The panelists brushed once in the morning and once in the evening each day for one minute , followed by a one-minute swish with the slurry and a rinse with @ ml of water .


The panelists brushed only their teeth and not the specimens directly .


There were four ex vivo challenges with @ % citric acid dispersed throughout the day : two in the morning , one in the afternoon , and one in the evening .


Mineral loss was monitored by a quantitative light fluorescence ( QLF ) technique .


Twenty-three of @ subjects successfully completed the study .


The one subject who did not complete the study did so for reasons unrelated to the study or products used .


The average percent mineral loss for the Test Dentifrice and Control Dentifrice was @ + / - @ and @ + / - @ , respectively .


The statistical analysis showed that the observed product differences were statistically significant ( p < @ ) .


The Test Dentifrice with @ % arginine , calcium carbonate , and @ ppm fluoride as MFP provided significantly better protection against erosive challenges in comparison to the Control Dentifrice with @ ppm fluoride as MFP .


An attentional bias for negative information plays an important role in the development and maintenance of ( social ) anxiety and depression , which are highly prevalent in adolescence .


Attention Bias Modification ( ABM ) might be an interesting tool in the prevention of emotional disorders .


The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents .


A visual search task was used as a training paradigm ; participants ( n = @ adolescents , aged @-@ ) had to repeatedly identify the only smiling face in a @ @ matrix of negative emotional faces , while participants in the control condition ( n = @ ) were randomly allocated to one of three placebo training versions .


An assessment version of the task was developed to directly test whether attentional bias changed due to the training .


Self-reported anxiety and depressive symptoms and self-esteem were measured pre - and post-training .


After two sessions of training , the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia , while the control group did not .


There were no effects of training on depressive mood or self-esteem .


No correlation between attentional bias and social phobia was found , which raises questions about the validity of the attentional bias assessment task .


Also , the small sample size precludes strong conclusions .


Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents , but further research with larger sample sizes and longer follow-up is needed .


To evaluate the effect of early oral stimulation before the introduction of oral feeding , over the duration of concomitant tube feeding ( `` transition period '' ) , the length of hospital stay and the breastfeeding rates upon discharge in preterm infants .


Preterm infants born between @ and @ weeks gestational age ( n = @ ) , were randomized into an intervention and control group .


Infants in the intervention group received an oral stimulation program consisting in stimulation of the oral structures for @ min at least for @ days , before introduction of oral feeding .


Oral feeding was introduced at @ weeks GA in both groups .


Breastfeeding rates upon discharge were significantly higher in the intervention than in the control group ( @ % versus @ % , p = @ ) .


There was no statistical difference between the two groups in terms of the length of the transition period or the length of the hospital stay .


The need for prolonged CPAP support ( HR = @ , p = @ ) and small size for gestational age at birth ( HR = @ , p = @ ) were shown to be risk factors for a prolonged transition period .


A pre-feeding oral stimulation program improves breastfeeding rates in preterm infants .


The study results suggest that oral stimulation , as used in our specific population , does not shorten the transition period to full oral feeding neither the length of hospital stay .


We sought to examine the short - and long-term outcomes of patients who developed contrast-induced acute kidney injury ( CI-AKI ; defined as an increase in serum creatinine of @ mg/dL or a @ % relative rise within @ h after contrast exposure ) from the large-scale HORIZONS-AMI trial .


Multivariable analyses were used to identify predictors of CI-AKI , as well predictors of the primary and secondary endpoints .


The incidence of CI-AKI in this cohort of ST-segment elevation myocardial infarction ( STEMI ) patients was @ % ( @/@ ) .


Predictors of CI-AKI were contrast volume , white blood cell count , left anterior descending infarct-related artery , age , anaemia , creatinine clearance < @ mL/min , and history of congestive heart failure .


Patients with CI-AKI had higher rates of net adverse clinical events -LSB- NACE ; a combination of major bleeding or composite major adverse cardiac events ( MACE ; consisting of death , reinfarction , target vessel revascularization for ischaemia , or stroke ) -RSB- at @ days ( @ vs. @ % ; P < @ ) and @ years ( @ vs. @ % ; P < @ ) .


They also had higher rates of mortality at @ days ( @ vs. @ % ; P < @ ) and @ years ( @ vs. @ % ; P < @ ) .


Multivariable analysis confirmed CI-AKI as an independent predictor of NACE -LSB- hazard ratio ( -LSB- HR ) , @ ; @ % confidence interval ( CI ) , @-@ @ ; P = @ -RSB- , MACE ( HR , @ ; @ % CI , @-@ @ ; P = @ ) , non-coronary artery bypass grafting major bleeding ( HR , @ ; @ % CI , @-@ @ ; P < @ ) , and mortality ( HR , @ ; @ % CI , @-@ @ ; P = @ ) at @-year follow-up .


Contrast-induced acute kidney injury is associated with poor short - and long-term outcomes after primary percutaneous coronary intervention in STEMI .


We investigated whether nebulization of budesonide via a NasoNeb device would treat perennial allergic rhinitis .


We performed a parallel , randomized , double-blind , placebo-controlled , pilot study in subjects ( n = @ ) with perennial allergic rhinitis .


After recording baseline symptoms , subjects were randomized to budesonide respules ( @ mg ) or an equivalent placebo for @ days .


Nasal peak inspiratory flow ( NPIF ) and nasal symptoms ( graded on a @ scale ) were recorded by the subjects twice daily .


Rhinoconjunctivitis quality of life ( RQOL ) as well as nasal volume , measured by acoustic rhinometry , was obtained at baseline , after @ weeks , and at the end of treatment .


The average change from baseline in symptoms over the treatment period was greater for the group on budesonide ( @ ) compared to placebo ( @ ) ( p = @ ) .


When the average change from baseline over the treatment period was compared between the groups , budesonide resulted in higher NPIF ( @ L/min ) than placebo ( @ L/min ) , p = @ .


QOL improved in both groups compared to baseline with no significant difference between the groups .


Although acoustic rhinometry indicated a larger volume in the group treated with budesonide on the last trial visit , the differences between the groups were not significant when accounting for the baseline values .


Compared to placebo , administration of nebulized budesonide in subjects with perennial allergic rhinitis resulted in improvements in symptoms and objective measures of nasal congestion which approached but did not achieve statistical significance .


A higher dose of active agent , a less effective placebo and a larger number of subjects might have improved statistical significance .


Randomized , controlled , crossover trial .


To examine the effects of elastic therapeutic taping ( ETT ) applied to the lumbar paraspinal region on back muscle endurance ( BME ) compared to no tape or a rigid therapeutic taping ( RTT ) procedure in individuals with nonspecific low back pain .


Elastic therapeutic taping is an increasingly popular intervention for clinicians who treat patients with low back pain .


However , no studies have investigated the effect of ETT on back extensor muscle performance in a symptomatic population .


We measured BME in @ patients ( mean SD age , @ @ years ; @ % female ) with nonspecific low back pain .


Back muscle endurance was measured using the Biering-Srensen test under @ different conditions : ETT , no tape , and RTT .


For the ETT condition , the tape was applied over the paraspinal muscles according to the Kinesio Tex taping protocol .


The RTT condition consisted of the same tape configuration but using nonelastic athletic tape .


All participants received each testing condition in random order , with @ to @ days between each condition .


Differences in BME between the @ testing conditions were explored with repeated-measures analyses of variance .


There were no differences in BME between ETT and RTT , or between the RTT and no-tape conditions .


The difference in BME between the ETT and no-tape conditions was statistically significant ( mean difference , @ seconds ; @ % confidence interval : @ , @ ; P = @ ) but within the threshold of measurement error .


Back muscle endurance was higher with ETT applied over the paraspinal musculature when compared to a no-tape condition .


However , the magnitude of difference did not exceed measurement error .


There was no difference in BME when using elastic or rigid therapeutic tape .


Studies have shown a mismatch between published cancer screening and genetic counseling referral recommendations and physician-reported screening and referral practices .


Inaccurate cancer risk assessment is one potential cause of this mismatch .


To assess U.S. physicians ' ability to accurately determine a woman 's colon and ovarian cancer risk level .


Cross-sectional survey of U.S. family physicians , general internists , and obstetrician-gynecologists .


A twelve-page questionnaire with a vignette of a woman 's annual examination included a question about the patient 's level of colon and ovarian cancer risk .


The final study sample included @,@ physicians weighted to represent practicing U.S. physicians nationally .


Accuracy of physicians ' ovarian and colon cancer risk assessments .


Overall , most physicians accurately assessed women 's risk of ovarian ( @ % , CI @ , @ ) and colon cancer ( @ % , CI @ , @ ) .


However , @ % ( CI @ , @ ) of physicians overestimated the ovarian cancer risk among women at the same risk as the general population , and @ % ( CI @ , @ ) underestimated ovarian cancer risk among women at much higher risk than the general population .


Physicians overestimated colon more than ovarian cancer risk ( @ % , CI @ , @ vs. @ % , CI @ , @ ) for women at the same risk as the general population .


Physicians ' misestimation of patient ovarian and colon cancer risk may put average risk patients in jeopardy of unnecessary screening and higher risk patients in jeopardy of missed opportunities for prevention or early detection of cancers .


The endoscopically magnified operative field in functional endoscopic sinus surgery ( FESS ) makes even a small amount of bleeding a potentially significant hindrance .


It is thought that irrigation with hot saline during surgery may improve surgical field of view by producing a hemostatic effect .


Our objective was to assess the effectiveness of hot saline irrigation ( HSI ) compared to room temperature saline irrigation ( RTSI ) in the control of intraoperative bleeding during FESS .


Sixty-two chronic rhinosinusitis ( CRS ) patients undergoing FESS were randomized to @ treatment arms in an equal ratio .


Subjects received either HSI ( @C ) or RTSI ( @C ) , @ mL every @ minutes , for the duration of FESS .


The Boezaart endoscopic field of view grading system was the primary outcome measure .


Boezaart score , heart rate , and mean arterial blood pressure ( MABP ) were recorded at @-minute intervals between irrigations .


Mean endoscopic surgical field of view ( Boezaart score ) did not significantly differ between the HSI and RTSI groups ( @ @ vs @ @ ; p = @ ) .


However , when FESS was longer than @ hours in duration , the Boezaart scores were significantly better in the HSI group ( @ @ vs @ @ ; p = @ ) .


We found that blood loss per minute was significantly reduced ( p = @ ) in all cases in which HSI was used ( @ @ ) compared to RTSI ( @ @ ) .


Despite this , heart rate ( p = @ ) and MABP ( p = @ ) did not significantly differ between treatment groups .


