Some reports suggest that the intake of active vitamin D might be beneficial to prevent infections .


Therefore , we aimed to determine if the oral intake of vitamin D receptor activator ( VDRA ) is associated with a lower risk of infection-related hospitalization ( IRH ) among incident chronic hemodialysis patients .


We conducted a nested case-control study in a cohort of @ patients initiating chronic hemodialysis between @ January @ and @ December @ in Quebec , Canada , using administrative databases .


We identified cases of hospital admission indicating an infection as main diagnosis on the hospital 's discharge sheet .


Up to @ controls were randomly selected for each case .


Association between oral VDRA use and risk of IRH was estimated using conditional logistic regression .


We identified @ cases of IRH and @ controls during the study period .


The intake of VDRA was not associated with the risk of being hospitalized due to an infection ( odds ratio -LSB- OR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ) .


Using the prior @-month cumulative dose of VDRA , we also found that a cumulative VDRA dose of less than @ mcg ( OR , @ ; @ % CI , @-@ @ ) or greater than @ mcg ( OR , @ ; @ % CI , @-@ @ ) was not associated with the IRH risk .


The oral intake of VDRA was not associated with the risk of IRH in incident hemodialysis patients .


We assessed differences in treatment between the screening and control arms of ERSPC Rotterdam and studied whether possible treatment differences could explain the positive study outcome .


In ERSPC Rotterdam men @ to @ years old were randomized to a screening arm of @,@ and a control arm of @,@ .


Treatment after diagnosis was at the discretion of the care provider chosen by the patient .


Initial treatment was compared in @ risk groups .


The relation between prostate cancer incidence and prostate cancer mortality was assessed by risk group by correlating the incidence RR and the mortality RR .


A direct relation would have supported a stage shift as the main cause of changes in prostate cancer mortality .


Initial treatment differed between the arms in the low , intermediate and high risk groups but not in the metastatic group .


The RRs of prostate cancer incidence and mortality per risk group were related @:@ ( regression line slope @ , @ % CI @-@ @ ) .


Of changes in prostate cancer mortality @ % could be explained by changes in prostate cancer incidence .


This made treatment differences unlikely as the reason for the observed decrease in prostate cancer mortality .


Differences in treatment between the ERSPC Rotterdam screening and control arms were unlikely to explain the differences in prostate cancer mortality .


Results are instead consistent with a decrease in prostate cancer mortality as the result of a favorable stage through screening .


Dalbavancin , a lipoglycopeptide antibiotic agent that is active against gram-positive pathogens , has a long plasma half-life , allowing for once-weekly dosing .


DISCOVER @ and DISCOVER @ were identically designed noninferiority trials of dalbavancin for the treatment of acute bacterial skin and skin-structure infection .


We randomly assigned patients to receive dalbavancin intravenously on days @ and @ or vancomycin intravenously for at least @ days with the option to switch to oral linezolid to complete @ to @ days of therapy .


The primary end point , early clinical response , required the cessation of spread of infection-related erythema and the absence of fever at @ to @ hours .


Secondary end points at the end of therapy included clinical status and investigator 's assessment of outcome .


Analysis of the primary end point showed noninferiority of dalbavancin in both DISCOVER @ and DISCOVER @ .


In the pooled analysis , @ of @ patients ( @ % ) in the dalbavancin group and @ of @ ( @ % ) in the vancomycin-linezolid group had an early clinical response indicating treatment success ( weighted difference , -@ percentage point ; @ % confidence interval , -@ to @ ) .


The outcomes were similar in the analyses by study and the pooled analyses of clinical status at the end of therapy and the investigator 's assessment of outcome .


For patients infected with Staphylococcus aureus , including methicillin-resistant S. aureus , clinical success was seen in @ % of the patients treated with dalbavancin and @ % of those treated with vancomycin-linezolid .


Adverse events and study days with an adverse event were less frequent in the dalbavancin group than in the vancomycin-linezolid group .


The most common treatment-related adverse events in either group were nausea , diarrhea , and pruritus .


Once-weekly intravenous dalbavancin was not inferior to twice-daily intravenous vancomycin followed by oral linezolid for the treatment of acute bacterial skin and skin-structure infection .


( Funded by Durata Therapeutics ; DISCOVER @ and DISCOVER @ ClinicalTrials.gov numbers , NCT@ and NCT@ . )


The primary aim of this study was to evaluate the long-term safety/tolerability of atomoxetine in Japanese adults with attention deficit hyperactivity disorder ( ADHD ) .


This @-week , open-label extension study involved participants with ADHD who completed a @-week randomized controlled trial of atomoxetine .


Participants received atomoxetine @mg/day , followed by step-wise titration to a maximum of @mg/day .


The primary outcome was safety/tolerability .


Secondary outcomes were symptoms of ADHD ( Conners ' Adult ADHD Rating Scales-Investigator Rated : Screening Version @-item total score ) , quality of life ( Adult Attention-Deficit/Hyperactivity Disorder Quality of Life scale ) , and executive function ( Behavior Rating Inventory of Executive Function-Adult Version : Self-report ) .


Of the @ % of participants overall who discontinued the study , @ % ( @/@ ) of participants discontinued because of adverse events ( AEs ) , primarily nausea ( @ % ; @/@ ) .


Overall , @ % ( @/@ ) of participants experienced treatment-emergent AEs ( TEAEs ) , most commonly nausea ( @ % ; @/@ ) , nasopharyngitis ( @ % ; @/@ ) , thirst ( @ % ; @/@ ) , headache ( @ % ; @/@ ) , and decreased appetite ( @ % ; @/@ ) .


Most TEAEs ( @ % ; @/@ ) were mild in intensity .


Overall , @ % ( @/@ ) of participants experienced @ adverse drug reaction , primarily nausea ( @ % ; @/@ ) .


Five participants experienced serious AEs during the open-label extension ; none was related/possibly related to treatment .


There were statistically significant increases in vital signs and decreases in body weight that were not considered clinically significant .


Symptoms of ADHD , quality of life , and executive function were significantly improved from baseline to endpoint ( P < @ ) .


Despite discontinuations due to the long-term , open-label design , AE related discontinuations were modest , suggesting that atomoxetine has acceptable long-term safety and tolerability in Japanese adults with ADHD .


Symptoms of ADHD improved and remained improved throughout the study .


To compare the efficacy and safety between low-fluence photodynamic therapy ( PDT ) and the intravitreal ranibizumab in the treatment of chronic central serous chorioretinopathy ( CSC ) .


Prospective , randomized , single-center , parallel-arm , controlled trial .


Thirty-four eyes of @ patients with chronic CSC with > @ months ' duration of symptoms or recurrent CSC were randomly placed into the low-fluence PDT group ( n = @ ) or the ranibizumab group ( n = @ ) .


The patients underwent a single session of low-fluence PDT or @ consecutive monthly injections of ranibizumab .


Rescue treatment was available from month @ if the subretinal fluid ( SRF ) persisted or recurred after primary treatment ; low-fluence PDT was given to the ranibizumab group and intravitreal ranibizumab to the low-fluence PDT group .


The primary outcome was the proportion of eyes with complete resolution of SRF without rescue treatment .


Secondary outcomes included the mean changes in logarithm of the minimum angle of resolution best-corrected visual acuity ( BCVA ) , central retinal thickness ( CRT ) , and angiographic findings from baseline to @ months .


At month @ , @ eyes ( @ % ) of the low-fluence PDT group maintained complete resolution of SRF without rescue treatment versus @ eyes ( @ % ) in the ranibizumab group ( P < @ ) .


Two eyes ( @ % ) in the low-fluence PDT group and @ eyes ( @ % ) in the ranibizumab group met the criteria for rescue treatment ( P = @ ) .


In the low-fluence PDT group , the mean decrease in CRT from baseline was significantly greater than that in the ranibizumab group until month @ ( P < @ ) , but the differences became insignificant thereafter .


The improvement in BCVA from baseline was superior in the low-fluence PDT group to that in the ranibizumab group , but the differences were not statistically significant except at month @ ( P = @ ) .


On indocyanine green angiography , a significantly greater proportion of the low-fluence PDT group ( @ eyes ; @ % ) showed a marked reduction in choroidal hyperpermeability after primary treatment than that of the ranibizumab group ( @ eyes ; P < @ ) .


No serious adverse events related to the drugs or procedures were observed .


This study represents the overall superiority of low-fluence PDT compared with intravitreal ranibizumab in the treatment of chronic CSC .


Drinking water induces short-term cardiovascular and metabolic changes .


These effects are considered to be triggered by gastric distension and osmotic factors , but little is known about the influence of water temperature .


We determined , in a randomized crossover study , the acute cardiovascular and metabolic responses to @ mL of tap water at @ C ( cold ) , @ C ( room ) and @ C ( body ) in @ young humans to ascertain an effect of water temperature .


We measured continuous beat-to-beat haemodynamics , skin blood flux with laser-Doppler flowmetry and resting energy expenditure by indirect calorimetry starting with a @-min baseline followed by a @-min drink period and a subsequent @-min post-drink observation .


Ingestion of cold - and room-tempered water led to decreased heart rate ( P < @ ) and double product ( P < @ ) , and increased stroke volume ( P < @ ) ; these effects were not observed with body-tempered water .


Drinking cold - and room - , but not body-tempered water , led to increased high frequency power of heart rate variability ( P < @ ) and baroreflex sensitivity ( P < @ ) .


Cold - and room-tempered water increased energy expenditure over @ min by @ % ( P < @ ) and @ % ( ns ) , respectively , accompanied by a diminished skin blood flux ( P < @ ) , thereby suggesting that both small increases in heat production together with decreased heat loss contribute to warming up the ingested water to intra-abdominal temperature levels .


Overall , ingestion of cold - and room - , but not body-tempered water reduced the workload to the heart through a reduction in heart rate and double product which could be mediated by an augmented cardiac vagal tone .


Post-term pregnancy , a pregnancy exceeding @ days or @ completed weeks , is associated with increased perinatal morbidity and mortality and is considered a high-risk condition which requires specialist surveillance and induction of labour .


However , there is uncertainty on the policy concerning the timing of induction for post-term pregnancy or impending post-term pregnancy , leading to practice variation between caregivers .


Previous studies on induction at or beyond @ weeks versus expectant management showed different results on perinatal outcome though conclusions in meta-analyses show a preference for induction at @ weeks .


However , interpretation of the results is hampered by the limited sample size of most trials and the heterogeneity in design .


Most control groups had a policy of awaiting spontaneous onset of labour that went far beyond @ weeks , which does not reflect usual care in The Netherlands where induction of labour at @ weeks is the regular policy .


