Reach for the social and physical environmental interventions ranged from @ % to @ % .


Mean satisfaction for the social environmental intervention was @ and for the physical environmental intervention was @ .


Generally , the results were higher for team leaders than for employees .


Furthermore , the implementation of the physical intervention was better at the departments that additionally received the social intervention .


Both interventions were better implemented on the level of the team leader than that of the employees .


Furthermore , the combined interventions received higher evaluation scores .


To increase satisfaction and participation , attention should be paid to both employees and team leaders during implementation .


We aimed to identify salutogenic patterns of parental knowledge , behaviors , attitudes , and beliefs that may support resistance to early childhood caries ( ECC ) among a high caries population of preschool American Indian ( AI ) children .


Participants were @ child-parent dyads living on a Southwestern reservation who completed baseline assessments for an ongoing randomized clinical trial .


T-tests were used to assess differences between reported knowledge , behaviors , and beliefs of parents whose children were caries-free ( @ percent ) and those whose children had caries ( @ percent ) .


Chi-square analyses were used for categorical variables .


Although there were no socio-demographic differences , parents of caries-free children viewed oral health as more important and reported more oral health knowledge and adherence to caries-preventing behaviors for their children .


Parents of caries-free children were more likely to have higher internal locus of control , to perceive their children as less susceptible to caries , and to perceive fewer barriers to prevention .


These parents also had higher sense of coherence scores and reported lower levels of personal distress and community-related stress .


Effective interventions for ECC prevention in high-caries AI populations may benefit from approaches that support and model naturally salutogenic behaviors .


Physical activity has a positive effect on people 's mental health and well-being .


The aim of this study was to compare the effects of hatha yoga and resistance exercises on mental health and well-being in sedentary adults .


Randomized controlled study .


Fifty-one participants aged mean ( SD ) @ ( @ ) years were randomly divided into three groups : Hatha Yoga Group , Resistance Exercise Group and Control Group .


The Hatha Yoga Group and Resistance Exercise Group participated in sessions three days per week for @ weeks and the Control Group did not participate in any sessions .


All the subjects were evaluated through the Rosenberg Self-Esteem Scale , Beck Depression Inventory , Body Cathexis Scale , Nottingham Health Profile and Visual Analog Scale for fatigue pre-and post-session .


Significant improvements were found in terms of all outcome measures in the Hatha Yoga Group and the resistance exercise group .


No improvements were found in the Control Group .


Hatha yoga more improved the dimensions fatigue , self-esteem , and quality of life , whilst resistance exercise training more improved body image .


Hatha yoga and resistance exercise decreased depression symptoms at a similar level .


The results indicated that hatha yoga and resistance exercise had positive effects on mental health and well-being in sedentary adults .


Hatha yoga and resistance exercise may affect different aspects of mental health and well-being .


Molecular imaging using positron emission tomography/computerized tomography ( PET/CT ) may add relevant incremental diagnostic information to standard structural cross-sectional imaging .


Such information may allow identification of patients with rectal cancer that are more likely to develop complete tumor regression after neoadjuvant chemoradiation therapy ( CRT ) .


The objective of this report was to identify PET/CT features that are associated with a complete response after CRT .


@ cT@-@N@-@M@ distal rectal cancer patients ( @ cm from anal verge ) were included in this prospective single center trial ( NCT @ ) .


Patients underwent baseline PET/CT followed by @ Gy and @-fluorouracil-based neoadjuvant CRT .


After completion of therapy , patients underwent @ - and @-week PET/CT .


Clinical assessment of tumor response was performed at @ weeks and was blinded to radiological information .


Patients were treated according to clinical assessment .


There were seven patients with a complete pathological response ( pCR ) and @ with a complete clinical response ( cCR ) ( @ complete responders ) .


Comparison of pCR exclusively and non-pCR revealed that only baseline primary tumor standard uptake value ( SUV ) was a significant predictor of response .


Comparison of complete responders ( pCR or cCR ) and non-complete responders showed that depth of rectal wall uptake at baseline PET/CT ( p = @ ) and variation between baseline and @-week maximum standard uptake value ( SUVmax ) of primary tumor ( p = @ ) were independent predictors for complete response at multivariate analysis .


A decrease > @ % between baseline and @-week or @ % between baseline and @-week SUVmax were associated with complete response ( pCR or cCR ; p = @ and p < @ , respectively ) .


Positron emission tomography/computerized tomography at baseline , @ and @ weeks , may provide information regarding patients with a higher likelihood of developing complete tumor regression following neoadjuvant CRT .


Acupuncture is often used for primary dysmenorrhea .


But there is no convincing evidence due to low methodological quality .


We aim to assess immediate effect of acupuncture at specific acupoint compared with unrelated acupoint and nonacupoint on primary dysmenorrhea .


The Acupuncture Analgesia Effect in Primary Dysmenorrhoea-II is a multicenter controlled trial conducted in six large hospitals of China .


Patients who met inclusion criteria were randomly assigned to classic acupoint ( N = @ ) , unrelated acupoint ( N = @ ) , or non-acupoint ( N = @ ) group on a @:@:@ basis .


They received three sessions with electro-acupuncture at a classic acupoint ( Sanyinjiao , SP@ ) , or an unrelated acupoint ( Xuanzhong , GB@ ) , or nonacupoint location , respectively .


The primary outcome was subjective pain as measured by a @-mm visual analog scale ( VAS ) .


Measurements were obtained at @ , @ , @ , @ , and @ minutes following the first intervention .


In addition , patients scored changes of general complaints using Cox retrospective symptom scales ( RSS-Cox ) and @-point verbal rating scale ( VRS ) during three menstrual cycles .


Secondary outcomes included VAS score for average pain , pain total time , additional in-bed time , and proportion of participants using analgesics during three menstrual cycles .


Five hundred and one people underwent random assignment .


The primary comparison of VAS scores following the first intervention demonstrated that classic acupoint group was more effective both than unrelated acupoint ( -@ mm , @ % CI -@ to -@ , P = @ ) and nonacupoint ( -@ mm , @ % CI -@ to -@ , P = @ ) groups .


However , no significant differences were detected among the three acupuncture groups for RSS-Cox or VRS outcomes .


The per-protocol analysis showed similar pattern .


No serious adverse events were noted .


Specific acupoint acupuncture produced a statistically , but not clinically , significant effect compared with unrelated acupoint and nonacupoint acupuncture in primary dysmenorrhea patients .


Future studies should focus on effects of multiple points acupuncture on primary dysmenorrhea .


There is an increased demand for the reduction of localized adipose tissue by noninvasive methods .


The objective of this study was to determine the safety and efficacy of noninvasive lipolysis of excess adiposities overlying the lateral thigh region using acoustic wave therapy ( AWT ) .


This study incorporates @ mechanical waves with varying properties in the same session : radial and planar AWT .


The treatment was performed using AWT on the lateral thigh areas of @ female patients .


The study was performed using the planar and radial pulse handpieces , with @ sessions performed within @ weeks .


Follow-up visits were performed @ , @ , and @ weeks after the last treatment .


Reduction in both thigh circumference and subcutaneous fat layer thickness , measured through ultrasound , was observed .


This study demonstrates that AWT is safe and efficacious for the treatment of localized adiposities in the saddlebag area .


However , the results obtained were not statistically significant .


Larger studies will be needed to further access the effects of AWT on thigh circumference reduction .


Furthermore , the authors also found an improvement in the appearance of both cellulite and skin firmness after the treatments .


Periarticular injection is becoming more commonly utilized for pain relief following total knee arthroplasty .


However , we are aware of no randomized controlled trial that has investigated the efficacy of periarticular injection for pain relief after simultaneous bilateral total knee arthroplasty .


We performed a randomized controlled trial of patients scheduled for simultaneous bilateral total knee arthroplasty .


Seventy-one patients with @ involved knees were randomly assigned to receive periarticular injection or epidural analgesia .


Other perioperative interventions , including spinal anesthesia , surgical techniques , and postoperative medication protocols , were identical for all patients .


The primary outcome was postoperative pain at rest , measured with the use of a @-mm visual analog scale ( VAS ) during the initial twenty-four-hour postoperative period .


The cumulative VAS score was calculated with use of the area under the curve and compared between the groups .


Postoperative pain at rest , quantified as the area under the curve of serial assessments during the initial twenty-four-hour postoperative period , was significantly less in the periarticular injection group than in the epidural analgesia group ( @ @ mm day compared with @ @ mm day ; p = @ ) .


The prevalences of nausea on the night of surgery and postoperative day @ and of pruritus were significantly lower in the periarticular injection group than in the epidural analgesia group ( @ % and @ % , p = @ ; @ % and @ % , p = @ ; and @ % and @ % , p = @ , respectively ) .


Periarticular injection was associated with better pain relief during the first twenty-four hours following simultaneous bilateral total knee arthroplasty and decreased opioid-related side effects compared with epidural analgesia .


Periarticular injection may be preferable to epidural analgesia for pain relief after simultaneous bilateral total knee arthroplasty .


Management of low back pain after spinal surgeries is one of the most challenging problems in pain medicine .


Transforaminal lumbar epidural steroid injection has been used with inconsistent response .


Most patients require multiple and frequent injections due to high recurrence of back pain .


To find out whether the addition of hyaluronidase to the epidural injectate affects the quality and duration of analgesia in patients with low back pain secondary to failed back surgery syndrome .


Prospective randomized trial .


The study was registered in the Government Clinical Trial registry and the protocol was reviewed and approved by the institutional review board .


After obtaining an informed consent , @ patients with low back pain due to failed back syndrome were randomly assigned to receive a transforaminal epidural injection of hyaluronidase @ IU ( HYL ) or normal saline ( NSL ) to a mixture of bupivacaine @ % ( @ mL ) and triamcinolone @ mg ( @ mL ) in a double-blind fashion .


An interventional pain specialist using fluoroscopic guidance performed all epidural injections .


The patients received a comprehensive neurological examination by a non-interventional pain specialist who was blinded to the treatment during their follow-up visits , scheduled one , @ , and @ weeks after the intervention .


Numerical pain scores , analgesic requirement , and satisfaction scores were recorded during every visit .


There was no difference in demographic data between the @ groups .


Pain scores and total analgesic requirement were significantly lower in the HYL group at @ and @ weeks after blockade ( P < @ ) .


Patient satisfaction was higher in the HYL group .


The study was limited by a relatively small sample size .


We conclude that adding hyaluronidase to the epidural injectate was effective in the management of chronic low back pain in patients with failed back surgery syndrome demonstrated over a period of @ weeks .


Creating the visual illusion of touch can improve tactile perception in healthy subjects .


We were interested in seeing if creating the illusion of touch in an insensate area could improve sensation in that area .


Fourteen people with chronic numbness participated in a randomized crossover experiment .


