Group @ patients were treated with preservative-free sodium hyaluronate @ % and preservative-free fluorometholone @ % eyedrops @ times a day in the first month and twice a day in the second month .


Group @ patients were treated with preserved eyedrops using the same schedule .


Ocular Surface Disease Index ( OSDI ) score , tear-film breakup time ( TBUT ) , Schirmer I test , corneal fluorescein staining , impression cytology , and antioxidant and inflammatory cytokine activities in tears were evaluated .


Both groups comprised @ patients .


At @ months , the OSDI score , TBUT , Schirmer I score , fluorescein staining score , impression cytology findings , and goblet cell count were significantly better in Group @ than in Group @ ( P < @ ) .


The interleukin-@ and tumor necrosis factor - concentrations were significantly less in the tears of Group @ patients than in the tears of Group @ patients , and catalase and superoxide dismutase @ fluorescence intensities were significantly greater in the tears of Group @ patients than in the tears of Group @ patients ( P < @ ) .


Preservative-free sodium hyaluronate @ % and fluorometholone @ % eyedrops can improve the symptoms and signs of dry-eye syndrome after cataract surgery .


Preservative-free fluorometholone eyedrops may have antiinflammatory and antioxidant effects in tears of patients with dry-eye syndrome .


To study the effect of a synthetic medium and compare it with a serum-based medium for corneal preservation in organ culture using an overall quality assessment system .


A randomized study with blinded observers was performed comparing parameters such as thickness , transparency , viable endothelial cell density ( VECD ) , morphology , and overall quality ( OQ ) of the corneal tissues preserved in synthetic and a serum-based medium , respectively .


Seven human paired corneas were randomly selected and assessed at day @ ( initial ) , day @ ( before organ culture ) , day @ ( before deturgescence/deswelling storage ) , and @ hours post deswelling .


Thickness was determined with optical coherence tomography and transparency with a validated , custom device .


The morphology and VECD were observed after treating the tissues with trypan blue and sucrose .


Data were compared using paired t tests with p < @ deemed significant .


Parameters were similar at the initial stage between the groups with no statistically significant difference .


However , after preservation in the deturgescent medium , the corneas stored in a serum-based medium showed a higher and statistically significant OQ value ( p = @ ) .


The OQ of a serum-based medium was higher than that of the synthetic medium .


A higher rate of transparency and reduction in thickness was observed in the serum-based medium at the end of the storage .


Although complete synthetic media may have distinct advantages of being serum/animal-free , the quality of the cornea is of a reasonable concern when it is deemed for transplantation .


Assess team performance within a net-worked supervisory control setting while manipulating automated decision aids and monitoring team communication and working memory ability .


Networked systems such as multi-unmanned air vehicle ( UAV ) supervision have complex properties that make prediction of human-system performance difficult .


Automated decision aid can provide valuable information to operators , individual abilities can limit or facilitate team performance , and team communication patterns can alter how effectively individuals work together .


We hypothesized that reliable automation , higher working memory capacity , and increased communication rates of task-relevant information would offset performance decrements attributed to high task load .


Two-person teams performed a simulated air defense task with two levels of task load and three levels of automated aid reliability .


Teams communicated and received decision aid messages via chat window text messages .


Task Load x Automation effects were significant across all performance measures .


Reliable automation limited the decline in team performance with increasing task load .


Average team spatial working memory was a stronger predictor than other measures of team working memory .


Frequency of team rapport and enemy location communications positively related to team performance , and word count was negatively related to team performance .


Reliable decision aiding mitigated team performance decline during increased task load during multi-UAV supervisory control .


Team spatial working memory , communication of spatial information , and team rapport predicted team success .


An automated decision aid can improve team performance under high task load .


Assessment of spatial working memory and the communication of task-relevant information can help in operator and team selection in supervisory control systems .


High-fidelity simulation is an effective tool in teaching neonatal resuscitation skills to professionals .


We aimed to determine whether in situ simulation training ( for @ % of the delivery room staff ) improved neonatal resuscitation performed by the staff at maternities .


A baseline evaluation of @ maternities was performed : a random sample of @ professionals in each unit was presented with @ standardized scenarios played on a neonatal high-fidelity simulator .


The medical procedures were video recorded for later assessments .


The @ maternities were then randomly assigned to receive the intervention ( a @-hour simulation training session delivered in situ for multidisciplinary groups of @ professionals ) or not receive it .


All maternities were evaluated again at @ months after the intervention .


The videos were assessed by @ neonatologists blinded to the pre - / postintervention as well as to the intervention/control groups .


The performance was assessed using a technical score and a team score .


After intervention , the median technical score was significantly higher for scenarios @ and @ for the intervention group compared with the control group ( P = @ and @ , respectively ) , the median team score was significantly higher ( P < @ ) for both scenarios .


In the intervention group , the frequency of achieving a heart rate > @ per minute at @ minutes improved significantly ( P = @ ) , and the number of hazardous events decreased significantly ( P < @ ) .


In situ simulation training with multidisciplinary teams can effectively improve technical skills and teamwork in neonatal resuscitation .


Dementia with Lewy bodies ( DLB ) is underrecognised in clinical settings .


To investigate whether performing a ( @ ) I-ioflupane injection ( ( @ ) I-FP-CIT also called DaTSCAN ) single photon emission computed tomography ( SPECT ) scan in patients with possible DLB would lead to a more certain diagnosis ( probable DLB or non-DLB dementia ) .


We randomised @ patients with possible DLB @:@ to have a scan or not ( control group ) .


The outcome measure was a change in diagnosis to probable DLB or non-DLB .


There were @ controls and @ scanned patients , of whom @ % had an abnormal scan .


More patients in the imaging group had a change in diagnosis compared with controls at @ and @ weeks ( @ % ( n = @ ) v. @ % ( n = @ ) and @ % ( n = @ ) v. @ % ( n = @ ) ; both P < @ ) .


Clinicians were more likely to change the diagnosis if the scan was abnormal ( @ % ) than if it was normal ( @ % ) .


Imaging significantly contributed to a more certain diagnosis , proving to be a useful adjunct in the work-up of patients with possible DLB .


Protein is indispensable in the human diet , and its intake appears tightly regulated .


The role of sensory attributes of foods in protein intake regulation is far from clear .


We investigated the effect of human protein status on neural responses to different food cues with the use of functional magnetic resonance imaging ( fMRI ) .


The food cues varied by taste category ( sweet compared with savory ) and protein content ( low compared with high ) .


In addition , food preferences and intakes were measured .


We used a randomized crossover design whereby @ healthy women -LSB- mean SD age : @ @ y ; mean SD body mass index ( in kg/m ( @ ) ) : @ @ -RSB- followed two @-d fully controlled dietary interventions involving consumption of either a low-protein diet ( @ g protein kg body weight ( -@ ) d ( -@ ) , ~ @ % of energy derived from protein , approximately half the normal protein intake ) or a high-protein diet ( @ g protein kg body weight ( -@ ) d ( -@ ) , ~ @ % of energy , approximately twice the normal intake ) .


On the last day of the interventions , blood oxygen level-dependent ( BOLD ) responses to odor and visual food cues were measured by using fMRI .


The @ interventions were followed by a @-d ad libitum phase , during which a large array of food items was available and preference and intake were measured .


When exposed to food cues ( relative to the control condition ) , the BOLD response was higher in reward-related areas ( orbitofrontal cortex , striatum ) in a low-protein state than in a high-protein state .


Specifically , BOLD was higher in the inferior orbitofrontal cortex in response to savory food cues .


In contrast , the protein content of the food cues did not modulate the BOLD response .


A low protein state also increased preferences for savory food cues and increased protein intake in the ad libitum phase as compared with a high-protein state .


Protein status modulates brain responses in reward regions to savory food cues .


These novel findings suggest that dietary protein status affects taste category preferences , which could play an important role in the regulation of protein intake in humans .


This trial was registered at www.trialregister.nl/trialreg/admin/rctview.asp?TC=@ as NTR@ .


WEB-Based Distress Management Program for Implantable CARdioverter defibrillator Patients ( WEBCARE ) is a Web-based randomized controlled trial , designed to improve psychological well-being in patients with an implantable cardioverter defibrillator ( ICD ) .


As in other Web-based trials , we encountered problems with attrition and adherence .


In the current study , we focus on the patient characteristics , reasons , and motivation of ( @ ) completers , ( @ ) those who quit the intervention , and ( @ ) those who quit the intervention and the study in the treatment arm of WEBCARE .


Consecutive first-time ICD patients from six Dutch referral hospitals were approached for participation .


After signing consent and filling in baseline measures , patients were randomized to either the WEBCARE group or the Usual Care group .


The treatment arm of WEBCARE contained @ patients .


Of these @ , @ ( @ % ) completed the treatment , @ ( @ % ) dropped out of treatment but completed follow-up , and @ ( @ % ) dropped out of treatment and study .


Results show no systematic differences in baseline demographic , clinical , or psychological characteristics between groups .


A gradual increase in dropout was observed with @ % ( @/@ ) completing the first lesson , while only @ % ( @/@ ) eventually completed the whole treatment .


Reasons most often given by patients for dropout were technical problems with the computer , time constraints , feeling fine , and not needing additional support .


Current findings underline the importance of focusing on adherence and dropout , as this remains a significant problem in behavioral Web-based trials .


Examining possibilities to address barriers indicated by patients might enhance treatment engagement and improve patient outcomes .


We previously conducted a randomized , clinical trial comparing early appendectomy with interval appendectomy for perforated appendicitis .


The purpose of the present study was to evaluate the effect this clinical trial had on subsequent practice patterns and outcomes for patients with perforated appendicitis at the free-standing children 's hospital conducting the trial .


A retrospective study was conducted comparing children with perforated appendicitis treated before the trial ( @-@ ) and after the trial ( @-@ ) .


Early appendectomy was performed within @ hours of diagnosis ; interval appendectomy occurred @-@ weeks after initial treatment with antibiotics .


Patient characteristics , treatment variables , and outcomes were collected and compared .


The pretrial group consisted of @ patients-@ ( @ % ) underwent early appendectomy , and @ ( @ % ) patients had interval appendectomy .


The posttrial group was composed of @ patients , with @ ( @ % ) undergoing early appendectomy and @ ( @ % ) interval appendectomy ( P = @ ) .


The groups were similar in patient and admission characteristics , although the posttrial group had a lower percentage of self-pay patients and fewer computed tomography scans ; health care use was similar between groups .


Overall , the posttrial group had fewer adverse events ( @ % vs @ % , P = @ ) , specifically fewer wound infections ( @ % vs @ % , P = @ ) and fewer unplanned readmissions ( @ % vs @ % , P = @ ) than the pretrial group .


