Forty-three patients who had undergone @D reconstruction underwent surgery .


Of the @ conventionally treated patients , @ underwent surgery .


The operative time , blood loss , length of hospital stay , and complication incidence of the @ patients were superior to that of the @ patients .


A peripancreatic vascular reconstruction can reveal the vascular anatomy , variations of peripancreatic vascular , and tumor-induced vascular changes ; the application of the simulation surgery platform could reduce surgical trauma and decrease operative time .


This study aims to evaluate the efficacy and safety of - lipoic acid in the treatment of aged type @ diabetes mellitus ( T@DM ) complicated with acute cerebral infarction .


@ patients were randomly divided into two groups , on the basis of conventional treatment .


The experiment group was administrated with - lipoic acid , while only Vitamin C for the control group , for @ consecutive weeks .


Before and after the experiment , superoxide dismutase ( SOD ) , glutathione peroxidase ( GSH-Px ) and malondialdehyde ( MDA ) levels were measured and scored with the NIHSS ( National Institutes of Health Stroke Scale ) , and the changes of blood glucose , insulin function and other indicators were observed .


After the treatment , the plasma SOD and GSH-Px levels increased , while MDA decreased ( p < @ ) , with statistical significance when compared with the control group ( p < @ ) .


NIHSS score , blood glucose , blood lipids and HOMA-IA of the experiment group decreased significantly ( p < @ ) ; and no significant adverse reactions were found in both groups .


- lipoic acid was safe and effective in the treatment of aged T@DM complicated with acute cerebral infarction , significantly reducing the patient 's oxidative stress , blood glucose and lipid levels and being able to improve islet function .


Several provincial and federal bills have recommended various forms of menu labelling that would require information beyond just calories ; however , the additional benefit of including sodium information is unknown .


The objective of this study was to determine whether sodium information on menus helps consumers make lower-sodium choices and to understand what other factors influence the effect of menu labelling on consumers ' meal choices .


A total of @,@ Canadian consumers completed an online survey that included a repeated measures experiment in which consumers were asked to select what they would typically order from four mock-restaurant menus .


Subsequently , consumers were randomly allocated to see one of three menu-labelling treatments ( calories ; calories and sodium ; or calories , sodium and serving size ) and were given the option to change their order .


There was a significant difference in the proportion of consumers who changed their order , varying from @ % to @ % , depending on the restaurant type .


After participants had seen menu labelling , sodium levels decreased in all treatments ( p < @ ) .


However , in three of the four restaurant types , consumers who saw calorie and sodium information ordered meals with significantly less sodium than consumers who saw only calorie information ( p < @ ) .


Consumers who saw sodium labelling decreased the sodium level of their meal by an average of @-@ mg , depending on the restaurant .


In the subset of consumers who saw sodium information and chose to change their order , sodium levels decreased by an average of @-@ ,@ mg , depending on the restaurant .


Sex , intent to lose weight and the amount of calories ordered at baseline were the most important predictors of who used menu labelling .


Eighty percent of survey panelists wanted to see nutrition information when dining out .


Including sodium information alongside calorie information may result in a larger decrease in the amount of sodium ordered by restaurant-goers .


A widened electrocardiographic spatial QRS-T angle has been shown to be predictive of cardiovascular disease in HIV-infected individuals .


However , determinants and risk factors of developing widened QRS-T angle over time in this population remain unknown .


Spatial QRS-T angle was automatically measured from standard electrocardiogram of @ HIV-infected individuals without baseline widened spatial QRS-T angle from the Strategies for Management of Antiretroviral Therapy -LSB- SMART -RSB- , a clinical trial comparing two antiretroviral treatment strategies -LSB- Drug Conservation ( DC ) vs. Viral Suppression ( VS ) -RSB- .


Conditional logistic regression analysis was used to examine the association between baseline characteristics and incident widened spatial QRS-T angle ( a new angle > @ in males and > @ in females ) .


During @ person-years of follow-up , @ participants developed widened angle at a rate of @ per @ person-years .


In unadjusted models , female sex , black race ( vs. white ) , DC treatment strategy , current and past smokers ( vs. never ) , history of alcohol abuse , greater body mass index , history of diabetes and higher levels of hs-C-reactive protein were associated with incident widened spatial QRS-T angle .


When these variables were entered together in the same model with adjustment for demographics and treatment strategy , DC treatment strategy -LSB- OR ( @ % CI ) : @ ( @ , @ ) -RSB- , female gender -LSB- @ ( @ , @ ) -RSB- , current and past smoking ( vs. never ) -LSB- @ ( @ , @ ) and @ ( @ , @ ) , respectively -RSB- , and diabetes -LSB- @ ( @ , @ ) -RSB- predicted incident widened spatial QRS-T angle .


Drug conservation treatment strategy , female gender , smoking , and diabetes are independently predictive of incident widened spatial QRS-T angle in HIV-infected individuals .


Empagliflozin is a potent , oral , selective inhibitor of sodium glucose cotransporter @ in development for the treatment of type @ diabetes mellitus .


The goal of these studies was to investigate potential drug-drug interactions between empagliflozin and gemfibrozil ( an organic anion-transporting polypeptide @B@ -LSB- OATP@B@ -RSB- / @B@ and organic anion transporter @ -LSB- OAT@ -RSB- inhibitor ) , rifampicin ( an OATP@B@/@B@ inhibitor ) , or probenecid ( an OAT@ and uridine diphosphate glucuronosyltransferase inhibitor ) .


Two open-label , randomized , crossover studies were undertaken in healthy subjects .


In the first study , @ subjects received the following in @ of @ randomized treatment sequences : a single dose of empagliflozin @ mg alone and gemfibrozil @ mg BID for @ days with a single dose of empagliflozin @ mg on the third day .


In the second study , @ subjects received a single dose of empagliflozin @ mg , a single dose of empagliflozin @ mg coadministered with a single dose of rifampicin @ mg , and probenecid @ mg BID for @ days with a single dose of empagliflozin @ mg on the second day in @ of @ randomized treatment sequences .


In the gemfibrozil study , @ subjects were male , mean age was @ years and mean body mass index ( BMI ) was @ kg/m ( @ ) .


In the rifampicin/probenecid study , @ subjects were male , mean age was @ years and mean BMI was @ kg/m ( @ ) .


Exposure to empagliflozin was increased by coadministration with gemfibrozil ( AUC@ - : geometric mean ratio -LSB- GMR -RSB- , @ % -LSB- @ % CI , @-@ @ -RSB- ; Cmax : GMR , @ % -LSB- @ % CI , @-@ @ -RSB- ) , rifampicin ( AUC@ - : GMR , @ % -LSB- @ % CI , @-@ @ -RSB- ; Cmax : GMR , @ % -LSB- @ % CI , @-@ @ -RSB- ) , and probenecid ( AUC@ - : GMR , @ % -LSB- @ % CI , @-@ @ -RSB- ; Cmax : GMR , @ % -LSB- @ % CI , @-@ @ -RSB- ) .


All treatments were well tolerated .


Increases in empagliflozin exposure were < @-fold , indicating that the inhibition of the OATP@B@/@B@ , OAT@ transporter , and uridine diphosphate glucuronosyltransferases did not have a clinically relevant effect on empagliflozin exposure .


No dose adjustments of empagliflozin were necessary when it was coadministered with gemfibrozil , rifampicin , or probenecid .


ClinicalTrials.gov identifiers : NCT@ and NCT@ .


Prostaglandins that constrict and relax airways are synthesized in reactions catalyzed by either COX-@ or COX-@ .


It is not known whether selective inhibition of COX-@ makes asthmatic responses better or worse .


To determine the effects of the selective COX-@ inhibitor , etoricoxib , on allergen-induced bronchoconstriction in asthmatic subjects .


Sixteen subjects with mild atopic asthma underwent rising dose inhalation challenges with allergen or methacholine to determine PD@ FEV@ during a control study period or after @ to @ days of treatment with etoricoxib ( @ mg once daily ) .


The order of study periods was randomized with at least @-week washout periods .


Induced sputum cells and fractional exhaled nitric oxide levels were used to assess airway inflammation and blood assays for COX-@ and COX-@ activity to assess enzyme inhibition .


Urinary excretion of lipids was used to assess prostaglandin biosynthesis .


Etoricoxib did not change baseline lung function , nor airway responsiveness to allergen or to methacholine .


Neither were the allergen-induced increase in sputum eosinophils and fractional exhaled nitric oxide levels affected by treatment .


The biochemical effectiveness of the treatment was established both in the blood assays and by the distinct inhibitory effect of etoricoxib on urinary excretion of tetranor-prostaglandin E@ ( P < @ ) .


This first study of COX-@ inhibition in provoked asthma found no negative effects of etoricoxib on allergen-induced airflow obstruction and sputum eosinophils , basal lung function , or methacholine responsiveness .


The study suggests that short-term use of COX-@ inhibitors is safe in subjects with asthma .


Higher body mass index is linked to lower prostate specific antigen .


This has given rise to concerns that prostate specific antigen may be less reliable for predicting prostate cancer among obese men .


We tested the accuracy of prebiopsy prostate specific antigen for predicting prostate cancer across body mass index categories .


We used the REDUCE study , which tested dutasteride for prostate cancer risk reduction in men with a prostate specific antigen of @ to @ ng/ml and a negative pre-study biopsy .


All men were required to have a biopsy at @ and @ years independent of prostate specific antigen .


We assessed the performance of prebiopsy prostate specific antigen to predict overall and high grade prostate cancer ( Gleason sum @ or greater ) in each body mass index group using AUC .


Of @,@ men who had a @-year biopsy @,@ ( @ % ) were normal weight , @,@ ( @ % ) were overweight and @,@ ( @ % ) were obese .


Mean adjusted prostate specific antigen for normal weight , overweight and obese subjects on placebo was @ , @ and @ ng/ml ( p-trend = @ ) , and on dutasteride @ , @ and @ ng/ml ( p = @ ) .


AUC analysis using raw prostate specific antigen data for predicting prostate cancer ranged from @ to @ in the placebo arm and @ to @ in the dutasteride arm with no difference across body mass index categories ( p-interactions @ ) .


Similar results were found for high grade prostate cancer with AUC ranging from @ to @ in the placebo arm and @ to @ in the dutasteride arm but no differences across body mass index categories ( p-interactions @ ) .


Among men with a previous negative biopsy the accuracy of prebiopsy prostate specific antigen to predict overall and high grade prostate cancer was independent of body mass index .


To observe the clinical effect of acupoint heat-sensitive moxibustion for acut knee arthralgia and to analyze its effect on serum osteopontin ( OPN ) and matrix metalloproteinase-@ ( MMP-@ ) contents in patients with knee osteoarthritis so as to study its mechanism underlying improving arthralgia .


One hundred and forty-four patients with acute knee knee osteoarthritis were randomly allocated to acupoint heat-sensitive moxibustion ( moxibustion ) , electroacupuncture ( EA ) and medication groups .


