Repeated-sprint training in hypoxia ( RSH ) was recently shown to improve repeated-sprint ability ( RSA ) in cycling .


This phenomenon is likely to reflect fiber type-dependent , compensatory vasodilation , and therefore , our hypothesis was that RSH is even more beneficial for activities involving upper body muscles , such as double poling during cross-country skiing .


In a double-blinded fashion , @ competitive cross-country skiers performed six sessions of repeated sprints ( each consisting of four sets of five @-s sprints , with @-s intervals of recovery ) either in normoxia ( RSN , @ m ; FiO@ , @ % ; n = @ ) or normobaric hypoxia ( RSH , @ m ; FiO@ , @ % ; n = @ ) .


Before ( pre ) and after ( post ) training , performance was evaluated with an RSA test ( @-s all-out sprints-@-s recovery , until peak power output declined by @ % ) and a simulated team sprint ( team sprint , @ @-min all-out with @-min rest ) on a double-poling ergometer .


Triceps brachii oxygenation was measured by near-infrared spectroscopy .


From pretraining to posttraining , peak power output in the RSA was increased ( P < @ ) to the same extent ( @ % @ % vs @ % @ % , nonsignificant ) in RSH and in RSN whereas the number of sprints performed was enhanced in RSH ( @ @ vs @ @ , P < @ ) but not in RSN ( @ @ vs @ @ , nonsignificant ) .


In addition , the amplitude in total hemoglobin variations during sprints throughout RSA rose more in RSH ( P < @ ) .


Similarly , the average power output during all team sprints improved by @ % @ % in RSH and @ % @ % in RSN .


Our findings reveal greater improvement in the performance of repeated double-poling sprints , together with larger variations in the perfusion of upper body muscles in RSH compared with those in RSN .


Atazanavir-associated hyperbilirubinemia can cause premature discontinuation of atazanavir and avoidance of its initial prescription .


We used genomewide genotyping and clinical data to characterize determinants of atazanavir pharmacokinetics and hyperbilirubinemia in AIDS Clinical Trials Group protocol A@ .


Plasma atazanavir pharmacokinetics and indirect bilirubin concentrations were characterized in HIV-@-infected patients randomized to atazanavir/ritonavir-containing regimens .


A subset had genomewide genotype data available .


Genomewide assay data were available from @ participants , of whom @ also had data on estimated atazanavir clearance and relevant covariates available .


Peak bilirubin concentration and relevant covariates were available for @ participants .


By multivariate analysis , higher peak on-treatment bilirubin levels were found to be associated with the UGT@A@ rs@ T allele ( P = @ ( -@ ) ) , higher baseline hemoglobin levels ( P = @ ( -@ ) ) , higher baseline bilirubin levels ( P = @ ( -@ ) ) , and slower plasma atazanavir clearance ( P = @ ( -@ ) ) .


For peak bilirubin levels greater than @ mg/dl , the positive predictive value of a baseline bilirubin level of @ mg/dl or higher with hemoglobin concentrations of @ g/dl or higher was @ , which increased to @ with rs@ TT homozygosity .


For peak bilirubin levels of @ mg/dl or lower , the positive predictive value of a baseline bilirubin level less than @ mg/dl with a hemoglobin concentration less than @ g/dl was @ , which increased to @ with rs@ CC homozygosity .


No polymorphism predicted atazanavir pharmacokinetics at genomewide significance .


Atazanavir-associated hyperbilirubinemia is best predicted by considering UGT@A@ genotype , baseline bilirubin level , and baseline hemoglobin level in combination .


Use of ritonavir as a pharmacokinetic enhancer may have abrogated genetic associations with atazanavir pharmacokinetics .


Permanent joint damage is a major consequence of rheumatoid arthritis ( RA ) , the most common and destructive form of inflammatory arthritis .


In aggressive disease , joint damage can occur within @months from symptom onset .


Early , intensive treatment with conventional and biologic disease-modifying anti-rheumatic drugs ( DMARDs ) can delay the onset and progression of joint damage .


The primary objective of the study is to investigate the value of magnetic resonance imaging ( MRI ) or radiography ( X-ray ) over standard of care as tools to guide DMARD treatment decision-making by rheumatologists for the care of RA .


A double-blind , randomized controlled trial has been designed .


Rheumatoid and undifferentiated inflammatory arthritis patients will undergo an MRI and X-ray assessment every @months .


Baseline adaptive randomization will be used to allocate participants to MRI , X-ray , or sham-intervention groups on a background of standard of care .


Prognostic markers , treating physician , and baseline DMARD therapy will be used as intervention allocation parameters .


The outcome measures in rheumatology RA MRI score and the van der Heijde-modified Sharp score will be used to evaluate the MRI and X-ray images , respectively .


Radiologists will score anonymized images for all patients regardless of intervention allocation .


Disease progression will be determined based on the study-specific , inter-rater smallest detectable difference .


Allocation-dependent , intervention-concealed reports of positive or negative disease progression will be reported to the treating rheumatologist .


Negative reports will be delivered for the sham-intervention group .


Study-based radiology clinical reports will be provided to the treating rheumatologists for extra-study X-ray requisitions to limit patient radiation exposure as part of diagnostic imaging standard of care .


DMARD treatment dose escalation and therapy changes will be measured to evaluate the primary objective .


A sample size of @ ( @ per group ) patients will be required to determine a @ % difference in pharmacological treatment escalation between the three groups with intermediate dispersion of data with @ % power at a @ % level of significance .


This study will determine if monitoring RA and undifferentiated inflammatory arthritis patients using MRI and X-ray every @months over @years provides incremental evidence over standard of care to influence pharmacotherapeutic decision-making and ultimately hinder disease progression .


Proton-pump inhibitor and ranitidine bismuth citrate-based triple regimens are the two recommended first line treatments for the eradication of Helicobacter pylori .


We aimed to compare the effectiveness and tolerability of these two treatments in a prospective , multicentric , randomized study .


Patients with dyspeptic complaints were recruited from @ study centers .


Presence of Helicobacter pylori was investigated by both histology and rapid urease test .


The patients were randomized to either ranitidine bismuth citrate @ mg bid plus amoxicillin @ g bid plus clarithromycin @ mg bid ( n = @ ) or lansoprazole @ mg bid plus amoxicillin @ g bid plus clarithromycin @ mg bid ( n = @ ) treatment arm for @ days .


Adverse events have been recorded during the treatment phase .


A @ C urea breath test was performed @ weeks after termination of treatment to assess the efficacy of the therapy .


Eradication rate was calculated by intention-to-treat and per-protocol analysis .


Two hundred seventy-nine patients ( @ male , @ female ) were eligible for randomization .


In per-protocol analysis ( n = @ ) , Helicobacter pylori was eradicated with ranitidine bismuth citrate - and lansoprazole-based regimens in @,@ % and @,@ % of cases , respectively ( p > @,@ ) .


Intention-to-treat analysis ( n = @ ) revealed that eradication rates were @,@ % and @,@ % in ranitidine bismuth citrate and in lansoprazole-based regimens , respectively ( p > @,@ ) .


Both regimes were well-tolerated , and no serious adverse event was observed during the study .


Ranitidine bismuth citrate-based regimen is at least as effective and tolerable as the classical proton-pump inhibitor-based regimen , but none of the therapies could achieve the recommendable eradication rate .


Centrally acting angiotensin converting enzyme inhibitors ( CACE-Is ) are associated with reduced rates of cognitive decline in patients with dementia .


CACE-Is may also improve exercise tolerance in functionally impaired older adults with normal cognition , suggesting that CACE-Is may positively influence activities of daily living ( ADL ) in dementia .


To compare rates of decline in patients with mild to moderate Alzheimer 's disease ( AD ) receiving CACE-Is to those not currently treated with CACE-Is ( NoCACE-I ) , included in the Doxycycline and Rifampicin for Alzheimer 's Disease study ( n = @ ) .


Patients were included if baseline and end-point ( twelve months apart ) scores were available for measures including the Standardized Alzheimer 's Disease Assessment Scale - Cognitive Subscale ; Quick Mild Cognitive Impairment screen ; Clinical Dementia Rating Scale ( CDR-SB ) , and Lawton-Brody ADL Scale .


There was a significant , @ % difference ( median one-point ) in the @-month rate of decline in ADL scores in patients taking CACE-Is ( n = @ ) , compared to the NoCACE-I group ( n = @ ) , p = @ .


This remained significant after adjusting for age , gender , education , and blood pressure , p = @ .


When individual CACE-Is were compared to the NoCACE-I group , a significant reduction in the rate of decline in ADLs ( median one versus four points ) , were only observed for perindopril , p = @ .


The CDR-SB was also reduced ( median one-point ) for the perindopril compared to the NoCACE-I group , p = @ .


This observational study suggests that CACE-Is , and potentially perindopril in particular , are associated with a reduced rate of functional decline in patients with AD , without an association with mood or behavior .


This suggests that CACE-Is may slow disease progression in AD .


Family caregivers of patients with dementia frequently experience psychological stress , depression and disturbed psychophysiological activity , with increased levels of diurnal cortisol secretion .


To compare the effects of a cognitive-behavioural group therapy ( CBT ) to a psychoeducation group programme ( EDUC ) on cortisol secretion in caregivers of patients with moderate Alzheimer 's disease ( AD ) .


Caregivers of AD outpatients were semi-randomly allocated to one of two intervention programmes ( CBT or EDUC ) consisting of eight weekly sessions .


Twenty-six participants completed the study .


Before and after intervention , salivary cortisol was collected at four different times of the day .


Effects of the interventions were evaluated with self-report psychological scales and questionnaires related to functional abilities and neuropsychiatric symptoms of the AD relative .


Only in the CBT group did salivary cortisol levels significantly decrease after intervention , with a large effect size and high achieved power .


Both groups reported a reduction of neuropsychiatric symptoms of their AD relative after intervention .


Psychoeducation for caregivers may contribute to a reduction of neuropsychiatric symptoms of AD patients while CBT additionally attenuates psychophysiological responses to stressful situations in caregivers , by reducing diurnal cortisol levels .


This may lead to a positive impact in the general health of the caregiver , eventually resulting in better care of the AD patient .


Transcranial direct current stimulation ( tDCS ) enhances treatment outcomes post-stroke .


Feasibility and tolerability of high-definition ( HD ) tDCS ( a technique that increases current focality and intensity ) for consecutive weekdays as an adjuvant to behavioral treatment in a clinical population has not been demonstrated .


To determine HD-tDCS feasibility outcomes : @ ) ability to implement study as designed , @ ) acceptability of repeated HD-tDCS administration to patients , and @ ) preliminary efficacy .


