We focused on traction methods and designed a new traction device , the `` S-O clip . ''


Its main advantage is that it allows direct visualization of the cutting line during submucosal dissection .


Moreover , it can be used at any location without withdrawing the endoscope .


The purpose of this study was to evaluate the efficacy and safety of traction device-assisted ESD for large colorectal tumors using the S-O clip .


Between August @ and December @ , ESD was performed in @ patients with a superficial colorectal tumor @ mm in diameter in our department .


Patients were randomized into two groups : @ cases in the S-O clip-assisted ESD group and @ cases in the conventional ESD group .


Included in the analysis were patient 's gender and age , tumor form , size , and location , rate of en bloc resection , procedure time , presence or absence of intraoperative perforation or delayed bleeding , and pathological findings .


Subgroup analysis stratified by these factors and multivariate analyses were conducted .


In the S-O clip-assisted ESD group , all @ tumors were resected en bloc without any complications .


Although a micro perforation occurred in one patient in the conventional ESD group , further surgical treatment was not required .


None of the other @ cases in the conventional ESD group experienced complications .


The mean procedure time for the S-O clip-assisted ESD group was significantly shorter than for the conventional ESD group ( @ @ vs. @ @ min , p = @ ) .


No significant between-group differences were found for the other factors .


Our results demonstrated that S-O clip-assisted ESD is safe and fast for en bloc resection of large superficial colorectal tumors .


A mosquito repellent has the potential to prevent malaria infection , but there has been few studies demonstrating the effectiveness of combining this strategy with the highly effective long-lasting insecticidal nets ( LLINs ) .


This study aimed to determine the effect of combining community-based mosquito repellent with LLINs in the reduction of malaria .


A community-based clustered-randomised trial was conducted in @ rural villages with @,@ households in southern Ethiopia between September and December of @ .


The villages were randomly assigned to intervention ( mosquito repellent and LLINs , eight villages ) and control ( LLINs alone , eight villages ) groups .


Households in the intervention villages received mosquito repellent ( i.e. , Buzz-Off petroleum jelly , essential oil blend ) applied every evening .


The baseline survey was followed by two follow-up surveys , at one month interval .


The primary outcome was detection of Plasmodium falciparum , Plasmodium vivax , or both parasites , through microscopic examination of blood slides .


Analysis was by intention to treat .


Baseline imbalances and clustering at individual , household and village levels were adjusted using a generalized linear mixed model .


@,@ individuals in intervention and @,@ in control group were enrolled into the study .


Compared with the control arm , the combined use of mosquito repellent and LLINs significantly reduced malaria infection of all types over time -LSB- adjusted Odds Ratio ( aOR ) = @ ; @ % CI = @-@ @ -RSB- .


Similarly , a substantial reduction in P. falciparum malaria infection during the follow-up surveys was observed in the intervention group ( aOR = @ , @ % CI = @-@ @ ) .


The protective efficacy of using mosquito repellent and LLINs against malaria infection of both P. falciparum/P .


vivax and P. falciparum was @ % and @ % , respectively .


Daily application of mosquito repellent during the evening followed by the use of LLINs during bedtime at community level has significantly reduced malaria infection .


The finding has strong implication particularly in areas where malaria vectors feed mainly in the evening before bedtime .


Most patients with acute myeloid leukemia ( AML ) eventually experience relapse .


Relapsed/refractory AML has a dismal prognosis and currently available treatment options are generally ineffective .


The objective of this large , international , randomized clinical trial was to investigate the efficacy of elacytarabine , a novel elaidic acid ester of cytarabine , versus the investigator 's choice of one of seven commonly used AML salvage regimens , including high-dose cytarabine , multiagent chemotherapy , hypomethylating agents , hydroxyurea , and supportive care .


A total of @ patients with relapsed/refractory AML were treated in North America , Europe , and Australia .


Investigators selected a control treatment for individual patients before random assignment .


The primary end point was overall survival ( OS ) .


There were no significant differences in OS ( @ v @ months ) , response rate ( @ % v @ % ) , or relapse-free survival ( @ v @ months ) between the elacytarabine and control arms , respectively .


There was no significant difference in OS among any of the investigator 's choice regimens .


Prolonged survival was only achieved in a few patients in both study arms whose disease responded and who underwent allogeneic stem-cell transplantation .


Neither elacytarabine nor any of the seven alternative treatment regimens provided clinically meaningful benefit to these patients .


OS in both study arms and for all treatments was extremely poor .


Novel agents , novel clinical trial designs , and novel strategies of drug development are all desperately needed for this patient population .


Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies .


In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability ( FINGER ) , a proof-of-concept randomised controlled trial , we aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population .


In a double-blind randomised controlled trial we enrolled individuals aged @-@ years recruited from previous national surveys .


Inclusion criteria were CAIDE ( Cardiovascular Risk Factors , Aging and Dementia ) Dementia Risk Score of at least @ points and cognition at mean level or slightly lower than expected for age .


We randomly assigned participants in a @:@ ratio to a @ year multidomain intervention ( diet , exercise , cognitive training , vascular risk monitoring ) , or a control group ( general health advice ) .


Computer-generated allocation was done in blocks of four ( two individuals randomly allocated to each group ) at each site .


Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation .


The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery ( NTB ) Z score .


Analysis was by modified intention to treat ( all participants with at least one post-baseline observation ) .


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


Between Sept @ , @ , and Nov @ , @ , we screened @ individuals and randomly assigned @ to the intervention group ( n = @ ) or control group ( n = @ ) .


@ ( @ % ) participants in the intervention group and @ ( @ % ) in the control group had at least one post-baseline assessment and were included in the modified intention-to-treat analysis .


Estimated mean change in NTB total Z score at @ years was @ ( SE @ , SD @ ) in the intervention group and @ ( @ , @ ) in the control group .


Between-group difference in the change of NTB total score per year was @ ( @ % CI @-@ , p = @ ) .


@ ( @ % ) individuals dropped out overall .


Adverse events occurred in @ ( @ % ) participants in the intervention group compared with six ( @ % ) participants in the control group ; the most common adverse event was musculoskeletal pain ( @ -LSB- @ % -RSB- individuals for intervention vs no individuals for control ) .


Findings from this large , long-term , randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population .


The central nervous system manifestations in Fabry disease ( FD ) include progressive white matter lesions ( WMLs ) and stroke .


Due to progressive microvascular involvement , men and women with FD over @ years of age develop WMLs .


Moreover , the prevalence of stroke has been estimated to be @ times higher in FD compared with the general population .


Enzyme replacement therapy ( ERT ) is available and has shown beneficial effects on renal , cardiac , and peripheral nerve function in FD , but the ERT effect on the progression of WMLs , or the reduction in cerebrovascular events , remains unknown .


The WML burden and the effect of agalsidase beta @ mg/kg biweekly on WML progression were assessed longitudinally in a Phase @ agalsidase-beta placebo-controlled analysis of untreated and treated FD patients with mild-to-moderate renal involvement ( serum creatinine measurements of @ mg/dl and < @ mg/dl ) .