Thus leaving the question unanswered if induction at @ weeks results in better perinatal outcomes than expectant management until @ weeks .


In this study we compare a policy of labour induction at @ + @ / +@ weeks with a policy of expectant management until @ weeks in obstetrical low risk women without contra-indications for expectant management until @ weeks and a singleton pregnancy in cephalic position .


We will perform a multicenter randomised controlled clinical trial .


Our primary outcome will be a composite outcome of perinatal mortality and neonatal morbidity .


Secondary outcomes will be maternal outcomes as mode of delivery ( operative vaginal delivery and Caesarean section ) , need for analgesia and postpartum haemorrhage ( @ ml ) .


Maternal preferences , satisfaction , wellbeing , pain and anxiety will be assessed alongside the trial .


This study will provide evidence for the management of pregnant women reaching a gestational age of @ weeks .


The objective of this study was to evaluate citalopram for executive functioning in Huntington 's disease ( HD ) .


The study was randomized , double-blind , and placebo-controlled .


Thirty-three adults with HD , cognitive complaints , and no depression ( Hamilton Depression -LSB- HAM-D -RSB- rating scale @ ) were administered citalopram @ mg or placebo ( @ visits , @ weeks ) , with practice and placebo run-ins .


The primary outcome was change in executive functioning .


The intent to treat analysis was controlled for practice effects , comparing visits @ and @ to visits @ and @ for citalopram versus placebo .


There were no significant benefits on the executive function composite ( treatment-placebo mean difference -@ ; @ % confidence interval -LSB- CI -RSB- , -@ to @ ; P = @ ) .


Citalopram participants showed improved clinician-rated depression symptoms on the HAM-D ( t = -@ ; P = @ ) .


There were no group differences on motor ratings , self-reported executive functions , psychiatric symptoms , or functional status .


There was no evidence that short-term treatment with citalopram improved executive functions in HD .


Despite excluding patients with active depression , participants on citalopram showed improved mood , raising the possibility of efficacy for subsyndromal depression in HD .


ACTG A@ randomized treatment-nave individuals to tenofovir-emtricitabine ( TDF/FTC ) or abacavir-lamivudine ( ABC/@TC ) combined with efavirenz ( EFV ) or atazanavir/ritonavir ( ATV/r ) .


Individuals in the high screening viral load ( VL ) stratum ( @,@ copies/mL ) had increased rates of virologic failure with ABC/@TC .


To compare regimen-specific early virologic response .


Using Wilcoxon rank-sum tests , we compared regimen-specific VL changes from entry to week @ in A@ subjects ( N = @,@ ) and from entry to week @ , @ , and @ in substudy subjects ( n = @ ) .


We evaluated associations between week @ VL change and time to virologic failure with Cox proportional hazards models .


TDF/FTC and ABC/@TC produced similar week @ VL declines in the entire study population and in the high VL stratum .


EFV produced greater VL declines from baseline at week @ than ATV/r ( median -@ vs -@ log@ copies/mL ; P < @ ) .


In the substudy of subjects with week @ , @ , and @ VL data , there was no difference in VL decline in individuals randomized to TDF/FTC versus ABC/@TC , but EFV resulted in greater VL decline from entry at each of these timepoints than ATV/r .


Smaller week @ VL decline was associated with increased risk of virologic failure .


Within all treatment arms , a less robust week @ virologic response was associated with higher risk for subsequent virologic failure .


However , between-regimen differences in week @ VL declines did not parallel the previously reported differences in longer term virologic efficacy in A@ , suggesting that between-regimen differences in responses were not due to intrinsic differences in antiviral activity .


To investigate the efficacy and effects of transcranial direct current stimulation ( tDCS ) on motor imagery brain-computer interface ( MI-BCI ) with robotic feedback for stroke rehabilitation .


A sham-controlled , randomized controlled trial .


Patients recruited through a hospital stroke rehabilitation program .


Subjects ( N = @ ) who incurred a stroke @ to @ years prior , with moderate to severe upper extremity functional impairment , and passed BCI screening .


Ten sessions of @ minutes of tDCS or sham before @ hour of MI-BCI with robotic feedback upper limb stroke rehabilitation for @ weeks .


Each rehabilitation session comprised @ minutes of evaluation and @ hour of therapy .


Upper extremity Fugl-Meyer Motor Assessment ( FMMA ) scores measured end-intervention at week @ and follow-up at week @ , online BCI accuracies from the evaluation part , and laterality coefficients of the electroencephalogram ( EEG ) from the therapy part of the @ rehabilitation sessions .


FMMA score improved in both groups at week @ , but no intergroup differences were found at any time points .


Online accuracies of the evaluation part from the tDCS group were significantly higher than those from the sham group .


The EEG laterality coefficients from the therapy part of the tDCS group were significantly higher than those of the sham group .


The results suggest a role for tDCS in facilitating motor imagery in stroke .


To date , the limited degrees of freedom ( DOF ) of most robotic training devices hinders them from providing functional training following stroke .


We developed a @-DOF exoskeleton ( `` BONES '' ) that allows movement of the upper limb to assist in rehabilitation .


The objectives of this pilot study were to evaluate the impact of training with BONES on function of the affected upper limb , and to assess whether multijoint functional robotic training would translate into greater gains in arm function than single joint robotic training also conducted with BONES .


Twenty subjects with mild to moderate chronic stroke participated in this crossover study .


Each subject experienced multijoint functional training and single joint training three sessions per week , for four weeks , with the order of presentation randomized .


The primary outcome measure was the change in Box and Block Test ( BBT ) .


The secondary outcome measures were the changes in Fugl-Meyer Arm Motor Scale ( FMA ) , Wolf Motor Function Test ( WMFT ) , Motor Activity Log ( MAL ) , and quantitative measures of strength and speed of reaching .


These measures were assessed at baseline , after each training period , and at a @-month follow-up evaluation session .


Training with the robotic exoskeleton resulted in significant improvements in the BBT , FMA , WMFT , MAL , shoulder and elbow strength , and reaching speed ( p < @ ) ; these improvements were sustained at the @ month follow-up .


When comparing the effect of type of training on the gains obtained , no significant difference was noted between multijoint functional and single joint robotic training programs .


However , for the BBT , WMFT and MAL , inequality of carryover effects were noted ; subsequent analysis on the change in score between the baseline and first period of training again revealed no difference in the gains obtained between the types of training .


Training with the @ DOF arm exoskeleton improved motor function after chronic stroke , challenging the idea that robotic therapy is only useful for impairment reduction .


The pilot results presented here also suggest that multijoint functional robotic training is not decisively superior to single joint robotic training .


This challenges the idea that functionally-oriented games during training is a key element for improving behavioral outcomes .


The aim of the present study was to compare vascular healing response between everolimus-eluting stent ( EES ) and biolimus-eluting stent ( BES ) using optical coherence tomography ( OCT ) .


In the NOBORI Biolimus-Eluting Versus XIENCE V/PROMUS Everolimus-Eluting Stent Trial ( NEXT ) , a formal OCT substudy investigated @ patients ( @ EES-treated lesions in @ patients and @ BES-treated lesions in @ patients ) with @-@ months follow-up imaging at @ centers .


A total of @ frames with @,@ struts in EES and @ frames with @,@ struts in BES were analyzed .


Mean neointima thickness in EES and BES was @m and @m , respectively ( P < @ ) .


With regard to stent-treated lesions , the percentage of struts not covered by neointima ( @ % vs. @ % , P < @ ) and the frequency of stent-treated lesions with any uncovered struts ( n = @ , @ % vs. n = @ , @ % ; P < @ ) were significantly lower in EES compared with BES .


In addition , the percentage of malapposed struts ( @ % vs. @ % , P = @ ) and the frequency of stent-treated lesions with any malapposed struts ( n = @ , @ % vs. n = @ , @ % ; P = @ ) were significantly lower in EES compared with BES .


Incomplete vascular healing characterized by the presence of struts not covered by neointima and malapposed struts was less common in EES compared with BES .


Pronase , a proteolytic enzyme , is known to improve mucosal visibility during esophagogastroduodenoscopy ( EGD ) , but little is known about its effects on gastric biopsy .


This study assessed whether endoscopic flushing with pronase improves the quality of gastric biopsy .


Consecutive patients who underwent EGD were randomly assigned to either the control group or the pronase group in a prospective setting .


The first biopsy of the identified lesion was performed during endoscopy .


Endoscopic flushing with either @mL of water and dimethylpolysiloxane ( DMPS ; control group ) or @mL of water , pronase , sodium bicarbonate , and DMPS ( pronase group ) was then applied to the lesion .


After @ minutes , the second biopsy was performed @-@mm away from the first biopsy site .


The thickness of mucus , depth of the specimen , overall diagnostic adequacy , anatomical orientation , and crush artifact were measured to assess the quality of the biopsy .


Of the @ patients , @ were not analyzed due to the absence of an identifiable lesion .


Compared with the control group , the pronase group showed significantly decreased thickness of mucus ( P < @ ) , increased depth of biopsy ( P < @ ) , improved anatomical orientation ( P = @ ) , and improved overall diagnostic assessment ( P = @ ) in the second biopsied specimen following endoscopic flushing .


The crush artifact and hemorrhage did not differ between the groups .


Endoscopic flushing with pronase not only improved the depth of biopsy but also the anatomical orientation and overall diagnostic adequacy .


Pronase can be recommended for flushing during EGD to improve the quantity and quality of biopsy .


The importance of adequate nutritional support is well established , but characterising what ` adequate nutrition ' represents remains contentious .


In recent years there has been increasing interest in the concept of ` permissive underfeeding ' where patients are intentionally prescribed less nutrition than their calculated requirements .


The aim of this study was to evaluate the effect of permissive underfeeding on septic and nutrition related morbidity in patients requiring short term parenteral nutrition ( PN ) .


This was a single-blinded randomised clinical trial of @ consecutive patients requiring parenteral nutritional support .


Patients were randomized to receive either normocaloric or hypocaloric feeding ( respectively @ % vs. @ % of estimated requirements ) .


The primary end point was septic complications .


Secondary end points included the metabolic , physiological and clinical outcomes to the two feeding protocols .


Permissive underfeeding was associated with fewer septic complications ( @ vs. @ patients ; p = @ ) , and a lower incidence of the systemic inflammatory response syndrome ( @ vs. @ patients ; p = @ ) .


Permissively underfed patients had fewer feed related complications ( @ vs. @ patients ; p = @ ) .


Permissive underfeeding in patients requiring short term PN appears to be safe and may results in reduced septic and feed-related complications .


Unlike conventional hemodialysis treatments , which rely almost solely on diffusion-related mechanisms for solute removal , hemodiafiltration ( HDF ) allows more efficient removal of higher molecular weight toxins due to convective transport mechanisms .