In the posttrial group , those patients selected for interval appendectomy were more likely to complete the planned course of therapy than in the pretrial group .


A clinical trial conducted at our institution to evaluate currently available treatment options for perforated appendicitis did change practice patterns at our hospital .


After the trial , there was an increase in the use of early appendectomy , a decrease in the number of computed tomography scans performed per patient , and a reduction in the overall adverse event rate .


To compare responses to therapy of Black African ( BA ) and non-Black African ( non - BA ) patients with hepatitis C virus genotype @ ( HCV-@ ) residing in Belgium .


In this retrospective multicenter study , @ patients with HCV-@ were selected from databases at @ Belgian centers ; @ treatment-naive patients ( @ BA ) had received treatment with peg-interferon ( peg-IFN ) plus ribavirin ( RBV ) and were included in the study .


There was a greater percentage of female patients in the BA group than in the non - BA group ; BA patients were also older , had a greater body mass index , and more frequently had abnormal glucose metabolism .


The route of contamination was more frequently unknown in BA than in non-BA patients and BA patients had more HCV-@ subtypes .


There were no differences in other demographic factors between the groups .


Sustained viral response ( SVR ) and complete early viral response rates were significantly lower and relapse rates significantly higher in BA than in non-BA patients .


There were no differences between groups in rates of dose modification or in drug tolerance .


In our cohort , treatment-naive BA patients with HCV-@ who were treated with peg-IFN and ribavirin had a much lower SVR rate than treatment-naive non-BA patients with HCV-@ who were treated with peg-IFN and ribavirin , and a higher relapse rate , possibly related to a weaker response to interferon-based therapy .


Treatment may need to be adapted in this population .


Vitamin D receptors have been identified in the spinal cord , nerve roots , dorsal root ganglia and glial cells , and its genetic polymorphism association with the development of lumbar disc degeneration and herniation has been documented .


Metabolic effects of active vitamin D metabolites in the nucleus pulposus and annulus fibrosus cells have been studied .


Lumbar disc herniation is a process that involves immune and inflammatory cells and processes that are targets for immune regulatory actions of vitamin D as a neurosteroid hormone .


In addition to vitamin D 's immune modulatory properties , its receptors have been identified in skeletal muscles .


It also affects sensory neurons to modulate pain .


In this study , we aim to study the role of vitamin D@ in discogenic pain and related sensory deficits .


Additionally , we will address how post-treatment @-hydroxy vitamin D@ level influences pain and sensory deficits severity .


The cut-off value for serum @-hydroxy vitamin D@ that would be efficacious in improving pain and sensory deficits in lumbar disc herniation will also be studied .


We will conduct a randomized , placebo-controlled , double-blind clinical trial .


Our study population will include @ cases with one-level and unilateral lumbar disc herniation with duration of discogenic pain less than @ weeks .


Individuals who do not have any contraindications , will be divided into three groups based on serum @-hydroxy vitamin D@ level , and each group will be randomized to receive either a single-dose @,@-IU intramuscular injection of vitamin D@ or placebo .


All patients will be under conservative treatment .


Pre-treatment and post-treatment assessments will be performed with the McGill Pain Questionnaire and a visual analogue scale .


For the @-day duration of this study , questionnaires will be filled out during telephone interviews every @ days ( a total of five times ) .


The initial and final interviews will be scheduled at our clinic .


After @ days , serum @-hydroxy vitamin D@ levels will be measured for those who have received vitamin D@ ( @ individuals ) .


In foot and ankle surgery , there are multiple sites used for autologous bone graft , including the proximal ( PT ) or distal tibia ( DT ) , calcaneus ( C ) , and iliac crest ( ICBG ) .


There has been no comparison between these anatomic areas and the potential for acute or persistent pain at @ year .


The purpose of this study was to prospectively compare patient-reported outcomes of acute and persistent pain at @ year after surgery to determine if harvest site selection made a difference .


As part of a clinical trial examining ankle and hindfoot fusion rates with autograft compared with synthetic graft , the autologous bone graft harvest sites were assessed with visual analog pain outcome scores at @ , @ , @ , and @ weeks after surgery .


Patients with a score of @ + defined clinically significant pain .


Four harvest sites were compared : ICBG , PT , DT , and C. Fisher exact test was used to compare the graft site pain between locations .


Twelve percent of subjects reported clinically significant pain at @ weeks and @ % at @ weeks postoperatively .


Each lower extremity harvest site ( C , DT , PT ) showed higher rates of clinically significant graft harvest site pain than the ICBG at @ weeks .


Autologous bone graft harvest carried a risk of persistent pain at up to @ year ( weeks @-@ ) in @ % of patients .


Lower-extremity bone graft sites had the greatest risk for persistent pain at @ year .


Level II , prospective comparative study .


Dermal fillers are commonly injected in the lips for aesthetic treatment .


Small gel particle hyaluronic acid ( SGP-HA ) is the only filler approved by the US Food and Drug Administration for this indication , based on a pivotal trial of effectiveness and safety .


To assess multiple measures of tolerability and lip function in a randomized controlled trial of SGP-HA ( without lidocaine ) for lip augmentation .


Patients were randomized to SGP-HA ( n = @ ) or no treatment ( n = @ ) at baseline ; all could receive SGP-HA after @ months .


Assessments for tolerability and lip function at clinic visits throughout the study included lip texture , firmness , symmetry , movement , function , and sensation ; device palpability ; mass formation ; and ease of repeat injection .


Many assessments were normal ( lip function , sensation ) or unremarkable ( movement , mass formation , ease of reinjection ) in most patients .


Nearly all abnormalities with other assessments ( texture , firmness , symmetry , device palpability ) were mild and transient ( < @ weeks ) .


Lip augmentation with SGP-HA showed excellent safety with the assessments used in this study .


Further study should be conducted to validate these assessments with the goal of developing a comprehensive scale for measuring potential functional complications and risks .


To examine the impact of dehydration , ethnicity , and gender on urinary concentrations of salbutamol in relation to the threshold stipulated by the World Anti-Doping Agency ( WADA ) .


Repeated measures open-label .


Eighteen male and @ female athletes ( @ white males , @ white females , @ Afro-Caribbean males , @ Afro-Caribbean females , @ Asian -LSB- Indian subcontinent -RSB- males , and @ Asian females ) were recruited .


All participants were nonasthmatic .


After inhalation of @ g or @ g of salbutamol , athletes exercised in a hot controlled environment ( @C , @ % relative humidity ) at a self-selected pace until a target weight loss ( @ % or @ % ) was achieved .


Urine concentration of free salbutamol .


After inhalation of @ g salbutamol , @ participants presented with a urine salbutamol concentrations above the current WADA limit ( @ ng/mL ) and decision limit ( @ ng/mL ) resulting in an adverse analytical finding .


There were no differences according to gender or ethnic origin .


Dehydration equivalent to a body mass loss greater than @ % concomitant to the acute inhalation of @ g of salbutamol may result in a urine concentration above the current WADA limit and decision limit leading to a positive test finding independent of gender or ethnic origin .


Asthmatic athletes using salbutamol should receive clear dosing advise and education to minimize the risk of inhaling doses of salbutamol that may produce urine concentrations of salbutamol above @ ng/mL .


To investigate the efficacy of fesoterodine vs placebo on nocturia , sleep disturbance , and sleep-related quality of life ( QoL ) in patients with overactive bladder and nocturia .


This posthoc analysis used data from a @-week , randomized , placebo-controlled trial of fesoterodine @ and @ mg per day in Asian adults reporting @ micturitions and @ urgency urinary incontinence episodes per @ hours at baseline .


Patients who reported @ nocturnal micturition/@ h were included in this analysis .


Efficacy variables included change from baseline to week @/end of treatment in nocturnal micturitions/@ h , nocturnal voided volume/micturition , and hours of undisturbed sleep .


Sleep-related QoL was assessed using King 's Health Questionnaire Sleep/Energy domain .


Treatment comparisons were made using analysis of covariance .


Among @ patients , reductions in nocturnal micturitions with fesoterodine @ mg ( -@ ) and @ mg ( -@ ) were numerically greater vs placebo ( -@ ) , but differences were not significant ( P > @ ) .


When patients with a nocturnal polyuria index > @ % were excluded , the decrease in nocturnal micturitions was significantly greater with fesoterodine @ mg vs placebo ( -@ ; P = @ ) .


Increases in nocturnal voided volume/micturition were significantly greater with fesoterodine @ ( @ mL ; P = @ ) and @ mg ( @ mL ; P < @ ) vs placebo ( @ mL ) .


Hours of undisturbed sleep was significantly longer with fesoterodine @ mg vs placebo ( @ vs @ minutes ; P = @ ) ; improvement in King 's Health Questionnaire Sleep/Energy scores was significantly greater with fesoterodine @ ( P = @ ) and @ mg ( P = @ ) vs placebo .


These results suggest that fesoterodine may reduce nocturnal micturitions and improve sleep quality and QoL in overactive bladder patients with nocturia .


Due to the gap in suicide-specific intervention training for mental health students and professionals , e-learning is one solution to improving provider skills in the Veterans Affairs ( VA ) health system .


This study focused on the development and evaluation of an equivalent e-learning alternative to the Collaborative Assessment and Management of Suicidality ( CAMS ) in-person training approach at a Veteran Health Affairs medical center .


The study used a multicenter , randomized , cluster , and three group design .


the development of e-CAMS was an iterative process and included pilot testing .


Eligible and consenting mental health providers , who completed a CAMS pre-survey , were randomized .


Provider satisfaction was assessed using the standard VA evaluation of training consisting of @ items .


Two post training focus groups , divided by learning conditions , were conducted to assess practice adoption using a protocol focused on experiences with training and delivery of CAMS .


A total of @ providers in five sites were randomized to three conditions : @ to e-learning , @ to in-person , @ to the control .


The providers were primarily female , Caucasian , midlife providers .


Based on frequency scores of satisfaction items , both learning groups rated the trainings positively .


In focus groups representing divided by learning conditions , participants described positive reactions to CAMS training and similar individual and institutional barriers to full implementation of CAMS .


This is the first evaluation study of a suicide-specific e-learning training within the VA. .


The e-CAMS appears equivalent to the in-person CAMS in terms of provider satisfaction with training and practice adoption , consistent with other comparisons of training deliveries across specialty areas .


Additional evaluation of provider confidence and adoption and patient outcomes is in progress .


The e-CAMS has the potential to provide ongoing training for VA and military mental health providers and serve as a tutorial for psychiatrists in preparation for specialty boards .


The safety of exercise-based cardiac rehabilitation ( CR ) has not been investigated in Japan , so a nationwide survey was conducted to investigate the incidence of adverse events ( AEs ) associated with CR and exercise testing .