Patients of the moxibustion group were treated by suspended moxibustion over bilateral Weizhong ( BL @ ) for @ min each point , once daily for @ days .


Patients of the EA group were treated by EA stimulation of Neixiyan ( EX-LE @ ) , Dubi ( ST @ ) , Xuehai ( SP @ ) and Liangqiu ( ST @ ) for @ min , once daily for @ days ; and those of the medication group treated by oral administration of Sanqi Tongshu capsules ( Panax Notoginseng , etc. used for promoting blood circulation and removing blood stasis ) , @ times daily for @ days .


Serum OPN and MMP-@ levels were detected with ELISA .


Following the treatment , of the @ , @ and @ cases in the moxibustion , EA and medication groups , @ , @ and @ were excellent , @ , @ and @ were good in therapeutic effect , @ , @ , and @ were effective , and @ , @ , and @ invalid , with the excellent and good rates being @ % , @ % and @ % , respectively .


Serum OPN content of the moxibistion and EA groups , and serum MMP-@ content of the moxibustion group were reduced considerably in comparison with pre-treatment in the same one group ( P < @ ) , while serum OPN level of the medication group and MMP-@ of the EA group were decreased slightly .


The effect of moxibustion was evidently superior to that of medication in lowering serum OPN level ( P < @ ) and superior to that of both EA and medication in lowering serum MMP-@ content ( P < @ ) .


Acupoint heat-sensitive moxibustion has a good therapeutic effect in relieving acute knee arthralgia , which may be related to its effects in decreasing serum OPN and MMP-@ levels .


The authors evaluated a sequential treatment strategy of fluoxetine and relapse-prevention cognitive-behavioral therapy ( CBT ) to determine effects on remission and relapse in youths with major depressive disorder .


Youths @-@ years of age with major depression were treated openly with fluoxetine for @ weeks .


Those with an adequate response ( defined as a reduction of @ % or more on the Children 's Depression Rating Scale-Revised -LSB- CDRS-R -RSB- ) were randomly assigned to receive continued medication management alone or continued medication management plus CBT for an additional @ months .


The CBT was modified to address residual symptoms and was supplemented by well-being therapy .


Primary outcome measures were time to remission ( with remission defined as a CDRS-R score of @ or less ) and rate of relapse ( with relapse defined as either a CDRS-R score of @ or more with a history of @ weeks of symptom worsening , or clinical deterioration ) .


Of the @ participants enrolled in acute-phase treatment , @ were assigned to continuation treatment with medication management alone ( N = @ ) or medication management plus CBT ( N = @ ) .


During the @-week continuation treatment period , time to remission did not differ significantly between treatment groups ( hazard ratio = @ , @ % CI = @ , @ ) .


However , the medication management plus CBT group had a significantly lower risk of relapse than the medication management only group ( hazard ratio = @ , @ % CI = @ , @ ) .


The estimated probability of relapse by week @ was lower with medication management plus CBT than with medication management only ( @ % compared with @ % ) .


Continuation-phase relapse-prevention CBT was effective in reducing the risk of relapse but not in accelerating time to remission in children and adolescents with major depressive disorder .


To compare parameters after @-piece and @-piece intraocular lens ( IOL ) implantation .


Moorfields West End Clinic , London , United Kingdom , and Hanusch Hospital , Vienna , Austria .


Prospective randomized controlled trial .


Each eye of patients having bilateral surgery for age-related cataract was randomized to have implantation of a @-piece IOL ( Tecnis ZCB@ ) or a @-piece IOL ( Tecnis ZA@ ) .


Changes in visual acuity , refraction , and anterior chamber depth ( ACD ) were evaluated during a @-year follow-up .


Intraocular lens tilt and decentration were evaluated using a Purkinje meter .


Regeneratory posterior capsule opacification ( PCO ) was analyzed using retroillumination photographs in Automated Quantification of After-Cataract image-analysis software .


This study comprised @ eyes of @ patients .


No statistically significant differences were found in IOL tilt or decentration between groups ( P. @ ) .


Minimal but statistically significant changes were observed in the vertical tilt component @ months postoperatively in the @-piece IOL group ( P < @ ) .


The tilt and decentration components did not correlate with changes in sphere or the regeneratory PCO score ( r = @ , P. @ ) .


The ACD decreased significantly between @ day and @ month postoperatively in both groups ( P < @ ) , with no significant changes afterward ( P. @ ) .


The anterior chamber was significantly deeper in the @-piece group at all follow-up visits ( P < @ ) .


Both the @-piece IOL and the @-piece IOL showed excellent positional stability in the capsular bag , resulting in good clinical outcomes .


Regeneratory PCO levels were low and comparable between the IOLs .


Japan is one of the most rapidly ageing societies in the world .


A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals , but the effectiveness of these services is currently insufficient .


Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects .


We administered a @-week intervention programme consisting of physical and leisure activities aimed at enhancing participants ' motivation to participate and support one another by providing a pleasant atmosphere , empathetic communication , praise , and errorless support .


This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi .


All participants underwent the Five-Cog test , which evaluated the cognitive domains of attention , memory , visuospatial function , language , and reasoning .


Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test .


Subjective health status , level of social support , functional capacity , subjective quality of life , and depressive symptoms were assessed with a questionnaire .


Grip strength test , timed up-and-go test , @-m maximum walking times test , and functional reach test were performed to evaluate physical function .


Fifty-two participants were randomly allocated to intervention ( n = @ ) and control ( n = @ ) groups .


Twenty-six participants , aged between @-@ years , received intervention once a week at a community centre .


The programme was conducted by health-care professionals , with the help of senior citizen volunteers .


The intervention group ( n = @ ) showed significant improvement on the analogy task of the Five-Cog test ( F ( @,@ ) = @ , P = @ ) and improved quality of life ( F ( @,@ ) = @ , P = @ ) as compared to the control group ( n = @ ) .


A community-based @-week intervention programme that aimed to enhance motivation to participate in activities resulted in improvements in some aspects of cognitive function and quality of life .


Senior citizens who volunteered in the present intervention enabled the smooth implementation of the programme and alleviated the burden on professional staff .


Intermittent preventive treatment in pregnancy has not been evaluated outside of Africa .


Low birthweight ( LBW , < @,@ g ) is common in Papua New Guinea ( PNG ) and contributing factors include malaria and reproductive tract infections .


From November @ to February @ , we conducted a parallel group , randomised controlled trial in pregnant women ( @ gestational weeks ) in PNG .


Sulphadoxine-pyrimethamine ( @,@ / @ mg ) plus azithromycin ( @ g twice daily for @ days ) ( SPAZ ) monthly from second trimester ( intervention ) was compared against sulphadoxine-pyrimethamine and chloroquine ( @ to @ mg , daily for three days ) ( SPCQ ) given once , followed by SPCQ placebo ( control ) .


Women were assigned to treatment ( @:@ ) using a randomisation sequence with block sizes of @ .


Participants were blinded to assignments .


The primary outcome was LBW .


Analysis was by intention-to-treat .


Of @,@ women randomised , @,@ ( @ % ) were included in the primary outcome analysis ( SPCQ : @,@ ; SPAZ : @,@ ) .


The prevalence of LBW was @ % ( @/@ ,@ ) .


SPAZ reduced LBW ( risk ratio -LSB- RR -RSB- : @ , @ % CI : @-@ @ , P = @ ; absolute risk reduction ( ARR ) : @ % , @ % CI : @-@ @ ; number needed to treat : @ ) , and preterm delivery ( @ , @ % CI : @-@ @ , P = @ ) , and increased mean birthweight ( @ g , @ % CI : @-@ @ , P = @ ) .


SPAZ reduced maternal parasitaemia ( RR : @ , @ % CI : @-@ @ , P = @ ) and active placental malaria ( @ , @ % CI : @-@ @ , P = @ ) , and reduced carriage of gonorrhoea ( @ , @ % CI : @-@ @ , P = @ ) at second visit .


There were no treatment-related serious adverse events ( SAEs ) , and the number of SAEs ( intervention @ % -LSB- @/@ ,@ -RSB- , control @ % -LSB- @/@ ,@ -RSB- , P = @ ) and AEs ( intervention @ % -LSB- @/@ ,@ -RSB- , control @ % -LSB- @/@ ,@ -RSB- , P = @ ) was similar .


A major limitation of the study was the high loss to follow-up for birthweight .


SPAZ was efficacious and safe in reducing LBW , possibly acting through multiple mechanisms including the effect on malaria and on sexually transmitted infections .


The efficacy of SPAZ in the presence of resistant parasites and the contribution of AZ to bacterial antibiotic resistance require further study .


The ability of SPAZ to improve pregnancy outcomes warrants further evaluation .


Dietary strategies in heart failure ( HF ) are focused on sodium and fluid restriction to minimize the risk for acute volume overload episodes .


However , the importance of dietary factors beyond sodium intake in the prognosis of the disease is uncertain .


The purpose of this study was to evaluate the association of macro - and micronutrients intake on @-y mortality in patients with HF .


A secondary analysis of @ patients with chronic HF enrolled in a randomized trial of sodium reduction was completed .


Patients with a complete @-d food record at baseline were included in this analysis ( N = @ ) ; both control and intervention arms were combined .


Three-d mean dietary intake was estimated .


Cox multivariable regression analysis was used to evaluate the association between dietary factors and @-y mortality .


Among the @ included patients , @ % were men , median ( @th-@th percentiles ) age @ y ( @-@ y ) , median ejection fraction @ % ( @ % -@ % ) , and ischemic etiology present in @ % of patients .


The association with @-y mortality was significant for both polyunsaturated fatty acids ( PUFA ; adjusted hazard ratio -LSB- HR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- .


@-@ @ for intake as percentage of daily energy ) and saturated fatty acids ( SFA ; adjusted HR , @ ; @ % CI , @-@ @ for intake as percentage of daily energy ) .


Median of intake as percentage of daily energy was @ % for PUFAs and @ % for SFAs .


Intake of PUFAs and SFAs was independently associated with @-y all-cause mortality in patients with chronic HF .


Limiting dietary SFA and increasing PUFA intake may be advisable in this population .


The aim of this study was to evaluate the effectiveness of a supervised exercise program ( SEP ) plus at home nonsupervised exercise therapy ( non-SET ) on functional status , quality of life ( QoL ) and hemodynamic response in post-lower-limb bypass surgery patients .


One hundred and seventeen patients were randomized to an intervention ( n = @ ) or a control group ( n = @ ) .


A new individual SEP was designed for patients with peripheral arterial disease ( PAD ) and applied to the studied subjects of the intervention group who also continued non-SET at home , whereas those assigned to the control group received just usual SEP according to a common cardiovascular program .


The participants of the study were assessed by a @-min walking test ( @ MWT ) , an ankle-brachial index ( ABI ) , and the Medical Outcomes Study Short Form-@ ( SF-@ ) of QoL at baseline , at @ and @ months after surgery .


