Batroxobin ( @ U ) could reduce the perioperative blood loss in patients with LMWH who had undergone the total hip replacement operation but did not show adverse effect on DVT .


With predicted increases in dementia incidence , interventions targeting neuroplasticity and neuroprotection are required .


Cognitive Training ( CT ) is an intervention which has been shown to improve aspects of cognition , but the pathophysiological mechanisms contributing to its efficacy are unknown .


We aimed to explore the neurobiological correlates of CT using Mismatch Negativity ( MMN ) , a neurophysiological marker of pre-attentive information processing , which in turn , is postulated to underpin higher-order cognitive processes .


As part of a larger randomized controlled trial , forty ` at risk ' ( i.e. , mild cognitive impairment or late-life depression ) participants aged @-@ years underwent neurophysiological , neuropsychological , and psychiatric assessments before and after a multi-faceted seven-week CT program or a ` treatment-as-usual ' seven-week waitlist period .


The treatment group demonstrated significantly increased fronto-central MMN responses ( p < @ ) , as well as improved phonemic verbal fluency ( p < @ ) and decreased self-rated memory difficulties ( p < @ ) following CT , in comparison to the waitlist control group .


However , there were no significant correlations between enhanced MMN and cognitive/psychosocial outcomes .


Results from this preliminary investigation indicate that CT is associated with enhanced neurophysiological mechanisms suggestive of improved pre-attentive processing , which may reflect alterations in underlying neurobiology .


Further research is warranted to confirm these findings , to explicate whether CT is associated with restorative or compensatory neuroplastic processes and to determine whether MMN is a useful biomarker for treatment response .


Children with gastroenteritis often develop dehydration with metabolic acidosis .


Serum ketones are frequently elevated in this population .


The goal was to determine the relationship between initial serum ketone concentration and both the degree of dehydration and the magnitude of acidosis .


This was a secondary analysis of a prospective trial of crystalloid administration for rapid rehydration .


Children @ months to @ years of age with gastroenteritis and dehydration were enrolled .


A point-of-care serum ketone ( beta-hydroxybutyrate ) concentration was obtained at the time of study enrollment .


The relationship between initial serum ketone concentration and a prospectively assigned and previously validated clinical dehydration score , and serum bicarbonate concentration , was analyzed .


A total of @ patients were enrolled .


The median serum ketone concentration was elevated at @ mmol/L ( interquartile range -LSB- IQR -RSB- = @ to @ mmol/L ) , and the median dehydration score was consistent with moderate dehydration .


A significant positive relationship was found between serum ketone concentration and the clinical dehydration score ( Spearman 's rho = @ , p = @ ) .


Patients with moderate dehydration had a higher median serum ketone concentration than those with mild dehydration ( @ mmol/L vs. @ mmol/L , p = @ ) .


Additionally , the serum ketone concentration was inversely correlated with serum bicarbonate concentration ( = -@ , p < @ ) .


Children with gastroenteritis and dehydration have elevated serum ketone concentrations that correlate with both degree of dehydration and magnitude of metabolic acidosis .


Point-of-care serum ketone measurement may be a useful tool to inform management decisions at the point of triage or in the initial evaluation of children with gastroenteritis and dehydration .


In this secondary analysis of results of the Clinical Outcomes in MEasurement-Based Treatment ( COMET ) trial , patient behaviors that might account for the differences observed in clinical outcomes were examined .


Patients ( N = @ ) diagnosed as having major depressive disorder participated in telephone interviews either monthly for six months ( intervention ) or at three and six months ( usual care ) asking about antidepressant medication-taking , use of psychotherapy or counseling , and participation in depression support groups .


Physicians ( N = @ ) in the intervention arm received monthly feedback regarding their patients ' depression severity .


A total of @ ( @ % ) patients completed the month @ interview .


The adjusted odds of current antidepressant use at six months were @ % greater ( p = @ ) for patients in the intervention ( N = @ ) versus usual care ( N = @ ) arms , according to multivariate regression analyses .


More frequent measurement of depression symptoms was associated with greater medication persistence , which in turn may have mediated clinical improvements .


To explore whether psychosocial challenges impact effects of vocational rehabilitation in Veterans with Posttraumatic Stress Disorder ( PTSD ) .


A post hoc exploratory analysis of possible moderators of treatment was conducted on outcomes from a randomized , controlled trial of Individual Placement and Support in Veterans with PTSD .


When examining groups within each moderator , there was a greater IPS supportive employment benefit in gaining competitive employment for those with inadequate transportation ( number needed to treat -LSB- NNT -RSB- = @ ) and inadequate housing ( NNT = @ ) compared with the main finding of the pilot study ( NNT = @ ) .


Compared with the main finding of the pilot study , there was no greater advantage of IPS for those with adequate transportation ( NNT = @ ) or adequate housing ( NNT = @ ) .


Compared with the main finding in the pilot study , those without a family care burden had a greater benefit from IPS ( NNT = @ ) and those with family care burden had a reduced treatment effect ( NNT = @ ) .


These results are exploratory and are not intended to guide clinical decision-making , but rather offer a potentially useful strategy in the design of larger trials of IPS .


To determine the effects of keratocyte loss on optical properties and vision after laser in situ keratomileusis ( LASIK ) with the flap created with a femtosecond laser or a mechanical microkeratome .


Randomized clinical paired-eye study .


Both eyes of @ patients received LASIK for myopia or myopic astigmatism .


One eye of each patient was randomized by ocular dominance to flap creation with a femtosecond laser and the other eye to flap creation with a mechanical microkeratome .


Before LASIK and at @ , @ , and @ months and @ , @ , and @ years after LASIK , keratocyte density was measured using confocal microscopy , and high-contrast visual acuity and anterior corneal wavefront aberrations were measured by standard methods .


At each visit , all variables were compared between methods of creating the flap and to the same variable before treatment using paired tests with Bonferroni correction for multiple comparisons .


Keratocyte density in the flap decreased by @ % during the first year after LASIK and remained low through @ years ( P < @ ) .


High-order wavefront aberrations increased and uncorrected visual acuity improved immediately after surgery , but these variables did not change further to @ years .


There were no differences in any variables between treatments .


A sustained reduction in keratocyte density does not affect vision or optical properties of the cornea through @ years after LASIK .


The method of creating a LASIK flap does not influence the changes in keratocyte density in the flap .


Many with alcohol and other drug dependence have concurrent marijuana use , yet it is not clear how to address it during addiction treatment .


This is partially due to the lack of clarity about whether marijuana use impacts one 's ability to achieve abstinence from the target of addiction treatment .


We examined the association between marijuana use and abstinence from other substances among individuals with substance dependence .


A secondary analysis of the Addiction Health Evaluation And Disease management study , a randomized trial testing the effectiveness of chronic disease management .


Individuals met criteria for drug or alcohol dependence and reported recent drug ( i.e. opioid or stimulant ) or heavy alcohol use .


Recruitment occurred largely at an inpatient detoxification unit , and all participants were referred to primary medical care .


The association between marijuana use and later abstinence from drug and heavy alcohol use was assessed using longitudinal multivariable models .


Of @ study participants , @ % completed at least one follow-up assessment and @ ( @ % ) had at least one pair of consecutive assessments and were included .


In adjusted analyses , marijuana use was associated with a @ % reduction in the odds of abstinence from drug and heavy alcohol use ( adjusted odds ratio @ -LSB- @ % CI , @-@ @ -RSB- , P = @ ) .


Marijuana use among individuals with alcohol or other drug dependence is associated with a lower odds of achieving abstinence from drug and heavy alcohol use .


These findings add evidence that suggests concomitant marijuana use among patients with addiction to other drugs merits attention from clinicians .


Delayed cord clamping ( DCC ) is recommended for premature infants to improve blood volume .


Most preterm infants are born by cesarean delivery ( CD ) , and placental transfusion may be less effective than in vaginal delivery ( VD ) .


We sought to determine whether infants < @ weeks born by CD who undergo umbilical cord milking ( UCM ) have higher measures of systemic blood flow than infants who undergo DCC .


This was a @-center trial .


Infants delivered by CD were randomly assigned to undergo UCM or DCC .


Infants delivered by VD were also randomly assigned separately .


UCM ( @ strippings ) or DCC ( @-@ seconds ) were performed .


Continuous hemodynamic measurements and echocardiography were done at site @ .


A total of @ infants were enrolled ( mean gestational age @ @ weeks ) .


Of the @ infants delivered by CD , @ were assigned to UCM and @ to DCC .


Of the infants delivered by CD , neonates randomly assigned to UCM had higher superior vena cava flow and right ventricular output in the first @ hours of life .


Neonates undergoing UCM also had higher hemoglobin , delivery room temperature , blood pressure over the first @ hours , and urine output in the first @ hours of life .


There were no differences for the @ infants delivered by VD .


This is the first randomized controlled trial demonstrating higher systemic blood flow with UCM in preterm neonates compared with DCC .


UCM may be a more efficient technique to improve blood volume in premature infants delivered by CD .


The objective of the study was to evaluate the effectiveness of a high-fidelity birth simulator ( Noelle ; Gaumard Scientific , Coral Gables , FL ) compared with a lower-cost , low-tech , birth simulator ( MamaNatalie ; Laerdal Medical , Stavanger , Norway ) in teaching medical students how to perform a spontaneous vaginal delivery ( SVD ) .


Prior to the obstetrics-gynecology clerkship , students were randomly assigned to @ groups .


The MamaNatalie group ( MG ) completed @ minutes of SVD simulation using an obstetrical abdominal-pelvic model worn by an obstetrics-gynecology faculty member .


The Noelle group ( NG ) completed @ minutes of SVD simulation using a high-fidelity , computer-controlled mannequin facilitated by an obstetrics-gynecology faculty member .


The primary outcome was student performance during his or her first SVD as rated by supervising preceptors .


Surveys were also completed by students on confidence in performing steps of a SVD ( secondary outcome ) .


One hundred ten medical students ( @ % of those eligible ) participated in this research study .


The final postclerkship survey was completed by @ students ( @ % follow-up rate ) .


There were no significant differences in performance of SVD steps between MG and NG students as rated by preceptors .


The SVD step with the least involvement by students was controlling the head ( @ % in MG , @ % in NG performed step with hands-off supervision ) .


Delivery of the placenta was the SVD step with the most involvement ( @ % in MG , @ % in NG performed step with hands-off supervision ) .


Baseline presimulation confidence levels were similar between MG and NG .


On the immediate postsimulation survey of confidence , MG students were significantly more confident in their ability to deliver the abdomen and legs and perform fundal massage with hands-off supervision ( P < @ ) than NG students .


Following the clerkship , MG students were significantly more confident in their ability to control the head and deliver the abdomen and legs ( P < @ ) than NG students .