Eight patients with chronic post-stroke aphasia participated in a randomized crossover trial with two arms : conventional sponge-based ( CS ) tDCS and HD-tDCS .


Computerized anomia treatment was administered for five consecutive days during each treatment arm .


Individualized modeling/targeting procedures and an @-channel HD-tDCS device were developed .


CS-tDCS and HD-tDCS were comparable in terms of implementation , acceptability , and outcomes .


Naming accuracy and response time improved for both stimulation conditions .


Change in accuracy of trained items was numerically higher ( but not statistically significant ) for HD-tDCS compared to CS-tDCS for most patients .


Regarding feasibility , HD-tDCS treatment studies can be implemented when designed similarly to documented CS-tDCS studies .


HD-tDCS is likely to be acceptable to patients and clinicians .


Preliminary efficacy data suggest that HD-tDCS effects , using only @ electrodes , are at least comparable to CS-tDCS .


Implementation of trial interventions is rarely assessed , despite its effects on findings .


We assessed the implementation of a nurse-led intervention to facilitate medication adherence in type @ diabetes ( SAMS ) in a trial against standard care in general practice .


The intervention increased adherence , but not through the hypothesised psychological mechanism .


This study aimed to develop a reliable coding frame for tape-recorded consultations , assessing both a priori hypothesised and potential active ingredients observed during implementation , and to describe the delivery and receipt of intervention and standard care components to understand how the intervention might have worked .


@ patients were randomised to intervention or comparison groups and @/@ consultations were tape-recorded .


Practice nurses delivered standard care to all patients and motivational and action planning ( implementation intention ) techniques to intervention patients only .


The coding frame was developed and piloted iteratively on selected tape recordings until a priori reliability thresholds were achieved .


All tape-recorded consultations were coded and a random subsample double-coded .


Nurse communication , nurse-patient relationship and patient responses were identified as potential active ingredients over and above the a priori hypothesised techniques .


The coding frame proved reliable .


Intervention and standard care were clearly differentiated .


Nurse protocol adherence was good ( M ( SD ) = @ ( @ ) ) and competence of intervention delivery moderate ( M ( SD ) = @ ( @ ) ) .


Nurses frequently reinforced positive beliefs about taking medication ( e.g. , @ % for advantages ) but rarely prompted problem solving of negative beliefs ( e.g. , @ % for barriers ) .


Patients ' action plans were virtually identical to current routines .


Nurses showed significantly less patient-centred communication with the intervention than comparison group .


It is feasible to reliably assess the implementation of behaviour change interventions in clinical practice .


The main study results could not be explained by poor delivery of motivational and action planning components , definition of new action plans , improved problem solving or patient-centred communication .


Possible mechanisms of increased medication adherence include spending more time discussing it and mental rehearsal of successful performance of current routines , combined with action planning .


Delivery of a new behaviour change intervention may lead to less patient-centred communication and possible reduction in overall trial effects .


Blood transfusion might affect long-term mortality by changing immune function and thus potentially increasing the risk of subsequent infections and cancer recurrence .


Compared with a restrictive transfusion strategy , a more liberal strategy could reduce cardiac complications by lowering myocardial damage , thereby reducing future deaths from cardiovascular disease .


We aimed to establish the effect of a liberal transfusion strategy on long-term survival compared with a restrictive transfusion strategy .


In the randomised controlled FOCUS trial , adult patients aged @ years and older , with a history of or risk factors for cardiovascular disease , and with postoperative haemoglobin concentrations lower than @ g/L within @ days of surgery to repair a hip fracture , were eligible for enrolment .


Patients were recruited from @ participating hospitals in the USA and Canada , and eligible participants were randomly allocated in a @:@ ratio by a central telephone system to either liberal transfusion in which they received blood transfusion to maintain haemoglobin level at @ g/L or higher , or restrictive transfusion in which they received blood transfusion when haemoglobin level was lower than @ g/L or if they had symptoms of anaemia .


In this study , we analysed the long-term mortality of patients assigned to the two transfusion strategies , which was a secondary outcome of the FOCUS trial .


Long-term mortality was established by linking the study participants to national death registries in the USA and Canada .


Treatment assignment was not masked , but investigators who ascertained mortality and cause of death were masked to group assignment .


Analyses were by intention to treat .


The FOCUS trial is registered with ClinicalTrials.gov , number NCT@ .


Between July @ , @ , and Feb @ , @ , @ patients were enrolled and randomly assigned to the two treatment groups : @ to the liberal transfusion strategy and @ to the restrictive transfusion strategy .


The median duration of follow-up was @ years ( IQR @-@ years ) , during which @ ( @ % ) patients died .


Long-term mortality did not differ significantly between the liberal transfusion strategy ( @ deaths ) and the restrictive transfusion strategy ( @ deaths ) ( hazard ratio @ -LSB- @ % CI @-@ -RSB- ; p = @ ) .


Liberal blood transfusion did not affect mortality compared with a restrictive transfusion strategy in a high-risk group of elderly patients with underlying cardiovascular disease or risk factors .


The underlying causes of death did not differ between the trial groups .


These findings do not support hypotheses that blood transfusion leads to long-term immunosuppression that is severe enough to affect long-term mortality rate by more than @-@ % or cause of death .


The study aimed to evaluate the effects of probiotic Lactobacillus reuteri DSM @ strain supplementation in patients suffering from systemic nickel allergy syndrome , in terms of modulation of faecal LAB population linked to a reduction of GI and cutaneous symptoms and to an increase of patient 's quality of life .


A preliminary double-blind randomized placebo-controlled study was planned and a culture-independent method based on denaturing gradient gel electrophoresis ( DGGE ) analysis coupled to the @S rRNA gene sequencing was applied to investigate on the dynamics of faecal LAB communities before and during a low-Ni diet , supplemented with the probiotic strain .


Moreover , the severity and the frequency of GI and cutaneous reactions as well as patient 's clinical condition perception ( VAS scores ) were estimated by statistical analysis .


PCR-DGGE fingerprinting obtained using LAB-specific primers revealed significant shift in faecal community with an increase in biodiversity in patients supplemented with probiotic Lact.reuteri strain .


In addition , GI reactions such as symptoms related to meals and type of stools significantly improved only in patients treated with Lact.reuteri , while severity and frequency of cutaneous symptoms ( urticaria , itch and eczema ) and recurrent abdominal pain ( RAP ) as well as VAS scores statistically decreased in both groups .


Our preliminary findings suggest that probiotic Lact.reuteri could be a useful supplementation during a low-Ni diet of patients with SNAS , to increase LAB population diversity , which could contribute to restore the intestinal homoeostasis conditions .


To date , no information is available on probiotics application and on their effects , in terms of intestinal microbiota modulation , on patients suffering from SNAS .


Therefore , the identification of dominant LAB community and the study of its shift during the probiotic supplementation could enhance the knowledge of the SNAS syndrome .


The authors hypothesized that the women enrolled in the HF-ACTION ( Heart Failure-A Controlled Trial Investigating Outcomes of Exercise TraiNing ) trial and randomly assigned to exercise training ( ET ) would improve functional capacity as measured by peak oxygen uptake ( VO@ ) compared with those in the usual care group .


Furthermore , they hypothesized that the improvement in peak VO@ would correlate with prognosis .


They explored whether exercise had a differential effect on outcomes in women versus men .


There is less evidence for the benefit of ET in women with heart failure ( HF ) compared with men because of the small numbers of women studied .


HF-ACTION was a randomized trial of ET versus usual care in @,@ patients with class II-IV HF and a left ventricular ejection fraction of @ % .


Sex differences in the effects of randomized treatment on clinical outcomes were assessed through the use of a series of Cox proportional hazards models , controlling for covariates known to affect prognosis in HF-ACTION .


Women had lower baseline peak VO@ and @-min walk distance than did men ( median , @ vs. @ ml/min/kg and @ vs. @ m , respectively ) .


An increase in peak VO@ at @ months was present in women and men in the ET group ( mean SD ; median , @ @ , @ and @ @ , @ , respectively , women vs. men ; p = @ ) .


Women randomly assigned to ET had a significant reduction in the primary endpoint , ( hazard ratio : @ ) compared with men ( hazard ratio : @ ) randomly assigned to ET , with a significant treatment-by-sex interaction ( p = @ ) .


Although there is no significant difference between men and women in the effect of ET on peak VO@ change at @ months , ET in women with HF is associated with a larger reduction in rate of the combined endpoint of all-cause mortality and hospital stay than in men .


To investigate the effectiveness of mirror therapy ( MT ) combined with bilateral arm training and graded activities to improve motor performance in the paretic upper limb after stroke .


Randomized , controlled , assessor-blinded study .


Inpatient stroke rehabilitation center of a tertiary care teaching hospital .


Patients with first-time ischemic or hemorrhagic stroke ( N = @ ) , confined to the territory of the middle cerebral artery , occurring < @ months before the commencement of the study .


The MT and control group participants underwent a patient-specific multidisciplinary rehabilitation program including conventional occupational therapy , physical therapy , and speech therapy for @ d/wk , @ h/d , over @ weeks .


The participants in the MT group received @ hour of MT in addition to the conventional stroke rehabilitation .


The Upper Extremity Fugl-Meyer Assessment for motor recovery , Brunnstrom stages of motor recovery for the arm and hand , Box and Block Test for gross manual hand dexterity , and modified Ashworth scale to assess the spasticity .


After @ weeks of MT , mean change scores were significantly greater in the MT group than in the control group for the Fugl-Meyer Assessment ( P = @ ) , Brunnstrom stages of motor recovery for the arm ( P = @ ) and hand ( P = @ ) , and the Box and Block Test ( P = @ ) .


No significant difference was found between the groups for modified Ashworth scale ( P = @ ) .


MT when combined with bilateral arm training and graded activities was effective in improving motor performance of the paretic upper limb after stroke compared with conventional therapy without MT.


To evaluate the effect of leukoreduction ( LR ) as compared to standard nonleukoreduced ( NLR ) units on cytokine concentrations in canine erythrocyte concentrates during regular storage time .


Randomized , experimental study .


University teaching hospital .


Ten random-source research dogs .


One unit of whole blood was collected from each dog and randomized to standard processing ( NLR , n = @ ) or prestorage LR ( n = @ ) .


All units were stored at @C .


Samples were aseptically collected from each unit weekly for @ weeks .


On day @ , @ mL of blood was collected from each unit and submitted for aerobic culture .


An ELISA assay was used to analyze the concentrations of IL-@ , IL-@ , TNF - , and IL-@ .


There were no significant effects of either group or storage time for IL-@ , IL-@ , or TNF - .