A significant improvement was observed in the walked distance in the intervention group after @ months compared with the control group ( p < @ ) .


The intervention group had significantly higher QoL score in the physical and mental component of SF-@ ( p < @ ) .


A @-month application of the new SEP and non-SET at home has yielded significantly better results in walking distance and QoL in the intervention group than in the controls .


Vaccination as a control method against the cattle tick , Rhipicephalus ( Boophilus ) microplus has been practiced since the introduction of two products in the mid-@s .


There is a need for a vaccine that could provide effective control of R. microplus in a more consistent fashion than existing products .


During our transcriptome studies of R. microplus , several gene coding regions were discovered to encode proteins with significant amino acid similarity to aquaporins .


A cDNA encoding an aquaporin from the cattle tick , Rhipicephalus microplus , was isolated from transcriptomic studies conducted on gut tissues dissected from fully engorged adult female R. microplus .


Bioinformatic analysis indicates this aquaporin , designated RmAQP@ , shows greatest amino acid similarity to the human aquaporin @ family .


Members of this family of water-conducting channels can also facilitate the transport of glycerol in addition to water .


The efficacy of this aquaporin as an antigen against the cattle tick was explored in cattle vaccine trials conducted in Brazil .


A cDNA encoding a significant portion of RmAQP@ was expressed as a recombinant protein in Pichia pastoris , purified under native conditions using a polyhistidine C-terminus tag and nickel affinity chromatography , emulsified with Montanide adjuvant , and cattle vaccinated intramuscularly .


The recombinant protein provided @ % and @ % efficacy in two cattle pen trials conducted in Campo Grande , Brazil on groups of @ one year old Holstein calves .


The effectiveness of this vaccine in reducing the numbers of adult female ticks shows this aquaporin antigen holds promise as an active ingredient in cattle vaccines targeted against infestations of R. microplus .


Previous investigations suggested that cherry blossoms could provide valuable bioactive materials .


However , few observations regarding the anti-inflammatory effect of cherry blossoms were reported .


This study was to explore the anti-inflammatory effect of cherry blossom extract ( CBE ) , which was used as a soothing ingredient in skincare product .


In vitro study , the anti-inflammatory effect of CBE on the nitric oxide ( NO ) inhibition assay in lipopolysaccharide ( LPS ) - treated RAW @ cells was investigated .


In vivo study , @ volunteers were included in a randomized , single-blinded , placebo-controlled trial .


@-hour-occlusive test chambers were applied on the flexor side of the forearm with @ % sodium lauryl sulphate ( SLS ) .


Subsequently , the test areas were treated on @ subsequent days with a cream containing @ % CBE or a placebo .


Evaluation included a visual score and determination of erythema value ( E value ) .


In vitro study , @ % CBE reduced NO production by @ % compared to the placebo .


In the SLS irritant patch test , the visual score and erythema value of CBE were lower than that of the placebo on D@ and D@ .


Cherry blossom extract shows good anti-inflammatory effect in vitro and in vivo and represents a promising functional ingredient in soothing skincare product by reducing skin inflammation .


Recent and national data on adherence to heart failure drugs are limited , particularly among the disabled and some small minority groups , such as Native Americans and Hispanics .


We compare medication adherence among Medicare patients with heart failure , by disability status , race/ethnicity , and income .


Observational study .


US Medicare Parts A , B , and D data , @ % random sample , @-@ .


@,@ elderly Medicare beneficiaries and @,@ disabled non-elderly beneficiaries .


We examined @ % of Medicare fee-for-service beneficiaries with heart failure in @-@ .


The main outcome was @-year adherence to one of three therapeutic classes : - blockers , diuretics , and angiotensin-converting enzyme inhibitors ( ACEIs ) / angiotensin II receptor blockers ( ARBs ) .


Adherence was defined as having prescriptions in possession for @ % of days .


Among aged beneficiaries , @-year adherences to at least one heart failure drug were @ % , @ % , @ % , @ % , and @ % for Whites , Asians , Hispanics , Native Americans and Blacks , respectively ; among the disabled , @-year adherence was worse for each group : @ % , @ % , @ % , @ % and @ % respectively .


The racial/ethnic difference persisted after adjustment for age , gender , income , drug coverage , location and health status .


Patterns of adherence were similar among beneficiaries on all three therapeutic classes .


Among beneficiaries with close-to-full drug coverage , minorities were still less likely to adhere relative to Whites , OR = @ ( @ % CI @-@ @ ) for Hispanics , OR = @ ( @ % CI @-@ @ ) for Blacks and OR = @ ( @ % CI @-@ @ ) for Native Americans .


After the implementation of Medicare Part D , adherence to heart failure drugs remains problematic , especially among disabled and minority beneficiaries , including Native Americans , Blacks , and Hispanics .


Even among those with close-to-full drug coverage , racial differences remain , suggesting that policies simply relying on cost reduction can not eliminate racial differences .


Corifollitropin alfa ( Elonva ) is the first hybrid follicle-stimulating hormone molecule with demonstrated sustained follicle-stimulating activity after a single subcutaneous injection .


This trial evaluated if corifollitropin alfa is associated with QT/QTc prolongation and / or proarrhythmic potential as compared to placebo in healthy post-menopausal women .


Participants were healthy , postmenopausal women .


Study treatments were corifollitropin alfa @ g , corifollitropin alfa @ g , and moxifloxacin @ mg with placebo .


This randomized , double blind , double-dummy , @-period crossover trial compared single doses of corifollitropin alfa @ g ( therapeutic dose ) , corifollitropin alfa @ g ( supratherapeutic dose ) , and moxifloxacin @ mg ( positive control ) with placebo .


Corifollitropin alfa was administered on day @ and moxifloxacin on day @ .


The largest time-matched mean QTcF difference versus placebo for the therapeutic dose of corifollitropin alfa was @ ms ( upper limit of @-sided @ % confidence interval ( UL @ % CI ) = @ ms ) , and for the supratherapeutic dose was @ ms ( UL @ % CI = @ ms ) .


For both the therapeutic and the supratherapeutic dose of corifollitropin alfa and at all time points , the UL @ % CI for the time matched QTcF differences compared with placebo was below @ ms , the threshold of relevance defined by the ICH E@ guideline .


Single therapeutic and supratherapeutic doses of corifollitropin alfa are not associated with clinically relevant QT/QTc-interval prolongation in healthy post-menopausal women .


No reference second-line treatment of small-cell lung cancer is available .


The aim of the present phase II randomized trial ( Groupe Franais de Pneumo-Cancrologie @ ) was to compare , in patients with progressive small-cell lung cancer after first-line platinum-based chemotherapy , oral multidrug chemotherapy ( lomustine , cyclophosphamide , etoposide ) and intravenous therapy with cyclophosphamide , doxorubicin , and vincristine ( CAV ) in terms of efficacy and tolerance .


The primary endpoint was overall survival .


The secondary endpoints were progression-free survival , response rate , and tolerance .


The study randomized @ patients ( @ % male ; median age , @ @ years , @ % with a performance status of @-@ ) , @ to oral therapy and @ to the CAV arm .


No statistically significant differences were found in the baseline patient characteristics .


The OS and PFS was @ and @ months for the oral arm and @ and @ months for the CAV arm , respectively .


The control disease rate was @ % and @ % in oral and CAV arms , respectively .


No unexpected adverse events occurred , and no statistically significant difference was found between the @ arms in terms of toxicity ( grade @ hematologic adverse events in @ % and @ % of patients in the oral and CAV arms , respectively ) .


Compared with CAV , oral therapy in this setting appears as feasible as , but not superior to , the efficacy in the CAV arm .


The regional Mediterranean Diet has been associated with lower risk of disease .


We tested the health effects of the New Nordic Diet ( NND ) , which is a gastronomically driven regional , organic , and environmentally friendly diet , in a carefully controlled but free-living setting .


A total of @ centrally obese men and women , with a mean ( range ) age of @ y ( @-@ y ) , body mass index ( in kg/m ( @ ) ) of @ ( @-@ @ ) , and waist circumference of @ cm ( @-@ cm ) were randomly assigned to receive either the NND ( high in fruit , vegetables , whole grains , and fish ) or an average Danish diet ( ADD ) for @ wk .


Participants received cookbooks and all foods ad libitum and free of charge by using a shop model .


The primary endpoint was the weight change analyzed by both completer and intention-to-treat analyses .


A total of @ subjects -LSB- @ % ( NND @ % ; ADD @ % ) -RSB- completed the intervention .


A high dietary compliance was achieved , with significant differences in dietary intakes between groups .


The mean ( SEM ) weight change was -@ @ kg for the NND compared with -@ @ kg for the ADD ( adjusted difference : -@ kg ; @ % CI : -@ , -@ kg ; P < @ ) for the completer analysis , and the difference was -@ kg ( @ % CI : -@ , -@ kg ) for the intention-to-treat analysis .


The NND produced greater reductions in systolic blood pressure ( adjusted difference : -@ mm Hg ; @ % CI : -@ , -@ mm Hg ) and diastolic blood pressure ( adjusted difference : -@ mm Hg ; @ % CI : -@ , -@ mm Hg ) than did the ADD .


An ad libitum NND produces weight loss and blood pressure reduction in centrally obese individuals .


This trial was registered at www.clinicaltrials.gov as NCT@ .


Women stopping alendronate are commonly monitored with serial bone mineral density ( BMD ) measurements , yet no information exists on how frequently or for whom these measurements should be performed .


The objective of the study was to develop a tool to guide post-alendronate BMD monitoring .


A predictive model was constructed to estimate the time until a given percentage of women 's BMD T-scores drop below a given threshold that indicates a management change ( such as retreatment ) would be considered .


This model was then used to estimate the time it would take for groups of women defined by their baseline BMDs to drop below the given threshold .


Data were derived from the Fracture Intervention Trial Long Term Extension ( FLEX ) , the largest multicenter clinical trial of its type to date .


Four hundred four women who had received an average of @ years of alendronate during the Fracture Intervention Trial and were subsequently observed for @ treatment-free years ( on placebo ) during the FLEX trial were used to estimate the change in BMD over time .


If a management change such as alendronate reinitiation would be considered when BMD T-score drops below -@ , the model shows that women with total hip BMD greater than -@ T-scores at the time of alendronate discontinuation have less than a @ % probability that at follow-up , monitoring BMD will be below the threshold within @ years .


The model performed similarly , and results are provided over a range of management change thresholds from -@ to -@ T-scores .


Using the tool developed in this analysis , it is possible to estimate when BMD repeat measurement after alendronate discontinuation could potentially be useful .


Measuring BMD within @ years after alendronate discontinuation is unlikely to change management for women with total hip BMD @ T-scores above a prespecified retreatment threshold within the range of -@ to -@ T-scores .


Home-based management of malaria ( HMM ) may improve access to diagnostic testing and treatment with artemisinin combination therapy ( ACT ) .


In the Sahel region , seasonal malaria chemoprevention ( SMC ) is now recommended for the prevention of malaria in children .


