Moreover , long term outcome and generalization of learned skills are little evaluated .


Additionally , there is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life .


We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life .


In a randomized controlled trial ( RCT ) with three conditions , @ participants with ASD at the end of primary school ( @-@ years of calendar age ) have been randomized to SST , SST-PTI ( SST with Parent & Teacher Involvement ) , or care-as-usual .


The SST consists of @ group sessions of @ hours for the children .


In the SST-PTI condition , parents additionally participate in @ parent sessions and parents and teachers are actively involved in homework assignments .


Assessment takes place at three moments : before and immediately after the intervention period and at @ months follow-up .


Primary outcome is socialization , as an aspect of adaptive functioning .


Secondary outcomes focus on specific social skills children learn during SST and on more general social skills pertaining to home and community settings from a multi-informant perspective .


Additionally , possible predictors of treatment outcome will be assessed .


The current study is an RCT study evaluating SST in a large sample of Dutch children with ASD in a specific age range ( @-@ years ) .


Strengths of the study are the use of one manualized protocol , application of standardized and internationally used rating instruments , use of multiple raters , investigation of generalization of learned skills to daily life , and the evaluation of efficacy in the longer term by follow-up measures at @ months after the end of training .


Immune factors determining clinical progression following HIV-@ infection remain unclear .


The SPARTAC trial randomized @ participants in primary HIV infection ( PHI ) to different short-course therapies .


The aim of this study was to investigate how early immune responses in PHI impacted clinical progression in SPARTAC .


Participants with PHI recruited to the SPARTAC trial were sampled at enrolment , prior to commencing any therapy .


HIV-@-specific CD@ ( + ) and CD@ ( + ) ELISpot responses were measured by gamma interferon ELISPOT .


Immunological data were associated with baseline covariates and times to clinical progression using logistic regression , Kaplan-Meier plots , and Cox models .


Making a CD@ ( + ) T-cell ELISpot response ( n = @ ) at enrolment was associated with higher CD@ ( + ) cell counts ( P = @ ) and to some extent lower plasma HIV RNA ( P = @ ) .


There was no correlation between the number of overlapping Gag CD@ ( + ) T-cell ELISpot responses ( n = @ ) and plasma HIV-@ RNA viral load .


Over a median follow-up of @ years , baseline CD@ ( + ) cell ELISpot responses ( n = @ ) were associated with slower clinical progression ( P = @ ; log-rank ) .


Over a median of @ years , there was no evidence for a survival advantage imposed by CD@ ( + ) T-cell immunity ( P = @ ) .


These data support a dominant protective role for CD@ ( + ) T-cell immunity in PHI compared with CD@ ( + ) T-cell responses , and are highly pertinent to HIV pathogenesis and vaccines , indicating that vaccine-induced CD@ ( + ) responses may confer sustained benefit .


To explore clinical effect of Bacillus Calmette-Guerin polysaccharide nucleic acid ( BCG PSN ) combined with CO ( @ ) laser for vitiligo and its impact on Th@ cells and Th@ associated cytokines in patients with vitiligo .


The patients ( n = @ ) with vitiligo from June @ to October @ in our hospital were randomly divided into control group ( n = @ ) and observation group ( n = @ ) .


Patients in the control group were treated with CO ( @ ) laser .


Patients in the observation group were treated with BCG PSN besides CO ( @ ) laser .


The total treatment efficacy in the two groups was appraised .


Th@ cell populations in peripheral blood were analyzed by flow cytometry .


IL-@ and IL-@ levels in peripheral blood were determined by ELISA .


The expressions of IL-@ and IL-@ mRNA in cutaneous lesion tissues were detected by real-time quantitative PCR .


Total treatment efficacy in the observation group was significantly better than that of the control group .


Compared with the control group after treatment , Th@ lymphocyte subsets in the observation group after treatment were significantly reduced in peripheral blood , the levels of serum IL-@ and IL-@ in the peripheral blood significantly dropped , and the expressions of IL-@ and IL-@ mRNA in cutaneous lesion tissues also decreased significantly .


BCG PSN combined with CO ( @ ) laser can down-regulate Th@ lymphocyte subsets and Th@ associated cytokines in peripheral blood and cutaneous lesion .


It has a good clinical efficacy for treating vitiligo .


Prior studies have found that early HIV protease inhibitors contribute to glucose dysregulation .


Few randomized trials have evaluated glucose indices in antiretroviral-naive individuals on newer antiretroviral therapy ( ART ) .


A@s was a substudy of A@ , a prospective trial of @ ART-naive participants randomized to blinded abacavir-lamivudine ( ABC/@TC ) or tenofovir DF-emtricitabine ( TDF/FTC ) with open-label efavirenz ( EFV ) or atazanavir-ritonavir ( ATV/r ) .


Analyses used two-sample t-tests , Spearman correlation coefficients and linear regression .


A@s included @ nondiabetic individuals : @ % men , @ % white non-Hispanic , baseline median age @ years , HIV-@ RNA @ log@ copies/ml and CD@ cell count @ cells/l .


Overall , significant @-week increases occurred in fasting glucose , insulin and the homeostatic model assessment of insulin resistance ( HOMA-IR ) , P @ .


Assignment to EFV ( versus ATV/r ) resulted in significantly greater glucose increase -LSB- mean difference @ ; @ % confidence interval ( CI ) @ , @ mg/dl ; P = @ -RSB- but not insulin or HOMA-IR ( P @ ) .


Glucose indices were not significantly different between ABC/@TC and TDF/FTC arms , P @ .


Significant correlations were detected between changes in glucose indices and changes in BMI ; all r @ , P @ .


In multivariable analyses , in addition to the EFV effect , higher baseline HIV-@ RNA and greater BMI change were significant independent factors associated with greater glucose increase .


Changes in glucose metabolism were not significantly different between TDF/FTC and ABC/@TC-based regimens .


A small but significantly greater increase in glucose was observed in those assigned to EFV .


As glucose dysregulation may increase with time on ART , longer term studies will be needed to further clarify the clinical significance of these findings .


The aim of this prospective single-blinded study was to analyze the stone-free ( SF ) rates between pneumatic lithotripsy ( PL ) and laser lithotripsy ( LL ) for the treatment of single and primary ureteral stones and to evaluate potentially predictive factors of a SF status .


From January @ to January @ , @ consecutive patients with single and primary ureteral stones were prospectively enrolled .


Uni - and multivariate logistic regression were performed to estimate predictive factors of a SF status .


The SF rate in the PL group was @ and @ % in the LL group ( p = @ ) .


Success rates with regard of stone position were not significantly different between groups .


At univariate logistic regression , middle ureteral stone ( OR @ , p = @ ) , distal ureteral stone ( OR @ , p = @ ) , LL ( OR @ , p = @ ) and Hounsfield units ( HUs ) ( OR @ , p = @ ) were significantly predictive factors of a SF status .


At a multivariate logistic regression , middle ureteral stone ( OR @ , p = @ ) , distal ureteral stone ( OR @ , p < @ ) , LL ( OR @ , p = @ ) and HUs @,@ ( OR @ , p = @ ) were significantly associated with a SF status .


LL significantly influences the SF status after ureteroscopy , allowing a higher SF rate when compared to PL .


HUs may significantly influence this success rate .


Anxiety in children is common and incapacitating and increases the risk of mental health disorders in adulthood .


Although effective interventions are available , few children are identified and referred for specialist treatment .


Alternative approaches in which prevention programmes are delivered in school appear promising .


However , comparatively little is known about the best intervention leader ( health care-led vs. school-led ) , long-term effects or the primary preventive value of such programmes .


Preventing Anxiety in Children through Education in Schools , or PACES , is a pragmatic cluster randomised controlled trial evaluating the effectiveness of a cognitive-behavioural therapy prevention programme ( FRIENDS ) on symptoms of anxiety and low mood in @ - to @-year-old children .


Forty-one schools were randomly assigned to one of three conditions : school-led FRIENDS , health care-led FRIENDS or treatment as usual .


Assessments were undertaken at baseline , @ months and @ months , with the primary outcome measure being the Revised Child Anxiety and Depression Scale score at @ months .


Secondary outcome measures are changes in self-esteem , worries , bullying and life satisfaction .


This protocol summarises the procedure for the @-month follow-up of this cohort .


The study will determine the medium-term effectiveness of an anxiety prevention programme delivered in schools .


There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care , but there is less practical information specific to primary care available to guide practices on how to better work as teams .


The purpose of this study was to describe how primary care practices have overcome challenges to providing team-based primary care and the implications for care delivery and policy .


Practices for this qualitative study were selected from those recognized as patient-centered medical homes ( PCMHs ) via the most recent National Committee for Quality Assurance PCMH tool , which included a domain on practice teamwork .


Sixty-three respondents , ranging from physicians to front-desk staff , were interviewed from May through December of @ .


Practice respondents came from @ primary care practices ranging in size , type , geography , and population served .


Practices emphasizing teamwork overcame common challenges through the incremental delegation of non-clinical tasks away from physicians .


The roles of medical assistants and nurses are expanding to include template-guided information collection from patients prior to the physician office visit as well as many other tasks .


The inclusion of staff input in care workflow redesign and the use of data to demonstrate how team care process changes improved patient care were helpful in gaining staff buy-in .


Team `` huddles '' guided by pre-visit planning were reported to assist in role delegation , consistency of information collected from patients , and structured communication among team members .


Nurse care managers were found to be important team members in working with patients and their physicians on care plan design and execution .


Most practices had not participated in formal teamwork training , but respondents expressed a desire for training for key team members , particularly if they could access it on-site ( e.g. , via practice coaches or the Internet ) .


Participants who adopted new forms of delegation and care processes using teamwork approaches , and who were supported with resources , system support , and data feedback , reported improved provider satisfaction and productivity .


There appears to be a need for more on-site teamwork training .


The effect of metformin on weight reduction in polycystic ovary syndrome ( PCOS ) is often unsatisfactory .


In this study , we investigated the potential add-on effect of treatment with the glucagon-like peptide-@ receptor agonist liraglutide on weight loss in obese nondiabetic women with PCOS who had lost < @ % body weight during pretreatment with metformin .


A total of @ obese women with PCOS , who had been pretreated with metformin for at least @ months , participated in a @-week open-label , prospective study .


They were randomized to one of three treatment arms : metformin ( MET ) arm @ mg BID , liraglutide ( LIRA ) arm @ mg QD s.c. , or combined MET @ mg BID and LIRA ( COMBI ) @ mg QD s.c. Lifestyle intervention was not actively promoted .


The primary outcome was change in body weight .


Thirty six patients ( aged @ @ years , BMI @ @ kg/m ) completed the study : @ on MET , @ on LIRA , and @ on combined treatment .


COMBI therapy was superior to LIRA and MET monotherapy in reducing weight , BMI , and waist circumference .