IL-@ concentration was significantly increased over the storage period in NLR units , and was significantly higher compared to LR units on days @ and @ .


Aerobic culture was negative on all units .


This study demonstrated a marked , storage time-dependent accumulation of IL-@ in canine erythrocyte concentrates .


Prestorage LR attenuated the accumulation of IL-@ .


This chemokine may contribute to the proinflammatory effects of transfusion of stored erythrocyte concentrates .


Research suggests that hypertonic saline ( HS ) may improve mucous flow in infants with acute bronchiolitis .


Data suggest a trend favoring reduced length of hospital stay and improved pulmonary scores with increasing concentration of nebulized solution to @ % and @ % saline as compared with @ % saline mixed with epinephrine .


To our knowledge , @ % HS has not been previously investigated .


We conducted a prospective , double-blind , randomized controlled trial in @ infants presenting with moderate to severe acute bronchiolitis .


Subjects received either @ % saline or @ % saline , both with epinephrine .


Our primary outcome was a change in bronchiolitis severity score ( BSS ) , obtained before and after treatment , and at the time of disposition from the emergency department ( ED ) .


Secondary outcomes measured were hospitalization rate , proportion of admitted patients discharged at @ hours , and ED and inpatient length of stay .


At baseline , study groups were similar in demographic and clinical characteristics .


The decrease in mean BSS was not statistically significant between groups ( @ vs @ for HS and control groups , respectively ) .


The difference between the groups in proportion of admitted patients ( @ % in HS versus @ % in normal saline ) , ED or inpatient length of stay , and proportion of admitted patients discharged at @ hours was not statistically significant .


In moderate to severe acute bronchiolitis , inhalation of @ % HS with epinephrine does not appear to confer any clinically significant decrease in BSS when compared with @ % saline with epinephrine .


Chronic hemodialysis patients experience accelerated atherosclerosis contributed to by dyslipidemia , inflammation , and an impaired antioxidant system .


Vitamin E tocotrienols possess anti-inflammatory and antioxidant properties .


However , the impact of dietary intervention with Vitamin E tocotrienols is unknown in this population .


A randomized , double-blind , placebo-controlled , parallel trial was conducted in @ patients undergoing chronic hemodialysis .


Subjects were provided daily with capsules containing either vitamin E tocotrienol-rich fraction ( TRF ) ( @ mg tocotrienols , @ mg tocopherols ) or placebo ( @ mg tocotrienols , @ mg tocopherols ) .


Endpoints included measurements of inflammatory markers ( C-reactive protein and interleukin @ ) , oxidative status ( total antioxidant power and malondialdehyde ) , lipid profiles ( plasma total cholesterol , triacylglycerols , and high-density lipoprotein cholesterol ) , as well as cholesteryl-ester transfer protein activity and apolipoprotein A@ .


TRF supplementation did not impact any nutritional , inflammatory , or oxidative status biomarkers over time when compared with the baseline within the group ( one-way repeated measures analysis of variance ) or when compared with the placebo group at a particular time point ( independent t-test ) .


However , the TRF supplemented group showed improvement in lipid profiles after @ and @ weeks of intervention when compared with placebo at the respective time points .


Normalized plasma triacylglycerols ( cf baseline ) in the TRF group were reduced by @ mg/dL ( P = @ ) and @ mg/dL ( P = @ ) after @ and @ weeks of intervention but no significant improvement was seen in the placebo group .


Similarly , normalized plasma high-density lipoprotein cholesterol was higher ( P < @ ) in the TRF group as compared with placebo at both week @ and week @ .


The changes in the TRF group at week @ and week @ were associated with higher plasma apolipoprotein A@ concentration ( P < @ ) and lower cholesteryl-ester transfer protein activity ( P < @ ) .


TRF supplementation improved lipid profiles in this study of maintenance hemodialysis patients .


A multi-centered trial is warranted to confirm these observations .


There are limited data on the efficacy of early fluid resuscitation with third-generation hydroxyethyl starch ( HES @ ) in burn injury .


Adverse effects of HES on survival and organ function have been reported .


In this randomized , controlled , double-blind trial , @ patients with severe burn injury were assigned to receive either lactated Ringer 's solution plus @ % HES @/@ @ in a ratio of @:@ or lactated Ringer 's solution with no colloid supplement for the first @ hours .


Primary outcome parameter was the group difference of administered total fluid from intensive care unit ( ICU ) admission up to day @ .


Secondary outcomes included kidney and lung injury and failure , length of stay , and mortality .


Three-day totals of administered resuscitation fluid ( medians ) were @,@ mL in the lactated Ringer 's group and @,@ mL in the HES group ( HES : -@,@ mL ; P = @ ) .


Creatinine levels from day @ to @ ( HES : +@ mol/L ; @ % confidence interval ( CI ) -@ to @ ; P = @ ) and urinary outputs from day @ to @ ( HES : -@ mL ; @ % CI -@ to @ ; P = @ ) were not different .


Six patients in each group developed acute respiratory distress syndrome ( ARDS ) ( risk ratio @ ; @ % CI @ to @ ; P = @ ) .


Length of ICU stay ( HES vs. lactated Ringer 's : @ vs. @ days ; P = @ ) and length of hospital stay ( @ vs. @ days ; P = @ ) were similar .


Twenty-eight-day mortality was @ patients in each group ( risk ratio @ ; @ % CI @ to @ ; P = @ ) , and in-hospital mortality was @ in the HES group vs. @ patients in the lactated Ringer 's group ( hazard ratio @ ; @ % CI @ to @ ; P = @ ) .


There was no evidence that early fluid resuscitation with balanced HES @/@ @ ( @ % ) in addition to lactated Ringer 's solution would lead to a volume-sparing effect in severe burn injury .


Together with the findings that early renal function , incidence of ARDS , length of stay , and mortality were not negatively influenced by HES in this setting , balanced HES @/@ @ ( @ % ) plus lactated Ringer 's solution could not be considered superior to lactated Ringer 's solution alone .


The purpose of this study was to investigate the efficacy and mechanism of oxaliplatin in combination with capecitabine ( XELOX ) regimen as neoadjuvant chemotherapy in the treatment of patients with advanced gastric cancer .


Eighty-five patients with advanced gastric cancer ( stage IIB and IIIC ) were randomly divided into two groups : neoadjuvant chemotherapy group ( @ cases ) and surgery alone group ( @ cases ) .


In the neoadjuvant chemotherapy group , patients received oral administration of Xeloda @ mg/m ( @ ) twice a day on days @-@ and intravenous infusion of oxaliplatin @ mg/m ( @ ) on day @ ( XELOX regimen ) .


The regimen was repeated every @ days .


In the surgery alone group , patients directly received radical resection of gastric cancer .


The R@ resection rate , overall survival and disease free survival ( DFS ) were observed in all cases .


The cycles and apoptosis rate of the gastric cancer cells were detected by flow cytometry .


The expression of proliferating cell nuclear antigen ( PCNA ) , p@ , p@ and survivin was detected by Western blot .


In the neoadjuvant chemotherapy group , the total effective rate was @ % ( @/@ ) , and the tumor control rate was @ % ( @/@ ) , with few side effects .


Compared with the surgery alone group , R@ resection rate was significantly higher in the neoadjuvant chemotherapy group ( P < @ ) .


The survival analysis indicated that both the overall survival and DFS were longer in the neoadjuvant chemotherapy group in comparison with those in the surgery alone group , but no significant differences were found ( P > @ ) .


In the neoadjuvant chemotherapy group , both the apoptosis rate and the ratio of cells in stage G@ and G@ were significantly higher than those in the surgery alone group ( P < @ ) .


The expression of PCNA and survivin was lower in the neoadjuvant chemotherapy group , while the expression of p@ and p@ was higher .


XELOX regimen as neoadjuvant chemotherapy in the treatment of patients with advanced gastric cancer can effectively improve the R@ resection rate and prolong the survival time of the patients .


Its mechanism is probably that the neoadjuvant chemotherapy can markedly enhance apoptosis in gastric cancer cells and inhibit their proliferation .


Despite the growing prevalence of prescription opioid dependence , longitudinal studies have not examined long-term treatment response .


The current study examined outcomes over @ months in the Prescription Opioid Addiction Treatment Study ( POATS ) .


POATS was a multi-site clinical trial lasting up to @ months , examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence , with participants randomized to receive or not receive additional opioid drug counseling .


A subset of participants ( N = @ of @ ) enrolled in a follow-up study .


Telephone interviews were administered approximately @ , @ , and @ months after main-trial enrollment .


Comparison of baseline characteristics by follow-up participation suggested few differences .


At Month @ , much improvement was seen : @ % were abstinent from opioids and not on agonist therapy ; @ % were receiving opioid agonist therapy , but met no symptom criteria for current opioid dependence ; @ % were using illicit opioids while on agonist therapy ; and the remaining @ % were using opioids without agonist therapy .


Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month @ ( OR = @ , @ % CI = @-@ @ , p < @ ) .


Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence .


Eight percent ( n = @/@ ) used heroin for the first time during follow-up ; @ % reported first-time injection heroin use .


Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline .


However , a subset exhibited a worsening course , by initiating heroin use and/or injection opioid use .


To identify dosimetry , clinical factors and medication intake impacting urinary symptoms after prostate radiotherapy .


Data describing clinical factors and bladder dosimetry ( reduced with principal component ( PC ) analysis ) for @ patients treated with external beam radiotherapy accrued by TROG @ RADAR prostate radiotherapy trial were available for analysis .


Urinary symptoms ( frequency , incontinence , dysuria and haematuria ) were prospectively assessed using LENT-SOMA to a median of @months .


The endpoints assessed were prevalence ( grade @ ) at the end of radiotherapy ( representing acute symptoms ) , at @ - , @ - and @-month follow-ups ( representing late symptoms ) and peak late incidence including only grade @ .


Impact of factors was assessed using multivariate logistic regression models with correction for over-optimism .


Baseline symptoms , non-insulin dependent diabetes mellitus , age and PC@ ( correlated to the mean dose ) impact symptoms at > @ timepoints .


Associations at a single timepoint were found for cerebrovascular condition , ECOG status and non-steroidal anti-inflammatory drug intake .


Peak incidence analysis shows the impact of baseline , bowel and cerebrovascular condition and smoking status .


The prevalence and incidence analysis provide a complementary view for urinary symptom prediction .


Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact .


Medical students experience a high burden of stress and suffer elevated rates of depression , burnout , and suicide compared to the general population , yet there is no consensus on how to address student wellness .


The purpose of this study was to determine whether an abridged mindfulness based stress reduction ( MBSR ) intervention can improve measures of wellness in a randomized sample of @st-year medical students .


