The experimental group performed twelve sessions to strengthen the knee extensors , hip abductor and lateral rotator muscles in association with neuromuscular training of the trunk and lower extremities .


The control group performed the same number of sessions to strengthen the muscles of the hip and knee .


The primary outcome was functional capacity ( Anterior Knee Pain Scale - AKPS ) at @weeks .


Pain intensity , muscle strength and kinematic changes were also measured during the step down test after four weeks of intervention .


Follow up assessments were conducted after three and six months to assess functional capacity and pain .


The effects of the treatment ( i.e. between-group differences ) were calculated using mixed linear models .


The present study was initiated on the @st of April @ and is currently in progress .


The results of this study may introduce another effective technique of conservative treatment and could guide physical therapists in the clinical decision-making process for women with PFPS .


The objective of this study was to evaluate the effect of nasal packing , septal suture technique and vacuum sealing drainage ( VSD ) after septoplasty .


Ninety patients of nasal septal deviation in Combination with outfracture of the inferior turbinates who had received septoplasty were selected in this study .


The patients were allocated into three groups , with thirty in each : for packing group , marcel materials were used for nasal packing after septoplasty ; for suturing group , septal suture technique was performed after septoplasty ; for VSD group , one drainage tube was used for negative pressure sucking after septoplasty without nasal packing .


Postoperative signs and symptoms were compared between three groups .


The comfort degree assessment included headache and nasal obstruction were evaluated by using visual analogue scale ( VAS ) at the @th hour and @ hour after operation .


The edema in nasal cavity , hemorrhage .


abscess , adhesive and healing rates after operation were compared among three groups .


The VAS score of headache and nasal obstruction and the severity of patient 's conditions were significantly less in septal suture group and VSD group than that in packing group at the @th and @th hour after operation .


The mucosa edema of nasal cavity was significantly slighter in septal suture group and VSD group than that in packing group at the third day after operation .


The healing rates and number of complications are better in septal suture group and VSD group than those in packing group at the @th day after operation .


There were no hemorrhage or abscess in VSD group .


Septal suture technique and VSD after septoplasty can significantly relieve the distress of patients and reduce the healing time of mucosa in nasal cavity without increasing the risk of complications .


To investigate baseline predictors of month @ best-corrected visual acuity ( BCVA ) and central foveal thickness ( CFT ) in patients with diabetic macular edema ( DME ) treated monthly with ranibizumab or sham .


Post hoc analysis of DME patients in @ identical phase @ studies .


Patients randomized to ranibizumab ( n = @ ) or sham ( n = @ ) .


Multivariate regression on predictors with P < @ in univariate logistic regression using backward selection to retain predictors with P < @ .


Patient characteristics correlating with month @ BCVA in Early Treatment Diabetic Retinopathy Study letter score @ ( @/@ ) or @ ( @/@ ) , gain or loss from baseline BCVA of @ , or CFT @ m.


Baseline predictors of BCVA @/@ in ranibizumab-treated patients were good BCVA , submacular fluid , no cardiovascular disease , no scatter photocoagulation , and male gender , whereas in sham-treated patients , they were mild increase in CFT , presence of hard exudates in center subfield , and absence of renal disease .


Predictors of improvement in BCVA letter score @ in ranibizumab-treated patients were poor BCVA , submacular fluid , young age , and short diabetes duration , and those in sham-treated patients were poor BCVA , young age , and mild increase in CFT .


Predictors of resolution of edema ( CFT @ m ) in ranibizumab-treated patients were mild foveal thickening and prominent subfoveal fluid , and those in sham-treated patients were poor BCVA , mild foveal thickening , and statin usage .


Month @ BCVA @/@ was predicted by poor baseline BCVA in ranibizumab-treated patients , and by poor baseline BCVA , large intraretinal cystoid spaces , renal disease , and absence of hypercholesterolemia in sham-treated patients .


Loss of BCVA @ letters was predicted in sham-treated patients by submacular fluid , intraretinal cystoid spaces , and renal disease .


Patients with DME and submacular fluid , intraretinal cysts , severe thickening , or renal disease respond poorly when untreated and respond well to ranibizumab treatment .


Elimination of submacular fluid , intraretinal cysts , and severe thickening are important goals of DME treatment , and in patients with renal disease , treatment should be very aggressive , with a goal of eliminating all macular fluid .


This study included @-month-old children with a history of institutional care .


Our goal was to : ( @ ) examine differences in indiscriminate social behaviors in children with a history of institutional care compared with home-reared children ; ( @ ) test whether foster care reduces indiscriminate social behaviors in a randomized controlled trial ; and ( @ ) examine early predictors of indiscriminate behaviors .


Participants were @ children with a history of institutional care and @ never-institutionalized control ( NIG ) subjects enrolled in a randomized controlled trial of foster care for institutional care , assessed from toddlerhood to @ months .


Indiscriminate social behaviors were measured naturalistically by using the Stranger at the Door procedure .


In the Stranger at the Door procedure , children with a history of institutional care left with a stranger at higher rates than NIG subjects ( @ % vs. @ % ; P < @ ) .


Children in the care as usual group left more than NIG subjects ( @ % vs. @ % ; P @ ) .


The differences between the foster care group ( @ % ) and the care as usual group and between foster care group and NIG were not significant .


In a logistic regression , early disorganized attachment behaviors , baseline developmental quotient , and caregiving quality after randomization contributed to variance at @ months .


In the same analysis using only children with a history of institutional care , only disorganized attachment contributed significantly to @-month indiscriminate social behaviors ( Exp -LSB- B -RSB- = @ -LSB- @ % confidence interval : @-@ @ -RSB- ) .


Observed socially indiscriminate behaviors at @ months were associated with prolonged exposure to institutional care .


Young children raised in conditions of deprivation who fail to develop organized attachments as toddlers are at increased risk for subsequent indiscriminate behaviors .


One goal of guideline-based asthma therapy is minimal use of short-acting agonist ( SABA ) medications .


Inner-city children with asthma are known to have high SABA use .


To examine factors associated with high SABA use in inner-city children with asthma .


One hundred inner-city children with persistent asthma were enrolled into a randomized controlled trial of an emergency department ( ED ) and home intervention .


All children underwent serologic allergen specific IgE and salivary cotinine testing at the ED enrollment visit .


Pharmacy records for the past @ months were obtained .


Number of SABA fills during the past @ months was categorized into low - to moderate - vs high-use groups .


SABA groups were compared by the number of symptom days and nights , allergen sensitization , and exposures .


Regression models were used to predict high SABA use .


Mean number of SABA fills over @ months was @ .


Unadjusted bivariate analysis showed that high SABA users were more than @ times more likely to have an asthma hospitalization , almost @ times more likely to have an asthma intensive care unit admission , and more than @ times more likely to have prior specialty asthma care or positive cockroach sensitization than low to moderate SABA users .


In the final regression model , for every additional inhaled corticosteroid fill , a child was @ times more likely and a child with positive cockroach sensitization was almost @ times more likely to have high SABA use when controlling for prior intensive care unit admission , receipt of specialty care , child age , and income .


Providers should closely monitor SABA and controller medication use , allergen sensitization , and exposures in children with persistent asthma .


To compare the cardiopulmonary effects of intravenous ( IV ) and intramuscular ( IM ) medetomidine and butorphanol with or without MK-@ .


Prospective , randomized experimental cross-over .


Eight purpose-bred beagles ( two females , six males ) , @-@ years old and weighing @ @ kg ( mean SD ) .


All dogs received four different treatments as follows : medetomidine @ g kg ( -@ ) and butorphanol tartrate @ mg kg ( -@ ) IV and IM ( MB ) , and MB combined with MK-@ ,@ g kg ( -@ ) ( MBMK ) IV and IM .


Heart rate ( HR ) , arterial blood pressures ( SAP , MAP , DAP ) , central venous pressure ( CVP ) , cardiac output , respiratory rate ( fR ) , rectal temperature ( RT ) were measured and arterial blood samples were obtained for gas analysis at baseline and at @ , @ , @ , @ , @ and @ minutes after drug administration .


The cardiac index ( CI ) , systemic vascular resistance index ( SVRI ) and oxygen delivery index ( DO@ I ) were calculated .