MamaNatalie is as effective as Noelle in training medical students how to perform a SVD and may be a useful , lower-cost alternative in teaching labor and delivery skills to novice learners .


Because birth simulation interventions involve both a simulation model and facilitator , research is required to further determine the effect of human interaction on learning outcomes .


Worldwide prevalence of generalized anxiety disorder ( GAD ) is considered high ; in Europe lifetime prevalence has been estimated at @ to @ % .


High levels of anxiety disorders have been reported in university students , affecting @ to @ % of the population .


Young adults are some of the most vulnerable for the onset of mental health disorders and any stressors may act as a catalyst for their onset .


The absence of resources can often mean that many do not seek treatment .


Other factors that impede access to resources include such things as a lack of trained professionals , personal stigma , and waiting lists .


Anxiety disorders can be treated successfully ; indeed brief forms of cognitive-behavior therapy have been recommended .


One potential avenue for research and development is that of delivering low-intensity interventions online for students with GAD .


Therefore , the current study seeks to investigate the potential effectiveness for a low-intensity online CBT-based treatment for GAD in a service-based setting ; implemented as one step in a stepped-care model .


The research is a service-based effectiveness study utilizing a randomized waiting-list controlled design .


The active intervention consists of six weekly modules of online CBT .


Participants are assigned a supporter who provides weekly post-session feedback on progress and exercises .


Participants will complete the GAD-@ as the primary outcome measure .


Secondary outcomes include pathological worry , depression and measures of well-being .


At three-months follow-up data will be collected using the GAD-@ , BDI-II , PSWQ , ED-Q@ and WSAS .


Post-session data will be collected on significant in-session events in treatment ( HAT ) .


A satisfaction with treatment measure will be administered post-treatment ( SAT ) .


The study will be a contribution to the potential for a low-intensity internet-delivered program implemented in a service-based setting ; implemented as one step in a stepped-care model .


The study will be a contribution to the already established work in online treatments for anxiety worldwide .


The study will assess the utility of an innovative digital health solution ( SilverCloud ) to deliver such interventions .


The aim of this study was to compare the effectiveness of single port/incision laparoscopic surgery ( SPILS ) with standard three-port laparoscopic surgery for appendicectomy in adults .


Feasibility data was collected to evaluate generalizability to other single-port techniques such as cholecystectomy .


This was a single-center , randomized controlled trial .


Participants were randomized to receive either SPILS or standard three-port laparoscopic appendicectomy .


The primary patient-reported outcomes were body image and cosmesis at @ weeks .


The primary clinical outcome was pain at @-@ days .


Secondary outcomes included duration of operation , conversion rates , complication rates , use of analgesia , hospital re-admission rates , re-operation rates , and time to return to normal activities .


Seventy-nine patients were randomized .


Sixty-seven completed the day @-@ diary and @ completed the @-week follow-up .


SPILS patients answered significantly more favorably to the items in the body image scale -LSB- mean ( SD ) @ ( @ ) vs. @ ( @ ) ; -@ ( @ % CI -@ to @ ; p = @ ) -RSB- and the cosmetic scale -LSB- @ ( @ ) vs. @ ( @ ) ; @ ( @ % CI @-@ @ ; p = @ ) -RSB- compared with patients in the Standard group .


The duration of operation was shorter for SPILS , and patients required less morphine in recovery ; however , there were no statistically significant differences in other outcomes .


Patient-reported body image and cosmesis outcomes were better , and surgical outcomes were similar following SPILS .


However , the SPILS procedure is more technically demanding and may not be achievable or necessary in routine clinical care .


Further assessment of the findings is needed through larger multicenter studies .


To explore the protective effects of target blood glucose control on cardiac dysfunction in septic patients .


For this prospective and randomized interventional study , a total of @ septic patients were divided into group A ( blood glucose levels of @ to @ mmol/L ) , group B ( @ to @ mmol/L ) and group C ( @ to @ mmol/L ) ( n = @ each ) .


And @ non-septic subjects were selected into control group .


Serial transthoracic echocardiogram ( TTEs ) was performed to measure left ventricle ejection fraction ( LVEF ) and ratio of blood flow velocity of mitral annulus during early diastole ( E ) and atrial contraction ( A ) before and @ , @ , @ days after blood glucose control with insulin therapy .


The plasma level of brain natriuretic peptide ( BNP ) was detected by enzyme-linked immunosorbent assay ( ELISA ) .


The patient records were reviewed to obtain information about demographics , Acute Physiology and Chronic Health Evaluation II ( APACHE II ) scores , incidence of hypoglycemia and @-days survival rates .


No significant inter-group improvement existed in mean values of LVEFs ( P = @ ) .


And E/As differed among the groups and there was statistical difference between groups A and C ( P = @ ) .


There was a increasing trend for the levels of BNP of groups A , B and C. And comparison of group A with group B/C had statistical variability ( PAB = @ , P ( Ac ) = @ ) .


LVEFs had no variation ( P = @ , P = @ ) while E/A and BNP were significantly higher or lower in group A than those in others at Day @ and @ ( P = @ ) .


The LVEFs were similar at Day @ and E/As and BNPs of groups A , B and C showed statistical differences .


The variation of E/As with time differed between groups A , B and C.


Maintaining a target blood glucose of @ to @ mmol/L may improve cardiac dysfunction .


Furthermore , it has more significant improvement of diastolic dysfunction than systolic counterpart .


Combined utilization of LVEF , E/A and BNP is better in evaluating critical ill patients with sepsis-induced cardiomyopathy under target blood glucose control .


It suggests that a glucose level of @ to @ mmol/L may benefit cardiac consistent dysfunction in septic patients during @ days after treatment .


The aim of this study was to examine non-cavitated approximal caries using non-invasive treatment methods .


Molar and premolar teeth with approximal caries were used in this in vivo study .


Approximal caries lesions were evaluated with visual and radiographic inspection and with the DIAGNOdent device .


Five groups were formed to study non-invasive treatment , and each had at least @ early approximal carious lesions .


Patients in the control group were not treated .


After the separation , either ozone application , acidulated phosphate fluoride gel , CPP-ACP-containing material ( Tooth Mousse ) , or an antibacterial bonding agent ( Clearfil Protect Bond ) was used .


For @ months after the non-invasive treatment , radiological controls were used to observe the progress of the initial and approximal caries in the @st , @rd , @th and @th months of follow-up .


A Mann-Whitney U-test was used to perform the statistical analysis ; in-group comparisons were made with the Wilcoxon signed-rank test , and a quantitative assessment was performed using a chi-squared test .


At the end of @ months , the caries lesions in the control group were observed to progress ( P < @ ) .


The lesions that were scored as @a during a visual inspection recovered by using non-invasive treatments .


Approximal caries lesions that were detected at the early stages remained stationary when using antibacterial agents and materials that promoted remineralisation .


Antibacterial agents and remineralisation materials can be used in treatment of early approximal caries lesions .


Co-administration of an investigational quadrivalent meningococcal serogroups A , C , W and Y tetanus toxoid conjugate vaccine ( MenACWY-TT ) with the fourth dose of diphtheria-tetanus-acellular pertussis vaccine ( DTaP ) at age @-@ months was investigated in @-dose Haemophilus influenzae type b-meningococcal serogroups C/Y conjugate vaccine ( HibMenCY-TT ) - primed toddlers .


Infants were randomized ( @:@ ) and primed at @ , @ and @ months of age with HibMenCY-TT and DTaP-hepatitis B-inactivated poliovirus ( DTaP-HBV-IPV ) vaccine , or Hib-TT and DTaP-HBV-IPV ( Control ) .


HibMenCY-TT + DTaP-HBV-IPV vaccinees were re-randomized ( @:@:@ ) to receive MenACWY-TT at @-@ months and DTaP at @-@ months ( MenACWY-TT group ) ; MenACWY-TT co-administered with DTaP at @-@ months ( Coad group ) ; or HibMenCY-TT at @-@ months and DTaP at @-@ months ( HibMenCY-TT group ) .


Controls received DTaP at @-@ months .


Only children in the HibMenCY-TT group received a fourth dose of Hib conjugate vaccine due to Hib conjugate vaccine shortage at the time of the study .


DTaP immunogenicity and reactogenicity were assessed one month post-vaccination .


Pre-defined statistical non-inferiority criteria between Coad and Control groups were met for diphtheria , tetanus and filamentous haemagglutinin but not pertussis toxoid and pertactin .


Following vaccination @ % of children had anti-diphtheria/anti-tetanus concentrations @ IU/ml .


Pertussis GMCs were lower in all investigational groups versus Control .


In post hoc analyses , pertussis antibody concentrations were above those in infants following @-dose DTaP primary vaccination in whom efficacy against pertussis was demonstrated ( Schmitt , von Knig , et al. , @ ; Schmitt , Schuind , et al. , @ ) .


The reactogenicity profile of the Coad group was similar to DTaP administered alone .


Routine booster DTaP was immunogenic with an acceptable safety profile when co-administered with MenACWY-TT vaccine in HibMenCY-TT-primed toddlers .


These data support the administration of a fourth DTaP dose following a @-dose HibMenCY-TT vaccination series , or co-administered with MenACWY-TT in HibMenCY-TT-primed children .


Many patients with peripheral artery disease ( PAD ) have walking impairment despite therapy .


Experimental studies in animals demonstrate improved perfusion in ischemic hind limb after mobilization of bone marrow progenitor cells ( PCs ) , but whether this is effective in patients with PAD is unknown .


To investigate whether therapy with granulocyte-macrophage colony-stimulating factor ( GM-CSF ) improves exercise capacity in patients with intermittent claudication .


In a phase @ double-blind , placebo-controlled study , @ patients ( median -LSB- SD -RSB- age , @ -LSB- @ -RSB- years ; @ % male , @ % with diabetes ) with intermittent claudication were enrolled at medical centers affiliated with Emory University in Atlanta , Georgia , between January @ and July @ .


Participants were randomized ( @:@ ) to received @ weeks of subcutaneous injections of GM-CSF ( leukine ) , @ g/day @ times a week , or placebo .


Both groups were encouraged to walk to claudication daily .


The primary outcome was peak treadmill walking time ( PWT ) at @ months .


Secondary outcomes were PWT at @ months and changes in circulating PC levels , ankle brachial index ( ABI ) , and walking impairment questionnaire ( WIQ ) and @-item Short-Form Health Survey ( SF-@ ) scores .


Of the @ patients randomized , @ were assigned to the GM-CSF group .


The mean ( SD ) PWT at @ months increased in the GM-CSF group from @ ( @ ) seconds to @ ( @ ) seconds ( mean change , @ seconds -LSB- @ % CI , @ to @ -RSB- ) and in the placebo group from @ ( @ ) seconds to @ ( @ ) seconds ( change of @ seconds -LSB- @ % CI , @ to @ -RSB- ) , but this difference was not significant ( mean difference in change in PWT , @ seconds -LSB- @ % CI , -@ to @ -RSB- , P = @ ) .


