group were higher than the control group. In the experimental group, aspartate aminotransferase, alanine aminotransferase, insulin, homeostasis model assessment of insulin resistance (HOMA‐IR) and total cholesterol were decreased. Conclusion: The motivational support programme affected the adolescents' health positively and can be recommended as a routine nursing intervention. SUMMARY STATEMENT: What is already known about this topic? Obesity is increasing in the world and becoming an important public health problem.Childhood obesity can critically affect health outcomes.Effective preventive interventions are greatly needed to decrease the prevalence of childhood obesity. What this paper adds? The motivational support programme that was provided to obese and overweight adolescents decreased their body mass index.The motivational support programme positively affected biochemical values and quality of life in adolescents who were obese and overweight.The present study found that this motivational support programme with parental involvement was an effective strategy in changing obesity‐related outcomes. Implications of this paper: Nurses evaluate adolescents who present to hospitals with other health problems and play an important role in recognizing overweight or obesityNurses could learn to apply this programme to decrease future health problems.Motivational support programmes can be applied to obese children and adolescents admitted to obesity clinics and their use should be more widespread. [ABSTRACT FROM AUTHOR]

Objectives: Quality of life, mental wellbeing, and physical function deteriorate among women with breast cancer. Tai Chi is a moderate form of exercise that may be effective in improving the mental and physical wellbeing, therefore, the quality of life of women with breast cancer. This protocol paper outlines a trial to determine the therapeutic effects of a Tai Chi programme on breast cancer management. Methods: The study will be an interventional, single-blind, double-armed, randomized, and controlled trial involving a 12-week Tai Chi programme for women with breast cancer. Forty participants aged 18 years and above who are diagnosed with breast cancer from the general community will be recruited. All participants will be randomized to either a Tai Chi programme or a waiting list control group. The Tai Chi programme will involve 12 weeks of group Tai Chi sessions, with 45 min per session, twice a week. The primary outcome will be potential improvements to the quality of life, and secondary outcomes will be potential improvements in mental wellbeing (anxiety and depression), and physical function (pain, flexibility, obesity, and vital signs). These outcomes will be assessed via self-administered online assessments and physical examinations pre-and post-intervention. Linear mixed modelling will be used to assess changes in outcomes. Discussion and dissemination: Tai Chi is a safe, easy to learn, inexpensive, and low-intensity exercise with increasing popularity worldwide. If the intervention improves the quality of life in women with breast cancer, this study will build research capacity and increase awareness of the potential for Tai Chi to empower patients and engage them in self-management of breast cancer symptoms. Research findings will be disseminated to the public, health professionals, researchers, and healthcare providers through conference presentations, lay summaries, and peer-reviewed publications. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effect of reflexology on lactation and postpartum comfort in primiparas giving births through caesarean section. Methods: This randomized controlled trial was conducted in 100 women with first birth through caesarean section between May 2016 and May 2017. Expectant mothers were randomly included into an intervention and a control group. The intervention group consisted of mothers in whom reflexology was performed three times per day at every eight hours for 30 min for 3 days. Results: The mean scores of the breastfeeding chart system and breastfeeding satisfaction scores of the mothers in the intervention group were significantly higher than those of the controls, and the first lactation period of the mothers in the intervention group was shorter than that of the controls. Mean breast‐tension, breast‐heat, and breast‐pain scores were similar in both groups on day 1; however, a significant increase was seen the intervention group on days 2 and 3, compared to those in the controls. The mean scores of the Postpartum Comfort Questionnaire in the intervention group were significantly better than those of the controls. Conclusions: Reflexology starts lactation earlier in mothers giving birth via caesarean section, supports the breastfeeding period, and increases mothers' postpartum comfort. SUMMARY STATEMENT: What is already known about this topic? Immediately after caesarean birth, many women suffer from breastfeeding problems due to pain, fatigue, activity intolerance, anaesthesia, and delayed onset of lactation.As a result of these avoidable problems, the baby cannot get enough breast milk, and mothers' postpartum comfort decreases. What this paper adds? Evidence in the study indicates that nurses can support effective breastfeeding, especially for caesarean‐delivery primiparous mothers, by delivering reflexology, which may start lactation sooner and improve postpartum comfort. The implications of this paper: This randomized controlled trial study provides evidence to support effective breastfeeding, especially for the caesarean‐delivery primiparous mothers, by delivering reflexology, which may start lactation sooner and improve postpartum comfort.This controlled trial study contributes to the knowledge base of healthcare professionals who provide care during childbirth by promoting the ability to offer appropriate interventions according to individual needs. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of PainReApp, an mHealth system, based on physical exercise recommendations for patients with chronic pain (low back pain, fibromyalgia and diabetic neuropathic pain) based on pain intensity, quality of life, anxiety and/or depression, and sleep quality. Design: Single‐blinded randomized controlled trial. Methods: One hundred patients from three different chronic conditions (low back pain, fibromyalgia and neuropathic diabetic pain) will be recruited and randomized into two groups to receive the intervention with a physical activity program guided by the PainReApp system (experimental group) or with the program information in paper format (control group). All patients will attend a first face‐to‐face session in which the smartphone application usage (experimental group) and exercise execution will be explained (both groups). Data will be collected at baseline, 4, 12 and 24 weeks. Nevertheless, the users of the application will have a daily registry of the exercise performed and the self‐perceived difficulty. The primary outcomes of the trial will be the intensity of pain and quality of life. Anxiety and/or depression and sleep quality will be also assessed to evaluate the influence of the physical activity at multiple levels. Discussion: Physical exercise is becoming one of the leading evidence‐based interventions to treat chronic pain. It needs to be adapted to the necessities of each pain condition. One of the major problems is the low adherence to the proposed program. New strategies that empower the patients, such as the m‐Health, are reliable and useful tools to ease this end. Impact: To the best of our knowledge, this is the first long‐term randomized controlled trial researching the impact of an m‐health system on chronic pain from different origin. The intervention is based on international physical exercise recommendations and can be performed without specific material, allowing the home‐based practice. Trial registration: Australian and New Zealand Clinical Trials Registry (ACTRN12621000783820). [ABSTRACT FROM AUTHOR]