After the follow-up period atipamezole @ g kg ( -@ ) IM was given to reverse sedation .


HR , CI and DO@ I were significantly higher with MBMK after both IV and IM administration .


Similarly , SAP , MAP , DAP , CVP , SVRI and RT were significantly lower after MBMK than with MB .


There were no differences in fR between treatments , but arterial partial pressure of oxygen decreased transiently after all treatments .


Recoveries were uneventful following atipamezole administration after all treatments .


MK-@ attenuated the cardiovascular effects of a medetomidine-butorphanol combination after IV and IM administration .


To evaluate adherence to therapy in acne patients using mobile phones and Short Message Service ( SMS ) to communicate .


@ patients were randomly assigned to two groups : the SMS group received @ text messages twice a day for a period of @ weeks ; the control group did not receive any messages .


Before and after @ weeks , the following evaluations were performed in all patients : digital photographs , the Global Acne Grading System , the Dermatology Life Quality Index , the Cardiff Acne Disability Index , the doctor-patient relationship evaluated through the Patient-Doctor Depth-of-Relationship Scale , and the adherence to treatment evaluated by asking patients how many days a week they had followed the therapy .


For statistical analysis we used Student 's t test .


The SMS group had a better improvement of all parameters compared to the control group .


Adherence and compliance are higher for patients who are included in a strategy of control .


Ondansetron , sometimes combined with acustimulation at PC@ ( Neiguan ) , is commonly used for preventing postoperative nausea and vomiting , but PC@ is not the only point that can be used for this purpose .


To evaluate the combined effects of ondansetron and ST@ ( Zusanli ) acupuncture point injection on postoperative vomiting ( POV ) after laparoscopic surgery .


A randomised , patient and assessor-blinded , placebo-controlled clinical study was conducted .


One hundred and sixty patients undergoing laparoscopic surgery were randomly assigned to one of four groups : ( @ ) group P ( placebo-control ) : intravenous normal saline + bilateral non-acupuncture point injection of vitamin B@ ( n = @ ) ; ( @ ) group O ( ondansetron ) : intravenous ondansetron + bilateral ST@ sham injection ( n = @ ) ; ( @ ) group A ( acupuncture point injection ) : intravenous normal saline + bilateral acupuncture point injection at ST@ of vitamin B@ ( n = @ ) ; ( @ ) group C ( combination ) : intravenous ondansetron + bilateral acupuncture point injection at ST@ of vitamin B@ ( n = @ ) .


Interventions were made on arrival at the postanaesthesia care unit .


The primary outcome was the incidence of POV within @ h after the operation .


Secondary outcomes included severity of vomiting , incidence of rescue treatment , patients ' satisfaction and the first anal exsufflation time @ h after the operation .


The incidence of POV within @ h postoperative period in each group was P @ % ; O @ % , A @ % and C @ % .


Outcomes for all intervention groups were significantly better than that for placebo ( p < @ ) .


For the three interventions compared with placebo , the numbers needed to treat ( NNTs ) were O , NNT = @ ; A , NNT = @ and C , NNT = @ .


The secondary outcomes also demonstrated greater benefits of the combined regimen , with improvement seen in all the measures .


Ondansetron , acupuncture , and ondansetron and acupuncture combined are effective prophylaxis for POV .


The impact of sugar-sweetened beverages ( SSB ) on lipid metabolism when consumed in moderate amounts by normal weight subjects is debated .


The objective of the study was to investigate the effect of different types of sugars in SSB on fatty acid metabolism ( ie , fatty acid synthesis and oxidation ) in healthy young men .


Thirty-four normal-weight men were studied in a randomized crossover study .


Four isocaloric @-week interventions with SSB were performed in random order : medium fructose ( MF ; @ g/d ) ; high fructose ( HF ; @ g/d ) , high sucrose ( HS ; @ g/d ) , and high glucose ( HG ; @g/d ) .


Fasting total plasma fatty acid composition was measured after each intervention .


Acylcarnitines were measured in the fasting state and after a euglycemic hyperinsulinemic clamp in nine subjects .


The relative abundance of palmitate ( @:@ ) and the molar fatty acid ratio of palmitate to linoleic acid ( @:@ to@ :@ ) as markers of fatty acid synthesis were increased after HF -LSB- relative abundance of palmitate : @ % @ % ( percentage of total fatty acids by weight SD ) -RSB- and MF ( @ % @ % ) compared with HS ( @ % @ % , P < @ ) , HG ( @ % @ % , P < @ ) , or baseline ( @ % @ % , P < @ ) .


After HS and HG , the relative abundance of palmitate was equal to baseline .


Fasting palmitoylcarnitine was significantly increased after HF and HS ( HF and HS vs. HG : P = @ ) , decreasing after inhibition of lipolysis by insulin in the clamp .


When consumed in moderate amounts , fructose but not sucrose or glucose in SSB increases fatty acid synthesis ( palmitate ) , whereas fasting long-chain acylcarnitines are increased after both fructose and sucrose , indicating an impaired - oxidation flux .


Little is known about global patterns of critical care unit ( CCU ) care and the relationship with outcomes in patients with acute decompensated heart failure ( ADHF ) .


Whether a ward or a CCU admission is associated with better outcomes is unclear .


Patients in the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure ( ASCEND-HF ) trial were initially hospitalized in a ward or CCU ( coronary or intensive care unit ) .


Sites were geographically classified : Asia-Pacific ( AP ) , Central Europe ( CE ) , Latin America ( LA ) , North America ( NA ) , and Western-Europe ( WE ) .


The primary outcome of @-day all-cause mortality or all-cause hospital readmission was adjusted using a two-stage multivariable logistic regression model with a generalized estimated equation that took sites within each country as a nested random factor .


Overall , @ ( @ % ) patients were admitted to a CCU and @ ( @ % ) to a ward , and this varied by region : @ % AP , @ % CE , @ % WE , @ % LA , and @ % NA .


The @-day death or readmission rate was @ % in ward patients and @ % in CCU patients ( risk-adjusted Odds Ratio -LSB- OR -RSB- @ : @ % CI , @-@ @ ) .


Compared with CCU patients in NA ( @ % @-day event rate ) , the primary outcomes were : AP ( @ % , Odds Ratio -LSB- OR -RSB- @ ; @ % confidence Interval -LSB- CI -RSB- , @ to @ ) , CE ( @ % , OR @ : @ % CI , @ to @ ) , LA ( @ % , OR @ : @ % CI , @ to @ ) , and WE ( @ % , OR @ , @ % CI , @ to @ ) .


No regional differences in @-day mortality were observed ; however , @-day readmission rates were highest in NA sites .


Management of patients with ADHF varies significantly , and after adjustment , CCU care was associated with higher risk of early mortality , not explained by international differences .


These findings may help to improve the early decisions regarding risk stratification of patients hospitalized with ADHF .


Hand-foot syndrome ( HFS ) is a frequently occurring adverse event associated with anticancer drugs .


This study compares a newly introduced ointment containing several antioxidants and exhibiting high radical protection factor , which has been available on the German market since @ , with urea cream for prevention of HFS in patients treated with capecitabine .


Patients with GI tumors or breast cancer treated with capecitabine were included in this randomized phase III study .


The primary end point was prevention of HFS of any grade within @ weeks of treatment as indicated by a standardized patient diary .


The study had @ % power to show a @ % reduction of the incidence of HFS with the new ointment .


Secondary end points included time to development of HFS greater than grade @ , evaluation of capecitabine dose intensity , and quality of life analyses .


A total of @ patients were evaluable .


In total , @ of @ patients experienced HFS ( @ % ) , @ % with the new ointment and @ % in the urea arm ( stratified odds ratio , @ ; P = @ ) .


Time to HFS greater than grade @ was comparable , but time to any-grade HFS was significantly longer in the urea group ( P = @ ) .


Capecitabine dose intensity , time under study , and percentage of days with correct administration of study medication were identical , as were adverse events except for HFS .


Skin-related quality of life was significantly worse in the group treated with the new ointment at the end of study treatment .


This trial demonstrated that @ % urea cream was superior to the new ointment at preventing HFS over the first @ weeks of treatment with capecitabine .


Atrial fibrillation ( AFib ) is common in heart failure ( HF ) with preserved ejection fraction ( HFpEF ) .