It is likely that combinations of antimalarial interventions can reduce the malaria burden .


This study assessed the feasibility , effectiveness and safety of combining SMC and HMM delivered by community health workers ( CHWs ) .


A cluster-randomised trial was carried out during two transmission seasons in eight villages located in the south-eastern part of Senegal .


Intervention communities received HMM+SMC while control communities received HMM .


Primary end point was the incidence of malaria attacks during the follow up period .


Secondary end points included : malaria diagnostic accuracy ; access to ACT treatment ; SMC coverage ; safety and drug tolerability .


The adjusted rate ratio for incidence of malaria attacks in intervention and control communities was @ , indicating a protective effect of HMM+SMC of @ % ( @ % CI : @-@ @ % , p = @ ) .


Access to ACT treatment was @ % while SMC coverage represented @ % ( @ % CI : @-@ % ) in @ , and @ % ( @ % CI : @-@ @ % ) in @ .


No serious adverse events were recorded .


It seems feasible and safe to combine SMC with HMM intervention , while achieving high coverage and effectiveness of both SMC and HMM .


To evaluate the usability of the educational needs assessment tool in clinical practice , from a practitioner and patient perspective and to establish whether patients perceive that they are getting an equally good or equally inadequate education service for their needs .


The educational needs assessment tool was developed to enable patients with Rheumatoid Arthritis to assess their education needs prior to a consultation with a health professional .


The educational needs assessment tool has been translated into nine languages and measurement properties have been established , however , its usability in clinical practice has not been studied .


A qualitative study embedded into a multicentre RCT in which patients had been randomised into either educational needs assessment tool-focused education ( Experimental Group ) or usual care ( control group ) .


Both groups were seen by a clinical nurse specialist .


Sixteen patients and four clinical nurse specialists were recruited from the Rheumatology Outpatient Departments of three Acute Hospitals within the U K. Data were collected by interviews with patients and clinical nurse specialist .


Analysis followed the Framework approach .


Patients and clinical nurse specialist found completion of the educational needs assessment tool straightforward , comprehensive and easy to use .


Completing the educational needs assessment tool helped patients to focus on what they needed to know from the clinical nurse specialist .


Patients in both the control group and the experimental group felt supported and reassured by their clinical nurse specialist and perceived that they received a good and adequate education provision .


This study provides useful insights into the ability of the educational needs assessment tool to assess the educational needs of patients with rheumatoid arthritis in routine clinical practice .


The educational needs assessment tool would be useful as a structured guide for nurses when assessing and meeting individual patient educational needs .


This has the potential to improve patient-centred care , involve patients more actively in their care and enhance the long-term effects of patient education provision .


The course of posttraumatic stress disorder ( PTSD ) is frequently and severely complicated by co-occurring alcohol use disorder ( AUD ) , yet there are few reports of pharmacologic treatments for these comorbid conditions .


The objective of this pilot study was to obtain a preliminary assessment of the efficacy and safety of topiramate in reducing alcohol use and PTSD symptoms in veterans with both disorders .


This was a prospective @-week , randomized , double-blind , placebo-controlled pilot trial of flexible-dose topiramate up to @mg/d in @ veterans with PTSD and AUD .


The primary outcome measure was frequency of drinking .


Secondary outcomes consisted of other measures of alcohol use and PTSD symptom severity .


Within-group analyses showed that topiramate treatment was associated with significant reductions in frequency and amount of alcohol use and alcohol craving from baseline through week @ .


Between-group analyses showed that topiramate reduced frequency of alcohol use and alcohol craving significantly more than placebo and tended to reduce drinking amount .


Topiramate treatment was also associated with decreased PTSD symptom severity and tended to reduce hyperarousal symptoms compared with placebo .


Topiramate transiently impaired learning and memory , with significant recovery by the end of treatment .


These preliminary results indicate that in veterans with co-occurring PTSD and AUD , topiramate may be effective in reducing alcohol consumption , alcohol craving , and PTSD symptom severity-particularly hyperarousal symptoms .


Topiramate was associated with transient cognitive impairment but was otherwise well tolerated .


Urinary tract infections ( UTIs ) are common and result in an enormous economic burden .


The increasing prevalence of antibiotic-resistant microorganisms has stimulated interest in non-antibiotic agents to prevent UTIs .


To evaluate the cost-effectiveness of cranberry prophylaxis compared to antibiotic prophylaxis with trimethoprim-sulfamethoxazole ( TMP-SMX ) over a @ month period in premenopausal women with recurrent UTIs .


An economic evaluation was performed alongside a randomized trial .


Primary outcome was the number of UTIs during @ months .


Secondary outcomes included satisfaction and quality of life .


Healthcare utilization was measured using questionnaires .


Missing data were imputed using multiple imputation .


Bootstrapping was used to evaluate the cost-effectiveness of the treatments .


Cranberry prophylaxis was less effective than TMP-SMX prophylaxis , but the differences in clinical outcomes were not statistically significant .


Costs after @ months in the cranberry group were statistically significantly higher than in the TMP-SMX group ( mean difference @ , @ % confidence interval @ to @ ) .


Cost-effectiveness planes and cost-effectiveness acceptability curves showed that cranberry prophylaxis to prevent UTIs is less effective and more expensive than ( dominated by ) TMP-SMX prophylaxis .


In premenopausal women with recurrent UTIs , cranberry prophylaxis is not cost-effective compared to TMP-SMX prophylaxis .


However , it was not possible to take into account costs attributed to increased antibiotic resistance within the framework of this randomized trial ; modeling studies are recommended to investigate these costs .


Moreover , although we based the dosage of cranberry extract on available evidence , this may not be the optimal dosage .


Results may change when this optimal dosage is identified .


The implantation process after embryo transfer depends on the embryo quality and endometrial receptivity .


It is estimated that fifty to seventy-five per cent of pregnancies are lost due to a failure of implantation .


There is evidence that there is an early secretion of human chorionic gonadotrophin before embryo implantation , and this secretion has been linked to an important function in angiogenesis and the inflammatory response that promotes the implantation process .


Our objective was to determine the effects of intrauterine injection of human chorionic gonadotropin ( hCG ) before the embryo transfer in an in vitro fertilisation cycle .


A prospective randomised study was conducted in Reproductive Medicine Centre PROCREA in Mexico City .


Infertile patients who had a medical indication for in vitro fertilisation were studied .


Two groups were included ( n @ ) ; the intervention group received an intrauterine injection of @IU of hCG before the embryo transfer ( n @ ) .


The control group ( n @ ) did not receive hCG .


Comparisons were performed using a chi-square test .


The clinical pregnancy rate ( CPR ) was our principal outcome .


The implantation rate was a secondary outcome .


The implantation rate was significantly higher in the hCG group compared to the control group ( @ % vs @ % , p @ ) .


The clinical pregnancy rate was also significantly higher ( @ vs @ % , p @ ) .


No adverse effects were observed .


The intrauterine injection of hCG before embryo transfer showed a significant increase in the clinical pregnancy rate .


More clinical trials are needed to reproduce these results on this promising intervention .


The live birth rate must be included in subsequent studies .


Concentric ( CON ) and eccentric ( ECC ) contractions may involve different mechanisms related to changes in sarcolemma status and the consequent alteration of action potential transmission along muscle fibers .


Muscle conduction velocity ( CV ) , surface electromyography signal ( sEMG ) , muscle quality , and blood lactate concentrations were analyzed during CON and ECC actions .


Compared with ECC , the CON protocol resulted in greater muscle force losses , blood lactate concentrations , and changes in sEMG parameters .


Similar reductions in CV were detected in both protocols .


Higher echo intensity values were observed @ days after ECC due to greater muscle damage .


The effects of the muscle damage produced by ECC exercise on the transmission of action potentials along muscle fibers ( measured as the CV ) may be comparable with the effects of hydrogen accumulation produced by CON exercise ( related to greater lactate concentrations ) , which causes greater force loss and change in other sEMG variables during CON than during ECC actions .


To investigate the role of genetic polymorphisms in candidate genes associated with the HPA axis and their interactions with environmental stressors in antidepressant response .


The remission of depressive symptoms after @ weeks of antidepressant treatment was tested against @ single nucleotide polymorphisms ( SNPs ) in five candidate genes associated with the HPA axis in a Chinese Han sample suffering from unipolar depression ( n = @ ) .


Any history of childhood trauma and recent negative life events were measured using the Childhood Trauma Questionnaire-Short Form ( CTQ-SF ) ( n = @ ) and the Life Event Scale ( @ item , LES ) ( n = @ ) , respectively .


Reporter gene assays were used to evaluate the possible effects of the most significant SNP on gene expression .


A functional polymorphism at @ ` UTR of the corticotropin-releasing hormone receptor @ ( CRHR@ ) gene ( rs@ ) and three haplotypes containing it showed significant relationships with antidepressant remission .


Further laboratory-based genomic studies showed that the G-to-A change of rs@ resulted in a @-@ % decrease in the intensity of luciferase activity .


However , we failed to find association of environments and their interaction with HPA system-related genes with antidepressant remission .


Our results support a definite role for CRHR@ in the pharmacogenetics of antidepressant drugs .


This may contribute to interpatient differences in their responses to antidepressant drugs .


Oxidative stress and inflammation are involved in the pathogenesis of non-alcoholic fatty liver disease ( NAFLD ) .


Bayberries contain high levels of polyphenols that possess antioxidative and anti-inflammatory properties invitro .


The purpose of this study was to investigate whether the consumption of bayberry juice beneficially alters the levels of oxidative , inflammatory , and apoptotic biomarkers in young individuals with features of NAFLD .


In this randomized , placebo-controlled , double-blind , crossover study , @ participants ( ages @-@ y ) were given @ mL of either bayberry juice or placebo twice daily for @ wk .


Several anthropometric characteristics were measured , and fasting blood samples were drawn before and after each intervention period .


The levels of plasma glucose , insulin , lipids , and some NAFLD-related biomarkers were determined .


No significant effects on the anthropometric parameters and the homeostasis model assessment for insulin resistance were observed .


Compared with placebo , the consumption of bayberry juice significantly decreased the plasma levels of protein carbonyl groups ( P = @ ) , tumor necrosis factor - ( P < @ ) , and interleukin-@ ( P = @ ) .


The apoptosis markers analysis revealed significant differences between the treatment and the placebo in the levels of tissue polypeptide-specific antigen ( P < @ ) and cytokeratin-@ fragment M@ ( P < @ ) .


The consumption of bayberry juice for a period of @ wk can protect against NAFLD in young adults by improving the plasma antioxidant status and inhibiting the inflammatory and apoptotic responses that are involved in this disease .


This study examined women 's perceptions of early infant feeding experiences and identified early postpartum barriers to successful breastfeeding .


We conducted semistructured exit interviews at @ months postpartum with a subsample of participants ( n = @ ) enrolled in two randomized controlled trials of breastfeeding promotion .