Subjects treated with COMBI lost on average @ @ kg compared with a @ @ kg loss in the LIRA group and a @ @ kg loss in the MET group ( P < @ ) .


The extent of weight loss was stratified : a total of @ % of subjects were high responders who lost @ % body weight , @ % of them in the COMBI arm compared with @ and @ % in the LIRA and MET arm respectively .


BMI decreased by @ @ in the COMBI arm compared with @ @ in LIRA and @ @ in the MET arm ( P < @ ) .


Waist circumference also decreased by @ @ cm in the COMBI arm compared with @ @ cm in LIRA and @ @ cm in the MET arm ( P = @ ) .


Subjects treated with liraglutide experienced more nausea than those treated with metformin , but severity of nausea decreased over time and did not correlate with weight loss .


Short-term combined treatment with liraglutide and metformin was associated with significant weight loss and decrease in waist circumference in obese women with PCOS who had previously been poor responders regarding weight reduction on metformin monotherapy .


Probiotics may help resolve bowel symptoms and improve quality of life .


We investigated the effects of @ weeks of probiotics administration in colorectal cancer patients .


We conducted a double-blind , randomized , placebo-controlled trial .


The participants took probiotics ( Lacidofil ) or placebo twice a day for @ weeks .


The cancer-related quality of life ( FACT ) , patient 's health-@ ( PHQ-@ ) , and bowel symptom questionnaires were completed by each participant .


We obtained data for @ participants in the placebo group and @ participants in the probiotics group .


The mean ages of total participants were @ @ years and @ % were male .


Administration of probiotics significantly decreased the proportion of patients suffering from irritable bowel symptoms ( @ week vs. @ week ; @ % vs. @ % , p = @ ) , improved colorectal cancer-related FACT ( baseline vs. @ weeks : @ @ vs. @ @ , p = @ ) and fatigue-related FACT ( baseline vs. @ weeks : @ ( @-@ @ ) vs. @ ( @-@ @ ) , p = @ ) and PHQ-@ scores ( @ weeks vs. @ weeks ; @ ( @-@ @ ) vs. @ ( @-@ @ ) , p = @ ) .


We found significant differences in changes of the proportion of patients with bowel symptoms ( p < @ ) , functional well-being scores ( p = @ ) and cancer-related FACT scores ( p = @ ) between the two groups .


Probiotics improved bowel symptoms and quality of life in colorectal cancer survivors .


To describe Action Schools !


BC ( AS !


BC ) from efficacy to scale-up .


Education and health system stakeholders and children in grades @-@ from elementary schools in British Columbia , Canada .


At the provincial level , the AS !


BC model reflected socioecological theory and a partnership approach to social change .


Knowledge translation and exchange were embedded as a foundational element .


At the school level , AS !


BC is a comprehensive school health-based model providing teachers and schools with training and resources to integrate physical activity ( PA ) and healthy eating ( HE ) into the school environment .


Our research team partnered with key community and government stakeholders to deliver and evaluate AS !


BC over efficacy , effectiveness and implementation trials .


On the basis of significant increases in PA , cardiovascular fitness , bone and HE in AS !


BC schools during efficacy trials , the BC government supported a provincial scale-up .


Since its inception , the AS !


BC Support Team and > @ trained regional trainers have delivered @ teacher-focused workshops ( training approximately @,@ teachers ) , reaching approximately @,@ students .


After scale-up , PA delivery was replicated but the magnitude of change appeared less .


One ( HE ) and @ ( PA ) years after scale-up , trained AS !


BC teachers provided more PA and HE opportunities for students even in the context of supportive provincial policies .


Whole school models like AS !


BC can enhance children 's PA and health when implemented in partnership with key stakeholders .


At the school level , adequately trained and resourced teachers and supportive school policies promoted successful scale-up and sustained implementation .


At the provincial level , multisectoral partnerships and embedded knowledge exchange mechanisms influenced the context for action at the provincial and school level , and were core elements of successful implementation .


Although resistance training adaptations in multiple sclerosis ( MS ) patients have been described , the detraining response in this population is largely unknown .


-LSB- corrected -RSB- This study was designed to evaluate the effects of a @-week detraining period on muscle strength ( isometric and endurance ) and muscle power of multiple sclerosis ( MS ) patients that had previously carried out a @-week resistance training program ( RTP ) .


Forty-two MS patients were randomly assigned into two groups : an exercise group ( EG ) that performed a @-week RTP for the knee extensors muscles ; and a control group ( CG ) , that did not perform any specific training .


Knee extension maximal voluntary isometric contraction ( MVIC ) , muscle power and muscle endurance were evaluated before and after the RTP , as well as @ weeks after training completion .


A strain gauge was used to measure the maximal voluntary isometric contraction and muscle power was assessed with a linear encoder .


Muscle endurance was interpreted as the number of repetitions that a patient could perform in a single set of knee extension exercise .


The EG increased MVIC and muscle power after the training period , although the training did not affect muscle endurance .


After @ weeks of detraining , MVIC returned to pre-training values but muscle power was still greater than pre-training values in the EG .


The CG did not present any change in the variables measured during the intervention .


A @-week RTP improved MVIC and muscle power in MS patients .


Additionally , @ weeks of detraining blunted strength training adaptations in MS patients , although muscle power training adaptations were still evident after the detraining period .


Central neurological injury ( CNI ) is a major contributor to physical disability that affects both adults and children all over the world .


The main sequelae of chronic stage CNI are spasticity , paresis of specific muscles , and poor selective motor control .


Here , we apply the concept of contralateral peripheral neurotization in spasticity releasing and motor function restoration of the affected upper extremity .


A clinical investigation was performed to verify the clinical efficacy of contralateral C@ neurotization for rescuing the affected upper extremity after CNI .


In the present study , @ adult hemiplegia patients received the nerve transfer surgery of contralateral C@ to C@ of the affected side .


Another @ patients with matched pathological and demographic status were assigned to the control group that received rehabilitation only .


During the @-year follow-up , muscle strength of bilateral upper extremities was assessed .


The Modified Ashworth Scale and Fugl-Meyer Assessment Scale were used for evaluating spasticity and functional use of the affected upper extremity , respectively .


Both flexor spasticity release and motor functional improvements were observed in the affected upper extremity in all @ patients who had surgery .


The muscle strength of the extensor muscles and the motor control of the affected upper extremity improved significantly .


There was no permanent loss of sensorimotor function of the unaffected upper extremity .


This contralateral C@ neurotization approach may open a door to promote functional recovery of upper extremity paralysis after CNI .


To assess the safety and the possible advantages of early ( @-wk ) cochlear implant switch-on in children and to compare impedance and ECAP threshold changes between subjects undergoing early switch-on and those undergoing traditional , @-month switch-on .


Prospective cohort study .


Tertiary care referral pediatric center .


Seventeen children receiving a unilateral or bilateral Nucleus Freedom cochlear implant were included , for a total of @ ears .


Ten ears were assigned to the early ( @-wk ) switch-on group and @ to the control group ( switch-on after @ wks ) .


Common ground impedance values and electrically evoked compound action potential thresholds were measured from intraoperation until @ months postoperatively .


Speech perception improvements over time were also assessed .


Complication rate , impedance levels ( k ) , and electrically evoked compound action potentials ( current levels )


Early switch-on was well tolerated by patients and did not cause complications .


Impedances dropped significantly after switch-on in both groups .


They also seemed to achieve an earlier stability in the early switch-on patients , although the difference between groups was not significant .


ECAP thresholds showed a similar , nonsignificant decreasing trend over time in both groups .


Speech perception improvements did not differ between groups .


This is the first study investigating the safety and the effects of an early cochlear implant switch-on in children .


Results show that such a procedure is well tolerated by pediatric subjects and free from complications .


Impedance measurements suggest that the earlier switched-on subjects benefit of lower and more stable impedances than subjects undergoing @-month switch-on .


The electronic self report assessment - cancer ( ESRA-C ) , has been shown to reduce symptom distress during cancer therapy The purpose of this analysis was to evaluate aspects of how the ESRA-C intervention may have resulted in lower symptom distress ( SD ) .


Patients at two cancer centers were randomized to ESRA-C assessment only ( control ) or the Web-based ESRA-C intervention delivered to patients ' homes or to a tablet in clinic .


The intervention allowed patients to self-monitor symptom and quality of life ( SxQOL ) between visits , receive self-care education and coaching to report SxQOL to clinicians .


Summaries of assessments were delivered to clinicians in both groups .


Audio-recordings of clinic visits made @ weeks after treatment initiation were coded for discussions of @ SxQOL issues , focusing on patients ' / caregivers ' coached verbal reports of SxQOL severity , pattern , alleviating/aggravating factors and requests for help .


Among issues identified as problematic , two measures were defined for each patient : the percent SxQOL reported that included a coached statement , and an index of verbalized coached statements per SxQOL .


The Wilcoxon rank test was used to compare measures between groups .


Clinician responses to problematic SxQOL were compared .


A mediation analysis was conducted , exploring the effect of verbal reports on SD outcomes .


@ ( @ intervention ) clinic visits were audio-recorded .


General discussion of problematic SxQOL was similar in both groups .


Control group patients reported a median @ % of problematic SxQOL using any specific coached statement compared to a median @ % in the intervention group ( p = @ ) .


The median report index of coached statements was @ for the control group and @ for the intervention group ( p = @ ) .


Fatigue , pain and physical function issues were reported significantly more often in the intervention group ( all p < @ ) .


Clinicians ' verbalized responses did not differ between groups .


Patients ' verbal reports did not mediate final SD outcomes ( p = @ ) .


Adding electronically-delivered , self-care instructions and communication coaching to ESRA-C promoted specific patient descriptions of problematic SxQOL issues compared with ESRA-C assessment alone .


However , clinician verbal responses were no different and subsequent symptom distress group differences were not mediated by the patients ' reports .


Endothelial progenitor cells ( EPC ) are bone marrow-derived cells which can undergo differentiation into endothelial cells and participate in endothelial repair and angiogenesis .


Insulin facilitates this in vitro mediated by the IGF-@ receptor .


Clinical trials showed that the number of circulating EPCs is influenced by glucose control and EPC are a predictor of cardiovascular death .


To study direct effects of insulin treatment on EPCs in type @ diabetes patients , add-on basal insulin treatment was compared to an escalation of oral medication aiming at similar glucose control between the groups .


@ patients with type @ diabetes ( @ years ) on oral diabetes medication were randomized in a @:@:@ ratio in @ groups .


Patients were treated additionally with insulin glargine ( n = @ ) , NPH insulin ( n = @ ) or escalated with oral medication ( n = @ ) .


Number of circulating EPC , EPC-outgrowth , intima media thickness , skin microvascular function and HbA@c were documented at baseline and/or after @ weeks and @ months .


HbA@c at baseline was , @ + / -@ % in the oral group , @ + / -@ % and @ + / -@ % in the glargine and NPH insulin respectively ( p = @ ) .