The @ conditions were the following : ( a ) stimulation over the unaffected limb with mirror visual feedback ( experimental condition ) , ( b ) stimulation over the affected limb with mirror visual feedback , ( c ) stimulation over the unaffected limb without mirror visual feedback , and ( d ) stimulation over the affected limb without mirror visual feedback .


Participants were assessed before and after each condition using the Ten-Test and mechanical detection thresholds .


Data were analyzed using linear mixed models .


Only the experimental condition produced a change in the Ten-Test ( mean difference = -@ ; @ % confidence interval = -@ to -@ ; P = @ ) , corresponding to a @ % improvement in sensation .


No differences were observed for any condition in mechanical detection thresholds .


Creating the illusion of touch may improve sensory function in areas of chronic numbness .


This preliminary finding adds to the growing body of evidence supporting the use of techniques that directly target cortical function in people with peripheral nerve injury .


A number of studies have described influenza vaccination coverage during pregnancy but few publications have described rates of other vaccinations .


To describe vaccination rates during pregnancy in the Vaccine Safety Datalink ( VSD ) , with particular focus on vaccinations contraindicated during pregnancy .


Pregnancies ending in @ through @ and vaccinations administered during these pregnancies were identified in the VSD .


Vaccination rates per @ pregnancies during the study period were calculated by vaccine type , recommendation category , pregnancy year , maternal age , and trimester .


Analyses were conducted in @-@ .


In the VSD , @,@ pregnancies and @,@ vaccinations were identified .


Trivalent inactivated influenza ( TIV ) was the most commonly administered vaccination ( @ doses per @ pregnancies ) and was most often administered during the @nd and @rd trimesters .


The most common vaccines in the `` consider if indicated '' category were tetanus-diphtheria ( @ per @ ) and hepatitis B ( @ per @ ) .


Contraindicated vaccination was infrequent , and the majority of these were measles-mumps-rubella ( MMR ) ( @ per @ ) ; varicella ( @ per @ ) ; and live-attenuated influenza vaccine ( LAIV ) ( @ per @ ) .


Both `` consider if indicated '' and contraindicated vaccines were more frequently administered during early pregnancy .


TIV was the most commonly administered vaccine .


With the exception of TIV , other vaccines were most frequently administered during early pregnancy and among younger women , suggesting that vaccination may occur when the woman and/or provider are unaware of the pregnancy .


Contraindicated vaccines were infrequently administered during pregnancy ; however , given that some women received contraindicated vaccines later in pregnancy , clearer recommendations and improved provider education may be needed .


Antidepressant medication ( ADM ) is efficacious in the treatment of depression , but not all patients achieve remission and fewer still achieve recovery with ADM alone .


To determine the effects of combining cognitive therapy ( CT ) with ADM vs ADM alone on remission and recovery in major depressive disorder ( MDD ) .


A total of @ adult outpatients with chronic or recurrent MDD participated in a trial conducted in research clinics at @ university medical centers in the United States .


The patients were randomly assigned to ADM treatment alone or CT combined with ADM treatment .


Treatment was continued for up to @ months until recovery was achieved .


Antidepressant medication with or without CT. .


Blind evaluations of recovery with a modified version of the @-item Hamilton Rating Scale for Depression and the Longitudinal Interval Follow-up Evaluation .


Combined treatment enhanced the rate of recovery vs treatment with ADM alone ( @ % vs @ % ; t@ = @ ; P = @ ; hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @-@ @ ; number needed to treat -LSB- NNT -RSB- , @ ; @ % CI , @-@ ) .


This effect was conditioned on interactions with severity ( t@ = @ ; P = @ ; NNT ,@ ) and chronicity ( @ = @ ; P = @ ; NNT ,@ ) such that the advantage for combined treatment was limited to patients with severe , nonchronic MDD ( @ % vs @ % ; n = @ ; t@ = @ ; P = @ ; HR , @ ; @ % CI , @-@ @ ; NNT , @ ; @ % CI , @-@ ) .


Fewer patients dropped out of combined treatment vs ADM treatment alone ( @ % vs @ % ; t@ = -@ ; P = @ ; HR , @ ; @ % CI , @-@ @ ) .


Remission rates did not differ significantly either as a main effect of treatment or as an interaction with severity or chronicity .


Patients with comorbid Axis II disorders took longer to recover than did patients without comorbid Axis II disorders regardless of the condition ( P = @ ) .


Patients who received combined treatment reported fewer serious adverse events than did patients who received ADMs alone ( @ vs @ ; P = @ ) , largely because they experienced less time in an MDD episode .


Cognitive therapy combined with ADM treatment enhances the rates of recovery from MDD relative to ADMs alone , with the effect limited to patients with severe , nonchronic depression .


Home-based rehabilitation following total knee replacement surgery can be as effective as clinic-based or in-patient rehabilitation .


The use of the Nintendo Wii has been postulated as a novel rehabilitation tool that adds an additional focus on balance and proprioception into the recovery protocol .


The aim of the proposed clinical trial is to investigate the effectiveness of this novel rehabilitation tool , used at home for three months after total knee replacement surgery and to assess any lasting improvements in functional outcome at one year .


This will be a randomised controlled trial of @ patients undergoing primary total knee replacement .


The participants will be recruited preoperatively from three surgeons at a single centre .


There will be no change to the usual care provided until @ weeks after the operation .


Then participants will be randomised to either the Wii-Fit group or usual rehabilitative care group .


Outcomes will be assessed preoperatively , a @-week post surgery baseline and then at @ weeks , @ months and @ year .


The primary outcome is the change in self-reported WOMAC total score from week @ to @ weeks .


Secondary outcomes include objective measures of strength , function and satisfaction scores .


The results of this clinical trial will be directly relevant for implementation into clinical practice .


If beneficial , this affordable technology could be used by many patients to rehabilitate at home .


Not only could it optimize the outcomes from their total knee replacement surgery but decrease the need for clinic-based or outpatient therapy for the majority .


To observe the changes of plasminogen activator inhibitor-@ and D-dimer during continuous blood purification ( CBP ) and related factors .


Sixteen patients who were diagnosed with multiple organ dysfunction syndrome ( MODS ) were randomly divided into @ groups : @ patients received standard continuous blood purification with heparin anticoagulation , and the other @ received CBP without anticoagulation .


Ten normal blood samples were collected from healthy volunteers as controls .


All patients underwent CBP for @ h. Blood was taken from those patients at @ , @ , @ , @ and @ min during the CBP .


Plasma plasminogen activator inhibitor-@ , D-dimer and serum TNF - and IL-@ were measured by ELISA .


Plasma levels of PAI-@ and D-dimer were increased significantly compared with those in the control group ( P < @ ) .


Plasma level of PAI-@ was reduced ( P < @ ) and D-dimer was increased ( P < @ ) after the CBP .


The level of plasma PAI-@ in the heparin group was significant reduced compared with the group of CBP without anticoagulation ( P < @ ) .


There was negative correlation between the level of PAI-@ and the dosage of heparin used during a CBP session in the heparin group ( r = -@ , P < @ ) .


The level of PAI-@ and D-dimer is higher in patients with MODS than that in the normal controls .


After the CBP treatment , there is significant decrease in PAI-@ and increase in D-dimer in both groups .


Heparin used during CBP can reduce PAI-@ which intensifies its function of anticoagulation .


In the TRACER trial , vorapaxar , a protease-activated receptor-@ antagonist , plus standard care in non-ST-segment elevation acute coronary syndrome ( NSTE ACS ) patients did not significantly reduce the primary composite end point but reduced a key secondary end point and significantly increased bleeding .


History of peripheral artery disease ( PAD ) was a risk-enrichment inclusion criterion .


We investigated the efficacy and safety of vorapaxar in NSTE ACS patients with documented PAD .


TRACER was a double-blind , randomized trial comparing vorapaxar with placebo in @,@ patients with NSTE ACS .


In total , @ ( @ % ) patients had a history of PAD .


Ischemic events occurred more frequently among patients with PAD ( @ % ) versus no PAD ( @ % , P < @ ) , and Global Use of Strategies to Open Occluded Coronary Arteries moderate/severe bleeding was more common in PAD ( @ % ) versus no PAD ( @ % , P = @ ) .


Similar rates of the composite end point ( cardiovascular death , myocardial infarction , or stroke ) occurred in patients with PAD treated with vorapaxar and placebo ( @ % vs @ % , P interaction = @ ) .


Patients with PAD treated with vorapaxar , when compared with placebo , also had a numerical reduction in peripheral revascularization procedures ( @ % vs @ % , P = @ ) and a lower extremity amputation rate ( @ % vs @ % , P = @ ) .


Vorapaxar increased Global Use of Strategies to Open Occluded Coronary Arteries moderate/severe bleeding similarly in patients with PAD ( hazard ratio @ , @ % CI @-@ @ ) and without ( hazard ratio @ , @ % CI @-@ @ ; P interaction = @ ) .


Patients with NSTE ACS and PAD were at increased risk for ischemic events .


Lower rates of ischemic end points , peripheral revascularization , and amputation with vorapaxar did not reach statistical significance but warrant further investigation .


Vorapaxar increased bleeding in both patients with and without PAD at a similar magnitude of risk .


This study sought to investigate the relationship of polymorphisms in ABCB@ and the predictive value of thromboelastography ( TEG ) on bleeding risk in clopidogrel-treated patients with ST-elevation myocardial infarction ( STEMI ) .


@ consecutive patients with STEMI undergoing percutaneous coronary intervention ( PCI ) were enrolled .


Twenty tag single nucleotide polymorphisms ( SNPs ) selected from ABCB@ gene and CYP@C@ * @ , * @ , * @ were detected by the ligase detection reaction .


Platelet reactivity was assessed by TEG .


The follow-up period was @months .


By receiver operating characteristic curve analysis , the TEG platelet mapping assay value of ADP inhibition had the best predictive value of bleeding academic research consortium definition ( BARC ) @b bleedings , yielding an area under the curve ( AUC ) of @ ( @ % CI @-@ @ , p = @ ; cut-off value > @ % ) .


ADP inhibition can also predict BARC @ bleedings with an AUC of @ ( @ % CI @-@ @ , p = @ ; cut-off value > @ % ) .


After adjustment for established risk factors of bleeding including the gain of function CYP@C@ * @ allele , age , female gender , renal function , the multivariable logistic regression model demonstrated that ADP inhibition > @ % ( OR @ , @ % CI @-@ @ , P = @ ) , carriage of rs@ ( OR @ , @ % CI @-@ @ , P = @ ) and rs@ ( OR @ , @ % CI @-@ @ , P = @ ) were independent predictors of BARC @ bleedings .


These associations were validated in a second cohort of @ STEMI patients .