Fifty-eight participants were randomized to control or @-week MBSR intervention and then invited to participate in the study .


All participants were assessed using the Perceived Stress Scale ( PSS ) , the Resilience Scale ( RS ) , and Self-Compassion Scale ( SCS ) at @ separate time points : baseline , at the conclusion of the study intervention ( @ weeks ) , and at @ months after the conclusion of the intervention .


The intervention consisted of @ minutes of weekly class time , suggested meditation at home , and a half-day retreat in the last week .


The intervention group achieved significant increase on SCS scores both at the conclusion of the study ( @ , p = @ ) , @ % confidence interval ( CI ) -LSB- @ , @ -RSB- , and at @ months ( @ , p = @ ) , @ % CI -LSB- @ , @ -RSB- .


PSS scores achieved significant reduction at the conclusion of the study ( @ , p = @ ) , @ % CI -LSB- @ , @ -RSB- , but not at @ months poststudy ( @ , p = @ ) , @ % CI -LSB- -@ , @ -RSB- .


The study did not demonstrate a difference in RS after the intervention , though RS was significantly correlated with both SCS and PSS .


An abridged MBSR intervention improves perceived stress and self-compassion in @st-year medical students and may be a valuable curricular tool to enhance wellness and professional development .


Results from this randomized , placebo-controlled study of aripiprazole augmentation to antidepressant therapy ( ADT ) in Japanese patients with major depressive disorder ( MDD ) ( the Aripiprazole Depression Multicenter Efficacy -LSB- ADMIRE -RSB- study ) revealed that aripiprazole augmentation was superior to ADT alone and was well tolerated .


In subgroup analyses , we investigated the influence of demographic - and disease-related factors on the observed responses .


We also examined how individual symptom improvement was related to overall improvement in MDD .


Data from the ADMIRE study were analyzed .


Subgroup analyses were performed on the primary outcome measures : the mean change in the Montgomery-sberg Depression Rating Scale ( MADRS ) total score from the end of selective serotonin reuptake inhibitor ( SSRI ) / serotonin norepinephrine reuptake inhibitor ( SNRI ) treatment to the end of the randomized treatment .


Changes in the MADRS total scores were consistently greater with aripiprazole than placebo in each of the subgroups .


Efficacy was not related to sex , age , number of adequate ADT trials in the current episode , MDD diagnosis , number of depressive episodes , duration of the current episode , age at first depressive episode , time since the first depressive episode , type of SSRI/SNRI , or severity at the end of SSRI/SNRI treatment phase .


Compared to placebo , aripiprazole resulted in significant and rapid improvement on seven of the @ MADRS items , including sadness .


These post-hoc analyses indicated that aripiprazole was effective for a variety of Japanese patients with MDD who had exhibited inadequate responses to ADT .


Additionally , we suggest that aripiprazole significantly and rapidly improved the core depressive symptoms .


Active virtual reality gaming ( AVG ) may be useful for children with developmental coordination disorder ( DCD ) to practice motor skills if their movement patterns are of good quality while engaged in AVG .


This study aimed to examine : ( @ ) the quality of motor patterns of children with DCD participating in AVG by comparing them with children with typical development ( TD ) and ( @ ) whether differences existed in the motor patterns utilized with @ AVG types : Sony PlayStation @ Move and Microsoft Xbox @ Kinect .


This was a quasi-experimental , biomechanical laboratory-based study .


Twenty-one children with DCD , aged @ to @ years , and @ age - and sex-matched children with TD played a match of table tennis on each AVG type .


Hand path , wrist angle , and elbow angle were recorded using a motion analysis system .


Linear mixed-model analyses were used to determine differences between DCD and TD groups and Move and Kinect AVG type for forehands and backhands .


Children with DCD utilized a slower hand path speed ( backhand mean difference -LSB- MD -RSB- = @ m/s ; @ % confidence interval -LSB- @ % CI -RSB- = @ , @ ) ; greater wrist extension ( forehand MD = @ ; @ % CI = @ , @ ) ; and greater elbow flexion ( forehand MD = @ ; @ % CI = @ , @ ) compared with children with TD when engaged in AVG .


There also were differences in movement patterns utilized between AVG types .


Only simple kinematic measures were compared , and no data regarding movement outcome were assessed .


If a therapeutic treatment goal is to promote movement quality in children with DCD , clinical judgment is required to select the most appropriate AVG type and determine whether movement quality is adequate for unsupervised practice .


To evaluate intravitreal aflibercept for treatment of macular edema secondary to central retinal vein occlusion ( CRVO ) .


Randomized , double-masked , phase @ study .


A total of @ patients with macular edema secondary to CRVO were randomized to receive @ mg intravitreal aflibercept ( n = @ ) or sham ( n = @ ) every @ weeks for @ weeks .


From weeks @ to @ , patients were monitored every @ weeks ; the former group received intravitreal aflibercept as needed ( PRN ) , and the sham group received sham .


From weeks @ to @ , patients were monitored every @ weeks , and both groups received intravitreal aflibercept PRN .


The primary endpoint ( proportion of patients who gained @ letters ) was at week @ .


This study reports exploratory outcomes at week @ .


The proportion of patients who gained @ letters in the intravitreal aflibercept and sham groups was @ % vs @ % at week @ ( patients discontinued before week @ were considered nonresponders ; P < @ ) , @ % vs @ % at week @ ( last observation carried forward , P < @ ) , and @ % vs @ % at week @ ( last observation carried forward ; P < @ ) .


Mean m change from baseline central retinal thickness was -@ vs -@ at week @ ( P < @ ) , -@ vs -@ at week @ ( P < @ ) , and -@ vs -@ at week @ ( P = @ ) .


Over @ weeks , the most common ocular serious adverse event in the intravitreal aflibercept group was macular edema ( @ % ) .


The visual and anatomic improvements seen after fixed , monthly dosing at week @ were largely maintained when treatment intervals were extended .


Patients with macular edema following CRVO benefited from early treatment with intravitreal aflibercept .


In Crohn 's disease patients failing infliximab therapy , interventions defined by an algorithm based on infliximab and anti-infliximab antibody measurements have proven more cost-effective than intensifying the infliximab regimen .


This study investigated long-term economic outcomes at the week @ follow-up study visit and after @ year .


Clinical outcomes were assessed at week @ .


Follow-up from a @-week , single-blind , clinical trial where patients with infliximab treatment failure were randomized to infliximab intensification ( @ mg/kg every @ weeks ) ( n = @ ) , or algorithm-defined interventions ( n = @ ) .


Accumulated costs , expressed as mean costs per patient , were based on the Danish National Patient Registry .


At the scheduled week @ follow-up study visit , response and remission rates were similar in all study subpopulations between patients treated by the algorithm or by infliximab intensification .


However , the sum of healthcare costs related to Crohn 's disease was substantially lower ( @ % ) for patients randomized to algorithm-based interventions than infliximab intensification in the intention-to-treat population : $ @,@ versus $ @,@ ; p = @ .


For per-protocol patients ( n = @ ) , costs at the week @ follow-up visit were even lower ( @ % ) in the algorithm group : $ @,@ versus $ @,@ ; p = @ .


Figures were similar for patients having completed the @-week trial as per protocol ( @ % reduction in costs ) ( n = @ ) .


Among patients continuing the allocated study intervention throughout the entire @-week follow-up period ( n = @ ) , costs were reduced by @ % in algorithm-treated patients : $ @,@ versus $ @,@ ; p < @ .


Cost-reduction percentages remained stable throughout one year .


Economic benefit of algorithm-based interventions at infliximab failure is maintained throughout @ year .


H@ is a paternally imprinted oncofetal gene expressed in various embryonic tissues and in @ % of bladder tumors but suppressed in the adult healthy bladder .


BC-@ is a DNA plasmid that carries the gene for diphtheria toxin-A under regulation of the H@ promoter sequence .


We assessed the efficacy and toxicity of intravesical BC-@ instillations to prevent tumor recurrence and ablate a marker lesion in a phase @b trial .


A total of @ patients with recurrent , multiple nonmuscle invasive bladder tumors in whom prior intravesical therapy had failed underwent transurethral resection of all except @ marker tumor .


Patients expressing H@ received a @-week induction course of intravesical BC-@ .


Patients who achieved a complete response ( absent new tumors at @ months ) were given @ maintenance courses of @-weekly instillations every @ months .


All patients were evaluable for adverse effects and @ were evaluable forefficacy .


Complete tumor ablation was achieved in @ % of patients and in @ % there were no new tumors at @ months .


Median time to recurrence was @ months in all cases but significantly longer ( @ months ) when analyzed byresponse status at @ months .


Adverse events were mild .


The study was limited by the small number of patients .


BC-@ prevented new tumor growth in two-thirds of the patients and ablated a third of the marker lesions .


Prolonged time to recurrence was observed in responding patients .


These results along with the good safety profile make BC-@ a potential medication for bladder cancer .


Conducting research in real life settings ( effectiveness studies ) can introduce many confounding factors .


Efficacy studies seek to control for researcher bias and data quality rather than considering how the efficacy of an intervention is changed by the contexts in which it is used .


Relatively little is known about the impact of context on educational interventions , in particular on multimedia learning .


An effectiveness study to understand implementation variance of online educational modules in surgery clerkships was conducted in six US medical schools participating in an efficacy trial of different multimedia designs .


Student and teacher experiences were captured through focus groups and one-to-one interviews with trial participants and their teachers .


Audio-recordings of these sessions were transcribed and analysed using grounded theory techniques .


Differences were identified in student and teacher perceptions of how the educational intervention had been implemented and how its uptake had been influenced by context-dependent factors : ( i ) the intervention was implemented in different ways to suit different educational contexts and this influenced how students and teachers responded to it ; ( ii ) the ways students and teachers interacted with , and behaved around , the intervention influenced its uptake ; ( iii ) the way the intervention was perceived by students and teachers influenced its uptake ; and ( iv ) the medium and design of the intervention had a directing influence on its uptake .


It was observed that each institutional context formed a complex educational ecology .


The intervention became interwoven with different educational ecologies so that it could no longer be considered a stable variable across the study .


We suggest that researchers should conduct implementation-profiling studies in advance of any intervention-based research to account for the constructing nature of educational ecologies on their interventions and in doing so to more clearly differentiate between efficacy and effectiveness studies .


In this study , we aimed to compare clinical outcomes of superior transseptal approach with the conventional left atriotomy in patients undergoing mitral valve surgery .