In total , @ hospitals reported operating recovery-phase CR programs , amounting to @,@ patient-hours of exercise training .


The incidence rates of all AEs and life-threatening AEs ( LAE : death , cardiac arrest , acute myocardial infarction , cardiac rupture ) during exercise sessions were @ and @ event/@ ,@ patient-hours ( @ and @ events/@ ,@ patient-hours ) , respectively .


When CR programs were categorized as `` Formal '' in which an exercise prescription based on exercise testing was issued to individual patients or `` Non-formal '' without exercise prescription , the incidence of AEs during and within the @ h after an exercise session was significantly lower in the Formal than the Non-formal CR programs ( P < @ ) , despite similar hospital size and coronary intervention volumes between the @ category hospitals .


Moreover , LAEs did not occur in @,@ patient-hours in Formal CR , whereas @ LAEs occurred in @,@ patient-hours in Non-formal CR ( P < @ ) .


During @,@ exercise testing sessions , @ LAEs ( @ event/@ ,@ tests ) and @ non-LAEs ( @ events/@ ,@ tests ) occurred .


This first nationwide survey in Japan revealed that both exercise-based CR and exercise testing are generally safe , and that Formal CR , in which an individual exercise prescription is determined by exercise testing , is particularly safe .


To compare the safety and efficacy of the two single-tablet regimens ( STRs ) , rilpivirine/emtricitabine/tenofovir disoproxil fumarate ( RPV/FTC/TDF ) and efavirenz/emtricitabine/tenofovir DF ( EFV/FTC/TDF ) , in HIV-@-infected , treatment-naive adults .


This is a phase @b , randomized , open-label , multicenter , international , @-week study .


Participants were randomized @:@ to receive either RPV/FTC/TDF or EFV/FTC/TDF .


The primary endpoint was the proportion of participants with HIV-@ RNA less than @ copies/ml at week @ by the Snapshot algorithm .


A total of @ participants were randomized .


RPV/FTC/TDF was noninferior to EFV/FTC/TDF ( @ vs. @ % ) at week @ for HIV-@ RNA less than @ copies/ml -LSB- difference @ % , @ % confidence interval ( CI ) -@ to @ % -RSB- .


A statistically significant difference in efficacy favoring RPV/FTC/TDF was demonstrated for participants with baseline HIV-@ RNA @ copies/ml or less -LSB- ( n = @ ) @ % RPV/FTC/TDF vs. @ % EFV/FTC/TDF ( difference @ % , @ % CI @-@ @ % ) -RSB- .


In participants with baseline HIV-@ RNA more than @ copies/ml ( n = @ ) , RPV/FTC/TDF demonstrated noninferior efficacy compared with EFV/FTC/TDF ( @ vs. @ % , respectively , difference -@ % , @ % CI -@ to @ % ) .


In the RPV/FTC/TDF arm , more virologic failure was observed as baseline HIV-@ RNA levels increased .


There were more participants with emergent resistance in the RPV/FTC/TDF arm than in the EFV/FTC/TDF arm ( @ vs. @ % , respectively ) .


There were fewer discontinuations because of adverse events with RPV/FTC/TDF ( @ % ) than with EFV/FTC/TDF ( @ % ) .


In treatment-naive participants , RPV/FTC/TDF demonstrated noninferior efficacy and improved tolerability compared with EFV/FTC/TDF , as well as a statistically significant difference in efficacy for participants with baseline HIV-@ RNA @ copies/ml or less at week @ .


Indwelling devices ( eg , urinary catheters and feeding tubes ) are often used in nursing homes ( NHs ) .


Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms ( MDROs ) and device-related infections in NHs .


To test whether a multimodal targeted infection program ( TIP ) reduces the prevalence of MDROs and incident device-related infections .


Randomized clinical trial at @ community-based NHs from May @ to April @ .


Participants were high-risk NH residents with urinary catheters , feeding tubes , or both .


Multimodal , including preemptive barrier precautions , active surveillance for MDROs and infections , and NH staff education .


The primary outcome was the prevalence density rate of MDROs , defined as the total number of MDROs isolated per visit averaged over the duration of a resident 's participation .


Secondary outcomes included new MDRO acquisitions and new clinically defined device-associated infections .


Data were analyzed using a mixed-effects multilevel Poisson regression model ( primary outcome ) and a Cox proportional hazards model ( secondary outcome ) , adjusting for facility-level clustering and resident-level variables .


In total , @ NH residents with indwelling devices were enrolled , with @,@ device-days and @ anatomic sites sampled .


Intervention NHs had a decrease in the overall MDRO prevalence density ( rate ratio , @ ; @ % CI , @-@ @ ) .


The rate of new methicillin-resistant Staphylococcus aureus acquisitions was lower in the intervention group than in the control group ( rate ratio , @ ; @ % CI , @-@ @ ) .


Hazard ratios for the first and all ( including recurrent ) clinically defined catheter-associated urinary tract infections were @ ( @ % CI , @-@ @ ) and @ ( @ % CI , @-@ @ ) , respectively , in the intervention group and the control group .


There were no reductions in new vancomycin-resistant enterococci or resistant gram-negative bacilli acquisitions or in new feeding tube-associated pneumonias or skin and soft-tissue infections .


Our multimodal TIP intervention reduced the overall MDRO prevalence density , new methicillin-resistant S aureus acquisitions , and clinically defined catheter-associated urinary tract infection rates in high-risk NH residents with indwelling devices .


Further studies are needed to evaluate the cost-effectiveness of this approach as well as its effects on the reduction of MDRO transmission to other residents , on the environment , and on referring hospitals .


To assess the time-dependent effect of continuous positive airway pressure ( CPAP ) , on insulin-like growth factor-@ ( IGF-@ ) , IGF binding proteins ( IGFBPs ) and pulsatile growth hormone ( GH ) secretion .


A randomized , double-blind , sham-controlled , parallel group study .


Sixty-five middle-aged men with moderate to severe obstructive sleep apnea .


Active ( n = @ ) or sham ( n = @ ) CPAP for @ weeks , followed by @ weeks of active CPAP ( n = @ ) .


Fasting morning IGF-@ , IGFBP-@ , and IGFBP-@ blood levels at @ , @ , @ , and @ weeks .


Overnight GH secretion was calculated by mathematical deconvolution of serial GH measurements from serum samples collected every @ min ( @:@ -@:@ ) during simultaneous polysomnography in a subset of @ men ( active n = @ , sham n = @ ) at week @ .


Active , compared with sham , CPAP increased IGF-@ at @ weeks ( P = @ ) , but not at @ weeks ( P = @ ) .


Changes in IGFBP-@ and IGFBP-@ were not different between groups at @ or @ weeks ( all P @ ) .


At week @ , there was a further increase in IGF-@ and a decrease in IGFBP-@ in the pooled group ( P = @ and @ , respectively ) .


In the subset , total ( P = @ ) and pulsatile ( P = @ ) GH secretion , mean GH concentration ( P = @ ) , mass of GH secreted per pulse ( P = @ ) and pulse frequency ( P = @ ) were all higher after @ weeks of CPAP compared with sham .


Basal secretion , interpulse regularity , and GH regularity were not different between groups ( all P > @ ) .


Twelve weeks , but not @ weeks , of CPAP increases IGF-@ , with a further increase after @ weeks .


Total and pulsatile GH secretion , secretory burst mass and pulse frequency are also increased by @ weeks .


CPAP improves specific elements of the GH/IGF -@ axis in a time-dependent manner .


Assessment of structural damage of sacroiliac joints ( SIJ ) in patients with axial spondyloarthritides ( axSpA ) has been discussed as a useful outcome measure in clinical trials .


The aim of our study was to evaluate different magnetic resonance imaging ( MRI ) scoring methods and pulse sequences with a focus on fatty lesions and bony erosions .


Seventy-five patients with the diagnosis of axSpA underwent MRI at @ timepoints as part of the ESTHER trial , which compared @ groups of patients treated with etanercept or sulfasalazine .


Two MRI sequences -LSB- unenhanced T@-weighted ( T@w ) turbo spin-echo ( TSE ) and unenhanced T@w opposed-phase gradient-echo sequences ( opGRE ) -RSB- and @ different scoring systems ( simple and comprehensive Berlin method ) were used for the evaluation of fatty lesions and erosions of the SIJ .


Differences between techniques and methods were evaluated by intraclass correlation coefficients ( ICC ) and standardized response means ( SRM ) .


Applying the simple Berlin method , mean fatty lesion scores for etanercept-treated patients were @ and @ at baseline and Week @ , respectively , while the comprehensive Berlin method revealed mean fatty lesion scores of @ and @ , respectively .


Corresponding SRM were @ and @ for simple and comprehensive methods , respectively , while ICC dropped from @-@ @ to @-@ @ .


Scoring of erosions on T@w opGRE images resulted in a higher interreader agreement ( ICC of @ ) compared to T@w TSE sequences ( ICC of @ ) .


Better characterization of fatty lesion changes within @ year was achieved by the comprehensive Berlin scoring method ; however , more reader variation has to be taken into account .


The delineation of erosions is markedly improved when using T@w opGRE pulse sequences .


Previous studies have shown that MRI of fresh hamstring injuries have diagnostic and prognostic value .


The clinical relevance of MRI at return to play ( RTP ) has not been clarified yet .


The aim of this study is to describe MRI findings of clinically recovered hamstring injuries in amateur , elite and professional athletes that were cleared for RTP .


We obtained MRI of @ consecutive athletes with hamstring injuries within @days of injury and within @days of RTP .


We assessed the following parameters : injured muscle , grading of injury , presence and extent of intramuscular signal abnormality .


We recorded reinjuries within @months of RTP .


MRIs of the initial injury showed @ ( @ % ) grade @ and @ ( @ % ) grade @ injuries .


Median time to RTP was @days ( range @-@ ) .


On MRI at RTP @ athletes ( @ % ) had intramuscular increased signal intensity on fluid-sensitive sequences with a mean longitudinal length of @mm ( @ ) and a median cross-sectional area of @ % ( range @-@ % ) of the total muscle area .


In @ athletes ( @ % ) there was abnormal intramuscular low-signal intensity .


We recorded five reinjuries .


@ % of the clinically recovered hamstring injuries showed intramuscular increased signal intensity on fluid-sensitive sequences on MRI .


Normalisation of this increased signal intensity seems not required for a successful RTP .


Low-signal intensity suggestive of newly developed fibrous tissues is observed in one-third of the clinically recovered hamstring injuries on MRI at RTP , but its clinical relevance and possible association with increased reinjury risk has to be determined .