The primary end point was the difference in the number of patients with increased WML burden between the agalsidase beta and placebo groups at the end of treatment .


The diameters of the WMLs were determined manually using axial flow-attenuated-inversion-recovery-weighted magnetic resonance imaging ( MRI ) scans taken at baseline and follow-up .


MRI scans from @ FD patients ( mean age @ , age range @-@ , @ females ; n = @ on ERT , n = @ on placebo ) were analyzed .


WML burden was present in @ % of patients at baseline , increased over a mean of @ months ( range @-@ months ) follow-up , and correlated with left ventricular hypertrophy ( LVPW ) .


Patients with previous or recent strokes ( n = @ , @-@ years ) showed an increase in the number of WMLs ( p = @ ) .


A greater proportion of younger patients ( @ years ) on ERT ( n = @ ) had stable WML burden compared with younger patients in the placebo group ( n = @ ) : @ % ( @ of @ ) versus @ % ( @ of @ ) , p = @ .


The number needed to treat was @ .


This FD patient cohort , with mild-to-moderate renal involvement , had a significant WML burden and high inter-individual variability associated with the degree of LVPW but not the degree of kidney dysfunction .


These advanced patients with increased LVPW and stroke evidence may have had a higher cerebrovascular risk .


The WML burden in patients on ERT was more likely to remain stable , compared with patients on placebo .


Thus , ERT may reduce the progression of vascular disease , even in advanced FD patients , suggesting that early treatment may stabilize WML progression and stroke risk .


The extent to which alterations in energy expenditure ( EE ) in response to sleep restriction contribute to the short sleep-obesity relationship is not clearly defined .


Short sleep may induce changes in resting metabolic rate ( RMR ) , thermic effect of food ( TEF ) and postprandial substrate oxidation .


Ten females ( age and body mass index : @-@ years and @-@kgm ( -@ ) ) completed a randomized , crossover study assessing the effects of short ( @h per night ) and habitual ( @h per night ) sleep duration on fasting and postprandial RMR and respiratory quotient ( RQ ) .


Measurements were taken after three nights using whole-room indirect calorimetry .


The TEF was assessed over a @-h period following consumption of a high-fat liquid meal .


Short versus habitual sleep did not affect RMR ( @ and @ kcalmin ( -@ ) ; P = @ ) .


Fasting RQ was significantly lower after short versus habitual sleep ( @ and @ ; P = @ ) .


Postprandial EE ( short : @ and habitual : @ , P = @ ) and RQ ( short : @ and habitual : @ , P = @ ) after the high-fat meal were not different between conditions .


TEF was similar between conditions ( @ kcalmin ( -@ ) in both ; P = @ ) , as was the ~ @-h incremental area under the curve ( @ and @ kcalmin ( -@ ) @min after short and habitual sleep , respectively ; P = @ ) .


Current findings observed in non-obese healthy premenopausal women do not support the hypothesis that alterations in TEF and postprandial substrate oxidation are major contributors to the higher rate of obesity observed in short sleepers .


In exploring a role of sleep duration on EE , research should focus on potential alterations in physical activity to explain the increased obesity risk in short sleepers .


One form of meditation intervention , the integrative body-mind training ( IBMT ) has been shown to improve attention , reduce stress and change self-reports of mood .


In this paper we examine whether short-term IBMT can improve performance related to creativity and determine the role that mood may play in such improvement .


Forty Chinese undergraduates were randomly assigned to short-term IBMT group or a relaxation training ( RT ) control group .


Mood and creativity performance were assessed by the Positive and Negative Affect Schedule ( PANAS ) and Torrance Tests of Creative Thinking ( TTCT ) questionnaire respectively .


As predicted , the results indicated that short-term ( @ min per day for @ days ) IBMT improved creativity performance on the divergent thinking task , and yielded better emotional regulation than RT. .


In addition , cross-lagged analysis indicated that both positive and negative affect may influence creativity in IBMT group ( not RT group ) .


Our results suggested that emotion-related creativity-promoting mechanism may be attributed to short-term meditation .


Randomized clinical trial .


To determine the effects of trigger point dry needling ( TrPDN ) on neck pain , widespread pressure pain sensitivity , and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle .


TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes .


Potential effects of TrPDN for decreasing pain and sensitization in individuals with acute mechanical neck pain are needed .


Methods Seventeen patients ( @ % female ) were randomly assigned to @ of @ groups : a single session of TrPDN or no intervention ( waiting list ) .


Pressure pain thresholds over the C@-@ zygapophyseal joint , second metacarpal , and tibialis anterior muscle ; neck pain intensity ; and cervical spine range-of-motion data were collected at baseline ( pretreatment ) and @ minutes and @ week after the intervention by an assessor blinded to the treatment allocation of the patient .


Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable .


Patients treated with @ session of TrPDN experienced greater decreases in neck pain , greater increases in pressure pain threshold , and higher increases in cervical range of motion than those who did not receive an intervention at both @ minutes and @ week after the intervention ( P < @ for all comparisons ) .


Between-group effect sizes were medium to large immediately after the TrPDN session ( standardized mean score differences greater than @ ) and large at the @-week follow-up ( standardized mean score differences greater than @ ) .


The results of the current randomized clinical trial suggest that a single session of TrPDN may decrease neck pain intensity and widespread pressure pain sensitivity , and also increase active cervical range of motion , in patients with acute mechanical neck pain .


Changes in pain , pressure pain threshold , and cervical range of motion surpassed their respective minimal detectable change values , supporting clinically relevant treatment effects .


Level of Evidence Therapy , level @b - .


To evaluate the applicability of single-incision laparoscopic ovariectomy ( SILOVE ) in cats using a single-incision laparoscopic port ( SILP ) ; to compare surgical time , complications , and postoperative pain after SILOVE using a LigaSure ( SILOVE-LS ) or extracorporeal suture ( SILOVE-ECS ) , and open ovariectomy ( open-OVE ) .


Randomized , blinded , prospective study .


Healthy , domestic female cats ( n = @ ) .


Cats underwent physical examination , packed cell volume , total solids and blood urea nitrogen analysis .


Cats were randomly assigned to @ of @ groups : SILOVE-LS ( n = @ ) , SILOVE-ECS ( @ ) or open-OVE ( @ ) .


Surgical time , complications , and postoperative pain scores were recorded .


Single-incision laparoscopic ovariectomy was successful in ( n = @ ) SILOVE-LS cats and ( n = @ ) SILOVE-ECS cats .


Surgical time was significantly longer for the SILOVE-ECS group compared with the SILOVE-LS ( P < @ ) and open-OVE ( P < @ ) groups , which were not different ( P = @ ) .


Complications were more frequent in the SILOVE-ECS group and removal of the SILP was required to complete ovariectomy in @ cats .


Cumulative @-hour pain scores were not different between groups .


Single-incision laparoscopic ovariectomy using a SILP is a feasible method for OVE in cats .


Single-incision laparoscopic ovariectomy using an extracorporeal suture is more time consuming and associated with more complications than either the SILOVE-LS or open-OVE methods .