To facilitate the removal of these toxins in HDF treatment modalities , dialyzers with highly efficient high-flux membranes are necessary .


This study assessed the large uremic toxin removal ability of a high-flux dialyzer ( FX CorDiax @ ) specifically designed to facilitate convective therapies compared with a standard high-flux dialyzer ( FX @ ) .


In an open , randomized , cross-over , single-center , controlled , prospective clinical study , @ adult chronic hemodialysis patients were treated by post-dilution online HDF with the FX @ or the FX CorDiax @ dialyzer .


All other dialysis parameters were kept constant in both study arms .


The reduction rate ( RR ) of blood urea nitrogen , phosphate , @-microglobulin ( @-m ) , myoglobin , prolactin , @-microglobulin , @-acid glycoprotein , albumin and total protein as well as the elimination into dialysate was intraindividually compared for the two dialyzer types .


For FX CorDiax @ versus FX @ , the RR was significantly higher for blood urea nitrogen ( @ @ vs. @ @ % , p = @ ) , @-m ( @ @ vs. @ @ % , p < @ ) , myoglobin ( @ @ vs. @ @ % , p < @ ) , prolactin ( @ @ vs. @ @ % , p < @ ) and @-microglobulin ( @ @ vs. @ @ % , p = @ ) .


There were no significant differences in the RR for phosphate , @-acid glycoprotein , albumin and total protein .


Mass removal was significantly higher with the FX CorDiax @ than with the FX @ for @-m ( @ @ vs. @ @ g , p = @ ) , myoglobin ( @ @ vs. @ @ mg , p = @ ) , prolactin ( @ @ vs. @ @ mg , p = @ ) and albumin ( @ @ vs. @ @ g , p = @ ) .


This study demonstrates that treating patients with an FX CorDiax @ instead of an FX @ dialyzer in post-dilution HDF mode significantly increases the elimination of middle molecules .


Inflammation contributes to the development of peripheral artery disease ( PAD ) and may contribute to intermittent claudication by adversely affecting vascular and skeletal muscle function .


We explored the association of inflammation to maximal walking time ( MWT ) in patients with claudication .


Circulating inflammatory biomarkers , including tumor necrosis factor ( TNF - ) , C-reactive protein ( CRP ) , interleukin-@ ( IL-@ ) , and soluble intercellular adhesion molecule @ ( sICAM ) , were measured in @ subjects with intermittent claudication as well as in @ healthy subjects .


Real-time polymerase chain reaction was used to quantify mRNA expression of TNF - , IL-@ , interferon - , and CD@ from peripheral blood monocytes .


Treadmill testing was performed in PAD subjects to assess MWT .


Compared with healthy subjects , PAD subjects had higher levels of circulating TNF - ( P < @ ) , CRP ( P = @ ) , sICAM ( P < @ ) , and IL-@ ( P < @ ) .


Expression of both IL-@ ( P = @ ) and CD@ ( P = @ ) was greater in PAD subjects than in healthy subjects .


Among subjects with PAD , higher gene expression of TNF - was associated inversely with MWT ( P = @ ) .


MWT was also associated inversely with greater levels of circulating TNF - ( P = @ ) , CRP ( P = @ ) , IL-@ ( P = @ ) , and sICAM ( P = @ ) .


Systemic inflammation , as indicated by TNF - inflammatory gene expression in peripheral blood monocytes and by circulating biomarker levels , is associated with impairment in walking time in patients with PAD and intermittent claudication .


Weight gain and obesity are common after kidney transplantation , particularly during the first year .


Obesity is a risk factor for the development of new-onset diabetes after transplantation , and is associated with reduced graft survival .


There is a lack of evidence for effective interventions to prevent weight gain after kidney transplantation .


The effect of INTEnsive Nutrition interventions on weight gain after kidney Transplantation ( INTENT ) trial is a single-blind ( outcomes assessor ) , randomised controlled trial to assess the effect of intensive nutrition interventions , including exercise advice , on weight gain and metabolic parameters in the first year after transplantation .


Participants will be randomised during the first post-transplant month to either standard care ( four visits with a renal dietitian over twelve months ) or intensive nutrition intervention ( eight visits with a renal dietitian over the first six months , four visits over the second six months , and three visits over the first six months with an exercise physiologist ) .


In the intensive intervention group , nutrition counselling will be provided using motivational interviewing techniques to encourage quality engagement .


Collaborative goal setting will be used to develop personalised nutrition care plans .


Individualised advice regarding physical activity will be provided by an exercise physiologist .


The primary outcome of the study is weight at six months after transplant , adjusted for baseline ( one month post-transplant ) weight , obesity and gender .


Secondary outcomes will include changes in weight and other anthropometric measures over @ months , body composition ( in vivo neutron activation analysis , total body potassium , dual-energy X-ray absorptiometry , and bioelectrical impedance ) , biochemistry ( fasting glucose , lipids , haemoglobin A@c and insulin ) , dietary intake and nutritional status , quality of life , and physical function .


There are currently few randomised clinical trials of nutrition interventions after kidney transplantation .


The INTENT trial will thus provide important data on the effect of intensive nutrition interventions on weight gain after transplant and the associated metabolic consequences .


Additionally , by assessing changes in glucose metabolism , the study will also provide data on the feasibility of undertaking larger multi-centre trials of nutrition interventions to reduce the incidence or severity of diabetes after transplantation .


Between @,@ and @,@ pregnant women die annually from pre-eclampsia and eclampsia .


Although magnesium sulphate and anti-hypertensive therapies can reduce the morbidity and mortality associated with pre-eclampsia , the only cure comes with delivery .


Prompt delivery of the baby , preferably by vaginal route , is vital in order to achieve good maternal and neonatal outcomes .


Induction of labour is therefore a critical intervention in order to prevent morbidity to both mother and baby .


Two low cost interventions - oral misoprostol tablets and transcervical Foley catheterization - are already used by some in low resource settings , but their relative risks and benefits are not known .


The trial will compare the risks , benefits , and trade-offs in efficacy , safety , acceptability and cost of misoprostol and Foley catheter for induction in women with preeclampsia or uncontrolled hypertension .


A total of @ women with an ongoing pregnancy with a live fetus requiring delivery because of pre-eclampsia or uncontrolled hypertension will be randomly assigned to labor induction with a transcervical Foley catheter or oral misoprostol @ micrograms .


Women will be recruited at two hospitals in Nagpur , India .


The misoprostol group will receive oral misoprostol @ microgram every @ hours for a maximum of @ doses or until active labor commences .


The Foley group will undergo induction using a Foley catheter ( silicone , size @ F with @ ml balloon ) which will remain until active labor starts , the Foley catheter falls out , or @ hours have elapsed .


The primary outcome will be the attainment of vaginal delivery within @ hours .


Providers administering the treatment and those assessing the outcomes will not be blinded to group assignment .


Tobacco cessation treatments have not been evaluated among Alaska Native ( AN ) adolescents .


This pilot study evaluated the feasibility and the potential efficacy of a targeted cessation intervention for AN youth using a group randomized design .


Eight villages in western Alaska were randomly assigned to receive the intervention ( n = @ villages ) or a delayed treatment control condition ( written materials only ; n = @ villages ) .


Ten adolescents aged @-@ years were targeted from each village with a planned enrollment of @ .


The intervention was held over a weekend , and youth traveled from their villages to quit tobacco use with other teens .


The intervention comprised @ hr of group-based counseling .


Talking circles , personal stories from elders , and recreational activities were included to enhance cultural acceptability and participation .


Newsletters were mailed weekly for @-weeks postprogram .


Assessments were conducted at baseline , week @ ( end-of-treatment ) , and @ months .


Self-reported tobacco abstinence was confirmed with salivary cotinine .


Recruitment targets were met in the intervention ( @ enrolled ) but not in control villages ( @ enrolled ) .


All intervention participants attended the weekend program .


Retention was high ; @ % of intervention and @ % of control participants completed @-month follow-up .


The @-day point-prevalence self-reported tobacco abstinence rates for intervention and control participants were @ % ( @/@ ) and @ % ( @/@ ) at both week @ and @ months ( p = @ ) .


Only @ adolescent in the intervention condition was biochemically confirmed abstinent at week @ and none at @ months .


The intensive individual-focused intervention used in this study was feasible but not effective for tobacco cessation among AN youth .


Alternative approaches are warranted .


The aim of this study was to verify the effects of loaded exercises associated with a task-oriented training ( TOT ) program in the recovery of upper-limb function in individuals with chronic hemiparesis after stroke .


This study used a single-blinded , randomized controlled trial .


Patients were included into two TOT groups : one that performed the task-oriented therapy without load ( TOT group , n = @ ) and another one that performed task-oriented therapy with personalized resistance ( TOT_ST group , n = @ ) for @ wks , for a total of @ sessions .


Main measures included The Upper Extremity Performance Test , shoulder flexor and handgrip strength , shoulder active range of motion , motor impairment ( Fugl-Meyer Scale ) , and muscle tone .


The TOT_ST group demonstrated better scores relating to unilateral tasks and in the quality aspects of bilateral movements ( The Upper Extremity Performance Test , P = @ ) at the end of rehabilitation protocol .


The highest muscle force gain was reached by the TOT_ST group for the shoulder flexors ( P = @ ) .


Similarly , the active range of motion ( P = @ ) and Fugl-Meyer scores ( P = @ ) were higher in the TOT_ST group compared with the TOT group .


Both groups showed improvement after training .


Strength training was able to intensify the upper-limb rehabilitation , as demonstrated by the superior scores achieved by the TOT_ST group in most of the evaluated parameters .


Muscle strength training might be a pivotal element of the task-oriented rehabilitation program of chronic patients with mild impairment after stroke .


Constipation is a frequent complaint and the combination of a prebiotic and probiotics could have a potentially synergic effect on the intestinal transit .


The present study therefore aims to investigate the combination of polydextrose ( Litesse ) , L. acidophilus NCFM and B. lactis HN@ in a yogurt on intestinal transit in subjects who suffer from constipation .


Patients with constipation were randomly divided into two groups , Control Group ( CG ) and Treatment Group ( TG ) , and had to eat @ ml of unflavored yogurt every morning for @ days .


Those in the CG received only yogurt , while the TG received yogurt containing polydextrose , L. acidophilus NCFM ( ATCC @ ) and B. lactis HN@ ( AGAL NM@/@ ) .


Favourable clinical response was assessed since Agachan score had a significant reduction at the end of the study in both groups and tended to be better in the TG .


The subjects in the treatment group also had a shorter transit time at the end of the intervention compared to the control group ( p = @ ) .