HbA@c after @ months decreased to @ + / -@ % , @ + / -@ % and @ + / -@ % , in the oral , glargine and NPH insulin group respectively ( p = @ ) .


FACS analysis showed no difference in number of circulating EPC between the groups after @ weeks and @ months .


However , the outgrowth of EPCs as detected by colony forming assay was increased in the NPH insulin and glargine groups ( @ + / -@ and @ + / - @ units respectively ) compared to the group on oral medication ( @ + / -@ , p = @ ) after @ months of treatment .


A significant decrease of IMT from @ mm ( + / -@ ) at baseline to @ mm ( + / -@ ) after @ months could be observed in all patients only ( p = @ ) with a trend towards a reduction of IMT after @ months when all patients on insulin treatment were compared to the oral treatment group ( p = @ ) .


Skin microvascular function revealed no differences between the groups ( p = @ ) .


The study shows that a @-month treatment with add-on insulin significantly increases the outgrowth of EPC in patients with type @ diabetes mellitus .


There is an increasing need for new treatments for patients with Crohn 's disease ( CD ) in whom previous therapy with tumor necrosis factor ( TNF ) antagonists has failed .


We performed a placebo-controlled , phase @ , double-blind trial to evaluate the efficacy and safety of vedolizumab , an antibody against the integrin @ , as induction therapy .


Patients with moderately to severely active CD ( CD activity index -LSB- CDAI -RSB- score , @-@ points ) were assigned randomly to groups given vedolizumab ( @ mg ) or placebo intravenously at weeks @ , @ , and @ .


The primary analysis involved @ patients with previous TNF antagonist failure ( ie , an inadequate response to , loss of response to , or intolerance of @ TNF antagonists ) ; we determined the proportion of patients in clinical remission ( CDAI , @ points ) at week @ .


Secondary analyses evaluated outcomes at weeks @ and @ in this population and in the overall population ( N = @ ) , which included patients naive to TNF antagonist therapy ( n = @ ) .


Among patients who had experienced previous TNF antagonist failure , @ % of those given vedolizumab and @ % of those given placebo were in remission at week @ ( P = @ ) .


At week @ , a higher proportion of this population given vedolizumab was in remission ( @ % ) than those given placebo ( @ % ) ( nominal P = @ ; relative risk , @ ; @ % confidence interval , @-@ @ ) .


A higher proportion of patients with previous TNF antagonist failure given vedolizumab also had a CDAI-@ response ( @-point decrease in CDAI score from baseline ) at week @ than those given placebo ( @ % vs @ % ; nominal P = @ ; relative risk , @ ; @ % confidence interval , @-@ @ ) .


Adverse event results were similar among all groups .


Vedolizumab was not more effective than placebo in inducing clinical remission at week @ among patients with CD in whom previous treatment with TNF antagonists had failed .


The therapeutic benefits of vedolizumab in these patients were detectable at week @ .


ClinicalTrials.gov number : NCT@ .


Proper caloric intake goals in critically ill surgical patients are unclear .


It is possible that overnutrition can lead to hyperglycemia and an increased risk of infection .


This study was conducted to determine whether surgical infection outcomes in the intensive care unit ( ICU ) could be improved with the use of hypocaloric nutritional support .


Eighty-three critically ill patients were randomly allocated to receive either the standard calculated daily caloric requirement of @-@ kcal kg ( -@ ) d ( -@ ) ( eucaloric ) or @ % of that value ( hypocaloric ) via enteral tube feeds or parenteral nutrition , with an equal protein allocation in each group ( @ g kg ( -@ ) d ( -@ ) ) .


There were @ infections in the hypocaloric group and @ in the eucaloric group , with no significant difference in the mean ( SE ) number of infections per patient ( @ @ and @ @ , respectively ; P = @ ) , percentage of patients acquiring infection -LSB- @ % ( @ of @ ) and @ % ( @ of @ ) , respectively ; P = @ -RSB- , mean ICU length of stay ( @ @ and @ @ d , respectively ; P = @ ) , mean hospital length of stay ( @ @ and @ @ d , respectively ; P = @ ) , mean @ glucose concentration ( @ @ and @ @ mg/dL , respectively ; P = @ ) , or number of mortalities -LSB- @ ( @ % ) and @ ( @ % ) , respectively ; P = @ -RSB- .


Further analyses revealed no differences when analyzed by sex , admission diagnosis , site of infection , or causative organism .


Among critically ill surgical patients , caloric provision across a wide acceptable range does not appear to be associated with major outcomes , including infectious complications .


The optimum target for caloric provision remains elusive .


Curry , one of the most popular foods in Japan , contains spices that are rich in potentially antioxidative compounds , such as curcumin and eugenol .


Oxidative stress is thought to impair endothelial function associated with atherosclerosis , a leading cause of cardiovascular events .


The aim of this study was to determine whether a single consumption of curry meal would improve endothelial function in healthy men .


Fourteen healthy male subjects ( BMI @ kg/m@ ; age @years ) were given a single serving of curry meal or spice-free control meal ( @g of curry or control and @g of cooked rice ; approximately @kcal in total ) in a randomized , controlled crossover design .


Before and @hr after the consumption , fasting and postprandial flow-mediated vasodilation ( FMD ) responses and other parameters were measured .


The consumption of the control meal decreased FMD from @ % to @ % ( P = @ ) .


On the other hand , the consumption of the curry meal increased FMD from @ % to @ % ( P = @ ) , and the postprandial FMD after the curry meal was higher than that after the control meal ( P = @ ) .


Presence of spices in the curry did not alter significantly the systemic and forearm hemodynamics , or any biochemical parameters including oxidative stress markers measured .


These findings suggest that the consumption of curry ameliorates postprandial endothelial function in healthy male subjects and may be beneficial for improving cardiovascular health .


This study 's purpose was to investigate the effect of a glass ionomer cement as a liner over infected unexcavated dentin after @ days and at @ to @ months .


Forty-five permanent molars with deep carious lesions were selected .


Fragments of carious dentin were removed prior to lining the cavity ( baseline sample ) with glass ionomer cement ( G@ ) or an inert wax material ( G@ ) .


Cavities were restored with composite resin and reopened @ days later , when other fragments were removed ( @-day sample ) .


The dentin morphology ( scanning electron microscopy ) and mineral content of calcium , phosphorus , and fluorine were assessed .


During the follow-up periods ( @ days and @ to @ months ) , restorations were evaluated and standardized radiographs were taken .


A postprocessing routine was used to identify changes in the radiographic density between periods .


After @ days , the dentin exhibited a better organization , fewer bacteria , and signs of remineralization .


The weight percents of calcium and phosphorus were higher @ days after the cavity sealing , regardless of the group .


Higher gray levels of carious and sound dentin were seen on the @ - to @-month radiographs , irrespective of the group .


The success rates of G@ and G@ were @ percent and @ percent , respectively .


The lining material is n't fundamental for caries arrestment .


Early ( @-day ) and late ( @ to @ months ) dentin changes occurred , indicating the remineralization of dentin carious tissue .


There is a lack of evidence on the best treatment option for umbilical granuloma .


The primary aim of this study was to compare three treatments for umbilical granuloma : standard treatment with topical silver nitrate , clobetasol propionate cream ( @ % ) and ethanol wipes .


The secondary aim was to evaluate whether the treatment could be successfully administered by a parent at home , rather than in the outpatient clinic .


A total of @ infants were randomised to one of three groups and @ infants completed the assigned treatment : @ infants received standard treatment with silver nitrate ( @ % ) in the outpatient clinic , @ infants had topical clobetasol propionate cream ( @ % ) applied at home , and @ infants received cleansing with ethanol wipes ( @ % ) at home .


Silver nitrate and clobetasol propionate cream ( @ % ) were significantly superior to ethanol wipes , with shorter healing times and higher resolution rates ( p = @ ) .


Healing time and resolution rates were identical for silver nitrate and clobetasol propionate cream ( @ % ) .


Mild side effects were occasionally reported , all of which were self-limiting .


Treating umbilical granuloma with topical clobetasol propionate cream ( @ % ) at home is as effective as treating it with topical silver nitrate ( @ % ) in the clinic .


The purpose of this study was to evaluate the diagnostic performance and interobserver agreement of @-dimensional ( @D ) and @-dimensional ( @D ) sonography for evaluating extrathyroidal extension of papillary thyroid carcinoma .


A total of @ papillary thyroid carcinomas in @ patients who underwent both @D and @D sonography for preoperative staging of papillary thyroid carcinoma were included .


When the lesion was abutting on the thyroid capsule on @D sonography , @D sonography was performed .


Three radiologists reviewed @ data sets : @D sonography , @D sonography , and a combined set of both for tumor staging .


The diagnostic performance , including sensitivity , specificity , positive predictive value , negative predictive value , and accuracy , for extrathyroidal extension was analyzed .


Interobserver agreement of the @ radiologists was assessed with values .


The overall accuracy rates for @D sonography , @D sonography , and the combined set in predicting extrathyroidal extension were @ % , @ % , and @ % , respectively .


The accuracy of the combined set was significantly higher than that of @D sonography ( P = @ ) .


The interobserver agreement of the @ reviewers was fair ( = @ ) for @D sonography and moderate for @D sonography ( = @ ) and the combined set ( = @ ) .


Adding @D sonography to @D sonography could improve the accuracy and interobserver agreement for predicting extrathyroidal extension of papillary thyroid carcinoma .


To compare corifollitropin alfa with recombinant FSH treatment in terms of the vital pregnancy rate in older patients undergoing IVF .


Phase @ randomized , double-blind , noninferiority trial .


Multicenter trial .


A total of @,@ women aged @-@ years .


A single injection of @ g of corifollitropin alfa or daily @ IU of recombinant FSH for the first @ days then daily recombinant FSH until three follicles reach @ mm in size .


Ganirelix was started on stimulation day @ up to and including the day of recombinant hCG administration .


If available , two good quality embryos were transferred on day @ .


Vital pregnancy rate ( PR ) , number of oocytes , and live birth rate .


Vital PRs per started cycle were @ % in the corifollitropin alfa group and @ % in the recombinant FSH group , with an estimated difference ( @ % confidence interval ) of -@ % ( -@ to @ ) .


The mean ( SD ) number of recovered oocytes per started cycle was @ ( @ ) and @ ( @ ) in the corifollitropin alfa and the recombinant FSH groups , respectively , with an estimated difference of @ ( -@ to @ ) .


The live birth rates per started cycle were @ % in the corifollitropin alfa group and @ % in the recombinant FSH group , with an estimated difference ( @ % confidence interval ) -@ % ( -@ to @ ) .


The incidence of serious adverse events was @ % versus @ % in the corifollitropin alfa and recombinant FSH groups , respectively , and of ovarian hyperstimulation syndrome ( OHSS ; all grades ) was @ % in both groups .