In STEMI patients treated with clopidogrel after PCI , the ABCB@ tag SNP rs@ is associated with higher risk of bleedings while rs@ is associated with lower bleeding risk , and ADP inhibition in TEG has a predictive value of bleedings .


The growing demand for cancer genetic services underscores the need to consider approaches that enhance access and efficiency of genetic counseling .


Telephone delivery of cancer genetic services may improve access to these services for individuals experiencing geographic ( rural areas ) and structural ( travel time , transportation , childcare ) barriers to access .


This cluster-randomized clinical trial used population-based sampling of women at risk for BRCA@/@ mutations to compare telephone and in-person counseling for : @ ) equivalency of testing uptake and @ ) noninferiority of changes in psychosocial measures .


Women @ to @ years of age with personal or family histories of breast or ovarian cancer and who were able to travel to one of @ outreach clinics were invited to participate .


Randomization was by family .


Assessments were conducted at baseline one week after pretest and post-test counseling and at six months .


Of the @ women randomly assigned , @ completed a follow-up assessment .


Cluster bootstrap methods were used to estimate the @ % confidence interval ( CI ) for the difference between test uptake proportions , using a @ % equivalency margin .


Differences in psychosocial outcomes for determining noninferiority were estimated using linear models together with one-sided @ % bootstrap CIs .


Uptake of BRCA@/@ testing was lower following telephone ( @ % ) than in-person counseling ( @ % , difference = @ % , @ % CI = @ % to @ % ; after imputation of missing data : difference = @ % , @ % CI = -@ % to @ % ) .


Telephone counseling fulfilled the criteria for noninferiority to in-person counseling for all measures .


BRCA@/@ telephone counseling , although leading to lower testing uptake , appears to be safe and as effective as in-person counseling with regard to minimizing adverse psychological reactions , promoting informed decision making , and delivering patient-centered communication for both rural and urban women .


To investigate the relation of residual worst lead ST segment elevation ( WL-STE ) after ST segment myocardial infarction ( STEMI ) with infarct size and microvascular injury assessed by cardiovascular magnetic resonance ( CMR ) imaging .


WL-STE in patients with acute reperfused STEMI has been shown to identify high risk patients for major adverse cardiovascular events ( MACE ) .


However , the relation of WL-STE with myocardial damage is unknown .


In this multicentre study we analysed ECG data @min after primary percutaneous coronary intervention ( PCI ) in @ STEMI patients .


WL-STE was defined as the absolute magnitude of STE in the most affected lead on the post-PCI ECG .


Patients were categorised into three groups ( < @mm , @-@mm , and @mm ) .


CMR was performed within @week after infarction for comprehensive assessment of myocardial damage using a standardised protocol .


The primary clinical endpoint was MACE defined as death , reinfarction , and new congestive heart failure within @months after infarction .


WL-STE < @mm , @-@mm , and @mm was present in @ ( @ % ) , @ ( @ % ) , and @ ( @ % ) patients , respectively .


Myocardial damage determined by CMR demonstrated a graded relationship of infarct size ( median ( IQR ) @ ( @-@ @ ) % LV vs @ ( @-@ @ ) % LV vs @ ( @-@ @ ) % LV , p < @ ) , the myocardial salvage index ( @ ( @-@ @ ) vs @ ( @-@ @ ) vs @ ( @-@ @ ) , p < @ ) , and microvascular obstruction ( @ ( @-@ @ ) % LV vs @ ( @-@ @ ) % LV vs @ ( @-@ @ ) % LV , p < @ ) across the three groups .


WL-STE @mm was strongly associated with MACE @month after infarction ( HR @ , @ % CI @ to @ ; p = @ ) .


This largest CMR study to date correlating post-PCI WL-STE with markers of myocardial damage demonstrates that WL-STE is significantly associated with infarct size , myocardial salvage , microvascular obstruction , and MACE in a high risk STEMI population .


The role of planning in binge eating episodes is unknown .


We investigated the characteristics of planning associated with food cues in binging patients .


We studied planning based on backward reasoning , reasoning that determines a sequence of actions back to front from the final outcome .


A cross-sectional study was conducted with @ healthy participants , @ bulimia nervosa ( BN ) , @ restrictive ( ANR ) and @ binging anorexia nervosa ( ANB ) , without any concomitant impulsive disorder .


In neutral/relaxing , binge food and stressful conditions , backward reasoning was assessed with the Race game , promotion of delayed large rewards with an intertemporal discounting task , attention with the Simon task , and repeating a dominant behavior with the Go/No-go task .


BN and to a lower extent ANB patients succeeded more at the Race game in food than in neutral condition .


This difference discriminated binging from non-binging participants .


Backward reasoning in the food condition was associated with lower approach behavior toward food in BN patients , and higher food avoidance in ANB patients .


Enhanced backward reasoning in the food condition related to preferences for delayed large rewards in BN patients .


In BN and ANB patients the enhanced success rate at the Race game in the food condition was associated with higher attention paid to binge food .


These findings introduce a novel process underlying binges : planning based on backward reasoning is associated with binges .


It likely aims to reduce craving for binge foods and extend binge refractory period in BN patients , and avoid binging in ANB patients .


Shifts between these goals might explain shifts between eating disorder subtypes .


The reported incidence of injuries due to cardiopulmonary resuscitation using manual chest compressions ( manual CPR ) varies greatly .


Our aim was to elucidate the incidence of CPR-related injuries by manual chest compressions compared to mechanical chest compressions with the LUCAS device ( mechanical CPR ) in non-survivors after out-of-hospital cardiac arrest .


In this prospective multicentre trial , including @ patients ( @ manual CPR/@ mechanical CPR ) , autopsies were conducted after unsuccessful CPR and the results were evaluated according to a specified protocol .


Among the patients included , @ % in the manual CPR group and @ % in the mechanical CPR group ( p = @ ) displayed CPR-related injuries .


Sternal fractures were present in @ % of the patients in the manual CPR group and in @ % in the mechanical CPR group ( p = @ ) .


Of the patients in the manual CPR group , there were @ % with at least one rib fracture versus @ % in the mechanical CPR group ( p = @ ) .


The median number of rib fractures among patients with rib fractures was @ in the manual CPR group and @ in the mechanical CPR group .


No CPR-related injury was considered to be the cause of death .


In patients with unsuccessful CPR after out-of-hospital cardiac arrest , rib fractures were more frequent after mechanical CPR but there was no difference in the incidence of sternal fractures .


No injury was deemed fatal by the pathologist .


Anecdotal reports suggest that clopidogrel may prevent migraine attacks .


We undertook a pilot randomised trial .


We randomised consecutive migraineurs with four to @ headache days per @-day month to receive clopidogrel @mg or placebo daily for three months .


Headache was primarily assessed with a headache diary .


There were no statistically significant treatment effects .


The number of headache days fell by @ on clopidogrel and @ on placebo ( adjusted difference @ , CI -@ to @ ) .


Headache severity rose by @ points ( out of @ ) on clopidogrel , and fell by @ on placebo ; treatment effect @ points ( CI -@ to @ ) .


The main treatment effect did not depend on the presence or absence of migraine with aura at baseline , a patent foramen ovale ( PFO ) or atrial septal aneurysm .


The evidence is inconclusive , but a multicentre trial would be feasible recruiting from primary care .


Pre-hospital emergency care is a particularly vulnerable setting for workplace violence .


However , there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care .


To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care .


A retrospective cross-sectional study .


@ pre-hospital emergency care services located in Madrid region .


A randomized sample of @ health care workers ( @ physicians , @ nurses and @ emergency care assistants ) .


Data were collected from February to May @ .


The survey was divided into four sections : demographic/professional information , level of burnout determined by Maslach Burnout Inventory ( MBI ) , mental health status using General Health Questionnaire ( GHQ-@ ) and frequency and type of violent behaviour experienced by staff members .


The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety , emotional exhaustion , depersonalization and burnout syndrome compared with those who had not been subjected to any aggression .


Frequency of verbal violence ( more than five times ) was related to emotional exhaustion and depersonalization .


Type of violence ( i.e. physical aggression ) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout ( emotional exhaustion and depersonalization ) .


Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence .


Lorcaserin , a novel selective @-HT@C receptor agonist , is approved by the US Food and Drug Administration ( FDA ) for weight management in combination with lifestyle modification for adults with obesity and adults with overweight and @ weight-related comorbid condition .


The safety and effectiveness of lorcaserin in adult patients without type @ diabetes mellitus was established based on @ phase III clinical trials of similar design : Behavioral Modification and Lorcaserin for Overweight and Obesity Management ( BLOOM ) and Behavioral Modification and Lorcaserin Second Study for Obesity Management ( BLOSSOM ) .


This report presents a prespecified analysis of pooled data from these trials .


Co-primary end points in this analysis include the proportion of patients with a reduction in baseline body weight of @ % and @ % , and a change in weight from baseline .


Key secondary end points include changes from baseline values in lipid parameters , quality-of-life measures , glycemic indicators , and vital signs .


At week @ , more than twice as many lorcaserin-treated patients achieved a weight loss of @ % compared with placebo ( lorcaserin , @ % ; placebo , @ % ) , and lorcaserin-treated patients lost significantly more body weight ( lorcaserin , -@ % ; placebo , -@ % ) .


A significantly greater proportion of lorcaserin-treated patients achieved a weight loss of @ % ( lorcaserin , @ % ; placebo , @ % ) .


There were statistically significant improvements in lipid parameters , glycemic indicators , quality-of-life measures , and vital signs in the lorcaserin group compared with placebo .


The most common adverse events associated with lorcaserin treatment were headache , upper respiratory tract infection , and nasopharyngitis .


Lorcaserin-treated patients had a rate of FDA-defined valvulopathy similar to placebo .


This pooled analysis of the phase III BLOOM and BLOSSOM trials shows that lorcaserin @ mg twice daily , in combination with diet and exercise , is safe and tolerable , and is associated with statistically significant weight loss and clinically relevant improvements in cardiometabolic parameters .


A novel multidimensional index of nociception , the nociception level ( NoL ) index , derived from the nonlinear composite of heart rate ( HR ) , HR variability , amplitude of the photoplethysmogram , skin conductance , fluctuations in skin conductance , and their time derivatives , was used to assess nociception during anesthesia .


Seventy-two American Society of Anesthesiologists I to III patients received propofol ( target bispectral index , @ ) and one of six remifentanil target concentrations in the range of @ to @ ng/ml .


The NoL , mean arterial pressure ( MAP ; derived from a beat-to-beat finger cuff measurement ) , and HR were measured during nonnoxious , moderate noxious ( skin incision ) , and intense noxious ( intubation ) stimulation .


Values are represented as average ( @ % CI ) .


NoL , HR , and MAP did not change during nonnoxious events .