HSI may be beneficial in improving surgical field of view in FESS after @ hours of operating time .


A significant reduction in rate of blood loss may be attained with HSI .


Cerebral ischemia is a known complication of carotid cross-clamping during carotid endarterectomy .


Selective intraluminal shunting for cerebral protection is not always effective and carries risks .


The purpose of this study was to identify potentially modifiable risk factors for intraoperative cerebral ischemia and shunting during carotid endarterectomy .


We performed an historical case-control chart review of primary carotid endarterectomies with electroencephalographic ( EEG ) monitoring and selective shunting .


Randomized controls and cases that showed ischemic EEG changes and required shunting were matched by year of surgery and the presence or absence of a contralateral carotid occlusion .


Detailed perioperative data were collected for all cases .


Results were analyzed using the Mantel-Haenszel test , analysis of variance , and a multivariate logistic regression model .


Of @ charts screened , @ patients had experienced evidence of cerebral ischemia on clamping of the carotid and required shunting .


These patients were more likely than their matched controls to have been receiving regular preoperative beta blockers ( @/@ vs @/@ , respectively ; P = @ ; odds ratio -LSB- OR -RSB- @ ; @ % confidence interval -LSB- CI -RSB- @ to @ ) .


Ipsilateral moderate carotid stenosis ( @-@ % ) was also associated with increased risk .


An adjusted multivariate regression model estimated an OR of @ ( @ % CI @ to @ ; P = @ ) for the association between use of a beta blocker and shunting .


Intraoperative hemodynamic values were similar for the shunt and control groups as well as for patients receiving and not receiving preoperative beta blockers .


The current study found an association between regular preoperative use of beta blockers and intraoperative cerebral ischemia in patients undergoing carotid endarterectomy .


This effect did not relate to intraoperative hemodynamics .


To observe the influence of Xinfengcapsule ( XFC ) on abarticular pathologic changes ( APCs ) and other indices of patients with rheumatoid arthritis ( RA ) and explore the mechanism of action of XFC in improving such changes .


Three-hundred RA patients were divided randomly into a treatment group ( n = @ ) and control group ( n = @ ) .


A normal control ( NC ) group ( n = @ ) was also created .


Changes in cardiac function , pulmonary function , anemia indices and platelet parameters of RA patients were measured .


Curative effects of the two groups were compared , and comparison carried out with the NC group .


In @ RA patients , late diastolic peak flow velocity ( A peak ) was much higher ( P < @ ) and early diastolic peak flow velocity ( E peak ) , E/A , and left ventricular fraction shortening much lower ( P < @ ) than those in the NC group .


Vital capacity ( VC ) , forced vital capacity in one second , forced vitalcapacity ( FVC ) , maximal voluntary ventilation ( MVV ) , maximal expiratory flow in @ % of VC ( FEF@ ) and FEF@ were lowered remarkably ( P < @ or P < @ ) .


Platelet count ( PLT ) , plateletcrit ( PCT ) and mean platelet volume ( MPV ) increased markedly ( P < @ or P < @ ) , and hemoglobin ( Hb ) level decreased significantly ( P < @ ) .


After XFC treatment , the A peak and PLT and PCT were much lower ( P < @ ) , and E/A and the number of red blood cells as well as Hb level were much higher ( P < @ ) , as were FVC , MVV and FEF@ ( P < @ or P < @ ) , in the treatment group than those in the NC group .


Total score of pain and swelling in joints , uric-acid level and high-sensitivity C-reactive protein level were much lower , and superoxide dismutase level as well as the number of CD@ + CD@ + regulation T cells ( Treg ) and CD@ + CD@ + CD@ - Treg were much higher ( P < @ or P < @ ) in the treatment group than those in the NC group .


RA patients with pathologic changes in joints also suffer from lower cardiac and pulmonary functions and from parameters of anemia and platelet factors .


XFC can improve the symptoms of RA patients , ameliorate their cardiac and pulmonary functions and reduce the parameters of anemia and platelet factors .


XFC lowers the immune inflammatory reaction to improve APCs in RA patients .


Although physiotherapy has demonstrated effectiveness in preventing ankle arthropathy compared to prophylaxis treatment from early ages , there have been no conclusive studies examining physiotherapy intervention once hemophilic arthropathy of the ankle has been established .


The aim of this study was to evaluate the effectiveness of two physiotherapy interventions , in patients with hemophilic arthropathy of the ankle that had not been operated on previously .


Nine patients with hemophilia ( mean age of @ SD @ years ) were randomized to a mobilization group ( n = @ ) and manual therapy group ( n = @ ) .


The two physiotherapy interventions were : ( @ ) passive mobilization and stretching ; and ( @ ) manual orthopaedic therapy , both with proprioception training .


The study lasted for six weeks , with two sessions a week .


Ankle mobility and pain perception , lower limb proprioception and quality of life were the outcome measures .


Both treatments improved all ankle movements ( p < @ ) .


The treatment with passive mobilizations also improved the perception of pain and quality of life .


Six months later , both groups still had improved articular movement with the exception of plantar flexion and continued to perceive less pain .


Both physiotherapy interventions improved the range of movement and lessened pain in patients with ankle arthropathy .


No haemarthrosis was recorded during treatment or during the follow-up period .


To investigate the therapeutic effect of transcutaneous electrical nerve stimulation ( TENS ) on poststroke urinary incontinence ( UI ) .


Sixty-one patients with poststroke UI were enrolled at the Neurology Department in the Shanghai Tenth People 's Hospital of Tongji University between January @-January @ and were divided into treatment and control groups ( n = @ and n = @ , respectively ) .


TENS was applied to the treatment group , while the control group received basic therapy .


The therapeutic group completed the whole set of TENS therapy with a treatment frequency of @ minutes once a day for @ days .


The positive electrode was placed on the second lumbar spinous process , and the negative electrodes were inside the middle and lower third of the junction between the posterior superior iliac spine and ischia node .


The overactive bladder symptom score , Barthel Index , and urodynamics examination were estimated before and after therapy in both groups .


The daily micturition , nocturia , urgent urination , and urge UI in the treatment group significantly improved compared to the control group ( P < @ ) .


The patients in the treatment group were superior in the self-care ability of daily living and also had an advantage over the indexes on maximum cystometry volume , flow rate , and the pressure of detrusor in the end of the filling phase .


TENS improved incontinence symptoms , enhanced the quality of life , and decreased adverse effects ; hence , it is recommended in treating poststroke UI .


To reveal the additional value of radiographic bitewings ( BW ) in detection of caries and in comparing the occurrence of clinically undetected severe decay between @-year olds with and without clinically observed dentinal caries in a low-caries prevalence population .


The cross-sectional study used @ pairs of radiographs read by one examiner without knowledge of the clinical findings .


The yield was analyzed on a tooth surface level by cross tabulating the clinical and radiographic information and on an individual level by counting the number of yield surfaces for all subjects .


Mann-Whitney U test was used .


On a tooth surface level , the contribution of BW was the greatest on the occlusal surfaces of the first molars , where established or severe dentinal decay was registered in BW in @ % of clinically sound surfaces and in @ % of established cavitated enamel lesions .


On an individual level , @ % of subjects benefited from BW .


The subjects clinically DMFS > @ benefited more than the clinically DMFS = @ subjects ( P = @ ) , nearly @ % in relation to @ % , respectively .


In a low-caries prevalence population a remarkable portion of both clinically DMFS = @ and DMFS > @ @-year olds benefit from BW examination .


Most of the benefit is obtained on the occlusal surfaces of the first and the second permanent molars .


The efficacy and safety of clindamycin phosphate @ % / tretinoin @ % ( Clin-RA ) were evaluated in three @-week randomised studies .


To perform a pooled analysis of data from these studies to evaluate Clin-RA 's efficacy and safety in a larger overall population , in subgroups of adolescents and according to acne severity .


@ patients were randomised to Clin-RA , clindamycin , tretinoin and vehicle .


Evaluations included percentage change in lesions , treatment success rate , proportions of patients with @ % or @ % continuous reduction in lesions , adverse events and cutaneous tolerability .


In the overall population , the percentage reduction in inflammatory , non-inflammatory and total lesions and the treatment success rate were significantly greater with Clin-RA compared with clindamycin , tretinoin and vehicle alone ( all p < @ ) .


The percentage reduction in all types of lesions was also significantly greater with Clin-RA in the adolescent subgroup ( @ patients , p < @ ) and in patients with mild/moderate acne ( @ patients , p < @ ) versus comparators .


In patients with severe acne ( n = @ ) , the percentage reduction in all lesion types was significantly greater with Clin-RA versus vehicle ( p < @ ) .


A greater proportion of Clin-RA treated patients had a @ % or @ % continuous reduction in all types of lesions at week @ compared with clindamycin , tretinoin and vehicle .


Adverse event frequencies in the active and vehicle groups were similar .


Baseline-adjusted mean tolerability scores over time were < @ ( mild ) and similar in all groups .


Clin-RA is safe , has superior efficacy to its component monotherapies and should be considered as one of the first-line therapies for mild-to-moderate facial acne .


Participant - and assessor-blinded randomized clinical trial .


To compare a rehabilitation program thought to increase the size of the intervertebral foramen ( IVF ) of the affected nerve root to a rehabilitation program that does n't include any specific techniques thought to increase the size of the IVF in patients presenting with cervical radiculopathy ( CR ) .


Clinical approaches for the treatment of CR commonly include exercises and manual therapy techniques thought to increase the size of the IVF , but evidence regarding the effectiveness of these specific manual therapy techniques is scarce .


Thirty-six participants with CR were randomly assigned either to a group that received a manual therapy and exercise program aimed at increasing the size of the IVF of the affected nerve root ( experimental group , n = @ ) or to a group that received a manual therapy and exercise program without the specific goal of increasing the size of the IVF of the affected level and side ( comparison group , n = @ ) .


Primary ( Neck Disability Index ) and secondary ( shortened version of the Disabilities of the Arm , Shoulder and Hand questionnaire -LSB- QuickDASH -RSB- and numeric pain-rating scale ) outcomes were evaluated at baseline , at the end of the @-week program ( week @ ) , and @ weeks later ( week @ ) .


A mixed-model , @-way analysis of variance was used to analyze treatment effects .


No significant group-by-time interaction or group effect was observed for Neck Disability Index , QuickDASH , and numeric pain-rating scale scores ( P. @ ) following the intervention .


However , both groups showed statistically and clinically significant improvement from baseline to week @ and to week @ in Neck Disability Index , QuickDASH , and numeric pain-rating scale scores ( P < @ ) .


Results suggest that manual therapy and exercises are effective in reducing pain and functional limitations related to CR .