Indacaterol/glycopyrronium ( IND/GLY ) is a once-daily inhaled fixed-dose combination of indacaterol ( IND ) , a long-acting @-adrenergic agonist ( LABA ) , and glycopyrronium ( GLY ) , a long-acting muscarinic antagonist ( LAMA ) for use as maintenance treatment to relieve symptoms of chronic obstructive pulmonary disease ( COPD ) in adults .


To determine the economic benefits of IND/GLY compared with the free combination of indacaterol and glycopyrronium ( IND+GLY ) , and with the fixed-dose combination of salmeterol/fluticasone ( SFC ) , in a moderate-to-severe COPD population with low-exacerbation risk .


The model-based analysis extrapolated results up to lifetime time horizon and calculated costs per quality-adjusted life year .


Assuming equal efficacy , a cost-minimisation analysis compared IND/GLY vs IND+GLY using model inputs from the double-blind , randomised SHINE trial .


The double-blind , randomised ILLUMINATE and TORCH trials were used to analyse cost-effectiveness versus SFC. To consider ICS-related pneumonia events , published odds ratio comparing an ICS-exposed group to a control group of COPD patients was used .


Direct and indirect drug costs as well as drug acquisition costs ( in Swedish Krona -LSB- SEK -RSB- ) were derived from published Swedish sources .


Cost and effects were discounted with @ % .


Uncertainty was assessed by one-way and probabilistic sensitivity analyses ( PSA ) .


IND/GLY was cost-saving vs IND+GLY with incremental savings of SEK ( EUR ) @ ( @ ) , and @ ( @ ) per patient over one and five years .


IND/GLY was found to be less costly and more effective compared to SFC with cost savings of SEK ( EUR ) @ ( @ ) , @ ( @ ) , @,@ ( @ ) , @,@ ( @ ) and @,@ ( @ ) over one , three , five , ten years and lifetime .


The PSA indicated that all iterations produced dominant results for IND/GLY .


IND/GLY is cost-minimising vs IND+GLY and dominates SFC in the maintenance treatment of COPD patients in Sweden .


Encouraging dual bronchodilator therapy over an ICS-containing combination results in lower total costs and better outcomes compared to combination therapy including fluticasone in moderate-to-severe COPD patients with low exacerbation risk .


Although the combination of midazolam-meperidine has been widely used as a sedation regimen for colonoscopy , its residual effect which is longer than the duration of a colonoscopy procedure can delay patient recovery and discharge .


Remifentanil , an ultra-short-acting opioid , has a very brief duration of action .


We hypothesized that using remifentanil alone for colonoscopy would provide shorter recovery time compared with the midazolam-meperidine combination .


Time to achieve Aldrete score = @ was determined and compared in patients who were randomly allocated to receive remifentanil alone ( group-R , n = @ ) or a midazolam-meperidine combination ( group-MM , n = @ ) for colonoscopy .


Intergroup differences in sedation , recall analgesia , cardio-respiratory profiles , and satisfaction of patient and endoscopist were also determined during and after colonoscopy .


Group-R showed a significantly shorter recovery time than group-MM ( median -LSB- @-@ % -RSB- , @ -LSB- @-@ -RSB- vs @ -LSB- @-@ -RSB- min , P < @ ) .


Group-R showed significantly higher bispectral-index values during colonoscopy ( @ -LSB- @-@ -RSB- vs @ -LSB- @-@ -RSB- , P = @ ) ; a higher incidence of recall of explanations given during and after colonoscopy ( @ vs @ % and @ vs @ % , both P < @ ) ; and a lower distress score ( visual analog scale @/@ vs @/@mm , P = @ ) , than did group-MM .


Neither extent of pain , incidence of hemodynamic instability nor incidence of respiratory depression differed between the groups .


Remifentanil for colonoscopy afforded faster recovery compared to midazolam-meperidine combination .


It also provided greater patient-endoscopist communication and satisfaction with comparable patient analgesia and cardiorespiratory profile during colonoscopy .


To define the role of increased fundus autofluorescence ( FAF ) , a surrogate for lipofuscin content , as a risk factor for progression of geographic atrophy ( GA ) .


Prospective natural history cohort study , the GAIN ( Characterization of geographic atrophy progression in patients with age-related macular degeneration ) .


setting : Single-center study conducted in Barcelona , Spain .


After screening of @ patients , @ eyes of @ patients with GA secondary to age-related macular degeneration and a minimum follow-up of @ months were included .


Lipofuscin content was classified independently by @ masked observers according to FAF patterns described previously .


Bivariate , stratified , and multivariable analyses were used to explore the associations between GA growth and independent variables .


Mediation analysis was used to evaluate the contribution of FAF patterns to GA progression .


Progression of GA in mm ( @ ) / year as measured with FAF .


Median follow-up was @ months ( range , @-@ ) .


Median GA growth was @ mm ( @ ) / year .


FAF , baseline area of atrophy , and time of follow-up were independently associated with GA progression ( P < @ ) .


FAF patterns and baseline area of atrophy were strongly associated ( P < @ ) , suggesting potential confounding .


Mediation analysis suggested that most of the effect of FAF patterns on GA growth was actually caused by baseline area of atrophy .


FAF patterns , baseline area of atrophy , and time of follow-up were associated with GA progression .


However , FAF patterns seem to be a consequence ( not a cause ) of enlarging atrophy and their effect on GA progression seems mostly driven by baseline area of atrophy .


Magnetic resonance imaging guided biopsy is increasingly performed to diagnose prostate cancer .


However , there is a lack of well controlled , prospective trials to support this treatment method .


We prospectively compared magnetic resonance imaging guided in-bore biopsy with standard systematic transrectal ultrasound guided biopsy in biopsy nave men with increased prostate specific antigen .


We performed a prospective study in @ biopsy nave men with increased prostate specific antigen ( greater than @ ng/ml ) .


After @ Tesla functional multiparametric magnetic resonance imaging patients were referred for magnetic resonance imaging guided in-bore biopsy of prostate lesions ( maximum @ ) followed by standard systematic transrectal ultrasound guided biopsy ( @ cores ) .


We analyzed the detection rates of prostate cancer and significant prostate cancer ( greater than @ mm total cancer length or any Gleason pattern greater than @ ) .


A total of @ patients with a mean SD age of @ @ years metall study requirements .


Median prostate specific antigen was @ ng/ml ( IQR @-@ @ ) .


Transrectal ultrasound and magnetic resonance imaging guided biopsies provided the same @ % detection rate , including @ % and @ % , respectively , for significant prostate cancer .


Magnetic resonance imaging and transrectal ultrasound guided biopsies missed @ % and @ % of clinically significant prostate cancers , respectively .


Magnetic resonance imaging biopsy required significantly fewer cores and revealed a higher percent of cancer involvement per biopsy core ( each p < @ ) .


Combining the @ methods provided a @ % detection rate with an @ % rate for significant prostate cancer .


Magnetic resonance imaging guided in-bore and systematic transrectal ultrasound guided biopsies achieved equally high detection rates inbiopsy nave patients with increased prostate specific antigen .


Magnetic resonance imaging guided in-bore biopsies required significantly fewer cores and revealed a significantly higher percent of cancer involvement per biopsy core .