Incision increased HR by @ / min ( -@ to @ / min ; not significant ) , MAP by @ mmHg ( -@ to @ mmHg ; not significant ) , and NoL by @ ( @ to @ ; P < @ ) .


Intubation increased HR by @ / min ( @ to @ / min ; P < @ ) , MAP by @ mmHg ( @ to @ mmHg ; P < @ ) , and NoL by @ ( @ to @ ; P < @ ) .


The NoL area under the curve ( @ ) of the receiver operating characteristic curve was greater compared with HR ( @ , P < @ ) and MAP ( @ , P < @ ) .


Under nonnociceptive conditions , remifentanil had no effect on NoL , in contrast to HR and MAP that showed a dose-dependent decrease .


The NoL is a reliable measure of moderate and intense noxious stimulation and outperforms HR and MAP in differentiating noxious from nonnoxious stimuli .


In contrast to HR and MAP , the NoL was not affected by hemodynamic effects of remifentanil .


The objective of this study was to assess the evolution of T@ contrast ( T@c ) between cardiovascular tissues , contrast agents , and magnetic field strengths .


This Health Insurance Portability and Accountability Act-compliant study was approved by the institutional review board , and written informed consent was obtained from all participants .


Eight healthy volunteers were recruited to undergo @ consecutive magnetic resonance ( MR ) scans with the same imaging parameters .


Scans @ and @ were performed using a @-T MR scanner , and scans @ and @ were performed using a @-T MR scanner .


Gadofosveset trisodium ( @ mmol/kg ) was injected for scans @ and @ , and gadopentetate dimeglumine ( Gd-DTPA ) ( @ mmol/kg ) was used for scans @ and @ .


Modified Look-Locker inversion recovery T@ maps with a midventricular short-axis view were acquired before contrast and repeated every @ minutes until @ minutes after contrast agent administration .


T@ contrast tissue ( T@ ( myocardium ) - T@ ( blood ) ) , T@c agent ( T@Gd-DTPA - T@ ( Gadofosveset ) ) , and T@c field ( T@ ( @T ) - T@ ( @ T ) ) were calculated and compared using t tests .


The T@c tissue of the @-T scanner was larger than that of the @-T scanner for both contrast agents .


In both the myocardium and the blood pool , the T@c agent of the @-T scanner was larger than that of the @-T scanner .


Gadofosveset trisodium exhibited a larger T@c field and T@c tissue than did Gd-DTPA .


The T@c tissue induced by Gd-DTPA diminished faster than that induced by gadofosveset trisodium at both @ and @ T.


Our study demonstrates the independent effects of timing , contrast agent type , and magnetic field strength on postcontrast T@c under general physiological conditions .


The behaviors of T@c can be used to tailor quantitative MR imaging protocols for various clinical purposes .


The purpose of this study was to evaluate the diagnostic accuracy of real-time shear-wave elastography for assessment of liver fibrosis in an unselected patient population , comparing shear-wave elastography measurements obtained at and remote from the site of random liver biopsy .


In a prospective study of @ patients ( @ with and @ without hepatitis C ) referred for clinically indicated random liver biopsy for diffuse liver disease , shear-wave elastography measurements were taken from four locations before biopsy : one at the left lobe , two at the right lobe , and one at the biopsy location .


The mean , minimum , maximum , and SD of shear-wave elastography were compared with pathologic grading .


Steatosis and serum markers were analyzed using multiple logistic regression .


Optimized shear-wave elastography thresholds were calculated using AUC analysis .


The AUC ( @ % CI ) at the biopsy site , ipsilateral lobe , and contralateral lobe were @ ( @-@ @ ) , @ ( @-@ @ ) , and @ ( @-@ @ ) in hepatitis C patients ; @ ( @-@ @ ) , @ ( @-@ @ ) , and @ ( @-@ @ ) in nonhepatitis C patients ; and @ ( @-@ @ ) , @ ( @-@ @ ) , and @ ( @-@ @ ) in all patients , respectively .


Optimized biopsy site shear-wave elastography values for detecting Metavir score F@ or greater were @ m/s ( @ % sensitivity and specificity ) , @ m/s ( @ % sensitivity and specificity ) , and @ m/s ( @ % sensitivity and specificity ) in hepatitis C , nonhepatitis C , and all patients , respectively .


Steatosis and serum markers were not significant .


Real-time shear-wave elastography accurately predicted significant fibrosis ( stage @ ) in an unselected patient population with diffuse disease , including patients with and without hepatitis C. Shear-wave elastography best predicts pathologic grading when taken at the biopsy site or ipsilateral lobe in hepatitis C patients .


Percentage steatosis was not predictive of shear-wave elastography results .


We evaluate patients with shock and traumatic brain injury who were previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome .


This was a secondary analysis of patients with shock and traumatic brain injury who were aged @ years or older and enrolled in a Resuscitation Outcomes Consortium out-of-hospital clinical trial by @ emergency medical services agencies transporting to @ Level I and II trauma centers in @ sites ( May @ through May @ ) .


Inclusion criteria were systolic blood pressure less than or equal to @ mm Hg or systolic blood pressure @ to @ mm Hg with pulse rate greater than or equal to @ beats/min ( shock cohort ) and Glasgow Coma Scale score less than or equal to @ ( traumatic brain injury cohort ) ; patients meeting both criteria were placed in the shock cohort .


Primary outcomes were @-day mortality ( shock cohort ) and @-month Glasgow Outcome Scale-Extended score less than or equal to @ ( traumatic brain injury cohort ) .


There were @ patients in the shock cohort ( @ % @-day mortality ) and @,@ patients in the traumatic brain injury cohort ( @ % @-month Glasgow Outcome Scale-Extended score @ ) .


Out-of-hospital time greater than @ minutes was not associated with worse outcomes after accounting for important confounders in the shock cohort ( adjusted odds ratio -LSB- aOR -RSB- @ ; @ % confidence interval -LSB- CI -RSB- @ to @ ) or traumatic brain injury cohort ( aOR @ ; @ % CI @ to @ ) .


However , shock patients requiring early critical hospital resources and arriving after @ minutes had higher @-day mortality ( aOR @ ; @ % CI @ to @ ) ; this finding was not observed among a similar traumatic brain injury subgroup .


Among out-of-hospital trauma patients meeting physiologic criteria for shock and traumatic brain injury , there was no association between time and outcome .


However , the subgroup of shock patients requiring early critical resources and arriving after @ minutes had higher mortality .


Noncompliance with scheduled ambulatory saliva sampling is common and has been associated with biased cortisol estimates in nonpregnant subjects .


This study is the first to investigate in pregnant women strategies to improve ambulatory saliva-sampling compliance , and the association between sampling noncompliance and saliva cortisol estimates .


We instructed @ pregnant women to collect eight scheduled saliva samples on two consecutive days each .


Objective compliance with scheduled sampling times was assessed with a Medication Event Monitoring System and self-reported compliance with a paper-and-pencil diary .


In a randomized controlled study , we estimated whether a disclosure intervention ( informing women about objective compliance monitoring ) and a reminder intervention ( use of acoustical reminders ) improved compliance .


A mixed model analysis was used to estimate associations between women 's objective compliance and their diurnal cortisol profiles , and between deviation from scheduled sampling and the cortisol concentration measured in the related sample .


Self-reported compliance with a saliva-sampling protocol was @ % , and objective compliance was @ % .


The disclosure intervention was associated with improved objective compliance ( informed : @ % , noninformed : @ % ) , F ( @,@ ) = @ , p < @ , but not the reminder intervention ( reminders : @ % , without reminders : @ % ) , F ( @,@ ) = @ , p = @ .


Furthermore , a woman 's increased objective compliance was associated with a higher diurnal cortisol profile , F ( @,@ ) = @ , p < @ .


Altered cortisol levels were observed in less objective compliant samples , F ( @,@ ) = @ , p = @ , with delayed sampling associated with lower cortisol levels .


The results suggest that in pregnant women , objective noncompliance with scheduled ambulatory saliva sampling is common and is associated with biased cortisol estimates .


To improve sampling compliance , results suggest informing women about objective compliance monitoring but discourage use of acoustical reminders .


There is currently little evidence defining the clinical importance of detecting and treating isolated distal DVT ( IDDVT ) .


International guidelines vary regarding diagnostic and therapeutic advice .


The potential benefits of anticoagulation are unquantified .


We sought to evaluate the feasibility of a randomized controlled study within a modern framework and provide a primary outcome point estimate .


In this open-label , external pilot randomized controlled trial , consecutive , symptomatic , ambulatory patients with IDDVT were approached for inclusion .


Participants were allocated to receive either therapeutic anticoagulation or conservative management .


Patients underwent blinded color-duplex imaging at @ and @ days and follow-up at @ months .


Principal feasibility outcomes included recruitment rate and attrition .


The principal clinical outcome was a composite including proximal propagation , pulmonary embolism , death attributable to VTE disease , or major bleeding .


Analysis was by intention to treat .


In total , @ patients with IDDVT were screened , and @ of those eligible ( @ % ) were recruited .


All patients but one were followed-up by direct contact after @ days .


Allocation crossover occurred in @ patients ( @ % ) .


The principal clinical outcome occurred in four of @ of those conservatively treated ( @ % ) and zero of @ in the anticoagulated group ( absolute risk reduction , @ % ; @ % CI , -@ to @ , P = @ , number needed to treat of nine ) .


There were no major bleeding episodes .


We have established the feasibility of definitive study regarding the value of therapeutic anticoagulation in IDDVT and provide an approximate point estimate for serious complications with a contemporary conservative strategy .


Considering both the burden determined by major depressive disorder ( MDD ) itself and the high refractoriness and recurrence index , alternative strategies , such as trigeminal nerve stimulation ( TNS ) , are the cutting edge instruments to optimize clinical response and to avoid treatment discontinuation and relapse of symptoms .


Trigeminal nerve stimulation is an incipient simple , low-cost interventional strategy based on the application of an electric current over a branch of the trigeminal nerve with further propagation of the stimuli towards brain areas related to mood symptoms .


The study was a phase II , randomized , sham-controlled trial with @ patients with MDD .


Patients with moderate or severe depressive symptoms as assessed by adequate clinical scales underwent a @-day intervention protocol .


Regarding main clinical outcome , analysis of variance ( ANOVA ) was performed to evaluate mean change scores in depressive symptoms as assessed by the HDRS-@ between baseline ( t@ ) , after intervention protocol ( t@ ) , and during one-month follow-up ( t@ ) .


There was a significant interaction between the mean percentage changes in depressive symptoms according to the HDRS in the two groups across the three assessments ( F = @ , df = @ , p = @ ) .


Post hoc analyses ( Bonferroni method ) demonstrated a statistically significant difference between depressive symptoms at baseline and t@ ( p = @ ) and between depressive symptoms at baseline and t@ ( p = @ ) .