Current AFib stroke risk prediction models include the presence of HF but do not specifically include HFpEF as a risk factor .


Whether a history of AFib should be used to identify patients with HFpEF who are at risk has not been established .


Baseline characteristics and outcomes of patients with HFpEF in the Irbesartan in Heart Failure with Preserved Ejection Fraction Trial were analyzed in relation to AFib .


At baseline , @ ( @ % ) had a history of AFib .


Of these @ ( @ % ) had history of AFib alone , whereas @ ( @ % ) had both a history and AFib on ECG ; @ ( @ % ) had neither .


There were no significant differences in the risk of stroke between the @ groups with a history of AFib who did or did not have AFib present on baseline ECG .


During a median follow-up of @ months , a fatal or nonfatal stroke occurred in @ % ( @/@ ) patients with history of AFib compared with @ % ( @/@ ) with no AFib .


Having a history of AFib was independently associated with higher risk of stroke ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P < @ ) compared with those with no history of AFib .


In patients with HFpEF , a history of AFib was common and independently associated with increased risk of stroke , regardless of whether AFib was present on ECG .


Patients with HFpEF and a history of AFib should be considered at risk .


Further studies are needed to determine whether this risk can be safely reduced .


Selective kappa opioid receptor antagonism is a promising experimental strategy for the treatment of depression .


The kappa opioid receptor antagonist , LY@ , exhibits ~ @-fold higher affinity for kappa opioid receptors over mu opioid receptors , which is the next closest identified pharmacology .


Here , we determined kappa opioid receptor pharmacological selectivity of LY@ by assessing mu opioid receptor antagonism using translational pupillometry in rats and humans .


In rats , morphine-induced mydriasis was completely blocked by the nonselective opioid receptor antagonist naloxone ( @mg/kg , which produced @ % mu opioid receptor occupancy ) , while @ and @ mg/kg LY@ ( which produced @ % and @ % mu opioid receptor occupancy , respectively ) only partially blocked morphine-induced mydriasis .


In humans , fentanyl-induced miosis was completely blocked by @mg naltrexone , and LY@ dose-dependently blocked miosis at @ and @ mg ( minimal-to-no blockade at @-@mg ) .


We demonstrate , for the first time , the use of translational pupillometry in the context of receptor occupancy to identify a clinical dose of LY@ achieving maximal kappa opioid receptor occupancy without evidence of significant mu receptor antagonism .


To compare the efficacy of an acupuncture regimen for persistent allergic rhinitis ( PER ) , aimed at improving a patient 's mind or Shen in Traditional Chinese Medicine , to that of a second-generation Hi-receptor antagonist , cetirizine hydrochloride .


This multicenter , randomized , controlled clinical trial on PER will be conducted at three institutions in China .


The total study period will be @ weeks .


After a @-week preparatory screening period , @ eligible participants with PER will be randomized to receive acupuncture or pharmacotherapy ( @:@ ) for @ weeks with a @-week follow-up .


The primary outcome will be changes in @-day average total nasal symptom score .


Secondary outcome measures include rhinoconjunctivitis quality of life questionnaire score and total non-nasal symptom score .


The presence and seriousness of psychological and emotional impairments should be considered in therapeutic programs for allergic rhinitis .


No clinical trial for treating allergic rhinitis via acupuncture regulation of psychological and emotional activities has been reported .


The findings of the trial will allow us to determine the effects of the mind ( Shen ) - regulation treatment approach .


We will also be able to confirm if the effects of acupuncture are equivalent to those of the conventional drug cetirizine hydrochloride .


Probiotics are microbial supplements that have shown efficacy in a wide range of applications .


To assess the safety and effects of enteral probiotics in critically ill neonates .


A double-blind , randomized controlled trial was conducted in @ full-term infants with critical illness according to scores of neonatal acute physiology .


Fifty neonatal intensive care patients were randomly assigned to receive probiotics three times daily after birth for @ days , and fifty patients were not given probiotics , but who received a placebo .


The incidence of sepsis , multiple organ dysfunction syndrome ( MODS ) , nosocomial pneumonia , and necrotizing enterocolitis were recorded .


The prognosis of probiotic treatment was determined based on the rate of recovery and hospital days .


Serum IgA , IgG , and IgM concentrations were measured on days @ and @ .


Infants in the probiotics group showed a significantly reduced rate of nosocomial pneumonia ( @ % versus @ % ) and multiple organ dysfunction syndrome ( @ % versus @ % ) compared with the placebo group ( p < @ ) .


Significant results were demonstrated in favour of the probiotics for days of hospital stay ( @ @ d versus @ @ d ) ( p < @ ) .


However , there were no significant differences in the occurrence of sepsis , necrotizing enterocolitis , and recovery rate .


Patients given probiotics had significantly greater levels of IgA than those in the placebo group ( p < @ ) .


No serious adverse effects in the study population were noted .


Supplements of probiotics to critically ill neonates could enhance immune activity , decrease occurrence of nosocomial pneumonia and MODS , and reduce days in hospital .


Recently , there have been investigations that have targeted improving the relatively poor validity and reliability of attentional bias measures .


These studies have demonstrated that individuals show elevated attentional bias to stimuli associated with their drinking history , although to date , the predictive utility of these measures has yet to be assessed .


The current study aimed to investigate the predictive value of an individualised alcohol Stroop task compared to that of an alcohol Stroop task with general alcohol-related words in a sample of non-dependent undergraduate drinkers .


@ undergraduate social drinkers completed questionnaire measures of alcohol consumption and hazardous drinking which were combined to get an alcohol involvement measure .


Participants also completed three blocked format Stroop tasks , a control Stroop ( containing soft drink-related words ) , a general alcohol Stroop ( containing a mixture of alcohol-related words ) and an individualised Stroop that contained words relating to the participants ' favourite alcoholic drink .


Although there was no significant difference in participants ' performance across the three different Stroop tasks , only performance on the individualised Stroop was associated with alcohol involvement .


Notably , the individualised Stroop predicted variance in drinking after controlling for demographics and general alcohol Stroop performance .


This study indicates that adopting individualised stimuli into attentional bias tasks may increase their predictive validity .


Following acute coronary syndrome ( ACS ) , the risk for future cardiovascular events is high and is related to levels of low-density lipoprotein cholesterol ( LDL-C ) even within the setting of intensive statin treatment .


Proprotein convertase subtilisin/kexin type @ ( PCSK@ ) regulates LDL receptor expression and circulating levels of LDL-C .


Antibodies to PCSK@ can produce substantial and sustained reductions of LDL-C .


The ODYSSEY Outcomes trial tests the hypothesis that treatment with alirocumab , a fully human monoclonal antibody to PCSK@ , improves cardiovascular outcomes after ACS .


This Phase @ study will randomize approximately @,@ patients to receive biweekly injections of alirocumab ( @-@ mg ) or matching placebo beginning @ to @ months after an index hospitalization for acute myocardial infarction or unstable angina .


Qualifying patients are treated with atorvastatin @ or @ mg daily , rosuvastatin @ or @ mg daily , or the maximum tolerated and approved dose of one of these agents and fulfill one of the following criteria : LDL-C @ mg/dL , non-high-density lipoprotein cholesterol @ mg/dL , or apolipoprotein B @ mg/dL .


The primary efficacy measure is time to first occurrence of coronary heart disease death , acute myocardial infarction , hospitalization for unstable angina , or ischemic stroke .


The trial is expected to continue until @ primary end point events have occurred with minimum follow-up of at least @ years , providing @ % power to detect a @ % hazard reduction .


Adverse events of special interest include allergic events and injection site reactions .


Interim analyses are planned when approximately @ % and @ % of the targeted number of primary end points have occurred .


ODYSSEY Outcomes will determine whether the addition of the PCSK@ antibody alirocumab to intensive statin therapy reduces cardiovascular morbidity and mortality after ACS .


Intrauterine growth restriction may be reduced by supplementing maternal diets during pregnancy , but few studies have assessed the impact of combined prenatal and postnatal interventions on child growth .


We tested a hypothesis that provision of small-quantity lipid-based nutrient supplements ( SQ-LNSs ) to mothers in pregnancy and @ mo postpartum and to their infants from @ to @ mo of age would promote infant and child growth in the study area in rural Malawi .