Between January @ and November @ , a total of @ consecutive adult patients ( @ males , @ females ; mean age : @ years ; range , @ to @ years ) who underwent mitral valve surgery in the Division of Cardiovascular Surgery at Kouyolu Training Hospital were included .


The patients were randomized to either superior transseptal approach ( n = @ ) or conventional left atriotomy ( n = @ ) .


Demographic characteristics of the patients , comorbidities , additional interventions , intraoperational data , pre - and postoperative electrophysiological study findings , and postoperative complications were recorded .


Of all patients , @ % ( n = @ ) were in New York Heart Association Class III , while @ were in New York Heart Association Class IV .


All patients underwent annuloplasty ( @ % ) or valve replacement surgery ( @ % ) .


There was no significant difference in pre - and postoperative electrocardiogram findings between the groups .


Change from baseline in the cardiac rhythm was statistically significant in superior transseptal approach group alone ( P < @ ) .


There was no statistically significant difference in mortality rate between the groups .


Permanent pacemaker implantation was performed in @ % of the patients in superior transseptal approach group and @ % in the conventional left atriotomy group .


No statistically significant difference in bleeding , total length of hospital and intensive care unit stay , the presence of low cardiac output syndrome was observed between the groups .


Our study results suggest that superior transseptal approach does not lead to serious or fatal adverse effects on sinus node function or atrial vulnerability , compared to conventional approach .


Induction of labor for postdate pregnancy using misoprostol is one of the most common interventions in pregnancy .


However , the optimal dose of misoprostol is yet to be determined with previous reports utilizing different dosages .


The main objective of this study was to compare the effectiveness and safety of @ g versus @ g of intravaginal misoprostol for induction of labor in nulliparous women with postdate pregnancy .


This was a prospective study in which @ nulliparous women with postdate pregnancy were randomly selected to receive either @ g or @ g of misoprostol for induction of labor .


Student 's t-test and Chi-square test were used to compare proportions .


There was no significant difference between the two groups with regard to the induction-vaginal delivery interval between the two doses .


The proportion of women delivering vaginally with a single dose of misoprostol ( @/@ vs. @/@ , P = @ ) and vomiting were significantly greater in the @ g group .


However , there was no significant difference between both groups in terms of the need for augmentation of labor , caesarean section , tachysystole and hyperstimulation syndrome .


Intravaginal administration of @ g of misoprostol appears to be as effective , but safer than @ g for induction of labor in nulliparous women with postdate pregnancy .


Increased recall rates in the Dutch breast cancer screening program call for a new assessment strategy aiming to reduce unnecessary costs and anxiety .


Diagnostic work-up ( usual care ) includes multidisciplinary hospital assessment and is similar for all recalled women , regardless of the radiologist 's suspicion of breast cancer .


This is similar in many Canadian settings .


We developed a novel assessment strategy that offers women with a low suspicion of breast cancer a quick and non-invasive assessment by a screening radiologist ( intervention ) .


We compared these two strategies in a cost-effectiveness analysis based on a randomized controlled trial : multicentre randomized controlled trial ( MASS trial , Netherlands National Trial Register : NTR@ ) .


Participants were enrolled between August @ and December @ and were randomly assigned to either the intervention or control group ( allocation ratio @:@ ) .


Fourteen assessment centres participated in the study .


Questionnaires were used to record quality of life ( EuroQol-@D ) , health care use and costs after recall .


Our study comprised @ women , of whom @ were randomly assigned to the intervention group and @ to the control group .


The mean difference in cost was @/CAD $ @ ( @ % confidence interval @-@ / CAD $ @-@ , p < @ ) .


We found no significant differences in quality of life .


The bootstrapped incremental cost-effectiveness ratios in the cost-effectiveness plane showed that the intervention was the efficient , cost-saving modality .


Our data show the benefits of tailoring diagnostic assessment to the screening radiologist 's suspicion of breast cancer .


Scenarios of implementing such a strategy in the Dutch screening or health care system are currently being discussed with various stakeholders .


Although informed consent is vital to patient-physician communication , little training is provided to surgical trainees .


We hypothesized that highlighting critical aspects of informed consent would improve resident performance .


Eighty ( out of @ ) surgical postgraduate year @ surgical residents were randomly assigned to one of the @ cases ( laparoscopic cholecystectomy or ventral herniorrhaphy ) and instructed to obtain and document informed consent with a standardized patient ( SP ) followed by a didactic training session .


The residents then obtained and documented informed consent with the other case with the other SP .


SPs graded encounters ( `` Checklist '' ) ; trained raters graded notes .


Repeated measures multivariate analysis of variance ( MANOVA ) was used to determine differences between pre - and post-training and Checklist versus `` Note '' scores .


Statistically significant pre - to post differences for Note ( P < @ ) and Checklist ( P < @ ) along with significant differences between Note and Checklist ( P < @ ) were noted .


Training improved surgery residents ' ability to discuss and document informed consent .


Despite this improvement , significant differences between discussion and documentation persisted .


Documentation training is a future area for improvement .


Studies show high comorbidity between anxiety disorder and depression .


Little is known regarding how anxiety symptoms affect prognosis in depression treatment , suggesting the importance of studying the impact of anxiety symptoms in the treatment of depression .


We evaluated the impact of anxiety symptoms in the remission of depressive symptoms after brief psychotherapies for depression .


This randomized clinical trial of @-@-year-old adults included individuals who met the diagnostic criteria for depression as assessed by the Structured Clinical Interview for DSM ( SCID ) .


Depressive symptoms were assessed using the Hamilton Rating Scale for Depression ( HRSD ) ; anxiety symptoms were assessed using the Hamilton Anxiety Rating Scale ( HARS ) .


The protocols of psychotherapy used were : Cognitive Narrative Psychotherapy ( CNP ) and Cognitive Behavioral Psychotherapy ( CBP ) .


Both treatments included seven sessions .


At the end of the treatment and six-month follow-up , an evaluation was made with the HRSD and HARS .


The sample included @ patients divided between the protocols of psychotherapy .


There was a significant , positive , moderate correlation between the severity of anxiety symptoms at baseline and the remission of depressive symptoms at post-intervention ( r = @ p < @ ) as well as a significant , positive , low correlation at follow up ( r = @ p = @ ) .


We found remission of anxiety symptoms and depressive symptoms after brief psychotherapies , and the remission persisted at follow up .


We did not evaluate the diagnosis of anxiety disorders .


The severity of anxiety symptoms did not compromise the treatment focused primarily on depressive symptoms .


Inadequate energy and micronutrient intake during childhood is a major public health problem in developing countries .


Ready-to-use supplementary food ( RUSF ) made of locally available food ingredients can improve micronutrient status and growth of children .


The objective of this study was to develop RUSF using locally available food ingredients and test their acceptability .


A checklist was prepared of food ingredients available and commonly consumed in Bangladesh that have the potential of being used for preparing RUSF .


Linear programming was used to determine possible combinations of ingredients and micronutrient premix .


To test the acceptability of the RUSF compared to Pushti packet ( a cereal based food-supplement ) in terms of amount taken by children , a clinical trial was conducted among @ children aged @-@ months in a slum of Dhaka city .


The mothers were also asked to rate the color , flavor , mouth-feel , and overall liking of the RUSF by using a @-point Hedonic Scale ( @ = dislike extremely , @ = like extremely ) .


Two RUSFs were developed , one based on rice-lentil and the other on chickpea .


The total energy obtained from @ g of rice-lentil , chickpea-based RUSF and Pushti packet were @ , @ and @ kcal respectively .


Children were offered @ g of RUSF and they consumed ( meanSD ) @ g rice-lentil RUSF , @ g chickpea based RUSF .


Pushti packet was also offered @ g but mothers were allowed to add water , and children consumed @ g. Mean feeding time for two RUSFs and Pushti packet was @ minutes .


Although the two RUSFs did not differ in the amount consumed , there was a significant difference in consumption between chickpea-based RUSF and Pushti packet ( p = @ ) .


Using the Hedonic Scale the two RUSFs were more liked by mothers compared to Pushti packet .


Recipes of RUSF were developed using locally available food ingredients .


The study results suggest that rice-lentil and chickpea-based RUSF are well accepted by children .


To compare the clinical and microbiological outcome of the @-h ultrasonic debridement of chronic periodontitis patients ( CPP ) with and without frequent sessions of oral hygiene reinforcement .


Clinical measurements and subgingival plaque were collected from @ CPP at baseline , @ - and @-months .


The control group received a single session of @-h full-mouth ultrasonic debridement , while oral hygiene instructions ( OHI ) were reiterated over four visits .


In the test group , OHI were limited in the @-h treatment session .


At @-months , both groups received additional debridement and OHI .


The `` Checkerboard '' DNA-DNA hybridization technique quantified Porphyromonas gingivalis , Tannerella forsythia and Treponema denticola in plaque .


At threemonths , smaller reductions in plaque and bleeding indices , and in P. gingivalis numbers were noted in the test group , while these differences disappeared at sixmonths .


After the @-month re-treatment visit , the test group presented with a greater probing pocket depth ( PPD ) reduction .


Plaque negatively affected PPD in a similar manner after both treatment approaches .


Lack of oral hygiene reinforcement in the @-h full-mouth debridement resulted in higher plaque and bleeding scores and numbers of P. gingivalis at threemonths ; professional removal of dental biofilm every threemonths is beneficial in subjects with compromised plaque control .


Initiating and maintaining physical activity presents the individual with challenges of inconvenience , discomfort , and counteractive energy .


Addressing these challenges requires an intervention that elicits motivation to engage in this activity , minimizes the direct relationship between unwanted internal experiences and inaction , and is also in itself accessible and convenient .


Accordingly , this study investigated the efficacy of a self-managed Acceptance and Commitment Therapy ( ACT ) intervention delivered via DVD and tailored for physical activity initiation .


Fifty-nine minimally active community participants were randomly allocated to receive a @-week pedometer-based walking programme , or the same walking programme with the additional provision of the ACT DVD .


The primary outcome was overall physical activity level ( assessed at baseline and post-intervention ) , and the secondary outcome was pedometer-assessed step count ( measured at @-weekly intervals throughout the intervention period ) .


Participants who received the ACT DVD achieved a significantly greater increase in physical activity levels post-intervention , were more likely to achieve the goals specified in the programme , and reported a higher average step count than participants who received the walking programme in isolation .


The ACT intervention , delivered via DVD for the promotion of physical activity , proved a simple , efficient , and accessible method to encourage positive short-term increases in an important health-promoting behaviour .


Statement of contribution What is already known ?


ACT interventions can increase physical activity levels through augmenting initiatory self-regulatory control .


Face-to-face delivery presents challenges of accessibility and feasibility for community implementation .