Objectives: Quality of life, mental wellbeing, and physical function deteriorate among women with breast cancer. Tai Chi is a moderate form of exercise that may be effective in improving the mental and physical wellbeing, therefore, the quality of life of women with breast cancer. This protocol paper outlines a trial to determine the therapeutic effects of a Tai Chi programme on breast cancer management. Methods: The study will be an interventional, single-blind, double-armed, randomized, and controlled trial involving a 12-week Tai Chi programme for women with breast cancer. Forty participants aged 18 years and above who are diagnosed with breast cancer from the general community will be recruited. All participants will be randomized to either a Tai Chi programme or a waiting list control group. The Tai Chi programme will involve 12 weeks of group Tai Chi sessions, with 45 min per session, twice a week. The primary outcome will be potential improvements to the quality of life, and secondary outcomes will be potential improvements in mental wellbeing (anxiety and depression), and physical function (pain, flexibility, obesity, and vital signs). These outcomes will be assessed via self-administered online assessments and physical examinations pre-and post-intervention. Linear mixed modelling will be used to assess changes in outcomes. Discussion and dissemination: Tai Chi is a safe, easy to learn, inexpensive, and low-intensity exercise with increasing popularity worldwide. If the intervention improves the quality of life in women with breast cancer, this study will build research capacity and increase awareness of the potential for Tai Chi to empower patients and engage them in self-management of breast cancer symptoms. Research findings will be disseminated to the public, health professionals, researchers, and healthcare providers through conference presentations, lay summaries, and peer-reviewed publications. [ABSTRACT FROM AUTHOR]

Zinc deficiency is a global public health problem, affecting ~17% of the world's population, with the greatest burden in low‐ and middle‐income countries. An increasing body of evidence suggests that biofortification may be a cost‐effective and sustainable approach to reducing zinc and other micronutrient deficiencies. Biofortification enhances the nutritional quality of food crops through conventional plant breeding techniques and agronomic practices. This paper presents ongoing research on biofortification in Pakistan, where over 40% of women are zinc deficient. The Biofortified Zinc Flour to Eliminate Deficiency (BiZiFED) project aims to investigate the impact of biofortification as a strategy to alleviate zinc deficiency in Pakistan. The project is supported by the Biotechnology and Biological Sciences Research Council (BBSRC) Global Challenges Research Fund from May 2017 to April 2019. This paper outlines the four objectives and work packages within the BiZiFED project: (1) a double‐blind, randomised controlled trial to examine the effect of consuming flour made from a high zinc variety of biofortified wheat (Zincol‐2016/NR‐421) on dietary zinc intake and status; (2) a cost‐effectiveness study to assess the health and economic impact of agronomic biofortification of wheat; (3) a mixed methods study to explore the cultural acceptability and sustainability of biofortification in Pakistan; (4) capacity building and development of long‐term research partnerships in Pakistan. The findings will contribute to the evidence base for the potential impact of biofortification to alleviate zinc deficiency among the poorest communities. [ABSTRACT FROM AUTHOR]