Study arms included ( @ ) routine pre - and postnatal visits with an International Board Certified Lactation Consultant ( IBCLC ) ( LC group ) , ( @ ) electronically prompted guidance from prenatal care providers ( EP group ) , ( @ ) EP+LC combined , and ( @ ) standard of care ( control group ) .


Interview transcripts were coded using grounded theory and analyzed in MAXqda .


Code matrices were used to identify early postpartum breastfeeding barriers and were further examined in relation to treatment group using a mixed methods analysis .


The majority of the participants reported experiencing at least one barrier to breastfeeding .


Barriers to breastfeeding were more commonly reported in the early postpartum than late postpartum period .


The most common barrier during the early postpartum period was the perception of inadequate milk supply ( `` lactational '' ) ( n = @ ) , followed by problems with latch , medical problems that were perceived as precluding breastfeeding , and medical staff and hospital practices .


Participants frequently reported that the IBCLCs assisted them in anticipating , managing , and overcoming these barriers .


Our findings underscore the importance of integrating IBCLCs into routine pre - and postpartum care because they provide critical support that effectively addresses early postpartum barriers to breastfeeding .


This study aimed at evaluating the effect of vaginal intercourse on spontaneous labor onset at term .


In a randomized controlled trial , patients with singleton , cephalic , term , and low-risk pregnancy were assigned to either vaginal intercourse at least twice a week or abstinence .


The following data were assessed : demographics , parity , vaginal coitus frequency before and during pregnancy , Bishop score at @th weeks , gestational age at delivery , mode of delivery , and days between recruitment and delivery .


The primary outcome was spontaneous labor onset .


Of the @ patient analyzed , @ were assigned to study group and @ to control group .


Mean interval between study recruitment and delivery was higher in sexually active women ( @ days @ compared with @ days @ , p = @ ) as well as the rate of cesarean delivery ( @ % compared with @ % , p = @ ) , but the differences were not statistically significant .


The rate of spontaneous labor was similar in both groups ( @ % in vaginal coitus group ; @ % in control group , p = @ ) .


Our results showed that vaginal intercourse does not hasten spontaneous labor onset at term .


The impact on carriage and optimal schedule for primary vaccination of older children with @-valent pneumococcal non-typeable Haemophilus influenzae protein-D conjugate vaccine ( PHiD-CV ) are unknown .


@ Kenyan children aged @-@ months were vaccinated at days @ , @ and @ in a double-blind randomized controlled trial according to the following vaccine sequence : Group A : PHiD-CV , PHiD-CV , diphtheria/tetanus/acellular pertussis vaccine ( DTaP ) ; Group B : PHiD-CV , DTaP , PHiD-CV ; Group C : hepatitis A vaccine ( HAV ) , DTaP , HAV .


Nasopharyngeal carriage of Streptococcus pneumoniae was measured at five timepoints .


In @ subjects , serotype-specific responses were measured by @F-inhibition ELISA and opsonophagocytic killing assays ( OPA ) one month after vaccination .


Following one dose of PHiD-CV , > @ % of recipients developed IgG@ @ g/mL to serotypes @ , @ , @ , @F , @V and @C and OPA@ to serotypes @ , @F , @V , @C , @F .


After a second dose > @ % of recipients had IgG@ @ g/mL to all vaccine serotypes and OPA@ to all vaccine serotypes except @ and @B .


At day @ , carriage of vaccine-type pneumococci was @ % in recipients of two doses of PHiD-CV ( Group A ) compared to @ % in controls ( p = @ ) .


Fever after dose @ was reported by @ % of PHiD-CV recipients compared to @ % of HAV recipients ( p < @ ) .


Other local and systemic adverse experiences were similar between groups .


Vaccination of children aged @-@ months with two doses of PHiD-CV two to six months apart was immunogenic , reduced vaccine-type pneumococcal carriage and was well-tolerated .


Administration of PHiD-CV would be expected to provide effective protection against vaccine-type disease .


Understanding exercise participation for overweight and obese adults is critical for preventing comorbid conditions .


Group-based high-intensity functional training ( HIFT ) provides time-efficient aerobic and resistance exercise at self-selected intensity levels which can increase adherence ; behavioral responses to HIFT are unknown .


This study examined effects of HIFT as compared to moderate-intensity aerobic and resistance training ( ART ) on exercise initiation , enjoyment , adherence , and intentions .


A stratified , randomized two-group pre-test posttest intervention was conducted for eight weeks in @ with analysis in @ .


Participants ( n = @ ) were stratified by median age ( < or @ ) and body mass index ( BMI ; < or @ ) .


Participants were physically inactive with an average BMI of @ @ kg/m@ , body fat percentage of @ @ % , weight of @ @ kg , and ages @ @ years .


Most participants were white , college educated , female , and married/engaged .


Both groups completed @ training sessions per week .


The ART group completed @ minutes of moderate aerobic exercise each session and full-body resistance training on two sessions per week .


The HIFT group completed @-minute sessions of CrossFit with actual workouts ranging from @-@ minutes .


Participants completed baseline and posttest questionnaires indicating reasons for exercise initiation ( baseline ) , exercise enjoyment , and exercise intentions ( posttest ) .


Adherence was defined as completing @ % of exercise sessions .


Daily workout times were recorded .


Participants provided mostly intrinsic reasons for exercise initiation .


Eighteen participants adhered ( ART = @ , @ % ; HIFT = @ , @ % ) .


HIFT dropouts ( p = @ ) and ART participants ( p = @ ) reported lower baseline exercise enjoyment than HIFT participants , although ART participants improved enjoyment at posttest ( p = @ ) .


More HIFT participants planned to continue the same exercise than ART participants ( p = @ ) .


No significant changes in BMI or body composition were found .


Workouts were shorter for HIFT than ART ( p < @ ) .


HIFT participants spent significantly less time exercising per week , yet were able to maintain exercise enjoyment and were more likely to intend to continue .


High-intensity exercise options should be included in public health interventions .


Partial-thickness burns are among the most frequently encountered types of burns , and numerous dressing materials are available for their treatment .


A multicenter , open , randomized , and parallel study was undertaken to determine the efficacy and tolerability of silver sulfadiazine ( SSD ) compared with an absorbent foam silver dressing , Mepilex Ag , on patients aged between @ years and @ years with deep partial-thickness thermal burn injuries ( @-@ % total body surface area ) .


Patients were randomly assigned to either SSD ( n = @ ) applied daily or a Mepilex Ag dressing ( n = @ ) applied every @ days to @ days .


The treatment period was up to @ weeks .


There was no significant difference between the two treatment groups with respect to the primary end point of time to healing , which occurred in @ ( @ % ) of @ patients after a median follow-up time of @ days in the Mepilex Ag group compared with @ ( @ % ) of @ patients after a median follow-up time of @ days in the SSD group ( p = @ ) .


There was also no significant difference in the percentage of study burn healed .


Patients in the Mepilex Ag group had @ % of their study burn healed ( out of the total burn area ) compared with @ % of patients in the SSD group .


However , the mean total number of dressings used was significantly more in the SSD group ( @ ) compared with the Mepilex Ag group ( @ , p < @ ) .


There was no significant difference in the time until skin graft was performed between the two study groups .


There was no difference in healing rates between Mepilex Ag and SSD , with both products well tolerated .


The longer wear time of Mepilex Ag promotes undisturbed healing and makes it easier for patients to continue with their normal lives sooner .


Therapeutic study , level III .


In incomplete spinal cord injury ( iSCI ) , sensorimotor impairments result in severe limitations to ambulation .


To improve walking capacity , physical therapies using robotic-assisted locomotor devices , such as the Lokomat , have been developed .


Following locomotor training , an improvement in gait capabilities-characterized by increases in the over-ground walking speed and endurance-is generally observed in patients .


To better understand the mechanisms underlying these improvements , we studied the effects of Lokomat training on impaired ankle voluntary movement , known to be an important limiting factor in gait for iSCI patients .


Fifteen chronic iSCI subjects performed twelve @-hour sessions of Lokomat training over the course of a month .


The voluntary movement was qualified by measuring active range of motion , maximal velocity peak and trajectory smoothness for the spastic ankle during a movement from full plantar-flexion ( PF ) to full dorsi-flexion ( DF ) at the patient 's maximum speed .


Dorsi - and plantar-flexor muscle strength was quantified by isometric maximal voluntary contraction ( MVC ) .


Clinical assessments were also performed using the Timed Up and Go ( TUG ) , the @-meter walk ( @MWT ) and the @-minute walk ( @MWT ) tests .


All evaluations were performed both before and after the training and were compared to a control group of fifteen iSCI patients .


After the Lokomat training , the active range of motion , the maximal velocity , and the movement smoothness were significantly improved in the voluntary movement .


Patients also exhibited an improvement in the MVC for their ankle dorsi - and plantar-flexor muscles .


In terms of functional activity , we observed an enhancement in the mobility ( TUG ) and the over-ground gait velocity ( @MWT ) with training .


Correlation tests indicated a significant relationship between ankle voluntary movement performance and the walking clinical assessments .


The improvements of the kinematic and kinetic parameters of the ankle voluntary movement , and their correlation with the functional assessments , support the therapeutic effect of robotic-assisted locomotor training on motor impairment in chronic iSCI .


Although lateral ankle sprains are common in athletes and can lead to chronic ankle instability ( CAI ) , strength-training rehabilitation protocols may improve the deficits often associated with CAI .


To determine whether strength-training protocols affect strength , dynamic balance , functional performance , and perceived instability in individuals with CAI .


Randomized controlled trial .


Athletic training research laboratory .


A total of @ individuals with CAI ( @ men -LSB- @ % -RSB- , @ women -LSB- @ % -RSB- ) participated in this study .


Chronic ankle instability was determined by the Identification of Functional Ankle Instability Questionnaire , and participants were randomly assigned to a resistance-band-protocol group ( n = @ -LSB- @ % -RSB- age = @ @ years , height = @ @ cm , weight = @ @ kg ) , a proprioceptive neuromuscular facilitation strength-protocol group ( n = @ -LSB- @ % -RSB- , age = @ @ years , height = @ @ cm , weight = @ @ kg ) , or a control group ( n = @ -LSB- @ % -RSB- , age = @ @ years , height = @ @ cm , weight = @ @ kg ) .


Both rehabilitation groups completed their protocols @ times/wk for @ weeks .


The control group did not attend rehabilitation sessions .


Before the interventions , participants were pretested by completing the figure-@ hop test for time , the triple-crossover hop test for distance , isometric strength tests ( dorsiflexion , plantar flexion , inversion , and eversion ) , the Y-Balance test , and the visual analog scale for perceived ankle instability .


Participants were again tested @ weeks later .


We conducted @ separate , multivariate , repeated-measures analyses of variance , followed by univariate analyses on any significant findings .