The product containing yogurt with polydextrose , B. lactis HN@ and L. acidophilus NCFM significantly shortened colonic transit time after two weeks in the TG compared to CG and may be an option for treatment of constipation .


Hepatocellular carcinoma ( HCC ) is a primary tumor of the liver with poor prognosis .


For early stage HCC , treatment options include surgical resection , liver transplantation , and percutaneous ablation .


Percutaneous ablative techniques ( radiofrequency and microwave techniques ) emerged as best therapeutic options for nonsurgical patients .


We aimed to determine the safety and efficacy of radiofrequency and microwave procedures for ablation of early stage HCC lesions and prospectively follow up our patients for survival analysis .


One Hundred and @ patients with early HCC are managed in our multidisciplinary clinic using either radiofrequency or microwave ablation .


Patients are assessed for efficacy and safety .


Complete ablation rate , local recurrence , and overall survival analysis are compared between both procedures .


Radiofrequency ablation group ( n = @ ) and microwave ablation group ( n = @ ) were nearly comparable as regards the tumor and patients characteristics .


Complete ablation was achieved in @ and @ % of patients managed by radiofrequency and microwave ablation techniques , respectively ( p value @ ) with a low rate of minor complications ( @ and @ , respectively ) including subcapsular hematoma , thigh burn , abdominal wall skin burn , and pleural effusion .


Ablation rates did not differ between ablated lesions @ and @-@ cm .


A lower incidence of local recurrence was observed in microwave group ( @ vs. @ % in radiofrequency group , p value @ ) .


No difference between both groups as regards de novo lesions , portal vein thrombosis , and abdominal lymphadenopathy .


The overall actuarial probability of survival was @ % at @ year and @ % at @ years with a higher survival rates noticed in microwave group but still without significant difference ( p value @ ) .


Radiofrequency and microwave ablations led to safe and equivalent ablation and survival rates ( with superiority for microwave ablation as regards the incidence of local recurrence ) .


Cooking with Kids ( CWK ) , an experiential school-based food education program , has demonstrated modest influence on fruit and vegetable preference , food and cooking attitudes ( AT ) , and self-efficacy ( SE ) among fourth-grade , mostly low-income Hispanic students in a quasiexperimental study with an inconsistent baseline .


Effect was notably strong for boys and those without previous cooking experience .


The aim of this project was to assess the effect of CWK with a mostly non-Hispanic white sample that assured no previous CWK exposure .


The randomized , controlled assessment of CWK effect on fourth graders was conducted with @ students in @ classes in four public schools .


CWK included a @-hour introductory lesson , three @-hour cooking classes , and three @-hour fruit and vegetable tasting sessions led by trained food educators during the school day for one semester .


Fruit preference , vegetable preference , and cooking AT and SE were assessed with a tested @-item measure , shown to have test-retest reliability .


Univariate analyses considered gender and previous cooking experience .


Intervention efficacy was confirmed in this mostly white sample ( @ % ; @ % with previous cooking experience ; @ % girls ) .


Increases in vegetable preference , AT , and SE were all significantly greater in CWK students with p ( @ ) of @ , @ , and @ , respectively .


CWK most strongly improved AT and SE for boys without previous cooking experience .


CWK significantly improved fourth-grade students ' vegetable preferences , AT , and SE toward food and cooking , which are factors important to healthful eating and obesity prevention .


Noncookers , especially boys , benefitted from this intervention .


Buruli Ulcer ( BU ) is a tropical infectious skin disease that is currently treated with @ weeks of intramuscular streptomycin and oral rifampicin .


As prolonged streptomycin administration can cause both oto - and nephrotoxicity , we evaluated its long term toxicity by following-up former BU patients that had received either @ or @ weeks of streptomycin in addition to other drugs between @ and @ , in the context of a randomized controlled trial .


Former patients were retrieved in @ , and oto - and nephrotoxicity were determined by audiometry and serum creatinine levels .


Data were compared with baseline and week @ measurements during the drug trial .


Of the total of @ former patients , @ ( @ % ) were retrieved .


Ototoxicity was present in @ % of adults and @ % of children .


Adults in the @ week streptomycin group had significantly higher hearing thresholds in all frequencies at long term follow-up , and these differences were most prominent in the high frequencies .


In children , no differences between the two treatment arms were found .


Nephrotoxicity that had been detected in @ % of adults and in @ % of children during treatment , was present in only @ % of patients at long term follow-up .


Prolonged streptomycin administration in the adult study subjects caused significant persistent hearing loss , especially in the high frequency range .


Nephrotoxicity was also present in both adults and children but appeared to be transient .


Streptomycin should be given with caution especially in patients aged @ or older , and in individuals with concurrent risks for renal dysfunction or hearing loss .


Basal cell carcinoma ( BCC ) is the most common form of cancer among Caucasians and its incidence continues to rise .


Surgical excision ( SE ) is considered standard treatment , though randomised trials with long-term follow-up are rare .


We now report the long-term results of a randomised trial comparing surgical excision with Mohs ' micrographic surgery ( MMS ) for facial BCC .


@ facial , high risk ( diameter at least @cm , H-zone location or aggressive histological subtype ) primary BCCs ( pBCCs ) and @ facial recurrent BCCs ( rBCCs ) were randomly allocated to treatment with either SE or MMS between @th October @ and @th February @ .


The primary outcome was recurrence of carcinoma .


A modified intention to treat analysis was performed .


For primary BCC , the @-year cumulative probabilities of recurrence were @ % after MMS and @ % after SE ( Log-rank test ( @ ) @ , p = @ ) .


For recurrent BCC , cumulative @-year recurrence probabilities were @ % and @ % for MMS and SE , respectively ( Log-rank ( @ ) @ , p = @ ) .


A substantial proportion of recurrences occurred after more than @years post-treatment : @ % for pBCC and @ % for rBCC .


Fewer recurrences occurred after treatment of high risk facial BCC with MMS compared to treatment with SE .


The proportion of recurrences occurring more than @years post-treatment was especially high for pBCC , stressing the need for long-term follow-up in patients with high risk facial pBCC .


To evaluate the pharmacokinetic and pharmacodynamic ( PK/PD ) results of three different infusion time regimens of single doses of @ mg linezolid in healthy Han Chinese volunteers .


We conducted a clinical trial involving @ male and @ female healthy Chinese volunteers .


They were randomized to receive intravenous linezolid infusion ( @ mg/@ @ hours , @ mg/@ hours , or @ mg/@ hours ) in three periods with washout periods of @ days between each dosage .


Serum linezolid concentration was measured in each subject at pre-dose ( at @ hours ) until @ hours after each dose .


The ratio of the area under the serum concentration-time curve ( AUC ) to the minimum inhibitory concentration ( MIC ) , AUC/MIC , was adopted as the major relevant parameter .


Monte Carlo simulation was used to evaluate the probability of target attainment ( PTA ) of these three linezolid regimens .


One subject in @ mg/@ @ hours regimen complained of mild pain at the injection site .


No significant difference was found in pharmacokinetic parameters among the three different infusion regimens .


When AUC/MIC was applied as parameter , PTA of @ hours infusion regimen was much lower than that of the @ hours and @ hours infusion regimens ( @ % vs. @ % and @ % , respectively ) .


Especially at higher MIC ( @ g/mL ) , the PTAs of the @ hours and @ hours infusion regimens decreased to @ % and @ % , respectively , while that of the @ hours infusion regimen dropped sharply to only @ % .


When T > MIC was applied as a parameter , PTA of the @ hours regimen was higher than @ % , while the @ hours and @ hours regimens remained @ % .


Our findings suggest that @ hours infusion of linezolid at a fixed dose ( @ mg ) regimen is appropriate to achieve the safety and efficacy against MRSA-caused infections in Chinese adults .


To evaluate the effectiveness of @ mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour .


Multicentre , randomised , double-blind , placebo-controlled trial .


Twenty-nine centres in Switzerland and Argentina .


A total of @ women with preterm labour ( @ ( @/@ ) to @ ( @/@ ) weeks of gestation ) treated with acute tocolysis .


Participants were randomly allocated to either @ mg daily of self-administered vaginal progesterone or placebo within @ hours of starting acute tocolysis .


Primary outcome was delivery before @ weeks of gestation .


Secondary outcomes were delivery before @ and @ weeks , adverse effects , duration of tocolysis , re-admissions for preterm labour , length of hospital stay , and neonatal morbidity and mortality .


The study was ended prematurely based on results of the intermediate analysis .


Preterm birth occurred in @ % of women in the progesterone group versus @ % in the placebo group ( relative risk -LSB- RR -RSB- @ ; @ % confidence interval -LSB- @ % CI -RSB- @-@ @ ) .


Delivery at < @ and < @ weeks did not differ between the two groups ( @ versus @ % ; -LSB- RR @ ; @ % CI @-@ @ -RSB- and @ versus @ % -LSB- RR @ ; @ % CI @-@ @ -RSB- , respectively ) .


The duration of tocolysis , hospitalisation , and recurrence of preterm labour were comparable between groups .


Neonatal morbidity occurred in @ ( @ % ) cases on progesterone versus @ ( @ % ) cases on placebo ( RR : @ ; @ % CI @-@ @ ) , whereas there were @ ( @ % ) neonatal deaths in each study group .


There is no evidence that the daily administration of @ mg vaginal progesterone decreases preterm birth or improves neonatal outcome in women with preterm labour .


Competency-based education and simulation are being used more frequently in surgical skills curricula .


We explored a novel student-led learning paradigm , which allows trainees to become more active participants in the learning process while maintaining expert guidance and supervision .


Twelve first-year orthopedic residents were randomized to either a student-led ( SL ) or a traditional instructor-led group during an intensive , month-long , laboratory-based technical skills training course .


A rigorous qualitative-description approach was used for analysis .


Four prominent themes emerged : instructional style , feedback , peer and instructor collaboration , and self-efficacy .


Compared with the instructor-led group , there was more peer assistance , feedback , collaboration , and hands-on and active learning observed in the SL group .


The flexible and socially rich nature of the SL learning environment may aid in development of both technical and nontechnical skills early in residency and ultimately privilege later clinical learning .


A low-cost virtual reality system that translates movements of the hand , fingers , and thumb into game play was designed to provide a flexible and motivating approach to increasing adherence to home-based rehabilitation .


Effectiveness depends on adherence , so did patients use the intervention to the recommended level ?


If not , what reasons did they give ?


The purpose of this study was to investigate these and related questions .


A prospective cohort study , plus qualitative analysis of interviews , was conducted .


Seventeen patients recovering from stroke recruited to the intervention arm of a feasibility trial had the equipment left in their homes for @ weeks and were advised to use it @ times a day for periods of no more than @ minutes .