Peer review is at the core of scholarly publishing; it is the lynchpin around which the whole research information exchange is based. Recently, the process has attracted criticism. In this global study, which was conducted in the later part of 2009, we examine the influences and attitudes of over 4,000 researchers towards peer review. We find that peer review is valued, but needs to be improved. Most reviewers are actually keen to review, but believe formal training of reviewers would improve peer review. Publishers and editors need to become better at matching reviewer expertise to manuscript subject. The research community believes overwhelmingly that double-blind peer review is the most effective form of review, and that formal peer review would benefit from some form of post-peer review commentary. [ABSTRACT FROM AUTHOR]

Background: There is evidence that caffeine increases the maximal fat oxidation rate (MFO) and aerobic capacity, which are known to be lower in the morning than in the afternoon. This paper examines the effect of caffeine intake on the diurnal variation of MFO during a graded exercise test in active men. Methods: Using a triple-blind, placebo-controlled, crossover experimental design, 15 active caffeine-naïve men (age: 32 ± 7 years) completed a graded exercise test four times at seven-day intervals. The subjects ingested 3 mg/kg of caffeine or a placebo at 8 am in the morning and 5 pm in the afternoon (each subject completed tests under all four conditions in a random order). A graded cycling test was performed. MFO and maximum oxygen uptake (VO2max) were measured by indirect calorimetry, and the intensity of exercise that elicited MFO (Fatmax) calculated. Results: MFO, Fatmax and VO2max were significantly higher in the afternoon than in the morning (all P < 0.05). Compared to the placebo, caffeine increased mean MFO by 10.7% (0.28 ± 0.10 vs. 0.31 ± 0.09 g/min respectively, P < 0.001) in the morning, and by a mean 29.0% (0.31 ± 0.09 vs. 0.40 ± 0.10 g/min, P < 0.001) in the afternoon. Caffeine also increased mean Fatmax by 11.1% (36.9 ± 14.4 [placebo] vs. 41.0 ± 13.1%, P = 0.005) in the morning, and by 13.1% (42.0 ± 11.6 vs. 47.5 ± 10.8%, P = 0.008) in the afternoon. Conclusion: These findings confirm the previously reported diurnal variation in the whole-body fat oxidation rate during graded exercise in active caffeine-naïve men, and indicate that the acute ingestion of 3 mg/kg of caffeine increases MFO, Fatmax and VO2max independent of the time of day. Trial registration: NCT04320446. Registered 25 March 2020 - Retrospectively registered [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is prevalent and has significant impact on individuals and society. Cognitive symptoms are frequent in MDD and insufficiently treated by antidepressant medications. Transcranial photobiomodulation (t-PBM) is a novel device therapy which shows promise as an antidepressant and pro-cognitive treatment. To date, despite the encouraging results, the optimal stimulation parameters of t-PBM to treat MDD are not established, and clinical studies are very heterogeneous in terms of these parameters. While the literature provides guidance on the appropriate fluence to achieve therapeutic results, little is known on the other parameters.Objective: To evaluate the relationship between different parameters and the antidepressant effect of t-PBM.Methods: We reviewed clinical studies on MDD and on depressive symptoms comorbid with other diseases. We calculated the standardized effect size of the change in symptoms severity before and after t-PBM and we performed a descriptive analysis of the reviewed papers.Results: The greatest effect sizes for the antidepressant effect were found in studies using pulse-wave t-PBM with high peak irradiance (but low average irradiance) over large skin surface. One well-designed and sufficiently powered, double-blind, sham-controlled trial indicated that t-PBM with low irradiance over a small skin surface is ineffective to treat depression.Conclusion: The use of t-PBM for Alzheimer's disease and for dementia is still at its inception; these dosimetry lessons from the use of t-PBM for depression might serve as guidance. [ABSTRACT FROM AUTHOR]