This study investigated the soothing effects of fragrance from yuzu , a Japanese citrus fruit ( Citrus junos Sieb .


ex Tanaka ) , with salivary chromogranin A ( CgA ) used as an endocrinologic stress marker reflecting sympathetic nervous system activity .


Twenty healthy women ( mean age , @ @ years ) participated in a randomized , controlled , crossover study .


Participants were examined on two separate occasions-once using the yuzu scent and once using unscented water as a control-in the follicular phase .


This experiment measured salivary CgA and the Profile of Mood States ( POMS ) as a psychological index before and after the aromatic stimulation .


Ten-minute inhalation of the yuzu scent significantly decreased salivary CgA .


At @ minutes after the inhalation period , the salivary CgA level further decreased .


In addition , POMS revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance , a global measure of affective state , as well as four subscores of emotional symptoms ( tension-anxiety , depression-dejection , anger-hostility , and confusion ) , as long as @ minutes after the olfactory stimulation .


Yuzu 's aromatic effects may alleviate negative emotional stress , which , at least in part , would contribute to the suppression of sympathetic nervous system activity .


Photodynamic therapy ( PDT ) with methyl aminolevulinate ( MAL ) is effective for treating multiple actinic keratoses ( AKs ) .


Ablative fractional laser ( FL ) creates vertical channels that may facilitate MAL delivery and improve PDT response .


To evaluate the efficacy of FL-assisted PDT ( FL-PDT ) in treating facial AKs in Korean patients .


A prospective randomized non-blinded trial initially evaluated @ facial AKs in @ patients .


All patients underwent one session of MAL-PDT using a red light-emitting diode lamp at @J/cm ( @ ) , and @ patients with @ AK lesions were randomly assigned to pre-treatment with a @-nm ablative fractional erbium : Yag laser .


Patients were followed up at @ , @ and @weeks and every month until @ and @months post-treatment .


Response , adverse events , cosmetic outcome and patient satisfaction were documented .


Finally , a total of @ facial AKs in @ patients were enrolled and analysed in this study .


FL-PDT was significantly more effective than MAL-PDT at treating all AK grades ( @ % vs. @ % ; P < @ ) .


The efficacy of FL-PDT was most pronounced in treating Olsen grade III AKs ( @ % vs. @ % ; P = @ ) .


FL-PDT also showed a lower lesion recurrence rate than MAL-PDT ( @ % vs. @ % ; P = @ ) .


Excellent or good cosmetic outcome was reported in > @ % cases .


Erythema and hyperpigmentation intensities were higher in the FL-PDT group ( P > @ ) .


Side-effects were more frequent in the FL-PDT group , but these were mild and well tolerated ( P > @ ) .


FL-PDT is effective for treating AKs , especially moderate-to-thick lesions .


Oral glucocorticoids are widely used to reduce pruritus and dermatitis associated with allergic dermatitis .


Data suggest that oclacitinib , a Janus kinase inhibitor , is a safe and effective alternative .


To evaluate the efficacy and safety of oclacitinib compared with prednisolone for the control of pruritus associated with allergic dermatitis in a single-masked , controlled clinical trial with a randomized complete block design .


Client-owned dogs ( n = @ ) with a presumptive diagnosis of allergic dermatitis and moderate to severe pruritus as assessed by the pet owner were enrolled .


Dogs were randomized to treatment with either oclacitinib ( @-@ @ mg/kg orally twice daily for @days , then once daily ) or prednisolone ( @-@ @ mg/kg once daily for @days , then every other day ) for @days .


An enhanced visual analog scale ( VAS ) was used by owners to assess pruritus and by veterinarians to assess dermatitis , at all time points assessed .


Both treatments produced a rapid onset of efficacy within @h .


The mean reductions in pruritus and dermatitis scores were not significantly different between the treatments except on day@ , when reductions were more pronounced for oclacitinib than prednisolone ( P = @ for owner pruritus scores ; P = @ for veterinarian dermatitis scores ) .


Adverse events were reported with similar frequency in both groups .


In this study , both oclacitinib and prednisolone provided rapid , effective and safe control of pruritus associated with allergic dermatitis , with substantial improvement in pruritus , reported by owners , and dermatitis , reported by veterinarians .


To evaluate the effectiveness of topical anaesthesia with cocaine versus lidocaine plus adrenaline for outpatient transcanalicular and endonasal dacryocystorhinostomy ( TCLDCR ) with diode laser under sedation .


A double blind randomised clinical trial was designed using topical anaesthesia for outpatient TCLDCR in the treatment of adult epiphora .


A total of @ patients were enrolled , and randomly allocated to be operated on under sedation and topical anaesthesia with cocaine @ % pledgets versus sedation and topical anaesthesia with lidocaine @ % plus @/@ @ adrenaline pledgets .


Main outcome measures were postoperative comfort , evaluated by a visual analogue scale , presence of secondary effects ( blood pressure , heart rate ) , and resolution of epiphora , evaluated by Munk 's scale and endoscopic control .


Patients in both groups reported being comfortable during and immediately after TCLDCR .


Visualization of the operative field was adequate , and surgery was successfully completed in all cases .


Complications were more common in the cocaine group : Sixteen patients from the cocaine group had high blood pressures , versus @ patients from the lidocaine group ( RR = @ ) .


Mean blood loss was @ ml in cocaine group , versus @ ml in lidocaine group ( RR = @ ) .


Both parameters were statistically significant ( p = @,@ ( -@ ) ) .


There were no cases of postoperative epistaxis requiring nasal packing or hospital admission in any group .


Success rate was similar in the @ groups ( @ % group @ and @ % group @ ) , after @ months of follow-up .


The combination of topical lidocaine and adrenaline is more effective for outpatient transcanalicular and endonasal dacryocystorhinostomy than topical cocaine .


Patient comfort was adequate in both groups , but high blood pressure and blood loss more common after cocaine .


This study was aimed to assess the ratio of total cholesterol ( TC ) to high-density density lipoprotein cholesterol ( HDLC ) and plasma nitrate levels in patients with ischemic nephropathy receiving statins and niacin extended release ( NER ) .


Kidney disease patients with a history of at least @ year of diabetes mellitus or @ year of hypertension were screened by renal artery Doppler ultrasonography .


Participants were randomly assigned into two groups to receive atorvastatin , @ mg/d , with and without NER , @ mg/d , for @ weeks .


Serum levels of lipid profile , creatinine , and nitrate were compared before and after the study .


Fifty-four patients received the statin and @ received statin-NER combination .


Both statin and statin-NER groups demonstrated significant decreases in plasma levels of TC and low-density lipoprotein cholesterol .


Triglyceride and very low-density lipoprotein cholesterol were significantly lowered only with statin-NER combination .


The increase in HDLC level was found in both groups , but significant only with statin-NER combination therapy ( P < @ ) .


Atorvastatin combined with NER reduced TC/HDLC ratio almost double as compared with that of atorvastatin alone ( @ % and @ % reduction , respectively ) .


A similar pattern was observed for nitrate levels ( @ % and @ % , respectively ) .


These findings indicated that a reduction in TC/HDLC ratio improves endothelial function in renovascular disease and use of NER in combination with atorvastatin may provide better outcomes .


This could be helpful in attenuating further vascular damage and associated systemic complications .


Elevated fibrinogen ( Fg ) level is a known risk factor for ischemic stroke .


There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention .


We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention .


This is a multicenter , randomized , parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for @ months .


Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules .


The NIH Stroke Scale scores ( NIHSSs ) and plasma Fg level were recorded .


The carotid artery intima-media thickness ( IMT ) and status of plaques were examined through carotid ultrasound examination .


Primary outcomes included all-cause mortality , any event of recurrent ischemic stroke/transient ischemic attack ( TIA ) , hemorrhagic stroke , myocardial infarction and angina , and other noncerebral ischemia or hemorrhage .


Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups .


Comparison of median values between two groups was done by the Student t test , one-way analysis of variance ( ANOVA ) , or non-parametric rank sum test .


A total of @ patients were enrolled , @ patients in the treatment group and @ patients in the control group .


Compared to the control group , the treatment group showed favorable outcomes in the Fg level , carotid IMT , the detection rate of vulnerable plaques , the volume of carotid plaques , NIHSS scores , and incidence of total vascular ( @ % and @ % , respectively ) and cerebral vascular events ( @ % and @ % , respectively ) ( P < @ ) .


In the treatment group , the volume of carotid plaques was significantly related to the carotid IMT , the plaque diameter , width and number ( P = @ , @ , @ , @ ; F = @ , @ , @ , -@ , but there was a weak correlation with the Fg level ( P = @ ) .


After @-year therapy , the incidence of overall vascular end points was reduced by @ % .


Long-term oral fibrinogen-depleting therapy may be beneficial for secondary ischemic stroke prevention .


This @-week , randomised , double-blind phase IIIb study assessed efficacy and safety of certolizumab pegol ( CZP ) as add-on therapy to non-biologic disease-modifying antirheumatic drugs ( DMARDs ) in rheumatoid arthritis ( RA ) patients with low to moderate disease activity , and stopping therapy in patients in sustained remission .


Patients were randomised @:@ to CZP ( @mg at weeks @ , @ and @ , then @mg every @weeks ) or placebo ( every @weeks ) plus current non-biologic DMARDs .


At week @ , patients who achieved the primary endpoint of Clinical Disease Activity Index ( CDAI ) remission at both weeks @ and @ stopped study treatment and continued in the study until week @ .


Of @ patients ( CZP = @ ; placebo = @ ) , > @ % had moderate disease activity at baseline .


Significantly more CZP patients met the primary endpoint than placebo patients ( week @ and @ CDAI remission rates : @ % vs @ % ; p@ @ ) .


At week @ , @ % vs @ % of CZP versus placebo patients ( p < @ ) achieved LDA .


Disease activity score ( ESR ) based on @-joint count and Simplified Disease Activity Index remission rates were also significantly higher with CZP versus placebo ( @ % vs @ % ; p@ @ and @ % vs @ % ; p@ @ ) .


CZP patients reported improvements in physical function versus placebo ( mean Health Assessment Questionnaire-Disability-Index change from baseline : CZP , -@ vs placebo , -@ ; p@ @ ) .


During the period following withdrawal of CZP or placebo , only @/@ prior CZP patients and @/@ prior placebo patients maintained CDAI remission until week @ , but CZP reinstitution allowed renewed improvement .


Adverse and serious adverse event rates were comparable between CZP and placebo groups .


Addition of CZP to non-biologic DMARDs is an effective treatment in RA patients with predominantly moderate disease activity , allowing low-disease activity or remission to be reached in a majority of the patients .


However , the data suggest that CZP can not be withdrawn in patients achieving remission .


The purpose of this analysis is to report the incremental costs and benefits of different doses of spinal manipulative therapy ( SMT ) in patients with chronic low back pain ( LBP ) .