Frequency and duration of use were automatically recorded .


At the end of the intervention , participants were interviewed to determine barriers to using it in the recommended way .


Duration of use and how many days they used the equipment are presented for the @ participants who successfully started the intervention .


These figures were highly variable and could fall far short of our recommendations .


There was a weak positive correlation between duration and baseline reported activities of daily living .


Participants reported lack of familiarity with technology and competing commitments as barriers to use , although they appreciated the flexibility of the intervention and found it motivating .


The small sample size limits the conclusions that can be drawn .


Level of use is variable and can fall far short of recommendations .


Competing commitments were a barrier to use of the equipment , but participants reported that the intervention was flexible and motivating .


It will not suit everyone , but some participants recorded high levels of use .


Implications for practice are discussed .


To determine the effect of choice of inhalational anaesthetic ( sevoflurane vs propofol ) on the incidence and severity of postoperative cognitive dysfunction ( POCD ) in elderly patients ( aged @ years ) with mild cognitive impairment ( MCI ) .


Elderly patients with MCI undergoing radical rectal resection were randomly assigned to receive sevoflurane or propofol general anaesthesia .


Cognitive function was assessed using neuropsychological testing before and @ days after surgery .


POCD severity was graded as mild , moderate or severe using standard deviation cut-offs .


At @ days after surgery , the incidence of POCD was @ % in the propofol group ( n = @ ) and @ % in the sevoflurane group ( n = @ ) .


There was a signicant between-group difference for POCD severity : sevoflurane anaesthesia had a more severe impact on cognitive function than propofol anaesthesia .


There was no difference in the incidence of POCD at @ days after radical rectal resection under sevoflurane or propofol-based general anaesthesia .


Both propofol and sevoflurane were associated with negative cognitive effects , but sevoflurane had a more severe impact on cognitive function than propofol , in elderly patients with MCI .


To compare the safety and efficacy of sedation induced by dexmedetomidine and propofol after oral and maxillofacial surgery .


In this trial , @ patients @ to @ years old received oral and maxillofacial surgery and required postoperative nasal endotracheal intubation under overnight sedation with dexmedetomidine or propofol .


The dexmedetomidine group ( group D ) received dexmedetomidine @ g/kg intravenously for @ minutes after entering the recovery room .


The dose was maintained by giving an intravenous injection of dexmedetomidine @ g/kg .


The injection rate could be modulated from @ to @ g/kg/hour in the intensive care unit ( ICU ) .


If the Ramsay score was lower than @ and involuntary limb movement occurred , other sedatives were used .


The propofol group ( group P ) was given propofol @ mg/kg intravenously for @ minutes after entering the recovery room and then maintained with intravenous injections of propofol @ to @ mg/kg/hour in the recovery room and ICU .


The oxygen desaturation of group P was higher than that of group D ( at the first sedation time of @ minutes ) , but the mean blood pressure of group P was significantly lower than that of group D at the @-minute time point .


The Ramsay score was higher in group D after the first @ hours of sedation than in group P ( P < @ ) .


Dexmedetomidine showed similar safety and efficacy as propofol and could be used for tube-retaining sedation after oral and maxillofacial surgery .


This study sought to prospectively study the impact of an appropriate use criteria ( AUC ) - based educational intervention on outpatient transthoracic echocardiography ( TTE ) ordering by physicians-in-training .


AUC were developed in response to concerns about inappropriate utilization .


It is unknown whether an educational intervention can reduce inappropriate outpatient TTE .


We conducted a randomized control trial in which physicians-in-training were randomized to an AUC-based educational intervention or a control group at an academic medical center in Boston , Massachusetts .


The primary endpoints were the rates of inappropriate and appropriate TTE .


For the cardiology physicians-in-training , the proportion of inappropriate TTE was significantly lower in the intervention than in the control group ( @ % vs. @ % , p < @ ) .


As a corollary , the proportion of appropriate TTE ordered by the intervention group was significantly higher than that of the control group ( @ % vs. @ % , p < @ ) .


The odds of ordering an appropriate TTE in the cardiology intervention group was @ ( @ % confidence interval -LSB- CI -RSB- : @ to @ , p = @ ) relative to the control group .


The internal medicine physicians-in-training ordered a small number of TTE overall , and there was a trend toward significant odds of ordering an appropriate TTE in the intervention group relative to the control group ( odds ratio -LSB- OR -RSB- : @ , @ % CI : @ to @ , p = @ ) .


Six clinical scenarios accounted for @ % of all inappropriate TTE , with the @ most common inappropriate indications being routine surveillance ( < @ year ) of known cardiomyopathy without a change in clinical status , routine surveillance of known small pericardial effusion , and routine surveillance of ventricular function with known coronary artery disease and no change in clinical status .


In cardiology fellows with a high rate of ordering inappropriate TTE , an AUC-based educational and feedback intervention reduced the proportion of inappropriate outpatient TTE and increased the proportion of appropriate outpatient TTE .


( Educational Intervention to Reduce Outpatient Inappropriate Transthoracic Echocardiograms ; NCT@ ) .


In patients receiving inhaled medication , dissatisfaction with and difficulty in using the inhaler can affect treatment adherence .


The incidence of handling errors is typically higher in the elderly than in younger people .


The aim of the study was to assess inhaler preference for and handling errors with the ELLIPTA dry powder inhaler ( DPI ) , ( GSK ) , compared with the established BREEZHALER , a single-dose capsule DPI ( Novartis ) , in inhalation device-nave Japanese volunteers aged @ years .


In this open-label , nondrug interventional , crossover DPI preference study comparing the ELLIPTA DPI and BREEZHALER , @ subjects were randomized to handle the ELLIPTA or BREEZHALER DPIs until the point of inhalation , without receiving verbal or demonstrative instruction ( first attempt ) .


Subjects then crossed over to the other inhaler .


Preference was assessed using a self-completed questionnaire .


Inhaler handling was assessed by a trained assessor using a checklist .


Subjects did not inhale any medication in the study , so efficacy and safety were not measured .


The ELLIPTA DPI was preferred to the BREEZHALER by @ % of subjects ( odds ratio -LSB- OR -RSB- @ , @ % confidence interval -LSB- CI -RSB- @-@ @ ; P-value not applicable for this inhaler ) for ease of use , by @ % of subjects ( OR @ , CI @-@ @ ; P < @ ) for ease of determining the number of doses remaining in the inhaler , by @ % for number of steps required , and by @ % for time needed for handling the inhaler .


The BREEZHALER was preferred to the ELLIPTA DPI for comfort of the mouthpiece by @ % of subjects ( OR @ , CI @-@ @ ; P < @ ) .


The incidence of handling errors ( first attempt ) was @ % with ELLIPTA and @ % with BREEZHALER ; differences in incidence were generally similar when analyzed by age ( < or @ years ) or sex .


These data , obtained in an inhalation device-nave population , suggest that the ELLIPTA DPI is preferred to an established alternative based on its ease-of-use features and is associated with fewer handling errors .


To compare the clinical results and the intraoperative and postoperative performance of an additional sulcus-fixated multifocal intraocular lens ( IOL ) with a conventional multifocal IOL implanted in the capsular bag .


In this prospective , randomised , monocentric study , the intraoperative and postoperative outcomes after implantation of an additional sulcus-fixated multifocal IOL ( group A ; @ eyes ) and a conventional , multifocal posterior chamber IOL ( group B ; @ eyes ) are compared .


@-year postoperatively , visual acuity , contrast sensitivity and defocus curve were determined .


Patients implanted bilaterally with the same IOL filled in a questionnaire to assess patient satisfaction .


Between the groups , only slight differences were found in visual acuity at all distances .


All patients achieved an uncorrected distance visual acuity of @ LogMAR or better and an uncorrected intermediate/near visual acuity of @ LogMAR or better .


Slightly better results in contrast sensitivity were achieved in group A at high spatial frequencies under almost all lighting conditions .


Patient survey showed a higher degree of satisfaction of patients in group B , while a smaller proportion of group A stated to have disturbing light phenomena .


Only small functional differences between the examined methods were found .


Both types of multifocal IOL performed well at all distances .


There were no intraoperative and postoperative complications in the add-on IOL group which affirms the high safety level such as with conventional multifocal IOL in the capsular bag .


We performed a pooled analysis based on patient-level data from the TITAX-AMI and BASE-ACS trials to evaluate the outcome of titanium-nitride-oxide-coated bioactive stents vs drug-eluting stents in patients with ST-segment elevation myocardial infarction at @-year follow-up .


The TITAX-AMI trial compared bioactive stents with paclitaxel-eluting stents in @ patients with acute myocardial infarction .


The BASE-ACS trial compared bioactive stents with everolimus-eluting stents in @ patients with acute coronary syndrome .


The primary endpoint for the pooled analysis was major adverse cardiac events : a composite of cardiac death , recurrent myocardial infarction , or ischemia-driven target lesion revascularization at @-year follow-up .


The pooled analysis included @ patients ; @ received bioactive stents , and @ received drug-eluting stents .


The pooled bioactive stent group was associated with a risk ratio of @ for major adverse cardiac events ( @ % confidence interval , @-@ @ ; P = @ ) compared to the pooled drug-eluting stent group .


Similarly , the pooled bioactive stent group was associated with a risk ratio of @ for cardiac death ( @ % confidence interval , @-@ @ ; P = @ ) , @ for recurrent myocardial infarction ( @ % confidence interval , @-@ @ ; P = @ ) , and @ for ischemia-driven target lesion revascularization ( @ % confidence interval , @-@ @ ; P = @ ) , compared to the pooled drug-eluting stent group .


These results were confirmed by propensity-score adjusted analysis of the combined datasets .


In patients with ST-segment elevation myocardial infarction , bioactive stents were associated with lower rates of recurrent myocardial infarction compared to drug-eluting stents at @-year follow-up ; yet , the rates of cardiac death and ischemia-driven target lesion revascularization were similar .


Dissemination of research results to study participants and stakeholders and provision of proven effective products in the immediate post-trial period are core elements of the conduct of biomedical HIV prevention clinical trials .


Few biomedical HIV prevention trials have demonstrated HIV protection with novel interventions , and thus , communication of positive trial results and provision of an effective product have not been tested in many situations .


In July @ , the independent Data and Safety Monitoring Board of the Partners PrEP Study , a randomized , placebo-controlled efficacy trial of daily oral antiretroviral preexposure prophylaxis ( PrEP ) for HIV prevention among @ African heterosexual HIV serodiscordant couples , recommended discontinuation of the trial 's placebo arm due to demonstration of PrEP efficacy .


We describe dissemination of results , discontinuation of the placebo arm , and provision of active PrEP to participants ' formerly assigned placebo .