At @ months , compared with placebo , GM-CSF improved the physical functioning subscore of the SF-@ questionnaire by @ ( @ % CI , @ to @ ) vs @ ( @ % CI , -@ to @ ) , with a mean difference in change for GM-CSF vs placebo of @ ( @ % CI , @ to @ ; P = @ ) .


Similarly , the distance score of the WIQ improved by @ ( @ % CI , @ to @ ) vs @ ( @ % CI , -@ to @ ) with GM-CSF compared with placebo ( mean difference in change , @ -LSB- @ % CI , @ to @ -RSB- , P = @ ) .


There were no significant differences in the ABI , WIQ distance and speed scores , claudication onset time , or mental or physical component scores of the SF-@ between the groups .


Therapy with GM-CSF @ times a week did not improve treadmill walking performance at the @-month follow-up .


The improvements in some secondary outcomes with GM-CSF suggest that it may warrant further study in patients with claudication .


Previously , a study of ours showed that the combination of dabrafenib and trametinib improves progression-free survival compared with dabrafenib and placebo in patients with BRAF Val@Lys/Glu mutation-positive metastatic melanoma .


The study was continued to assess the secondary endpoint of overall survival , which we report in this Article .


We did this double-blind phase @ study at @ sites in @ countries .


We enrolled previously untreated patients with BRAF Val@Glu or Val@Lys mutation-positive unresectable stage IIIC or stage IV melanoma .


Participants were computer-randomised ( @:@ ) to receive a combination of dabrafenib ( @ mg orally twice daily ) and trametinib ( @ mg orally once daily ) , or dabrafenib and placebo .


The primary endpoint was progression-free survival and overall survival was a secondary endpoint .


This study is registered with ClinicalTrials.gov , number NCT@ .


Between May @ , @ , and Nov @ , @ , we screened @ patients for eligibility , of whom @ were randomly assigned to receive dabrafenib and trametinib ( n = @ ) or dabrafenib only ( n = @ ) .


The final data cutoff was Jan @ , @ , at which time @ patients had died .


Median overall survival was @ months ( @ % CI @-not reached ) in the dabrafenib and trametinib group versus @ months ( @-@ ) in the dabrafenib only group ( hazard ratio -LSB- HR -RSB- @ , @ % CI @-@ ; p = @ ) .


Overall survival was @ % at @ year and @ % at @ years in the dabrafenib and trametinib group versus @ % and @ % , respectively , in the dabrafenib only group .


Based on @ events , median progression-free survival was @ months ( @ % CI @-@ ) in the dabrafenib and trametinib group and @ months ( @-@ ) in the dabrafenib only group ( HR @ , @ % CI @-@ ; p = @ ; unadjusted for multiple testing ) .


Treatment-related adverse events occurred in @ ( @ % ) of @ patients in the dabrafenib and trametinib group and @ ( @ % ) of @ patients in the dabrafenib only group ; the most common was pyrexia ( @ patients , @ % ) in the dabrafenib and trametinib group , and hyperkeratosis ( @ patients , @ % ) in the dabrafenib only group .


Grade @ or @ adverse events occurred in @ ( @ % ) patients in the dabrafenib and trametinib group and @ ( @ % ) patients in the dabrafenib only group .


The improvement in overall survival establishes the combination of dabrafenib and trametinib as the standard targeted treatment for BRAF Val@ mutation-positive melanoma .


Studies assessing dabrafenib and trametinib in combination with immunotherapies are ongoing .


Mild adverse events ( AEs ) are common with acupuncture , but the risk factors remain unclear .


A prospective study using a standardised AE assessment and acupuncture protocol was undertaken to address the question .


A @-item AE report form investigated local and systemic AEs in @ adults with insomnia randomised to receive traditional , minimal and non-invasive sham acupuncture .


Sociodemographic , clinical and psychological variables at baseline and past history and perceived credibility of acupuncture were assessed .


The incidence of any AEs per patient was @ % with traditional acupuncture , @ % with minimal acupuncture and @ % with non-invasive sham acupuncture .


Traditional and minimal acupuncture were associated with a greater number of local AEs , while the presence of a chronic medical condition was predictive of fewer local and systemic AEs .


Greater severity of insomnia , anxiety , depression , somatic symptoms and pain catastrophising thoughts were associated with lower risk , but most of the significant correlations disappeared after logistic regression .


Divorce and widowhood were the only significant sociodemographic variables , while previous acupuncture treatment and perceived credibility of acupuncture were found to be unrelated .


The risk of any AEs was higher in participants receiving traditional acupuncture ( OR @ ) and minimal acupuncture ( OR @ ) and in those without medical comorbidity ( OR @ ) .


The prevalence of AEs was higher than usual , probably due to the low threshold in our definition of AEs and the systematic collection from the patients ' perspective .


Baseline variables were largely unable to predict AEs associated with acupuncture .


Further studies should explore the roles of practitioners , patients ' anxiety during treatment and patient-practitioner interactions .


Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography ( ERCP ) .


The aim of this prospective trial was to compare the effect of ulinastatin and nafamostat on the prophylaxis of post-ERCP complications .


A total of @ patients who underwent ERCP were divided into ulinastatin ( n = @ ) , nafamostat ( n = @ ) and control ( n = @ ) groups .


Each patient received ulinastatin ( @,@ units ) , nafamostat ( @ mg ) , or placebo from @-@ h before ERCP to @-@ h after ERCP .


The primary endpoint was the incidence of PEP , and the secondary endpoints were the incidence of post-ERCP hyperamylasemia , hyperlipasemia and abdominal pain .


The overall incidence of PEP was @ % ( @/@ ) and no significant differences were observed between ulinastatin and nafamostat groups in terms of the incidences of PEP ( @ % and @ % , P = @ ) , hyperamylasemia , hyperlipasemia , and abdominal pain , although these were significantly lower than those of the control group ( P < @ ) .


There was no significant difference for preventing PEP between ulinastatin and nafamostat and both drugs were efficacious for preventing post-ERCP complications .


Dysphagia is the most common complication of anterior cervical discectomy and fusion ( ACDF ) , and it is closely related to prevertebral soft-tissue swelling ( PSTS ) .


A few studies have found that local or systemic methylprednisolone is effective against laryngopharyngeal edema and airway obstruction .


To assess the effectiveness of short-term use of systemic methylprednisolone in relieving dysphagia and decreasing PSTS during the hospitalization period .


A prospective study .


Forty patients who underwent multilevel ( more than three levels ) ACDF with same plate fixation .


Radiologic and clinical measures .


Twenty of these patients were given @ mg of methylprednisolone intravenously ( IV ) four times a day only for @ hours after the operation ( at @-hour intervals ) , whereas the remaining @ did not receive methylprednisolone and served as controls .


We used the Bazaz scale to compare the degree of dysphagia between groups during the hospitalization period .


We used the C-spine lateral view to assess the degree of pre - and postoperative PSTS from C@ to C@ .


At the final follow-up , we assessed the relationship between the occurrence of complications and steroid use .


The degree of dysphagia according to the Bazaz scale was less severe in the group that received methylprednisolone ( p values ; postoperative Day -LSB- POD -RSB- @ < @ , POD @ = @ , POD @ = @ ) .


Prevertebral soft-tissue swelling was also significantly lower in the group that received methylprednisolone ( p values ; POD @POD @ < @ , POD @ = @ , POD @ = @ , POD @ = @ ) .


The amount of PSTS and dysphagia did not differ according to sex , age , smoking history , or length of surgery .


The period of hospitalization in the experimental group was shorter than in the control group .


No complications related to steroid use were found at the final follow-up .


The short-term use of systemic methylprednisolone after ACDF appears to be effective in relieving dysphagia and decreasing the PSTS .


Furthermore , the short-term use of methylprednisolone was not associated with any adverse effects of short-term IV steroid usage , such as peptic ulcer disease or postoperative infection .


The clinical use of methylprednisolone in relieving dysphagia and decreasing PSTS deserves consideration during the early postoperative period .


Mass drug administration ( MDA ) with azithromycin , carried out for the control of blinding trachoma , has been linked to reduced mortality in children .


While the mechanism behind this reduction is unclear , it may be due , in part , to improved nutritional status via a potential reduction in the community burden of infectious disease .


To determine whether MDA with azithromycin improves anthropometric indices at the community level , we measured the heights and weights of children aged @ to @ years in communities where one ( single MDA arm ) or three annual rounds ( annual MDA arm ) of azithromycin had been distributed .


Data collection took place three years after treatment in the single MDA arm and one year after the final round of treatment in the annual MDA arm .


Mean height-for-age , weight-for-age and weight-for-height z scores were compared between treatment arms .


No significant differences in mean height-for-age , weight-for-age or weight-for-height z scores were found between the annual MDA and single MDA arms , nor was there a significant reduction in prevalence of stunting , wasting or underweight between arms .


Our data do not provide evidence that community MDA with azithromycin improved anthropometric outcomes of children in The Gambia .


This may suggest reductions in mortality associated with azithromycin MDA are due to a mechanism other than improved nutritional status .


This study was designed to determine whether a @ day perioperative regimen of gabapentin added to celecoxib improves in-hospital rehabilitation and physical function on postoperative day @ and @ weeks and @ months after total knee arthroplasty ( TKA ) .


After Research Ethics Board approval and informed consent , @ patients were enrolled in a randomized , double-blinded , placebo-controlled study .


Two hours before surgery , patients received celecoxib @ mg p.o. and were randomly assigned to receive either gabapentin @ mg or placebo p.o. Two hours later , patients received femoral , sciatic nerve blocks , and spinal anaesthesia .


After operation , patients received gabapentin @ mg or placebo three times per day ( TID ) for @ days .


All patients also received celecoxib @ mg q@ h for @ h and i.v. patient-controlled analgesia for @ h. Pain and function were assessed at baseline , during hospitalization , on postoperative day @ ( POD@ ) , and @ weeks and @ months after surgery .


The gabapentin group used less morphine in the first @ h after surgery -LSB- G = @ ( @ mg ) , P = @ ( @ mg ) -RSB- ( P < @ ) and had increased knee range of motion compared with the placebo group in-hospital ( P < @ ) .


There were no differences between groups in favour of the gabapentin group for pain or physical function on POD @ -LSB- @ % confidence interval ( CI ) : pain : -@ , @ ; function : -@ , @ -RSB- , @ weeks ( @ % CI : pain : @ , @ ; function : -@ , @ ) or @ months ( @ % CI : pain : -@ , @ ; function : -@ , @ ) after TKA .


In the context of celecoxib , spinal anaesthesia , femoral and sciatic nerve blocks , a dose of gabapentin @ mg before operation followed by @ days of gabapentin @ mg TID decreased postoperative analgesic requirements and improved knee range of motion after TKA .