Treatment with corifollitropin alfa was proven noninferior to daily recombinant FSH with respect to vital PRs , number of oocytes retrieved , and live birth rates , and was generally well tolerated .


Recent reviews suggest Web-based interventions are promising approaches for weight management but they identify difficulties with suboptimal usage .


The literature suggests that offering some degree of human support to website users may boost usage and outcomes .


We disseminated the POWeR ( `` Positive Online Weight Reduction '' ) Web-based weight management intervention in a community setting .


POWeR consisted of weekly online sessions that emphasized self-monitoring , goal-setting , and cognitive/behavioral strategies .


Our primary outcome was intervention usage and we investigated whether this was enhanced by the addition of brief telephone coaching .


We also explored group differences in short-term self-reported weight loss .


Participants were recruited using a range of methods including targeted mailouts , advertisements in the local press , notices on organizational websites , and social media .


A total of @ adults were randomized at an individual level through an online procedure to ( @ ) POWeR only ( n = @ ) , ( @ ) POWeR plus coaching ( n = @ ) , or ( @ ) a waiting list control group ( n = @ ) .


Those in the POWeR plus coaching arm were contacted at approximately @ and @ days after randomization for short coaching telephone calls aimed at promoting continued usage of the website .


Website usage was tracked automatically .


Weight was assessed by online self-report .


Of the @ participants allocated to the two intervention groups , the median number of POWeR sessions completed was just one ( IQR @-@ for POWeR only , IQR @-@ for POWeR plus coach ) .


Nonetheless , a substantial minority completed at least the core three sessions of POWeR : @ participants ( @ % , @/@ ) in the POWeR-only arm and @ participants ( @ % , @/@ ) in the POWeR plus coaching arm .


Participants in the POWeR plus coaching group persisted with the intervention for longer and were @ times more likely to complete the core three sessions than the POWeR-only group ( ( @ ) @ = @ ; OR @ , @ % CI @-@ @ ; n = @ ) .


An intention-to-treat analysis showed between-group differences in weight loss ( F@ ,@ = @ , P < @ ) .


Both intervention groups reported more weight loss than the waiting list control group .


Weight loss was slightly , but not significantly , greater in the POWeR plus coaching group .


A large proportion of participants assigned to POWeR plus coaching refused phone calls or were not contactable ( @ % , @/@ ) .


Exploratory analyses identified health and sociodemographic differences between those who did and did not engage in coaching when it was made available to them .


Users who engaged with coaching used the intervention more and lost more weight than those who did not .


In common with most Web-based intervention studies , usage of POWeR was suboptimal overall .


However , our findings suggest that supplementing Web-based weight management with brief human support could improve usage and outcomes in those who take it up .


Patients with Addison 's disease ( AD ) report impaired subjective health status ( SHS ) .


Since cortisol exhibits a robust circadian cycle that entrains other biological clocks , impaired SHS may be due to the noncircadian cortisol profile achieved with conventional glucocorticoid replacement .


Continuous subcutaneous hydrocortisone infusion ( CSHI ) reproduces a circadian cortisol profile , but its effects on SHS have not been objectively evaluated .


The aim of this study was to determine the effect of CSHI on SHS in AD .


This was a multicentre , double-blind , placebo-controlled trial of CSHI vs oral glucocorticoid therapy .


Participants received in random order @ weeks of : CSHI and oral placebo , and subcutaneous placebo and oral hydrocortisone , separated by a @-week washout period .


SHS was assessed using the Short-Form @ ( SF-@ ) , General Health Questionnaire ( GHQ-@ ) , Fatigue Scale ( FS ) , Gastrointestinal Symptom Rating Scale ( GSRS ) ; and Addison 's Quality of Life Questionnaire ( AddiQoL ) .


Participants were asked their ( blinded ) treatment preference .


Twenty-four hour urine free cortisol ( UFC ) and diurnal salivary cortisol collections compared cortisol exposure during each treatment .


Ten participants completed the study .


Baseline SHS scores ( mean SE ) were consistent with mild impairment : SF-@ physical component summary @ ( @ ) , mental component summary @ ( @ ) ; GHQ-@ @ ( @ ) ; GSRS @ ( @ ) , and AddiQoL @ ( @ ) .


FS was similar to other AD cohorts @ ( @ ) ( P = @ ) .


UFC between treatments was not different ( P = @ ) .


The salivary cortisol at @ h was higher during CSHI ( P = @ ) , but not at any other time points measured .


There was no difference between the treatments in the SHS assessments .


Five participants preferred CSHI , four oral hydrocortisone , and one was uncertain .


Biochemical measurements indicate similar cortisol exposure during each treatment period , although a more circadian pattern was evident during CSHI .


CSHI does not improve SHS in AD with good baseline SHS .


This casts some doubt on the potential benefit of circadian cortisol delivery on SHS in AD .


To evaluate the role of bladder training during postoperative hospital stay in patients submitted to nerve-sparing radical hysterectomy , and to identify any clinical or surgical factor associated with postoperative bladder dysfunction .


Parallel group randomized single institution trial , on gynaecologic malignancies patients conducted in Catholic University of Sacred Heart Rome , between April @ and November @ .


Randomization was on @:@ , using a block randomized computer-generated list .


Patients underwent Querleu-Morrow type B@ or C@ radical hysterectomy .


After @ days from surgery , patients were randomized to perform or not bladder training ( scheduled clamping and unclamping of the trans-urethral catheter every three hours ) .


Main outcome measures Necessity and duration of clean intermittent self catheterization .


Randomized participants were @ women ( bladder training arm n = @ ; control arm n = @ ) .


A total of @ women ( @ % ) required clean intermittent self catheterization , equally distributed in the two arms .


At univariate analysis , only the type of radical hysterectomy was significantly associated with need of clean intermittent self catheterization ( type C@ vs. type B@ ; p = @ ) .


At univariate analysis , duration of clean intermittent self-catheterization was not associated with age , BMI , type of hysterectomy and of neo-adjuvant treatment .


Functional bladder disfunctions are the most common long-term complications following radical hysterectomy .


Systematic postoperative bladder training following nerve-sparing radical hysterectomy does not influence the rate of urinary retention or re-admission for bladder catheterization .


To evaluate the efficacy and safety of empagliflozin/linagliptin in subjects with type @ diabetes .


Subjects not receiving antidiabetes therapy for @ weeks were randomized to empagliflozin @ mg/linagliptin @ mg ( n = @ ) , empagliflozin @ mg/linagliptin @ mg ( n = @ ) , empagliflozin @ mg ( n = @ ) , empagliflozin @ mg ( n = @ ) , or linagliptin @ mg ( n = @ ) for @ weeks .


The primary end point was change from baseline in HbA@c at week @ .


Mean HbA@c at baseline was @-@ @ % ( @ mmol/mol ) .


At week @ , adjusted mean ( SE ) changes from baseline in HbA@c with empagliflozin @ mg/linagliptin @ mg , empagliflozin @ mg/linagliptin @ mg , empagliflozin @ mg , empagliflozin @ mg , and linagliptin @ mg were -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) , -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) , -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) , -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) , and -@ ( @ ) % ( -@ -LSB- @ -RSB- mmol/mol ) , respectively .


Reductions in HbA@c were significantly greater for empagliflozin @ mg/linagliptin @ mg compared with linagliptin @ mg ( P < @ ) but not compared with empagliflozin @ mg and were significantly greater for empagliflozin @ mg/linagliptin @ mg compared with the individual components ( P < @ for both ) .


At week @ , @ % , @ % , @ % , @ % , and @ % of subjects with baseline HbA@c @ % ( @ mmol/mol ) reached HbA@c < @ % with empagliflozin @ mg/linagliptin @ mg , empagliflozin @ mg/linagliptin @ mg , empagliflozin @ mg , empagliflozin @ mg , and linagliptin @ mg , respectively .


Efficacy was maintained at week @ .


The proportion of subjects with adverse events ( AEs ) over @ weeks was similar across groups ( @-@ @ % ) , with no confirmed hypoglycemic AEs .


Reductions from baseline in HbA@c with empagliflozin/linagliptin were significantly different versus linagliptin and empagliflozin @ mg but not versus empagliflozin @ mg .


Empagliflozin/linagliptin was well tolerated .


The aims of this study were to test the hypothesis that people with stroke who receive formal powered wheelchair skills training improve their wheelchair skills to a significantly greater extent than participants in a control group who do not and to explore the influence of spatial neglect .


Seventeen participants with stroke ( including nine with spatial neglect ) were randomly allocated to intervention ( n = @ ) or control ( n = @ ) groups .


Those in the intervention group received up to five @-min training sessions based on the Wheelchair Skills Training Program @ .


The powered Wheelchair Skills Test version @ was administered at baseline ( T@ ) and after training ( T@ ) .


A rank order analysis of covariance on the T@ Wheelchair Skills Test score , having adjusted for the T@ score , showed a significant effect caused by group ( P = @ ) .


A secondary analysis showed no significant effect caused by spatial neglect ( P = @ ) .


People with stroke who receive formal powered wheelchair skills training improve their powered wheelchair skills to a significantly greater extent ( @ % ) than participants who do not ( @ % ) .


The extent of change was not affected by the presence of spatial neglect .


These findings have significance for the wheelchair provision process and the rehabilitation of people with stroke .


The aims of this paper are ( i ) to compare the excitability of visual cortex in migraine patients with healthy volunteers ; and ( ii ) if an abnormal excitability has been found , to modulate cortical excitability in migraine patients with transcranial direct current stimulation ( tDCS ) and observe their clinical and neurophysiological effects .


The study was divided into two steps .


A cross-sectional study ( step @ ) was conducted to compare the cortical excitability of @ migraineurs ( @ with and @ without aura ) on @ healthy individuals .


On step @ , a randomized , double blinded , controlled pilot trial was carried on with @ migraineurs , randomly divided into : experimental and control group .


During @ sessions , experimental and group received active tDCS to visual cortex and control group received sham tDCS .


The headache diary was applied for a total of @days ( before , during and after tDCS sessions ) .


Phosphene threshold ( PT ) induced by transcranial magnetic stimulation was recorded to measure the excitability of the visual cortex before and after each session .


Step @ showed higher level of cortical excitability between migraineurs when compared to healthy volunteers ; therefore , cathodal tDCS was applied over visual cortex in step @ .


After tDCS application , a significant decrease was observed in a number of migraine attacks , painkiller intake and duration of each attack just in experimental group .


The analysis of PT indicated no difference in cortical excitability after tDCS .


Findings of the study suggested that inhibitory tDCS on visual cortex might be an alternative and non-pharmacological treatment for migraine prophylaxis .


However the clinical improvements of patients after tDCS treatment are not correlated with changes in cortical excitability .


To evaluate breast self examination ( BSE ) practice and the effect of a training program conducted by healthcare professionals on BSE .


Women were randomized into control and test groups with both groups completing a questionnaire and three independent interviews where their BSE practices were evaluated .