We enrolled @ pregnant women in a randomized trial in Malawi .


During pregnancy and @ mo thereafter , the women received daily @ capsule of iron-folic acid ( IFA ) , @ capsule containing @ micronutrients ( MMN ) , or one @-g sachet of SQ-LNS -LSB- lipid-based nutrient supplements ( LNS ) , containing @ MMN , protein , carbohydrates , essential fatty acids , and @ kcal -RSB- .


Children in the IFA and MMN groups received no supplementation ; children in the LNS group received SQ-LNSs from @ to @ mo. .


Primary outcome was child length at @ mo. .


At @ mo , the mean length in the IFA , MMN , and LNS groups was @ , @ , and @ cm ( P = @ ) , respectively , and the prevalence of stunting was @ % , @ % , and @ % ( P = @ ) , respectively .


No intergroup differences were found in the mean weight , head circumference , or midupper arm circumference or the proportions with low z scores for these variables ( P > @ ) .


Covariate adjustment did not change the analysis results , and the associations between the intervention and child length were not modified by maternal parity , age , or nutritional status ( P > @ ) .


The findings do not support a hypothesis that provision of SQ-LNSs to women in pregnancy and postpartum and to children from @ to @ mo of age would promote child growth in this Malawian study area .


This trial was registered at clinicaltrials.gov as NCT@ .


Femoral nerve block ( FNB ) with varying concentrations of bupivacaine is often used for postoperative analgesia after anterior cruciate ligament ( ACL ) reconstruction .


To determine whether FNB using @ % or @ % bupivacaine provided better analgesia with less effect on quadriceps strengths after ACL reconstruction .


One hundred patients were randomized to receive FNB with @ mL of @ % or @ % bupivacaine .


Data regarding demographic , effectiveness of FNB , time to first pain , time to first analgesic , pain scores , morphine use , and recovery of sensory and motor function were recorded .


Median time to first morphine requirement was @ hours in @ % bupivacaine group and @ hours in @ % bupivacaine group ( p = @ ) .


Pain score at @ hours was lower in @ % bupivacaine group compared with @ % bupivacaine group ( p = @ ) .


When specify to the patellar tendon graft subgroup , the patients requiring morphine were @ % in @ % bupivacaine group and @ % in @ % bupivacaine group ( p = @ ) .


No differences were found in demographic data , effectiveness of FNB , time to first pain , morphine consumption , and recovery of sensorimotor function .


FNB with @ % bupivacaine provided longer time to first analgesic and lower narcotic requirements after patellar tendon graft ACL reconstruction when compared to @ % bupivacaine .


Both concentrations showed similar effect on quadriceps strengths .


To establish a preoperative deep venous thrombosis predictor score for patients with fresh lower extremity fractures by statistical analysis .


From January @ to December @ , @ @ patients with fresh lower extremity fractures were admitted to department of orthopaedic trauma , Beijing Jishuitan Hospital .


They were randomly divided into two groups , the group @ ( n = @ ) was used to screen risk factors and derived a predictive models based on logistic regression , the group @ ( n = @ ) validated the models .


Among the patients , there were @ @ male and @ female patients , with an average age of ( @ @ ) years.Variables related to preoperative deep venous thrombosis were age , length of time before surgery , cause of injury , low/high-energy injury , location of injury , history of cardiovascular and cerebrovascular diseases , and D-Dimer .


The scores based on OR were : age @ years : @ point , > @ - < @ years : @ points , @ years : @ points ; length of time before surgery , < @ days :@ point , @ days :@ points ; low-energy injury :@ point , high energy injury :@ points ; location of injury , foot and ankle :@ point , calf :@ points , around the knee : @ points , femoral diaphysis and proximal femur :@ points , pelvis and acetabulum :@ points , @ sites :@ point ; history of cardiovascular and cerebrovascular diseases , yes :@ points , no :@ point .


D-Dimer < @ g/L :@ point , @ g/L :@ points .


Area under receiver operating characteristic curve was @ , critical point @ points , sensitivity was @ % , specificity was @ % .


The score can predict the preoperative deep venous thrombosis for patients with fresh lower extremity fractures , but limited .


To investigate if baseline depression moderated response to Media Smart , an @-lesson school-based program previously found to achieve a long-term risk reduction effect in young adolescents .


@ Grade @ students ( M age = @ years , SD = @ ) from @ schools participated with @ classes receiving the Media Smart program ( @ girls ; @ boys ) and @ comparison classes receiving their normal lessons ( @ girls ; @ boys ) .


Shape and weight concern , media internalization , body dissatisfaction , dieting , ineffectiveness , and perceived pressure were the outcome variables .


Moderation was indicated by significant interaction effects for group ( Media Smart ; Control ) moderator ( high depression ; low depression ) time ( post-program ; @-month follow-up ; @-year follow-up ) , with baseline entered as a covariate .


Such effects were found for shape and weight concern , media internalization , body dissatisfaction , ineffectiveness and perceived pressure .


Post-hoc testing found high depression Media Smart participants scored significantly lower than their control counterparts at post-program on shape and weight concern , media internalization and dieting , whereas low depression Media Smart participants scored significantly lower on shape and weight concern at @-year follow-up .


Media Smart achieved a reduction in eating disorder risk factors for high-depression participants and a reduced rate of growth in risk factor scores for low-depression participants .


Trial registry name : Australian New Zealand Clinical Trials Registry .


URL : http://www.anzctr.org.au .


Registration identification number : ACTRN@ .


The purpose of this study was to determine the effects of early outpatient exercise on muscle mass , function , and fractional synthetic rate in severely burned children .


Forty-seven children with @ % total body surface area burn performed a @-wk standard of care rehabilitation ( SOC , n = @ ) or rehabilitative exercise training ( RET , n = @ ) immediately after hospital discharge .


Dual-energy x-ray absorptiometry was used to assess lean body mass ( LBM ) at discharge , posttreatment , and @ months post-burn .


Muscle function was evaluated with a Biodex Isokinetic Dynamometer , and peak aerobic fitness ( VO@peak ) was measured using a modified Bruce treadmill protocol posttreatment .


Stable isotope infusion studies were performed in a subset of patients ( SOC , n = @ ; RET , n = @ ) at discharge and posttreatment to determine mixed-muscle fractional synthetic rate .


Relative peak torque ( RET , @ @ Nmkg , vs SOC , @ @ Nmkg ) and VO@peak ( RET , @ @ mLkgmin , vs SOC , @ @ mLkgmin ) were greater at posttreatment with RET compared with those with SOC .


In addition , RET increased whole-body ( @ % @ % ) and leg ( @ % @ % ) LBM compared with SOC .


Furthermore , the percentage change in whole-body ( @ % @ % ) and leg ( @ % @ % ) LBM from discharge to @ months post-burn was greater with RET compared to SOC .


Muscle fractional synthetic rate decreased from discharge to posttreatment in both groups ( @ % @ % per day vs @ @ % per day ) ; however , no differences were observed between treatment groups at each time point .


Early outpatient exercise training implemented at hospital discharge represents an effective intervention to improve muscle mass and function after severe burn injury .


This study compared generalized complex fractionated atrial electrograms ( CFAE ) ablation versus a selective CFAE ablation strategy targeting areas of continuous electric activity .


Subjects with symptomatic , persistent/high-burden paroxysmal atrial fibrillation ( AF ) were enrolled at @ centers ( n = @ ) and randomized to @ of @ arms .


For group I , all CFAE regions with an interval confidence level > @ were ablated followed by pulmonary vein isolation ( PVI ) .


For group II , only CFAE sites with continuous electric activity were ablated followed by PVI .


For PVI , all @ PV antra were isolated with confirmed entrance block .


Subjects were followed for @ year with a visit , ECG , and @-hour Holter every @ months .


Symptoms were confirmed by loop recording .


The primary end point was freedom from arrhythmia > @ seconds at @ year .


For both group I and II , CFAE ablation prolonged AF cycle length ( @ versus @ ms ; P = @ ) and resulted in similar rates of AF termination ( @ % versus @ % ; P = @ ) .


Radiofrequency duration during CFAE ablation was significantly less in group II ( @ versus @ minutes ; P = @ ) .