The addition of techniques thought to increase the size of the IVF of the affected nerve root yielded no significant additional benefits .


Given the absence of a `` no treatment '' group , a spontaneous resolution of symptoms can not be excluded .


However , the magnitude of improvement makes spontaneous resolution unlikely .


The trial was registered at ClinicalTrials.gov ( NCT@ ) .


Therapy , level @b - .


To study the changes of adenosine diphosphate ( ADP ) - induced platelet aggregation rate , and evaluate the effects of Maixuekang Capsule ( , MKC ) on platelet aggregation rate and long-term prognosis of patients with acute coronary syndrome after percutaneous coronary intervention ( PCI ) .


A total of @ patients with acute coronary syndrome , who received successful PCI , were randomly assigned to a trial group ( @ cases ) and a control group ( @ cases ) according to random numbers ; treatment allocation occurred when the participants met the inclusion criteria and signed the informed consent forms .


In the trial group , the patients were treated with MKC combined with routine medication , and in the control group the patients were treated with routine medication .


The therapeutic course for the two groups was @ months and the follow-up was @ months .


The levels of ADP-induced platelet aggregation rate and serum high-sensitive C-reactive protein ( hs-CRP ) were determined before PCI , @ h and @ days after PCI .


In the meantime , the incidence of cardio - / cerebrovascular events was recorded during the @-month follow-up .


Compared with before PCI , the levels of ADP-induced platelet aggregation rate and serum hs-CRP were significantly higher at @ h after PCI ( P < @ ) .


They were significantly reduced after @-day-treatment of MKC , showing statistical differences when compared with those in the control group ( P < @ ) .


During the @-month follow-up , the incidence of cardio - / cerebrovascular events was significantly lower in the trial group than in the control group ( @ % vs. @ % , P < @ ) .


ADP-induced platelet aggregation function was significantly elevated after PCI .


MKC improved the prognosis of patients with acute coronary syndrome , possibly through inhibiting the platelet aggregation , fighting against inflammation , and protecting the vascular endothelial function .


To test the hypothesis that telemedicine can reliably be used for many aspects of circulatory and neurologic examinations of children admitted to a pediatric intensive care unit ( PICU ) .


A prospective , randomized study in a @-bed PICU in a tertiary care , academic-affiliated institution .


Eligible patients were > @ months or < @ years of age , not involved in a concurrent study , had parents/guardian able to sign an informed consent form , were not at end-of-life , and had an attending who not only deemed them medically stable , but also felt that the study would not interrupt their care .


Other than the Principal Investigator , @ pediatric intensivists and @ pediatric critical care fellows were eligible study providers .


Two physician providers were randomly assigned to perform circulatory and neurologic examinations according to the American Heart Association/Pediatric Advanced Life Support guidelines in-person and via telemedicine .


Findings were recorded on a standardized data collection form and compared .


One hundred ten data collection forms were completed .


For many aspects of the circulatory and neurologic examinations , outcomes showed substantial to perfect agreement between the in-person and telemedical care providers ( kappa = @-@ @ ) .


However , assessments of muscle tone had a kappa = @ , with a kappa = @ for skin color .


Telemedicine can reliably identify normal and abnormal findings of many aspects of circulatory and neurologic examinations in PICU patients .


This finding opens the door to further studies on the use of telemedicine across other disciplines .


Vitamin C has been proposed to improve outcomes after a distal radial fracture by promotion of bone and soft-tissue healing and reduction of the prevalence of complex regional pain syndrome ( CRPS ) .


Our primary aim was to examine the effect of vitamin C on functional outcome after a distal radial fracture .


A total of @ adult patients with an acute fracture of the distal aspect of the radius were recruited over a one-year period and randomized to receive @ mg of vitamin C or placebo daily for fifty days after the fracture .


The primary outcomes were the DASH ( Disabilities of the Arm , Shoulder and Hand ) score at six weeks and at one year .


Secondary variables included complications , wrist and finger motion , grip and pinch strength , pain , and a CRPS score .


There were no significant differences in patient or fracture characteristics between the treatment groups .


There was no significant effect of vitamin C on the DASH score throughout the study period .


At six weeks , patients in the vitamin C group with a nondisplaced fracture had a significantly greater wrist flexion deficit ( p = @ ) and pinch strength deficit ( p = @ ) and a greater rate of CRPS ( p = @ ) , but there was no difference in the CRPS rate at any other time point .


At twenty-six weeks , there was a higher rate of complications ( p = @ ) and greater pain with use ( p = @ ) in the patients with a displaced fracture treated with vitamin C.


There was no significant difference in the time to fracture-healing .


This study demonstrated no significant difference at one year in the DASH score , other functional outcomes , the rate of CRPS , or osseous healing of nondisplaced or displaced distal radial fractures treated with vitamin C compared with placebo .


We conclude that administration of vitamin C confers no benefit to patients with a displaced or nondisplaced fracture of the distal aspect of the radius .


Therapeutic Level II .


See Instructions for Authors for a complete description of levels of evidence .


Heart failure ( HF ) is a common but serious condition which involves a significant economic burden on the health care economy .


The purpose of this study was to evaluate cost and quality of life ( QoL ) implications of implementing a HF management program ( HFMP ) in primary health care ( PHC ) .


This was a prospective randomized open-label study including @ patients with a diagnosis of HF from five PHC centers in south-eastern Sweden .


Patients randomized to the intervention group received information about HF from HF nurses and from a validated computer-based awareness program .


HF nurses and physicians followed the patients intensely in order to optimize HF treatment according to current guidelines .


The patients in the control group were followed by their regular general practitioner ( GP ) and received standard treatment according to local management routines .


No significant changes were observed in NYHA class and quality-adjusted life years ( QALY ) , implying that functional class and QoL were preserved .


However , costs for hospital care ( HC ) and PHC were reduced by EUR @ , or @ % .


The total cost was EUR @ in the intervention group and EUR @ in the control group .


Introducing HFMP in Swedish PHC in patients with HF entails a significant reduction in resource utilization and costs , and maintains QoL .


Based on these results , a broader implementation of HFMP in PHC may be recommended .


However , results should be confirmed with extended follow-up to verify long-term effects .


Postoperative nausea and vomiting ( PONV ) is one of common complications in patients undergoing laparoscopic cholecystectomy ( LC ) .


Aim of this study was to compare the efficacy of subhypnotic ( @ mg/kg/h ) infusion of propofol with dexamethasone on PONV in patients undergoing LC .


A total of @ patients were included in this randomized , double-blind , placebo-controlled study .


Patients were randomly assigned to @ groups ; patients of group dexamethasone ( group D ) were administrated @ mg dexamethasone before induction of anesthesia , patients of group propofol ( group P ) were infused to subhypnotic ( @ mg/kg/h ) propofol during operation and patients of group control ( group C ) were applied infusion of @ % intralipid .


The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first @ h postoperatively .


In the @-@ h , the incidence of PONV was significantly lower in the group D and group P compared with the group C ( @ % , @ % , and @ % , resp . )


There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.


We concluded that infusion of propofol @ mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first @ hours after anesthesia in patients undergoing LC .


The ODYSSEY COMBO I study ( http://clinicaltrials.gov/show/NCT@ ) evaluated efficacy and safety of alirocumab as add-on therapy to stable maximally tolerated daily statin with or without other lipid-lowering therapy in high cardiovascular risk patients with suboptimally controlled hypercholesterolemia .


This multicenter , phase @ , randomized ( @:@ alirocumab vs placebo ) , double-blind , @-week trial enrolled @ patients with established coronary heart disease or coronary heart disease risk equivalents and hypercholesterolemia .


Alirocumab ( @ mg every @ weeks -LSB- Q@W -RSB- ) or placebo Q@W was self-administered subcutaneously via @ mL prefilled pen .


The alirocumab dose was increased to @ mg Q@W ( also @ mL ) at week @ if week @ low-density lipoprotein cholesterol ( LDL-C ) was @ mg/dL .


The primary efficacy end point was percent change in LDL-C from baseline to week @ ( intention-to-treat analysis ) .


At week @ , estimated mean ( @ % CI ) changes in LDL-C from baseline were -@ % ( -@ % to -@ % ) and -@ % ( -@ % to @ % ) for alirocumab and placebo , respectively , an estimated mean ( @ % CI ) difference of -@ % ( -@ % to -@ % ) ( P < @ ) .


Low-density lipoprotein cholesterol < @ mg/dL was achieved by @ % alirocumab versus @ % placebo patients at week @ .


At week @ , @ % of evaluable alirocumab-treated patients remained on @-mg Q@W .


Treatment-emergent adverse events were comparable between groups .


Alirocumab treatment achieved a significantly greater reduction in LDL-C and allowed a greater proportion of patients to achieve LDL-C goals , versus placebo after @ weeks in high cardiovascular risk patients with suboptimally controlled hypercholesterolemia at baseline despite receiving maximally tolerated statin with or without other lipid-lowering therapy .


The frequency of treatment-emergent adverse events and study medication discontinuations were generally comparable between treatment groups .


The Trial to Assess Chelation Therapy ( TACT ) showed clinical benefit of an EDTA-based infusion regimen in patients aged @ years with prior myocardial infarction .


Diabetes mellitus before enrollment was a prespecified subgroup .


Patients received @ infusions of EDTA chelation or placebo .


A total of @ ( @ % ) patients had diabetes mellitus ( @ EDTA and @ placebo ) .


EDTA reduced the primary end point ( death , reinfarction , stroke , coronary revascularization , or hospitalization for angina ; @ % versus @ % ; hazard ratio , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P < @ ) over @ years .


The result remained significant after Bonferroni adjustment for multiple subgroups ( @ % CI , @-@ @ ; adjusted P = @ ) .


All-cause mortality was reduced by EDTA chelation ( @ % versus @ % ; hazard ratio , @ ; @ % CI , @-@ @ ; P = @ ) , as was the secondary end point ( cardiovascular death , reinfarction , or stroke ; @ % versus @ % ; hazard ratio , @ ; @ % CI , @-@ @ ; P = @ ) .


However , after adjusting for multiple subgroups , those results were no longer significant .


The number needed to treat to reduce @ primary end point over @ years was @ ( @ % CI , @-@ @ ) .


There was no reduction in events in non-diabetes mellitus ( n = @ ; P = @ ) , resulting in a treatment by diabetes mellitus interaction ( P = @ ) .


Post-myocardial infarction patients with diabetes mellitus aged @ demonstrated a marked reduction in cardiovascular events with EDTA chelation .


These findings support efforts to replicate these findings and define the mechanisms of benefit .


However , they do not constitute sufficient evidence to indicate the routine use of chelation therapy for all post-myocardial infarction patients with diabetes mellitus .