There is a need for effective interventions that maximize impact while minimizing inconvenience .


What does this study add ?


Supplementing a walking programme with a self-managed ACT DVD produced significant increases in physical activity .


The ACT DVD is a convenient , accessible , and potentially cost-effective approach to physical activity initiation .


ACT lends itself to implementation as a self-managed electronically delivered intervention .


The biocompatibility of dialyzers may influence the inflammatory state of hemodialysis patients .


This study compares the effect of a high-flux polynephron membrane with other high-flux membranes , helixone and polyamide , on some inflammation biomarkers based on the analysis of circulating mononuclear cells ( MC ) .


The study included @ patients on hemodialysis with helixone and polyamide ; @ formed the control group , without changes in their dialyzers throughout the study , and @ formed the intervention group , in which their dialyzers were replaced by polynephron .


In both groups , blood samples were taken at the beginning of the study before and after hemodialysis session , and at the end of the study @ months later .


In each extraction , biochemical parameters were determined , and MC isolated using Ficoll gradient .


Production of reactive oxygen species and the percentage of activated MC ( CD@ + CD@ + ) were measured by flow cytometry , and protein levels of heat-shock proteins ( Hsp@/Hsp@ ) studied by Western blot .


After @ hemodialysis session with different membranes , no significant differences were observed in the different parameters considered .


After @ months of dialysis with polynephron , a significant reduction in the percentage of CD@ + CD@ + and in the @-microglobulin reduction ratio were found , with respect to helixone and polyamide , without changes in the other parameters analyzed .


The use of polynephron for @ months reduces the percentage of CD@ + CD@ + compared to helixone and polyamide , suggesting a better profile regarding activation of the inflammatory response .


These findings could be explained by a better biocompatibility or an increased reduction of medium-sized toxic molecules .


Injuries at home are a major cause of death , disability , and loss of quality of life among young children .


Despite current safety education , required safety behavior of parents is often lacking .


To prevent various childhood disorders , the application of Web-based tools has increased the effectiveness of health promotion efforts .


Therefore , an intervention with Web-based , tailored , safety advice combined with personal counseling ( E-Health@Uth home safety ) was developed and applied .


To evaluate the effect of E-Health@Uth home safety on parents ' safety behaviors with regard to the prevention of falls , poisoning , drowning , and burns .


A randomized controlled trial was conducted ( @-@ ) among parents visiting well-baby clinics in the Netherlands .


Parents were randomly assigned to the intervention group ( E-Health@Uth home safety intervention ) or to the control condition consisting of usual care .


Parents in the intervention condition completed a Web-based safety behavior assessment questionnaire ; the resulting tailored safety advice was discussed with their child health care professional at a well-baby visit ( age approximately @ months ) .


Parents in the control condition received counseling using generic safety information leaflets at this well-baby visit .


Parents ' child safety behaviors were derived from self-report questionnaires at baseline ( age @ months ) and at follow-up ( age @ months ) .


Each specific safety behavior was classified as safe/unsafe and a total risk score was calculated .


Logistic and linear regression analyses were used to reveal differences in safety behavior between the intervention and the control condition at follow-up .


A total of @ parents ( response rate @ % ) were analyzed .


At follow-up , parents in the intervention condition ( n = @ ) showed significantly less unsafe behavior compared to parents in the control condition ( n = @ ) : top of staircase ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; bottom of staircase ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; top and bottom of staircase ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; storage of cleaning products ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; bathing of the child ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; drinking hot fluids ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; using rear hotplates ( @ % vs. @ % ; OR @ , @ % CI @-@ @ ) ; and the total risk score in which a higher score indicates more unsafe behavior ( mean @ , SD @ vs. mean @ , SD @ ; beta -@ , @ % CI -@ to -@ ) .


There were no significant differences for other specific behaviors between the two study conditions .


Compared to generic written materials , the E-Health@Uth home safety intervention seems more effective in promoting parents ' safety behavior for safe staircases , storage of cleaning products , bathing , drinking hot fluids , and cooking .


This study supports the application of Web-based , tailored , safety advice for the prevention of unintentional injuries in the youth health care setting .


The main objective of this study was to compare the effect of two anaesthetic techniques ( general vs combined ) on plasma levels of NGAL ( Neutrophil Gelatinase Associated Lipocalin ) after robotic urogenital oncosurgery .


The secondary objective was to correlate NGAL levels with the incidence of acute kidney injury ( AKI ) .


This was a longitudinal prospective study .


Forty patients were included and randomized in @ groups : group C ( N = @ cases ; combined general-epidural anesthesia ) and group G ( N = @ cases ; control group with general anesthesia ) .


Demographic data , Charlson Comorbidity Index , Apache II , SOFA and ASA scores were similar in both groups .


Serum creatinine was determined preoperatively and every @ hrs for @ postoperative days to identify AKI according to RIFLE and AKIN criteria .


Serum NGAL was determined at @ and @ hrs after induction of anesthesia .


Serum creatinine increased at @ hrs postoperatively in both groups as compared to baseline , but significant changes were registered only in the G group ( p ( control ) = @ ) .


Serum NGAL increased significantly in both groups as compared with baseline levels ( pcase = @ vs p ( control ) = @ ) .


The incidence of AKI was @ % ( @ % CI @-@ ) in the C group and @ % ( @ % CI @-@ ) in the G group ( p = @ ) , respectively .


Impaired renal function and AKI occurred in robot-assisted laparoscopic urogenital oncosurgery under both general and combined anaesthesia .


The incidence of AKI was lower in patients undergoing combined anesthesia compared to general anaesthesia after robotic urogenital oncosurgery but the difference did not reach statistical significance .


However , plasma levels of NGAL were significantly increased at @ and @ hrs in the general anaesthesia group as compared with combined anaesthesia .


NGAL may be a better marker in detecting postoperative acute kidney injury .


Further studies are needed .


Concerns about pain medications are major barriers to pain management in hospice , but few studies have focused on systematic methods to address these concerns .


The objective of this study was to test the preliminary efficacy of the Effective Management of Pain : Overcoming Worries to Enable Relief ( EMPOWER ) intervention , which included hospice staff education , staff screening of barriers to pain management at admission , and discussion about misunderstandings regarding pain management with family caregivers and patients .


We conducted a pilot , cluster randomized , controlled trial with four hospices .


One hundred twenty-six family caregivers ( @ interventions and @ controls ) were interviewed at two weeks after admission .


If patients survived three months after admission , caregivers were reinterviewed .


At two weeks , caregivers in the intervention group reported better knowledge about pain management ( P = @ ) , fewer concerns about pain and pain medications ( P = @ ) , and lower patient pain over the past week ( P = @ ) and trended toward improvement in most other areas under study .


Exploratory analyses suggest that EMPOWER had a greater effect for black subjects ( vs. whites ) on reducing concern about stigma .


At three months , the intervention group trended better on most study outcomes .


EMPOWER is a promising model to reduce barriers to pain management in hospice .


To study the clinical efficacy of adjuvant therapy with glucocorticoids in children with lobar pneumonia caused by Mycoplasma pneumoniae .


One hundred and eight children with lobar pneumonia caused by Mycoplasma pneumoniae were randomly divided into routine treatment and hormone treatment groups .


Both groups were treated with azithromycin and other symptomatic therapies .


In addition to the basic treatment , the hormone treatment group was given dexamethasone @-@ @ mg / ( kgd ) by intravenous drip until the body temperature was normal .


Then given oral prednisone tablets @-@ mg / ( kgd ) ( gradually reduced ) for a total treatment course of @-@ days .


Before and after treatment pulmonary functions were examined , and serum C-reactive protein ( CRP ) , erythrocyte sedimentation rate ( ESR ) , interleukin-@ ( IL-@ ) and interleukin-@ ( IL-@ ) were measured .


The duration of fever , cough relief time and pulmonary shadow absorption time on chest X-ray were significantly shorter in the hormone treatment group than in the routine treatment group ( P < @ ) .


After treatment , the two groups showed improvements in serum CRP , ESR , IL-@ , and IL-@ ( P < @ ) , but the hormone treatment group showed significantly more improvement ( P < @ ) .


Varying degrees of mixed ventilation dysfunction were seen in the two groups before treatment , and hormone therapy significantly improved pulmonary function , especially promoting the recovery of small airway function .


Adjuvant therapy with glucocorticoids can effectively alleviate clinical symptoms , promote the absorption of pulmonary inflammation , and improve pulmonary function in children with lobar pneumonia caused by Mycoplasma pneumoniae .


We sought to identify risk factors for mechanical ventilation in patients with malignancies and acute respiratory failure ( ARF ) .


We analyzed data from a previous randomized controlled trial in which nonintubated oncology and hematology subjects with ARF were randomized to early bronchoalveolar lavage or routine care in @ ICUs in France .


Consecutive patients with malignancies were admitted to the ICU for ARF in @ and @ with no intervention .


During the study period , @ patients were admitted to the ICU for ARF , and @ patients were not included due to a nonintubation order .


Data on the underlying disease , pulmonary involvement , and extrapulmonary organ dysfunctions were recorded at admission in the @ remaining subjects .


Ventilatory support included oxygen only ( @ subjects ) , noninvasive ventilation ( NIV ) only ( @ subjects ) , NIV followed by invasive mechanical ventilation ( @ subjects ) , and first-line invasive mechanical ventilation ( @ subjects ) .


The @ subjects who required invasive mechanical ventilation were compared with the @ subjects who remained on oxygen or NIV .


Factors associated with invasive mechanical ventilation by multivariate analysis were the oxygen flow required at ICU admission , the number of quadrants involved on chest x-ray , and hemodynamic dysfunction .


Mortality rates for subjects who had NIV failure were @ % compared with @ % for subjects who were first-line intubated ( P = @ ) .


In cancer patients with ARF , hypoxemia , extent of pulmonary infiltration on chest x-ray , or hemodynamic dysfunction are risk factors for invasive mechanical ventilation .


Mortality was not significantly different between NIV failure and first-line intubation .


Vitamin D deficiency , defined by the total serum @-hydroxyvitamin D -LSB- @ ( OH ) D -RSB- level , is common and more prevalent among Blacks than whites .


Vitamin D-binding protein ( DBP ) levels vary with race and may modulate `` bioavailable '' levels of @ ( OH ) D.


To determine the effect of DBP levels on the functional response to vitamin D.


A randomized , placebo-controlled trial of vitamin D repletion for @ mo , which took place at an outpatient research unit .


Participants included @ vitamin D-deficient ( @ ( OH ) D < @ ng/mL ) adults .


Participants were randomly assigned to receive either @,@ IU of vitamin D@ or placebo weekly for @ weeks .