We randomized @ patients with chronic LBP to receive a dose of @ , @ , @ , or @ sessions of SMT .


Participants were scheduled for @ visits for @ weeks and received SMT or light massage control from a doctor of chiropractic .


Societal costs in the year after study enrollment were estimated using patient reports of health care use and lost productivity .


The main health outcomes were the number of pain-free days and disability-free days .


Multiple regression was performed on outcomes and log-transformed cost data .


Lost productivity accounts for most societal costs of chronic LBP .


Cost of treatment and lost productivity ranged from $ @ for @ SMT sessions to $ @ for @ SMT sessions with no statistically significant differences between groups .


Baseline patient characteristics related to increase in costs were greater age ( P = @ ) , greater disability ( P = @ ) , lower quality-adjusted life year scores ( P = @ ) , and higher costs in the period preceding enrollment ( P < @ ) .


Pain-free and disability-free days were greater for all SMT doses compared with control , but only SMT @ yielded a statistically significant benefit of @ pain-free days ( P = @ ) and @ disability-free days ( P = @ ) .


No statistically significant group differences in quality-adjusted life years were noted .


A dose of @ SMT sessions yielded a modest benefit in pain-free and disability-free days .


Care of chronic LBP with SMT did not increase the costs of treatment plus lost productivity .


To examine whether a phenylalanine-free protein substitute with prolonged release may be beneficial to the protein status of children with phenylketonuria ( PKU ) compared to conventional substitutes .


Sixty children with PKU , @ to @ years of age , were randomly allocated to receive either a prolonged-release ( test ) or the current conventional protein substitute for @ days .


Subjects were additionally sex and age matched with @ subjects with mild hyperphenylalaninemia and @ unaffected subjects .


The protein status in children with PKU was assessed by albumin , transthyretin , and retinol-binding protein ( RBP ) , and changes throughout the trial period were the primary outcome measures .


Children with PKU did not differ in anthropometry from children with mild hyperphenylalaninemia or unaffected children but they ingested lower amounts of proteins ( p < @ ) .


No differences occurred throughout the trial between or within children with PKU who received the test or conventional substitute for macronutrient intake .


Albumin and RBP concentrations were within the age-specific reference range for all children .


The rate of protein insufficiency ( transthyretin concentration less than @ mg/dL ) did not differ statistically between children receiving test or conventional substitute ( recruitment @ % vs @ % ; end of the trial @ % vs @ % ) but mean transthyretin recovered over @ mg/dL in children who received the test substitute , increasing from @ to @ mg/dL ( mean change , @ mg/dL ; @ % confidence interval @ to @ mg/dL ) .


In children receiving conventional substitute mean transthyretin changed from @ to @ mg/dL ( @ ; -@ to @ ) mg/dL .


Protein substitutes with prolonged release might be beneficial to protein status in children with phenylketonuria .


Spinal cord stimulation ( SCS ) for the treatment of chronic pain is a well-established therapy .


However , the requirement that paresthesia be continually felt by the patient has important downsides .


This study evaluated the effectiveness of a new paresthesia-free SCS paradigm , called burst stimulation , for the treatment of failed back surgery syndrome ( FBSS ) with a prospective , randomized , double-blind , placebo-controlled design .


Twenty patients with FBSS and a preexisting SCS system each received three treatment allocations in random order for a period of one week : @-Hz tonic stimulation , burst stimulation , and placebo stimulation .


The primary outcome measure was pain intensity measured on a numerical rating scale ( NRS ) .


Secondary outcome measures were pain quality measured using the Short-Form McGill Pain Questionnaire ( SFMPQ ) and safety .


Additional data were collected relating to pain-related disability measured using the Oswestry Disability Index ( ODI ) .


The lowest mean NRS and SFMPQ scores were observed under burst stimulation .


For the burst stimulation treatment group , mean NRS and SFMPQ scores were significantly decreased compared with the other treatment groups .


Mean NRS and SFMPQ scores were not significantly different between @-Hz tonic stimulation and placebo stimulation .


Although the lowest mean ODI score was observed under burst stimulation , no significant differences were found between the ODI categories .


No adverse events occurred , and burst stimulation was significantly preferred by @ patients ( @ % ) .


Overall , burst stimulation resulted in significantly better pain relief and improved pain quality in the short term compared with @-Hz tonic stimulation and placebo stimulation and was preferred by the majority of patients .


During recent years scientific research has demonstrated a growing interest in elastic and anaelastics adhesive taping techniques .


However , only a few studies investigating the principles behind the effects of taping .


At present , the action mechanisms of kinesiology taping remain speculative .


To investigate the effects of taping application on the tone of the pectoralis major muscle at rest , in absence of any relevant pathologies .


The study involved a prospective , randomised and blinded clinical trial on healthy individuals and a repeated measures study design .


Two different taping techniques ( facilitatory and inhibitory ) were applied over the pectoralis major of @ healthy volunteers .


The outcome measure was passive range of motion of external rotation of the glenohumeral joint .


Facilitatory taping significatively enhanced the activity of the underlying muscle .


Results showed a negative correlation between facilitatory taping application and the contralateral pectoralis major length , indicating a possible effect on the muscle tone of areas outside the site of direct application .


The inhibitory taping application did not produce significant results .


effects on ipsilateral and contralateral muscle physiology could be interpreted through the initial hypothesis of taping inducing changes in fascial stiffness .


These could be transmitted along the continuing system .


Further studies are needed to inform the possible uses of taping in clinical practice .


The objective of the current study was to assess mean self-monitored blood glucose ( SMBG ) , on day @ of @ days of continuous reservoir wear ( @D ) , with insulin lispro ( Lis ) or insulin aspart ( Asp ) .


Two @-week , randomized trials were conducted in subjects with type @ diabetes treated by continuous subcutaneous insulin infusion ( CSII ) for @ months , with a mean total daily insulin dose capable of supporting @ days of in-reservoir use .


Study @ had an open-label , six-sequence , three-treatment , three-period , cross-over design .


Study @ had a double-blind , two-sequence , two-treatment , two-period , cross-over design .


The primary efficacy measure was the mean of Day @ , seven-point SMBG profiles for insulin lispro @D ( Lis@D ) and insulin aspart @D ( Asp@D ) treatment periods .


Safety measures were also assessed .


Lis did not achieve noninferiority ( SMBG ; margin = @ mmol/L -LSB- @ mg/dL -RSB- ) to Asp on Day @ of reservoir wear in either Study ( least-squares mean difference : Study @ = @ mmol/L -LSB- @ mg/dL -RSB- ; @ % confidence interval -LSB- CI -RSB- -LSB- @ , @ -RSB- , Study @ = @ mmol/L -LSB- @ mg/dL -RSB- ; @ % CI -LSB- @ , @ -RSB- ) .


Noninferiority was demonstrated for overall daily mean of SMBG values over days @ to @ of reservoir use during each treatment period .


In the Lis treatment period , subjects reported a lower documented and total hypoglycemia rate per @ days and a higher rate of non-explained hyperglycemia than in the Asp treatment period .


While the mean blood glucose on Day @ of Lis@D did not meet non-inferiority , the overall daily mean blood glucose was not different , with a decreased rate of hypoglycemia with Lis .


Two types of material are used to manufacture double-lumen endobronchial tubes ( DLTs ) : Polyvinylchloride ( PVC ) and silicon .


PVC DLTs ( Broncho-Cath ) and silicon DLTs ( Silbroncho ) not only differ in material , but also subtly differ in structure .


The goal of this study was to determine whether the incidences of postoperative sore throat and hoarseness differed between PVC DLTs and silicon DLTs .


Prospective , single-blind , balanced ( @:@ ) , randomized , controlled trial .


Single university hospital .


Sixty ASA I-II patients , aged @ to @ years , scheduled for thoracoscopic pulmonary lobectomy .


Patients were randomized into the Broncho-cath group ( group B , n = @ ) and the Silbroncho group ( group S , n = @ ) .


Intubation was performed with DLT according to the allocated group by an anesthesiologist .


The incidence of sore throat and hoarseness was evaluated at @ hour and @ hours after DLT extubation .


The intensity of sore throat was assessed by visual analog scale ( VAS < @-@ ) at @ , @ , @ , @ , and @ hours after DLT extubation .


The incidence of sore throat was significantly lower in group S compared with that in group B at @ h ( @ % v @ % , p = @ ) and @ hours ( @ % v @ % , p = @ ) .


No significant difference was observed in the incidence of hoarseness between the @ groups .


The VAS scores for sore throat in group B were significantly higher than those in group S throughout the study ( p < @ ) .


The use of silicon DLTs resulted in a lower incidence of postoperative sore throat than did the use of PVC DLTs .


Pyridoxamine dihydrochloride ( Pyridorin ) blocks pathogenic oxidative pathways in the progression of diabetic nephropathy .


The pyridoxamine pilot study was designed to test entry criteria and outcomes .


Subjects had SCr @-@ @ mg/dl , protein-to-creatinine @,@ mg/g and used a surrogate outcome of SCr over @ weeks .


Subjects had to be on a maximally tolerated dose of ACE/ARB for @ months ; stable other antihypertensive doses for @ months ; stable diuretic dose for @ weeks , and BP @/@ mm Hg ; or enter a Pharmaco-Stabilization Phase ( PSP ) .


This pilot failed to detect an effect on SCr in intent-to-treat analysis .


We queried the locked clinical trial database for subgroups in which there was a treatment effect .


Subjects not requiring PSP and those with entry SCr < @ mg/dl had a treatment effect .


Subjects entering PSP required more changes in antihypertensive medications and experienced larger SCr over @ weeks .


PSP subjects with BP > @/@ mm Hg had no treatment effect , but those @/@ mm Hg did .


Time required for acute effects of ACE/ARB to stabilize is unknown , but these data suggest > @ months .


Thus , subjects in the pivotal trial must be on ACE/ARB for @ months .


Frequent antihypertensive adjustment could engender SCr changes unrelated to CKD progression .


Thus , we will require subjects to have BP @/@ mm Hg and on stable antihypertensives for @ weeks , or @/@ mm Hg and on stable antihypertensives for @ weeks .


Since SCr over @ weeks is limited as a surrogate outcome , the pivotal trial uses a time-to-event analysis of baseline SCr to at least a @ % increase in SCr or ESRD as the primary outcome .


This substantial SCr is protected from noise and is clinically relevant .


The pyridoxamine pilot provided critical information to inform the design of PIONEER-CSG-@ , which we conducted under the SPA agreement with FDA .


The efficacy of coronary angiography may be different in the right radial approach ( RRA ) and the left radial approach ( LRA ) due to more common vascular tortuosity in the RRA .