At @-year follow-up , freedom from AF/atrial flutter/atrial tachycardia recurrence was significantly higher in group I versus group II after @ procedure ( @ % versus @ % ; P = @ ) .


There were also significantly fewer repeat procedures in group I ( @ % versus @ % ; P = @ ) .


Continuous electric activity ablation + PVI result in a similar incidence of acute AF termination with significantly less radiofrequency time .


However , incidence of repeat procedures and long-term recurrence of AF/atrial flutter/atrial tachycardia are significantly lower using generalized CFAE ablation + PVI .


Clinical Trial Registration - URL : http://www.clinicaltrials.gov .


Unique identifier : NCT@ .


To determine if the use of a Bakri balloon at cesarean delivery ( CD ) for placenta previa is associated with a reduced need for additional surgical or pharmacologic measures and less blood loss than usual practices .


In a randomized controlled trial , @ women undergoing CD for placenta previa were randomly allocated @:@ into an intervention arm ( prophylactic Bakri balloon immediately following placental delivery ) or a control arm ( use of any usual surgical/pharmacologic measures to achieve hemostasis ) .


The primary outcomes were a clinician 's decision to undertake further intervention to control bleeding , and the difference between preoperative and postoperative hemoglobin levels .


Although fewer women in the intervention group required additional measures to achieve hemostasis during CD , the difference between the groups was not significant ( relative risk @ ; @ % confidence interval , @-@ @ ) .


The change in hemoglobin level among women in the intervention arm was also similar to that among controls ( @ g/dL ; @ % confidence interval , -@ to @ ) .


The prophylactic use of a Bakri balloon at CD for placenta previa tended to be of benefit , with no evidence of harm or patient dissatisfaction , but the need for additional medical/surgical measures to control blood loss was not significantly reduced .


Australian New Zealand Clinical Trials Registry : ACTRN@ .


Exercise training is recommended for chronic heart failure ( HF ) patients to improve functional status and reduce risk of adverse outcomes .


Elevated plasma levels of amino-terminal pro-brain natriuretic peptide ( NT-proBNP ) , high-sensitivity C-reactive protein ( hs-CRP ) , and cardiac troponin T ( cTnT ) are associated with increased risk of adverse outcomes in this patient population .


Whether exercise training leads to improvements in biomarkers and how such improvements relate to clinical outcomes are unclear .


Amino-terminal pro-brain natriuretic peptide , hs-CRP , and cTnT levels were assessed at baseline and @ months in a cohort of @ subjects from the HF-ACTION study , a randomized clinical trial of exercise training versus usual care in chronic HF patients with reduced left ventricular ejection fraction ( < @ % ) .


Linear and logistic regressions were used to assess @-month biomarker levels as a function of baseline value , treatment assignment ( exercise training vs usual care ) , and volume of exercise .


Linear regression and Cox proportional hazard modeling were used to evaluate the relations between changes in biomarker levels and clinical outcomes of interest that included change in peak oxygen consumption ( peak VO@ ) , hospitalizations , and mortality .


Exercise training was not associated with significant changes in levels of NT-proBNP ( P = @ ) , hs-CRP ( P = @ ) , or detectable cTnT levels ( P = @ ) at @ months .


Controlling for baseline biomarker levels or volume of exercise did not alter these findings .


Decreases in plasma concentrations of NT-proBNP , but not hs-CRP or cTnT , were associated with increases in peak VO@ ( P < @ ) at @ months and decreased risk of hospitalizations or mortality ( P @ ) , even after adjustment for a comprehensive set of known predictors .


Exercise training did not lead to meaningful changes in biomarkers of myocardial stress , inflammation , or necrosis in patients with chronic HF .


Only improvements in NT-proBNP translated to reductions in peak VO@ and reduced risk of clinical events .


Biofortification is a strategy to relieve vitamin A ( VA ) deficiency .


Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies .


The study sought to determine changes in total body reserves ( TBRs ) of vitamin A with consumption of biofortified maize .


A randomized , placebo-controlled biofortified maize efficacy trial was conducted in @ rural Zambian children .


The paired ( @ ) C-retinol isotope dilution test , a sensitive biomarker for VA status , was used to measure TBRs before and after a @-d intervention .


Treatments were white maize with placebo oil ( VA - ) , orange maize with placebo ( orange ) , and white maize with VA in oil -LSB- @ g retinol activity equivalents ( RAEs ) in @ L daily -RSB- ( VA + ) .


In total , @ children completed the trial and were analyzed for TBRs ( n = @ or @/group ) .


Change in TBR residuals were not normally distributed ( P < @ ) ; median changes ( @ % CI ) were as follows : VA - , @ ( -@ , @ ) mol ; orange , @ ( @ , @ ) mol ; and VA + , @ ( @ , @ ) mol .


Nonparametric analysis showed no statistical difference between VA + and orange ( P = @ ) ; both were higher than VA - ( P = @ ) .


Median ( @ % CI ) calculated liver reserves at baseline were @ ( @ , @ ) mol/g liver , with @ % > @ mol/g , the subtoxicity cutoff ; none were < @ mol/g , the deficiency cutoff .


The calculated bioconversion factor was @ g - carotene equivalents/@ g retinol by using the middle @ quintiles of change in TBRs from each group .


Serum retinol did not change in response to intervention ( P = @ ) but was reduced with elevated C-reactive protein ( P = @ ) and -@ - acid glycoprotein ( P = @ ) at baseline .


- Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification .


Use of more sensitive methods other than serum retinol alone , such as isotope dilution , is required to accurately assess VA status , evaluate interventions , and investigate the interaction of VA status and infection .


This trial was registered at clinicaltrials.gov as NCT@ .


Submassive pulmonary embolism ( PE ) has a low mortality rate but can degrade functional capacity .


The present study aims to provide rationale , methodology , and initial findings of a multicentre , randomised trial of fibrinolysis for PE that used a composite end-point , including quality of life measures .


This investigator-initiated study was funded by a contract between a corporate partner and the investigator 's hospital ( the prime site ) .


The investigator was the Food and Drug Administration ( FDA ) sponsor .


The prime site subcontracted , indemnified , and trained consortia members .


Consenting , normotensive patients with PE and right ventricular strain ( by echocardiography or biomarkers ) received low-molecular-weight heparin and random assignment to a single bolus of tenecteplase or placebo in double-blinded fashion .


The outcomes were : ( i ) in-hospital rate of intubation , vasopressor support , and major haemorrhage , or ( ii ) at @ days , death , recurrent PE , or composite that defined poor quality of life ( echocardiography , @ min walk test and surveys ) .


The planned sample size was n = @ .


Eight sites enrolled @ patients over @ years .


The ratio of patients screened for each enrolled was @ to @ , equating to @ h screening time per patient enrolled .


Primary barrier to enrolment was the cost of screening .


Two patients died ( @ % , @ % CI -LSB- @-@ % -RSB- ) , one developed shock , but @ ( @ % , @ % CI : -LSB- @-@ % -RSB- ) had a poor quality of life .


An investigator-initiated , FDA-regulated , multicentre trial of fibrinolysis for submassive PE was conducted , but was limited by screening costs and a low mortality rate .


Quality of life measurements might represent a more important patient-centred end-point .


Crashes are the leading cause of death for teens , and parent-based interventions are a promising approach .


We assess the effectiveness of Steering Teens Safe , a parent-focused program to increase safe teen driving .


Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with @ safe driving lessons .


A randomized controlled trial involved @ parent-teen dyads ( @ intervention and @ control ) .


Intervention parents received a @-minute session to learn the program with four follow-up phone sessions , a DVD , and a workbook .


Control parents received a standard brochure about safe driving .


Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving .


The main outcome measure was a previously validated Risky Driving Score reported by teens .


Because the Score was highly skewed , a generalized linear model based on a gamma distribution was used for analysis .


Intervention teens ranked their parent 's success in talking about driving safety higher than control teens ( p = @ ) and reported that their parents talked about more topics ( non-significant difference ) .


The Risky Driving Score was @ % lower in intervention compared to control teens ( @ % CI = @ , @ ) .


Interaction between communication quantity and the intervention was examined .


Intervention teens who reported more successful communication had a @ % lower Risky Driving Score ( @ % CI = @ , @ ) than control parents with less successful communication .