Within @ hours , of the Data and Safety Monitoring Board meeting the study results were publicly released and disseminated to stakeholders and study participants .


Within @ months , the study protocol was modified to permit participants initially assigned to the study 's placebo arm to be offered active PrEP .


Of the @ participants initially randomized to placebo who were clinically eligible to receive PrEP , @ % ( @/@ ) consented .


Prompt dissemination of a positive HIV prevention trial result and subsequent provision of effective product to research participants was feasible and efficient for > @ HIV serodiscordant couples in East Africa .


The extent to which study sponsors can assure continued product access to research participants remains a subject of discussion for future HIV prevention clinical trials .


To evaluate the heating and magnetic field interactions of fixed orthodontic appliances with different wires and ligaments in a @-T MRI environment and to estimate the safety of these orthodontic materials .


@ non-carious extracted human maxillary teeth were embedded in polyvinyl chloride boxes , and orthodontic brackets were bonded .


Nickel-titanium and stainless steel arch wires , and elastic and stainless steel ligaments were used to obtain four experimental groups in total .


Specimens were evaluated at @T for radiofrequency heating and magnetic field interactions .


Radiofrequency heating was evaluated by placing specimens in a cylindrical plastic container filled with isotonic solution and measuring changes in temperature after T@ weighted axial sequencing and after completion of all sequences .


Translational attraction and torque values of specimens were also evaluated .


One-way ANOVA test was used to compare continuous variables of temperature change .


Significance was set at p < @ .


None of the groups exhibited excessive heating ( highest temperature change : < @ C ) , with the maximum increase in temperature observed at the end of the T@ weighted axial sequence .


Magnetic field interactions changed depending on the material used .


Although the brackets presented minor interactions that would not cause movement in situ , nickel-titanium and stainless steel wires presented great interactions that may pose a risk for the patient .


The temperature changes of the specimens were considered to be within acceptable ranges .


With regard to magnetic field interactions , brackets can be considered `` MR safe '' ; however , it would be safe to replace the wires before MRI .


To observe differences of clinical therapeutic effects between deep-oblique acupuncture with long needle and regular perpendicular acupuncture at Guanyuan ( CV @ ) for urinary retention to explore standard acupuncture method in clinic .


One hundred and thirty-two cases of urinary retention were randomly divided into an observation group ( @ cases ) and a control group ( @ cases ) .


Needles with @ mm in length were deeply and obliquely inserted into Guanyuan ( CV @ ) in the observation group while needles with @ mm in length were perpendicularly inserted .


Clinical therapeutic effects in two groups were observed .


After treatment the total effective rate was @ % ( @/@ ) in the observation group and @ % ( @/@ ) in the control group , which had significant difference between two groups ( P < @ ) .


The curative effect of postpartum retention of urine was obviously superior to that of postoperative and prostate-induced urinary retention in the ebservation group , and the effect of urinary retention due to different etiology in the observation was also superior to that in the control group in the ebservation group -LSB- in the observation group total effective rate was @ % ( @/@ ) in postpartum retention of urine , @ % ( @/@ ) in prostate-induced urinary retention and @ % ( @/@ ) in orthopedic postoperative retention of urine while in the control group total effective rate was @ % ( @/@ ) in postpartum retention of urine , @ % ( @/@ ) in prostate-induced urinary retention and @ % ( @/@ ) in orthopedic postoperative retention of urine ) -RSB- .


The deep-oblique acupuncture with long needle at Guanyuan ( CV @ ) has significant curative effect on urinary retention in clinic , especially for patients with postpartum urinary retention , which could be taken as standard acupuncture method .


Knee osteoarthritis is a major cause of disability in the aging population .


Based on pathological , magnetic resonance imaging ( MRI ) and arthroscopy studies , progressive osteoarthritis involves all tissues of the joint and includes bone marrow lesions , synovial proliferation , fat pad inflammation , and high subchondral bone turnover .


Recent research suggests that abnormal perfusion in bone marrow lesions , fat pads , and subchondral bone is associated with pain in knee osteoarthritis , and that dynamic contrast-enhanced MRI is a promising method for studying micro-perfusion alteration in knee osteoarthritis .


Traditional Chinese Medicine approaches have been employed for thousands of years to relieve knee osteoarthritis pain .


Among herbal medicines , the Jingui external lotion is the preferred and most commonly used method in China to reduce pain in patients with knee osteoarthritis ; however , there is a lack of validated evidence for its effectiveness .


The purpose of this study is to explore the effectiveness of Jingui external lotion for the management of painful knee osteoarthritis in a short-term study .


In addition , we will assess micro-perfusion alteration in the patellar fat pad as well as the femur and tibia subchondral bone via dynamic contrast-enhanced MRI .


This trial is a randomized , controlled study .


A total of @ patients will be randomized into the following two groups : @ ) the Jingui external lotion group ( treatment group ) ; and @ ) the placebo lotion group ( control group ) .


In both groups , lotion fumigation and external washing of the patients ' knees will be administered twice a day for @ consecutive days .


Follow-up will be at regular intervals during a @-week period with a visual analog scale to assess pain , and additional characterization with the Western Ontario and McMaster Universities Index score ; rescue medication will be recorded as the extent and time pattern .


In addition , micro-perfusion alteration in the patellar fat pad , femur and tibia subchondral bone will be assessed via dynamic contrast-enhanced MRI .


This study will provide clinical evidence of the efficacy of Jingui external lotion in treating knee osteoarthritis , and it will be the first randomized controlled trial to investigate micro-perfusion alteration of knee osteoarthritis with Traditional Chinese Medicine external lotion via dynamic contrast-enhanced MRI .


Reports of prevalence of spinal pain indicate the prevalence of thoracic pain in approximately @ % of the general population compared to @ % of the population with neck pain and @ % of the population with low back pain during the past year .


Even though , thoracic pain is less common than neck or low back pain , the degree of disability resulting from thoracic pain disorders seems to be similar to other painful conditions .


Interventions in managing chronic thoracic pain are also less frequent , leading to the paucity of literature about various interventions in managing chronic thoracic pain .


Thoracic intervertebral discs and thoracic facet joints have been shown to be pain generators , even though thoracic radicular pain is very infrequent .


Thoracic epidural injections are one of the commonly performed procedures in managing thoracic pain .


The efficacy of thoracic epidural injections has not been well studied .


A randomized , double-blind , active controlled trial .


Private interventional pain management practice and specialty referral center in the United States .


The primary objective was to assess the effectiveness of thoracic interlaminar epidural injections in providing effective pain relief and improving function in patients with chronic mid and/or upper back pain .


One hundred and ten patients were randomly assigned into @ groups with @ patients in each group receiving either local anesthetic alone ( Group I ) or local anesthetic with steroids ( Group II ) .


Randomization was performed by computer-generated random allocation sequence by simple randomization .


Outcomes were assessed utilizing Numeric Rating Scale ( NRS ) , the Oswestry Disability Index ( ODI ) @ , employment status , and opioid intake .


The patients experiencing greater than @ weeks of significant improvement with the first @ procedures were considered as successful .


Others were considered as failed participants .


Significant improvement was defined as a decrease of greater than @ % NRS scores and ODI scores with measurements performed at baseline , @ , @ , @ , @ , and @ months post treatment .


Significant improvement was seen in @ % in Group I and @ % in Group II at the end of @ years with all participants ; however , improvement was seen in @ % and @ % when only successful patients were considered .


Therapeutic procedural characteristics showed @ to @ procedures per @ years with total average relief of @ weeks in Group I and @ weeks in Group II in the successful patient category ; whereas , it was @ and @ weeks when all patients were considered .


Limitations of this assessment include lack of a placebo group .


Based on the results of this trial , it is concluded that chronic thoracic pain of non-facet joint origin may be managed conservatively with thoracic interlaminar epidural injections with or without steroids .


Falls are common in older people and are associated with substantial health-care costs .


A recent randomized controlled trial of a multifaceted podiatric medical intervention demonstrated a @ % reduction in the fall rate over @ months .


We evaluated the acceptability of and levels of satisfaction with this intervention in the older people who participated in the trial .


Participants allocated to the intervention group ( which included a home-based program of foot and ankle exercises , assistance with the purchase of safe footwear when necessary , and provision of prefabricated foot orthoses ) completed a structured questionnaire @ months after they had received the intervention .


The questions addressed participants ' perceptions of their balance and foot and ankle strength , the perceived difficulty of the exercise program , and the degree of satisfaction with the footwear and orthoses provided .


Of @ participants , @ ( @ % ) attended the @-month follow-up assessment and completed the questionnaire .


Most participants perceived improvements in balance ( @ % ) and foot and ankle strength ( @ % ) after @ months of performing the exercises , and @ % considered the difficulty level of the exercises to be `` about right . ''


Most participants reported that they were somewhat or very satisfied with the footwear ( @ % ) and orthoses ( @ % ) provided .


The multifaceted podiatric medical intervention used in this trial was generally perceived to be beneficial and demonstrated high levels of satisfaction among participants .


Further research is now required to evaluate the feasibility of implementing the intervention in a range of clinical practice settings .


The effect of teaching crisis resource management skills on the resuscitation performance of pediatric residents is unknown .


The primary objective of this pilot study was to determine if teaching crisis resource management to residents leads to improved clinical and crisis resource management performance in simulated pediatric resuscitation scenarios .


A prospective , randomized control pilot study .


Simulation facility at tertiary pediatric hospital .


Junior pediatric residents .


Junior pediatric residents were randomized to @ hour of crisis resource management instruction or no additional training .


Time to predetermined resuscitation tasks was noted in simulated resuscitation scenarios immediately after intervention and again @ months post intervention .


Crisis resource management skills were evaluated using the Ottawa Global Rating Scale .


Fifteen junior residents participated in the study , of which seven in the intervention group .


The intervention crisis resource management group placed monitor leads @ seconds earlier ( p = @ ) , placed an IV @ seconds sooner ( p = @ ) , called for help @ seconds faster ( p = @ ) , and checked for a pulse after noticing a rhythm change @ seconds quicker ( p = @ ) .


There was no statistically significant difference in time to initiation of cardiopulmonary resuscitation ( p = @ ) .


The intervention group had overall crisis resource management performance scores @ points higher ( Ottawa Global Rating Scale -LSB- out of @ -RSB- ) ( p = @ ) .


Three months later , these differences between the groups persisted .


A @-hour crisis resource management teaching session improved time to critical initial steps of pediatric resuscitation and crisis resource management performance as measured by the Ottawa Global Rating Scale .


The control group did not develop these crisis resource management skills over @ months of standard training indicating that obtaining these skills requires specific education .