Ulcerative colitis ( UC ) is a chronic inflammatory bowel disease .


The probiotic bacterium Escherichia coli Nissle @ ( EcN ) has been used to maintain and induce clinical remission in UC .


Our aim was to test the effect of Ciprofloxacin and/or orally administered EcN as add-on to conventional therapies in patients with active UC .


Our single center double-blinded randomized placebo controlled study included patients with a Colitis Activity Index ( CAI ) score of at least @ .


Patients were randomized to Ciprofloxacin or placebo for @week followed by EcN or placebo for @weeks .


All @ treatments were given as add-on treatments .


One hundred subjects with active UC were recruited .


In the per-protocol analysis we , surprisingly , found that in the group receiving placebo/EcN fewer patients , @ % , reached remission compared to the group receiving placebo/placebo , @ % , p < @ .


Among patients treated with Cipro/placebo and Cipro/EcN , @ % and @ % reached remission , respectively .


Furthermore , the group receiving placebo/EcN had the largest number of withdrawals , @ of @ ( @ % ) , compared to @ of @ ( @ % ) in any of the other groups , p < @ .


Indication of lack of mucosal healing was found in the group treated with placebo/Nissle , since only @ ( @ % ) of the @ patients , who completed the study , reported no blood in stools at week @ ( p < @ ) , compared to @ % , @ % and @ % in groups treated with Cipro/Nissle , Cipro/placebo and placebo/placebo , respectively .


Our data suggest that there is no benefit in the use of E. coli Nissle as an add-on treatment to conventional therapies for active ulcerative colitis .


Furthermore , treatment with E. coli Nissle without a previous antibiotic cure resulted in fewer patients reaching clinical remission .


Perirectal spacing , whereby biomaterials are placed between the prostate and rectum , shows promise in reducing rectal dose during prostate cancer radiation therapy .


A prospective multicenter randomized controlled pivotal trial was performed to assess outcomes following absorbable spacer ( SpaceOAR system ) implantation .


Overall , @ patients with clinical stage T@ or T@ prostate cancer underwent computed tomography ( CT ) and magnetic resonance imaging ( MRI ) scans for treatment planning , followed with fiducial marker placement , and were randomized to receive spacer injection or no injection ( control ) .


Patients received postprocedure CT and MRI planning scans and underwent image guided intensity modulated radiation therapy ( @ Gy in @-Gy fractions ) .


Spacer safety and impact on rectal irradiation , toxicity , and quality of life were assessed throughout @months .


Spacer application was rated as `` easy '' or `` very easy '' @ % of the time , with a @ % hydrogel placement success rate .


Perirectal spaces were @ mm and @ mm in the spacer and control groups , respectively .


There were no device-related adverse events , rectal perforations , serious bleeding , or infections within either group .


Pre-to postspacer plans had a significant reduction in mean rectal V@ ( @ % to @ % , P < @ ) .


Overall acute rectal adverse event rates were similar between groups , with fewer spacer patients experiencing rectal pain ( P = @ ) .


A significant reduction in late ( @-@months ) rectal toxicity severity in the spacer group was observed ( P = @ ) , with a @ % and @ % late rectal toxicity incidence in the spacer and control groups , respectively .


There was no late rectal toxicity greater than grade @ in the spacer group .


At @months @ % and @ % of spacer and control patients , respectively , experienced @-point declines in bowel quality of life .


MRI scans at @months verified spacer absorption .


Spacer application was well tolerated .


Increased perirectal space reduced rectal irradiation , reduced rectal toxicity severity , and decreased rates of patients experiencing declines in bowel quality of life .


The spacer appears to be an effective tool , potentially enabling advanced prostate RT protocols .


In older adults reduced mobility is common and is an independent risk factor for morbidity , hospitalization , disability , and mortality .


Limited evidence suggests that physical activity may help prevent mobility disability ; however , there are no definitive clinical trials examining whether physical activity prevents or delays mobility disability .


To test the hypothesis that a long-term structured physical activity program is more effective than a health education program ( also referred to as a successful aging program ) in reducing the risk of major mobility disability .


The Lifestyle Interventions and Independence for Elders ( LIFE ) study was a multicenter , randomized trial that enrolled participants between February @ and December @ , who participated for an average of @ years .


Follow-up ended in December @ .


Outcome assessors were blinded to the intervention assignment .


Participants were recruited from urban , suburban , and rural communities at @ centers throughout the United States .


We randomized a volunteer sample of @ sedentary men and women aged @ to @ years who had physical limitations , defined as a score on the Short Physical Performance Battery of @ or below , but were able to walk @ m.


Participants were randomized to a structured , moderate-intensity physical activity program ( n = @ ) conducted in a center ( twice/wk ) and at home ( @-@ times/wk ) that included aerobic , resistance , and flexibility training activities or to a health education program ( n = @ ) consisting of workshops on topics relevant to older adults and upper extremity stretching exercises .


The primary outcome was major mobility disability objectively defined by loss of ability to walk @ m.


Incident major mobility disability occurred in @ % ( @ participants ) of the physical activity group and @ % ( @ participants ) of the health education group ( hazard ratio -LSB- HR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- , P = @ ) .


Persistent mobility disability was experienced by @ participants ( @ % ) in the physical activity group and @ participants ( @ % ) in the health education group ( HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


Serious adverse events were reported by @ participants ( @ % ) in the physical activity group and @ participants ( @ % ) in the health education group ( risk ratio , @ -LSB- @ % CI , @-@ @ -RSB- ) .


A structured , moderate-intensity physical activity program compared with a health education program reduced major mobility disability over @ years among older adults at risk for disability .


These findings suggest mobility benefit from such a program in vulnerable older adults .


This study was conducted to assess the effectiveness of combinations of Ayurvedic drugs in alleviating the toxicity of chemotherapy and improving the quality of life of cancer patients .


The following was the research question : Can Ayurvedic drugs be used to alleviate the side effects of chemotherapy and improve the quality of life of cancer patients ?


Random patients with malignancies of different tissues , grades , and stages were divided into two groups according to their treatment modality .


Group @ consisted of @ patients treated with six cycles of chemotherapy alone and who did not receive any Ayurvedic drugs ( control group ) .


Group @ consisted of patients ( divided into three arms ) who received Ayurvedic drugs during chemotherapy and after chemotherapy .


Nineteen patients in arm @ received the Ayurvedic drugs Mauktikyukta Kamdudha ( MKD ) and Mauktikyukta Praval Panchamruta ( MPP ) along with a full course of chemotherapy .


Fifteen patients in arm @ received the same Ayurvedic treatment , but the treatment was started after completing the sixth cycle of chemotherapy .


Eighteen patients in arm @ received the Suvarnabhasmadi formulation ( SBD ) in addition to MKD and MPP after completing the sixth cycle of chemotherapy .


Treatment was given for @ weeks in all three arms .


Patients from both groups were observed for a period of @ months .


The assessment criteria depended on Common Toxicity Criteria ( CTC designed by NIH and NCI ) : haemogram ; weight ; physical examination including Quality of Life Questionnaire ( QLQ designed by the European Organization of Research and Treatment of Cancer ( EORTC ) ) for functional , symptom and global scores ; and Karnofsky score for assessment of general well-being and activities of daily life .