This is a post-hoc analysis using DBP , @ ( OH ) D , PTH , and calcium levels .


Blacks had lower total @ ( OH ) D ( @ vs @ ng/mL , P < @ ) and DBP levels ( @ vs @ g/mL , P < @ ) than non-Blacks .


DBP levels were similar before and after vitamin D@ or placebo treatment ( r = @ , P < @ ) .


Baseline total @ ( OH ) D levels were a significant determinant of baseline PTH levels ( P < @ ) .


The change in total @ ( OH ) D was associated with the change in PTH ( P < @ ) and calcium levels ( P < @ ) .


In contrast , DBP levels were not a determinant of baseline PTH ( P = @ ) nor significantly related to changes in either PTH ( P = @ ) or calcium levels ( P = @ ) .


DBP levels are stable in Blacks and non-Blacks , and do not change with correction of vitamin D deficiency .


Even for individuals with total @ ( OH ) D levels < @ ng/mL , Blacks have significantly lower DBP levels than non-Blacks .


However , within this range of total @ ( OH ) D , DBP levels do not influence the effect of vitamin D repletion on PTH or calcium levels .


Heart failure ( HF ) significantly impacts on the daily lives of patients and their carers .


In Western society HF education programs have increased patient and carer knowledge and improved health-related quality of life .


However , there is a paucity of such evidence in Asia .


For example , to date no studies have been conducted in Thailand to investigate the potential benefits of a family-based education program on the health outcomes of HF patients and carers .


This randomised controlled trial will evaluate the effectiveness of an education program on knowledge , self-care and health-related quality of life of Thai HF patients and their carers .


Assessments will be conducted at baseline , three and six months .


Participants will be assigned by independent random allocation to an intervention ( family-based education plus usual care ) or a control ( usual care ) group .


Analyses will be conducted on an intention-to-treat basis .


This trial will be the first to evaluate the effectiveness of family-based education for HF patients and carers residing in rural Thailand .


It attempts to advance understanding of family-based HF education and address the gap in service provision .


One-lung ventilation ( OLV ) can result in local and systemic inflammation .


This prospective , randomized trial was to evaluate the effect of therapeutic hypercapnia on lung injury after OLV .


Fifty patients aged @ to @ yr undergoing lobectomy were randomly provided with air or carbon dioxide ( partial pressure of carbon dioxide : @ to @ mmHg or @ to @ mmHg ) .


Peak pressure , plateau pressure , and lung compliance were recorded .


Bronchoalveolar lavage fluid ( BALF ) and blood samples were collected .


Adverse events were monitored .


The primary outcome was the concentration of BALF tumor necrosis factor , and the secondary outcomes were serum cytokine concentrations .


The BALF tumor necrosis factor was lower in the carbon dioxide group than in the air group ( median -LSB- range -RSB- , @ -LSB- @ to @ -RSB- vs. @ -LSB- @ to @ -RSB- ; P = @ ) .


Patients in the carbon dioxide group had lower concentrations of serum and BALF interleukin ( IL ) -@ , IL-@ , and IL-@ , but higher serum concentrations of IL-@ , accompanied by reduced numbers of cells and neutrophils as well as lower concentrations of protein in the BALF .


Also , patients in the carbon dioxide group had lower peak ( mean SD , @ @ vs. @ @ ) and plateau pressures ( @ @ vs. @ @ ) , but higher dynamic compliance ( @ @ vs. @ @ ) .


Furthermore , patients in the carbon dioxide group had higher postoperation oxygenation index values .


Ten patients experienced slightly increased blood pressure and heart rate during OLV in the carbon dioxide group .


Under intravenous anesthesia , therapeutic hypercapnia inhibits local and systematic inflammation and improves respiratory function after OLV in lobectomy patients without severe complications .


The purpose was to explore operable lung cancer patient experiences with an exercise intervention from a longitudinal perspective according to patient motivation and patient perceived benefits and barriers of exercise .


Nineteen patients enrolled in an exercise intervention @ weeks post-surgery participated in qualitative interviews at three time points .


A criteria sampling strategy was applied .


Ricoeur 's phenomenological hermeneutical philosophy inspired the analysis .


Patients initiated exercising median @ days postoperative .


Eight patients included in the interview study dropped out of the intervention due to side effects of chemotherapy ( n = @ ) and external circumstances ( n = @ ) .


The mean attendance rate for the eleven participants who completed the intervention was @ % .


No patients experienced severe adverse events .


Motivation for participation included patients ' expectations of physical benefits and the security of having professionals present .


Patients experienced physical and emotional benefits and affirmed their social identity .


Barriers were primarily related to side effects of chemotherapy .


The exercise intervention was undertaken safely by operable lung cancer patients initiated @ weeks after surgery .


The intervention put the patients on track to a healthier lifestyle regarding physical activity and smoking .


The study indicates that exercise initiated early in the treatment trajectory is beneficial for operable lung cancer patients and especially for those who were physically active and motivated pre-illness and who did not experience side effect of treatment .


We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers , linked to evidence-based treatment algorithms and reference guides ( the longer-term stroke care system of care ) to address the poor longer-term recovery experienced by many patients with stroke .


A pragmatic , multicentre , cluster randomized controlled trial of this system of care .


Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice .


The primary outcome was improved patient psychological well-being ( General Health Questionnaire-@ ) at @ months ; secondary outcomes included functional outcomes for patients , carer outcomes , and cost-effectiveness .


Follow-up was through self-completed postal questionnaires at @ and @ months .


Thirty-two stroke services were randomized ( @ participated ) ; @ patients ( @ control ; @ intervention ) and @ carers ( @ control ; @ intervention ) were recruited .


In intention to treat analysis , the adjusted difference in patient General Health Questionnaire-@ mean scores at @ months was -@ points ( @ % confidence interval , -@ to @ ; P = @ ) indicating no evidence of statistically significant difference between the groups .


Costs of Stroke Care Coordinator inputs , total health and social care costs , and quality-adjusted life year gains at @ months , @ months , and over the year were similar between the groups .


This robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice .


To investigate the comparative efficacy of cognitive behavioral therapy ( CBT ) , Tai Chi Chih ( TCC ) , and sleep seminar education control ( SS ) on the primary outcome of insomnia diagnosis , and secondary outcomes of sleep quality , fatigue , depressive symptoms , and inflammation in older adults with insomnia .


Randomized controlled , comparative efficacy trial .


Los Angeles community .


@ older adults with chronic and primary insomnia .


Random assignment to CBT , TCC , or SS for @-hour group sessions weekly over @ months with follow-up at @ and @ months .


Insomnia diagnosis , patient-reported outcomes , polysomnography ( PSG ) , and high-sensitivity C-reactive protein ( CRP ) levels .


CBT performed better than TCC and SS in remission of clinical insomnia as ascertained by a clinician ( P < @ ) , and also showed greater and more sustained improvement in sleep quality , sleep parameters , fatigue , and depressive symptoms than TCC and SS ( all P values < @ ) .


As compared to SS , CBT was associated with a reduced risk of high CRP levels ( > @ mg/L ) at @ months ( odds ratio -LSB- OR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- P < @ ) .


Remission of insomnia was associated with lower levels of CRP ( P < @ ) at @ months .


TCC was associated with improvements in sleep quality , fatigue , and depressive symptoms as compared to SS ( all P 's < @ ) , but not insomnia remission .


PSG measures did not change .


Treatment of late-life insomnia is better achieved and sustained by cognitive behavioral therapies .


Insomnia treatment and remission reduces a marker of inflammatory risk , which has implications for cardiovascular morbidity and diabetes observed with sleep disturbance in epidemiologic surveys .


The use of bone marrow mononuclear cells ( BM-MNCs ) has achieved great outcomes in clinical practice .


We aim to evaluate the efficacy and safety of autologous BM-MNC infusion and hyperbaric oxygen therapy ( HOT ) in type @diabetes mellitus .


This single-center , randomized , open-label , controlled clinical trial with a factorial design included two phases .


The patients received standard medical therapy in the run-in phase ; in the treatment phase , patients with glycated hemoglobin of @-@ @ % were randomly assigned into four groups and underwent BM-MNC infusion along with HOT ( BM-MNC + HOT group ) , BM-MNC infusion ( BM-MNC group ) , HOT ( HOT group ) and standard medical therapy ( control group ) , respectively .


The area under the curve of C-peptide was recorded as a primary end point .


Our research is registered at ClinicalTrials.gov ( NCT@ ) .


A total of @ patients completed the follow-up .


At @months after treatment , the area under the curve of C-peptide ( ng/mL per @ min ) of the BM-MNC + HOT group and the BM-MNC group were significantly improved ( @ % and @ % from the baseline , respectively ) .


The changes were both significant compared with that in the control group , but no remarkable change was observed in the HOT group .


Treatment-related adverse events were mild , including transient abdominal pain ( n = @ ) and punctual hemorrhage ( n = @ ) .


BM-MNC infusion for type @ diabetes mellitus improves islet function and metabolic control , with mild adverse effects .


HOT does not synergize with BM-MNC infusion .


Alcohol consumption in adolescence is associated with problem drinking in later life , and there is a need to develop evidence-based interventions to reduce adolescent alcohol consumption .


The aims of the present study were to test the ability of a very brief intervention based on self-affirmation theory to reduce alcohol consumption in a sample of adolescents and to examine potential mediators of the effects .


@ adolescents were randomly allocated either to form a self-affirming implementation intention or to complete a distractor task .


All participants were exposed to a threatening message concerning the health risks of alcohol consumption .


The main outcome measure was subsequent alcohol intake , but message processing ( operationalized as perceived threat and message derogation ) , behavioral intention , and self-efficacy were also measured as potential mediators .


The intervention produced a significant decrease in alcohol consumption : Participants in the self-affirming implementation intention condition consumed @ fewer grams of pure alcohol per day at the end of the study than adolescents who completed the distractor task .


The effect was not mediated by perceived threat , message derogation , behavioral intention , or self-efficacy .


The findings provide support for the efficacy of the self-affirming implementation intention for promoting health behavior change and extend previous research by testing an adolescent sample and observing longer term effects .


Further research is needed to find out what mediates the effects of self-affirming implementation intentions on health behavior change .


Impaired sexual function is increasingly recognized as a side effect of psychopharmacological treatment .


However , underlying mechanisms of action of the different drugs on sexual processing are still to be explored .


Using functional magnetic resonance imaging , we previously investigated effects of serotonergic ( paroxetine ) and dopaminergic ( bupropion ) antidepressants on sexual functioning ( Abler et al. , @ ) .