To compare the efficacy differences between dog-days medicinal vesiculation and regular-day medicinal vesiculation for perennial allergic rhinitis ( PAR ) , and observe their effects on serum immune globulin E ( IgE ) and interleukin-@ ( IL-@ ) .


Seventy-two patients were randomly divided into a dog-days moxibustion group ( @ cases ) and a regular-day moxibustion group ( @ cases ) .


In the dog-days moxibustion group , medicinal vesiculation was applied on the @st dog-day , @nd dog-day and last dog-day in summer by lunar calendar , @ treatments per dog-day for totally @ times .


In the regular-day moxibustion group , the moxibustion was given on the regular day for continuous @ times .


The symptom score , rhinoconjunctivitis quality of life questionnaire ( RQLQ ) and the level of IgE and IL-@ were compared before and after treatment in two groups ; the short-term and two-year efficacy evaluation were performed too .


The short-term total effective rate was @ % ( @/@ ) in the dog-days moxibustion group , which was not significantly different to @ % ( @/@ ) in the regular-day moxibustion group ( P > @ ) .


The long-term total effective rate was @ % ( @/@ ) in the dog-days moxibustion group , which was significantly superior to @ % ( @/@ ) in the regular-day moxibustion group ( P < @ ) .


After treatment , the serum IgE , IL-@ and RQLQ were significantly reduced ( all P < @ ) , but the difference between two groups was not significant ( all P > @ ) .


Medicinal moxibustion could be taken as a regular treatment for PAR , which could be performed during the whole year , and dog-days moxibustion could be considered as an enhanced method for prevention and treatment of PAR .


The prefrontal cortex may be a promising target for the use of transcranial direct current stimulation ( tDCS ) in the management of pain symptoms .


The present study explored the effects of anodal and cathodal tDCS over the left dorsolateral prefrontal cortex on the effects of perceived pain controllability .


Forty-one participants received continuous anodal or cathodal tDCS and underwent a laboratory pain task designed to manipulate the perception of pain control .


Participants were told that they would be completing a reaction-time task ( press keyboard button of corresponding arrow shown on computer screen with either green or red background ) .


A thermal pain stimulus was delivered following each trial by a thermode placed on the participant 's left forearm .


Although pain stimuli were pseudorandomally ordered and matched for total duration between control ( green ) and noncontrol ( red ) trials , participants were told that if they responded correctly and more quickly on green trials than their average reaction times , the thermal pain stimulus duration would be decreased ( ie , perceived control ) .


Participants were told they had no control of pain stimulus duration over trials presented with the red background .


There was a significant main effect for tDCS condition ( anode vs. cathode ) on pain unpleasantness ratings ( P < @ ) .


Specifically , individuals receiving cathodal tDCS reported higher pain unpleasantness ratings ( least squares mean = @ , SE = @ ) , whereas those receiving anodal tDCS reported lower pain unpleasantness ratings ( least squares mean = @ , SE = @ ) .


Exploratory analysis revealed a simple main effect for tDCS group at the level of perceived controllability ( P < @ ) .


In addition , participants receiving cathodal tDCS subjectively reported feeling less control of the painful stimuli than those receiving anodal tDCS .


Left dorsolateral prefrontal cortex tDCS may play a role in modulating the neurocircuitry involved with the perception of control over pain .


Hereditary angioedema ( HAE ) is a rare disease caused by C@-esterase inhibitor ( C@-INH ) deficiency , characterized by periodic attacks of acute edema affecting subcutaneous ( SC ) tissues and mucous membranes .


Human C@-INH concentrate given intravenously ( IV ) is effective and safe , but venous access may be difficult .


We compared SC and IV administration of human pasteurized C@-INH concentrate with respect to pharmacokinetics , pharmacodynamics , and safety .


This was a prospective , randomized , open-label , crossover study .


Twenty-four subjects with mild or moderate HAE were randomly assigned during an attack-free interval to receive @ units of human pasteurized C@-INH concentrate IV or SC .


Plasma levels of C@-INH activity and antigen , C@ antigen , cleaved high-molecular-weight kininogen ( clHK ) , and C@-INH antibodies were measured .


The mean relative bioavailability of functional C@-INH after SC administration was @ % .


Maximum C@-INH activity after SC administration occurred within @ hours and persisted longer than after IV administration .


C@ antigen levels increased and clHK levels decreased after IV and SC administration , indicating the pharmacodynamic action of C@-INH .


The mean half-life of functional C@-INH was @ hours after IV administration and @ hours after SC administration ( p = @ ) .


C@-INH concentrate was safe and well tolerated when administered via both routes .


As expected , SC administration resulted in a higher incidence of injection site reactions , all of which were mild .


With a relative bioavailability of @ % , SC administration of human pasteurized C@-INH yields potentially clinically relevant and sustained plasma levels of C@-INH and is safe and well tolerated .


Safe parenteral drug administration includes preparation of safe medication for administration .


Training medical students is crucial to minimize medication administration errors .


The study aims to develop a module to teach drug preparation skills and to develop objective structured practical examination ( OSPE ) stations to assess these skills .


Students ' perceptions regarding the module were also assessed .


A module was developed to teach following skills to @ ( nd ) year medical students : Aspiration of a drug from the ampule , aspiration of the drug from the vial , aspiration of the drug in powdered form from vial ( reconstitution ) , and setting up an intravenous ( IV ) infusion .


A randomized case control study design was used to establish the validity of OSPE stations .


Student volunteers were grouped into case ( n = @ ) and control groups ( n = @ ) by simple randomization .


The test group watched videos of skills and received demonstration of skills and a practice session before OSPE , whereas the control group watched videos before the OSPE and received demonstration and a practice session only after the OSPE .


Each student was assessed by two faculty members during OSPE using a validated checklist .


Mean OSPE scores of control and test groups were compared using independent samples t-test .


Interrater reliability and concurrent validity of stations were analyzed using interclass correlation coefficient ( ICC ) and Pearson correlation , respectively .


Students ' responses were expressed as median and interquartile range .


The response rate in the questionnaire was @ % .


Significant difference between mean scores ( P < @ ) of test and control groups revealed fulfillment of construct validity of OSPE stations .


Interrater reliability ( ICC > @ ) and concurrent validity ( r value > @ ) of all the stations was high .


Perceptions revealed acceptability of module and OSPE stations by students ( median @ , scale @-@ ) .


A module to teach drug preparation skills was developed and along with valid and reliable OSPE stations that were acceptable to students .


The study demonstrated that students acquire better skills through teaching than merely watching these skills in videos .


Medication nonadherence is a major obstacle to better control of glucose , blood pressure ( BP ) , and LDL cholesterol in adults with diabetes .


Inexpensive effective strategies to increase medication adherence are needed .


In a pragmatic randomized trial , we randomly assigned @,@ adults with diabetes mellitus who had recently been prescribed a new class of medication for treating elevated levels of glycated hemoglobin ( A@C ) @ % ( @ mmol/mol ) , BP @/@ mmHg , or LDL cholesterol @ mg/dL , to receive @ ) one scripted telephone call from a diabetes educator or clinical pharmacist to identify and address nonadherence to the new medication or @ ) usual care .


Hierarchical linear and logistic regression models were used to assess the impact on @ ) the first medication fill within @ days of the prescription ; @ ) two or more medication fills within @ days of the prescription ; and @ ) clinically significant improvement in levels of A@C , BP , or LDL cholesterol .


Of the @,@ subjects , @ % in the intervention group and @ % in the usual-care group had sufficient data to analyze study outcomes .


In intent-to-treat analyses , intervention was not associated with significant improvement in primary adherence , medication persistence , or intermediate outcomes of care .


Results were similar across subgroups of patients defined by age , sex , race/ethnicity , and study site , and when limiting the analysis to those who completed the intended intervention .


This low-intensity intervention did not significantly improve medication adherence or control of glucose , BP , or LDL cholesterol .


Wide use of this strategy does not appear to be warranted ; alternative approaches to identify and improve medication adherence and persistence are needed .


We conducted a prospective trial of BRAF and mitogen-activated protein kinase kinase ( MEK ) targeted therapy in advanced , operable BRAF mutation-positive melanoma to determine feasibility , tumor response rates , and biomarkers of response and resistance .


Thirteen patients with locally or regionally advanced BRAF mutation-positive melanoma received dabrafenib @ mg po bid for @ days , followed by dabrafenib plus trametinib @ mg po daily for @ days before operation .


Biopsies and tumor measurements were obtained at baseline and days @ and @ .


Formalin-fixed paraffin embedded specimens were analyzed with hematoxylin and eosin , Ki-@ , cleaved caspase-@ , CD@ , phosphorylated extracellular signal-regulated kinase ( ERK ) , and phosphorylated MEK immunostains .


Therapy was tolerated well , with toxicity grade @ in @ of @ ( @ % ) patients .


All @ patients receiving > @ days of therapy had substantial reduction in tumor volume ( @ % at day @ and @ % at day @ ) and underwent resection .


After @ days of dabrafenib therapy , there was a marked reduction in viable melanoma cells and a CD@ T-cell -- rich infiltrate .


Proliferation of the residual melanoma cells was reduced and apoptosis was increased .


The cells continued to express phosphorylated ERK and phosphorylated MEK consistent with incomplete mitogen-activated protein kinase pathway inhibition .


Preoperative targeted therapy of advanced BRAF-mutant melanoma is feasible , well tolerated , induces brisk tumor responses , and facilitates correlative science .


A CD@ T-cell-rich infiltrate indicates a potential immune-mediated mechanism of action .


Both proliferation and apoptosis were inhibited , but the mitogen-activated protein kinase pathway remained activated , suggesting intrinsic resistance in a subset of tumor cells .


Additional investigation of the anti-tumor immune response during targeted therapy and the mechanisms of intrinsic resistance can yield novel therapeutic strategies .


Subarachnoid administration of opioids such as pethidine and fentanyl had been proven safe but that oftramadol has been controversial .


Tramadol is cheap and readily available , hence the need to further evaluate its intrathecal safety .


The study aimed at determining the hemodynamic and side effect profile of intrathecal tramadol .


One hundred and eighty six ( @ ) ASA I or II patients scheduled for emergency open appendicectomy under spinal anesthesia were included in the study .


Group BF ( n = @ ) received intrathecal fentanyl @ microg plus @ ml of @ % hyperbaric bupivacaine , Group BS ( n = @ ) received @ ml normal saline plus @ ml of @ % hyperbaric bupivacaine and Group BT ( n = @ ) received intrathecal tramadol @ mg plus @ ml of @ % hyperbaric bupivacaine .