ECOG ( Eastern Cooperation Oncology Group ) score was also additionally included for assessment of symptoms .


From amongst the symptomatic criteria , there was significant improvement in all the three arms compared with the control group in nausea , loss of appetite , constipation , and fatigue .


There was significant improvement in the Karnofsky score and global score of the QLQ , which in fact incorporate symptomatic criteria , general condition , functional ability and disease-related symptoms .


These significant differences were observed in group @ ( arms @ , @ , @ ) in comparison with group @ ( control ) , in spite of the fact that in arms @ and @ , the Ayurvedic treatment was started after completion of chemotherapy .


The haemogram did not show a significant difference between the control and the three arms of group @ .


Adjunct treatment with herbo-mineral and metallic Ayurvedic drugs appears to have a significant effect on reducing the toxic side effects of chemotherapy drugs in cancer patients .


Our preliminary data suggests that Ayurvedic treatment should be given simultaneously from the beginning of chemotherapy to have the desired effect .


However , there is a need to extend this work by conducting a well-planned two-armed study on cancer patients with defined cancer sites with selected Ayurvedic drug combinations , and observing the patients for a longer period of time to confirm the effectiveness of Ayurvedic drugs in reducing the side effects of chemotherapy .


There is no widely accepted treatment for non-alcoholic fatty liver disease ( NAFLD ) or its advanced form , non-alcoholic steatohepatitis ( NASH ) .


We administered rosuvastatin ( @ mg/day ) for @ year in patients with metabolic syndrome ( MetS ) , NASH on liver biopsy and dyslipidaemia ( but without diabetes or arterial hypertension ) .


Patients also received lifestyle advice .


We report preliminary results for @ patients .


The second biopsy ( at the end of the study ) showed complete resolution of NASH in @ patients , while the @ ( th ) , which had no improvement , developed arterial hypertension and substantial rise in triglyceride levels during the study .


We suspect alcohol abuse despite advice to abstain .


Serum alanine transaminase ( ALT ) and aspartate transaminase ( AST ) activities were reduced by @ and @ % , respectively ( p < @ for both ) , during treatment , while - glutamyl transpeptidase ( - GT ) , and alkaline phosphatase ( AP ) showed smaller non significant reductions .


Fasting plasma glucose and glycated haemoglobin ( HbA@c ) were significantly reduced ( p < @ ) .


Lipid values were totally normalised and liver ultrasonography showed a complete resolution of NASH in @ patients .


Body mass index and waist circumference remained unchanged during the study .


Thus , changes in liver pathology and function should be attributed to treatment with rosuvastatin .


A substantial limitation of the study is the small number of patients .


These preliminary findings suggest that rosuvastatin could ameliorate NASH within a year of treatment in MetS patients with dyslipidaemia .


We tested whether a structural intervention combining savings-led microfinance and HIV prevention components would achieve enhanced reductions in sexual risk among women engaging in street-based sex work in Ulaanbaatar , Mongolia , compared with an HIV prevention intervention alone .


Between November @ and August @ , we randomized @ eligible women who completed baseline assessments to either a @-session HIV sexual risk reduction intervention ( HIVSRR ) alone ( n = @ ) or a @-session HIVSRR plus a savings-led microfinance intervention ( n = @ ) .


At @ - and @-month follow-up assessments , participants reported unprotected acts of vaginal intercourse with paying partners and number of paying partners with whom they engaged in sexual intercourse in the previous @ days .


Using Poisson and zero-inflated Poisson model regressions , we examined the effects of assignment to treatment versus control condition on outcomes .


At @-month follow-up , the HIVSRR plus microfinance participants reported significantly fewer paying sexual partners and were more likely to report zero unprotected vaginal sex acts with paying sexual partners .


Findings advance the HIV prevention repertoire for women , demonstrating that risk reduction may be achieved through a structural intervention that relies on asset building , including savings , and alternatives to income from sex work .


This article describes the rationale , design and methodology of the Building research initiative group : chronic illness management and adherence in transplantation ( BRIGHT ) study .


This study of heart transplant patients will : ( @ ) describe practice patterns relating to chronic illness management ; ( @ ) assess prevalence and variability of non-adherence to the treatment regimen ; ( @ ) determine the multi-level factors related to immunosuppressive medication non-adherence .


The unaltered long-term prognosis after heart transplantation underscores an urgent need to identify and improve factors related to survival outcomes .


The healthcare system ( e.g. level of chronic illness management implemented ) and patient self-management are major drivers of outcome improvement .


The study uses a survey design in @ heart transplant centres covering @ countries in four continents .


Theoretical frameworks informed variable selection , which are measured by established and investigator-developed instruments .


Heart transplant recipients , outpatient clinicians and programme 's directors complete a survey .


A staged convenience sampling strategy is implemented in heart transplant centres , countries and continents .


Depending on the centre 's size , a random sample of @-@ patients is selected ( N estimated @ heart transplant recipients ) .


Five randomly selected clinicians and the medical director from each centre will be invited to participate .


This is the first multi-centre , multi-continental study examining healthcare system and heart transplant centres chronic illness management practice patterns and potential correlates of immunosuppressive medication non-adherence .


The knowledge gained will inform clinicians , researchers and healthcare policy makers at which level ( s ) interventions need to be implemented to improve long-term outcomes for transplant recipients .


Increased body mass index and weight gain are risk factors for psoriasis , and the prevalence of obesity in patients with psoriasis is higher than in the general population .


Limited data exist regarding the role of diet in psoriasis .


To assess the impact of a dietary intervention combined with physical exercise for weight loss on improving psoriasis in overweight or obese patients .


This study included @ overweight or obese patients with moderate-to-severe chronic plaque psoriasis who did not achieve clearance after @ weeks of continuous systemic treatment .


They were randomized to receive either a @-week quantitative and qualitative dietary plan associated with physical exercise for weight loss or simple informative counselling at baseline about the utility of weight loss for clinical control of psoriatic disease .


The main outcome was any reduction of the Psoriasis Area and Severity Index ( PASI ) from baseline to week @ .


Intention-to-treat analysis showed a median PASI reduction of @ % ( @ % confidence interval @-@ @ % ) in the dietary intervention arm and @ % ( @ % confidence interval @-@ @ % ) in the information-only arm ( P = @ ) .


Among secondary outcomes , PASI score reduction of @ % significantly differed between study arms ( @ % with dietary intervention vs. @ % with information only , P = @ ) .


The weight-loss target ( a @ % reduction from baseline ) was reached by @ % of patients in the dietary intervention arm compared with @ % in the information-only arm ( P = @ ) .


A @-week dietetic intervention associated with increased physical exercise reduced psoriasis severity in systemically treated overweight or obese patients with active psoriasis .


According to the results of the international study Relapsed AML @/@ response was better after re-induction with L-DNR/FLAG ( liposomal daunorubicin , fludarabine , cytarabine , G-CSF ) compared to FLAG only but survival rate was not improved .


However , the findings might be group-specific .


