14 research outputs found

    The Ethical Dimension in \u27Ordinary Nursing Care\u27

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    Prominent members of the human gut microbiota express endo-acting O-glycanases to initiate mucin breakdown

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    Epithelial cells that line the gut secrete complex glycoproteins that form a mucus layer to protect the gut wall from enteric pathogens. Here, the authors provide a comprehensive characterisation of endo-acting glycoside hydrolases expressed by mucin-degrading members of the microbiome that are able to cleave the O-glycan chains of a range of different animal and human mucins

    Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

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    Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

    Challenging Unjust Authority and Creating a Profession

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    Linda Richards and Nursing in Japan, 1885–1890

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    Articles: Sister Mary Joseph Croke: Another Voice from the Crimean War, 1854–1856

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    Morality and Health

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    Dyeing Para-Aramid Textiles Pretreated with Soybean Oil and Nonthermal Plasma Using Cationic Dye

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    The increasing use of functional aramids in a wide array of applications and the inert nature of aramids against conventional dye and print methods requires developing new dyeing methods. This study aims to use environmentally friendly method with a cationic dye as an alternative for dyeing para-aramid fabrics. Experiments used a multi-factorial design with functions of pretreatment, dye solvent (water and/or glycerol) and auxiliary chemical additives (swelling agent and surfactant) and a sequential experimentation methodology. The most effective dyeing procedures involved the following steps: (i) pretreatments of the fabrics with soybean oil and nonthermal plasma (NTP), (ii) using water at T = 100 °C as the dye solvent, and (iii) omitting other chemical additives. With a commercial cationic dye, these conditions achieved a color strength in K/S value of 2.28, compared to ~1 for untreated samples. FTIR analysis revealed that a functional network formed on the fibers and yarns of the fabrics by chemical reactions of excited plasma species with double bonds in the soybean oil molecules was responsible for significantly improving the color strength. These results extend the potential uses of a renewable material (soybean oil) and an environmentally friendly technology (NTP) to improve the dyeing of para-aramid textiles and reduce the use of harsh dye chemicals.Department of Agriculture HATCH project (No. TEN00521
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