The resistance-band protocol group improved in strength ( dorsiflexion , inversion , and eversion ) and on the visual analog scale ( P < @ ) ; the proprioceptive neuromuscular facilitation group improved in strength ( inversion and eversion ) and on the visual analog scale ( P < @ ) as well .


No improvements were seen in the triple-crossover hop or the Y-Balance tests for either intervention group or in the control group for any dependent variable ( P > @ ) .


Although the resistance-band protocol is common in rehabilitation , the proprioceptive neuromuscular facilitation strength protocol is also an effective treatment to improve strength in individuals with CAI .


Both protocols showed clinical benefits in strength and perceived instability .


To improve functional outcomes , clinicians should consider using additional multiplanar and multijoint exercises .


Epidemiologic and biological evidence supports an inverse association between polyphenol consumption and the risk of cardiovascular disease ( CVD ) .


However , no previous studies have prospectively evaluated the relationship between polyphenol intake and the incidence of CVD in such a comprehensive way .


The aim was to evaluate the association between intakes of total polyphenol and polyphenol subgroups , and the risk of major cardiovascular events ( myocardial infarction , stroke or death from cardiovascular causes ) in the PREDIMED study .


The present work is an observational study within the PREDIMED trial .


Over an average of @ years of follow-up , there were @ confirmed cases of CVD among the @ participants ( @ % ) who completed a validated @-item food frequency questionnaire ( FFQ ) at baseline .


Polyphenol consumption was calculated by matching food consumption data from the FFQ with the Phenol-Explorer database on polyphenol content of each reported food .


After multivariate adjustment , a @ % reduction in risk of CVD risk was observed comparing Q@ vs. Q@ of total polyphenol intake ( HR = @ ; @ % confidence interval -LSB- CI -RSB- = @-@ @ ; P-trend = @ ) .


The polyphenols with the strongest inverse associations were flavanols ( HR = @ ; CI @-@ @ ; P-trend = @ ) , lignans ( HR = @ ; CI @-@ @ ; P-trend = @ ) , and hydroxybenzoic acids ( HR = @ ; CI @-@ @ ; P-trend @ ) .


Greater intake of polyphenols , especially from lignans , flavanols , and hydroxybenzoic acids , was associated with decreased CVD risk .


Clinical trials are needed to confirm this effect and establish accurate dietary recommendations .


Inhaled therapies reduce risk of chronic obstructive pulmonary disease ( COPD ) exacerbations , but their effect on mortality is less well established .


We hypothesized that heterogeneity in baseline mortality risk influenced the results of drug trials assessing mortality in COPD .


The @ patients with COPD from the Understanding Potential Long-term Impacts on Function with Tiotropium ( UPLIFT ) study that had complete clinical information for variables associated with mortality ( age , forced expiratory volume in @s , St George 's Respiratory Questionnaire , pack-years and body mass index ) were classified by cluster analysis .


Baseline risk of mortality between clusters , and impact of tiotropium were evaluated during the @-yr follow up .


Four clusters were identified , including low-risk ( low mortality rate ) patients ( n = @ ; @ % ; cluster @ ) , and high-risk patients ( n = @ ; @ % ; cluster @ ) , who had a @ - and a six-fold increase in all-cause and respiratory mortality compared with cluster @ , respectively .


Tiotropium reduced exacerbations in all clusters , and reduced hospitalizations in high-risk patients ( p < @ ) .


The beneficial effect of tiotropium on all-cause mortality in the overall population ( hazard ratio , @ ; @ % confidence interval , @-@ @ , p = @ ) was explained by a @ % reduction in cluster @ ( p = @ ) , with no effect in other clusters .


Large variations in baseline risks of mortality existed among patients in the UPLIFT study .


Inclusion of numerous low-risk patients may have reduced the ability to show beneficial effect on mortality .


Future clinical trials should consider selective inclusion of high-risk patients .


To investigate the safety and effects of intravitreal sirolimus for the potential treatment of geographic atrophy ( GA ) .


The study was a single-center , open-label , phase I/II trial enrolling six participants with bilateral GA treated with intravitreal sirolimus in only one randomly assigned eye , with the fellow eye as control .


The primary efficacy outcome measure was the change in total GA area from baseline on color fundus photography ( CFP ) ; secondary outcomes included changes in GA area on fundus autofluorescence ( FAF ) , visual acuity , central retinal thickness ( CRT ) , and macular sensitivity from baseline .


Although no systemic adverse events were attributed to treatment , two of six participants had ocular adverse events that were possibly associated .


The treated eye of one participant developed abnormal paralesional changes on FAF that were associated with accelerated retinal thinning .


This accelerated retinal thinning was also seen in the treated eye of a second participant .


Because of concern that these events were associated with treatment , treatment was suspended .


Comparisons of treated and fellow eyes for change in visual acuity , change in GA area , and change in CRT showed no evidence of treatment benefit and generally favored the untreated fellow eye .


While paralesional FAF changes and rapid retinal thinning observed are potentially part of the natural course of GA , they may possibly be related to treatment .


No general evidence of anatomical or functional benefit was detected in treated eyes .


Further data on intravitreal sirolimus for GA treatment will be available from a larger phase II trial .


( ClinicalTrials.gov number , NCT@ . )


Invasive candidiasis is the third most common bloodstream infection in the intensive care unit ( ICU ) and is associated with morbidity and mortality .


Prophylaxis and preemptive therapy are attractive strategies for this setting .


We conducted a multicenter , randomized , double-blind , placebo-controlled trial of caspofungin as antifungal prophylaxis in @ adults who were in the ICU for at least @ days , were ventilated , received antibiotics , had a central line , and had @ additional risk factor ( parenteral nutrition , dialysis , surgery , pancreatitis , systemic steroids , or other immunosuppressants ) .


Subjects ' ( @,@ ) -- d-glucan levels were monitored twice weekly .


The primary endpoint was the incidence of proven or probable invasive candidiasis by EORTC/MSG criteria in patients who did not have disease at baseline .


Patients who had invasive candidiasis were allowed to break the blind and receive preemptive therapy with caspofungin .


The preemptive approach analysis included patients all patients who received study drug , including those positive at baseline .


The incidence of proven/probable invasive candidiasis in the placebo and caspofungin arms was @ % ( @/@ ) and @ % ( @/@ ) , respectively , for prophylaxis ( P = @ ) , and @ % ( @/@ ) and @ % ( @/@ ) , respectively , for the preemptive approach ( P = @ ) ; however , this analysis included patients with baseline disease .


There were no significant differences in the secondary endpoints of mortality , antifungal use , or length of stay .


There were no safety differences .


Caspofungin was safe and tended to reduce the incidence of invasive candidiasis when used for prophylaxis , but the difference was not statistically significant .


A preemptive therapy approach deserves further study .


Very few studies have investigated the effects of individual disorder-specific treatment of social phobia ( SP ) in adolescents .


The objective of this study was to compare the effects of individual cognitive therapy for SP , group cognitive behavioural therapy ( CBTG ) and attentional placebo ( AP ) among adolescents with a primary diagnosis of SP .


A randomized controlled design was used , and a total of @ adolescents were assessed .


Fifty-seven adolescents , between @ and @ years old , were allocated to individual cognitive therapy , CBTG or AP .


The participants were assessed before treatment , at the end of treatment and at a @-month follow-up using both self-report and a semi-structured interview .


The individual cognitive therapy showed significant reductions in symptoms , impairment and diagnostic criteria both at the end of treatment and at the @-month follow-up .


Compared with CBTG and AP , the individual cognitive therapy group demonstrated significantly greater effects on both symptom reduction and impairment .


There were no significant differences between CBTG and AP .


In a direct comparison between the most commonly used treatments for adolescent SP , we found that individual therapy was the most effective , yielding better effects than both CBTG and AP .


To assess the behavioral effects of receiving personal genetic information , using apoE genotypes as a tool for promoting lifestyle changes .


apoE was chosen because it has a significant impact on lipid metabolism and cholesterol absorption , both factors in cardiovascular disease .


This study was a @-year intervention study of healthy adults aged @-@ years ( n = @ ) .


Their behavioral changes were measured by diet ( e.g. , fat quality , as well as consumption of vegetables , berries , fruits , and fatty and sugary foods ) , alcohol consumption , and exercise .


Health and taste attitudes were assessed with the Health and Taste Attitude Scales ( HTAS ) .


The measurements were performed @ times : at baseline ( T@ ) , as well as @ weeks ( T@ ) , @ months ( T@ ) , and @ months after baseline ( T@ ) .


These behavioral effects were assessed for three groups : a high-risk ( @ + ; n = @ ) , a low-risk ( @ - ; n = @ ) , and a control group ( n = @ ) .


Personal genetic information affected health behavior .


Dietary fat quality improved more in the @ + group than in the @ - and control groups after personal , genotype-based health advice .


This change differed significantly between the @ + and the control group ( p < @ ) , but only for a short time .


Personal genetic information , based on apoE , may affect dietary fat quality .


More research is required to determine how to utilize genotype-based health information and how to efficiently achieve long-term changes in the prevention of lifestyle-related diseases .


To test the hypothesis that in very prematurely born infants remaining ventilated beyond the first week , proportional assist ventilation ( PAV ) compared with assist control ventilation ( ACV ) would be associated with reduced work of breathing , increased respiratory muscle strength and less ventilator-infant asynchrony which would be associated with improved oxygenation .


Randomised crossover study .


Tertiary neonatal unit .


@ infants with a median gestational age of @ ( range @-@ ) weeks were studied at a median of @ ( range @-@ ) days .


Infants were studied for @h each on PAV and ACV in random order .


At the end of each hour , the work of breathing ( assessed by measuring the diaphragmatic pressure time product ) , thoracoabdominal asynchrony and respiratory muscle strength ( maximal inspiratory pressure , maximal expiratory pressure ( Pemax ) and maximal transdiaphragmatic pressure ( Pdimax ) ) were assessed .


Blood gas analysis was performed and the oxygenation index ( OI ) calculated .


After @h on PAV compared with @h on ACV , the median OI ( @ ( range @-@ ) vs @ ( range @-@ ) , p = @ ) and PTP levels were lower ( @ ( range @-@ ) cmH@O.s / min vs @ ( range @-@ ) cmH@O.s / min , p = @ ) , while Pdimax ( @ ( range @-@ ) cmH@O vs @ ( range @-@ ) cmH@O , p = @ ) and Pemax ( @ ( range @-@ ) cmH@O vs @ ( range @-@ ) cmH@O levels p = @ ) were higher .


These results suggest that PAV compared with ACV may have physiological advantages for prematurely born infants who remain ventilated after the first week after birth .


The effects of tongue cleaning on reconstruction of bacterial flora in dental plaque and tongue coating itself are obscure .


We assessed changes in the amounts of total bacteria as well as Fusobacterium nucleatum in tongue coating and dental plaque specimens obtained with and without tongue cleaning .


We conducted a randomized examiner-blind crossover study using @ volunteers ( average @ @ years old ) without periodontitis .


After dividing randomly into @ groups , @ group was instructed to clean the tongue , while the other did not .