Patient characteristics , actual therapy given and long-term course of the disease in @ pediatric patients ( including non-randomized ) with first relapse and @ primary nonresponders treated in Germany were analyzed .


Overall @-year survival rates after relapse were similar in the @ treatment groups L-DNR/FLAG and FLAG ( @ @ vs. @ @ , p ( log-rank ) = @ ) .


The rate of randomization was low ( @ % ) and @ % of the @ randomized patients changed the treatment arm .


Therefore , induction was based in @ % patients on an individual decision with preference for L-DNR/FLAG .


There were less patients with favorable cytogenetics and morphology in the L-DNR/FLAG-group ( p < @ ) .


Response to the first re-induction course at day @ tended to be more unfavorable with FLAG only .


In this patient group protocol intensifications were more frequent as compared to the L-DNR/FLAG-group ( p = @ ) , and late CR could be achieved after intensification in @/@ poor responding patients .


The initial selection bias of relapse patients with unfavorable risk factors to the disadvantage of the L-DNR/FLAG-group and the more drug - and time-intensive treatment after @ ( st ) re-induction given in the FLAG-group may have nullified the initial beneficial effect of L-DNR containing re-induction therapy and led to similar and relatively favorable survival rates in both treatment groups in Germany .


Vitamin D insufficiency drives secondary hyperparathyroidism ( SHPT ) and is associated with increased cardiovascular mortality in patients with chronic kidney disease ( CKD ) .


SHPT is poorly addressed by current vitamin D repletion options .


The present study evaluated a novel investigational vitamin D repletion therapy : a modified-release ( MR ) formulation of calcifediol designed to raise serum @-hydroxyvitamin D in a gradual manner to minimize the induction of CYP@ and , thereby , improve the SHPT control .


This randomized , double-blind , placebo-controlled trial evaluated MR calcifediol in CKD subjects ( n = @ ) with plasma intact parathyroid hormone ( iPTH ) > @ pg/ml and serum total @-hydroxyvitamin D < @ ng/ml .


Subjects received daily treatment for six weeks with oral MR calcifediol ( @ , @ or @ g ) or a placebo .


More than @ % of subjects treated with MR calcifediol achieved serum @-hydroxyvitamin D levels @ ng/ml versus @ % of subjects treated with placebo ( p < @ ) .


Mean plasma iPTH decreased from baseline ( @ pg/ml ) by @ @ % ( SE ) , @ @ and @ @ % in the @ , @ and @ g dose groups , respectively , and increased @ @ % in the pooled placebo group ( p < @ ) .


No clinically significant safety concerns arose during MR calcifediol treatment .


Oral MR calcifediol appears safe and highly effective in treating SHPT associated with vitamin D insufficiency in CKD .


Chronic autoimmune thyroiditis ( CAT ) ( chronic lymphocytic thyroiditis-Hashimoto 's thyroiditis ) , which is the most common inflammatory disorder of the thyroid gland , causes hypothyroidism .


Ultrasound elastography is a newly developed sonographic technique that provides an estimation of tissue elasticity by measuring the degree of tissue displacement under the application of an external force .


In this study , our aim was to evaluate the accuracy of strain index ratio with real-time ultrasound elastography and to calculate the cut-off point for the diagnosis of CAT .


Our aim was also to lead further studies on other pathological changes such as lymphoma , malign nodules etc. based on CAT by using this cut-off point .


The gains from this study and further studies will assist clinical diagnoses and follow-up .


Aplio @ ultrasound machine ( Toshiba Medical Systems Co. Ltd , Otawara , Japan ) with linear @-@ @ MHz transducers and elastography software was used .


Routine B-mode ( dimensions and parenchymal echogenicity ) ultrasound evaluation was performed prior to the ultrasound elastography .


A total of @ randomized patients ( @ males , @ females ) with a mean age of @ years ( range , @-@ years ) with CAT and @ healthy controls ( @ males , @ females ) with mean age of @ years ( range , @-@ years ) were prospectively examined .


The mean values of thyroid-stimulating hormone ( TSH ; normal TSH value is @-@ @ IUml ( -@ ) ) and anti-thyroid peroxidase ( anti-TPO ; normal anti-TPO value is @-@IUml ( -@ ) ) were @ and @ IUml ( -@ ) , respectively .


No correlation was detected between serum TSH and thyroid tissue strain index ( Spearman r coefficient of TSH was -@ ) .


Positive-sided correlation was detected between anti-TPO values and thyroid tissue strain index ratio ( Spearman r coefficient of anti-TPO was @ ) .


The median strain index ratio of patients with CAT ( @ ) was significantly higher than the mean ratio of the controls ( @ ) .


The area under the receiver operating characteristic curve was @ ( @ % confidence interval ) .


The optimal cut-off value ( in which the sum of sensitivity and specificity was highest ) for the prediction of diffuse thyroid pathology was @ .


For this cut-off ratio , thyroid stiffness had @ % sensitivity and @ % specificity .


A total of @ of @ patients ( @ % ) and a total of @ of @ healthy controls ( @ % ) exceeded the cut-off points .


The strain index ratio was higher in CAT than in normal thyroid parenchyma in real-time ultrasound elastography .


Thus , it seems to be a useful method for the assessment of CAT with real-time ultrasound elastography , and further studies assessing the correlation of sonoelastography findings and histopathological subtypes of CAT would enrich the findings of the present study .


In our study , we detected the stiffness ratio of the thyroid tissue in patients with CAT .


The cut-off value should be helpful for diagnosis or follow-up of the recently developed lesions such as lymphoma , malign nodule , etc. based on CAT .


This study should also encourage new studies about CAT and ultrasound elastography .


The aim of the present study was to evaluate the surgical and obstetric results of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy .


Sixty-nine eligible patients who met our criteria were randomly divided into the laparoscopy group ( n = @ ) and the laparotomy group ( n = @ ) .


The two groups were compared for their surgical and obstetric outcomes and the extent of pelvic adhesion discovered in later cesarean section ( CS ) .


The laparoscopy group had less blood loss ( @ vs @mL , P = @ ) , shorter postoperative hospital stay ( @ vs @ days , P < @ ) , and lower postoperative pain score ( @ vs @ , P < @ ) compared with the laparotomy group .


The operative time , neonates ' Apgar scores and birthweights between the two groups showed no significant differences ( P > @ ) .


Sixteen patients in the laparoscopy group , and @ patients in the laparotomy group underwent cesarean section .


The filmy and dense type adhesion rate was significantly different between the laparoscopy group and the laparotomy group ( @ % vs @ % , and @ % vs @ % , respectively ) .


The present results suggest that laparoscopy is a better choice than laparotomy for ovarian cyst during pregnancy , with less blood loss , less postoperative pain and less postoperative hospital stay .


It offers a faster recovery , results in less pelvic adhesion and does not affect the fetus ; however , studies encompassing larger numbers of cases are needed .


Exemestane , a steroidal aromatase inhibitor , reduced invasive breast cancer incidence by @ % among @,@ postmenopausal women randomly assigned to exemestane ( @ mg per day ) compared with placebo in the National Cancer Institute of Canada ( NCIC ) Clinical Trials Group MAP @ ( Mammary Prevention @ ) trial , but effects on quality of life ( QOL ) were not fully described .