No severe adverse effects were reported .


Our results in the present controlled trial highlight the possibility of more practical treatment protocols for clinical research , which are similar to those for different neuromodulation strategies such as transcranial direct current stimulation ( tDCS ) .


The in-office administration of TNS in our protocol is similar to the schedule for repetitive transcranial magnetic stimulation ( rTMS ) , though over fewer treatment sessions .


Further controlled studies will contribute to the establishment of the clinical relevance of this new treatment strategy for MDD .


Moderate wound pain and opiate analgesia requirement is reported following thyroid and parathyroid surgery .


A randomized clinical trial was performed to investigate whether intraoperative superficial cervical plexus block ( SCPB ) would decrease postoperative pain and analgesia use .


Patients were randomized to incisional local anaesthesia ( control ) or incisional local anaesthesia plus intraoperative SCPB .


The primary outcome measure was pain , assessed by a visual analogue scale ( VAS ) .


Secondary outcome measures were analgesia use ( strong opiates defined as having potency at least as strong as that of oral morphine ) , respiratory rate and sedation score .


Primary outcome measures were analysed with non-parametric tests , as well as with receiver operating characteristic ( ROC ) curves calculated as area under the curve ( AUC ) to discriminate between trial limbs .


Twenty-nine patients were randomized to each group .


Pain ( VAS ) scores were lower in patients who received intraoperative SCPB than in controls @min after surgery and subsequently ( P < @ at all time points ) , with a median pain score of zero on the day of operation in the SCPB group .


Corresponding analysis of ROC curves showed differences between groups at @min ( AUC = @ , P = @ ) , @min ( AUC = @ , P = @ ) , @min ( AUC = @ , P < @ ) and @min ( AUC = @ , P < @ ) after surgery , and at @ hours on postoperative day @ ( AUC = @ , P = @ ) .


Fewer patients in the SCPB group required strong opiates ( @ of @ versus @ of @ in the control group ; P = @ ) and rescue opiates ( @ of @ versus @ of @ ; P < @ ) .


Intraoperative SCPB reduces pain scores following thyroid and parathyroid surgery , and reduces the requirement for strong and rescue opiates .


Elevated blood viscosity is a risk factor for atherosclerosis , thrombosis and other cardiovascular events .


Our previous studies have suggested that consumption of Yerba mate tea ( Ilex paraguariensis ) has strong antioxidant and lipid-lowering properties in animals .


The in vivo effects of Yerba mate on blood viscosity in humans , however , have not been studied .


This study aims to investigate the effect of Yerba mate tea on the reduction of blood viscosity and the improvement of microcirculatory parameters commonly regarded as risk factors for serious cardio and cerebrovascular disorders .


@ subjects with high blood viscosity were recruited in this randomized , double-blind , placebo-controlled study .


Yerba mate tea or placebo ( @ g/day ) was administered to different groups for @ weeks .


After treatment , results of hemorheological indexes , nailfold microcirculation , @-keto-PGF@ and TXB@ and lipid profiles of subjects in the Yerba mate tea group were compared with those in the placebo-receiving group .


Parameters of blood viscosity and microcirculation were improved in the subjects from the Yerba mate tea group but not in placebo-receiving patients .


After treatment , whole blood viscosity , plasma viscosity and the Equation K value of erythrocyte sedimentation rate ( ESRK ) decreased significantly in the Yerba mate group .


Meanwhile , shape , flow state and nailfold microcirculation appeared positively changed .


Specifically , blood flow speeds accelerated gradually and nailfold weighted integral values decreased significantly .


Moreover , the vasodilator @-keto PGF@ increased while the thromboxane TXB@ decreased in serum samples of subjects in the Yerba mate-receiving group .


Overall , Yerba mate tea-receiving subjects saw nearly all measured values improve to levels comparable to those characteristic of patients with normal microcirculation .


These results indicate the therapeutic capacity of Yerba mate tea in the treatment of high blood viscosity .


Here , Yerba mate tea played a role in the regulation of various indexes of hemorheology , nailfold microcirculation , and the platelet aggregating factors @-keto-PGF@a and TXB@ .


The regulation of these might be correlated with reduced blood viscosity and accelerating blood flow .


Thus , Yerba mate tea may reduce some key risk-factors of cardiovascular disease .


Daily consumption of Yerba mate tea may be a better-tolerated option for individuals with high blood viscosity and microcirculatory disturbance and as such , a novel preventative strategy for patients at-risk for vascular disease .


For the management of retinal disease , the use of intravitreous injections of anti-vascular endothelial growth factor has increased .


Recent reports have suggested that this therapy may cause sustained elevation of intraocular pressure ( IOP ) and may potentially increase the risk of glaucoma for patients with retinal disease .


To assess the risk of sustained IOP elevation or the need for IOP-lowering treatments for eyes with diabetic macular edema following repeated intravitreous injections of ranibizumab .


An exploratory analysis was conducted within a Diabetic Retinopathy Clinical Research Network randomized clinical trial .


Study enrollment dates were from March @ , @ , to December @ , @ .


Of @ eyes ( of @ participants ) with center-involved diabetic macular edema and no preexisting open-angle glaucoma , @ were randomly assigned to receive a sham injection plus focal/grid laser treatment , and @ were randomly assigned to receive ranibizumab plus deferred or prompt focal/grid laser treatment .


The cumulative probability of sustained IOP elevation , defined as IOP of at least @ mm Hg and an increase of at least @ mm Hg from baseline at @ consecutive visits , or the initiation or augmentation of ocular hypotensive therapy , through @ years of follow-up .


The mean ( SD ) baseline IOP in both treatment groups was @ ( @ ) mm Hg ( range , @-@ mm Hg ) .


The cumulative probability of sustained IOP elevation or of initiation or augmentation of ocular hypotensive therapy by @ years , after repeated ranibizumab injections , was @ % for the participants who received ranibizumab plus prompt or deferred focal/grid laser treatment vs @ % for the participants who received a sham injection plus focal/grid laser treatment ( difference , @ % -LSB- @ % CI , -@ % to @ % -RSB- ; hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


The distribution of IOP and the change in IOP from baseline at each visit through @ years were similar in each group .


In eyes with center-involved diabetic macular edema and no prior open-angle glaucoma , repeated intravitreous injections of ranibizumab may increase the risk of sustained IOP elevation or the need for ocular hypotensive treatment .


Clinicians should be aware of this risk and should consider this information when following up with patients who have received intravitreous injections of anti-vascular endothelial growth factor for the treatment of diabetic macular edema .


To compare outcomes of intravitreal therapy from an observational study cohort with those of participants receiving treatment in the Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab ( MARINA ) for the treatment of neovascular age-related macular degeneration ( wet AMD ) .


Database observational study .


Participants in the observational cohort were chosen to match demographic features and entry criteria of the treatment group from MARINA .


Outcomes over @ months were compared .


Eight hundred twenty-one anti-vascular endothelial growth factor ( anti-VEGF ) - nave eyes treated with ranibizumab with @ months or more of follow-up were included in the total Fight Retinal Blindness !


( FRB-All ) cohort , whereas a subset of this cohort of @ eyes who were matched to the MARINA treatment group were included as the FRB-MARINA cohort .


Intravitreal ranibizumab therapy of @ mg for wet AMD .


Visual acuity ( VA ) in logarithm of the minimum angle of resolution ( logMAR ) letters and treatments given were recorded continuously and anonymously in an electronic database for @ months .


Locally weighted scatterplot smoothing ( LOESS ) regression was used to plot change in visual acuity data over the course of @ months for both the FRB-All cohort and the FRB-MARINA cohort , whereas results from the MARINA trial were taken from the published study report .


Change in VA in logMAR letters over @ months , treatment , and visit intensity .


Mean visual acuity improvement after @ months in FRB-MARINA ( +@ letters ) was similar to that of the @-mg group from MARINA ( +@ letters ) .


Improvement in FRB-ALL was slightly less ( +@ letters ) .


Mean treatment effect compared with the MARINA control group was similar for the MARINA treated group ( +@ letters ) and the FRB-MARINA cohort ( +@ letters ) .


A mean of @ injections in @ months was received by the observational cohorts .


Similarity of mean VA improvement in the matched observational cohort with that of the phase @ clinical trial suggests that these results can be achieved in real-world clinical practice with a modified treatment regimen .


Interventions to support people with hypertension in attending clinics and taking their medication have potential to improve outcomes , but delivery on a wide scale and at low cost is challenging .


Some trials evaluating clinical interventions using short message service ( SMS ) text-messaging systems have shown important outcomes , although evidence is limited .


We have developed a novel SMS system integrated with clinical care for use by people with hypertension in a low-resource setting .


We aim to test the efficacy of the system in improving blood pressure control and treatment adherence compared to usual care .


The SMS Text-message Adherence suppoRt trial ( StAR ) is a pragmatic individually randomised three-arm parallel group trial in adults treated for hypertension at a single primary care centre in Cape Town , South Africa .


The intervention is a structured programme of clinic appointment , medication pick-up reminders , medication adherence support and hypertension-related education delivered remotely using an automated system with either informational or interactive SMS text-messages .


Usual care is supplemented by infrequent non-hypertension related SMS text-messages .


Participants are @:@:@ individually randomised , to usual care or to one of the two active interventions using minimisation to dynamically adjust for gender , age , baseline systolic blood pressure , years with hypertension , and previous clinic attendance .


The primary outcome is the change in mean systolic blood pressure at @-month follow-up from baseline measured with research staff blinded to trial allocation .


Secondary outcomes include the proportion of patients with @ % or more of days medication available , proportion of participants achieving a systolic blood pressure less than @mmHg and a diastolic blood pressure less than @mmHg , hospital admissions , health status , retention in clinical care , satisfaction with treatment and care , and patient related quality of life .


Anonymised demographic data are collected on non-participants .


The StAR trial uses a novel , low cost system based on widely available mobile phone technology to deliver the SMS-based intervention , manage communication with patients , and measure clinically relevant outcomes .


The results will inform implementation and wider use of mobile phone based interventions for health care delivery in a low-resource setting .


FlexTouch ( FT ) is a new prefilled insulin pen with no push-button extension and a low injection force used to deliver several basal insulins , including insulin degludec across a wide dose range ( @ - @ units with FT @ IU/ml -LSB- FT@ -RSB- and @ - @ units with @ IU/ml -LSB- FT@ -RSB- ) .


This study was carried out to evaluate whether the novel features of FT affect the preferences of the device among patients with diabetes and healthcare professionals compared with the widely used SoloSTAR pen .


A multicenter , randomized , open-label , crossover study compared FT@ and FT@ with SoloSTAR .