Hemodynamic profile and side effects were monitored intraoperatively and @ hours postoperatively .


Fifteen ( @ % ) , @ ( @ % ) and @ ( @ % ) patients respectively in Groups BF , BS and BT had hypotension ( P = @ ) .


The incidence of postoperative vomiting occurred in @ patients ( @ % ) in Group BF as compared to @ patients ( @ % ) in Group BS and @ patients ( @ % ) in Group BT ( P = @ ) .


No surgeon in Group BF reported dissatisfaction but @ patients ( @ % ) in Group BS and @ patient ( @ % ) in Group BT had their surgeons reporting dissatisfaction ( P = @ ) .


This study shows that intrathecal tramadol @ mg has higher incidence of post operative nausea and vomitting than @ microg of intrathecal fentanyl but both drugs were safe .


Once-weekly administration of @ g teriparatide improved cortical bone parameters and biomechanical parameters at the proximal femur by CT geometry analysis .


The aim of this study was to evaluate the effects of weekly administration of teriparatide -LSB- human PTH ( @-@ ) -RSB- on bone geometry , volumetric bone mineral density ( vBMD ) , and parameters of bone strength at the proximal femur which were longitudinally investigated using computed tomography ( CT ) .


The subjects were a subgroup of a recent , randomly assigned , double-blind study ( @ subjects ) comparing the anti-fracture efficacy of a once-weekly subcutaneous injection of @ g teriparatide with placebo ( TOWER trial ) .


Sixty-six ambulatory postmenopausal women with osteoporosis were enrolled at @ study sites having multi-detector row CT , and included women injected with teriparatide ( n = @ , @ @ years ) or with placebo ( n = @ , @ @ years ) .


CT data were obtained at baseline and follow-up scans were performed at @ and @ weeks .


The data were analyzed to obtain cross-sectional densitometric , geometric , and biomechanical parameters including the section modulus ( SM ) and buckling ratio ( BR ) of the femoral neck , inter-trochanter , and femoral shaft .


We found that once-weekly teriparatide increased cortical thickness/cross-sectional area ( CSA ) and total area , and improved biomechanical properties ( i.e. , decreasing BR ) at the femoral neck and shaft .


Teriparatide did not change the cortical perimeter .


Our longitudinal analysis of proximal femur geometry by CT revealed that once-weekly administration of @ g teriparatide improved cortical bone parameters at the femoral neck and shaft and also improved biomechanical parameters .


Age-related endothelial dysfunction and vascular stiffening are associated with increased cardiovascular ( CV ) risk .


Many groups have encouraged goals of @ @ steps/day or @ min/day of moderate intensity physical activity ( MPA ) to reduce age-related CV risk .


The impact of MPA on the vasculature of older adults remains unclear .


We randomized @ sedentary older adults ages @ to @ weeks of either no intervention ( group @ ) , a pedometer-only intervention ( group @ ) , or a pedometer with an interactive website employing strategies to increase the adoption of habitual physical activity ( PA , group @ ) .


Endothelial function by brachial flow-mediated dilation ( FMD % ) , vascular stiffness by tonometry , step-count by pedometer , and PA intensity/distribution by accelerometer were measured .


Step-count increased in groups @ ( @ to @ , P < @ ) and @ ( @ to @ , P < @ ) but not in group @ ( @ to @ ) .


Both groups @ and @ increased MPA @ min/day .


Only group @ increased MPA in continuous bouts of @ minutes ( P < @ ) and improved FMD % ( P = @ ) .


Neither achievement of @ @ steps/day nor @ min/day of MPA resulted in improved FMD % .


However , achieving @ min/day in MPA bouts resulted in improved FMD % .


No changes in vascular stiffness were observed .


MPA reverses age-related endothelial dysfunction , but may require MPA to be performed in bouts of @ minutes duration for @ min/day to be effective .


Commonly encouraged PA goals do not guarantee improved endothelial function and may not be as effective in reducing CV risk .


A wide range of effective smoking cessation interventions have been developed to help smokers to quit .


Smoking rates remain high , especially among people with a lower level of education .


Multiple tailoring adapted to the individual 's readiness to quit and the use of visual messaging may increase smoking cessation .


The results of video and text computer tailoring were compared with the results of a control condition .


Main effects and differential effects for subgroups with different educational levels and different levels of readiness to quit were assessed .


During a blind randomized controlled trial , smokers willing to quit within @ months were assigned to a video computer tailoring group with video messages ( n = @ ) , a text computer tailoring group with text messages ( n = @ ) , or to a control condition with short generic text advice ( n = @ ) .


After @ months , effects on @-day point prevalence abstinence and prolonged abstinence were assessed using logistic regression analyses .


Analyses were conducted in @ samples : ( @ ) respondents ( as randomly assigned ) who filled in the baseline questionnaire and completed the first session of the program , and ( @ ) a subsample of sample @ , excluding respondents who did not adhere to at least one further intervention session .


In primary analyses , we used a negative scenario in which respondents lost to follow-up were classified as smokers .


Complete case analysis and multiple imputation analyses were considered as secondary analyses .


In sample @ , the negative scenario analyses revealed that video computer tailoring was more effective in increasing @-day point prevalence abstinence than the control condition ( OR @ , @ % CI @-@ @ , P = @ ) .


Video computer tailoring also resulted in significantly higher prolonged abstinence rates than controls among smokers with a low ( ready to quit within @-@ months ) readiness to quit ( OR @ , @ % CI @-@ @ , P = @ ) .


Analyses of sample @ showed similar results , although text computer tailoring was also more effective than control in realizing @-day point prevalence abstinence .


No differential effects were found for level of education .


Complete case analyses and multiple imputation yielded similar results .


In all analyses , video computer tailoring was effective in realizing smoking cessation .


Furthermore , video computer tailoring was especially successful for smokers with a low readiness to quit smoking .


Text computer tailoring was only effective for sample @ .


Results suggest that video-based messages with personalized feedback adapted to the smoker 's motivation to quit might be effective in increasing abstinence rates for smokers with diverse educational levels .


Ban-Lan-Gen ( BLG ) is a traditional Chinese herbal medicine .


It has been used for the prevention and treatment of virus-related respiratory diseases such as influenza virus infection .


BLG contains some antiviral compounds , but few evidence-based clinical studies have been conducted to assess its efficacy against influenza .


We assessed the effects of BLG ( including efficacy and safety ) on the treatment of seasonal influenza in an evidence-based clinical trial .


We conducted a randomized , double-blinded , oseltamivir - and placebo-controlled , parallel-design clinical trial .


A total of @ subjects are going to be recruited after satisfying the criteria : ( i ) @ to @ years of age ; ( ii ) illness onset within @ h ; ( @ ) axillary temperature @ C ; and ( iv ) positive influenza ( type A/B ) virus test .


Subjects will be assigned randomly into three groups in equal proportions : oseltamivir treatment , BLG granule treatment , and placebo treatment .


Each group receives @-day treatment and is followed up @ , @ , @ , @ and @ days later .


Symptoms and patient compliance are recorded , and virus/serum viral antibodies tested .


We will use the primary outcome , secondary outcome , and safety indicators to evaluate the efficacy and safety of BLG granules in the treatment of seasonal influenza .


We have described the first clinical trial for treatment using a single herb against influenza A and B viruses in China .


We will hold a large-scale clinical trial to comprehensively evaluate the effectiveness and safety of BLG against influenza infection based on the results of this pilot study .


And this clinical trial will serve as an example for the study of other traditional herbal medicines in evidence-based clinical trials .


We evaluated whether a brief , universal , postnatal nurse home-visiting intervention can be implemented with high penetration and fidelity , prevent emergency health care services , and promote positive parenting by infant age @ months .


Durham Connects is a manualized @ - to @-session program to assess family needs and connect parents with community resources to improve infant health and well-being .


All @ resident births in Durham , North Carolina , between July @ , @ , and December @ , @ , were randomly assigned to intervention and control conditions .


A random , representative subset of @ families received blinded interviews for impact evaluation .


Of all families , @ % initiated participation ; adherence was @ % .


Hospital records indicated that Durham Connects infants had @ % fewer infant emergency medical care episodes than did control infants .


Durham Connects mothers reported fewer infant emergency care episodes and more community connections , more positive parenting behaviors , participation in higher quality out-of-home child care , and lower rates of anxiety than control mothers .


Blinded observers reported higher quality home environments for Durham Connects than for control families .


A brief universal home-visiting program implemented with high penetration and fidelity can lower costly emergency medical care and improve family outcomes .


Interruption of the renin-angiotensin-aldosterone system prevents incident diabetes in high-risk individuals , although the mechanism remains unclear .


To test the hypothesis that activation of the endogenous renin-angiotensin-aldosterone system or exogenous aldosterone impairs insulin secretion in humans .


We conducted a randomized , blinded crossover study of aldosterone vs vehicle and compared the effects of a low-sodium versus a high-sodium diet .


Academic clinical research center .


Healthy , nondiabetic , normotensive volunteers .


Infusion of exogenous aldosterone ( @ g/kg/h for @ h ) or vehicle during low or high sodium intake .


Low sodium ( @ mmol/d ; n = @ ) vs high sodium ( @ mmol/d ; n = @ ) intake for @-@ days .


Change in acute insulin secretory response assessed during hyperglycemic clamps while in sodium balance during a low-sodium vs high-sodium diet during aldosterone vs vehicle .


A low-sodium diet increased endogenous aldosterone and plasma renin activity , and acute glucose-stimulated insulin ( -@ @ % ; P = @ ) and C-peptide responses ( -@ @ % ; P = @ ) were decreased , whereas the insulin sensitivity index was unchanged ( -@ @ % ; P = @ ) .


Aldosterone infusion did not affect the acute insulin response ( +@ @ % ; P = @ ) or insulin sensitivity index ( +@ @ % ; P = @ ) .


Systolic blood pressure and serum potassium were similar during low and high sodium intake and during aldosterone infusion .


Low dietary sodium intake reduces insulin secretion in humans , independent of insulin sensitivity .


A peripheral nerve stimulus can enhance or suppress the evoked response to transcranial magnetic stimulation ( TMS ) depending on the latency of the preceding peripheral nerve stimulation ( PNS ) pulse .


Similarly , somatosensory afference from the passively moving limb can transiently alter corticomotor excitability , in a phase-dependent manner .


The repeated association of PNS with TMS is known to modulate corticomotor excitability ; however , it is unknown whether repeated passive-movement associative stimulation ( MAS ) has similar effects .