In all , @ % of the participants were previously provided information on BSE by healthcare professionals while @ % had no knowledge of BSE prior to enrollment .


Compared to those informed about BSE through other means such as television , radio , and the internet , the scores of the first , second , and third visits were higher ( p < @ ) in individuals who received BSE education from healthcare professionals and hospitals .


BSE training provided by healthcare professionals may increase early breast cancer diagnosis and treatment rates by improving BSE awareness and practice .


This study aimed to assess the efficacy of early intensive diabetes therapy with either insulin plus metformin ( INS ) or triple oral therapy ( TOT ) with metformin , glyburide , and pioglitazone on glycemic control and A-cell function .


Fifty-eight treatment-naive newly diagnosed patients with type @ diabetes underwent a @-month lead-in treatment period with insulin and metformin , then were randomized to INS or TOT for @ years .


- Cell function was measured using mixed-meal challenge test .


- Cell function remained stable throughout the @-year study in both groups , as measured by the C-peptide area under the curve ( AUC ; P = @ ) , the AUC C-peptide/AUC glucose ( P = @ ) , and by the disposition index ( P = @ ) .


Excellent glycemic control was maintained in both groups ( end-of-study hemoglobinA@c , @ % -LSB- SD , @ % -RSB- INS vs @ % -LSB- @ % -RSB- TOT ; P = @ ) .


There were @ treatment failures ( confirmed hemoglobinA@c , @ % ) in INS and @ in TOT ( P = @ ) .


The predictors of treatment failure included higher fasting glucose ( P = @ ) , fasting C-peptide ( P = @ ) , systolic blood pressure ( P = @ ) , and lower insulin sensitivity ( P = @ ) at randomization .


Early intensive treatment at the time of type @ diabetes diagnosis-initial short-term insulin treatment followed by either insulin-based or intensive oral hypoglycemic-based therapy-stabilizes - cell function for at least @ years .


Treatment failure was independent of intervention and was associated with worse disease pathology at baseline .


To investigate the change in eating behavior and the factors related with the change among successful dieters ( maintained a weight loss of @ % of original weight ) .


Obese adult subjects ( @ male , @ female ) were randomized into three-year lifestyle intervention ( n = @ ) and control groups ( n = @ ) .


Eating behavior ( cognitive restraint of eating , uncontrolled eating and emotional eating ) was evaluated by the TFEQ-@ and motivation to lose weight and tolerance to problems by a separate questionnaire .


Weight , height and body mass index were measured .


Weight decreased more in the intervention group than in the control group ( @ % vs @ % , p = @ ) .


Cognitive restraint increased twice as much in the intervention group compared to the control group ( @ vs. @ , p = @ ) .


The increment in cognitive restraint was positively associated with weight loss and high baseline motivation and tolerance to problems .


Cognitive restraint increased in both successful ( n = @ ) and unsuccessful dieters ( n = @ ) , but only the successful dieters were able to decrease uncontrolled eating in the long term .


Our results showed that intensive lifestyle counseling improved cognitive restraint which was associated with enhanced weight loss among obese adults .


Successful dieters also showed a long-term improvement of uncontrolled eating .


Eating behavior should be evaluated and followed before and during lifestyle interventions in order to support the change , e.g. by finding methods to control eating at risk situations and strengthening motivation and tolerance to problems .


The aim of this study was to evaluate the effects of premedication with oral atenolol or enalapril , in combination with remifentanil under sevoflurane anesthesia , on intraoperative blood loss by achieving adequate deliberate hypotension ( DH ) during orthognathic surgery .


Furthermore , we investigated the impact thereof on the amount of nitroglycerin ( NTG ) administered as an adjuvant agent .


Seventy-three patients undergoing orthognathic surgery were randomly allocated into one of three groups : an angiotensin converting enzyme inhibitor group ( Group A , n = @ ) with enalapril @ mg , a blocker group ( Group B , n = @ ) with atenolol @ mg , or a control group ( Group C , n = @ ) with placebo .


All patients were premedicated orally @ h before the induction of anesthesia .


NTG was the only adjuvant agent used to achieve DH when mean arterial blood pressure ( MAP ) was not controlled , despite the administration of the maximum remifentanil dose ( @ g kg min ) with sevoflurane .


Seventy-two patients completed the study .


Blood loss was significantly reduced in Group A , compared to Group C ( adjusted p = @ ) .


Over the target range of MAP percentage during DH was significantly higher in Group C than in Groups A and B ( adjusted p-values = @ and @ , respectively ) .


The total amount of NTG administered was significantly less in Group A than Group C ( adjusted p = @ ) .


Premedication with enalapril ( @ mg ) combined with remifentanil under sevoflurane anesthesia attenuated blood loss and achieved satisfactory DH during orthognathic surgery .


Furthermore , the amount of NTG was reduced during the surgery .


To compare a peer leader ( PL ) versus a community health worker ( CHW ) telephone outreach intervention in sustaining improvements in HbA@c over @ months after a @-month diabetes self-management education ( DSME ) program .


One hundred and sixteen Latino adults with type @ diabetes were recruited from a federally qualified health center and randomized to ( @ ) a @-month DSME program followed by @ months of weekly group sessions delivered by PLs with telephone outreach to those unable to attend or ( @ ) a @-month DSME program followed by @ months of monthly telephone outreach delivered by CHWs .


The primary outcome was HbA@c .


Secondary outcomes were cardiovascular disease risk factors , diabetes distress , and diabetes social support .


Assessments were conducted at baseline , @ , @ , and @ months .


After DSME , the PL group achieved a reduction in mean HbA@c ( @-@ @ % or @-@ mmol/mol , P < @ ) that was maintained at @ months ( -@ % or -@ mmol/mol from baseline -LSB- P = @ -RSB- ) .


The CHW group also showed a reduction in HbA@c ( @ vs. @ % or @ vs. @ mmol/mol , P = @ ) post-@ month DSME ; however , it was attenuated at @ months ( -@ % or -@ mmol/mol from baseline , within-group P = @ ) .


Only the PL group maintained improvements achieved in blood pressure at @ months .


At the @-month follow-up , both groups maintained improvements in waist circumference , diabetes support , and diabetes distress , with no significant differences between groups .


Both low-cost maintenance programs led by either a PL or a CHW maintained improvements in key patient-reported diabetes outcomes , but the PL intervention may have additional benefit in sustaining clinical improvements beyond @ months .


The provision of several doses of monovalent type @ oral poliovirus vaccine ( mOPV@ ) and bivalent OPV@ and @ ( bOPV ) vaccines through campaigns is essential to stop the circulation of remaining wild polioviruses .


Our study aimed to assess the shortening of intervals between campaigns with bOPV and mOPV@ and to assess the immunogenicity of bOPV in routine immunisation schedules .


We did an open-label , non-inferiority , five-arm , randomised controlled trial in Bangladesh .


We recruited healthy infants aged @ weeks at @ immunisation clinics and randomly assigned them ( with blocks of @ , three per group ) to receive a short three-dose schedule of bOPV ( bOPV short ) or mOPV@ ( mOPV@ short ) with the first dose given at age @ weeks , the second at age @ weeks , and the third at age @ weeks ; or to a standard three-dose schedule of bOPV ( bOPV standard ) or mOPV@ ( mOPV@ standard ) or trivalent OPV ( tOPV standard ) with the first dose given at age @ weeks , the second at @ weeks , and the third at age @ weeks .


The primary outcome was the proportion of infants with antibody seroconversion for type @ , type @ , and type @ polioviruses .


The primary , modified intention-to-treat analysis included all patients who had testable serum samples before and after receiving at least one OPV dose .


We used a @ % margin to establish non-inferiority for bOPV groups versus mOPV@ groups in seroconversion for type @ poliovirus , and for bOPV@ short versus bOPV@ standard for types @ and @ .


This trial is registered at ClinicalTrials.gov , number NCT@ , and is closed to new participants .


Between May @ , @ , and Jan @ , @ , we randomly assigned @ infants to our study groups .


@ completed all study visits and were included in the primary analysis .


Seroconversion for type-@ poliovirus was recorded in @ ( @ % , @ % CI @-@ ) of @ infants given bOPV short , @ ( @ % , @-@ ) of @ given bOPV standard , @ ( @ % , @-@ ) of @ given mOPV short , @ ( @ % , @-@ ) of @ given mOPV@ standard , and @ ( @ % , @-@ ) of @ given tOPV standard .


Seroconversion for type @ was noted in @ infants ( @ % , @-@ ) on bOPV short , @ ( @ % , @-@ ) on bOPV standard , @ ( @ % , @-@ ) on mOPV short , @ ( @ % , @-@ ) on mOPV@ standard , and @ ( @ % , @-@ ) on tOPV standard .


The short schedules for mOPV@ and bOPV elicited a non-inferior antibody response compared with the bOPV standard schedule .


@ adverse events were reported in @ infants during follow up .


@ of these events needed admission to hospital ( @ were pneumonia , two were vomiting or feeding disorders , one was septicaemia , and one was diarrhoea with severe malnutrition ) .


One of the infants admitted to hospital for pneumonia died @ days after admission .


No adverse event was attributed to the vaccines .


Our trial showed that three doses of mOPV@ or bOPV with a short schedule of @ week intervals between doses induces an immune response similar to that obtained with the standard schedule of giving doses at @ week intervals .


These findings support the use of these vaccines in campaigns done at short intervals to rapidly increase population immunity against polioviruses to control outbreaks or prevent transmission in high-risk areas .


To study the immediate and short-term efficacy of adding transcutaneous electrical nerve stimulation ( TENS ) to standardized physical therapy on subacute spasticity within @ months of spinal cord injury .


Randomized controlled trial for @ weeks .


A university hospital .


Subjects ( N = @ ) with clinically determined spasticity were randomly assigned to either the experimental group ( n = @ ) or the control group ( n = @ ) .


Sixty-minute sessions of TENS over the bilateral common peroneal nerves before @ minutes of physical therapy for the experimental group and @ minutes of physical therapy alone for the control group .


All patients in both groups had access to standardized rehabilitation care .


The composite spasticity score , which included @ subscores ( ankle jerk , muscle tone , and ankle clonus scores ) , was used as the primary end point to assess plantar flexor spasticity .


These subscores were designated as secondary end points .


Serial evaluations were made at baseline before study entry and immediately after the first and last sessions in both groups .


On analysis for immediate effects , there was a significant reduction only in the composite spasticity score ( mean difference , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ ) in the experimental group , but no significant reduction was observed in all outcome variables in the control group .


A significant difference in the composite spasticity score ( @ ; @ % CI , @-@ @ ; P = @ ) was observed between the @ groups .


After @ sessions of treatment , a significant reduction was determined in the composite spasticity score ( @ ; @ % CI , @-@ @ ; P < @ ) , the muscle tone score ( @ ; @ % CI , @-@ @ ; P = @ ) , and the ankle clonus score ( @ ; @ % CI , @-@ @ ; P = @ ) in the experimental group , whereas none of the outcome variables revealed a significant reduction in the control group .