Menopause-specific and health-related QOL were assessed by using the four Menopause-Specific Quality of Life Questionnaire ( MENQOL ) domains and the eight Medical Outcomes Study Short Form Health Survey ( SF-@ ) scales at baseline , @ months , and yearly thereafter .


MENQOL questionnaire completion was high ( @ % to @ % ) in both groups at each follow-up visit .


Change scores for each MENQOL and SF-@ scale , calculated at each assessment time relative to baseline , were compared by using the Wilcoxon rank-sum test .


Clinically important worsened QOL was defined as a MENQOL change score increase of more than @ ( of @ ) points and an SF-@ change score decrease of more than @ ( of @ ) points from baseline .


Exemestane had small negative effects on women 's self-reported vasomotor symptoms , sexual symptoms , and pain , which occurred mainly in the first @ months to @ years after random assignment .


However , these changes represented only a small excess number of women being given exemestane with clinically important worsening of QOL at one time or another ; specifically , @ % more in the vasomotor domain and @ % more each in the sexual domain and for pain .


No other between-group differences were observed .


Overall , slightly more women in the exemestane arm ( @ % ) than in the placebo arm ( @ % ) discontinued assigned treatment .


Exemestane given for prevention has limited negative impact on menopause-specific and health-related QOL in healthy postmenopausal women at risk for breast cancer .


To explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma ( HCC ) .


In this three-center open-label study from November @ to May @ , we randomly assigned @ patients with advanced Child-Pugh class B or C HCC patients into two groups , one group with @ patient to receive sorafenib ( @ mg a time , twice a day ) and the other group with @ patients to receive best supportive care .


The primary end points were progression-free survival and overall survival .


The median progression-free survival was @ months and @ months in the sorafenib group and best supportive care group respectively ( Hazard ratio in the sorafenib group , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


The median overall survival was @ months and @ months in the sorafenib group and best supportive care group respectively ( Hazard ratio in the sorafenib group , @ ; @ % confidence interval , @-@ @ ; P < @ ) .


The main adverse effect of sorafenib was rash and acne of the skin ( in @ % patients ) .


The incidences of severe rash , diarrhea , and dry skin were @ % , @ % , and @ % in the sorafenib group .


One patient reached partial response in the sorafenib group .


Sorafenib is safe in patients with liver function impaired advanced HCC .


It is effective in terms of progression-free survival and overall survival compared with best supportive care .


Liver functions are the important predictive factors .


Cardiovascular disease ( CVD ) is an important worldwide cause of mortality .


In The Netherlands , CVD is the leading cause of death for women and the second cause of death for men .


Recommendations for diagnosis and treatment of CVD are not well implemented in primary care .


In this study , we aim to examine the effectiveness of a tailored implementation program targeted at practice nurses to improve healthcare for patients with ( high risk for ) CVD .


A two-arm cluster randomized trial is planned .


We offer practice nurses a tailored program to improve adherence to six specific recommendations related to blood pressure and cholesterol target values , risk profiling and lifestyle advice .


Practice nurses are offered training and feedback on their motivational interviewing technique and an e-learning program on cardiovascular risk management ( CVRM ) .


They are also advised to screen for the presence and severity of depressive symptoms in patients .


We also advise practice nurses to use selected E-health options ( selected websites and Twitter-consult ) in patients without symptoms of depression .


Patients with mild depressive symptoms are referred to a physical exercise group .


We recommend referring patients with major depressive symptoms for assessment and treatment of depressive symptoms if appropriate before starting CVRM .


Data from @ patients at high risk of CVD or with established CVD will be collected in @ general practices in several geographical areas in The Netherlands .


The primary outcome measure is performance of practice nurses in CVRM and reflects application of recommendations for personalized counselling and education of CVRM patients .


Patients ' health-related lifestyles ( physical exercise , diet and smoking status ) will be measured with validated questionnaires and medical record audit will be performed to document estimated CVD risk .


Additionally , we will survey and interview participating healthcare professionals for exploration of processes of change .


The control practices will provide usual care .


Tailored interventions can improve healthcare .


An understanding of the methods to reach the improved healthcare can be improved .


This research contributes a share of it .


Identification of the determinants of practice and developing implementation interventions were two steps which were completed .


The subsequent step was implementation of the tailored intervention program .


This randomised phase III trial evaluated first-line trabectedin versus doxorubicin-based chemotherapy ( DXCT ) in patients with advanced/metastatic translocation-related sarcomas ( TRS ) .


Patients were randomly assigned ( @:@ ) to receive trabectedin @ mg/m@ @-h intravenous ( i.v. ) infusion every @ weeks ( q@wk ) ( Arm A ) , or doxorubicin @ mg/m@ i.v. , q@wk , or doxorubicin @ mg/m@ i.v. plus ifosfamide ( range , @-@ g/m@ ) i.v. q@wk ( Arm B ) .


Progression-free survival ( PFS ) by independent review was the primary efficacy end-point .


One hundred and twenty-one patients were randomised ; @ of them had TRS confirmed by central pathology review ( efficacy population ) .


Twenty-nine PFS events were assessed by independent review ( @ with trabectedin ; @ with DXCT ) .


PFS showed non-significant difference between arms ( stratified log rank test , p = @ ; hazard ratio = @ , p = @ ) .


At the time of this analysis , @ % and @ % of patients were alive in trabectedin and DXCT arms , respectively .


There was no statistically significant difference in survival curves .


Response rate according to Response Evaluation Criteria in Solid Tumours ( RECIST ) v. @ was significantly higher in DXCT arm ( @ % versus @ % ) , but response according to Choi criteria showed fewer differences between treatment arms ( @ % versus @ % ) .


Safety profile was as expected for both arms , with higher incidence of severe neutropenia , alopecia and mucositis in the DXCT arm .


Neither trabectedin nor doxorubicin-based chemotherapy showed significant superiority in the first-line treatment of patients with advanced translocation-related sarcoma .


Multicenter randomized trial with patients listed as sick for @ to @ months due to neck or back pain and referred to secondary care .


To compare the return-to-work ( RTW ) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation .


A growing number of studies have focused on the RTW processes associated with patients with back pain .


Many studies have combined a workplace focus with multidisciplinary treatments ; however , this focus has not been evaluated in Norway among patients with neck and back pain thus far .


A total of @ patients who were referred to the spine clinics at @ university hospitals in Norway were randomly assigned into work-focused and control intervention groups .


The existing treatments at each hospital were used as the control interventions , which entailed either a comprehensive multidisciplinary intervention or a brief multidisciplinary intervention .


The RTW rates and proportions were compared at @ months .


During the first @ months after inclusion , @ ( @ % ) participants in the work-focused rehabilitation group and @ ( @ % ) participants in the control group returned to work .


The median time to RTW was @ days in the work-focused group and @ days in the control group .


A comparison of the work-focused and control interventions revealed a relative RTW probability ( hazard ratio ) of @ ( @ % confidence interval = @-@ @ ) after adjusting for age , sex , and education .