Prader-Willi Syndrome (PWS) is a neurodevelopmental genetic disorder with executive deficits. Planning is one of the impaired executive functions implied in the regulation of behavior and everyday actions. We aimed to explore the feasibility and the effectiveness of a metacognitive strategy training designed to improve planning in adults with PWS using a double-blind between-group (training versus usual care) randomized controlled trial, with computerized tests and paper-pencil ecological outcome measures targeting planning, other executive functions, and achievement of personalized goal. Results showed better performances in several executive tasks and in achievement of personalized goals after both interventions, but better improvement for the experimental group (n = 27) compared to control (n = 26) only on the task assessing planning abilities. Interviews with occupational therapists demonstrated the feasibility of this training with this population. Despite a small number of sessions, the metacognitive strategy training showed encouraging results on planning abilities of patients. [ABSTRACT FROM AUTHOR]

Objective: To establish the reliability, validity, and sensitivity to change of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) among Chinese subjects with osteoarthritis (OA) of the knee, living in mainland China.Methods: A multicenter, randomized, double-blind, placebo-controlled, parallel-group study was conducted for validation of the electronic personal digital assistant version of the WOMAC Numerical Rating Scale (NRS) 3.1 Index in China. A total of 287 subjects with OA of the knee were randomized to receive either meloxicam (15 mg) or placebo. Psychometric properties of the WOMAC were evaluated by estimating the reliability, validity, and sensitivity to change. Equivalence of the electronic version was also compared with the paper version.Results: Intraclass correlation coefficients for the WOMAC pain, stiffness, and physical function subscales were 0.81, 0.76, and 0.85, respectively, indicating good test-retest reliability. Similarly, internal consistency was strong (Cronbach's alpha for the 3 WOMAC subscales was 0.84, 0.86, and 0.96, respectively). Pearson's correlation coefficients for WOMAC pain and Short Form 36 health survey (SF-36) bodily pain, as well as WOMAC physical function and SF-36 physical functioning domains were >0.4, indicating convergent validity, whereas the coefficients for all 3 WOMAC domains with SF-36 mental health and mental health component scores were <0.4, indicating divergent validity. There was strong discriminant validity between healthy volunteers and OA patients. The effect sizes of change from baseline to week 12 in WOMAC subscale scores were large, demonstrating sensitivity to change. Equivalence between paper and electronic versions was very high.Conclusion: The culturally and linguistically validated Chinese version of the WOMAC NRS 3.1 for mainland China is psychometrically robust in its validity, reliability, and sensitivity to change for patients with OA of the knee. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the clinical outcome of and determine the differences in periodonto-pathogenic microbiota around two types of implant collar surfaces: laser-microtextured (test) vs machined (control). Materials and Methods: Seventeen patients (11 periodontally healthy, and 6 periodontally compromised) were selected to receive the two different implants, placed randomly, in two edentulous sites. Six months following the surgical placement of the dental implants, subgingival plaque samples were collected using paper points from the peri-implant sulcus and from the sulcus of an adjacent tooth. The presence of five putative periodontal pathogens, namely, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythensis, was assessed using real-time polymerized chain reaction (RT-PCR). Peri-implant parameters and intraoral radiographs were recorded up to 1 year after abutment connection. Results: In the main population, and in the periodontally compromised subgroup, the total number of periodontal pathogens around test implant sites was lower than control implant sites and adjacent tooth sites, with a statistically significant difference (P < .05). In periodontally healthy patients, the mean probing pocket depth for the test implant was 1.31 ± 0.51 mm, compared with 2.66 ± 0.83 mm for the control implant, while in periodontally compromised patients, it was 1.61 ± 0.58 mm for the test implant, compared with a mean value of 2.84 ± 1.0 mm for the control implant. Conclusion: Implants with a laser-microtextured collar surface are not more vulnerable to pathogenic microflora colonization than implants with a machined collar surface. In both of the subgroups of patients (periodontally healthy and periodontally compromised), implants with a laser-microtextured collar surface have a better clinical outcome at 1 year of loading, compared with implants with a machined collar surface. [ABSTRACT FROM AUTHOR]