The aim of the study was to determine whether LRA is a valid alternative for coronary angiography compared with RRA in Asian populations .


This is a single-center , prospective , randomized controlled study .


A total of @,@ consecutive patients undergoing diagnostic coronary angiography were recruited and randomized to the RRA ( number -LSB- n -RSB- = @ ) or LRA ( n = @ ) group .


The primary end point was total procedural duration .


Secondary end points included fluoroscopy time , dose of radiation including cumulative air kerma and dose area product , contrast volume , and the incidence of vascular complications .


Coronary procedural success was achieved in @ of @ ( @ % ) patients in the RRA and @ of @ ( @ % ) in the LRA .


The total procedural time ( RRA @ minutes versus LRA @ minutes ; P = @ ) and fluoroscopy time ( RRA @ minutes versus LRA @ minutes ; P = @ ) were significantly shorter via LRA in comparison to RRA .


The percentage of hydrophilic wire use was also lower in the LRA group ( @ % -LSB- RRA -RSB- versus @ % -LSB- LRA -RSB- ; P = @ ) .


The dose of radiation and contrast volume were not different between the two approaches .


No cases of major bleeding and vascular complications requiring surgical intervention were reported , other than with one patient who experienced a symptomatic stroke and died in the RRA group compared with none in the LRA group .


The LRA seems to be a feasible alternative for coronary angiography in Asian patients due to shorter procedural duration and fluoroscopy time , as well as less hydrophilic wire use in comparison to RRA .


The potential health benefits of curcumin are limited by its poor solubility , low absorption from the gut , rapid metabolism and rapid systemic elimination .


The purpose of this study was the comparative measurement of the increases in levels of curcuminoids ( curcumin , demethoxycurcumin , bisdemethoxycurcumin ) and the metabolite tetrahydrocurcumin after oral administration of three different curcumin formulations in comparison to unformulated standard .


The relative absorption of a curcumin phytosome formulation ( CP ) , a formulation with volatile oils of turmeric rhizome ( CTR ) and a formulation of curcumin with a combination of hydrophilic carrier , cellulosic derivatives and natural antioxidants ( CHC ) in comparison to a standardized curcumin mixture ( CS ) was investigated in a randomized , double-blind , crossover human study in healthy volunteers .


Samples were analyzed by HPLC-MS/MS .


Total curcuminoids appearance in the blood was @-fold higher for CTR and @-fold higher for CP in comparison to unformulated CS .


CHC showed a @-fold higher absorption over CS and significantly improved absorption over CP ( @-fold ) and CTR ( @-fold , all p < @ ) .


A formulation of curcumin with a combination of hydrophilic carrier , cellulosic derivatives and natural antioxidants significantly increases curcuminoid appearance in the blood in comparison to unformulated standard curcumin CS , CTR and CP .


After pancreaticoduodenectomy , the Finnish binding pancreaticojejunal anastomosis ( FBPJ ) seems to reduce the risk for pancreatic fistula ( POPF ) .


Our aim was to investigate whether FBPJ is feasible and prevents the risk for POPF even after left pancreatectomy ( LP ) .


@ consecutive patients underwent LP .


@ patients were recruited on the basis of CT and , of these , @ patients were randomized on the basis of findings during surgery ( transection line must be left of portal vein , as @-@cm pancreatic mobilization is required for FBPJ ) to receive either Roux-Y FBPJ or hand-sewn closure of the pancreatic remnant .


Only @ % ( @/@ ) of the patients met the randomization criteria .


Clinically significant POPF rate was higher in FBPJ group ( @ % ) compared to thand-sewn closure group ( @ % ; P < @ ) .


POPF rate in FBPJ group was higher even when compared to all patients with hand-sewn closure ( @ % versus @ % ; P < @ ) .


Overall , FBPJ was technically feasible for only @ % of patients .


FBPJ can not be recommended for the routine closure of the pancreatic remnant after LP , as it was not technically achievable in @ % of the cases .


Moreover , the technique does not seem to reduce the risk for POPF compared to the hand-sewn closure .


Disulfiram and naltrexone were evaluated in treatment of individuals with co-occurring alcohol dependence and other Axis I disorders ( e.g. , Major Depression ) .


We explored pharmacogenetic interactions in genotyped subjects .


Alcohol dependent ( AD ) subjects received naltrexone alone , placebo alone , disulfiram with placebo or disulfiram with naltrexone .


They were genotyped for OPRM@ rs@ ( Asn@Asp ) , and DBH rs@ ( C-@T ) .


N = @ male European-American subjects were included .


There were no significant interactions with OPRM@ .


DBH interacted with naltrexone on the primary outcome of abstinence from heavy drinking ( ( @ ) ( @ ) = @ , p = @ ) .


`` T '' allele carriers on naltrexone had more abstinence compared to `` CC '' subjects on naltrexone ( FET , p = @ ) .


`` T '' allele carriers on naltrexone had the highest overall rates of abstinence from heavy drinking ( > @ % ) .


Also , DBH genotype interacted with disulfram ( F ( @,@ ) = @ , p = @ ) on drinks per drinking day with less drinking for subjects with the `` CC '' genotype than for T allele carriers on disulfiram .


DBH * rs@ * T associated with better response to naltrexone , while for those on disulfiram that drank , `` CC '' subjects drank less than T carriers .


For rs@ * G , we did not replicate findings from previous studies showing a more favorable response to NTX , possibly due to the small available sample .


Genotyping rs@ may be useful in understanding inter-individual differences in AD treatment response .


Further study of rs@ pharmacogenetics is warranted .


Hip fracture is a condition with high mortality and morbidity in elderly frail patients .


Intraoperative fluid optimization may be associated with benefit in this population .


We investigated whether intraoperative fluid management using pulse-contour analysis cardiac monitoring , compared with standard care in patients undergoing spinal anaesthesia , would provide benefits in terms of reduced time until medically fit for discharge and postoperative complications .


Patients undergoing surgical repair of fractured neck of femur , aged > @ yr , receiving spinal anaesthesia were enrolled in this single-centre , blinded , randomized , parallel group trial .


Patients were allocated to either anaesthetist-directed fluid therapy or a pulse-contour-guided fluid optimization strategy using colloid ( Gelofusine ) boluses to optimize stroke volume .


The primary outcome was time until medically fit for discharge .


Secondary outcomes included postoperative complications , mobility , and mortality .


We updated a systematic review to include relevant trials to @ .


We recruited @ patients .


Time until medically fit for discharge was similar in both groups , mean -LSB- @ % confidence interval ( CI ) -RSB- @ ( @-@ @ ) vs @ ( @-@ @ ) days ( P = @ ) , as was total length of stay @ ( @-@ @ ) vs @ ( @-@ @ ) days ( P = @ ) .


There were no significant differences in complications , function , or mortality .


An updated meta-analysis ( four studies , @ patients ) found non-significant reduction in early mortality -LSB- relative risk @ ( @-@ @ ) -RSB- and in-hospital complications -LSB- relative risk @ ( @-@ @ ) -RSB- .


Goal-directed fluid therapy during hip fracture repair under spinal anaesthesia does not result in a significant reduction in length of stay or postoperative complications .


There is insufficient evidence to either support or discount its routine use .


We recently published that platelet-activating factor receptor ( PAFr ) is upregulated on the epithelium of the proximal airways of current smokers and also in bronchial epithelial cells exposed to cigarette smoke extract .


These treated cells also showed upregulation of Streptococcus pneumoniae adhesion .


Bacterial wall phosphorylcholine specifically binds to PAFr expressed on airway epithelium , thus facilitating adherence and tissue invasion , which may be relevant to chronic obstructive pulmonary disease ( COPD ) .


Moreover , the use of inhaled corticosteroids ( ICS ) in COPD patients is associated with an increased risk of invasive respiratory pneumococcal infections .


In this study , we have investigated whether PAFr expression is especially upregulated in airway epithelium in COPD patients and whether this expression may be modulated by ICS therapy .


We cross-sectionally evaluated PAFr expression in bronchial biopsies from @ COPD patients who were current smokers ( COPD-smokers ) and @ COPD-ex-smokers , and we compared these to biopsies from @ smokers with normal lung function .


We assessed immunostaining with anti-PAFr monoclonal antibody .


We also used material from a previous double-blinded randomized placebo-controlled @-month ICS intervention study in COPD patients to explore the effect of ICS on PAFr expression .


We employed computer-aided image analysis to quantify the percentage of epithelium stained for PAFr .


Markedly enhanced expression of PAFr was found in both COPD-smokers ( P < @ ) and COPD-ex-smokers ( P < @ ) compared to smokers with normal lung function .


There was little evidence that PAFr expression was affected by ICS therapy over @ months .


Epithelial PAFr expression is upregulated in smokers , especially in those with COPD , and is not obviously affected by ICS therapy .


Intramedullary nailing of displaced proximal humerus fractures is an attractive option in the elderly patient .


However , in recent reports , some existing intramedullary nails have shown high rate of complications , so new designs are being developed .


The objective of the present study is to report on outcomes and complications when comparing a straight to a curvilinear nail design .


We prospectively include @ patients with Neer 's @ - or @-part proximal humerus fractures .


Two were lost to follow-up , @ were surgically treated with a new straight humeral nail ( MultiLoc , Synthes ) mean age @ ( range , @-@ years ) , and @ with a curvilinear nail ( Polarus , Acumed ) mean age @ ( range , @-@ years ) .


At final follow-up ( average @ months ) , patients underwent a clinical and radiographic evaluation .


Clinical outcome was assessed with the adjusted Constant score .


All but @ fracture went on to radiographic union .


Mean Constant score in the Polarus nail was @ @ and @ @ in the MultiLoc ( P = @ ) .


Symptoms related with rotator cuff disease were present in @/@ patients ( @ % ) and in @/@ ( @ % ) , respectively ( P = @ ) .


The mean neck-shaft angle at final follow-up was @ in the MultiLoc group and @ in the Polarus group ( P > @ ) .


Reoperation rate was @ % for Polarus and @ % for MultiLoc .


Straight intramedullary nails had a comparable union rate to an accepted curvilinear design , with a much lower incidence of complications .


Rotator cuff pain and dysfunction can be minimized with the use of newer generation straight nails .


This was a prospective , randomized , controlled multicenter study with @-month follow-up .


The purpose of this study was to evaluate the safety and efficacy in a Food and Drug Administration Investigation Device Exemption of a new lumbar total disc replacement ( TDR ) by comparing it to an earlier TDR approved for sale .


Randomized trials have reported TDR to produce results similar or superior to lumbar fusion .


Results for various TDRs seem to be similar , but differences in study design and outcome measures pose challenges in definitively comparing devices .


The purpose of this study was to perform a direct comparison of @ lumbar TDRs in a prospective , randomized trial .