In a proof-of-principal study , using a cross-over design , seven healthy subjects received in separate sessions : ( @ ) TMS ( @ % of the resting motor threshold-RMT , optimal site for Flexor Carpi Radialis ) with muscle at rest ; ( @ ) TMS paired with cyclic passive movement during extension cyclic passive movement ( @ pairs , @ Hz ) , with the intervention order randomly assigned .


Normality was tested using the Kolmogorov-Smirnov test , then compared to pre-intervention baseline using repeated measures ANOVA with a Dunnet multiple comparisons test .


MAS led to a progressive and significant decrease in the motor evoked potential ( MEP ) amplitude over the intervention ( R ( @ ) = @ , P < @ ) , which was not evident with TMS alone ( R ( @ ) = @ , P = @ ) .


Post-intervention excitability reduction , only present with MAS intervention , remained for @ min ( @-@ min = @ @ % , P < @ ; @-@ min = @ @ % , P < @ ) .


The association of somatosensory afference from the moving limb with TMS over primary motor cortex in healthy subjects can be used to modulate corticomotor excitability , and may have therapeutic implications .


The objective of this pilot @-month randomized controlled trial was to determine the effectiveness of an intensive , community-based , group intervention that focused on diet , physical activity , and peer support for reducing weight among urban-dwelling African Americans with comorbid type @ diabetes and hypertension .


Sixty-one participants were randomized into an intervention or control group .


The @-month intervention consisted of @ group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter .


The intervention featured culturally tailored nutrition education , behavioral skills training , and social support focused on changes to diet and physical activity .


The control group consisted of two @-hour group sessions of diabetes self-management education taught by a community health worker .


Outcome measures were assessed at baseline and @ months .


The primary outcome was achievement of a @ % weight reduction at @ months .


A secondary outcome was achievement of a @ percentage-point reduction in hemoglobin A@c ( HbA@c ) .


Groups did not differ in achievement of the weight-loss goal .


Intervention participants lost a mean of @ kg ( P = @ ) ; control participants did not lose a significant amount of weight .


A greater proportion of intervention ( @ % ) than control ( @ % ) participants reduced HbA@c by @ percentage points or more at @ months ( P = @ ) .


The intervention was more effective than usual care ( short-term diabetes education ) at improving glycemic control , but not weight , in low-income African Americans with comorbid diabetes and hypertension .


A community-based @-month group class with culturally tailored education , behavioral skills training , and peer support can lead to a clinically significant reduction in HbA@c .


Mandibular advancement devices ( MADs ) are used to treat obstructive sleep apnoea-hypopnoea syndrome ( OSAHS ) but evidence is lacking regarding their clinical and cost-effectiveness in less severe disease .


To compare clinical - and cost-effectiveness of a range of MADs against no treatment in mild to moderate OSAHS .


This open-label , randomised , controlled , crossover trial was undertaken at a UK sleep centre .


Adults with Apnoea-Hypopnoea Index ( AHI ) @ - < @/h and Epworth Sleepiness Scale ( ESS ) score @ underwent @weeks of treatment with three non-adjustable MADs : self-moulded ( SleepPro @ ; SP@ ) ; semi-bespoke ( SleepPro @ ; SP@ ) ; fully-bespoke MAD ( bMAD ) ; and @weeks no treatment .


Primary outcome was AHI scored by a polysomnographer blinded to treatment .


Secondary outcomes included ESS , quality of life , resource use and cost .


@ patients were randomised and @ were analysed .


All devices reduced AHI compared with no treatment by @ % ( @ % CI @ % to @ % , p = @ ) for SP@ , @ % ( @ % CI @ % to @ % ) for SP@ and @ % ( @ % CI @ % to @ % , p < @ ) for bMAD .


ESS was @ ( @ % CI @ to @ , p < @ , SP@ ) to @ ( @ % CI @ to @ , p < @ , bMAD ) lower than no treatment ( p < @ for all ) .


Compliance was lower for SP@ , which was the least preferred treatment at trial exit .


All devices were cost-effective compared with no treatment at a @,@ / quality-adjusted life year ( QALY ) threshold .


SP@ was the most cost-effective up to @,@ / QALY .


Non-adjustable MADs achieve clinically important improvements in mild to moderate OSAHS and are cost-effective .


Of those trialled , the semi-bespoke MAD is an appropriate first choice .


Investigate the effect of a brimless interface design compared with ischial ramus containment ( IRC ) of interfaces when using vacuum-assisted suspension ( VAS ) on transfemoral amputees ( TFAs ) .


Randomized experimental crossover .


Household , community , and clinic .


Unilateral TFAs ( N = @ enrolled , N = @ analyzed ) .


Mean age : @ years .


Mean residual limb length : @ % of the sound side femur length .


Participants ' mean time as an amputee : @ years and median AMP score : @ .


( @ ) IRC VAS interface , and ( @ ) brimless VAS interface .


Average medial wall height for IRC interfaces was @ cm proximal to the distal-most aspect of the ischial tuberosity ( IT ) .


The medial wall on the brimless design was an average of @ cm distal to the distal-most aspect of the IT .


Spatiotemporal gait parameters , limits of stability , four square step test , and subjective perception using the prosthetic evaluation questionnaire ( PEQ ) .


Step length was significantly improved towards the IRC ( p = @ ) , when calculating degree of asymmetry .


Base of support was significantly narrowed toward the brimless ( p = @ ) .


All subjective measures reached statistical significance in favor of improvement with the brimless design , compared to the IRC .


The brimless design was equivalent to IRC in most gait and balance outcome measures .


However , step length was more symmetrical toward the IRC while base of support was narrowed toward the brimless demonstrating mixed inconsistent performance changes .


Further , the PEQ demonstrated significant subjective improvements in prosthetic related function and quality of life when participants used the brimless design .


Brimless interface design may be a clinically viable choice .


This study assessed changes in cardiovascular disease risk factors among participants in a @-week behavioral weight loss intervention featuring a commercial format .


@ participants were enrolled in a randomized controlled trial of a @-week group-based lifestyle intervention that involved two structured food plan conditions .


Of them , @ ( @ women and @ men , mean BMI = @ @ kg/m ( @ ) ) completed the program with post-treatment assessments .


Weight and changes in risk factors ( cholesterol , triglycerides , fasting blood glucose , and blood pressure ) were assessed at pre - and posttreatment .


Additionally , changes for each risk factor were examined among participants with baseline values of risk factors beyond recommended cut points .


With no weight loss differences between conditions , analyses used the combined sample .


Participants lost @ @ kg ( @ @ % of baseline weight ) , and exhibited significant decreases in triglyceride , total cholesterol and LDL-cholesterol levels .


There were trends toward reductions in fasting glucose , systolic blood pressure , and HDL cholesterol .


Among participants with elevated baseline values , significant reductions were seen on all risk factors , with the exception of HDL cholesterol .


Modest weight loss achieved via a relatively brief , non-intensive intervention using a commercial format can yield significant improvements in cardiovascular disease risk factors , particularly among individuals with initially higher-risk values .


Effective non-invasive ventilation ( NIV ) therapy is dependent on optimal ventilator settings to maximize clinical benefit and patient tolerance .


Intelligent volume-assured pressure support ( iVAPS ) is a hybrid mode of servoventilation , providing constant automatic adjustment of pressure support ( PS ) to achieve a target ventilation determined by the patient 's requirements .


In a randomized crossover trial , we tested the hypothesis that iVAPS , with automated selection of ventilator settings , was non-inferior to standard PS ventilation , with settings determined by an experienced health-care professional , for controlling nocturnal hypoventilation in patients naive to NIV .


Eighteen patients referred to a ventilator clinic with chronic obstructive or restrictive lung disease and newly diagnosed nocturnal hypoventilation ( @ male , median ( interquartile range ) : age @ ( @-@ ) years , mean daytime PaO@ @ ( @-@ @ ) kPa , - PaCO@ @ ( @-@ @ ) kPa were randomized to iVAPS and standard PS .


Polysomnography with transcutaneous CO@ monitoring was performed at baseline and @ month after each treatment period .


Nightly hours of therapy were recorded by the ventilator .


iVAPS delivered a lower median PS compared with standard PS ( @ ( @-@ @ ) vs @ ( @-@ @ ) cmH@ O ; P = @ ) for the same ventilatory outcome ( mean overnight : SpO@ @ ( @-@ ) vs @ ( @-@ ) % ; P = @ and PtcCO@ @ ( @-@ @ ) vs @ ( @-@ @ ) ; P = @ ) .


There was no difference in outcome between ventilator modes for spirometry , respiratory muscle strength , sleep quality , arousals or O@ desaturation index .


Adherence was greater with iVAPS ( @:@ ( @:@ -@:@ ) vs @:@ ( @:@ -@:@ ) hh : mm/night ; P = @ ) .


iVAPS servoventilation with automation of ventilation settings is as effective as PS ventilation initiated by a skilled health-care professional in controlling nocturnal hypoventilation and produced better overnight adherence in patients naive to NIV .


To evaluate the risk of documented hypoglycaemia with glimepiride versus linagliptin .


This was an exploratory analysis of data from a @-year , randomized , double-blind study of the dipeptidyl peptidase-@ inhibitor linagliptin @mg once daily ( n = @ ) versus the sulphonylurea glimepiride @-@mg once daily ( n = @ ) in patients with type @ diabetes uncontrolled by metformin .


Patients randomized to glimepiride started on @mg and after @weeks were allowed to be individually uptitrated stepwise to glimepiride @mg if a fasting plasma glucose concentration @ mmol/l was not achieved .


Investigator-reported hypoglycaemia was evaluated by dose , over time , and by the degree of glycated haemoglobin ( HbA@c ) reduction .


The percentages of patients with at least one hypoglycaemic event at the individual maximum glimepiride dose were : @mg , @ % ; @mg , @ % ; @mg , @ % ; and @mg , @ % .


The incidence of hypoglycaemia was higher with glimepiride than with linagliptin ( @ vs. @ % ; p < @ ) ; after performing sensitivity analyses by excluding events during dose escalation ( weeks@-@ ) , this difference remained significant ( weeks@-@ : @ vs. @ % ; p < @ ) .


Notably , the incidence of hypoglycaemia was higher with glimepiride than with linagliptin in each quartile of HbA@c change from baseline ( all p < @ ) ; the incidence of hypoglycaemic episodes was not increased with greater reductions in HbA@c in either group .


In all @-week intervals across the @-year study , the incidence of hypoglycaemia was lower with linagliptin than with glimepiride .


Linagliptin was associated with a lower risk of hypoglycaemia than glimepiride at all dose levels and time intervals , and regardless of change in HbA@c level .


IgE-mediated allergic rhinitis to grass pollen can successfully be treated with either allergen immunotherapy tablets ( SLIT tablet ) or SQ-standardized subcutaneous immunotherapy ( SCIT ) .