Background. Percutaneous coronary intervention (PCI) is widely used in China, but it does not fundamentally improve exercise endurance or reduce mortality associated with cardiovascular disease. Standardized cardiac rehabilitation (CR) can reduce the mortality associated with coronary heart disease and reduce the need for repeated PCI procedures. Currently, research on CR after PCI is mainly based on traditional exercise prescription, while research on TCM is limited. Often, the combination of traditional Chinese medicine (TCM) and exercise rehabilitation is adopted, from which it is difficult to determine the unique advantages of TCM. Qishen Yiqi dripping pills (QSYQ) can improve myocardial energy metabolism and alleviate myocardial reperfusion injury after PCI. This paper describes the protocol for the clinical assessment of QSYQ on CR. Methods. A randomized, double-blind, placebo-controlled trial will be used to evaluate the efficacy and safety of QSYQ on improving exercise endurance and quality of life. We plan to recruit 66 patients with stable angina pectoris with Qi deficiency and blood stasis syndrome differentiation after PCI from the China-Japan Friendship Hospital. On the basis of conventional drug treatment, QSYQ or placebo will be used for 12 weeks. PeakVO2 will be the main efficacy evaluation index, while Seattle scale and quality of life scale will be the secondary efficacy evaluation indexes. Discussion. CR therapy with integrated traditional Chinese and Western medicine has been developed as a treatment modality in China and has been included in the expert consensus of TCM diagnosis and treatment. A rigorous trial design will ensure objective and scientific evaluation of the efficacy and safety of QSYQ in improving exercise endurance and quality of life in patients with PCI. Trial Registration. This trial is registered with Clinical trial registration in China: ChiCTR2000040838 (registration date: December 11, 2020). [ABSTRACT FROM AUTHOR]

Background: Rotavirus vaccination is recommended in all countries to reduce the burden of diarrhea-related morbidity and mortality in children. In resource-limited settings, rotavirus vaccination in the national immunization program has important cost implications, and evidence for protection beyond the first year of life and against the evolving variety of rotavirus strains is important. We assessed the extended and strain-specific vaccine efficacy of a heat-stable, affordable oral rotavirus vaccine (Rotasiil, Serum Institute of India, Pune, India) against severe rotavirus gastroenteritis (SRVGE) among healthy infants in Niger.Methods and Findings: From August 2014 to November 2015, infants were randomized in a 1:1 ratio to receive 3 doses of Rotasiil or placebo at approximately 6, 10, and 14 weeks of age. Episodes of gastroenteritis were assessed through active and passive surveillance and graded using the Vesikari score. The primary endpoint was vaccine efficacy of 3 doses of vaccine versus placebo against a first episode of laboratory-confirmed SRVGE (Vesikari score ≥ 11) from 28 days after dose 3, as previously reported. At the time of the primary analysis, median age was 9.8 months. In the present paper, analyses of extended efficacy were undertaken for 3 periods (28 days after dose 3 to 1 year of age, 1 to 2 years of age, and the combined period 28 days after dose 3 to 2 years of age) and by individual rotavirus G type. Among the 3,508 infants included in the per-protocol efficacy analysis (mean age at first dose 6.5 weeks; 49% male), the vaccine provided significant protection against SRVGE through the first year of life (3.96 and 9.98 cases per 100 person-years for vaccine and placebo, respectively; vaccine efficacy 60.3%, 95% CI 43.6% to 72.1%) and over the entire efficacy follow-up period up to 2 years of age (2.13 and 4.69 cases per 100 person-years for vaccine and placebo, respectively; vaccine efficacy 54.7%, 95% CI 38.1% to 66.8%), but the difference was not statistically significant in the second year of life. Up to 2 years of age, rotavirus vaccination prevented 2.56 episodes of SRVGE per 100 child-years. Estimates of efficacy against SRVGE by individual rotavirus genotype were consistent with the overall protective efficacy. Study limitations include limited generalizability to settings with administration of oral polio virus due to low concomitant administration, limited power to assess vaccine efficacy in the second year of life owing to a low number of events among older children, potential bias due to censoring of placebo children at the time of study vaccine receipt, and suboptimal adapted severity scoring based on the Vesikari score, which was designed for use in settings with high parental literacy.Conclusions: Rotasiil provided protection against SRVGE in infants through an extended follow-up period of approximately 2 years. Protection was significant in the first year of life, when the disease burden and risk of death are highest, and against a changing pattern of rotavirus strains during the 2-year efficacy period. Rotavirus vaccines that are safe, effective, and protective against multiple strains represent the best hope for preventing the severe consequences of rotavirus infection, especially in resource-limited settings, where access to care may be limited. Studies such as this provide valuable information for the planning of national immunization programs and future vaccine development.Trial Registration: ClinicalTrials.gov NCT02145000. [ABSTRACT FROM AUTHOR]