TDR was performed in @ patients from @ sites ( @ patients in the investigational group ( Kineflex-L Disc ; metal-on-metal design anchored with keels , @ randomized and @ nonrandomized training cases ) , and @ in the control group ( CHARITE artificial disc ; metal with polyethylene core with teeth for anchoring ; @ randomized and @ nonrandomized training cases ) .


All patients were treated nonoperatively for single-level symptomatic disc degeneration for at least @ months prior to surgery .


Perioperative data were collected .


Clinical outcome data were collected prospectively , as approved by the Food and Drug Administration , through @-month follow-up .


Primary outcome measures used were the Oswestry Disability Index , visual analogue scales assessing pain , patient satisfaction , and reoperations .


Success was defined to be at least @-point improvements in Oswestry Disability Index scores , no reoperation , and no major adverse events .


Radiographical measures included range of motion , disc space height , and assessment for device migration , subsidence , and fusion at the TDR level .


There were no significant differences between the groups when comparing operative time , blood loss , or length of hospital stay .


Both groups improved significantly on Oswestry Disability Index and visual analogue scale scores ( P < @ ) with no differences between the groups .


Success rates were similar ( @ % investigational vs. @ % control ) .


At @-month follow-up , @ % of the investigational group and @ % of controls were satisfied with outcome .


Reoperation was performed in @ % of the investigational group and @ % of the control group .


This prospective , randomized , controlled study comparing @ TDRs , the first to the authors ' knowledge , found the devices produced very similar clinical outcomes .


Both groups improved significantly by @ weeks postoperatively and remained improved throughout follow-up with a high patient satisfaction rate .


A single bout of exercise improves postprandial glycemia and insulin sensitivity in prediabetic patients ; however , the impact of exercise intensity is not well understood .


The present study compared the effects of acute isocaloric moderate ( MIE ) and high-intensity ( HIE ) exercise on glucose disposal and insulin sensitivity in prediabetic adults .


Subjects ( n = @ ; age @ y ; fasting glucose @ mg/dL ; @ h glucose @ mg/dL ) completed a peak O@ consumption/lactate threshold ( LT ) protocol plus three randomly assigned conditions : @ ) control , @ hour of seated rest , @ ) MIE ( at LT ) , and @ ) HIE ( @ % of difference between LT and peak O@ consumption ) .


One hour after exercise , subjects received an oral glucose tolerance test ( OGTT ) .


Plasma glucose , insulin , and C-peptide concentrations were sampled at @ - to @-minute intervals at baseline , during exercise , after exercise , and for @ hours after glucose ingestion .


Total , early-phase , and late-phase area under the glucose and insulin response curves were compared between conditions .


Indices of insulin sensitivity ( SI ) were derived from OGTT data using the oral minimal model .


Compared with control , SI improved by @ % ( P = @ ) and @ % ( P < @ ) on the MIE and HIE days , respectively .


No differences in SI were observed between the exercise conditions ( P = @ ) .


Improvements in SI corresponded to significant reductions in the glucose , insulin , and C-peptide area under the curve values during the late phase of the OGTT after HIE ( P < @ ) , with only a trend for reductions after MIE .


These results suggest that in prediabetic adults , acute exercise has an immediate and intensity-dependent effect on improving postprandial glycemia and insulin sensitivity .


Bleomycin-etoposid-cisplatin ( BEP ) chemotherapy is curative in most patients with disseminated germ cell cancer ( GCC ) but also associated with toxic actions and dysfunction in non-targeted tissues .


We investigated changes in muscle function during BEP and the safety and efficacy of resistance training to modulate these changes .


Thirty GCC patients were randomly assigned to resistance training ( resistance training group ( INT ) , n = @ ) or usual care ( CON , n = @ ) during @ weeks of BEP therapy .


Resistance training consisted of thrice weekly sessions of four exercises , @-@ sets/exercise of @-@ repetitions at @-@ repetition maximum load .


The primary endpoint was muscle fibre size , assessed in muscle biopsies from musculus vastus lateralis .


Secondary endpoints were fibre phenotype composition , body composition , strength , blood biochemistry and patient-reported endpoints .


Healthy age-matched subjects ( REF , n = @ ) performed the same RT-programme for comparison purposes .


Muscle fibre size decreased by -@ m ( @ ) ( @ % confidence interval ( CI ) : -@ to @ ; P = @ ) in the CON-group and increased by +@ m ( @ ) ( @ % CI : -@ to @ ; P = @ ) in the INT-group ( adjusted mean difference ( AMD ) , +@ m ( @ ) , @ % CI : -@ to @ , P = @ ) .


Mean differences in type II fibre size ( AMD , +@ m ( @ ) , P = @ ) and lean mass ( AMD , +@ kg , P = @ ) in favour of the INT-group approached significance .


The REF-group improved all muscular endpoints and had significantly superior changes compared with the INT-group ( P < @ ) .


BEP was associated with significant reduction in lean mass and strength and trends toward unfavourable changes in muscle fibre size and phenotype composition .


Resistance training was safe and attenuated dysfunction in selected endpoints , but BEP blunted several positive adaptations observed in healthy controls .


Thus , our study does not support the general application of resistance training in this setting but larger-scaled trials are required to confirm this finding .


Purse-string suture is a closure method that purportedly reduces the scar area compared with second intention healing .


Randomized clinical trials comparing these @ methods appear to be limited or absent .


To determine if purse-string suture improves cosmetic outcome , healing time , and scar to defect area compared with second intention healing for circular defects on the trunk and extremities .


Prospective , @-arm , randomized , evaluator-blinded clinical trial in a single-center outpatient academic dermatology center .


Patients were eligible if they were older than @ years , able to give informed consent , and had circular or oval postoperative defects larger than @ mm on the trunk or extremities .


For the purse-string treatment arm , wounds were sewn in circumferential fashion using polydiaxanone suture .


Patients in the other treatment arm were allowed to heal by second intent .


The primary outcome measures were the mean total Patient and Observer Scar Assessment Scale ( POSAS ) scores ascertained from the patient and @ blinded observers .


Secondary outcomes included the ratio of scar to initial defect size , healing time , pain scores , and complication rates .


Fifty-two patients were screened , and a total of @ patients with @ surgical sites were enrolled .


Forty-two patients with @ surgical sites completed the study .


The mean total observer POSAS score was @ for the purse-string group vs @ for the secondary intention group , a nonsignificant difference ( P = @ ) .


Similarly , there were no significant differences for any of the following secondary outcome measures : mean total patient POSAS score ( P = @ ) , mean scar-to-defect area ( P = @ ) , and mean pain level at week @ ( P = @ ) .


Statistical trends toward significance were seen in the mean healing time in favor of purse-string suture ( P = @ ) and scar relief , which favored second intention healing ( P = @ ) .


The purse-string suture results in similar cosmetic outcomes , scar sizes , and pain levels compared with second intention healing for circular or oval wounds on the trunk and extremities .


A larger study might better define the potential differences in our secondary outcome measures of healing time and scar relief .


To evaluate the effect of health education on prevention from schistosome infection in engineering construction workers in Poyang Lake area .


The workers for constructing `` De Chang '' highway in Poyang Lake area were divided randomly into an experiment group and a control group , `` health education + protective skill training '' was carried out in the experiment group , whereas , no intervention was implemented in the control group .


In the experiment group , the awareness rates of schistosomiasis control knowledge were @ % and @ % before and after the intervention , respectively ; the rates of contacting infested water were @ % and @ % pre - and post-intervention , respectively ; the work protective rates increased from zero before the intervention to @ % after the intervention ; there was no person infected with schistosome after the intervention .


However , in the control group , all the indexes above-mentioned had no significant changes .


The intervention model `` health education + protective skill training '' , can effectively prevent from schistosome infection in engineering construction workers in Poyang Lake area .


Research has consistently identified a disparity between the prevalence of mental health concerns among young adults and their rates of formal help seeking .


However , a few randomised controlled trials have identified effective interventions for increasing formal help seeking among young adults .


The aim of this study was to evaluate the effectiveness of a brief online psychoeducational intervention , targeting depression , anxiety and suicide stigma , for increasing positive attitudes towards help seeking and increasing help seeking intentions among young adults .


The study followed a single-blind parallel group randomized controlled trial design with @ young adult ( @-@ years ) Australian participants , assigned to receive online psychoeducation ( n = @ ) or online attention-matched control information ( n = @ ) over @ weeks .


Participants in the experimental group received information on depression , anxiety , and suicide .


The control group received information unrelated to mental health .


Primary outcome measures were mental health literacy , mental illness stigma , attitudes toward professional help seeking and intentions to seek help .


Secondary outcome variables were symptomology , satisfaction and adherence .


Significant between-group differences were found for the pre - to post-test , including increased anxiety literacy ( Cohens d = @ ) , decreased depression stigma ( d = @ ) , and increased help seeking attitudes and intentions for the experimental group ( d = @ and d = @ , respectively ) .


Due to the small sample size and homogenous nature of the sample , generalisations should be made with caution .


This study demonstrates the utility and effectiveness of a brief online psychoeducation intervention for promoting help seeking among young adults .


Antimicrobial pharmacokinetic and pharmacodynamic data are limited in obesity .


To evaluate the steady-state pharmacokinetics and pharmacodynamics of doripenem and meropenem in obese patients hospitalized on a general ward .


Patients with a body mass index ( BMI ) @ kg/m or total body weight ( TBW ) @ pounds over their ideal body weight randomly received doripenem @ mg ( @-hour infusion ) or meropenem @ g ( @-hour infusion ) every @ hours .


Differences in pharmacokinetic parameters were determined by unpaired t test .


Monte Carlo simulations were performed for @ mg and @ g every @ hours , infused over @ and @ hours for doripenem and @ and @ hours for meropenem .


Probability of target attainment ( PTA ) was calculated using a pharmacodynamic target of @ % fT > MIC ( free drug concentrations above the minimum inhibitory concentration -LSB- MIC -RSB- ) , and cumulative fraction of response ( CFR ) was calculated using MIC data for @ Gram-negative pathogens .


Twenty patients were studied .


Volume of distribution at steady state , corrected for TBW , was significantly larger ( @ @ vs @ @ L/kg , P = @ ) and systemic clearance was significantly faster for doripenem ( @ @ vs @ @ L/h , P = @ ) .


PTA was > @ % for all regimens at MICs @ g/mL .


CFR was > @ % for all regimens against @ enteric Gram-negative pathogens and for @ of @ regimens for each drug against Pseudomonas aeruginosa .


Doripenem and meropenem pharmacokinetics differ in obesity .


However , currently approved dosing regimens provide adequate pharmacodynamic exposures for susceptible bacteria in obese patients .