Gabapentin provided no improvement in pain or physical function on POD@ and @ weeks or @ months after surgery .


Under-reporting of substance use and other sensitive information is a substantial threat to internal study validity , particularly during the perinatal period .


Anonymous approaches are associated with greater disclosure but are incompatible with longitudinal follow-up .


Alternative approaches include use of a U.S. Federal Certificate of Confidentiality ( CoC ) and quasi-anonymous methods , in which there is no link between name and data .


However , the relative effect of these procedures on disclosure is unknown .


This randomized study was designed to evaluate the effects of consent condition ( anonymous , quasi-anonymous , CoC , and traditional confidentiality ) on disclosure of sensitive information among postpartum women .


Participants were @ postpartum , primarily African-American women who were randomly assigned to one of the four consent conditions and completed a brief computer-delivered assessment of alcohol and drug use , sexual risk , intimate partner violence , and emotional distress .


Participants in the anonymous and quasi-anonymous conditions disclosed significantly more sensitive information than those in the traditional consent condition .


In contrast , no advantage in overall disclosure was observed for the CoC condition .


This result was largely consistent across specific content areas with the exception of emotional distress , disclosure of which was unrelated to consent condition .


Although use of a CoC has limited impact on disclosure , the quasi-anonymous method may increase disclosure to a similar extent as full anonymity .


Quasi-anonymous approaches should be considered when under-reporting is likely , a context in which the disadvantages of this approach must be balanced against its advantages .


Protein-energy wasting ( PEW ) is common in hemodialysis patients and is a powerful predictor of morbidity and mortality .


Although much progress has been made in recent years in identifying the causes and pathogenesis of PEW in hemodialysis patients , actual management by nutritional interventions is not always able to correct PEW .


Some investigators suggest that physical exercise may increase the anabolic effects of nutritional interventions , and therefore may have a potential to reverse PEW .


The aim of this study is to investigate the effect of intra-dialytic progressive exercise training and adequate nutritional supplementation on markers of PEW , functional capacities and quality of life of adult hemodialysis patients .


Fifty end-stage renal disease patients undergoing hemodialysis , who meet the diagnostic criteria for PEW , will be randomly allocated into an exercise or control group for @ months .


The exercise consists of a progressive submaximal individualized cycling exertion using an adapted cycle ergometer , during the three weekly dialysis sessions .


Biological markers of nutrition ( albumin , prealbumin ) will be followed monthly and all patients will be assessed for body composition , walk function , muscle strength , postural stability and quality of life at baseline and during the eighth week ( t +@ ) , the sixteenth week ( t +@ ) and the twenty-fourth week ( t +@ ) of the @-month adapted rehabilitation program .


The successful completion of this current trial may give precious clues in understanding PEW and encourage nephrologists to extend prescription of exercise programs as well as therapeutic and as preventive interventions in this high-risk population .


The knowledge of factors that may influence blood donation in Cameroon is limited .


The objectives of this study are to assess the characteristics of previous and potential blood donors by exploring the religious beliefs , and knowledge and understanding of blood donations among individuals present at a district hospital .


Forty-nine in-depth , semi-structured interviews were conducted among consenting , randomly selected @ years or older community members present at a district hospital in the Adamaoua region during October and November @ .


Ninety-eight per cent ( @/@ ) of the individuals present at this district hospital had heard of blood transfusions .


Forty-seven per cent ( @/@ ) had not previously been asked to donate blood ; however , @ % ( @/@ ) said that they would donate if given the opportunity .


Thirty-three per cent ( @/@ ) had previously donated blood to family members or for replacement , and @ % of these said they would repeat donations .


The majority of both donors and non-donors were motivated to donate blood for altruistic reasons .


The findings suggest that community members present at this district hospital in Cameroon may be recruited for repeat blood donations .


Although the altruistic motivation to donate blood suggests that donors could be recruited from a district hospital population , targeted information about blood donations and accessible blood transfusion services need to be put in place .


The study may add to the understanding of the preconditions for blood donations and the possibility to establish sustainable blood transfusion services in the Adamaoua region in Cameroon .


Antibiotic-resistant strains of pathogenic bacteria are increasingly prevalent in hospitals and the community .


Acute exacerbations of COPD ( AE-COPD ) often result in administration of antibiotics although more than half of exacerbations are associated with detection of respiratory viruses and potentially pathogenic bacteria can only be detected in @-@ % of cases .


There is a paucity of placebo-controlled clinical trials and up to today no single study has been powered sufficiently to prove the efficacy of antibiotic treatment in AE-COPD .


Most studies so far did not include current standards of care comprising administration of systemic corticosteroids .


A total of @ patients with moderate acute exacerbations will be included in @ German centers ( hospitals and private practices ) .


Patients will receive a standardized treatment for exacerbation including systemic corticosteroids , inhaled bronchodilators and supplementary oxygen if needed and will be randomized to additional treatment with placebo or antibiotic ( oral sultamicillin ) for five days.The primary endpoint is clinical failure defined by need for additional antibiotic treatment until day @ .


Secondary endpoints will assure that management of AE-COPD without antibiotics does not result either in increased occurrence of relapse , new exacerbations , prolonged recovery , or unwanted long-term consequences .


ABACOPD will be the first sufficiently powered double-blind placebo-controlled study in the field to systematically assess the question whether antibiotics , known to increase antibiotic resistance , are really needed in a well-defined patient cohort receiving state-of-the art treatment in all other aspects .


To determine the effects of resveratrol ( RES ) on growth and immune status in chickens receiving conventional vaccinations .


Two hundred forty @-day-old layer chickens .


Chickens received conventional vaccinations throughout the study and were randomly assigned to @ of @ treatments in @ replicate pens/treatment .


Treatments included @ control group ( basal diet ) and @ experimental groups fed the basal diet plus @ , @ , and @ mg of RES/kg of diet .


At @ days of age , @ bird/pen was randomly selected to have blood and tissues collected to determine serum immunity indices ; mRNA relative expression of proinflammatory cytokines in splenocytes ; mRNA relative expression of nuclear transcription factor-B , growth hormone receptor , and insulin-like growth factor-@ in hepatocytes ; cell proliferation ; and apoptosis .


Average daily gain , antibody titers against Newcastle disease virus and avian influenza viruses H@ and H@ , and insulin-like growth factor-@ expression were quadratically increased with increasing RES concentration .


In hepatocytes , growth hormone receptor gene mRNA relative expression was quadratically increased and nuclear transcription factor-B gene mRNA relative expression was linearly decreased with increasing RES concentration .


In splenocytes , nterleukin-@ and tumor necrosis factor - mRNA relative expression was linearly decreased with increasing RES concentration .


Resveratrol supplementation delayed cell proliferation and reduced apoptosis in immunocytes .


With increasing RES concentration , proliferation index and relative weight of the thymus , ratio of CD@ + to CD@ + cells , and CD@ + cell count were quadratically increased , and IgM concentration was linearly increased .


Dietary resveratrol supplementation improved growth , protected immunocytes against antigen-induced apoptosis , and upregulated immune response in chickens that received conventional vaccinations .


Various external factors can influence patients ' experiences of noxious stimuli , but little is known of how patients ' natural behaviour may be relevant .


We ascertained how often patients spontaneously look or look away during venepuncture and associated reports of pain during a previously reported experimental randomized study .


The study was conducted in the outpatient department of a U.K. district general hospital .


Patients were randomized to hearing ` sharp scratch ' or the verbal cue ` ready ? '


immediately before venepuncture .


Whether patients looked or looked away during needle insertion was recorded .


Patients were asked to rate their pain using a verbal numerical rating score ( VNRS ) and verbal response scale ( VRS ) .


One hundred ninety-two patients were included ; mean age @ years , @ % male .


During needle insertion , @ % spontaneously looked away , whereas @ % looked .


There was no significant difference in the proportion of these patients assigned to the ` sharp scratch ' or ` ready ? '


groups , nor was there any difference in mean age or gender .


For the group that looked , mean VNRS was @ and VRS was @ , significantly less than the group that looked away ( mean VNRS @ , p = @ ; VRS @ , p = @ ) .


As previously reported , pain ratings between ` sharp scratch ' and ` ready ? '


groups were not significantly different .


Almost three quarters of patients spontaneously look away during venepuncture , but their pain ratings are almost twice that of the quarter of patients who look .


It is unclear why this may be , but previous experimental studies indicate that observing the body when a noxious stimulus is applied can have an analgesic effect .


The aim of this study was to investigate if there is any interaction between ondansetron and nefopam when they are continuously co-administrated during patient-controlled intravenous analgesia ( PCIA ) .


The study was a prospective , randomized , controlled , non-inferiority clinical trial comparing nefopam-plus-ondansetron to nefopam alone .


A total of @ postoperative patients using nefopam for PCIA , were randomly assigned either to a group receiving continuous infusion of ondansetron ( Group O ) or to the other group receiving the same volume of normal saline continuously ( Group N ) .


Postoperative pain intensity scores , the sum of pain intensity difference over @ hours postoperatively ( SPID@hr ) , the incidence of adverse events , and the total consumption of nefopam were evaluated respectively .


Postoperative pain was treated successfully in both groups .


The mean SPID@hr scores were @ mm in Group N and @ mm in Group O -LSB- @ % confidence interval ( CI ) -@ , @ -RSB- .


The lower margin of the @ % CI was above the pre-determined non-inferiority margin ( -@ mm ) for SPID@hr , which indicated that nefopam-plus-ondansetron was not worse than the nefopam alone in term of analgesic efficacy .


In addition , there was no statistical difference between the two groups in term of cumulative consumption of nefopam .


Compared with Group N , postoperative vomiting was significantly reduced in Group O during the postoperative @ hours ( P < @ ) .


Less rescue antiemetics were given to patients in Group O than those receiving nefopam alone ( P < @ ) .


There were no differences in postoperative nausea between the two groups .


Nefopam-plus-ondansetron is not inferior to nefopam alone in relieving the pain in PCIA after minimally invasive surgery .


In addition , adverse events are reduced without compromising analgesic efficacy .


To evaluate the efficacy of a delayed home exercise programme compared with normal care after primary total knee arthroplasty .


Single-blind , prospective , randomized , controlled trial .


A total of @ participants ( @ % females , mean age @ years -LSB- standard deviation @ -RSB- ) , were randomized to a home-based exercise group ( EG , n = @ ) or to a control group ( CG , n = @ ) .


Two months post-operatively , the EG received a home exercise programme , while the CG received no additional guidance .


The outcome measurements were : pain and disability , measured using the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) ; health-related quality of life ( HRQoL ) , measured using the Short Form-@ questionnaire ( SF-@ ) ; maximal walking speed ; isometric knee muscle strength ; and the Timed Up and Go ( TUG ) test .


Measurements were made at baseline and at @ months thereafter .