The study included patients with either type @ ( n = @ ) or type @ diabetes ( n = @ ) , nurses ( n = @ ) and physicians ( n = @ ) .


Subjects were randomized to test each of the FT@ , FT@ and SoloSTAR pens in a crossover set up .


Subjects performed injections into a foam cushion at @ - @ different doses per device ( @ , @ , @ , @ , @ and @ IU ) .


Overall , a significantly higher proportion of subjects , including dexterity-impaired and pen-naive patients , preferred to use FT@ ( @ % ; @/@ ) and FT@ ( @ % ; @/@ ) compared with @ % ( @/@ ) and @ % ( @/@ ) who preferred SoloSTAR ( p < @ ) , respectively .


FT@ and FT@ were preferred over SoloSTAR by nurses , physicians and patients with diabetes .


This may be due to the novel design of FT , which improves ease of use , preference and confidence in delivering a complete , accurate dose of insulin , even at high doses .


Suboptimal vitamin D status is prevalent in HIV-infected patients and associated with increased risk of disease severity and morbidity .


We aimed to determine @-month safety and efficacy of daily @ IU vitamin D@ ( vitD@ ) versus placebo to sustain increased serum @-hydroxyvitamin D ( @ ( OH ) D ) and improve immune status in HIV-infected subjects .


This was a double-blind trial of perinatally acquired HIV ( PHIV ) - infected subjects or behaviorally acquired HIV ( BHIV ) - infected subjects ( @-@ @ years ) .


Safety , @ ( OH ) D-related parameters and immune status were assessed at baseline , @ , @ and @ months .


Fifty-eight subjects enrolled ( @ % male , @ % African American and @ % BHIV ) and @ completed with no safety concerns .


In unadjusted analyses , there were no differences between randomization groups at baseline ; at @ , @ and @ months , @ ( OH ) D was higher with supplementation than baseline and higher than with placebo ( P < @ ) .


In adjusted mixed models , in the supplementation group , the fixed effect of @ ( OH ) D was higher ( P < @ ) .


Percentage of naive T-helper cells ( Th naive % ) were significantly ( P < @ ) and T-helper cells ( CD@ % ) marginally ( P < @ ) increased with supplementation in those taking highly active antiretroviral therapy ( HAART ) , and RNA viral load was reduced ( P @ ) .


In exploratory linear models , change in @ ( OH ) D predicted RNA viral load at @ and @ months and CD@ % at @ months ( P < @ ) .


Daily @ IU vitD@ for @ months was safe in HIV-infected subjects and effective in increasing @ ( OH ) D. Supplementation improved some clinically important HIV immune markers in subjects on HAART .


Adjunct therapy with high-dose , daily vitD@ for HIV-infected subjects and for those on/off HAART requires further investigation .


To evaluate the immediate effect of repetitive wrist extension on grip strength in patients with distal radial fracture .


Interventional study .


Patients who were admitted to a hospital department of occupational therapy .


Consecutive patients with a unilateral distal radial fracture ( N = @ ) .


Each patient was randomly allocated to either the experimental group ( n = @ ) or the control group ( n = @ ) .


The experimental group performed @ repetitive wrist extensions with maximal isometric contraction of the extensors of their affected hands during a @-minute intervention period , whereas the control group did not perform the exercise .


Grip strength was measured just before and after the intervention period .


Pain during grip strength measurements was also quantified using the visual analog scale .


Wrist extension strength was measured @ minutes after the grip strength measurement .


Grip strength increased immediately after repetitive wrist extension in the experimental group , but it remained the same in the control group .


Visual analog scale scores indicated that pain was relieved only in the experimental group .


However , pain was unrelated to strength production .


The intervention used in this study might be useful during physical examination to reveal the potential grip strength of patients .


The intervention may also be an effective warm-up training procedure in preparation for conventional grip-strengthening exercises .


Preclinical and clinical data suggest that pregnenolone may be a promising therapeutic in schizophrenia .


Pregnenolone is neuroprotective and enhances learning and memory , myelination , and microtubule polymerization .


Treatment with pregnenolone elevates allopregnanolone ( a neurosteroid that enhances GABAA receptor responses ) and pregnenolone sulfate ( a positive NMDA receptor modulator ) .


Pregnenolone could thus potentially mitigate GABA dysregulation and/or NMDA receptor hypofunction in schizophrenia via metabolism to other neurosteroids .


The objective of this study is to conduct a randomized controlled trial of adjunctive pregnenolone in schizophrenia .


Following a placebo lead-in , @ participants were randomized to pregnenolone or placebo for @ weeks ( Institute for Mental Health , Singapore ) .


Primary endpoints were changes in MATRICS Consensus Cognitive Battery ( MCCB ) composite scores ( cognitive symptoms ) , UCSD Performance-based Skills Assessment-Brief ( UPSA-B ) composite scores ( functional capacity ) , and Scale for Assessment of Negative Symptoms ( SANS ) total scores ( negative symptoms ) .


A modified intent-to-treat analysis approach was utilized .


No significant changes compared to placebo were demonstrated in composite MCCB scores .


In contrast , participants randomized to pregnenolone ( n = @ ) demonstrated greater improvements in functional capacity ( UPSA-B composite changes ) compared to placebo ( n = @ ) , p = @ .


Pregnenolone was also superior to placebo in the communication subscale of the UPSA-B ( p < @ ) .


Serum pregnenolone changes post-treatment were correlated with UPSA-B composite score changes in females ( r s = @ , p < @ , n = @ ) but not in males .


Mean total SANS scores were very low at baseline and did not improve further post-treatment .


Pregnenolone was well-tolerated .


Pregnenolone improved functional capacity in participants with schizophrenia , but did not improve cognitive symptoms over an @-week treatment period .


Neurosteroid changes correlated with functional improvements in female participants .


Neurosteroid interventions may exhibit promise as new therapeutic leads for schizophrenia .


Polyphenol-rich foods such as pomegranate , green tea , broccoli and turmeric have demonstrated anti-neoplastic effects in laboratory models involving angiogenesis , apoptosis and proliferation .


Although some have been investigated in small , phase II studies , this combination has never been evaluated within an adequately powered randomised controlled trial .


In total , @ men , average age @ years , with localised prostate cancer , @ % managed with primary active surveillance ( AS ) or @ % with watchful waiting ( WW ) following previous interventions , were randomised ( @:@ ) to receive an oral capsule containing a blend of pomegranate , green tea , broccoli and turmeric , or an identical placebo for @ months .


The median rise in PSA in the food supplement group ( FSG ) was @ % ( @ % confidence intervals ( CIs ) @-@ @ % ) , as opposed to @ % in the placebo group ( PG ) ( @ % CI @-@ @ % ) , difference @ % ( P = @ ) .


In all , @ % of men in the FSG and @ % in the PG opted to leave surveillance at the end of the intervention ( @ P = @ ) .


There were no significant differences within the predetermined subgroups of age , Gleason grade , treatment category or body mass index .


There were no differences in cholesterol , blood pressure , blood sugar , C-reactive protein or adverse events .


This study found a significant short-term , favourable effect on the percentage rise in PSA in men managed with AS and WW following ingestion of this well-tolerated , specific blend of concentrated foods .


Its influence on decision-making suggests that this intervention is clinically meaningful , but further trials will evaluate longer term clinical effects , and other makers of disease progression .


To evaluate the efficacy and safety of PMC therapy ( Prednisone , Methotrexate , Chloroquine ) combined Langchuang Fuzheng Jiedu Capsule ( LFJC ) , thus choosing a better therapy of integrative medicine for SLE in the period of glucocorticoid use .


Sixty active SLE patients were randomly assigned to two groups , the control group and the treatment group .


Those in the control group received PMC therapy ( As for Prednisone , it was given at the daily dose of @ mg/kg till @ weeks after the condition being stable or after @ weeks of treatment .


Then the dose was reduced by @ % every two weeks .


When the dose was reduced to @ mg/kg daily , it was reduced by @ mg per two weeks .


When the dose was reduced to @ mg daily , the dose was reduced to @ mg per four weeks .


As for Methotrexate , @ mg each time , once a week .


As for Chloroquine , @ mg each time , twice daily ) , while those in the treatment group received PMC therapy ( the same way as that for the control group ) combined with LFJC ( consisting of Astragalus membranaceus @ g , Angelica sinensis @ g , Ligusticum Chuanxiong @ g , prepared Rehmannia Rhizome @ g , Herba Serissae @ g , Centella @ g , centipede @ g , scorpions @ g , nidus versace @ g , et al. , @ g per pill , containing @ g crude drug .


When the hormone was given at a large dose , LFJC was administered at @ pills each time , three times daily ) .


When the hormone was given at a middle dose , LFJC was administered at @ pills each time , three times daily .


When the hormone was given at a small dose , LFJC was administered at @ pills each time , three times daily .


The treatment course was six months .


The improvement of symptoms and signs between before and after treatment , SLE disease activity index ( SLEDAI ) , efficacy of Chinese medical syndrome , UPro quantitation , erythrocyte sedimentation rate ( ESR ) , complement @ ( C@ ) , C-reactive protein ( CRP ) , the reduction and withdrawal of hormones , and infection of the respiratory tract were observed .


The difference in post-SLEDAI was obviously larger in the treatment group than in the control group ( P < @ ) .


The fatigue severity scale ( FSS ) was less after treatment than before treatment in the treatment group , showing statistical difference when compared with that of the control group ( P < @ ) .


The total effective rate was @ % in the treatment group , showing statistical difference when compared with that of the control group ( @ % ; chi@ = @ , P < @ ) .


The ESR decreased after treatment in the treatment group , showing statistical difference when compared with that of the control group ( P < @ ) .


C@ increased after treatment in the treatment group , showing statistical difference when compared with that of the control group ( P < @ ) .


The hormone was reduced to ( @ + / - @ ) mg/d by the end of the therapeutic course in the treatment group , obviously less than that of the control group -LSB- ( @ + / - @ ) mg/d , P < @ ) .


Seven patients suffered from secondary infection of the respiratory tract infection in the treatment group ( @ from upper respiratory tract infection and @ from lower respiratory tract infection ) , obviously less than those of the control group ( @ from upper respiratory tract infection and @ from lower respiratory tract infection ) ( P < @ ) .


PMC combined LFJC was a better treatment program for severe active SLE ( SLEDAI > or = @ ) .


It was more safe and effective when compared with using Western medicine alone .


It could enhance the efficacy of hormones and help reduction/withdrawal of hormones .


Infections occur in @ % of stroke patients and are associated with unfavorable outcomes .


Preventive antibiotic therapy lowers the infection rate after stroke , but the effect of preventive antibiotic treatment on functional outcome in patients with stroke is unknown .


The PASS is a multicenter , prospective , phase three , randomized , open-label , blinded end-point ( PROBE ) trial of preventive antibiotic therapy in acute stroke .