Here , we studied the impact of noradrenergic and antidopaminergic medication on neural correlates of visual sexual stimulation in a new sample of subjects .


Nineteen healthy heterosexual males ( mean age @ years , SD @ ) under subchronic intake ( @ days ) of the noradrenergic agent reboxetine ( @ mg/d ) , the antidopaminergic agent amisulpride ( @mg/d ) , and placebo were included and studied with functional magnetic resonance imaging within a randomized , double-blind , placebo-controlled , within-subjects design during an established erotic video-clip task .


Subjective sexual functioning was assessed using the Massachusetts General Hospital-Sexual Functioning Questionnaire .


Relative to placebo , subjective sexual functioning was attenuated under reboxetine along with diminished neural activations within the caudate nucleus .


Altered neural activations correlated with decreased sexual interest .


Under amisulpride , neural activations and subjective sexual functioning remained unchanged .


In line with previous interpretations of the role of the caudate nucleus in the context of primary reward processing , attenuated caudate activation may reflect detrimental effects on motivational aspects of erotic stimulus processing under noradrenergic agents .


Several studies on lactobacilli have demonstrated they are effective against atopic dermatitis ( AD ) in children , but there are very few reports of their effects in adults .


We investigated the changes in AD symptoms in adults after the ingestion of the Lactobacillus acidophilus strain L-@ ( L-@ ) , which has been shown to have a curative effect on AD in children .


A double-blind , parallel-group , placebo-controlled comparison was performed on @ AD patients aged @ years using heat-killed L-@ .


Skin lesions were assessed using the SCORing AD ( SCORAD ) index before the start of L-@ ingestion and @ and @ weeks after ingestion .


Serum cytokine and blood marker levels were measured @ weeks after the start of L-@ ingestion .


The group that ingested L-@ had lower SCORAD scores than the controls ( p = @ ) .


The L-@ group also had decreased ratios of change for eosinophil count ( p = @ ) and increased ratios of change for serum TGF - ( p = @ ) .


Ratios of change for serum TGF - rose significantly ( p = @ ) in patients showing mitigated symptoms with L-@ administration .


Administration of heat-killed L-@ was effective for AD symptoms in adults .


L-@ may contribute to the suppression of Th@-dominant inflammation .


Our preliminary trial is the first to report the effects of L-@ on adult AD .


The incidence and severity of gastroesophageal reflux disease ( GERD ) in Japan tends to increase in elderly women .


Rikkunshito ( RKT ) , a traditional Japanese medicine , acts as a prokinetic agent and improves gastric emptying and gastric accommodation .


Our previous prospective randomized placebo-controlled study showed that RKT combined with a standard-dose of rabeprazole ( RPZ ) significantly improved the acid-related dysmotility symptoms ( ARD ) in elderly patients with proton pump inhibitor ( PPI ) - refractory non-erosive reflux disease ( NERD ) .


This study aimed to evaluate clinical characteristics of elderly PPI-refractory NERD patients with ARD symptoms who responded to RKT .


Two hundred forty-two patients with PPI-refractory NERD were randomly assigned to @ weeks of either RPZ ( @ mg/q .


d. ) + RKT ( @ g/t .


i.d. ) ( RKT group ) or RPZ + placebo ( PL group ) .


Among them , @ were elderly ( @ years ) with ARD ( RKT group : n = @ ; PL group : n = @ ) .


We analyzed the changes using the @ subscale score of frequency scale for the symptoms of GERD ( FSSG ) and @ items of the Gastrointestinal Symptom Rating Scale at @ and @ weeks and compared the therapeutic efficacy between the @ groups .


There were no marked differences in baseline demographic or clinical characteristics in the @ groups except for rate of current smoking .


The FSSG score ( mean SD at @ , @ , and @ weeks ) in both the RKT ( @ @ ; @ @ ; @ @ ) and PL ( @ @ ; @ @ , @ @ ) groups significantly decreased after treatment .


However , the degree of improvement of total and ARD scores of FSSG after the @-week treatment was significantly greater in the RKT group than in the PL group .


Combination therapy with RKT for @ weeks showed significant improvement in @ subscale scores ( abdominal bloating , heavy feeling in stomach and sick feeling after meals ) of the ARD domain and @ subscale score ( heartburn after meals ) of the reflux symptom domain .


RKT may be useful for improving GERD symptoms in elderly PPI-refractory NERD patients with ARD .


Thus , RKT was particularly effective for resolving postprandial GERD symptoms ( heavy feeling in stomach , sick feeling , and heartburn after meals ) .


Acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ) is a common cause of morbidity and mortality .


Traditional Chinese medicine ( TCM ) is used to treat AECOPD as adjunctive therapy .


This study aimed to evaluate the efficacy and safety of the TCM formula Xuan Bai Cheng Qi as an adjuvant therapy for AECOPD patients with the syndrome type of phlegm-heat obstructing the lungs .


A multicenter , randomized , double-blind , placebo-controlled clinical trial was conducted .


A total of @ patients were divided into the intervention group ( n = @ , treated with conventional medicine and Xuan Bai Cheng Qi ) and the control group ( n = @ , treated with conventional medicine and placebo ) .


Total symptom scores ( cough , phlegm , wheezing , chest congestion ) before treatment and at @ , @ , @ , @ days post-treatment were recorded .


Lung function , arterial blood gas , serum inflammatory cytokines , oxidation/anti-oxidation index were observed before treatment and at the end of the @-day treatment .


A total of @ patients completed the study .


The full analysis set ( FAS ) population was @ and the per-protocol analysis set ( PPS ) population was @ .


After the @-day treatment , symptom scores of the Xuan Bai Cheng Qi group were significantly lower over time compared with the control group ( FAS : mean difference -@ , @ % CI -@ to -@ , P < @ ; PPS : mean difference -@ , @ % CI -@ to -@ , P < @ ) .


FEV@ , FVC , and FEV@ % pred were significantly higher over time in the Xuan Bai Cheng Qi group compared with those in the control group ( day @ , FAS and PPS : P < @ ) .


PaO@ and PaCO@ were significantly improved in the Xuan Bai Cheng Qi group ( day @ , FAS and PPS : P < @ ) .


Xuan Bai Cheng Qi was also found to ameliorate cytokine levels and oxidation/antioxidant index compared with placebo .


There were no differences in safety variables and adverse events between the two groups .


Xuan Bai Cheng Qi formula appears to be a safe and beneficial treatment for AECOPD of phlegm-heat obstructing the lungs syndrome type .


Both contingency management ( CM ) and exercise have shown promise as smoking cessation treatments , but their combined effects have not been evaluated .


The present study evaluated whether CM ( in which motivational incentives are provided for abstinence ) plus exercise reduced smoking more than either component alone .


In a within-subjects design , @ smokers were exposed to exercise plus CM , exercise plus CM-control ( non-contingent incentives ) , inactivity plus CM , and inactivity plus CM-control .


CM increased latencies to smoke and decreased total puffs ( Mdns = @ min and @ puffs , respectively ) relative to CM-control ( Mdns = @ min and @ puffs ) .


Exercise decreased craving relative to baseline for craving based on both the pleasurable consequences of smoking ( D = -@ on a @-point visual analog scale ) and anticipated relief from withdrawal ( D = -@ ) , whereas inactivity increased both components of craving ( Ds = @ and @ ) .


Exercise had no effect on smoking or a measure of temporal discounting .


Although exercise decreased craving , it did not affect smoking behavior .


Exercise plus CM was not more effective than CM alone .


The diagnosis of varicocle is clinical .


In order to improve diagnosis of varicocele , we compared the clinical with the ultrasound findings in schoolboys with the condition .


This is because the conditions can affect testicular growth .


It was a cross-sectional , descriptive study of schoolboys aged from @ to @ years who had varicocele .


Among @ boys examined , @ had varicocele and only @ had scrotal ( @ with Doppler ) and renal ultrasound examination .


Among the @ adolescents who were clinically diagnosed with varicocele and also with the aid of ultrasound scan , @ , @ and @ had grade @ , @ and @ , respectively .


Testicular hypotrophy ( TH ) was clinically noticed in @ cases .


At ultrasonography , varicocele was bilateral in @ % and unilateral in @ % ( P = @ ) with @ adolescents ( @ % ) showing TH compared with @ % being diagnosed with TH using clinical examination alone ( P = @ ) .


In @ schoolboys ( @ % ) with unilateral varicocele , a subclinical type was discovered at other side .


Renal ultrasound revealed abnormalities in @ % of cases .


Doppler ultrasound helped in finding varicoceles along the top edge of the testis ( n = @ ) and under tunica albuginea ( n = @ ) .


TH due to varicocele is better studied by ultrasound .


To evaluate the psychological consequences among family members given the option to be present during the CPR of a relative , compared with those not routinely offered the option .


Prospective , cluster-randomized , controlled trial involving @ prehospital emergency medical services units in France , comparing systematic offer for a relative to witness CPR with the traditional practice among @ family members .


Main outcome measure was @-year assessment included proportion suffering post-traumatic stress disorder ( PTSD ) , anxiety and depression symptoms , and/or complicated grief .


Among the @ family members -LSB- intention to treat ( ITT ) population -RSB- , @ ( @ % ) were evaluated at @ year .


In the ITT population ( N = @ ) , family members had PTSD-related symptoms significantly more frequently in the control group than in the intervention group -LSB- adjusted odds ratio , @ ; @ % confidence interval ( CI ) @-@ @ ; P = @ -RSB- as did family members to whom physicians did not propose witnessing CPR -LSB- adjusted odds ratio , @ ; @ % CI @-@ @ ; P = @ -RSB- .


In the observed cases population ( N = @ ) , the proportion of family members experiencing a major depressive episode was significantly higher in the control group ( @ vs. @ % ; P = @ ) and among family members to whom physicians did not propose the opportunity to witness CPR ( @ vs. @ % ; P = @ ) .


The presence of complicated grief was significantly greater in the control group ( @ vs. @ % ; P = @ ) and among family members to whom physicians did not propose the opportunity to witness resuscitation ( @ vs. @ % ; P = @ ) .


At @ year after the event , psychological benefits persist for those family members offered the possibility to witness the CPR of a relative in cardiac arrest .


During leisure activities young people are often exposed to excessive noise levels resulting in an increase of noise-induced symptoms such as hearing loss , tinnitus and hyperacusis .


Noise-induced tinnitus is often perceived after loud music exposure and provides an important marker for overexposure as a temporary threshold shift that is often not experienced by the individual itself .


As oxidative stress plays an important role in the pathogenesis of noise-induced hearing loss , the use of antioxidants to prevent hearing damage has recently become the subject of research .