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Most respondents reported moral distress when being required to run (75%), do chest compressions for (80%), or witness (78%) a cardiac resuscitation attempt they believe to be medically futile.
Slow codes occur in practice, even though many clinicians ethically disagree with their use. The use of cardiac resuscitation attempts in medically futile situations can cause significant moral distress to medical professionals who agree or are forced to participate in them.
Slow codes occur in practice, even though many clinicians ethically disagree with their use. The use of cardiac resuscitation attempts in medically futile situations can cause significant moral distress to medical professionals who agree or are forced to participate in them.
The management of cancer pain has gained attention in China since the proposal of the three-step analgesic ladder in 1986 and has been further improved after the Chinese Ministry of Health launched the campaign for "Good Pain Management Ward" in 2011. The Beijing Pain Management Center for Quality Control and Improvement was formed with the intent to improve the quality of pain management by various means such as providing continuing medical education (CME) and conducting evaluation in Beijing, the capital of China.
The objective of this study was to investigate the impact of CME on cancer pain treatment in hospitals in Beijing, China.
The Beijing Pain Management Center for Quality Control and Improvement carried out annual CME on cancer pain treatment for physicians in Beijing in February from 2016 to 2019. The quality of cancer pain treatment in these hospitals was evaluated in August 2015, 2017 and 2019 by using an evaluation instrument containing eight domains. The evaluation results were retrospectively reviewed to assess the impact of CME.
After annual CME for four successive years, a significant increase in evaluation scores for cancer pain treatment was observed in the participating hospitals. find more The increased trend varied widely both among the levels of hospitals (secondary and two tiers of tertiary hospitals) and among evaluation domains. These hospitals scored lowest in domains related to opioid tolerance, ongoing care, and risk of nonsteroidal anti-inflammatory drugs in the last evaluation.
CME significantly improved the quality of cancer pain treatment in the participating hospitals. Thus, standard CME courses may be adopted to improve the quality of cancer pain treatment by other regions in China and other countries.
CME significantly improved the quality of cancer pain treatment in the participating hospitals. Thus, standard CME courses may be adopted to improve the quality of cancer pain treatment by other regions in China and other countries.More than half of the calories consumed by humans are provided by three major cereal crops (rice, maize, and wheat). Orphan crops are usually well adapted to low-input agricultural conditions, and they not only play vital roles in local areas but can also contribute to food and nutritional needs worldwide. Interestingly, many wild relatives of orphan crops are important weeds of major crops. Although orphan crops and their wild relatives have received little attentions from researchers for many years, genomic studies have recently been performed on these plants. Here, we provide an overview of genomic studies on orphan crops, with a focus on orphan cereals and their wild relatives. The genomes of at least 12 orphan cereals and/or their wild relatives have been sequenced. In addition to genomic benefits for orphan crop breeding, we discuss the potential ways for mutual utilization of genomic data from major crops, orphan crops, and their wild relatives (including weeds) and provide perspectives on genetic improvement of both orphan and major crops (including de novo domestication of orphan crops) in the coming genomic era.
To evaluate whether a blue covarine containing silica-based toothpaste promotes a whitening effect immediately after tooth brushing.
A triple-blind, parallel group, randomized design was used to compare the tooth color before and after brushing. Two silica-based toothpastes were chosen, one of them containing blue covarine (BCT) and the other one without pigment to serve as control (CT). Tooth color was measured using a spectrophotometer and expressed as CIEDE 2000 ΔE, CIELAB values, WIO index, WI
index and VITA scale tooth shade. In addition, the participants' satisfaction with and perception of their own tooth color were registered using an aesthetic numeric analogue scale.
No significant changes in color components or dimensions measured using CIEDE 2000 ΔE (CT mean = 1.3, 95% CI 0.8, 1.7; BCT mean = 1.6, 95% CI 1.2, 2.1), WIO, WI
, VITA scale or CIELAB values were detected for the CT and BCT groups, comparing the results before and after brushing. Likewise, the participants' satisfaction with the treatment results (P = 0.31) and the participants' evaluation of tooth color (P = 0.71) did not differ significantly between groups.
After a single application, no significant improvement in tooth whiteness by the presence of blue covarine in a silica-based toothpaste was detected in color dimensions or by assessing the participants' satisfaction and perception.
The present study does not show a clinically relevant increase in tooth whiteness after a single brushing with a blue covarine containing toothpaste, nor could the study participants observe a difference between treatment with blue covarine containing toothpaste and control treatment.
The present study does not show a clinically relevant increase in tooth whiteness after a single brushing with a blue covarine containing toothpaste, nor could the study participants observe a difference between treatment with blue covarine containing toothpaste and control treatment.
This in vivo study compared the antibacterial effect of a self-etch adhesive with and without the brominated monomer 12-methacryloyloxydodecyl-pyridinium bromide (MDPB) on carious dentin after selective caries removal.
10 patients showing deep primary carious lesions at two posterior teeth without pulpal symptoms were included. At visit I, carious tissue was selectively removed and carious dentin was sampled with a sterile roundbur (Komet No. 18). One cavity was restored with composite (SDR, Ceram X; DENTSPLY DeTrey) using an MDPB-containing self-etch adhesive (Clearfil Protect Bond, Kuraray Noritake; PB). The other restoration served as a control (Clearfil SE Bond II, Kuraray Noritake; SE). At visit II after 8 weeks, carious dentin was sampled again. Bacterial growth in carious dentin was differentiated using microbial cultivation. Bacterial DNA from intact cells and cell-free DNA were quantified using 16S rRNA gene-based real-time PCR and the microbial community composition was analyzed by amplicon deep-sequencing.