At the @-month follow-up , maximal walking speed ( p < @ ) and knee flexion strength ( p = @ ) were significantly greater in the EG .


Both groups showed similar improvements in all of the WOMAC subscale scores , the SF-@ summary scores and the TUG time .


Home-based training was not superior to normal care with regard to pain , disability or HRQoL , but resulted in greater improvement in objectively measured physical performance .


Corticosteroids have been evaluated for management of severe Mycoplasma pneumoniae pneumonia ( MP ) in children .


However , it is unclear whether the timing of treatment with corticosteroids affects the patients ' clinical outcome .


We did a prospective randomized clinical trial to evaluate the effect of early use of corticosteroids .


Fifty-three patients were randomly assigned to treatment with corticosteroids within @ h after admission ( cases ) , and @ patients were treated @ h after admission ( control patients ) .


Cases had a shorter fever duration -LSB- @ days ( range @-@ ) vs. @ days ( range @-@ ) , p < @ -RSB- and length of hospital stay -LSB- @ days ( range @-@ ) vs. @ days ( range @-@ ) , p = @ -RSB- .


Four cases ( @ % ) had a complete radiographic resolution time > @ weeks compared with @ control patients ( @ % ; p = @ ; Table @ ) .


Early treatment with corticosteroids was associated with a better outcome in patients with severe MP .


Endotracheal intubation ( ETI ) is an essential resuscitation procedure in children .


Video laryngoscopes have been developed to avoid intubation failures in a variety of scenarios , including cardiopulmonary resuscitation .


We hypothesized that the video laryngoscope RIFL ( AI Medical Devices , Inc , Williamston , MI ) offers advantages in the ETI of a pediatric manikin while performing chest compressions ( CCs ) .


Randomized nonblinded crossover simulation trial conducted among @ paramedics with no prior experience with RIFL .


Each participant performed intubations with Miller ( MIL ; Mercury Medical , Clearwater , FL ) laryngoscope and RIFL in a PediaSIM CPR training manikin ( FCAE HealthCare , Sarasota , FL ) in @ airway scenarios : ( a ) normal airway at rest ( without concomitant CC ) , ( b ) normal airway with mechanically controlled CC , and ( c ) difficult airway with concomitant CC .


The primary outcome was the time to intubation , and secondary one was the success of the intubation attempt .


In the manikin at rest with normal airway , nearly all participants performed successful ETI both with MIL and RIFL , with similar intubation times .


However , in the other scenarios ( normal and difficult airway with uninterrupted CC ) , the results with RIFL were significantly better than with MIL ( P < @ ) for all the analyzed variables ( success of first attempt , overall success rate , time to intubation , Cormac-Lehane grade , dental compression , and easy of intubation scores ) .


In simulated child arrest scenarios with normal/difficult airway conditions and with concomitant mechanical CC , paramedics performed better with the RIFL video laryngoscope than with the standard MIL .


To determine if a stabilised , stannous-containing sodium fluoride dentifrice provides greater enamel protection in situ against intraoral dietary erosive challenges compared with a sodium fluoride/potassium nitrate dentifrice .


A single-centre , investigator blind , randomised , supervised , two-treatment , non-brushing , four-period crossover in situ study was undertaken , with each test period being @ days .


Thirty-five healthy adult subjects were recruited to participate in the study , which included four erosive acid challenges per day .


Subjects were randomised to product treatment , which included either : ( @ ) a stannous-containing sodium fluoride dentifrice ( Oral-B ( ) Pro-Expert Sensitive ) or ( @ ) a sodium fluoride/potassium nitrate dentifrice ( Sensodyne ( ) Pronamel ( ) ) .


Each study subject wore an intraoral appliance retaining two sterilised , polished human enamel samples for @ hours/day .


Subjects swished with an allocated dentifrice slurry twice a day and with @ ml of orange juice for @ minutes ( @ ml/minute over a @-minute period ) four times per day .


The primary and secondary outcomes for this study were enamel loss measured using contact profilometry at days @ and @ , respectively , using parametric analysis methods .


At day @ , a @ % lower enamel loss ( P < @ ) was observed , with estimated medians of @ m ( SE @ ) and @ m ( SE @ ) , in favour of the stannous-containing dentifrice .


At day @ , specimens treated with the stannous-containing sodium fluoride dentifrice demonstrated @ % less enamel loss than those treated with the sodium fluoride/potassium nitrate dentifrice .


Treatment differences at day @ were also statistically significant ( P < @ ) , with estimated medians of @ m ( SE @ ) and @ m ( SE @ ) , respectively .


Results of this in situ study suggest the stabilised , stannous-containing sodium fluoride dentifrice could be used to provide significantly greater protection to enamel from erosive acid challenge compared with that provided by conventional fluoride-containing products .


To compare the effectiveness of the alveolar recruitment maneuver and the breath stacking technique with respect to lung mechanics and gas exchange in patients with acute lung injury .


Thirty patients were distributed into two groups : Group @ - breath stacking ; and Group @ - alveolar recruitment maneuver .


After undergoing conventional physical therapy , all patients received both treatments with an interval of @ day between them .


In the first group , the breath stacking technique was used initially , and subsequently , the alveolar recruitment maneuver was applied .


Group @ patients were initially subjected to alveolar recruitment , followed by the breath stacking technique .


Measurements of lung compliance and airway resistance were evaluated before and after the use of both techniques .


Gas analyses were collected before and after the techniques were used to evaluate oxygenation and gas exchange .


Both groups had a significant increase in static compliance after breath stacking ( p = @ ) and alveolar recruitment ( p = @ ) , but with no significant differences between the groups ( p = @ ) .


The dynamic compliance did not increase for the breath stacking ( p = @ ) and alveolar recruitment ( p = @ ) groups , with no significant difference between the groups ( p = @ ) .


The airway resistance did not decrease for either groups , i.e. , breath stacking ( p = @ ) and alveolar recruitment ( p = @ ) , with no significant difference between the groups ( p = @ ) .


The partial pressure of oxygen increased significantly after breath stacking ( p = @ ) and alveolar recruitment ( p = @ ) , but there was no significant difference between the groups ( p = @ ) .


The alveolar-arterial O@ difference decreased for both groups after the breath stacking ( p = @ ) and alveolar recruitment ( p = @ ) interventions , and there was no significant difference between the groups ( p = @ ) .


Our data suggest that the breath stacking and alveolar recruitment techniques are effective in improving the lung mechanics and gas exchange in patients with acute lung injury .


This randomised , open-label , multicenter phase II study compared progression-free survival ( PFS ) of S-@ plus oxaliplatin ( SOX ) with that of S-@ alone in patients with gemcitabine-refractory pancreatic cancer .


Patients with confirmed progressive disease following the first-line treatment with a gemcitabine-based regimen were randomised to receive either S-@ ( @/@/@mgday ( -@ ) based on body surface area ( BSA ) , orally , days @-@ , every @ weeks ) or SOX ( S-@ @/@/@mgday ( -@ ) based on BSA , orally , days @-@ , plus oxaliplatin @mgm ( -@ ) , intravenously , day @ , every @ weeks ) .


The primary end point was PFS .


Between January @ and July @ , @ patients were randomly allocated to either S-@ ( n = @ ) or SOX ( n = @ ) .


Median PFS for S-@ and SOX were @ and @ months , respectively ( hazard ratio ( HR ) = @ ; @ % confidence interval ( CI ) , @-@ @ ; stratified log-rank test P = @ ) .


Median overall survival ( OS ) was @ vs @ months ( HR = @ ; @ % CI , @-@ @ ; stratified log-rank test P = @ ) .


The response rate ( RR ) was @ % vs @ % ( P = @ ) .


The major grade @/@ toxicities ( S-@ and SOX ) were neutropenia ( @ % and @ % ) , thrombocytopenia ( @ % and @ % ) and anorexia ( @ % and @ % ) .


Although SOX showed an advantage in RR , it provided no significant improvement in PFS or OS compared with S-@ alone .


Changes in cancer therapy , in addition to changes in obesity prevalence , suggest the need for a current assessment of weight gain patterns following breast cancer diagnosis .


The aim of this study was to evaluate factors associated with weight gain among breast cancer survivors prior to enrolling into a behavioral weight loss intervention .


Anthropometric measures and data on weight-related factors were collected at baseline on @ breast cancer survivors .


Postdiagnosis weight gain was determined between entry into the trial and previous diagnosis up to @ years .


Multivariate logistic regression analyses were used to evaluate the association between weight gain and influencing factors .


The mean weight gain was @ % body weight ( standard deviation = @ ) ; @ % of women experienced @ % body weight gain .


The risk of weight gain was inversely associated with age ( adjusted odds ratio ( ORadj ) = @ , @ % confidence interval ( @ % CI ) @-@ @ ) , Hispanic ethnicity ( ORadj = @ , @ % CI @-@ @ ) , and overweight ( ORadj = @ , @ % CI @-@ @ ) or obese ( ORadj = @ , @ % CI @-@ @ ) status at diagnosis and positively associated with time elapsed since diagnosis ( ORadj = @ / year , @ % CI @-@ @ ) .


Women prescribed aromatase inhibitors were @ % less likely to gain weight compared to women prescribed selective estrogen-receptor modulators ( ORadj = @ , @ % CI @-@ @ ) .


The risk of weight gain was positively associated with smoking at diagnosis ( ORadj = @ , @ % CI @-@ @ ) although this was attributable to women who subsequently quit smoking .


Postdiagnosis weight gain is common and complex and influenced by age , ethnicity , weight , smoking status , time elapsed since diagnosis , and endocrine-modulating therapy .


Weight gain continues to be a concern following a diagnosis of breast cancer .


Factors influencing this weight gain include age , ethnicity , weight , smoking status , time elapsed since diagnosis , and endocrine-modulating therapy .


Effective weight management strategies are needed for this population of women .


To observe the efficacy on post-stroke mild cognitive impairment ( MCI ) treated with acupuncture at Jing-well points on the differentiated meridians and temple-three-needle therapy .


Seventy-three of stroke patients were randomized into an acupuncture group ( @ cases ) and a conventional treatment group ( @ cases ) .


Twenty healthy aged people in physical examination were collected as a control group .


In the acupuncture group , on the basis of the conventional treatment of internal medication , the acupuncture at Jing-well points on the differentiated meridians and temple-three-needle therapy were applied .


In the conventional treatment group , no any therapy was used except the conventional treatment of internal medication .


In the control group , no any intervention was adopted .


Neuroscan Nuamps electroencephalogram recording analysis system was used to determine the event-related potentials P@ , and the amplitude and mini mental state examination ( MMSE ) score was observed before and after treatment in both groups .


After treatment , in the acupuncture group , P@ latent stage was shortened , and the amplitude and the score of MMSE were increased ( P < @ , P < @ ) .