The between-group difference was significant only for the composite spasticity score ( @ ; @ % CI , @-@ @ ; P = @ ) and the muscle tone score ( @ ; @ % CI , @-@ @ ; P = @ ) after @ intervention sessions .


Addition of TENS to standardized physical therapy had synergistically antispastic action , providing more effective reduction of clinical spasticity .


To determine whether the immunogenicity of a single dose infant priming schedule of serogroup C meningococcal ( MenC ) conjugate vaccine is non-inferior to a two dose priming schedule when followed by a booster dose at age @ months .


Phase IV open label randomised controlled trial carried out from July @ until August @ SETTING : Four centres in the United Kingdom and one centre in Malta .


Healthy infants aged @-@ weeks followed up until age @ months .


In the priming phase of the trial @ infants were randomised in a @:@:@:@ ratio into four groups to receive either a single MenC-cross reacting material @ ( CRM ) dose at @ months ; two doses of MenC-CRM at @ and @ months ; a single MenC-polysaccharide-tetanus toxoid ( TT ) dose at @ months ; or no MenC doses , respectively .


Haemophilus influenzae type b ( Hib ) - MenC-TT vaccine was administered to all infants at @ months of age .


All infants also received the nationally routinely recommended vaccines .


Blood samples were taken at age @ , @ , @ , and @ months .


MenC serum bactericidal antibody assay with rabbit complement ( rSBA ) one month after the Hib-MenC-TT vaccine .


Non-inferiority was met if the lower @ % confidence limit of the difference in the mean log@ MenC rSBA between the single dose MenC-CRM and the two dose MenC-CRM groups was > -@ .


The primary objective was met : after a Hib-MenC-TT booster dose at @ months of age the MenC rSBA geometric mean titres induced in infants primed with a single MenC-CRM dose were not inferior to those induced in participants primed with two MenC-CRM doses in infancy ( @ ( @ % confidence interval @ to @ ) v @ ( @ to @ ) ) with a corresponding difference in the mean log@ MenC rSBA of @ ( @ to @ ) that showed superiority of the single over the two dose schedule ) .


Exploration of differences between the priming schedules showed that one month after Hib-MenC-TT vaccination , MenC rSBA @:@ was observed in > @ % of participants previously primed with any of the MenC vaccine schedules in infancy and in @ % of those who were not vaccinated against MenC in infancy .


The MenC rSBA geometric mean titres induced by the Hib-MenC-TT boost were significantly higher in children who were primed with one rather than two MenC-CRM doses in infancy .


Only priming with MenC-TT , however , induced robust MenC bactericidal antibody after the Hib-MenC-TT booster that persisted until @ months of age .


MenC vaccination programmes with two MenC infant priming doses could be reduced to a single priming dose without reducing post-boost antibody titres .


When followed by a Hib-MenC-TT booster dose , infant priming with a single MenC-TT vaccine dose induces a more robust antibody response than one or two infant doses of MenC-CRM .


Bactericidal antibody induced by a single Hib-MenC-TT conjugate vaccine dose at @ months of age ( that is , a toddler only schedule ) , without infant priming , is not well sustained at @ months .


Because of rapid waning of MenC antibody , programmes using toddler only schedules will still need to rely on herd protection to protect infants and young children.Trial registration Eudract No : @-@-@ ; NCT@ ; study ID : @_@ ( http://clinicaltrials.gov ) .


To evaluate skin irritation and patch adhesiveness of a new weekly low-dose levonorgestrel ( LNG ) and ethinyl estradiol ( EE ) contraceptive patch ( LNG/EE patch ) .


This analysis was part of an open-label , parallel-group , multicenter , phase @ study that randomized healthy women to the LNG/EE patch ( one patch weekly for three consecutive weeks , followed by a patch-free week for @ cycles ) or to an oral contraceptive for six cycles followed by seven LNG/EE patch cycles .


Participants selected patch application sites of abdomen , buttock or upper torso .


Investigators rated patch adhesiveness and skin irritation using standardized scales .


Participants rated skin irritation and itching daily using standardized scales and recorded patch fall-off on daily diary cards .


A total of @,@ patches were applied ( n = @ ) .


At the five clinic visits in which investigators rated the patches , they rated adhesiveness = @ ( no lift ) for @ % of participants and skin irritation = absent/mild for @ % of patches .


Participants reported that @-@ @ % of patches fell off and rated skin irritation as absent or mild for @ - @ % of patches , according to site .


Investigator - and participant-rated assessments of LNG/EE patch adhesiveness and irritation demonstrated a low incidence of patch detachment , skin irritation and pruritus .


This secondary analysis of a phase @ clinical trial of a new weekly low-dose LNG and EE contraceptive patch , which used assessment by both investigators and participants , observed a low incidence of skin irritation , pruritus and patch detachment .


We examine the role of body mass index in the assessment of prostate cancer risk .


A total of @,@ participants who underwent biopsy ( including @,@ men with a diagnosis of prostate cancer ) were identified from the Selenium and Vitamin E Cancer Prevention Trial .


The associations of body mass index with prostate cancer and high grade prostate cancer were examined using logistic regression , adjusting for age , race , body mass index adjusted prostate specific antigen , digital rectal examination , family history of prostate cancer , biopsy history , prostate specific antigen velocity , and time between study entry and the last biopsy .


The prediction models were compared with our previously developed body mass index adjusted Prostate Cancer Prevention Trial prostate cancer risk calculator .


Of the study subjects @ % were overweight and @ % were obese .


After adjustment , among men without a known family history of prostate cancer , increased body mass index was not associated with a higher risk of prostate cancer ( per one-unit increase in logBMI OR @ , p = @ ) but was significantly associated with a higher risk of high grade prostate cancer ( ieGleason score @ or greater prostate cancer ) ( OR @ , p = @ ) .


For men with a known family history of prostate cancer the risks of prostate cancer and high grade prostate cancer increased rapidly as body mass index increased ( prostate cancer OR @ , p = @ ; high grade prostate cancer OR @ , p = @ ) .


The previously developed risk calculator generally underestimated the risks of prostate cancer and high grade prostate cancer .


Body mass index provided independently predictive information regarding the risks of prostate cancer and high grade prostate cancer after adjusting for other risk factors .


Body mass index , especially in men with a known family history of prostate cancer , should be considered for inclusion in any clinical assessment of prostate cancer risk and recommendations regarding prostate biopsy .


Fast track recovery is a care process goal after cardiac surgery .


Intraoperative anesthetic depth may impact recovery , but the impact of brain monitoring on time to extubation and intensive care unit ( ICU ) length of stay after cardiac surgery has not been extensively studied .


Our goal was to determine if BIS-guided anesthesia improves time to extubation compared to MAC-guided anesthesia in a cardiac surgery population .


In this secondary outcome analysis of a randomized controlled study , we analyzed @ patients undergoing elective coronary bypass grafting , valve replacements , and bypass plus valve replacements at a single tertiary referral center between February @ , @ and April @ , @ .


We analyzed cardiac surgery patients that had been randomized to BIS-guided anesthesia alerts ( n = @ ) or MAC-guided anesthesia alerts ( n = @ ) .


The primary outcome measure was time to extubation in the BIS-guided and anesthetic concentration-guided groups .


Secondary outcomes were length of stay in the ICU and total postoperative hospital length of stay .


Valid extubation time data were available for @ of @ patients .


The median -LSB- IQR -RSB- time to extubation was @ -LSB- @ to @ -RSB- minutes in the BIS group and @ -LSB- @ to @ -RSB- minutes in the anesthetic concentration group ( p = @ ) .


The median -LSB- IQR -RSB- ICU length of stay was @ -LSB- @ to @ -RSB- hours versus @ -LSB- @ to @ -RSB- hours ( p = @ ) .


In terms of postoperative hospital length of stay , there was no difference between the groups with median -LSB- IQR -RSB- times of @ -LSB- @-@ -RSB- days ( p = @ ) in each group .


The use of intraoperative BIS monitoring during cardiac surgery did not change time to extubation , ICU length of stay or hospital length of stay .


Data regarding BIS monitoring and recovery in an exclusively cardiac surgery population are consistent with recent effectiveness studies in the general surgical population .


Behavioral and psychological symptoms of dementia ( BPSD ) are often considered to be the greatest challenge in dementia care , leading to increased healthcare costs , caregiver burden , and placement into care facilities .


With potential for pharmacological intervention to exacerbate behaviors or even lead to mortality , the development and rigorous testing of non-pharmacological interventions is vital .


A pilot of the Tailored Activities Program ( TAP ) for reducing problem behaviors in people with dementia was conducted in the United States with promising results .


This randomized trial will investigate the effectiveness of TAP for reducing the burden of BPSD on persons with dementia and family caregivers within an Australian population .


This trial will also examine the cost-effectiveness and willingness to pay for TAP compared with a control group .


This randomized trial aims to recruit @ participant dyads of a person with dementia and their caregivers .


Participants will have a diagnosis of dementia , exhibit behaviors as scored by the Neuropsychiatric Inventory , and the caregiver must have at least @ h per week contact .


Participants will be randomly allocated to intervention ( TAP ) or control ( phone-based education sessions ) groups , both provided by a trained occupational therapist .


Primary outcome measure will be the revised Neuropsychiatric Inventory - Clinician rating scale ( NPI-C ) to measure BPSD exhibited by the person with dementia .


This trial investigates the effectiveness and cost-effectiveness of TAP within an Australian population .


Results will address a significant gap in the current Australian community-support base for people living with dementia and their caregivers .


Armodafinil is a medication used to treat excessive sleepiness in individuals with shift work disorder ( SWD ) .


In the present study , we investigate whether armodafinil can normalize nocturnal sleepiness in a group of typical SWD patients .


Participants were @ night workers ( aged @ @ years , @ female subjects ) with excessive sleepiness ( @ on the Epworth Sleepiness Scale ; mean , @ @ ) , meeting the International Classification of Sleep Disorders , Second Edition criteria for SWD , with no other sleep or medical disorders verified by polysomnogram .


The multiple sleep latency test ( MSLT ) was not used as an entry criteria .


Armodafinil was administered at @:@ pm in a randomized , double-blind , placebo-controlled , crossover design with experimental nights separated by @ week .


Primary end point was the MSLT , with naps at @:@ , @:@ , @:@ , and @:@ am .


Other study measures included a sleepiness-alertness visual analog scale administered before each nap , and @ computer-based performance tests evaluating attention and memory .


Subjects with SWD had a mean MSLT of @ @ minutes , indicating a mean level of pathological sleepiness .


Armodafinil significantly improved MSLT score to @ @ minutes ( P = @ ) .


Subjective levels of alertness on the visual analog scale also improved ( P = @ ) .