The efficacy of these two treatment modalities for grass allergy is comparable , but the immunological mechanisms may differ .


ClinicalTrials.gov ID : NCT@ .


To compare the immunological changes induced by SQ-standardized SCIT and SLIT tablet .


We randomized @ individuals with grass pollen rhinitis into groups receiving SCIT , SLIT tablet , or neither and followed them for @ months with regular serum measurements of specific IgE , IgG@ , IgE-blocking factor , facilitated antigen presentation ( FAP ) , and basophil activation test ( BAT ) .


Nasal challenges were used to assess changes in nasal sensitivity .


After @ months of treatment IgG@ , IgE-blocking factor , FAP , and BAT values differed significantly in both SCIT and SLIT-tablet treatment groups when compared to the control group .


Both SCIT and SLIT-tablet groups were significantly different from the control group after @ months of treatment .


In general , the changes induced by SCIT reached twice that of SLIT tablet , with the exception of specific IgE where SLIT tablet induced initial threefold increase compared with SCIT .


A slight but significant increase in IgE and BAT after season was seen only in the control group .


Significant differences between SCIT and SLIT tablet were observed early , but the differences diminished with the length of treatment , especially for FAP inhibition .


Both SCIT and SLIT tablet induce significant changes in specific antibodies ( IgE and IgG@ ) and competition assays ( IgE-blocking factor , FAP , and BAT ) .


Overall , SCIT induced larger ( two - to threefold ) changes than SLIT tablet , with the exception of FAP , where SLIT tablet showed a gradual increase ending at the same level as SCIT .


Maximal change was generally reached after @ months ' treatment .


Painful diabetic peripheral neuropathy ( PDPN ) is a common complication of diabetes mellitus .


Unfortunately , pharmacological treatment is often partially effective or accompanied by unacceptable side effects , and new treatments are urgently needed .


Small observational studies suggested that spinal cord stimulation ( SCS ) may have positive effects .


We performed a multicenter randomized clinical trial in @ PDPN patients with severe lower limb pain not responding to conventional therapy .


Twenty-two patients were randomly assigned to SCS in combination with the best medical treatment ( BMT ) ( SCS group ) and @ to BMT only ( BMT group ) .


The SCS system was implanted only if trial stimulation was successful .


Treatment success was defined as @ % pain relief during daytime or nighttime or '' ( very ) much improved '' for pain and sleep on the patient global impression of change ( PGIC ) scale at @ months .


Trial stimulation was successful in @ % of the SCS patients .


Treatment success was observed in @ % of the SCS and in @ % of the BMT patients ( P < @ ) .


Pain relief during daytime and during nighttime was reported by @ and @ % in the SCS group and @ and @ % in the BMT group , respectively ( P < @ ) .


Pain and sleep were '' ( very ) much improved '' in @ and @ % in the SCS group , whereas no changes were seen in the BMT group , respectively ( P < @ and P < @ ) .


One SCS patient died because of a subdural hematoma .


Treatment success was shown in @ % of patients with PDPN who were treated with SCS over a @-month period , although this treatment is not without risks .


Direct-to-consumer ( DTC ) genetic tests have facilitated easy access to personal genetic information related to health and nutrition ; however , consumer perceptions of the nutritional information provided by these tests have not been evaluated .


The objectives of this study were to assess individual perceptions of personalized nutrition and genetic testing and to determine whether a personalized nutrition intervention modifies perceptions .


A double-blind , parallel-group , randomized controlled trial was conducted among healthy men and women aged @-@ years ( n = @ ) .


Participants in the intervention group ( n = @ ) were given a report of DNA-based dietary advice and those in the control group ( n = @ ) were given a general dietary advice report .


A survey was completed at baseline and @ and @ months after distributing the reports to assess perceptions between the two groups .


No significant differences in perceptions of personalized nutrition and genetic testing were observed between the intervention and control group , so responses of both groups were combined .


As compared to baseline , participant responses increased significantly toward the positive end of a Likert scale at @ months for the statement ' I am interested in the relationship between diet and genetics ' ( mean change SD : @ @ , p = @ ) .


The majority of participants indicated that a university research lab ( @ % ) or health care professional ( @ % ) were the best sources for obtaining accurate personal genetic information , while a DTC genetic testing company received the fewest selections ( @ % ) .


Most participants ( @ % ) considered dietitians to be the best source of personalized nutrition followed by medical doctors ( @ % ) , naturopaths ( @ % ) and nurses ( @ % ) .


These results suggest that perceptions of personalized nutrition changed over the course of the intervention .


Individuals view a research lab or health care professional as better providers of genetic information than a DTC genetic testing company , and registered dietitians are considered to be the best providers of personalized nutrition advice .


Until now , there has not been any evaluated , disease-specific education and treatment program for patients with coronary heart disease ( CHD ) in Germany .


It is thought that education can improve these patients ' physical activity and quality of life and teach them how to lessen their risk factors , what to do in case of an emergency , and how to assess their own medical treatment .


A randomized controlled open intervention trial was carried out from February @ to September @ patients were assigned to receive the intervention ( patient education ) , while @ were assigned to a control group .


In an intention-to-treat analysis , baseline and follow-up data were compared after a mean interval of @ days .


The evaluative instruments included the Freiburg Questionnaire of Physical Activity , the MacNew Heart Disease Quality of Life Questionnaire , questionnaires regarding knowledge about CHD , ergometric performance ability , and the body-mass index .


The patients in the intervention group reported having increased their physical activity by a mean of @ MET/week ( MET = metabolic equivalent of task ) , compared to @ MET/week in the control group ; the difference of @ MET/week was statistically significant ( p = @ ) .


The patients in the intervention group also rated their quality of life higher than those in the control group ( @ @ vs. @ @ -LSB- mean standard deviation -RSB- , p = @ ) .


They were significantly better informed than patients in the control group about risk factors and about what to do in an emergency .


Persistently unhealthy lifestyle is a common problem of CHD patients ; the education and treatment program presented here may be a suitable means of improving patients ' lifestyle for secondary prevention .


Further studies will be needed to document long-term efficacy and to determine whether occasional refresher courses will be needed as well .


The present study aimed to compare the outcome of secondary cytoreductive surgery retrospectively in patients with positive and negative Arbeitsgemeinschaft Gynkologische Onkologie ( AGO ) score that were operated on at the Department of Gynecology , Charit Comprehensive Cancer Center , Medical University , between @ and @ .


A total of @ consecutive patients presenting a first recurrence of epithelial ovarian cancer were enrolled : @ patients had a positive AGO score , and @ patients had at least one negative criterion of the AGO score .


All patients underwent secondary cytoreductive surgery and data were evaluated retrospectively .


Total macroscopic tumor resection was obtained during secondary cytoreductive surgery in @ patients ( @ % ) , @ ( @ % ) in the AGO-positive group and @ ( @ % ) in the AGO-negative group .


Overall ( OS ) and progression-free survival ( PFS ) were identical in both groups of patients when secondary cytoreductive surgery succeeded in achieving complete tumor resection .


PFS was @ months in AGO-positive patients who were tumor-free after secondary cytoreductive surgery and @ months in AGO-negative patients with complete resection after secondary cytoreductive surgery .


There were no significant differences in morbidity and mortality rates for both groups .


AGO score is a useful predictor for operability in patients with a first recurrence of ovarian cancer .


Patients with negative scores may still have a @ % chance of achieving optimal tumor resection after secondary cytoreductive surgery .


This will be a pivotal factor when counseling patients with recurrent disease regarding further management options .


Obsessive-Compulsive Disorder ( OCD ) is a common chronic psychiatric disorder that constitutes a leading cause of disability .


Although Cognitive-Behaviour Therapy ( CBT ) has been shown to be an effective treatment for OCD , this specialised treatment is unavailable to many due to access issues and the social stigma associated with seeing a mental health specialist .


Internet-based psychological treatments have shown to provide effective , accessible and affordable treatment for a range of anxiety disorders , and two Randomised Controlled Trials ( RCTs ) have demonstrated the efficacy and acceptability of internet-based CBT ( iCBT ) for OCD , as compared to waitlist or supportive therapy .


Although these initial findings are promising , they do not isolate the specific effect of iCBT .


This paper details the study protocol for the first randomised control trial evaluating the efficacy of therapist-assisted iCBT for OCD , as compared to a matched control intervention ; internet-based therapist-assisted progressive relaxation training ( iPRT ) .


It will aim to examine whether therapist-assisted iCBT is an acceptable and efficacious treatment , and to examine how effectiveness is influenced by patient characteristics .


A randomised controlled trial using repeated measures with two arms ( intervention and matched control ) will be used to evaluate the efficacy and acceptability of iCBT for OCD .


The RCT will randomise @ Australian adults with a primary diagnosis of OCD into either the active intervention or control condition , for @ weeks duration .


Outcomes for participants in both study arms will be assessed at baseline and post-intervention .


Participants in iCBT will be further assessed at six month follow-up , while participants in the control condition will be crossed over to receive the iCBT intervention and reassessed at post-intervention and six month follow-up .


The primary outcome will be clinically significant change in obsessive-compulsive symptom scores .


This will be the first known therapist assisted internet-based trial of a comprehensive CBT treatment for OCD as compared to a matched control intervention .


Demonstrating the efficacy of an internet-based treatment for OCD will allow the development of models of care for broad-based access to an evidence-based but complex treatment .


To observe the differences in clinical effect on menstrual migraine between subgaleal acupoint injection with metoclopramide and oral administration of medication .


Sixty-four patients of menstrual migraine were randomized into a subgaleal acupoint injection group and a medication group , @ cases in each one .


In the subgaleal acupoint injection group , the acupoint injection started @ days before menstruation .


Eight acupoints on the head were selected and injected alternatively in two groups , once every @ days , @ treatments made one session and @ sessions ( @ menstrual cycles ) were required .


In the medication group , flunarizine was applied with oral administration , @ mg each time , once every night .


The duration of treatment was @ months .


The analgesic effect , frequency and time of pain attack were observed in @ and @ months after treatment in the two groups .


After treatment , VAS scores were lower than those before treatment in the two groups ( P < @ , P < @ ) , the attack frequency and pain time were all reduced as compared with those before treatment ( all P < @ ) .


After treatment , VAS score , the frequency and time of pain attack in the subgaleal acupoint injection group were improved significantly as compared with the medication group ( all P < @ ) .


The subgaleal acupoint injection with metoclopramide achieves the superior preventive effect in clinical treatment of menstrual migraine as compared with flunarizine .