In the conventional treatment group , above indices were not changed obviously as compared with that before treatment ( all P > @ ) .


Compared with the conventional treatment group , the differences in P@ latent stage , amplitude and MMSE score were remarkable in the acupuncture group ( P < @ , P < @ ) .


The acupuncture at Jing-well points on the differentiated meridians and temple-three-needle therapy improves the cognitive function of the patients with MCI .


Postural tachycardia syndrome ( POTS ) is characterized clinically not only by an exaggerated increase in heart rate ( HR ) , but an associated cognitive impairment that disables many patients .


Modafinil might be effective in improving the cognitive symptoms , but modafinil may stimulate the sympathetic nervous system and worsen tachycardia in POTS .


We tested the hypothesis that modafinil would worsen tachycardia and orthostatic symptoms in POTS .


Patients with POTS ( n = @ ) underwent a randomized crossover trial with modafinil @ mg versus placebo .


Heart rate and systolic blood pressure ( SBP ) were measured seated and standing before modafinil or placebo administration and then hourly for @ hours .


Over @ hours , standing HR was not significantly different between the modafinil and placebo groups ( analysis of variance -LSB- ANOVA -RSB- Pdrug = @ ) , but seated SBP was significantly higher in the modafinil group ( mean -LSB- SD -RSB- , @ -LSB- @ -RSB- mm Hg vs @ -LSB- @ -RSB- mm Hg ; P = @ ) .


Modafinil also significantly increased both the seated SBP ( ANOVA Pdrug = @ ) and the standing SBP ( ANOVA Pdrug = @ ) over time .


There was no significant difference between modafinil and placebo over the @-hour period with regard to POTS symptom burden scores ( @ -LSB- @ -RSB- vs @ -LSB- @ -RSB- ; P = @ ) .


Modafinil did not significantly worsen standing HR or acute orthostatic symptoms in patients with POTS compared with the placebo group and improved upright blood pressure .


Therefore , modafinil could be tested as a potential treatment for the cognitive impairment in POTS .


To evaluate changes in anterior corneal topography and higher-order aberrations ( HOA ) after @-days of rigid gas-permeable ( RGP ) contact lens ( CL ) wear in keratoconus subjects comparing two different fitting approaches .


Thirty-one keratoconus subjects ( @ eyes ) without previous history of CL wear were recruited for the study .


Subjects were randomly fitted to either an apical-touch or three-point-touch fitting approach .


The lens ' back optic zone radius ( BOZR ) was @ mm and @ mm flatter than the first definite apical clearance lens , respectively .


Differences between the baseline and post-CL wear for steepest , flattest and average corneal power ( ACP ) readings , central corneal astigmatism ( CCA ) , maximum tangential curvature ( KTag ) , anterior corneal surface asphericity , anterior corneal surface HOA and thinnest corneal thickness measured with Pentacam were compared .


A statistically significant flattening was found over time on the flattest and steepest simulated keratometry and ACP in apical-touch group ( all p < @ ) .


A statistically significant reduction in KTag was found in both groups after contact lens wear ( all p < @ ) .


Significant reduction was found over time in CCA ( p = @ ) and anterior corneal asphericity in both groups ( p < @ ) .


Thickness at the thinnest corneal point increased significantly after CL wear ( p < @ ) .


Coma-like and total HOA root mean square ( RMS ) error were significantly reduced following CL wearing in both fitting approaches ( all p < @ ) .


Short-term rigid gas-permeable CL wear flattens the anterior cornea , increases the thinnest corneal thickness and reduces anterior surface HOA in keratoconus subjects .


Apical-touch was associated with greater corneal flattening in comparison to three-point-touch lens wear .


The current debate on overdiagnosis and overtreatment of screen-detected ductal carcinoma in situ ( DCIS ) urges the need for prospective studies to address this issue .


A substantial number of DCIS lesions will never form a health hazard , particularly if it concerns non - to slow-growing low-grade DCIS .


The LORD study aims to evaluate the safety of active surveillance in women with low-risk DCIS .


This is a randomised , international multicentre , open-label , phase III non-inferiority trial , led by the Dutch Breast Cancer Research Group ( BOOG @-@ ) and the European Organization for Research and Treatment of Cancer ( EORTC-BCG @ ) .


Standard treatment will be compared to active surveillance in @ women aged @ years with asymptomatic , screen-detected , pure low-grade DCIS based on vacuum-assisted biopsies of microcalcifications only .


Both study arms will be monitored with annual digital mammography for a period of @ years .


The primary end-point is @-year ipsilateral invasive breast cancer free percentage .


Secondary end-points include patient reported outcomes , diagnostic biopsy rate during follow-up , ipsilateral mastectomy rate and translational research .


To explore interest in and feasibility of the LORD study we conducted a survey among EORTC and BOOG centres .


A vast majority of EORTC and BOOG responding centres expressed interest in participation in the LORD study .


The proposed study design is endorsed by nearly all centres .


Although falls in people with Parkinson 's disease ( PD ) associate with dual tasking and freezing of gait ( FoG ) , it is not known whether falls during dual tasking are due to FoG .


This study investigated the effects of a cognitive task on the occurrence of falls and FoG when subjects with PD step in response to a postural perturbation .


Ten subjects with PD and a history of FoG as well as @ age-matched subjects without PD stepped in response to large , backward displacements of the support surface , with and without performing a fluency task of listing items in a category .


Subjects with PD performed the task in the `` off '' and `` on '' dopaminergic medication states .


We recorded the percentage of trials with FoG ( a lack of step in response to the perturbation ) , foot-lift latencies , and trials with falls into a safety harness .


Dual tasking significantly increased the incidence of falls in people with PD , but subjects without PD did not fall in any condition .


Dual tasking did not significantly increase trials without steps or foot-lift latencies .


Falls were often coincident with a lack of step ( FoG ) in the single-task condition , but the increased falls with dual tasking occurred on trials with steps .


Levodopa tended to decrease FoG and falls with or without dual tasking .


However , medication did not significantly alter the effects of dual tasking on FoG or falls .


For people with PD and FoG , forward falls may not always be caused by FoG , particularly under attention-distracting conditions .


Observational studies suggest that breastfeeding benefits later maternal child-feeding practices , which in turn may contribute to positive eating attitudes .


We investigated the effect of a randomized intervention to increase duration and exclusivity of breastfeeding on pre-adolescent eating attitudes .


Long-term follow-up of the Promotion of Breastfeeding Intervention Trial ( PROBIT ) , a cluster-randomized trial in @ maternity hospitals and affiliated polyclinics in Belarus .


Sites were randomly assigned an experimental intervention to promote longer duration and exclusivity of breastfeeding in mothers who initiated breastfeeding ( n = @ sites ) , or a control intervention of continuing usual care ( n = @ sites ) ; @ @ healthy infants were enrolled in @-@ , of whom @ @ ( @ % ) completed the Children 's Eating Attitude Test ( ChEAT ) at @ years of age .


A ChEAT score @ ( @th percentile ) was used as an indicator of problematic eating attitudes .


Analysis was based on intention-to-treat , accounting for clustering within hospitals/clinics .


Compared with the control arm , the experimental intervention substantially increased breastfeeding exclusivity ( @ % vs @ % exclusively breastfed at @ months of age ) and duration of any breastfeeding throughout infancy .


The proportion of children with ChEAT scores @ was lower in the experimental than control arm ( boys @ % vs @ % ; girls @ % vs @ % ) -LSB- cluster-adjusted odds ratio ( OR ) , boys : @ ; @ % confidence interval ( CI ) : @,@ ; girls : @ ; @ % CI : @,@ ) .


Results were robust to adjustment for potential confounders and using a ChEAT score @ ( @st percentile ) as the outcome ( OR : @ ; @ % CI : @,@ ) .


An intervention to improve the duration and exclusivity of breastfeeding among term infants in Belarus was associated with a reduction in problematic eating attitudes at @ years of age .


This qualitative study examines performance bias , i.e. unintended differences between groups , in the context of a weight loss trial in which a novel patient counseling program was compared to usual care in general practice .


@/@ consecutive interviewees ( @ intervention group , @ control group ) within the CAMWEL ( Camden Weight Loss ) effectiveness trial process study were asked about their engagement with various features of the research study and a thematic content analysis undertaken .


Decisions to participate were interwoven with decisions to change behavior , to the extent that for many participants the two were synonymous .


The intervention group were satisfied with their allocation .


The control group spoke of their disappointment at having been offered usual care when they had taken part in the trial to access new forms of help .


Reactions to disappointment involved both movements toward and away from behavior change .


There is a prima facie case that reactions to disappointment may introduce bias , as they lead the randomized groups to differ in ways other than the intended experimental contrast .


In-depth qualitative studies nested within trials are needed to understand better the processes through which bias may be introduced .


To evaluate serum pharmacokinetics of tapentadol administered to healthy subjects as extended-release ( ER ) tablets .


Seven single-dose studies ( five randomized , crossover , bioequivalence studies ; a study in Japanese men ; and a randomized , crossover , effects-of-food study ) and one repeated-dose study .


Clinical research settings in the United States and The Netherlands .


Healthy males and females were enrolled into seven studies ; one study enrolled only Japanese males .


In the bioequivalence studies , subjects first received one polyethylene oxide - or hypromellose-based tapentadol ER tablet ( @ , @ , @ , @ , or @ mg ; one dose per study ) , then ( after washout ) the other formulation ( matching dose ) .


In all other studies , subjects received polyethylene oxide-based tapentadol ER tablets .


In the repeated-dose study , subjects received one @ mg tablet , then ( after washout ) one @ mg tablet every @ hours ( five doses ) .


In the food-effect study , subjects received one @ mg tablet within @ minutes after a high-fat meal or after @ hours of fasting .


In the study in Japanese men , subjects received one @ mg tablet .


Maximum tapentadol concentrations ( Cmax ) were typically observed @ hours after dosing .


Mean terminal half-life values ranged from @ to @ hours .


Tapentadol Cmax and AUC values increased proportionally following single ER ( polyethylene oxide-based tablets ) doses of @ to @ mg .


Trough tapentadol concentrations increased during repeat dosing until reaching steady-state by the third dose .


Serum Cmax and area under the concentration-time curve ( AUC ) values at steady state were @ and @ times higher relative to single-dose administration .


Coadministration of the @ mg dose with a high-fat meal increased Cmax and AUC values by an average of < @ percent .


The pharmacokinetics of tapentadol ER are consistent after repeated and single-dose administration .


Tapentadol ER may be administered without regard to food intake .


No clinically significant differences were observed in the pharmacokinetics of tapentadol between Japanese and Caucasian subjects .


Children often require relief of pain and anxiety when undergoing painful procedures .


To determine the differences by comparing fentanyl and ketamine used in cancer-diagnosed children undergoing painful procedures .