For performance , reaction time to central ( P = @ ) and peripheral ( P = @ ) stimuli and free recall memory ( P = @ ) were also improved .


Armodafinil @ mg administered at the beginning of a night shift normalizes nocturnal sleepiness in individuals with SWD unselected for objective sleepiness .


Subjective measures of sleepiness and cognitive performance are also improved .


This suggests that armodafinil can improve levels of nocturnal alertness to within normal daytime levels in the majority of patients with SWD .


HIV-@ transmitted drug resistance ( TDR ) in treatment-nave individuals is a well-described phenomenon .


Baseline genotypic resistance testing is considered standard of care in most developed areas of the world .


The aim of this analysis was to characterize HIV-@ TDR and the use of resistance testing in START trial participants .


In the Strategic Timing of AntiRetroviral Treatment ( START ) trial , baseline genotypic resistance testing results were collected at study entry and analysed centrally to determine the prevalence of TDR in the study population .


Resistance was based on a modified @ World Health Organization definition to reflect newer resistance mutations .


Baseline resistance testing was available in @ study participants .


Higher rates of testing occurred in Europe ( @ % ) , the USA ( @ % ) and Australia ( @ % ) as compared with Asia ( @ % ) , South America ( @ % ) and Africa ( @ % ) .


The overall prevalence of TDR was @ % , more commonly to nonnucleoside reverse transcriptase inhibitors ( @ % ) and nucleoside reverse transcriptase inhibitors ( @ % ) compared with protease inhibitors ( @ % ) .


The most frequent TDR mutations observed were M@L , D@N/G/E , T@F/Y/I / S/C/D / E/V/N , @Q/E/N / R , K@N/S , and G@A/S/E in reverse transcriptase , and M@I/L and L@M in protease .


By country , the prevalence of TDR was highest in Australia ( @ % ) , France ( @ % ) , the USA ( @ % ) and Spain ( @ % ) .


No participant characteristics were identified as predictors of the presence of TDR .


START participants enrolled in resource-rich areas of the world were more likely to have baseline resistance testing .


In Europe , the USA and Australia , TDR prevalence rates varied by country .


To assess the efficacy of epidural motor cortex stimulation ( MCS ) on dystonia , spasticity , pain , and quality of life in patients with dystonia secondary to a focal basal ganglia ( BG ) lesion .


In this double-blind , crossover , multicenter study , @ patients with dystonia secondary to a focal BG lesion were included .


Two quadripolar leads were implanted epidurally over the primary motor ( M@ ) and premotor cortices , contralateral to the most dystonic side .


The leads were placed parallel to the central sulcus .


Only the posterior lead over M@ was activated in this study .


The most lateral or medial contact of the lead ( depending on whether the dystonia predominated in the upper or lower limb ) was selected as the anode , and the other @ as cathodes .


One month postoperatively , patients were randomly assigned to on - or off-stimulation for @ months each , with a @-month washout between the @ conditions .


Voltage , frequency , and pulse width were fixed at @ V , @ Hz , and @ s , respectively .


Evaluations of dystonia ( Burke-Fahn-Marsden Scale ) , spasticity ( Ashworth score ) , pain intensity ( visual analog scale ) , and quality of life ( @-Item Short Form Health Survey ) were performed before surgery and after each period of stimulation .


Burke-Fahn-Marsden Scale , Ashworth score , pain intensity , and quality of life were not statistically significantly modified by MCS .


Bipolar epidural MCS failed to improve any clinical feature in dystonia secondary to a focal BG lesion .


This study provides Class I evidence that bipolar epidural MCS with the anode placed over the motor representation of the most affected limb failed to improve any clinical feature in dystonia secondary to a focal BG lesion .


Intermittent normobaric hypoxia training , an alternative to altitude training for athletes , may be beneficial to treat overweight and obesity .


The purpose of this study is to investigate whether normobaric hypoxia training combined with low-caloric diet has the additive effect on weight loss compared with normoxia training in obese young adults .


Twenty-two subjects ( age @-@ years , body mass index > @ kg/m ( @ ) ) were recruited for a @-week residential camp of weight loss with low caloric intake , and trained at @-@ % maximal heart rate of aerobics and @-@ % of maximal strength of training .


They were randomly assigned to either a normobaric hypoxia ( HT , FiO@ = @-@ @ % ) or normoxia training group ( NT , FiO@ = @ % ) , and subjects in HT and NT groups experienced weekly @-h normoxia and @-h hypoxia or @-h normoxia training , respectively .


Body composition , resting blood pressure ( BP ) and brachial-ankle pulse wave velocity ( baPWV ) were determined before and after the intervention .


Weight loss was found in HT ( -@ kg or -@ % , p < @ ) and NT groups ( -@ kg or -@ % , p < @ ) significantly , and the former lost more weight than the latter ( p < @ ) .


Hypoxia training improved systolic BP ( -@ % ) and mean BP ( -@ % ) significantly ( p < @ ) despite having no effect on baPWV .


Four weeks of normobaric hypoxia residential training with low caloric diet has an additive improvement on weight loss .


It seems that normobaric hypoxia training might be a promising method to treat obesity .


Determine the cost-effectiveness of extracellular matrix ( ECM ) relative to human fibroblast-derived dermal substitute ( HFDS ) on diabetic foot ulcer ( DFU ) wound closure .


Outcomes data were obtained from a @-week , randomised , clinical trial of adults aged @ years or older diagnosed with type @ or type @ diabetes with a DFU .


Patients were treated with either ECM or HFDS treatment .


A two-state Markov model ( healed and unhealed ) with a @-week cycle length was developed using wound-closure rates from the trial to estimate the number of closed-wound weeks and the expected DFU cost per patient .


Results were recorded over @ weeks to estimate the number of closed-wound weeks per treatment and the average cost to achieve epithelialisation ( primary outcome ) .


The perspective of the analysis was that of the payer , specifically the Centers for Medicare and Medicaid Services .


No cost discounting was performed because of the short duration of the study .


The study consisted of @ patients , with @ in each group .


In the ECM group , @ wounds closed ( @ % ) , with an average closure time of @ days ; @ wounds closed in the HFDS group ( @ % ) , with an average closure time of @ days .


There was no significant difference between these results ( p = @ ) .


Over @ weeks , the expected cost per DFU was $ @ ( @ ) for ECM and $ @ ( @ ) for HFDS .


Patients treated with HFDS incurred total treatment costs that were approximately @ % higher than those treated with ECM .


Sensitivity analyses revealed that the total cost of care for two applications of HFDS was more costly than eight applications of ECM by approximately $ @ ( @ ) .


In patients with DFU , ECM yielded similar clinical outcomes to HFDS but at a lower cost .


Health-care providers should consider ECM as a cost-saving alternative to HFDS .


To better understand the relationship between efficacy and perampanel dose , integrated actual ( last ) dose data from three phase III trials and an extension study ( blinded Conversion Period ; open-label Maintenance Period ) were analyzed .


Seizure frequency data were analyzed in patients who were randomized to and completed the @-week Maintenance Period of the phase III studies on perampanel @mg , and who received an actual ( last ) dose of @mg during ( @ ) the extension @-week blinded Conversion Period or ( @ ) weeks @-@ of the extension Maintenance Period .


Due to a treatment-by-region interaction ( p = @ ) , analyses excluded patients from the Latin America region ( n = @/@ ,@ ; @ % of the treated cohort ) .


Of @ patients randomized to @mg in the phase III studies , @ completed the Maintenance Period at @mg and @ entered the extension study .


In patients who then had an actual ( last ) dose of @mg during the extension blinded Conversion Period ( n = @ ) , median percent change in seizure frequency per @days improved from -@ % ( @mg , phase III Maintenance Period ) to -@ % ( @mg , extension blinded Conversion Period ) ; @ % responder rates increased slightly from @ % to @ % .


In patients who completed the phase III studies on @mg and had an actual ( last ) dose of @mg during weeks @-@ of the extension Maintenance Period ( n = @ ) , median percent change in seizure frequency per @days improved from -@ % ( phase III Maintenance Period ) to -@ % ( weeks @-@ extension Maintenance Period ) ; @ % responder rates were @ % and @ % .


Seizure control remained substantially unchanged in patients who completed the phase III studies at @mg and continued on that dose during the extension .


Increasing perampanel dose from @ to @mg can produce additional benefits in seizure control in at least some patients who tolerate the higher dose .


Individualizing antiplatelet therapy after platelet function testing did not improve outcome after coronary stenting in the Assessment by a Double Randomization of a Conventional Antiplatelet Strategy Versus a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation and of Treatment Interruption Versus Continuation One Year After Stenting ( ARCTIC ) study .


Whether results are different during the phase of secondary prevention starting after hospital discharge , when periprocedural events have been excluded , is unknown .


In ARCTIC , @ patients were randomized before coronary stenting to a strategy of platelet function monitoring ( VerifyNow P@Y@/aspirin point-of-care assay ) with drug adjustment in suboptimal responders to antiplatelet therapy or to a conventional strategy without monitoring and without drug or dose changes .


We performed a landmark analysis starting at the time of hospital discharge evaluating the primary end point of death , myocardial infarction , stent thrombosis , stroke , or urgent revascularization through @ year .


After discharge , the primary end point occurred in @ % of patients in the monitoring arm and @ % in the conventional arm ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


Stent thrombosis or urgent revascularization occurred in @ % and @ % in the monitoring and conventional arms , respectively ( P = @ ) .


There was no difference for any of the other ischemic end points .


Major bleeding event rates were @ % in the monitoring arm and @ % in the conventional arm ( P = @ ) , whereas major or minor bleeding event rates were @ % and @ % , respectively ( P = @ ) .


Detection of platelet hyper-reactivity by platelet function testing in patients undergoing coronary stenting with further therapeutic adjustment does not reduce ischemic recurrences after intervention .


On-treatment platelet hyperreactivity can not be considered as a risk factor requiring intervention for secondary prevention after percutaneous coronary revascularization .


Age-related sleep changes have been associated with altered hypothalamic-pituitary-adrenal axis reactivity and impaired feedback inhibition at the glucocorticoid ( GR ) and mineralocorticoid ( MR ) receptor level .


To further investigate the specific role of this binary receptor system in the elderly , sleep electroencephalogram ( EEG ) effects of the MR antagonist spironolactone and GR antagonist mifepristone in old-aged men were compared in this pilot study .


Old-aged healthy men ( n = @ , @-@ years ) were treated on three occasions in a single-blinded design in random order with mifepristone , spironolactone and placebo , respectively , and nocturnal sleep EEG was recorded .


Mifepristone led to increased wake time , decreased stage @ and rapid eye movement ( REM ) sleep and prolonged REM sleep latency in the first half of the night , whereas spironolactone had no considerable effects on sleep EEG .


GR antagonism can potentiate age-related sleep pattern alterations and further support the role of impaired GR signaling in age-related changes in sleep architecture .


Obesity often occurs co-morbid with chronic , non-cancer pain .