The aim of this study was to compare the effectiveness of a new index of perceived mental workload , the Multiple Resource Questionnaire ( MRQ ) , with the standard measure of workload used in the study of vigilance , the NASA Task Load Index ( NASA-TLX ) .


The NASA-TLX has been used extensively to demonstrate that vigilance tasks impose a high level of workload on observers .


However , this instrument does not specify the information-processing resources needed for task performance .


The MRQ offers a tool to measure the workload associated with vigilance assignments in which such resources can be identified .


Two experiments were performed in which factors known to influence task demand were varied .


Included were the detection of stimulus presence or absence , detecting critical signals by means of successive-type ( absolute judgment ) and simultaneous-type ( comparative judgment ) discriminations , and operating under multitask vs. single-task conditions .


The MRQ paralleled the NASA-TLX in showing that vigilance tasks generally induce high levels of workload and that workload scores are greater in detecting stimulus absence than presence and in making successive as compared to simultaneous-type discriminations .


Additionally , the MRQ was more effective than the NASA-TLX in reflecting higher workload in the context of multitask than in single-task conditions .


The resource profiles obtained with MRQ fit well with the nature of the vigilance tasks employed , testifying to the scale 's content validity .


The MRQ may be a meaningful addition to the NASA-TLX for measuring the workload of vigilance assignments .


By uncovering knowledge representation associated with different tasks , the MRQ may aid in designing operational vigilance displays .


The effects of less-tight versus tight control of hypertension on pregnancy complications are unclear .


We performed an open , international , multicenter trial involving women at @ weeks @ days to @ weeks @ days of gestation who had nonproteinuric preexisting or gestational hypertension , office diastolic blood pressure of @ to @ mm Hg ( or @ to @ mm Hg if the woman was taking antihypertensive medications ) , and a live fetus .


Women were randomly assigned to less-tight control ( target diastolic blood pressure , @ mm Hg ) or tight control ( target diastolic blood pressure , @ mm Hg ) .


The composite primary outcome was pregnancy loss or high-level neonatal care for more than @ hours during the first @ postnatal days .


The secondary outcome was serious maternal complications occurring up to @ weeks post partum or until hospital discharge , whichever was later .


Included in the analysis were @ women ; @ % had preexisting hypertension .


The primary-outcome rates were similar among @ women assigned to less-tight control and @ women assigned to tight control ( @ % and @ % , respectively ; adjusted odds ratio , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ) , as were the rates of serious maternal complications ( @ % and @ % , respectively ; adjusted odds ratio , @ ; @ % CI , @ to @ ) , despite a mean diastolic blood pressure that was higher in the less-tight-control group by @ mm Hg ( @ % CI , @ to @ ) .


Severe hypertension ( @/@ mm Hg ) developed in @ % of the women in the less-tight-control group and @ % of the women in the tight-control group ( P < @ ) .


We found no significant between-group differences in the risk of pregnancy loss , high-level neonatal care , or overall maternal complications , although less-tight control was associated with a significantly higher frequency of severe maternal hypertension .


( Funded by the Canadian Institutes of Health Research ; CHIPS Current Controlled Trials number , ISRCTN@ ; ClinicalTrials.gov number , NCT@ . )


The menopausal transition ( MT ) is a biological inevitability for all ageing women that can be associated with changes in mood , including depressive symptoms .


There is tentative evidence that women who develop depression during the MT have greater risk of subsequent depressive episodes , as well as increased health morbidity and mortality .


Thus , preventing depression during the MT could enhance both current and the future health and well-being of women .


This study aims to test the efficacy of a client-centred health promotion intervention to decrease the @-month incidence of clinically significant symptoms of depression among women undergoing the MT.


This randomised controlled trial will recruit @ women undergoing the MT living in the Perth metropolitan area .


They will be free of clinically significant symptoms of depression and of psychotic or bipolar disorders .


Consenting participants will be stratified for the presence of subsyndromal symptoms of depression and then randomly assigned to the intervention or control group .


The intervention will consist of eight telephone health promotion sessions that will provide training in problem solving and education about the MT , healthy ageing , depression and anxiety , and management of chronic health symptoms and problems .


The primary outcome of interest is the onset of a major depressive episode according the DSM-IV-TR criteria during the @-month follow-up or of clinically significant symptoms of depression , as established by a score of @ or greater on the Patient Health Questionnaire ( PHQ-@ ) .


Secondary outcomes of interest include changes in the severity of symptoms of depression and anxiety ( Hospital Anxiety and Depression Scale , HADS ) , quality of life ( Short Form Health Survey , SF-@ ) , and lifestyle .


Current evidence shows that depressive symptoms and disorders are leading causes of disability worldwide , and that they are relatively common during the MT. This study will use a multifaceted health promotion intervention with the aim of preventing depression in these women .


If successful , the results of this trial will have implications for the management of women undergoing the MT.


The UK has one of the highest fatality rates for deaths from fire-related injuries in children aged @-@years ; these injuries have the steepest social gradient of all injuries in the UK .


Children 's centres provide children under five years old and their families with a range of services and information , including home safety , but their effectiveness in promoting injury prevention has yet to be evaluated .


We developed a fire prevention intervention for use in children 's centres comprising an Injury Prevention Briefing ( IPB ) which provides evidence on what works and best practice from those running injury prevention programmes , and a facilitation package to support implementation of the IPB .


This protocol describes the design and methods of a trial evaluating the effectiveness and cost-effectiveness of the IPB and facilitation package in promoting fire prevention .


Pragmatic , multicentre cluster randomised controlled trial , with a nested qualitative study , in four study centres in England .


Children 's centres in the most disadvantaged areas will be eligible to participate and will be randomised to one of three treatment arms comprising : IPB with facilitation package ; IPB with no facilitation package ; usual care ( control ) .


The primary outcome measure will be the proportion of families who have a fire escape plan at follow-up .


Eleven children 's centres per arm are required to detect an absolute difference in the percentage of families with a fire escape plan of @ % in either of the two intervention arms compared with the control arm , with @ % power and a @ % significance level ( @-sided ) , an intraclass correlation coefficient of @ and assuming outcomes are assessed on @ families per children 's centre .


Secondary outcomes include the assessment of the cost-effectiveness of the intervention , other fire safety behaviours and factors associated with degree of implementation of the IPB .


This will be the first trial to develop and evaluate a fire prevention intervention for use in children 's centres in the UK .


Its findings will be generalisable to children 's centres in the most disadvantaged areas of the UK and may also be generalisable to similar interventions to prevent other types of injury .


The Cornea Donor Study ( CDS ) showed that donor age is not a factor in survival of most penetrating keratoplasties for endothelial disease .


Secondary analyses confirm the importance of surgical indication and presence of glaucoma in outcomes at @ years .


To assess the relationship between donor and recipient factors and corneal graft survival in the CDS .


Multicenter prospective , double-masked , controlled clinical trial conducted at @ clinical sites .


One hundred five surgeons enrolled @ participants undergoing corneal transplant for a moderate-risk condition , principally Fuchs dystrophy or pseudophakic or aphakic corneal edema ( PACE ) .


Forty-three eye banks provided corneas .


Corneas from donors younger than @ years and donors @ years or older were assigned , masked to donor age .


Surgery and postoperative care were performed according to the surgeons ' usual routines .


Participants were followed up for as long as @ years .


Graft failure , defined as a regrafting procedure or a cloudy cornea for @ consecutive months .


The @-year cumulative probability of graft failure was higher in participants with PACE than in those with Fuchs dystrophy ( @ % vs @ % ; hazard ratio -LSB- HR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- ; P < @ ) and in participants with a history of glaucoma before penetrating keratoplasty , particularly with prior glaucoma surgery ( @ % with prior glaucoma surgery and use of medications to lower intraocular pressure at the time of surgery vs @ % with no history of glaucoma surgery or medication use ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P < @ ) .


We found trends toward increased graft failure in recipients who were @ years or older compared with those younger than @ years ( @ % vs @ % ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) or were African American ( HR , @ ; P = @ ) or who had a history of smoking ( @ % vs @ % ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


Lower endothelial cell density ( ECD ) and higher corneal thickness ( CT ) at @ months ( @ % vs @ % for ECD @ vs < @ cells/mm@ -LSB- P < @ -RSB- ; @ % vs @ % for CT < @ vs @ m -LSB- P = @ -RSB- ) , @ year ( @ % vs @ % for ECD @ vs < @ cells/mm@ -LSB- P < @ -RSB- ; @ % vs @ % for CT < @ vs @ m -LSB- P = @ -RSB- ) , and @ years ( @ % vs @ % for ECD @ vs < @ cells/mm@ -LSB- P < @ -RSB- ; @ % vs @ % for CT < @ vs @ m -LSB- P < @ -RSB- ) were associated with subsequent graft failure .


Most penetrating corneal grafts for Fuchs dystrophy or PACE remain clear at @ years .


The risk for failure is greater for graft recipients with PACE and those with a history of glaucoma .


Measurements of ECD and CT during the course of postkeratoplasty follow-up are associated with a risk for failure .


However , even with very low ECD and high CT at @ years , most corneas remain clear at @ years .


Digital nerve blocks are commonly used as effective techniques of anaesthesia to allow a variety of surgical procedures performed on digits .


This study was conducted to compare the efficacy of volar subcutaneous single injection block and the traditional dorsal two injections digital block .


This randomized controlled trial was conducted at Plastic and Reconstructive Surgery Department , Hayatabad Medical Complex Peshawar from December .


A total of @ patients with pathology distal to the first palmer digital crease divided into two equal groups .


Group A received volar subcutaneous digital block while group B dorsal two injections block .


Efficacy of digital block was measured in terms of time of onset of anaesthesia , which was the total time duration after administering local anaesthetic to loss of pinprick sensation and total duration of anaesthesia , which was defined as the time period from onset of block ( loss of pinprick sensation ) till the appearance of pain which required additional local anaesthetic or postoperative analgesia .


A total of @ patients were studied , @ in each group .


Of the total patients , @ ( @ % ) were male and @ ( @ % ) female with a mean age of @ @ years ( range @-@ years ) .


The mean time of onset of anaesthesia from injection till the loss of pin prick sensation was @ @ minutes for volar single injection group and @ minutes @ minutes for dorsal two injections group ( p = @ ) .


Similarly the mean total duration of anaesthesia for the volar subcutaneous group was @ @ minutes while for the dorsal two injections group , it was @ @ minutes ( p = @ ) .


Single injection volar subcutaneous digital block provides faster onset of anaesthesia , produces predictable , consistent dense anaesthesia of all of the fingers with the help of single injection prick .


Pain is underrecognized and undermanaged in older adults with dementia .