A randomized , double-blinded , crossover trial was conducted with @ children undergoing painful procedures ( intrathecal chemotherapy and/or bone marrow aspiration/biopsy ) .


Patients were randomly assigned in a double-blinded fashion to receive either intravenous fentanyl or ketamine at @ mcg/kg/dose and @ mg/kg/dose , respectively .


The result in effectiveness of the drug was measured using three parameters , @ ) satisfaction score ranging from @ to @ , @ ) perception of procedural pain using FLACC scale , Wong-Baker FACES Pain Rating Scale and Visual Analog Scale , and @ ) the frequency of vomiting nausea score .


The satisfaction amongpatients receiving fentanyl was significantly greater than ketamine ( p = @ ) .


In addition , both painful and nausea/vomiting were significantly decreased in the patients receiving fentanyl ( p = @ and p < @ , respectively ) .


No serious complications were observed


This study demonstrated that intravenous fentanyl generated a superior clinical effect in satisfaction , decreased pain and nausea/vomiting , and showed no significant side-effects over ketamine .


Fentanyl may also be recommended as a reasonable option before undergoing oncology procedures in children with cancer .


Coronary heart disease ( CHD ) places a major burden on the Australian health care system .


Determining the likelihood of CHD in a patient presenting with chest pain can be particularly difficult in a remote setting where access to transportation and specialised investigations including myocardial stress studies and coronary angiography can be difficult and delayed .


The objective is to develop a predictive model for determining the risk of CHD , including the value of high sensitivity C-reactive protein ( hsCRP ) , in patients presenting with chest pain with a particular emphasis on resources and information likely to be available in a remote primary health care setting .


A prospective , cross-sectional observational study of patients with no prior diagnosis of CHD presenting to a specialist chest pain assessment clinic at Cairns Hospital from November @ to May @ .


Out of the @ participants included in the study analyses , a total of @ were classified as CHD likely ( @ % ( @ % CI @-@ @ ) ) .


Logistic regression modelling identified two factors that were independently associated with likely CHD , namely the presence of typical chest pain ( OR @ ( @ % CI @-@ @ ) ) and an abnormal baseline ECG ( OR @ ( @ % CI @-@ @ ) ) .


In this study , it was demonstrated that the presence of typical chest pain and an abnormal resting ECG , remain the cornerstone of predicting a subsequent diagnosis of CHD .


This information is easily accessible in remote primary health care and should be utilised to expedite assessment in patients presenting with symptoms suggestive of CHD .


To determine whether ciclosporin is superior to prednisolone for the treatment of pyoderma gangrenosum , a painful , ulcerating skin disease with a poor evidence base for management .


Multicentre , parallel group , observer blind , randomised controlled trial .


@ UK hospitals , recruiting from June @ to November @ .


@ patients ( @ women , mean age @ years ) with clinician diagnosed pyoderma gangrenosum .


Clinical diagnosis was revised in nine participants after randomisation , leaving @ participants in the analysis set ( @ ciclosporin ; @ prednisolone ) .


Oral prednisolone @ mg/kg/day compared with ciclosporin @ mg/kg/day , to a maximum dose of @ and @ mg/day , respectively .


The primary outcome was speed of healing over six weeks , captured using digital images and assessed by blinded investigators .


Secondary outcomes were time to healing , global treatment response , resolution of inflammation , self reported pain , quality of life , number of treatment failures , adverse reactions , and time to recurrence .


Outcomes were assessed at baseline and six weeks and when the ulcer had healed ( to a maximum of six months ) .


Of the @ participants , @ had complete primary outcome data at baseline and six weeks ( @ ciclosporin ; @ prednisolone ) .


Groups were balanced at baseline .


The mean ( SD ) speed of healing at six weeks was -@ ( @ ) cm ( @ ) / day in the ciclosporin group compared with -@ ( @ ) cm ( @ ) / day in the prednisolone group .


The adjusted mean difference showed no between group difference ( @ cm ( @ ) / day , @ % confidence interval -@ to @ ; P = @ ) .


By six months , ulcers had healed in @/@ ( @ % ) participants in the ciclosporin group compared with @/@ ( @ % ) in the prednisolone group .


In those with healed ulcers , eight ( @ % ) receiving ciclosporin and seven ( @ % ) receiving prednisolone had a recurrence .


Adverse reactions were similar for the two groups ( @ % ciclosporin and @ % prednisolone ) , but serious adverse reactions , especially infections , were more common in the prednisolone group .


Prednisolone and ciclosporin did not differ across a range of objective and patient reported outcomes .


Treatment decisions for individual patients may be guided by the different side effect profiles of the two drugs and patient preference .


Trial registration Current Controlled Trials ISRCTN@ .


To assess otolaryngology physician knowledge of and attitudes toward the Patient Protection and Affordable Care Act ( PPACA ) and compare the association of bias toward the PPACA with knowledge of the provisions of the PPACA .


Cross-sectional survey .


Nationwide assessment .


Members of the American Academy of Otolaryngology-Head and Neck Surgery .


Otolaryngology physicians answered @ true/false questions about major provisions of the PPACA .


They also indicated their level of agreement with @ statements about health care and the PPACA .


Basic demographic information was collected .


Email solicitation was sent to @ otolaryngologists and @ responses were obtained ( @ % response rate ) .


Overall correct response rate was @ % .


Fewer than @ % of physicians correctly answered questions on whether small businesses receive tax credits for providing health insurance , the effect of the PPACA on Medicare benefits , and whether a government-run health insurance plan was created .


Academic center practice setting , bias toward the PPACA , and Democratic Party affiliation were associated with significantly more correct responses .


Overall physician knowledge of the PPACA is assessed as fair , although better than the general public in @ .


There are several areas where knowledge of physicians regarding the PPACA is poor , and this knowledge deficit is more pronounced within certain subgroups .


These knowledge issues should be addressed by individual physicians and medical societies .


Despite treatment with glucocorticoids , mortality remains high in patients with severe alcoholic hepatitis .


Oxidative stress and depletion of mitochondrial glutathione are implicated factors in liver injury .


The aim of this study was to evaluate the impact of the addition of metadoxine , a drug which possesses a multifactorial mechanism of action , including antioxidant properties , to standard treatment with glucocorticoids in patients with severe alcoholic hepatitis .


This randomized open label clinical trial was performed in Mexico 's General Hospital ( Registry Key DIC/@/@ / @/@ ) .


We randomized @ patients with severe alcoholic hepatitis .


The first group received prednisone ( @ mg/day ) , and the second group received prednisone ( @ mg/day ) plus metadoxine tablets ( @ mg three times daily ) .


The duration of treatment in both groups was @ days .


Survival at @ and @ days , development of complications , adverse events and response to treatment ( Lille model ) were assessed .


In the group receiving metadoxine , significant improvements were observed , as follows : survival at @ days ( @ vs. @ % , P = @ ) ; survival at @ days ( @ vs. @ % , P = @ ) .


There was less development or progression of encephalopathy ( @ vs. @ % , P = @ ) and hepatorenal syndrome ( @ vs. @ % , P = @ ) , and the response to treatment ( Lille model ) was higher in the metadoxine group ( @ vs. @ , P = @ ; @ % CI @ to @ ) .


There were no differences between groups regarding the development or progression of variceal hemorrhage or infection .


The incidence of adverse events , mainly gastrointestinal , was similar in both groups .


Addition of metadoxine to glucocorticoid treatment improves the short-term survival of patients with severe alcoholic hepatitis and diminishes the development or progression of encephalopathy and hepatorenal syndrome .


Kidney transplantation is associated with rapid loss of bone mineral density ( BMD ) in the first months after transplantation .


The effect of pamidronate on bone loss after transplantation was evaluated in a randomized controlled trial .


Forty patients were enrolled in this study ( @ in the pamidronate group and @ in the control group ) .


Pamidrinate was administered as @-mg intravenous infusion within @ days after transplantation and @ months later .


All of the patients received calcium and vitamin D supplementation .


Laboratory parameters and BMD ( lumbar spine and femoral neck ) were measured at baseline and @ months after kidney transplantation .


Bone mineral density at the initiation of study had no significant differences between the two groups .


In each group , BMD of femoral neck and lumbar spine had no significant differences @ months after transplantation in comparison to pretransplantation values .


There was no significant difference in BMD changes after intervention between two groups .


Parathyroid hormone level normalized in both of the pamidronate and control groups @ months after kidney transplantation .


Glomerular filtration rate at the end of study was not significantly different between the two groups .


Our study suggests that administration of calcium and vitamin D following transplantation may be beneficial to counterbalance the substantial bone loss occurring within @ months after transplantation , and addition of pamidronate has no beneficial effect in BMD in this short interval after kidney transplantation .


To compare the efficacy of metformin plus megestrol acetate ( MA ) with that of MA alone for treating endometrial atypical hyperplasia ( EAH ) .


This pilot study included @ EAH patients who met at least one metabolic syndrome ( MS ) criterion and received either adjunctive metformin plus MA ( MET group ) or MA monotherapy ( MA group ) .


Each patient in the MA group received @ mg of MA daily , whereas patients in the MET group received the same dose of MA plus @ g of metformin thrice daily .


Treatment response was assessed by histological examination of dilation and curettage specimens obtained after @ weeks of therapy .


Each group had eight patients , and half of the patients in each group were diagnosed with MS. The complete response ( CR ) rate was @ % ( @/@ ) in the MET group and @ % ( @/@ ) in the MA group ( p = @ ) .


Complications of MS did not affect the response rates in either group .


In the MET group , @ % ( @/@ ) of the patients had CR in the presence or absence of MS. In the MA group , @ % ( @/@ ) of the patients with MS had CR , whereas no patient without MS had CR .


No irreversible toxicities were observed .


Metformin plus MA may be a potential alternative therapy for treating EAH , and the MS status of patients may have no effect on the efficacy of metformin plus MA therapy .


Real-time virtual sonography is an innovative imaging technology that detects the spatial position of an ultrasound probe and immediately reconstructs a section of computed tomography ( CT ) and/or magnetic resonance in accordance with the ultrasound image , thereby allowing a real-time comparison of those modalities .


A novel intraoperative navigation system for liver resection using real-time virtual sonography has been devised for the detection of tumors and navigation of the resection plane .


Sixteen patients with hepatic malignancies ( @ tumors in total ) were involved in this study , and the system was used intraoperatively .


The tumor size ranged @ to @ mm ( @ mm in median ) .


By the navigation system , operators could refer intraoperative ultrasound image displayed on the television monitor side-by-side with corresponding images of CT and/or magnetic resonance .


In addition , the system overlaid preoperative simulation on the CT image and highlighted the extent of resection so as to navigate the resection plane .


Because the system used electromagnetic power in the operation room , the feasibility and safety of the system was investigated as well as its validity .


The system could be used uneventfully in each operation .


All of the @ tumors scheduled to be resected were detected by the navigation system .