Patients are randomly assigned to either ceftriaxone at a dose of @ g , given every @ h intravenously for @ days , in addition to standard stroke-unit care , or standard stroke-unit care without preventive antibiotic therapy .


The aim of this study is to assess whether preventive antibiotic treatment improves functional outcome at @ months by preventing infections .


This paper presents in detail the statistical analysis plan ( SAP ) of the Preventive Antibiotics in Stroke Study ( PASS ) and was submitted while the investigators were still blinded for all outcomes .


The primary outcome is the score on the modified Rankin Scale ( mRS ) , assessed by ordinal logistic regression analysis according to a proportional odds model .


Secondary analysis of the primary outcome is the score on the mRS dichotomized as a favorable outcome ( mRS @ to @ ) versus unfavorable outcome ( mRS @ to @ ) .


Secondary outcome measures are death rate at discharge and @ months , infection rate during hospital admission , length of hospital admission , volume of post-stroke care , use of antibiotics during hospital stay , quality-adjusted life years and costs .


Complications of treatment , serious adverse events ( SAEs ) and suspected unexpected serious adverse reactions ( SUSARs ) are reported as safety outcomes .


The data from PASS will establish whether preventive antibiotic therapy in acute stroke improves functional outcome by preventing infection and will be analyzed according to this pre-specified SAP .


Chronic uncomplicated musculoskeletal pain in the spine ( cervical , thoracic or lumbar ) is highly prevalent and may severely limit the daily activities of those affected by it .


To evaluate the efficacy and safety of treatment with auriculopressure applied to patients with non-specific spinal pain .


A multicentre randomised controlled trial with two parallel arms ( true auriculopressure ( TAP ) and placebo auriculopressure ( PAP ) ) was performed .


The intervention phase lasted @weeks and outcomes were measured @week after the last intervention ( T@ ) and @months after baseline ( T@ ) .


The primary outcome measure was change in pain intensity according to a @mm visual analogue scale ( pain VAS ) at T@ .


Secondary outcome measures were the Lattinen index , the McGill Pain Questionnaire and the SF-@ health-related quality of life scale ( Spanish version in every case ) .


There were @ participants ( TAP group , n = @ ; PAP group , n = @ ) .


Pain was most frequently located in the upper back ( @ % , n = @ ) , followed by the lower back ( @ % , n = @ ) and the dorsal area ( @ % , n = @ ) .


Nineteen patients ( @ % ) reported pain affecting the entire spine .


There were statistically significant differences between TAP and PAP in the change in the pain VAS at T@ of @mm ( @ % CI @ to @ , p = @ ) and in the change in the pain VAS at T@ of @ mm ( @ % CI @ to @ , p = @ ) in favour of TAP .


We also observed a statistically significant difference of @ points in the physical component of the SF-@ in favour of TAP at T@ ( @ % CI @ to @ , p = @ ) .


No severe adverse effects were detected or reported during treatment .


The application of auriculopressure in patients with non-specific spinal pain in primary healthcare is effective and safe , and therefore should be considered for inclusion in the portfolio of primary healthcare services .


To compare changes in intraocular pressure ( IOP ) immediately after clear corneal incision ( CCI ) cataract surgery between eyes in which IOP was adjusted to a high or normal range at the conclusion of surgery .


Hayashi Eye Hospital , Fukuoka , Japan .


Comparative case series .


Either eye of patients scheduled for phacoemulsification was randomized to @ of @ groups as follows : eyes that were to be adjusted to ( @ ) high IOP ( @ to @ mm Hg ) or ( @ ) normal IOP ( @ to @ mm Hg ) .


The IOP was measured using a rebound tonometer preoperatively ; at the conclusion of surgery ; and @ , @ , @ , @ , and @ minutes and @ hours postoperatively .


The Seidel test and anterior segment optical coherence tomography ( AS-OCT ) were performed .


The mean IOP at the conclusion of surgery was @ mm Hg in the high IOP group and @ mm Hg in the normal IOP group .


The IOP decreased to approximately @ mm Hg by @ minutes and did not change until @ minutes in either group .


The mean IOP did not differ significantly between groups throughout the observation period ( P @ ) .


Hypotony of @ mm Hg or less was not detected in any eye .


The Seidel test was negative and based on AS-OCT , the wound was closed at @ minutes in all eyes .


After adjusting IOP to a high or normal range , the IOP normalized within @ minutes postoperatively and was stable for @ hours .


The wound was closed within @ minutes postoperatively .


Bacillus Calmette-Gurin ( BCG ) is considered the most effective treatment to reduce recurrence and progression of non-muscle invasive bladder cancer ( NMIBC ) but can induce local side effects leading to treatment discontinuation or interruption .


Aim of this exploratory study is to investigate if the sequential administration of Hyaluronic acid ( HA ) may reduce local side effects of BCG .


@ consecutive subjects undergoing BCG intravesical administration for high risk NMIBC were randomized to receive BCG only ( Group A ) or BCG and HA ( Group B ) .


A @ to @ Visual Analog Scale ( VAS ) for bladder pain , International Prostate Symptom Score ( IPSS ) and number of micturitions per day were evaluated in the two groups before and after six weekly BCG instillations .


Patients were also evaluated at @ and @ months by means of cystostopy and urine cytology .


One out of @ ( @,@ % ) patients in group A dropped out from the protocol , for local side effects .


Mean VAS for pain was significantly lower in group B after BCG treatment ( @ vs. @ , p = @ ) .


Post vs. pre treatment differences in VAS for pain , IPSS and number of daily micturitions were all significantly lower in group B. Three patients in group A and @ in group B presented with recurrent pathology at @ month follow up .


These preliminary data suggest a possible role of HA in reducing BCG local side effects and could be used to design larger randomized controlled trials , assessing safety and efficacy of sequential BCG and HA administration .


Positive interim analysis findings from four large adjuvant trials evaluating trastuzumab in patients with early-stage human epidermal growth factor receptor @ ( HER@ ) - positive breast cancer were first reported in @ .


One of these reports , the joint analysis of North Central Cancer Treatment Group NCCTG N@ ( Combination Chemotherapy With or Without Trastuzumab in Treating Women With HER@-Overexpressing Breast Cancer ) and the National Surgical Adjuvant Breast and Bowel Project NSABP B-@ ( Doxorubicin and Cyclophosphamide Plus Paclitaxel With or Without Trastuzumab in Treating Women With Node-Positive Breast Cancer That Overexpresses HER@ ) , was updated in @ .


We now report the planned definitive overall survival ( OS ) results from this joint analysis along with updates on the disease-free survival ( DFS ) end point .


In all , @,@ patients with HER@-positive operable breast cancer were enrolled to receive doxorubicin and cyclophosphamide followed by paclitaxel with or without trastuzumab in both trials .


The required number of events for the definitive statistical analysis for OS ( @ events ) was reached in September @ .


Updated analyses of overall DFS and related subgroups were also performed .


Median time on study was @ years .


Adding trastuzumab to chemotherapy led to a @ % relative improvement in OS ( hazard ratio -LSB- HR -RSB- , @ ; @ % CI , @ to @ ; P < @ ) and an increase in @-year OS rate from @ % to @ % .


These results were accompanied by an improvement in DFS of @ % ( HR , @ ; @ % CI , @ to @ ; P < @ ) and increase in @-year DFS rate from @ % to @ % .


All patient subgroups benefited from addition of this targeted anti-HER@ agent .


The addition of trastuzumab to paclitaxel after doxorubicin and cyclophosphamide in early-stage HER@-positive breast cancer results in a substantial and durable improvement in survival as a result of a sustained marked reduction in cancer recurrence .


Optimal therapy for children and adolescents with advanced stage anaplastic large cell lymphoma ( ALCL ) is unknown .


ANHL@ examined whether a maintenance regimen including vinblastine compared to the standard APO ( doxorubicin , prednisone , vincristine , methotrexate , @-mercaptopurine ) regimen would result in superior event-free survival .


One hundred and twenty five eligible patients were enrolled .


Induction was identical for both arms .


Post induction patients were randomized to receive APO with vincristine every @ weeks or a regimen that substituted vincristine with weekly vinblastine ( APV ) .


There was no difference between the patients randomized to the APO versus APV arms in either event free survival ( EFS ) or overall survival ( OS ) ( three year EFS @ % vs. @ % , P = @ and three years OS of @ % vs. @ % , P = @ , respectively ) .


Patients in the APV arm required dose reduction secondary to myelosuppression and had a higher incidence of neutropenia as well as infection with neutropenia compared to those in the APO arm ( P < @ , P = @ , respectively ) .


Treatment with weekly vinblastine instead of every three week vincristine as part of multi-agent maintenance therapy did not result in improvement in EFS or OS .


Weekly vinblastine was associated with increased toxicity .


( ClinicalTrials.gov Identifier NCT@ ) .


Multiple sclerosis ( MS ) treatment options are primarily limited to immunomodulatory therapies in MS non-progressive forms .


Nutrition intervention studies suggest that diet may be considered as a complementary treatment to control disease progression .


Therefore , dietary intervention may help to improve wellness and ameliorate symptoms of MS patients .


To assess the effect of a low-fat diet with antioxidant supplementation on biochemical markers of institutionalized patients with progressive forms of multiple sclerosis .


A randomized prospective placebo-controlled study involving @ participants , @ of them assigned to the intervention group ( low-fat diet and antioxidant supplementation ) and the other @ to the placebo group ( low-fat diet ) .


The effect of the dietary intervention , involving diet modification and antioxidant supplementation , was examined for @ days by measuring anthropometric , biochemical parameters and oxidative stress markers in blood at baseline ( day @ ) , intermediate ( day @ ) and end ( day @ ) stages of the treatment .


The intervention group obtained C reactive protein levels significantly lower than those observed in the corresponding placebo group at the end of the study .


Oxidative stress and inflammatory markers isoprostane @-iso-PGF@ and interleukine IL-@ values also diminished after dietary intervention in the intervention group .


Catalase activity increased significantly in the intervention group prior antioxidant supplementation .


No significant differences were observed in other oxidative stress markers .


The results suggest that diet and dietary supplements are involved in cell metabolism modulation and MS-related inflammatory processes .


Consequently , low fat diets and antioxidant supplements may be used as complementary therapies for treatment of multiple sclerosis .


To compare the effects between dezocine and flurbiprofen axetil on postoperative sore throat ( POST ) after maxillofacial procedures .


In the study , @ adult patients with maxillofacial diseases were divided randomly into control group ( group C ) , flurbiprofen group ( group F ) and dezocine group ( group D ) .


Physiological saline , flurbiprofen axetil ( @ mg/kg ) and dezocine ( @ mg/kg ) were administered intravenously for each group @ minutes before the end of the operation .