Larger studies of crisis resource education are required .


Cardiovascular disease and dementia are growing medical and social problems in aging societies .


Appropriate knowledge of cardiovascular disease and cognitive decline risk factors ( RFs ) are critical for global CVR health preventive intervention .


Many epidemiological studies use case definition based on data collected/measured in a single visit , a fact that can overestimate prevalence rates and distant from clinical practice demanding criteria .


Portugal displays an elevated stroke mortality rate .


However , population 's global CV risk characterization is limited , namely , considering traditional/nontraditional RF and new intermediate phenotypes of CV and renal disease .


Association of hemodynamic variables ( pulse wave velocity and central blood pressure ) with global CVR stratification , cognitive performance , and kidney disease are practically inexistent at a dwelling population level .


After reviewing published data , we designed a population-based cohort study to analyze the prevalence of these cardiovascular RFs and intermediate phenotypes , using random sampling of adult dwellers living in @ adjacent cities .


Strict definition of phenotypes was planned : subjects were observed twice , and several hemodynamic and other biological variables measured at least @ months apart .


Three thousand thirty-eight subjects were enrolled , and extensive data collection ( including central and peripheral blood pressure , pulse wave velocity ) , sample processing , and biobank edification were carried out .


One thousand forty-seven cognitive evaluations were performed .


Seeking for CV risk reclassification , early identification of subjects at risk , and evidence of early vascular aging and cognitive and renal function decline , using the strict daily clinical practice criteria , will lead to better resource allocation in preventive measures at a population level .


Cow 's milk protein ( CMP ) - specific IgG@ responses and the efficacy of oral desensitization in infants with cow 's milk allergy ( CMA ) warrant more clarification .


To explore whether CMP-specific IgG@ responses develop during infancy and whether regular CM exposure is efficacious for inducing a CMP-specific IgG@ response accompanying CM desensitization in @ - to @-month-old infants .


CM-specific IgE and CMP ( - lactalbumin , - lactoglobulin , and casein ) - specific IgG@ levels were measured in @ CM-sensitized children .


Of these , @ infants @ to @ months old with challenge-proved CMA were randomly assigned to oral desensitization or an elimination diet and evaluated @ months later .


CMP-specific IgG@ levels in @ - to @-month-old infants were higher than in those younger than @ months but comparable to those in children older than @ months .


CMP-specific IgG@ levels in @ - to @-month-old infants with CMA were significantly lower than in those without CMA .


Fourteen of @ patients receiving oral desensitization could accept daily doses of @ mL of CM , whereas all but @ dropout patients receiving the elimination diet still showed allergic symptoms at the follow-up food challenge .


In patients who became desensitized , CM-specific IgE levels were lower than at baseline , whereas CMP-specific IgG@ levels were significantly increased .


In patients receiving the elimination diet , CM-specific IgE and CMP-specific IgG@ levels remained unchanged .


CMP-specific IgG@ responses did not develop sufficiently in @ - to @-month-old infants with CMA .


Oral desensitization in @ - to @-month-old infants with CMA was associated with the upregulation of CMP-specific IgG@ responses accompanying the alleviation of CMA symptoms .


Data are needed to guide therapeutic decisions about stopping bisphosphonates after an initial treatment period .


To define significant predictors of fracture and quantify fracture incidence in risk factor-defined subgroups of women who discontinue zoledronic acid ( ZOL ) after @ years of treatment .


To determine if continuing ZOL reduces fracture risk in subgroups .


This study is based on data from the @ year extension of HORIZON .


Subjects were in the ZOL arm of the Multicenter HORIZON trial .


One thousand two hundred thirty three women who previously received @ ZOL treatments during the Core trial .


Randomization to three additional annual ZOL ( Z@ , n = @ ) or placebo infusions ( Z@P@ , n = @ ) .


The risk of morphometric vertebral fractures ( MorphVertFx ) and clinical nonvertebral fractures ( NVF ) .


The incidence of MorphVertFx in Z@P@ was predicted by femoral neck ( FN ) t-score -@ -LSB- OR @ ( @ , @ ) , p = @ -RSB- , total hip ( TH ) t-score -@ -LSB- OR @ ( @ , @ ) , p = @ -RSB- , and incident MorphVertFx during Core -LSB- OR @ ( @ , @ ) , p < @ -RSB- .


Incidence of NVF was predicted by TH t-score -LSB- for @ decline , HR @ ( @ , @ ) , p = @ -RSB- , incident NVF during Core -LSB- HR @ ( @ , @ ) , p = @ -RSB- , and prevalent vertebral fracture -LSB- HR @ ( @ , @ ) , p = @ -RSB- .


For MorphVertFx , there were no significant treatment subgroup interactions ; absolute fracture reductions with continued ZOL were greatest in high-risk subgroups .


For NVF , there were no significant treatment reductions overall or in subgroups and no significant interactions .


After @ years of ZOL , in women who have a TH t-score above -@ , no recent incident fracture and no more than one risk factor ( almost @ % of the population ) , risk for subsequent fracture ( over three additional years ) is low if treatment is discontinued ( for MorphVertFx , average risk @ % and for NVF , average risk @ % ) .


In these patients , discontinuation for up to @ years is reasonable .


Brief interventions delivered by family physicians to address excessive alcohol use among adult patients are effective .


We conducted a study to determine whether such an intervention would be similarly effective in reducing binge drinking and excessive cannabis use among young people .


We conducted a cluster randomized controlled trial involving @ family physicians in Switzerland .


Physicians in the intervention group received training in delivering a brief intervention to young people during the consultation in addition to usual care .


Physicians in the control group delivered usual care only .


Consecutive patients aged @-@ years were recruited from each practice and , before the consultation , completed a confidential questionnaire about their general health and substance use .


Patients were followed up at @ , @ and @ months after the consultation .


The primary outcome measure was self-reported excessive substance use ( @ episode of binge drinking , or @ joint of cannabis per week , or both ) in the past @ days .


Of the @ participating physicians , @ were randomly allocated to the intervention group and @ to the control group .


Of the @ participating patients , @ ( @ % ) identified themselves as binge drinkers or excessive cannabis users , or both , at baseline .


Excessive substance use did not differ significantly between patients whose physicians were in the intervention group and those whose physicians were in the control group at any of the follow-up points ( odds ratio -LSB- OR -RSB- and @ % confidence interval -LSB- CI -RSB- at @ months : @ -LSB- @-@ @ -RSB- ; at @ mo : @ -LSB- @-@ @ -RSB- ; and at @ mo : @ -LSB- @-@ @ -RSB- ) .


The differences between groups were also nonsignificant after we restricted the analysis to patients who reported excessive substance use at baseline ( OR @ , @ % CI @-@ @ , at @ mo ; OR @ , @ % CI @-@ @ , at @ mo ; and OR @ , @ % CI @-@ @ , at @ mo ) .


Training family physicians to use a brief intervention to address excessive substance use among young people was not effective in reducing binge drinking and excessive cannabis use in this patient population .


To evaluate a new levonorgestrel-releasing intrauterine system ( LNG-IUS ) called Levosert ( ) for the treatment of heavy menstrual bleeding ( HMB ) in comparison to the reference product Mirena ( ) .


A multicentre , randomised , controlled trial , in non-menopausal women diagnosed with functional HMB ( defined as menstrual blood loss -LSB- MBL -RSB- @ mL ) randomised to either Levosert ( ) or Mirena ( ) and followed for up to one year .


MBL was evaluated using a validated modified version of the Wyatt pictogram .


A total of @ women were randomised ( @ to Levosert ( ) and @ to Mirena ( ) ) .


During the one-year treatment period , both Levosert ( ) and Mirena ( ) dramatically decreased MBL and increased haemoglobin and ferritin levels .


There were no statistically significant differences between Levosert ( ) and Mirena ( ) regarding any of the parameters evaluated during the study .


Similar bleeding patterns were observed in both groups .


Levosert ( ) was inserted with the same ease as Mirena ( ) .


Both treatments were associated with identical expulsion rates and no perforations occurred in either treatment group .


Levosert ( ) , a new LNG-IUS designed to release the same daily amount of LNG as Mirena ( ) , is highly effective in the treatment of HMB .


No differences were observed between Levosert ( ) and Mirena ( ) regarding all evaluated outcomes , including safety profile .


Cardiopulmonary bypass is still a major cause of lung injury and delay in pulmonary recovery after cardiac surgery .


Although it has been shown that pulsatile flow induced by intra-aortic balloon pumping is beneficial for preserving lung function , it is not clear if the same beneficial effect can be accomplished with pulsatile flow generated in the extracorporeal circuit .


Therefore , we investigated the effect of pulsatile flow , produced by a centrifugal pump , on lung function in elderly patients .


Serial measurements of lung biomarkers Clara cell @ kD protein , surfactant protein D , and elastase were performed on blood samples from @ elderly patients ( @ years ) who underwent elective aortic valve replacement surgery with CPB , either with pulsatile perfusion or continuous perfusion .


Pulmonary function was assessed by postoperative ventilation time , the arterial blood oxygenation ( PaO@/FiO@ ) , the alveolar-arterial oxygen gradient ( Aa-O@ gradient ) and the pulmonary vascular resistance indexed by body surface area ( PVRi ) .


There was no difference in lung function between both groups , as assessed by the postoperative ventilation time , the PaO@/FiO@ ratio , and the Aa-O@ gradient .


The PVRi , however , was significantly lower in the pulsatile perfusion group @ mins after the administration of protamine ( p < @ ) .


The plasma concentrations of the lung biomarkers increased during surgery and peaked at @ h ICU , there were however no differences between groups .


Pulsatile flow does not seem beneficial to postoperative lung function in elderly patients .


Moreover , pulsatile flow does not affect lung function on a subclinical level as assessed by lung biomarkers .


The objective of this study was to investigate functional abnormalities of the brain in females with migraine using magnetoencephalography ( MEG ) and a finger-tapping task .


Twenty-nine female patients with migraine ( aged @-@years ) and age - and gender-matched healthy controls were studied with an MEG system at a sampling rate of @Hz .


MEG recordings were performed during an attack in migraineurs with and without aura .


Neuromagnetic brain activation was elicited by a finger-tapping task .


The latency and amplitude of neuromagnetic responses were analyzed with averaged waveforms in the frequency range of @-@Hz .


The Morlet wavelet and beamformers were used to analyze the spectral and spatial signatures of MEG data from subjects in two frequency ranges of @-@ and @-@Hz .


The latency of motor-evoked magnetic fields evoked by finger movement was significantly prolonged in migraineurs as compared with controls .


Neuromagnetic spectral power in the motor cortex in migraineurs was significantly elevated .