The weight of the resected specimen correlated with the preoperatively simulated volume ( R = @ , P < @ ) .


The feasibility and safety of the navigation system were confirmed .


The system should be helpful for intraoperative tumor detection and navigation of liver resection .


Anemia is a significant public health concern , especially among women and young children .


An improved understanding of the complex etiology of anemia is crucial for developing appropriate prevention strategies .


This paper examines the determinants of anemia in a large sample of Vietnamese women of reproductive age ( WRA ) .


We included baseline data from @ WRA participating in a randomized controlled trial ( PRECONCEPT ) .


Hemoglobin ( Hb ) concentrations were measured with Hemocue .


Plasma ferritin ( Fe ) , retinol binding protein ( RBP ) and markers of inflammation were assessed using the ELISA technique .


We used multivariate logistic regression to describe associations with anemia and structural equation modeling ( SEM ) to characterize direct and indirect pathways influencing Hb concentrations .


Prevalence of anemia , iron deficiency ( Fe < @ g/l ) , insufficient iron stores ( Fe < @ g/l ) and iron deficiency anemia was @ , @ , @ and @ % , respectively .


Ferritin concentration ( @ per log-mg/dl ) , being an ethnic minority ( -@ compared with Kinh ) , number of children ( -@ ) and socioeconomic status ( @ ) were directly associated with Hb concentration ( P < @ ) .


Similarly , RBP was directly ( @ per mg/dl ) associated with Hb and also indirectly ( @ mg/dl ) with ferritin .


Hookworm infection was indirectly associated with Hb ( -@ ) through RBP and ferritin .


These findings illustrate the complex etiology of anemia and provide a useful framework for designing , targeting and evaluating appropriate strategies for the prevention and control of anemia .


Contrary to expectations , iron deficiency accounted for a very small proportion of anemia in Northern Vietnam .


The recent enormous increase in colonoscopy demand prompted this multicentre observational study assessing overall acceptability and efficacy of commonly used bowel preparations in Italian clinical practice .


Consecutive outpatients undergoing colonoscopy were recruited from @ major gastroenterological centres in Italy .


Each patient evaluated overall acceptability of the bowel cleansing preparation through a @-@mm Visual Analogue Scale .


The Visual Analogue Scale score was dichotomized by a median split : @-@ ( high acceptability ) vs. @-@ ( low acceptability ) .


Bowel cleansing was assessed through a validated scale .


The influence of potential individual determinants on patients ' acceptability and cleansing efficacy of the bowel preparations was determined by multivariate analyses .


@ evaluable patients were enrolled ; @ % received @L-PEG preparations , @ % @L-PEG preparations and @ % @-glasses-solutions ( Na-phosphate/Mg-citrate/Na-picosulphate-containing preparations ) .


Overall acceptability was significantly higher for @L-PEG and @-glasses solutions than @L-PEG ( adjusted odds ratio , @ ; and adjusted odds ratio @ , respectively ) .


Successful bowel cleansing achieved with @L-PEG ( @ % ) was similar to @L-PEG ( @ % ; adjusted odds ratio @ ) and significantly higher than @-glasses solutions ( @ % ; adjusted odds ratio @ vs. @L-PEG ) .


Split regimen , lower total preparation volume and colonoscopy reason ( periodical control vs. @st procedure ) were significantly associated with high acceptability .


Age @ years , dissatisfaction with the preparation taken , and @/week bowel movements were major determinants of a poor bowel cleansing .


@L-PEG and @L-PEG preparations provide the most effective bowel cleansing for colonoscopy in clinical practice , with a significantly higher acceptability for @L-PEG preparations .


The prognostic importance of anemia for cardiovascular ( CV ) events and mortality has been extensively investigated .


However , little is known about the impact of transferrin saturation ( TSAT ) , a marker reflecting the availability of iron for erythropoiesis , on clinical outcome in dialysis patients .


A total of @ anemic incident dialysis patients were recruited from the Clinical Research Center for End-Stage Renal Disease in Korea and were divided into @ groups according to baseline TSAT of @ % , @-@ % , and > @ % .


There were no differences in hemoglobin levels and the proportion of patients on erythropoiesis-stimulating agents or iron supplements among the @ groups .


During a mean follow-up duration of @ months , @ ( @ % ) patients died .


CV composite ( @ vs. @ events/@ patient-years , P = @ ) and all-cause mortality rates ( @ vs. @ events/@ patient-years , P = @ ) were significantly higher in patients with TSAT @ % compared to those with TSAT @-@ % ( reference group ) .


Cox regression analysis revealed that patients with TSAT @ % had @ - and @-fold higher risks for CV composite outcome ( P = @ ) and all-cause mortality ( P = @ ) .


Moreover , TSAT @ % was significantly associated with left ventricular hypertrophy -LSB- odds ratio ( OR ) = @ -RSB- , high-sensitivity C-reactive protein @ mg/dL ( OR = @ ) , N-terminal pro B-type natriuretic peptide @ pg/mL ( OR = @ ) , and troponin-T@ @ ng/mL ( OR = @ ) , on logistic regression analysis .


Low TSAT was a significant independent risk factor for adverse clinical outcome in incident dialysis patients with anemia , which may be partly attributed to cardiac dysfunction and inflammation .


Auvi-Q is a novel epinephrine autoinjector ( EAI ) that provides audio and visual cues for patients at risk for life-threatening allergic reactions .


We tested the preference for Auvi-Q or EpiPen with regard to method of instruction , preference to carry , device size , and device shape .


This large , multicenter , simulated-use study evaluated whether adults ( aged @-@ years ) , caregivers ( parents/guardians aged @-@ years of children aged @-@ years ) , and children ( aged @-@ years ) , with and without experience in using an EAI , had a preference for the current design of Auvi-Q or the current design of EpiPen .


Participants were given a scenario that involved anaphylaxis and were instructed to simulate use of an EAI .


They received and tested each device individually according to the randomization assignment .


After testing both devices , they completed a survey to indicate their preference for Auvi-Q versus EpiPen .


Among all @ participants combined , Auvi-Q was preferred over EpiPen on all study end points ( P < @ ) .


For experienced and inexperienced participants in all @ groups ( adults , caregivers , and children ) , Auvi-Q was preferred over EpiPen for method of instruction , preference to carry , and device size ( all P < @ ) .


The preference for Auvi-Q device shape was not significant among experienced children ( P = @ ) ; however , it was significant for inexperienced children ( P = @ ) and highly significant for experienced and inexperienced adults and caregivers ( P < @ ) .


In this large multicenter , simulated-use study , Auvi-Q was preferred over EpiPen by experienced and inexperienced adults , caregivers , and children .


To observe the difference in the clinical efficacy on peripheral facial palsy between electro-acupuncture ( EA ) assisted with surface electromyography ( sEMG ) and conventional EA .


Sixty cases of peripheral facial palsy were randomized into an observation group and a control group , @ cases in each one .


EA was applied during the first @ days of sickness in the two groups , at Xiaguan ( ST @ ) , Jiache ( ST @ ) , Dicang ( ST @ ) , Yangbai ( GB @ ) , Taiyang ( EX-HN @ ) , Quanliao ( SI @ ) and Hegu ( LI @ ) , once a day .


In the observation , group , @ days after sickness , according to the situation in sEMG , on the basis of the acupoints in the previous treatment , the corresponding acupoints were reselected for EA .


In the control group , the conventional EA was kept on .


The treatment was given once every two days till the @th day of sickness .


Separately , on the @th , @th and @th days of sickness , according to the detection of sEMG in the patients of two groups , the means ratios of : root mean square ( RMS ) of musculi buccinators , orbicularis oris , frontalis and nasalis on the healthy and affected sides were recorded and analyzed .


The differences of ratio in RMS of musculi buccinators , orbicularis oris , frontalis and nasalis on the healthy and affected sides were significant statistically in comparison between the , @th day and the @th day , and between the @th day and the @th day of sickness within each group ( all P < @ ) .


The differences of ratio in RMS of the muscles on the healthy and affected sides were significant statistically on the @th and @th days between the two groups ( all P < @ ) .


EA assisted with sEMG achieves the significant efficacy on peripheral facial palsy , better than the conventional EA .


Interleukin-@ ( IL-@ ) has been implicated as a key driver of UC .


This trial evaluates the efficacy and safety of tralokinumab , an IL-@-neutralising antibody , as add-on therapy in adults with moderate-to-severe UC despite standard treatments .


Non-hospitalised adults with UC ( total Mayo score @ ) were randomised to receive tralokinumab @mg or placebo subcutaneously every @weeks for @weeks .


The primary end point was the rate of clinical response at week @ .


Secondary efficacy end points included clinical remission and mucosal healing rates at week @ and changes in total Mayo score , total modified Riley score , partial Mayo score and disease activity markers .


Clinical response rate was @ % ( @/@ ) for tralokinumab vs. @ % ( @/@ ) for placebo ( p = @ ) .


Clinical remission rate was @ % ( @/@ ) vs. @ % ( @/@ ) ( p = @ ) and mucosal healing rate was @ % ( @/@ ) vs. @ % ( @/@ ) ( p = @ ) for tralokinumab vs placebo .


Changes to week @ in total Mayo score and total modified Riley score were similar for tralokinumab and placebo ( least-squares mean difference between groups : -@ ( p = @ ) and @ ( p = @ ) , respectively ) .


Partial Mayo score at week @ was lower with tralokinumab than placebo ( least-squares mean difference between groups : -@ ( p = @ ) ) .


No consistent patterns were observed for disease activity markers .


Tralokinumab had an acceptable safety profile .


Add-on therapy with tralokinumab did not significantly improve clinical response .


However , the higher clinical remission rate with tralokinumab than placebo suggests that tralokinumab may benefit some patients with UC .


Tralokinumab was well tolerated .


Colorectal cancer is the second-leading cause of cancer deaths in the United States .


The Strategies and Opportunities to Stop Colorectal Cancer ( STOP CRC ) in Priority Populations study is a pragmatic trial and a collaboration between two research institutions and a network of more than @ safety net clinics .


The study will assess the effectiveness of a system-based intervention designed to improve the rates of colorectal-cancer screening using fecal immunochemical testing ( FIT ) in federally qualified health centers in Oregon and Northern California .


STOP CRC is a cluster-randomized comparative-effectiveness pragmatic trial enrolling @ clinics .


Clinics will be randomized to one of two arms .


Clinics in the intervention arm ( @ ) will use an automated , data-driven , electronic health record-embedded program to identify patients due for colorectal screening and mail FIT kits ( with pictographic instructions ) to them ; ( @ ) will conduct an improvement process ( e.g. Plan-Do-Study-Act ) to enhance the adoption , reach , and effectiveness of the program .


Clinics in the control arm will provide opportunistic colorectal-cancer screening to patients at clinic visits .