While behavioral treatments have proved effective for pain management and weight loss independently , integrated interventions are lacking .


The study Simultaneously Targeting Obesity and Pain ( STOP ) is a prospective , pragmatic , randomized controlled trial that aims to determine whether overweight/obese individuals with chronic pain who are randomized to receive an integrated treatment Simultaneously Targeting Obesity and Pain ( STOP ) will show more weight loss and greater reduction in pain intensity over a @-month period and greater maintenance at @months than those who receive standard care behavioral weight loss or standard care behavioral pain management .


We hypothesize that individuals randomized to receive the STOP treatment will demonstrate improved weight loss , pain reduction , and maintenance compared to standard care treatment approaches .


Adults aged@ with a body mass index@ and who report persistent pain ( @ out of @-@ for > @months ) will be recruited for treatment at the Health Behavior Research Lab at the University of the Sciences .


After baseline assessments and goal setting , participants will be randomized to receive one of three treatments .


Participants will receive eleven treatment sessions delivered during @hour , weekly individual meetings with a clinic therapist .


Follow-up will occur at @ , @ and @-month time points ; assessments will include measures of weight and pain intensity ( primary outcomes ) .


A mixed-method approach to evaluating study outcomes will include individual interviews with participants about their treatment experience .


These interviews will be led by a research staffer who was not involved in study intervention or assessment using a semi-structured discussion guide .


This study fills an important gap in intervention research , evaluating best-practices for behavioral management of a highly prevalent co-morbidity that has sub-optimal outcomes with currently-implemented approaches .


STOP 's pragmatic focus builds upon treatments already in use in clinical practice .


Should STOP be found efficacious in achieving the dual outcomes of pain management and weight loss , such an approach could be integrated into practice with minimal additional cost or training .


To compare the visual outcome of microincision ( @ mm ) with standard ( @ mm ) corneal incision phacoemulsification .


In this prospective , randomized comparative study , patients with senile cataract and less than @ diopter ( D ) of astigmatism were divided into two groups .


Group @ included patients undergoing phacoemulsification with @ mm clear corneal incision and group @ included those undergoing phacoemulsification with @ mm incision .


The steep axis measured on keratometry was marked preoperatively .


Phacoemulsification was performed through clear corneal incision on this steep axis .


Assessment of visual acuity ( distance and near ) , keratometry , keratometric cylinder , contrast sensitivity by Functional Acuity Contrast Test , and surgically induced astigmatism ( SIA ) was performed at @ day , @ week , and @ , @ , and @ months .


Fifty eyes of @ patients were included in the study ( @ were male ) .


There were @ patients in each group .


The mean ( SD ) SIA calculated by vector analysis method ( Holladay-Cravy-Koch ) using keratometry value , at the end of @ months , was @ ( @ ) D and @ ( @ ) D in groups @ and @ , respectively ( p = @ ) .


No significant differences were found in the distance and near uncorrected visual acuity , mean keratometry , keratometric cylinder , contrast sensitivity , and SIA at any follow-up visit between two groups .


In patients with less than @ D astigmatism undergoing phacoemulsification , both @-mm and @-mm clear corneal incisions result in similar postoperative visual outcome in terms of SIA , keratometry , and contrast sensitivity .


To evaluate the safety and efficacy of the novel tenofovir prodrug , tenofovir alafenamide ( TAF ) , as part of the first protease inhibitor-based single-tablet regimen ( STR ) for initial treatment of HIV-@ infection .


Antiretroviral therapy ( ART ) - naive adults with estimated glomerular filtration rate @ mL/min were randomized @:@ to receive the darunavir/cobicistat/emtricitabine / tenofovir alafenamide ( D/C/F / TAF ) STR ( TAF : N = @ ) or darunavir + cobicistat + emtricitabine/tenofovir disoproxil fumarate ( TDF : N = @ ) once daily with matched placebos for @ weeks .


At week @ , viral suppression ( HIV-@ RNA < @ copies/mL ) rates were similar ( TAF @ % vs. TDF @ % ) .


At week @ , rates were TAF @ % vs. TDF @ % ; the difference was driven by higher rate of discontinuations in TAF ( @ % ) vs. TDF ( @ % ) .


Among those with virologic failure , none developed resistance .


Most adverse events were of mild/moderate severity .


The mean change in serum creatinine from baseline at week @ was @ mg/dL ( @ % confidence interval : @ to @ ) for TAF vs. @ mg/dL ( @ % confidence interval : @ to @ ) for TDF ( P = @ ) .


The % change in retinol binding protein/Cr ratio was +@ ( TAF ) vs. +@ ( TDF ) , P = @ ; the % change in urine -@ microglobulin/Cr ratio was -@ ( TAF ) vs. +@ ( TDF ) , P = @ .


The % change in hip bone mineral density ( BMD ) was -@ ( TAF ) vs. -@ ( TDF ) , P < @ and in spine BMD was -@ ( TAF ) vs. -@ ( TDF ) , P = @ .


There were no fractures in either group .


The TAF arm had significantly improved renal and bone safety parameters : less proteinuria and less change in hip and spine BMD , consistent with results from a similarly designed study of the elvitegravir/C/F / TAF STR .


This D/C/F / TAF STR offers a promising option for initial HIV treatment , with the high barrier to resistance of darunavir , and the potential for improved long-term renal and bone safety with TAF .


Therapeutic hypothermia is recommended for comatose adults after witnessed out-of-hospital cardiac arrest , but data about this intervention in children are limited .


We conducted this trial of two targeted temperature interventions at @ children 's hospitals involving children who remained unconscious after out-of-hospital cardiac arrest .


Within @ hours after the return of circulation , comatose patients who were older than @ days and younger than @ years of age were randomly assigned to therapeutic hypothermia ( target temperature , @ C ) or therapeutic normothermia ( target temperature , @ C ) .


The primary efficacy outcome , survival at @ months after cardiac arrest with a Vineland Adaptive Behavior Scales , second edition ( VABS-II ) , score of @ or higher ( on a scale from @ to @ , with higher scores indicating better function ) , was evaluated among patients with a VABS-II score of at least @ before cardiac arrest .


A total of @ patients underwent randomization .


Among the @ patients with data that could be evaluated and who had a VABS-II score of at least @ before cardiac arrest , there was no significant difference in the primary outcome between the hypothermia group and the normothermia group ( @ % vs. @ % ; relative likelihood , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ) .


Among all the patients with data that could be evaluated , the change in the VABS-II score from baseline to @ months was not significantly different ( P = @ ) and @-year survival was similar ( @ % in the hypothermia group vs. @ % in the normothermia group ; relative likelihood , @ ; @ % CI , @ to @ ; P = @ ) .


The groups had similar incidences of infection and serious arrhythmias , as well as similar use of blood products and @-day mortality .


In comatose children who survived out-of-hospital cardiac arrest , therapeutic hypothermia , as compared with therapeutic normothermia , did not confer a significant benefit in survival with a good functional outcome at @ year .


( Funded by the National Heart , Lung , and Blood Institute and others ; THAPCA-OH ClinicalTrials.gov number , NCT@ . )


Many patients with lung cancer are deconditioned with poor physical fitness .


Lung resection reduces physical fitness further , impairing the patient 's ability to function in daily life .


We conducted a single-blind randomised controlled trial of high-intensity endurance and strength training ( @min , three times a week , @weeks ) , starting @-@weeks after surgery .


The control group received standard postoperative care .


The primary outcome was the change in peak oxygen uptake measured directly during walking until exhaustion .


Other outcomes included changes in pulmonary function , muscular strength by one-repetition maximum ( @RM ) , total muscle mass measured by dual energy X-ray absorptiometry , daily physical functioning and quality of life ( QoL ) .


The intention-to-treat analysis of the @ randomised patients showed that the exercise group had a greater increase in peak oxygen uptake ( @ mL/kg/min between-group difference , p = @ ) , carbon monoxide transfer factor ( Tlco ) ( @ % predicted , p = @ ) , @RM leg press ( @ kg , p < @ ) , chair stand ( @ times p < @ ) , stair run ( @ steps , p = @ ) and total muscle mass ( @ kg , p = @ ) compared with the controls .


The meanSD QoL ( SF-@ ) physical component summary score was @ and @ ( p = @ ) , and the mental component summary score was @ and @ ( p = @ ) in the exercise and control groups , respectively .


In patients recently operated for lung cancer , high-intensity endurance and strength training was well tolerated and induced clinically significant improvements in peak oxygen uptake , Tlco , muscular strength , total muscle mass , functional fitness and QoL .


This study may provide a basis for exercise therapy after lung cancer surgery .


To investigate the efficacy and mechanisms of Bawei Xilei Powder ( BXP ) in treating ulcerative colitis ( UC ) .


Totally @ patients with left hemicolon mild to moderate UC in the active phase at the outpatient clinics of West China Hospital from June @ to October @ were randomly assigned to the treatment group ( @ cases ) and the control group ( @ cases ) .


Patients in the treatment group were treated with BXP ( adding @ g in @ mL worm boiled water ) and those in the control group received by @ mg/@ mL hydrocortisone edema solution ( once every evening before sleep ) .


The therapeutic course for all was @ weeks .


The disease activity degree ( Mayo scoring ) , endoscopic , and histologic manifestations were compared between post-and pre-treatment in the two groups .


The expression of toll-like receptor-@ ( TLR@ ) , nuclear factor-kappaB ( NF-kappaB ) , and Occludin were detected .


The clinical remission rate and the response rate in the treatment group were @ % and @ % respectively , higher than those of the control group ( @ % and @ % , P < @ ) .


The endoscopically mucosal healing rate was @ % in the treatment group and @ % in the control group ( P < @ ) .


The histological remission rate and the effective rate in the treatment group were @ % and @ % respectively , but higher than those of the control group ( @ % and @ % , P > @ ) .


The rate of adverse events was @ % in the treatment ( occurred in @ cases ) and @ % in the control group ( occurred in @ cases , P > @ ) .


Compared with pre-treatment , the expression of TLR@ and NF-kappaB p@ significantly decreased ( P < @ ) , while the expression of Occludin significantly increased ( P < @ ) .


BXP was effective and safe in patients with active mild to moderate UC .


Its effects might be involved in regulating the expression of inflammatory factors and enhancing mucosa barrier functions .


ulcerative colitis ; Bawei Xilei Powder ; enema therapy


To evaluate the efficacy of oral sucrose combined with non-nutritive sucking for reducing pain associated with retinopathy of prematurity screening .


This was a randomised controlled study of @ infants undergoing eye examination for retinopathy of prematurity screening .


Topical anaesthetic ( Proparacaine ; Alcaine ( ) drop @ % : ALCON CANADA Inc. , Mississauga , Canada ) was applied @ sec before the eye examination in all infants .


The infants in intervention group ( Group @ , n = @ ) received @ mL/kg of @ % sucrose with a pacifier .