Increased circulating cathepsin S levels have been linked to increased risk of cardiometabolic diseases and cancer .


However , whether cathepsin S is a modifiable risk factor is unclear .


We aimed to investigate the effects of a prudent diet on plasma cathepsin S levels in healthy individuals .


Explorative analyses of a randomized study were performed in @ normal to slightly overweight and hyperlipidemic men and women ( aged @ to @ ) that were randomly assigned to ad libitum prudent diet , i.e. healthy Nordic diet ( ND ) or a control group ( habitual Western diet ) for @weeks .


Whereas all foods in the ND were provided , the control group was advised to consume their habitual diet throughout the study .


The ND was in line with dietary recommendations , e.g. low in saturated fats , sugars and salt , but high in plant-based foods rich in fibre and unsaturated fats.The ND significantly decreased cathepsin S levels ( from @ ( + / -@ SD ) to @ g/L ( + / -@ SD ) ) compared with control group ( from @ ( + / -@ SD ) to @ g/L ( + / -@ SD ) ) .


This difference remained after adjusting for sex and change in insulin sensitivity ( P = @ ) , and near significant after adjusting for baseline cathepsin S levels ( P = @ ) , but not for change in weight or LDL-C .


Changes in cathepsin S levels were directly correlated with change in LDL-C .


Compared with a habitual control diet , a provided ad libitum healthy Nordic diet decreased cathepsin S levels in healthy individuals , possibly mediated by weight loss or lowered LDL-C .


These differences between groups in cathepsin S were however not robust and therefore need further investigation .


The purpose of the study was to assess what effect daily cleaning of contact lenses with a multipurpose disinfection solution ( MPDS ) , during @ nights extended wear , would have on contact lens-related adverse events .


This was a prospective , open-label , randomized , controlled , parallel-group , @-month clinical study in which @ participants were dispensed with lotrafilcon A silicone hydrogel lenses for a @-day extended-wear schedule and with lenses replaced monthly .


Participants were randomized to a control or test group .


Test subjects were required to remove lenses daily after waking , clean them with the MPDS , and reinsert the lenses .


Control subjects wore lenses without removal for @ days extended wear .


Handling-related lens contamination was assessed at the baseline visit .


There was no significant difference between the test and control groups for the incidence of significant corneal infiltrative events ( @ vs. @ % , p = @ ) , total corneal infiltrative events ( @ vs. @ % , p = @ ) , or mechanical events ( @ vs. @ % , p = @ ) .


The test group had greater corneal staining ( p < @ ) and fewer mucin balls ( p = @ ) .


Handling-related lens contamination ( unworn lenses ) resulted in isolation of Gram-positive bacteria from @ % of test lenses compared with @ % of control lenses ( p = @ ) .


Gram-negative bacteria were isolated from @ % of test subjects compared with @ % of control subjects ( p = @ ) .


Fungus was isolated from @ % of subjects in both the test and control groups ( p = @ ) .


The intervention of daily morning cleaning of the lens surface with an MPDS during extended wear did not significantly influence the incidence of adverse events .


For economic reasons , i.e. , to reduce costs of in-hospital patient accommodations , constant pressure has been applied in recent years to increase the percentage of ambulatory surgeries .


Effective control of post-operative pain after ambulatory surgery is challenging to all health professionals .


Computerised systems are being implemented more frequently for remote patient monitoring , including during the at-home post-operative period .


This study evaluates the feasibility of delivering a computerised system , developed in-house , for remote pain monitoring .


It evaluates the user-friendliness of the system and the extent of patient compliance .


Finally , a comparative assessment of the system is made with respect to the quality of pain treatment in ambulatory surgery .


The participants included @ adults , aged @-@ , randomly assigned to a control group or to a computerised treatment group .


The primary treatment outcome was measured by pain intensity ratings ( @-@ NRS ) reported several times per day during a five-day monitoring period , using an electronic pain diary combined with a web-based personal health record .


The findings demonstrated the feasibility and suitability of the proposed system for pain management .


Its handling was user-friendly , without requiring advanced skill or prior experience .


In addition , the results showed that the guidance of health care professionals is essential to patients ' satisfaction and positive experience with the system .


There were no significant group differences with respect to improvements in the quality of pain treatment ; however , this can be explained by the low pain scores registered in both groups , related to the type of surgical interventions recruited and the degrees of pain that are easily treated .


To evaluate the benefits from a patient-centred perspective , studies of major ambulatory surgeries or of patients in chronic pain , including oncologic and non-oncologic pain resistant to treatment , are necessary .


A wide variety of orthodontic wires made of different alloys is available to be used in orthodontic practice and may produce different clinical responses during tooth movement .


This research evaluated the alignment and leveling of lower dental arches after the use of three types of orthodontic wires .


A sample of @ patients was randomly divided into @ groups : stainless steel , multistranded steel and superelastic nickel-titanium , according to the first leveling arches used .


In order to observe differences in tooth position and axial inclination of the lower incisors , all patients had lateral cephalometric radiographs taken before the insertion of the first arches and @ months later .


The irregularity index and the curve of Spee were measured , compared between groups and considered influential on the proclination of incisors during the initial phase of alignment and leveling .


TheReflex microscope was used to measure the irregularity index , whereas the ANOVA analysis of variance was used to verify differences between groups with regard to the degree of dental alignment and leveling .


There were significant differences between groups only at T@ for the irregularity index .


The NiTi and multistranded steel wires showed greater aligning capacity when compared with stainless steel wires .


The objectives of this study are to compare the effects of two nursing intervention models on the ability of preschool children with malignant tumors to socialize and to determine if these interventions improved their social adaption capability ( SAC ) and quality of life .


Inpatient preschool children with malignant tumors admitted to the hospital between December @ and March @ were recruited and randomized into either the experimental or control groups .


The control group received routine nursing care , and the experimental group received family-centered nursing care , including physical , psychological , and social interventions .


The Infants-Junior Middle School Student 's Social-Life Abilities Scale was used to evaluate SAC development of participants .


Participants ( n = @ ) were recruited and randomized into two groups .


After the intervention , the excellent and normal SAC rates were @ % and @ % in the experimental group , respectively , compared with @ % and @ % in the control group ( p < @ ) .


After the intervention , SAC in experimental group was improved compared with before intervention ( @ vs @ , p < @ ) .


However , no differences in SAC were observed between baseline and after intervention in the control group ( @ vs. @ , p = @ ) .


The family-centered nursing care model that included physical , psychological , and social interventions improved the SAC of children with malignancies compared with children receiving routine nursing care .


Establishing a standardized family-school-community-hospital hierarchical multi-management intervention model for children is important to the efficacy of long-term interventions and to the improvement of SAC of children with malignancies .


Most trials comparing percutaneous coronary intervention ( PCI ) with coronary-artery bypass grafting ( CABG ) have not made use of second-generation drug-eluting stents .


We conducted a randomized noninferiority trial at @ centers in East Asia .


We planned to randomly assign @ patients with multivessel coronary artery disease to PCI with everolimus-eluting stents or to CABG .


The primary end point was a composite of death , myocardial infarction , or target-vessel revascularization at @ years after randomization .


Event rates during longer-term follow-up were also compared between groups .


After the enrollment of @ patients ( @ patients randomly assigned to the PCI group and @ randomly assigned to the CABG group ) , the study was terminated early owing to slow enrollment .


At @ years , the primary end point had occurred in @ % of the patients in the PCI group and in @ % of those in the CABG group ( absolute risk difference , @ percentage points ; @ % confidence interval -LSB- CI -RSB- , -@ to @ ; P = @ for noninferiority ) .


At longer-term follow-up ( median , @ years ) , the primary end point had occurred in @ % of the patients in the PCI group and in @ % of those in the CABG group ( hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) .


No significant differences were seen between the two groups in the occurrence of a composite safety end point of death , myocardial infarction , or stroke .


However , the rates of any repeat revascularization and spontaneous myocardial infarction were significantly higher after PCI than after CABG .


Among patients with multivessel coronary artery disease , the rate of major adverse cardiovascular events was higher among those who had undergone PCI with the use of everolimus-eluting stents than among those who had undergone CABG .


( Funded by CardioVascular Research Foundation and others ; BEST ClinicalTrials.gov number , NCT@ . )


There is a paucity of data on the use of optimal medical therapy ( OMT ) in patients with complex coronary artery disease undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting ( CABG ) and its long-term prognostic significance .


The Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery ( SYNTAX ) trial is a multicenter , randomized , clinical trial of patients ( n = @ ) with complex coronary disease randomized to revascularization with percutaneous coronary intervention or CABG .


Detailed drug history was collected for all patients at discharge and at the @-month , @-month , @-year , @-year , and @-year follow-ups .


OMT was defined as the combination of at least @ antiplatelet drug , statin , - blocker , and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker .


Five-year clinical outcomes were stratified by OMT and non-OMT .


OMT was underused in patients treated with coronary revascularization , especially CABG .


OMT was an independent predictor of survival .


OMT was associated with a significant reduction in mortality ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) and composite end point of death/myocardial infarction/stroke ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) at the @-year follow-up .


The treatment effect with OMT ( @ % relative reduction in mortality over @ years ) was greater than the treatment effect of revascularization strategy ( @ % relative reduction in mortality with CABG versus percutaneous coronary intervention over @ years ) .


On stratified analysis , all the components of OMT were important for reducing adverse outcomes regardless of revascularization strategy .


The use of OMT remains low in patients with complex coronary disease requiring coronary intervention with percutaneous coronary intervention and even lower in patients treated with CABG .


Lack of OMT is associated with adverse clinical outcomes .


Targeted strategies to improve OMT use in postrevascularization patients are warranted .


To determine whether an education programme targeted at schoolchildren could lower salt intake in children and their families .


Cluster randomised controlled trial , with schools randomly assigned to either the intervention or control group .


@ primary schools in urban Changzhi , northern China .


@ children in grade @ of primary school , with mean age of @ ; @ adult family members ( mean age @ ) .


Children in the intervention group were educated on the harmful effects of salt and how to reduce salt intake within the schools ' usual health education lessons .


Children then delivered the salt reduction message to their families .


The intervention lasted for one school term ( about @ months ) .


The primary outcome was the difference between the groups in the change in salt intake ( as measured by @ hour urinary sodium excretion ) from baseline to the end of the trial .


The secondary outcome was the difference between the two groups in the change in blood pressure .


At baseline , the mean salt intake in children was @ ( SE @ ) g/day in the intervention group and @ ( SE @ ) g/day in the control group .


In adult family members the salt intakes were @ ( SE @ ) and @ ( SE @ ) g/day , respectively .


During the study there was a reduction in salt intake in the intervention group , whereas in the control group salt intake increased .