On days @ ( baseline ) , @ , and @ , tongue coating and dental plaque samples were collected after recording tongue coating score ( Winkel tongue coating index : WTCI ) .


After a washout period of @ weeks , the same examinations were performed with the subjects allocated to the alternate group .


Genomic DNA was purified from the samples and applied to SYBR Green-based real-time PCR to quantify the amounts of total bacteria and F. nucleatum .


After @ days , the WTCI score recovered to baseline , though the amount of total bacteria in tongue coating was significantly lower as compared to the baseline .


In plaque samples , the bacterial amounts on day @ and @ were significantly lower than the baseline with and without tongue cleaning .


Principal component analysis showed that variations of bacterial amounts in the tongue coating and dental plaque samples were independent from each other .


Furthermore , we found a strong association between amounts of total bacteria and F. nucleatum in specimens both .


Tongue cleaning reduced the amount of bacteria in tongue coating .


However , the cleaning had no obvious contribution to inhibit dental plaque formation .


Furthermore , recovery of the total bacterial amount induced an increase in F. nucleatum in both tongue coating and dental plaque .


Thus , it is recommended that tongue cleaning and tooth brushing should both be performed for promoting oral health .


Given concerns that dexrazoxane may reduce treatment efficacy , induce second cancers , and thus compromise overall survival among children , we examined long-term overall and cause-specific mortality and disease relapse rates from three randomized clinical trials .


Children 's Oncology Group trials P@ ( T-cell acute lymphoblastic leukemia/lymphoma ; n = @ ) , P@ ( intermediate/high-risk Hodgkin lymphoma ; n = @ ) , and P@ ( low-risk Hodgkin lymphoma ; n = @ ) were conducted between @ and @ .


Each trial randomly assigned patients to doxorubicin with or without dexrazoxane .


The dexrazoxane : doxorubicin dose ratio was @:@ , and the cumulative protocol-specified doxorubicin dose was @ to @ mg/m ( @ ) .


Dexrazoxane was given as an intravenous bolus before each doxorubicin dose .


Data from all three trials were linked with the National Death Index to determine overall and cause-specific mortality by dexrazoxane status .


Among @,@ patients ( @ received dexrazoxane ) with a median follow-up of @ years ( range , @ to @ years ) , @ died ( @ received dexrazoxane ) .


Overall mortality did not vary by dexrazoxane status ( @ % with dexrazoxane at @ years v @ % without ; hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @ to @ ) .


Findings were similar when each trial was examined separately .


Dexrazoxane also was not significantly associated with differential causes of death .


The original cancer caused @ % of all deaths ( HR , @ ; @ % CI , @ to @ ) followed by second cancers ( @ % of deaths ; HR , @ ; @ % CI , @ to @ ) .


Specifically , dexrazoxane was not associated with deaths from acute myeloid leukemia/myelodysplasia or cardiovascular events .


Among pediatric patients with leukemia or lymphoma , after extended follow-up , dexrazoxane use did not seem to compromise long-term survival .


Scholarly activity is expected of program directors of Accreditation Council for Graduate Medical Education ( ACGME ) - accredited residency training programs .


Anesthesiology residency programs are cited more often than surgical programs for deficiencies in academic productivity .


We hypothesized that this may in part reflect differences in scholarly activity between program directors of anesthesiology and surgical trainings programs .


To test the hypothesis , we examined the career track record of current program directors of ACGME-accredited anesthesiology and surgical residency programs at the same institutions using PubMed citations and funding from the National Institutes of Health ( NIH ) as metrics of scholarly activity .


Between November @ , @ and December @ , @ , we obtained data from publicly available Web sites on program directors at @ institutions that had ACGME-accredited programs in both anesthesiology and surgery .


Information gathered on each individual included year of board certification , year first appointed program director , academic rank , history of NIH grant funding , and number of PubMed citations .


We also calculated the h-index for a randomly selected subset of @ institution-matched program directors .


There were no differences between the groups in number of years since board certification ( P = @ ) , academic rank ( P = @ ) , or years as a program director ( P = @ ) .


However , program directors in anesthesiology had less prior or current NIH funding ( P = @ ) , fewer total and education-related PubMed citations ( both P < @ ) , and a lower h-index ( P = @ ) than surgery program directors .


Multivariate analysis revealed that the publication rate for anesthesiology program directors was @ % ( @ % confidence interval , @-@ @ ) that of the corresponding program directors of surgical residency programs , holding other variables constant .


Program directors of anesthesiology residency programs have considerably less scholarly activity in terms of peer-reviewed publications and federal research funding than directors of surgical residency programs .


As such , this study provides further evidence for a systemic weakness in the scholarly fabric of academic anesthesiology .


In recent years , several oral antidiabetic drugs with new mechanisms of action have become available , expanding the number of treatment options .


Sodium/glucose cotransporter-@ ( SGLT@ ) inhibitors are a new class of oral antidiabetic drugs with an insulin-independent mechanism promoting urinary glucose excretion .


We report the results of a combined Phase @ and @ clinical study ( Japic CTI-@ ) of the SGLT@ inhibitor tofogliflozin ( CSG@ , RG@ ) in Japanese patients with type @ diabetes mellitus .


The efficacy and safety of tofogliflozin were assessed in this multicenter , placebo-controlled , randomized , double-blind parallel-group study involving @ patients with type @ diabetes mellitus with inadequate glycemic control on diet/exercise therapy .


Between @ October @ and @ February @ , patients at @ centers were randomized to either placebo ( n = @ ) or tofogliflozin ( @ , @ , or @ mg ; n = @ each ) orally , once daily for @ weeks .


The primary efficacy endpoint was the change from baseline in HbA@c at week @ .


Overall , @ patients were included in the full analysis set ( placebo : n = @ ; tofogliflozin @ mg : n = @ ; tofogliflozin @ and @ mg : n = @ each ) .


The least squares ( LS ) mean change ( @ % confidence interval ) from baseline in HbA@c at week @ was -@ % ( -@ to @ ) in the placebo group , compared with -@ % ( -@ to -@ ) in the tofogliflozin @ mg group , -@ % ( -@ to -@ ) in the tofogliflozin @ mg group , and -@ % ( -@ to -@ ) in the tofogliflozin @ mg group ( p < @ for the LS mean differences in all tofogliflozin groups vs placebo ) .


There were also prominent decreases in fasting blood glucose , @-h postprandial glucose , and body weight in all tofogliflozin groups compared with the placebo group .


The main adverse events were hyperketonemia , ketonuria , and pollakiuria .


The incidence of hypoglycemia was low .


Furthermore , most adverse events were classified as mild or moderate in severity .


Tofogliflozin @ , @ , or @ mg administered once daily as monotherapy significantly decreased HbA@c and body weight , and was generally well tolerated in Japanese patients with type @ diabetes mellitus .


Phase @ studies were recently completed and support the findings of this combined Phase @ and @ study .


To observe the effects of daily consumption of milk powder on Healthy young women , including the effect on menstrual cycles , ovulation time and sex hormone concentrations in morning urine .


Thirty-two young women were recruited as subjects and randomly assigned into two groups for a milk powder consumption experiment which lasted three menstrual cycles .


The first menstrual cycle is control cycle , the second menstrual cycle is milk-taking cycle .


The subjects take milk diluted by @g or @g milk powder each day , from the @th to the @th day of the second menstrual cycle .


The third menstrual cycles is control cycle after milk-taking .


During the whole three menstrual cycle , record the length of each menstrual cycle , determine ovulation time by using basal body temperature and oviposit test paper , collect their morning urine samples at specified times ( the @th , @th , @th , @rd , @th , @th and @th day of first and the third menstrual cycle ; the @th , @th , @th , @th , @th , @nd , @th , @th , @st and @th day of the second menstrual cycle ) , determine the concentrations of estradiol , pregnanediol and creatinine in morning urine samples ; draw the curve of the concentration changing over time and calculate the area under the curve to the @th day .


In the high-dose group , the mean of the menstrual cycle length are ( @ @ ) d , ( @ @ ) d , ( @ @ ) d , the mean of the ovulation time are ( @ @ ) d.


There was no significant difference in menstrual cycle length and ovulation time among cycles and between groups ( P > @ ) .


Calculate the difference between the first and the second menstrual cycle , and the difference between the two groups .


In the high-dose group , the area under the curve of estradiol concentrations adjusted by creatinine are ( @ @ ) , ( @ @ ) ; ( @ @ ) ; the area under the curve of pregnanediol concentrations corrected by creatinine are ( @ @ ) , ( @ @ ) and ( @ @ ) .


In the low-dose group , the area under the curve of estradiol concentrations adjusted by creatinine are ( @ @ ) , ( @ @ ) and ( @ @ ) / The area under the curve of pregnanediol concentrations adjusted by creatinine are ( @ @ ) , ( @ @ ) and ( @ @ ) .


Theres no significant difference of the area under the curve among three menstrual cycles and between two groups ( P > @ ) .


@ days continuous daily consumption of milk powder does not have a significant impact on menstrual cycle , or on the estradiol/pregnanediol concentrations in morning urine .


Single-pass , contrast-enhanced whole body multidetector computed tomography ( MDCT ) emerged as the diagnostic standard for evaluating patients with major trauma .


Modern iterative image algorithms showed high image quality at a much lower radiation dose in the non-trauma setting .


This study aims at investigating whether the radiation dose can safely be reduced in trauma patients without compromising the diagnostic accuracy and image quality .


Prospective observational study with two consecutive cohorts of patients .


A high-volume , academic , supra-regional trauma centre in Germany .


Consecutive male and female patients who @ .


had been exposed to a high-velocity trauma mechanism , @ .


present with clinical evidence or high suspicion of multiple trauma ( predicted Injury Severity Score -LSB- ISS -RSB- @ ) and @ .


are scheduled for primary MDCT based on the decision of the trauma leader on call.Imaging protocols : In a before/after design , a consecutive series of @ patients will undergo single-pass , whole-body @-row multi-detector computed tomography ( MDCT ) with a standard , as low as possible radiation dose .


This will be followed by a consecutive series of @ patients undergoing an approved ultra-low dose MDCT protocol using an image processing algorithm .


Routine administrative data and electronic patient records , as well as digital images stored in a picture archiving and communications system will serve as the primary data source .


The protocol was approved by the institutional review board .


( @ ) incidence of delayed diagnoses , ( @ ) diagnostic accuracy , as correlated to the reference standard of a synopsis of all subsequent clinical , imaging , surgical and autopsy findings , ( @ ) patients ' safety , ( @ ) radiation exposure ( e.g. effective dose ) , ( @ ) subjective image quality ( assessed independently radiologists and trauma surgeons on a @-mm visual analogue scale ) , ( @ ) objective image quality ( e.g. , contrast-to-noise ratio ) .


Multivariate regression will be employed to adjust and correct the findings for time and cohort effects .