We recorded visual analogue scale ( VAS ) and Bruggrmann comfort scale ( BCS ) at the time points of @ h , @ h , @ h , and @ h after extubation .


The incidence of POST in group D decreased significantly ( P < @ ) .


There was no difference between the incidences of groups F and C.


The VAS of group F was lower than that of group C ( P < @ ) just at the time points of @ h and @ h after extubation , from then on , there was no difference between the @ groups .


The VAS of group D was lower than that of group F , and the BCS was higher than that of group F significantly .


Dezocine has notable analgesia effect for postoperative sore throat , so it is a better choice to carry out postoperative analgesia after maxillofacial procedures .


Only a few studies have provided information on awareness , use , and harm perceptions of e-cigarettes in Europe .


We fill the knowledge gap in Italy .


We used data from a face-to-face survey conducted in @ of a sample of @,@ individuals , representative of the Italian population aged @ years ( @ million inhabitants ) .


Awareness of e-cigarettes was @ % ; it was lowest among women ( @ % ) , the elderly ( @ % ) , those with less education ( @ % ) , and never-smokers ( @ % ) .


Ever e-cigarette use was @ % overall and was inversely related to age , whereas no significant difference was observed according to sex .


With regard to smoking status , @ % of never-smokers , @ % of ex-smokers , and @ % of current smokers tried the e-cigarette at least once .


Regular e-cigarette use was @ % overall , @ % among men , and @ % among women , and it was highest among young ( @ % ) and current smokers ( @ % ) .


Among @ e-cigarette regular users , @ % did not change their smoking habit , @ % reduced traditional cigarette consumption , and @ % quit smoking .


After fewer than @ years from the opening of the first Italian e-cigarette shop , more than @ million Italians have heard about e-cigarettes , @ million have tried e-cigaretts , and more than @,@ Italians regularly use e-cigarettes .


Three out of @ e-cigarette users reported to have favorably modified their smoking habit ; however , @ % of users did not quit smoking as a consequence of starting vaping e-cigarettes .


Almost @,@ Italian never-smokers , particularly young never-smokers , have tried this new and potentially addictive product at least once .


It has been suggested that perturbations in branched-chain amino acid ( BCAA ) catabolism are associated with insulin resistance and contribute to elevated systemic BCAAs .


Evidence in rodents suggests dietary protein rich in BCAAs can increase BCAA catabolism , but there is limited evidence in humans .


We hypothesize that a diet rich in BCAAs will increase BCAA catabolism , which will manifest in a reduction of fasting plasma BCAA concentrations .


The metabolome of @ obese women with metabolic syndrome before and after weight loss was investigated to identify changes in BCAA metabolism using GC-time-of-flight mass spectrometry .


Subjects were enrolled in an @-wk weight-loss study including either a @-g/d whey ( whey group , n = @ ) or gelatin ( gelatin group , n = @ ) protein supplement .


When matched for total protein by weight , whey protein has @ times the amount of BCAAs compared with gelatin protein .


Postintervention plasma abundances of Ile ( gelatin group : @ @ , quantifier ion peak height @ ; whey group : @ @ ) , Leu ( gelatin group : @ @ ; whey group : @ @ ) , and Val ( gelatin group : @ @ ; whey group : @ @ ) did not differ between treatment groups .


BCAAs were significantly correlated with homeostasis model assessment of insulin resistance at baseline ( r = @ , @ , and @ for Leu , Ile , and Val , respectively ; all , P < @ ) , but correlations were no longer significant at postintervention .


Pro- and Cys-related pathways were found discriminant of whey protein vs. gelatin protein supplementation in multivariate statistical analyses .


These findings suggest that BCAA metabolism is , at best , only modestly affected at a whey protein supplementation dose of @ g/d .


Furthermore , the loss of an association between postintervention BCAA and homeostasis model assessment suggests that factors associated with calorie restriction or protein intake affect how plasma BCAAs relate to insulin sensitivity .


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


The aim was to study a client-centred activities of daily living ( ADL ) intervention ( CADL ) compared with the usual ADL intervention ( UADL ) in people with stroke regarding : independence in ADL , perceived participation , life satisfaction , use of home-help service , and satisfaction with training and , in their significant others , regarding : caregiver burden , life satisfaction , and informal care .


In this multicentre study , @ rehabilitation units were randomly assigned to deliver CADL or UADL .


The occupational therapists who provided the CADL were specifically trained .


Eligible for inclusion were people with stroke treated in a stroke unit @ months after stroke , dependent in two ADL , not diagnosed with dementia , and able to understand instructions .


Data were collected at inclusion and three months thereafter .


To detect a significant difference between the groups in the Stroke Impact Scale ( SIS ) domain `` participation '' , @ participants were required .


Intention-to-treat analysis was applied .


At three months , there was no difference in the outcomes between the CADL group ( n = @ ) and the UADL group ( n = @ ) , or their significant others ( n = @/n = @ ) except in the SIS domain `` emotion '' in favour of CADL ( p = @ ) .


The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required .


Early nutrition is recognized as a target for the effective prevention of childhood obesity .


Protein intake was associated with more rapid weight gain during infancy-a known risk factor for later obesity .


We tested whether the reduction of protein in infant formula reduces body mass index ( BMI ; in kg/m ( @ ) ) and the prevalence of obesity at @ y of age .


The Childhood Obesity Project was conducted as a European multicenter , double-blind , randomized clinical trial that enrolled healthy infants born between October @ and July @ .


Formula-fed infants ( n = @ ) were randomly assigned to receive higher protein ( HP ) - or lower protein ( LP ) - content formula ( within recommended amounts ) in the first year of life ; breastfed infants ( n = @ ) were enrolled as an observational reference group .


We measured the weight and height of @ ( @ % ) formula-fed children at @ y of age .


BMI was the primary outcome .


HP children had a significantly higher BMI ( by @ ; @ % CI : @ , @ ; P = @ ) at @ y of age .


The risk of becoming obese in the HP group was @ ( @ % CI : @ , @ ; P = @ ) times that in the LP group .


There was a tendency for a higher weight in HP children ( @ kg ; @ % CI : -@ , @ kg ; P = @ ) but no difference in height between the intervention groups .


Anthropometric measurements were similar in the LP and breastfed groups .


Infant formula with a lower protein content reduces BMI and obesity risk at school age .


Avoidance of infant foods that provide excessive protein intakes could contribute to a reduction in childhood obesity .


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


Effective treatment algorithms are needed to guide diabetes care at hospital discharge in general medicine and surgery patients with type @ diabetes .


This was a prospective , multicenter open-label study aimed to determine the safety and efficacy of a hospital discharge algorithm based on admission HbA@c .


Patients with HbA@c < @ % ( @ mmol/mol ) were discharged on their preadmission diabetes therapy , HbA@c between @ and @ % ( @-@ @ mmol/mol ) were discharged on a preadmission regimen plus glargine at @ % of hospital daily dose , and HbA@c > @ % were discharged on oral antidiabetes agents ( OADs ) plus glargine or basal bolus regimen at @ % of inpatient dose .


The primary outcome was HbA@c concentration at @ weeks after hospital discharge .


A total of @ patients were discharged on OAD ( @ % ) , combination of OAD and glargine ( @ % ) , basal bolus ( @ % ) , glargine alone ( @ % ) , and diet ( @ % ) .


The admission HbA@c was @ @ % ( @ mmol/mol ) and decreased to @ @ % ( @ mmol/mol ) at @ weeks of follow-up ( P < @ ) .


The change of HbA@c from baseline at @ weeks after discharge was -@ @ , -@ @ , and -@ @ in patients with HbA@c < @ % , @-@ % , and > @ % , respectively ( P < @ ) .


Hypoglycemia ( < @ mg/dL ) was reported in @ % of patients discharged on OAD only , @ % on OAD plus glargine , @ % on basal bolus , and @ % on glargine alone and was similar in patients with admission HbA@c @ % ( @ % ) compared with those with HbA@c > @ % ( @ % , P = @ ) .


Measurement of HbA@c on admission is beneficial in tailoring treatment regimens at discharge in general medicine and surgery patients with type @ diabetes .


The primary target cells for the human immunodeficiency virus ( HIV ) infection in the genital tract are CD@ T cells that express CCR@ on the surface .


Alterations in genital tract T cells that express CCR@ could impact HIV acquisition risk .


We hypothesized that , when compared with baseline , the use of a hormonal intrauterine device ( IUD ) would alter HIV target cells ( primarily CCR@ + CD@ cells ) in the female genital tract more than a nonhormonal IUD .


Thirty-four healthy HIV-negative women aged @-@ years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T@A IUD .


A parallel group of @ control women who did not need contraception was also enrolled .


Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and @ months after IUD placement were analyzed by flow cytometry .


Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests .


Neither IUD altered the number of T cells within the upper and lower genital tracts .


Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR@ in the endometrium and cervix after @ months of use compared with baseline .


There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after @ months of IUD use , compared with baseline .


Women who use IUDs have reduced expression of the CCR@ HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement .


These findings suggest that susceptibility to HIV infection would not be increased by IUD use .


To investigate the hospital cost and short-term clinical outcome of traditional minimally invasive hysterectomy vs robot-assisted hysterectomy in women primarily not considered candidates for vaginal surgery .


Randomized controlled trial ( Canadian Task Force classification I ) .


University Hospital in Sweden .


One hundred twenty-two women with uterine size @ gestational weeks scheduled to undergo minimally invasive hysterectomy because of benign disease .


Robot-assisted hysterectomy or traditional vaginal or laparoscopic minimally invasive hysterectomy .


All women underwent surgery as randomized .


There were no demographic differences between the @ groups .


Vaginal hysterectomy was possible in @ % in the traditional minimally invasive group , at a mean hospital cost of $ @ compared with $ @ for traditional laparoscopic hysterectomy .


This was reflected in a mean hospital cost of $ @ more per robotic-assisted hysterectomy than for traditional minimally invasive hysterectomy when the robot was a preexisting investment .


This hospital cost increased by $ @ when including investments and cost of maintenance .


A per-protocol subanalysis comparing laparoscopy and robotics demonstrated similar hospital cost when the robot was a preexisting investment ( $ @ vs $ @ ) .


Robotic-assisted hysterectomy was associated with less blood loss and fewer postoperative complications .


A similar hospital cost can be attained for laparoscopy and robotics when the robot is a preexisting investment .


From the perspective of hospital costs , robotic-assisted hysterectomy is not advantageous for treating benign conditions when a vaginal approach is feasible in a high proportion of patients .


National Institutes of Health Stroke Scale ( NIHSS ) item profiles that were recently proposed may prove useful both clinically and for research studies .


We aimed to validate the NIHSS item profiles in an acute cohort .


We conducted a retrospective analysis on pooled data from randomized clinical trials .