This program had a positive although not strong effect , and it may hold the most promise in partnership with other programs , such as Driver 's Education or Graduated Driver 's License policies .


Deep molecular response ( MR ( @ ) ) defines a subgroup of patients with chronic myeloid leukemia ( CML ) who may stay in unmaintained remission after treatment discontinuation .


It is unclear how many patients achieve MR ( @ ) under different treatment modalities and whether MR ( @ ) predicts survival .


Patients from the randomized CML-Study IV were analyzed for confirmed MR ( @ ) which was defined as @ log reduction of BCR-ABL on the international scale ( IS ) and determined by reverse transcriptase polymerase chain reaction in two consecutive analyses .


Landmark analyses were performed to assess the impact of MR ( @ ) on survival .


Of @,@ randomly assigned patients , @,@ were assessable .


After a median observation time of @ months , @-year overall survival ( OS ) was @ % , @-year progression-free-survival was @ % , and @-year OS was @ % .


The cumulative incidence of MR ( @ ) after @ years was @ % ( median , @ years ) ; confirmed MR ( @ ) was @ % .


MR ( @ ) was reached more quickly with optimized high-dose imatinib than with imatinib @ mg/day ( P = @ ) .


Independent of treatment approach , confirmed MR ( @ ) at @ years predicted significantly higher survival probabilities than @ % to @ % IS , which corresponds to complete cytogenetic remission ( @-year OS , @ % v @ % ; P = @ ) .


High-dose imatinib and early major molecular remission predicted MR ( @ ) .


No patient with confirmed MR ( @ ) has experienced progression .


MR ( @ ) is a new molecular predictor of long-term outcome , is reached by a majority of patients treated with imatinib , and is achieved more quickly with optimized high-dose imatinib , which may provide an improved therapeutic basis for treatment discontinuation in CML .


To compare the efficacy and safety of endoscopic dacryocystorhinostomy ( En-DCR ) with different stent materials for lacrimal sac intubation in primary nasolacrimal ductal obstructions .


Randomized controlled study with three parallel groups .


Level of evidence is @b .


A total of @ patients ( five bilateral ) with primary nasolacrimal duct obstruction ( NLDO ) at a tertiary referral center scheduled for En-DCR were to allocated into three stent groups with a sealed envelope and were randomized into three treatments : silicone , Prolene ( polypropylene ) , and otologic T-tube .


Ophthalmology and otolaryngology clinics evaluated the patients preoperatively and postoperatively with endoscopes , lacrimal system syringing , and dacryocystography .


The success of the stents was evaluated @ months after surgery with symptom relief and ostial patency .


Complications were also noted .


The overall success rate of the En-DCR in the stent groups was @ % ( @/@ ) ; specifically , @ % ( @/@ ) with silicone , @ % ( @/@ ) with Prolene , and @ % ( @/@ ) with T-tube .


The efficacy of the procedures with the T-tube was significantly lower than that of the Prolene and silicone ( p = @ , ( @ ) test ) .


There were no significant differences between the silicone and Prolene ( p = @ , ( @ ) test ) .


Prolene was found to be related with orbital complications .


Spontaneous loss is a particular complication of otologic T-tube and highly portends to failure .


The results of our study suggest that efficacy , defined as anatomic and functional success , is equally high for silicone and Prolene stents and lower for otologic T-tube in En-DCR .


Little is known about the longer-term effects of adjunctive benzodiazepines on symptom response during treatment in patients with bipolar disorders .


The study sample consisted of @ patients with bipolar I or II disorder enrolled in a @-month , randomized , multi-site comparison of lithium - and quetiapine-based treatment .


Changes in clinical measures ( BISS total and subscales , CGI-BP , and CGI-Efficacy Index ) were compared between participants who did and did not receive benzodiazepine treatment at baseline or during follow-up .


Selected outcomes were also compared between patients who did and did not initiate benzodiazepines during follow-up using stabilized inverse probability weighted analyses .


Significant improvement in all outcome measures occurred within each benzodiazepine exposure group .


Benzodiazepine users ( at baseline or during follow-up ) experienced significantly less improvement in BISS total , BISS irritability , and CGI-BP scores than did benzodiazepine non-users .


There were no significant differences in these measures between patients who did and did not initiate benzodiazepines during follow-up in the weighted analyses .


There was no significant effect of benzodiazepine use on any outcome measure in patients with comorbid anxiety or substance use disorders .


This is a secondary analysis of data from a randomized effectiveness trial that was not designed to address differential treatment response according to benzodiazepine use .


Adjunctive benzodiazepines may not significantly affect clinical outcome in lithium - or quetiapine-treated patients with bipolar I or II disorder over @ months , after controlling for potential confounding factors .


Most patients with diabetic kidney disease ( DKD ) experience disease progression despite receiving standard care therapy .


Oxidative stress is associated with DKD severity and risk of progression , but currently approved therapies do not directly attenuate the pathologic consequences of oxidative stress .


GS-@ is a once daily , oral molecule that inhibits Apoptosis Signal-regulating Kinase @ ( ASK@ ) , which is a key mediator of the deleterious effects of oxidative stress .


We describe the rationale and design of a Phase @ placebo-controlled clinical trial investigating the effects of GS-@ in patients with T@DM and stage @/@ DKD receiving standard of care therapy .


Approximately , @ subjects will be randomized in a stratified manner , based on the estimated glomerular filtration rate ( eGFR ) and urine albumin to creatinine ratio , to one of four arms in this dose-ranging study .


The primary endpoint is change in eGFR at @ weeks , and the key secondary endpoint is change in albuminuria .


Guided by the biology of oxidative stress signaling through ASK@ , the biology of DKD pathogenesis , and solid statistical methods , the decisions made for this Phase @ study regarding delineating study population , efficacy outcomes , treatment period and statistical methods represent innovative attempts to resolve challenges specific to DKD study design .


Adherence to medication is often low .


Pharmacists may improve adherence , but a one-size-fits-all approach will not work : different patients have different needs .


Goal of the current study is to assess the effectiveness of a patient-tailored , telephone-based intervention by a pharmacist at the start of pharmacotherapy aimed at improving medication adherence , satisfaction with information and counselling and the beliefs about medicines .


A cluster randomized controlled intervention trial in @ Dutch pharmacies , randomly assigned to @ of @ intervention groups .


Each group consists of an intervention arm and an usual care arm .


The intervention arm in the first group is the usual care arm in the second group and vice versa .


One intervention arm focuses on patients starting with antidepressants or bisphosphonates and the other on antilipaemic drugs or renin angiotensin system ( RAS ) - inhibitors .


The intervention consists of a telephone call by a pharmacist @ or @ weeks after a new prescription .


A random sample of pharmacies will send questionnaires @ months after the first prescription .


This contains socio-demographic questions , a measure of beliefs about medicines ( BMQ ) , satisfaction with information received ( SIMS , abbreviated ) and frequency of pharmacy counselling ( Consumer Quality Index , CQI , abbreviated ) .


The primary outcome measure will be medication adherence calculated from dispensing records retrieved @ months after the intervention .


Patients ' beliefs on medication , perception of the quality of information received and pharmacy counselling are secondary outcomes .


The TelCIP study will determine the effectiveness of telephone counselling to improve adherence in patients initiating a new treatment .


By measuring satisfaction with information and counselling and beliefs about medication the study will also give clues for the reason of a potential increase in adherence .


Finally the study will provide information on which patients are most likely to benefit from this intervention .


The purpose of this study was to examine the effects of including female athletes ' weights in athletic event programs on female spectators ' body image , eating disorder symptoms , self-esteem , and affective state and to investigate whether the magnitude of the athletes ' reported weights had differential effects on female spectators ( i.e. , do female spectators who view heavier athletes respond differently than those who view less heavy athletes ? )


We used an experimental design to examine hypotheses derived from competing theories to determine whether exposure to female athletes of varying weight would adversely or beneficially impact female undergraduates ( N = @ ) who served as athletic event spectators .


Analyses indicated that in this simulated study , female spectators ' body image , eating disorder symptoms , self-esteem , and affective states were not impacted by the presence or by the magnitude of female athletes ' weights in athletic event programs .