There were significantly higher odds of activation in @-@ , @-@ and @-@Hz frequency ranges in the ipsilateral primary motor cortices and the supplementary motor area in migraineurs as compared with controls .


Neuromagnetic signal abnormalities in this study suggest cortical hyperexcitability in females with migraine during migraine attack , which could be measured and analyzed with MEG signal in a frequency range of @-@Hz .


These findings may help to identify neurophysiological biomarkers for studying mechanisms of migraine , and may facilitate to develop new therapeutic strategies for migraine by alterations in cortical excitability .


Among older home health care patients , depression is highly prevalent , is often inadequately treated , and contributes to hospitalization and other poor outcomes .


Feasible and effective interventions are needed to reduce this burden of depression .


To determine whether , among older Medicare Home Health recipients who screen positive for depression , patients of nurses receiving randomization to an intervention have greater improvement in depressive symptoms during @ year than patients receiving enhanced usual care .


This cluster randomized effectiveness trial conducted at @ home health care agencies nationwide assigned nurse teams to an intervention ( @ teams ) or to enhanced usual care ( @ teams ) .


Between January @ , @ , and December @ , @ , Medicare Home Health patients @ years and older who screened positive for depression on routine nursing assessments were recruited , underwent assessment , and were followed up at @ , @ , and @ months by research staff blinded to intervention status .


Patients were interviewed at home and by telephone .


Of @ eligible patients , @ enrolled in the study .


The Depression Care for Patients at Home ( Depression CAREPATH ) trial requires nurses to manage depression at routine home visits by weekly symptom assessment , medication management , care coordination , education , and goal setting .


Nurses ' training totaled @ hours ( @ onsite and @ via the web ) .


Researchers telephoned intervention team supervisors every other week .


Depression severity , assessed by the @-item Hamilton Scale for Depression ( HAM-D ) .


The @ participants were predominantly female ( @ % ) , were racially/ethnically diverse ( @ % black and @ % Hispanic ) , and had a mean ( SD ) age of @ ( @ ) years .


In the full sample , the intervention had no effect ( P = @ for intervention time interaction ) .


Adjusted HAM-D scores ( Depression CAREPATH vs control ) did not differ at @ months ( @ vs @ , P = @ ) or at @ months ( @ vs @ , P = @ ) but reached significance at @ months ( @ vs @ , P = @ ) .


In the subsample with mild depression ( HAM-D score , < @ ) , the intervention had no effect ( P = @ ) , and HAM-D scores did not differ at any follow-up points .


Among @ participants with a HAM-D score of @ or higher , the Depression CAREPATH demonstrated effectiveness ( P = @ ) , with lower HAM-D scores at @ months ( @ vs @ , P = @ ) , at @ months ( @ vs @ , P = @ ) , and at @ months ( @ vs @ , P = @ ) .


Home health care nurses can effectively integrate depression care management into routine practice .


However , the clinical benefit seems to be limited to patients with moderate to severe depression .


In preparing novice anesthesiologists to perform their first ultrasound-guided axillary brachial plexus blockade , we hypothesized that virtual reality simulation-based training offers an additional learning benefit over standard training .


We carried out pilot testing of this hypothesis using a prospective , single blind , randomized controlled trial .


We planned to recruit @ anesthesiologists who had no experience of performing ultrasound-guided regional anesthesia .


Initial standardized training , reflecting current best available practice was provided to all participating trainees .


Trainees were randomized into one of two groups ; ( i ) to undertake additional simulation-based training or ( ii ) no further training .


On completion of their assigned training , trainees attempted their first ultrasound-guided axillary brachial plexus blockade .


Two experts , blinded to the trainees ' group allocation , assessed the performance of trainees using validated tools .


This study was discontinued following a planned interim analysis , having recruited @ trainees .


This occurred because it became clear that the functionality of the available simulator was insufficient to meet our training requirements .


There were no statistically significant difference in clinical performance , as assessed using the sum of a Global Rating Score and a checklist score , between simulation-based training -LSB- mean @ ( standard deviation @ ) -RSB- and control trainees -LSB- @ ( @ ) -RSB- ( p = @ ) .


We have described a methodology for assessing the effectiveness of a simulator , during its development , by means of a randomized controlled trial .


We believe that the learning acquired will be useful if performing future trials on learning efficacy associated with simulation based training in procedural skills .


The aim of this study was to evaluate the clinical efficacy of submandibular gland transfer for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma .


Using the randomized controlled clinical research method , @ patients with nasopharyngeal carcinoma were randomly divided into an experimental group consisting of @ patients and a control group consisting of @ patients .


The submandibular glands were averted to the submental region in @ patients with nasopharyngeal carcinoma before they received conventional radiotherapy ; a lead block was used to shield the submental region during therapy .


Prior to radiotherapy , the function of the submandibular glands was assessed using imaging .


Submandibular gland function was measured using @mTc radionuclide scanning at @ months after radiotherapy .


The data in the questionnaire regarding the degree of xerostomia were investigated and saliva secretion was measured at @ , @ , @ , and @ months after radiotherapy .


In addition , the @-year survival rate was calculated .


After follow-up for @ , @ , and @ months , the incidence of moderate to severe xerostomia was significantly lower in the experimental group than in the control group .


The average amount of saliva produced by the experimental and control groups was @ g and @ g , respectively ( P < @ ) .


After follow-up for @ months , the uptake and secretion functions of the submandibular glands in the experimental group were found to be significantly higher than in the control group ( P < @ and P < @ , respectively ) .


The incidence of moderate or severe xerostomia was significantly lower than in the control group ( @ % and @ % , respectively ; P < @ ) .


The @-year survival rates of the experimental group and the control group were @ % and @ % , respectively , and there was no significant difference between the two groups ( P = @ ) .


After a @ year follow-up period involving @ patients who had their submandibular glands transferred for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma , we found that clinical efficacy was good .


This approach could improve the quality of life of nasopharyngeal carcinoma patients after radiotherapy and would not affect long-term treatment efficacy .


To provide a framework for implementation of multicomponent , school-based nutrition interventions .


This article describes the research methods for the Shaping Healthy Choices Program , a model to improve nutrition and health-related knowledge and behaviors among school-aged children .


Longitudinal , pretest/posttest , randomized , controlled intervention .


Four elementary schools in California .


Fourth-grade students at intervention ( n = @ ) and control ( n = @ ) schools and their parents and teachers .


Power analyses demonstrate that a minimum of @ students per group will be needed to achieve sufficient power .


The sample size was determined using the variables of nutrition knowledge , vegetable preference score , and body mass index percentile .


A multicomponent school-based nutrition education intervention over @ academic year , followed by activities to support sustainability of the program .


Dietary and nutrition knowledge and behavior , critical thinking skills , healthy food preferences and consumption , and physical activity will be measured using a nutrition knowledge questionnaire , a food frequency questionnaire , a vegetable preferences assessment tool , the Test of Basic Science Process Skills , digital photography of plate waste , PolarActive accelerometers , anthropometrics , a parent questionnaire , and the School and Community Actions for Nutrition survey .


Evaluation will include quantitative and qualitative measures .


Quantitative data will use paired t , chi-square , and Mann-Whitney U tests and regression modeling using P = @ to determine statistical significance .


The performance of glomerular filtration rate ( GFR ) equations incorporating both cystatin C ( CysC ) and serum creatinine ( Creat ) in living kidney donors has not been studied before .


From a population of @,@ living kidney donors , @ donors were randomly selected to undergo GFR measurement ( mGFR ) by the plasma disappearance of iohexol .


GFR was estimated with the Modification of Diet in Renal Disease ( MDRD ) equation and the Chronic Kidney Disease Epidemiology Collaboration study eGFR ( CKD-EPI-Creat ) in @ donors and the two newly developed equations using CysC with and without Creat , eGFR ( CKD-EPI-CysC ) and eGFR ( CKD-EPI-Creat + CysC ) , in @ donors .


Mean mGFR was @ mL/min/@ @ m.


The eGFR ( MDRD ) exhibited least and only negative bias and the three other models were comparable in terms of bias .


The eGFR ( CKD-EPI-Creat + CysC ) equation was most precise ; r = @ .


Both eGFR ( MDRD ) and eGFR ( CKD-EPI-Creat + CysC ) had high percentage ( @ % and @ % , respectively ) of estimates falling within @ % of mGFR versus estimates by eGFR ( CKD-EPI-Creat ) and eGFR ( CKD-EPI-CysC ) equations ( @ % and @ % , respectively ) .


The eGFR ( MDRD ) was by far most accurate in identifying those with mGFR less than @ mL/min/@ @ m whereas the CKD-EPI models were extremely accurate in classifying those with mGFR greater than or equal to @ mL/min/@ @ m.


eGFR ( CKD-EPI-Creat + CysC ) equation provides comparable accuracy to the eGFR ( MDRD ) in overall estimation of mGFR , but with higher precision .


However , eGFR ( CKD-EPI-Creat + CysC ) clearly misses many of those with a post-donation GFR less than @ mL/min/@ @ m and therefore eGFR ( MDRD ) is preferable in detecting donors with GFR less than @ mL/min/@ @ m.


To compare the clinical efficacy of navigated pattern and conventional slit-lamp pattern panretinal photocoagulation ( PRP ) .


Randomized clinical trial .


Seventy-four eyes with proliferative diabetic retinopathy ( PDR ) in need of PRP were randomly assigned to @ of @ groups : PRP conventional pattern @ ms , @ ms , navigated pattern @ ms , @ ms pulse .


Navigated laser is a fundus camera-based photocoagulator with retinal eye tracking .


Outcome variables included stability of visual acuity , regression or development of neovascularization and need for retreatment sessions and surgical intervention , pain perception , and procedure time .


There was no change in visual acuity between pre - and post-treatment measurements among the study groups .


Short pulse groups in total required @ procedures compared to @ procedures in long pulse groups ( P < @ ) .


A trend toward worse outcome using @ ms pulse duration treatments is expressed by slightly increased relative risk of @ compared to @ ms groups .


Only @ eyes required vitreoretinal surgery for nonclearing vitreous hemorrhage , @ in each @ ms group ; insignificantly different between study groups ( P = @ ) .


The pain score was lower with navigated laser as compared to conventional laser in both @ ms groups ( P = @ ) and @ ms groups , where it reached statistical significance ( P = @ ) .


Pain experience was significant ( P < @ ) between navigated @ ms pattern and conventional single-spot @ ms treatments .


This study demonstrates better clinical efficacy of @ ms compared to @ ms treatments using both conventional and navigated pattern lasers .


The ability to use long-pulse-duration navigated pattern treatments broadens therapeutic options for PRP in proliferative diabetic retinopathy .