An exploratory interim analysis halfway after introduction of low-dose MDCT will be conducted to assess whether this protocol is clearly inferior or superior to the current standard .


Although non-experimental , this study will generate first large-scale data on the utility of imaging-enhancing algorithms in whole-body MDCT for major blunt trauma .


Little is known about the incidence of prosthesis-patient mismatch ( PPM ) and its impact on outcomes after transcatheter aortic valve replacement ( TAVR ) .


The objectives of this study were : @ ) to compare the incidence of PPM in the TAVR and surgical aortic valve replacement ( SAVR ) randomized control trial ( RCT ) arms of the PARTNER ( Placement of AoRTic TraNscathetER Valves ) I Trial cohort A ; and @ ) to assess the impact of PPM on regression of left ventricular ( LV ) hypertrophy and mortality in these @ arms and in the TAVR nonrandomized continued access ( NRCA ) registry cohort .


The PARTNER Trial cohort A randomized patients @:@ to TAVR or bioprosthetic SAVR .


Postoperative PPM was defined as absent if the indexed effective orifice area ( EOA ) was > @ cm ( @ ) / m ( @ ) , moderate if the indexed EOA was @ but @ cm ( @ ) / m ( @ ) , or severe if the indexed EOA was < @ cm ( @ ) / m ( @ ) .


LV mass regression and mortality were analyzed using the SAVR-RCT ( n = @ ) , TAVR-RCT ( n = @ ) , and TAVR-NRCA ( n = @,@ ) cohorts .


The incidence of PPM was @ % ( severe : @ % ) in the SAVR-RCT cohort versus @ % ( severe : @ % ) in the TAVR-RCT cohort ( p < @ ) and @ % ( severe : @ % ) in the TAVR-NRCA cohort .


In patients with an aortic annulus diameter < @ mm , severe PPM developed in @ % undergoing SAVR compared with @ % undergoing TAVR ( p = @ ) .


PPM was an independent predictor of less LV mass regression at @ year in the SAVR-RCT ( p = @ ) and TAVR-NRCA ( p = @ ) cohorts but not in the TAVR-RCT cohort ( p = @ ) .


Severe PPM was an independent predictor of @-year mortality in the SAVR-RCT cohort ( hazard ratio -LSB- HR -RSB- : @ ; p = @ ) but not in the TAVR-RCT cohort ( HR : @ ; p = @ ) .


In the TAVR-NRCA cohort , severe PPM was not a predictor of @-year mortality in all patients ( HR : @ ; p = @ ) but did independently predict mortality in the subset of patients with no post-procedural aortic regurgitation ( HR : @ ; p = @ ) .


In patients with severe aortic stenosis and high surgical risk , PPM is more frequent and more often severe after SAVR than TAVR .


Patients with PPM after SAVR have worse survival and less LV mass regression than those without PPM .


Severe PPM also has a significant impact on survival after TAVR in the subset of patients with no post-procedural aortic regurgitation .


TAVR may be preferable to SAVR in patients with a small aortic annulus who are susceptible to PPM to avoid its adverse impact on LV mass regression and survival .


( The PARTNER Trial : Placement of AoRTic TraNscathetER Valve Trial ; NCT@ ) .


The purpose of our study was to determine whether sex affects the predictive value of perfusion and wall motion imaging obtained with real time myocardial contrast echocardiography ( RTMCE ) when compared with conventional stress echocardiography ( CSE ) .


We prospectively enrolled @ age-matched men and women with intermediate pretest probability of coronary artery disease ( CAD ) undergoing stress echocardiography for suspicion of CAD .


Patients with known CAD were excluded .


Those who consented to participate in the study were randomised to undergo either CSE or RTMCE .


Events were defined as death , non-fatal myocardial infarction ( MI ) and need for revascularisation .


Median follow-up was @ years ( @ women , @ men ) .


Mean age was @years in both sexes .


There were a total of @ deaths , @ MIs and @ revascularisations with a @-year event rate of @ % ( @ % CI @ % to @ % ) .


Male sex was a significant independent predictor of adverse outcome ( death , non-fatal MI ) in both CSE and RTMCE ( CSE HR @ , @ % CI @ to @ , RTMCE HR @ ; @ % CI @ to @ ) .


Higher @-year event rates were noted in men in comparison with women after a normal CSE ( men @ % , women @ % , p = @ ) , but not after a normal RTMCE ( men @ % , women @ % , p = @ ) .


Event rates were also significantly higher in men after an abnormal RTMCE ( men @ % , women @ % , p = @ ) but no difference in outcome between sexes was observed after an abnormal CSE ( men @ % , women @ % , p = @ ) .


The addition of perfusion imaging with RTMCE improves the predictive value of stress echocardiography in men with no known CAD , but does not improve the predictive value in age-matched women .


To compare effects of raisin snacks with conventional snacks on glycemia and cardiovascular risk factors .


A @-week , randomized , controlled trial compared @-times-a-day consumption of raisins with intake of processed snacks on glycemia and cardiovascular risk factors .


Men and women were randomized to snacks ( n = @ ) or raisins ( n = @ ) .


Outcome measures were performed at baseline , @ , @ , and @ weeks .


Fasting plasma glucose levels were not significantly affected by intake of raisins or snacks .


Mean subject post prandial glucose levels were significantly reduced by raisin intake at @ weeks ; changes with raisin intake were -@ mg/dL ( P = @ vs baseline ; P = @ vs snacks ) .


Eating raisins significantly decreased glycated hemoglobin ( HbA@c ) level ( -@ % ; P = @ ) , a significantly greater level decrease than seen with snack intake ( P = @ ) .


Snack intake did not significantly affect subject systolic or diastolic blood pressure ( BP ) .


Raisin intake was associated with reductions in systolic blood pressure ( SBP ) at @ , @ , and @ weeks with mean changes of -@ to @ mmHg ; all these changes were statistically significant ( P = @ to @ ) .


Raisins were associated with significantly greater changes in diastolic blood pressure ( DBP ) at @ , @ , and @ weeks than snacks ( P < @ ) .


Body weight did not significantly change within or between groups .


Regular consumption of raisins may reduce glycemia and cardiovascular risk factors , including BP rate .


Previous studies have shown improvement in patellar tendinopathy symptoms after platelet-rich plasma ( PRP ) injections , but no randomized controlled trial has compared PRP with dry needling ( DN ) for this condition .


To compare clinical outcomes in patellar tendinopathy after a single ultrasound-guided , leukocyte-rich PRP injection versus DN .


Randomized controlled trial ; Level of evidence , @ .


A total of @ patients with patellar tendinopathy on examination and MRI who had failed nonoperative treatment were enrolled and randomized to receive ultrasound-guided DN alone ( DN group ; n = @ ) or with injection of leukocyte-rich PRP ( PRP group ; n = @ ) , along with standardized eccentric exercises .


Patients and the physician providing follow-up care were blinded .


Participants completed patient-reported outcome surveys before and at @ , @ , @ , @ , and @ weeks after treatment during follow-up visits .


The primary outcome measure was the Victorian Institute of Sports Assessment ( VISA ) score for patellar tendinopathy at @ weeks , and secondary measures included the visual analog scale ( VAS ) for pain , Tegner activity scale , Lysholm knee scale , and Short Form ( SF-@ ) questionnaire at @ and @ weeks .


Results were analyzed using @-tailed paired and unpaired t tests .


Patients who were dissatisfied at @ weeks were allowed to cross over into a separate unblinded arm .


At @ weeks after treatment , VISA scores improved by a mean standard deviation of @ @ points ( P = @ ) in the DN group ( n = @ ) and by @ @ points ( P = @ ) in the PRP group ( n = @ ) ; at @ weeks , the scores improved by @ @ points ( P = @ ) in the DN group ( n = @ ) and by @ @ points ( P = @ ) in the PRP group ( n = @ ) .


The PRP group had improved significantly more than the DN group at @ weeks ( P = @ ) , but the difference between groups was not significant at @ weeks ( P = @ ) .


Lysholm scores were not significantly different between groups at @ weeks ( P = @ ) , but the DN group had improved significantly more than the PRP group at @ weeks ( P = @ ) .


At @ weeks , @ patients in the DN group failed treatment and subsequently crossed over into the PRP group .


These patients were excluded from the primary @-week analysis .


There were no treatment failures in the PRP group .


No adverse events were reported .


Recruitment was stopped because interim analysis demonstrated statistically significant and clinically important results .


A therapeutic regimen of standardized eccentric exercise and ultrasound-guided leukocyte-rich PRP injection with DN accelerates the recovery from patellar tendinopathy relative to exercise and ultrasound-guided DN alone , but the apparent benefit of PRP dissipates over time .


To improve patient-centred care by determining the impact of baseline levels of conscientiousness and diabetes self-efficacy on the outcomes of efficacious interventions to reduce diabetes distress and improve disease management .


Adults with Type @ diabetes with diabetes distress and self-care problems ( N = @ ) were randomized to one of three distress reduction interventions : computer-assisted self-management ; computer-assisted self-management plus problem-solving therapy ; and health education .


The baseline assessment included conscientiousness and self-efficacy , demographics , diabetes status , regimen distress , emotional burden , medication adherence , diet and physical activity .


Changes in regimen distress , emotional burden and self-care between baseline and @ months were recorded and ancova models assessed how conscientiousness and self-efficacy qualified the significant improvements in distress and management outcomes .


Participants with high baseline conscientiousness displayed significantly larger improvements in medication adherence and emotional burden than participants with low baseline conscientiousness .


Participants with high baseline self-efficacy showed greater improvements in diet , physical activity and regimen distress than participants with low baseline self-efficacy .


The impact of conscientiousness and self-efficacy were independent of each other and occurred across all three intervention groups .


A significant interaction indicated that those with both high self-efficacy and high conscientiousness at baseline had the biggest improvement in physical activity by @ months .


Both broad personal traits and disease-specific expectations qualify the outcomes of efficacious interventions .


These findings reinforce the need to change from a one-size-fits-all approach to diabetes interventions to an approach that crafts clinical interventions in ways that fit the personal traits and skills of individual people .


To determine the effect of mechanical tooth cleaning by toothbrush and dental floss on mutans streptococci in the saliva of preschool children .


This blinded , randomised controlled clinical trial included @ @-year-old preschool children with detectable mutans streptococci in saliva .


The children were randomly divided into a test and a control group .


Dental college students cleaned the teeth of test group participants with toothbrush and dental floss under the indication of a plaque disclosing agent once a day .


The control group received no intervention .


Dentocult SM Strip mutans ( D-SM ) strips were used to test the mutans streptococci in saliva .


The D-SM test scores declined from @ to @ for the test group after the teeth were cleaned @ times ( P < @ ) and the scores increased to @ after tooth cleaning ceased for @ weeks ( P > @ compared with baseline ) .


The D-SM level of the control group did not change significantly .


Meticulous and continuous plaque control with toothbrush and dental floss can decrease the mutans streptococci level in preschool children .


However , the effect ceased as the intervention ceased .