The results imply that including athletes ' weights in game-day programs at women 's athletic events does not affect female spectators on an individual level .


Approximately @ % of patients are not satisfied with the outcome of total knee replacement , great volumes of which are carried out yearly .


Physiotherapy is often provided by the NHS to address dysfunction following knee replacement ; however the efficacy of this is unknown .


Although clinically it is accepted that therapy is useful , provision of physiotherapy to all patients post-operatively does not enhance outcomes at one year .


No study has previously assessed the effect of targeting therapy to individuals struggling to recover in the early post-operative phase.The aim of the TRIO study is to determine whether stratifying care by targeting physiotherapy to those individuals performing poorly following knee replacement is effective in improving the one year outcomes .


We are also investigating whether the structure of the physiotherapy provision itself influences outcomes .


The study is a multi-centre prospective randomised controlled trial ( RCT ) of patients undergoing primary total knee replacement , with treatment targeted at those deemed most susceptible to gain from it .


Use of the national PROMS programme for pre-operative data collection allows us to screen all patients at initial post-operative clinical review , and recruit only those deemed to be recovering slowly.We aim to recruit @ patients through various NHS orthopaedic centres who will undergo six weeks of physiotherapy .


The intervention will be either ` intensive ' involving both hospital and home-based functional exercise rehabilitation , or ` standard of care ' consisting of home exercises .


Patients will be randomised to either group using a web-based system .


Both groups will receive pre and post-intervention physiotherapy review .


Patients will be followed-up to one year post-operation .


The primary outcome measure is the Oxford Knee Score .


Secondary outcomes are patient satisfaction , functional ability , pain scores and cost-effectiveness .


In developing countries , mortality in children with very severe pneumonia is high , even with the provision of appropriate antibiotics , standard oxygen therapy , and other supportive care .


We assessed whether oxygen therapy delivered by bubble continuous positive airway pressure ( CPAP ) improved outcomes compared with standard low-flow and high-flow oxygen therapies .


This open , randomised , controlled trial took place in Dhaka Hospital of the International Centre for Diarrhoeal Disease Research , Bangladesh .


We randomly assigned children younger than @ years with severe pneumonia and hypoxaemia to receive oxygen therapy by either bubble CPAP ( @ L/min starting at a CPAP level of @ cm H@O ) , standard low-flow nasal cannula ( @ L/min ) , or high-flow nasal cannula ( @ L/kg per min up to the maximum of @ L/min ) .


Randomisation was done with use of the permuted block methods ( block size of @ patients ) and Fisher and Yates tables of random permutations .


The primary outcome was treatment failure ( ie , clinical failure , intubation and mechanical ventilation , death , or termination of hospital stay against medical advice ) after more than @ h of treatment .


Primary and safety analyses were by intention to treat .


We did two interim analyses and stopped the trial after the second interim analysis on Aug @ , @ , as directed by the data safety and monitoring board .


This trial is registered at ClinicalTrials.gov , number NCT@ .


Between Aug @ , @ , and July @ , @ , @ eligible children were recruited .


We randomly allocated @ ( @ % ) children to receive oxygen therapy by bubble CPAP , @ ( @ % ) to low-flow oxygen therapy , and @ ( @ % ) to high-flow oxygen therapy .


Treatment failed for @ ( @ % ) children , of whom five ( @ % ) had received bubble CPAP , @ ( @ % ) had received low-flow oxygen therapy , and ten ( @ % ) had received high-flow oxygen therapy .


Significantly fewer children in the bubble CPAP group had treatment failure than in the low-flow oxygen therapy group ( relative risk -LSB- RR -RSB- @ , @ % CI @-@ ; p = @ ) .


No difference in treatment failure was noted between patients in the bubble CPAP and those in the high-flow oxygen therapy group ( RR @ , @ % @-@ ; p = @ ) .


@ ( @ % ) children died .


Three ( @ % ) children died in the bubble CPAP group , ten ( @ % ) children died in the low-flow oxygen therapy group , and ten ( @ % ) children died in the high-flow oxygen therapy group .


Children who received oxygen by bubble CPAP had significantly lower rates of death than the children who received oxygen by low-flow oxygen therapy ( RR @ , @ % CI @-@ ; p = @ ) .


Oxygen therapy delivered by bubble CPAP improved outcomes in Bangladeshi children with very severe pneumonia and hypoxaemia compared with standard low-flow oxygen therapy .


Use of bubble CPAP oxygen therapy could have a large effect in hospitals in developing countries where the only respiratory support for severe childhood pneumonia and hypoxaemia is low-flow oxygen therapy .


The trial was stopped early because of higher mortality in the low-flow oxygen group than in the bubble CPAP group , and we acknowledge that the early cessation of the trial reduces the certainty of the findings .


Further research is needed to test the feasibility of scaling up bubble CPAP in district hospitals and to improve bubble CPAP delivery technology .


Blood Pressure related disease affected @ million people in India in the year @ ; this figure will double by @ .


Around one in four adults in rural India have hypertension , and of those , only a minority are accessing appropriate care .


Health systems in India face substantial challenges to meet these gaps in care , and innovative solutions are needed .


We hypothesise that a multifaceted intervention involving capacity strengthening of primary healthcare doctors and non-physician healthcare workers through use of a mobile device-based clinical decision support system will result in improved blood pressure control for individuals at high risk of a cardiovascular disease event when compared with usual healthcare .


This intervention will be implemented as a stepped wedge , cluster randomised controlled trial in @ primary health centres and @ villages in rural Andhra Pradesh involving adults aged @ years at high cardiovascular disease event risk ( approximately @,@ people ) .


Cardiovascular disease event risk will be calculated based on World Health Organisation/International Society of Hypertension 's region-specific risk charts .


Cluster randomisation will occur at the level of the primary health centres .


Outcome analyses will be conducted blinded to intervention allocation .


The primary study outcome is the difference in the proportion of people meeting guideline-recommended blood pressure targets in the intervention period vs. the control period .


Secondary outcomes include mean reduction in blood pressure levels ; change in other cardiovascular disease risk factors , including body mass index , current smoking , reported healthy eating habits , and reported physical activity levels ; self-reported use of blood pressure and other cardiovascular medicines ; quality of life ( using the EQ-@D ) ; and cardiovascular disease events ( using hospitalisation data ) .


Trial outcomes will be accompanied by detailed process and economic evaluations .


The findings are likely to inform policy on a scalable strategy to overcome entrenched inequities in access to effective healthcare for under-served populations in low and middle income country settings .


To observe the effect of external application of Zhuangshenling Recipe ( ZR ) combined with Western medicine ( WM ) on the heart function of chronic heart failure ( CHF ) patients of Xin-Shen yang deficiency , interior retention of water-fluid syndrome ( XSYDIRWFS ) .


Totally @ CHF patients of XSYDIRWFS were randomly assigned to two groups , the treatment group and the control group , @ in each group .


All patients received WM therapy .


Those in the treatment group were applied with ZR at Xinshu ( BL@ ) and Shenshu ( BL@ ) , while those in the control group were applied with placebos at Xinshu ( BL@ ) and Shenshu ( BL@ ) .


The therapeutic course for all was @ weeks .


The integrals of TCM syndrome , grading of cardiac function , brain natriuretic polypeptide ( BNP ) , and @ min walking distance were observed before and after treatment .


After twelve weeks of treatment , the effective rate of improved grading of cardiac function , the total effective rate of TCM syndrome efficacy , and the BNP level were obviously better in the treatment group ( P < @ ) .


There was no statistical difference in @ min walking distance between the two groups ( P > @ ) .


External application of ZR combined with WM could improve the heart function of CHF patients of XSYDIRWFS .


High levels of circulating fibroblast growth factor @ ( FGF@ ) are associated with chronic kidney disease ( CKD ) progression and high mortality .


In the Phosphate Reduction Evaluation of FGF@ in Early CKD Treatment ( PREFECT ) study , we assessed the effect of reducing intestinal phosphate absorption using lanthanum carbonate on FGF@ levels in normophosphatemic patients with CKD stage @ .


Thirty-five individuals were randomized to lanthanum carbonate @ mg/day ( n = @ ) or placebo ( n = @ ) for @ weeks .


Levels of intact FGF@ ( iFGF@ ) , C-terminal FGF@ , serum and urinary phosphate and calcium , intact parathyroid hormone and @,@-dihydroxyvitamin D were assessed .


The median age was @ years in the lanthanum group and @ years in the placebo group ; @ % and @ % were men , respectively .


No significant difference was seen in mean iFGF@ between groups at week @ .


There was , however , a transient reduction from baseline in iFGF@ in the lanthanum group at week @ , from @ pg/ml to @ pg/ml , which was not seen in the placebo group ; this between-group difference in percentage change from baseline was significant in post hoc analyses ( p = @ ) .


Urinary phosphate decreased after @ week of lanthanum treatment and remained low at week @ .


Reducing intestinal phosphate absorption with lanthanum carbonate did not lead to sustained reductions in iFGF@ in patients with CKD stage @ , although phosphaturia decreased .


This suggests that factors other than phosphate burden may be responsible for driving increases in circulating FGF@ in patients with CKD .


This study sought to compare the efficacy of drug-eluting balloons ( DEB ) with that of everolimus-eluting stents ( EES ) in patients with bare-metal stents ( BMS ) in-stent restenosis ( ISR ) .


Treatment of patients with ISR remains a challenge .


This was a prospective , multicenter , randomized trial comparing DEB with EES in patients with bare-metal stents ( BMS ) in-stent restenosis ( ISR ) .


The primary endpoint was the minimal lumen diameter at @ months ' follow-up .


A total of @ patients with BMS-ISR from @ Spanish sites were included ( @ were allocated to DEB and @ to EES ) .


Procedural success was achieved in all patients .


At late angiography ( median @ days ; @ % of eligible patients ) , patients in the EES arm had a significantly larger minimal lumen diameter ( @ @ mm vs. @ @ mm , p < @ ; absolute mean difference : @ mm ; @ % confidence interval -LSB- CI -RSB- : @ to @ ) and a lower percent of diameter stenosis ( @ @ % vs. @ @ % , p < @ ) .


However , late loss ( @ @ mm vs. @ @ mm , p = @ ) and binary restenosis rate ( @ % vs. @ % , p = @ ) were very low and similar in both groups .


Clinical follow-up ( median @ days ) was obtained in all ( @ % ) patients .


Occurrences of the combined clinical outcome measure ( cardiac death , myocardial infarction , and target vessel revascularization ; @ % vs. @ % ; hazard ratio -LSB- HR -RSB- : @ ; @ % CI : @ to @ , p = @ ) and the need for target vessel revascularization ( @ % vs. @ % ; HR : @ : @ % CI : @ to @ , p = @ ) were similar in the @ groups .


In patients with BMS-ISR , both DEB and EES provided excellent clinical results with a very low rate of clinical and angiographic recurrences .


However , compared with DEB , EES provide superior late angiographic findings .


( Restenosis Intra-stent of Bare Metal Stents : Paclitaxel-eluting Balloon vs. Everolimus-eluting Stent -LSB- RIBS V -RSB- ; NCT@ ) .


Irregularity measures have been suggested as risk indicators in patients with atrial fibrillation ( AF ) ; however , it is not known to what extent they are affected by commonly used rate-control drugs .


We aimed at evaluating the effect of metoprolol , carvedilol , diltiazem , and verapamil on the variability and irregularity of the ventricular response in patients with permanent AF .


Sixty patients with permanent AF were part of an investigator-blind cross-over study , comparing @ rate-control drugs ( diltiazem , verapamil , metoprolol , and carvedilol ) .


We analyzed five @-minute segments per patient : baseline and the @ drug regimens .


On every segment , heart rate ( HR ) variability and irregularity of RR series were computed .


The variability was assessed as standard deviation , pNN@ , pNN@ , pNN@ , and rMSSD .


The irregularity was assessed by regularity index , approximate ( ApEn ) , and sample entropy .


A significantly lower HR was obtained with all drugs , the HR was lowest using the calcium channel blockers .


All drugs increased the variability of ventricular response in respect to baseline ( as an example , rMSSD : baseline @ @ milliseconds , carvedilol @ @ milliseconds ; P < @ vs. baseline , metoprolol @ @ milliseconds ; P < @ vs. baseline , verapamil @ @ ; P < @ vs. baseline , diltiazem @ @ milliseconds ; P < @ vs. baseline and all other drugs ) .


Only - blockers significantly increased the irregularity of the RR series ( as an example , ApEn : baseline @ @ , carvedilol @ @ ; P < @ vs. baseline , metoprolol @ @ ; P < @ vs. baseline , verapamil @ @ ns , diltiazem @ @ ns ) .


Modification of AV node conduction by rate-control drugs increase RR variability , while only - blockers affect irregularity .


Among patients with quiescent ulcerative colitis ( UC ) , lower fecal concentrations of calprotectin are associated with lower rates of relapse .


We performed an open-label , randomized controlled trial to investigate whether increasing doses of mesalamine reduce concentrations of fecal calprotectin ( FC ) in patients with quiescent UC .


We screened @ patients with UC in remission on the basis of Simple Clinical Colitis Activity Index scores , FC > @ g/g , and intake of no more than @ g/day mesalamine .


Participants taking mesalamine formulations other than multimatrix mesalamine were switched to multimatrix mesalamine ( @ g/day ) for @ weeks ; @ participants were then randomly assigned ( @:@ ) to a group that continued its current dose of mesalamine ( controls , n = @ ) or a group that increased its dose by @ g/day for @ weeks ( n = @ ) .


The primary outcome was continued remission with FC < @ g/g .


Secondary outcomes were continued remission with FC < @ g/g or < @ g/g ( among patients with pre-randomization values above these levels ) .


The primary outcome was achieved by @ % of controls and @ % of the dose escalation group ( P = @ ) .


More patients in the dose escalation group reduced FC to below @ g/g ( P = @ ) and @ g/g ( P = @ ) .


Among the patients who were still in remission after the randomization phase , clinical relapse occurred sooner in patients with FC > @ g/g compared with those with FC < @ g/g ( P = @ ) .


Among patients with quiescent UC and increased levels of FC , increasing the dose of mesalamine by @ g/day reduced fecal concentrations of calprotectin to those associated with lower rates of relapse .


Clinicaltrials.gov number : NCT@ .


Despite standard statin therapy , a majority of patients retain a high `` residual risk '' of cardiovascular events .


The aim of this study was to evaluate the effects of ezetimibe plus atorvastatin versus atorvastatin monotherapy on the lipid profile and coronary atherosclerosis in Japanese patients who underwent percutaneous coronary intervention ( PCI ) .


This trial was a prospective , randomized , controlled , multicenter study .


Eligible patients who underwent PCI were randomly assigned to atorvastatin alone or atorvastatin plus ezetimibe ( @ mg ) daily .


Atorvastatin was uptitrated with a treatment goal of low-density lipoprotein cholesterol ( LDL-C ) < @ mg/dl .


Serial volumetric intravascular ultrasound was performed at baseline and again at @ to @ months to quantify the coronary plaque response in @ patients .


The combination of atorvastatin/ezetimibe resulted in lower levels of LDL-C than atorvastatin monotherapy ( @ @ mg/dl vs. @ @ mg/dl ; p < @ ) .


For the absolute change in percent atheroma volume ( PAV ) , themean difference between the @ groups ( -@ % ; @ % confidence interval -LSB- CI -RSB- : -@ % to @ % ) did not exceedthe pre-defined noninferiority margin of @ % , but the absolute change in PAV did show superiority for the dual lipid-lowering strategy ( -@ % ; @ % CI : -@ % to -@ % vs. -@ % ; @ % CI : -@ % to @ % with atorvastatin alone ; p = @ ) .


For PAV , a significantly greater percentage of patients who received atorvastatin/ezetimibe showed coronary plaque regression ( @ % vs. @ % ; p = @ ) .


Both strategies had acceptable side effect profiles , with a low incidence oflaboratory abnormalities and cardiovascular events .


Compared with standard statin monotherapy , the combination of statin plus ezetimibe showed greater coronary plaque regression , which might be attributed to cholesterol absorption inhibition-induced aggressive lipid lowering .


( Plaque Regression With Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound -LSB- PRECISE-IVUS -RSB- ; NCT@ ) .