The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments .


Compared with open resection , laparoscopic resection of rectal cancers is associated with improved short-term outcomes , but high-level evidence showing similar long-term outcomes is scarce .


We aimed to compare survival outcomes of laparoscopic surgery with open surgery for patients with mid-rectal or low-rectal cancer .


The Comparison of Open versus laparoscopic surgery for mid or low REctal cancer After Neoadjuvant chemoradiotherapy ( COREAN ) trial was an open-label , non-inferiority , randomised controlled trial done between April @ , @ , and Aug @ , @ , at three centres in Korea .


Patients ( aged @-@ years ) with cT@N@-@M@ mid-rectal or low-rectal cancer who had received preoperative chemoradiotherapy were randomly assigned ( @:@ ) to receive either open or laparoscopic surgery .


Randomisation was stratified by sex and preoperative chemotherapy regimen .


Investigators were masked to the randomisation sequence ; patients and clinicians were not masked to the treatment assignments .


The primary endpoint was @ year disease-free survival , with a non-inferiority margin of @ % .


Analysis was by intention to treat .


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


We randomly assigned @ patients to receive either open surgery ( n = @ ) or laparoscopic surgery ( n = @ ) .


@ year disease-free survival was @ % ( @ % CI @-@ ) for the open surgery group and @ % ( @-@ ) for the laparoscopic surgery group , with a difference that was lower than the prespecified non-inferiority margin ( -@ % , @ % CI -@ to @ ; p < @ ) .


@ ( @ % ) patients died in the open group and @ ( @ % ) died in the laparoscopic group .


No deaths were treatment related .


Our results show that laparoscopic resection for locally advanced rectal cancer after preoperative chemoradiotherapy provides similar outcomes for disease-free survival as open resection , thus justifying its use .


Great strides have been made in improving heart health in the United States during the last @ decades , yet these strides have not encompassed many ethnic minority populations .


There are significant health disparity gaps stemming from both a paucity of valid research and a lack of culturally sensitive interventions .


In particular , many Korean Americans with chronic illnesses encounter difficulty navigating the healthcare system because of limited health literacy .


The effect of a multimodal Self-Help Intervention Program on the Control of High Blood Pressure ( HBP ) was tested in a community-based clinical trial for Korean American seniors .


Of @ seniors enrolled , @ completed the study ( @ in the intervention group and @ in the control group ; mean age = @ years ) .


The intervention group received @ weekly educational sessions on HBP management skill building , including health literacy training , followed by telephone counseling and home blood pressure ( BP ) monitoring for @ months .


Findings support that the Self-Help Intervention Program on the Control of HBP was effective in controlling BP in this ethnic/linguistic minority population .


The BP control rates for the intervention and control groups were @ % vs. @ % at baseline , @ % vs. @ % at @ months , @ % vs. @ % at @ months , and @ % vs. @ % at @ months .


Significant changes were observed over time in some psychobehavioral outcomes , including self-efficacy for BP control , medication adherence behavior , HBP knowledge , and depression .


The study findings suggest that the multimodal Self-Help Intervention Program on the Control of HBP is effective at promoting optimal HBP control for this ethnic/linguistic minority population .


To investigate the impact of education on the quality of life of parent of children with leukemia referred to the oncology clinic at Kerman 's Afzali-Poor hospital ( Iran ) .


This was an interventional study with @ parents of children with leukemia ; all of the caregivers were mothers and were included in the research .


They were chosen using the convenience sampling method and categorized randomly into two groups ( intervention and control , each with @ participants ) .


Research tools included demographic information and Quality of Life ( QoL ) scale ( a specific form for first-degree family caregivers of patients with leukemia ) .


Questionnaires were applied at the beginning of the research and after three months ; this second evaluation coincided in the study group with the end of the intervention .


The intervention lasted four sessions of @ - to @-minute classes , with lectures and question and answer sessions , educational booklets , and posters in groups with @ - @ members .


In the first evaluation , mean QoL scores in the study and control groups were @ and @ , which , after three months changed to @ and @ , respectively .


T-test verified these increases ( p < @ ) in quality of life in the intervention group .


According to the effectiveness of the education on the parent 's quality of life , it is recommended to implement consulting and educational programs for parents , especially parents of children with leukemia , to promote care , reduce anxiety , and consequently , enhance quality of life .


To determine the response of nebulized magnesium sulfate on the lung function of acetylcholine-induced asthma children .


Three hundred and thirty children of asthma with positive bronchial provocation test were randomly divided into three groups : magnesium sulfate , albuterol , and a combination of magnesium sulfate and albuterol .


Lung function was compared between the three groups .


Forced expiratory volume in one second ( FEV@ ) and peak expiratory flow ( PEF ) as percentage over predicted at @ min and @ min in albuterol and combination group were significantly improved when compared to magnesium group .


The changes in FEV@ and PEF expressed as absolute and percentage over predicted was not statistically significant from baseline to @ min in magnesium , albuterol , and combination of magnesium sulfate and albuterol .


There was no significant adverse effect observed during the present study .


Nebulized magnesium sulfate alone has a bronchodilatory effect in Ach-induced asthmatic children .


The combination of MgSO@ and albuterol did not has a synergistic effect .


Genome-wide association studies have yet to identify the majority of genetic variants involved in asthma .


We hypothesized that expression quantitative trait locus ( eQTL ) mapping can identify novel asthma genes by enabling prioritization of putative functional variants for association testing .


We evaluated @ cis-acting expression-associated variants ( eSNPs ) identified through a genome-wide eQTL survey of CD@ ( + ) lymphocytes for association with asthma .


eSNPs were tested for association with asthma in @ asthmatic patients and @ control subjects from the Childhood Asthma Management Program , with verification by using family-based testing .


Significant associations were tested for replication in @ parent-child trios with asthma from Costa Rica .


Further functional validation was performed by using formaldehyde-assisted isolation of regulatory elements ( FAIRE ) quantitative PCR and chromatin immunoprecipitation PCR in lung-derived epithelial cell lines ( Beas-@B and A@ ) and Jurkat cells , a leukemia cell line derived from T lymphocytes .


Cis-acting eSNPs demonstrated associations with asthma in both cohorts .


We confirmed the previously reported association of ORMDL@/GSDMB variants with asthma ( combined P = @ @ ( -@ ) ) .


Reproducible associations were also observed for eSNPs in @ additional genes : fatty acid desaturase @ ( FADS@ ; P = @ ) , N-acetyl -- D-galactosaminidase ( NAGA ; P = @ ) , and Factor XIII , A@ ( F@A@ ; P = @ ) .


Subsequently , we demonstrated that FADS@ mRNA is increased in CD@ ( + ) lymphocytes in asthmatic patients and that the associated eSNPs reside within DNA segments with histone modifications that denote open chromatin status and confer enhancer activity .


Our results demonstrate the utility of eQTL mapping in the identification of novel asthma genes and provide evidence for the importance of FADS@ , NAGA , and F@A@ in the pathogenesis of asthma .


To observe the clinical therapeutic effect of blood-letting plus acupuncture intervention for acute facial paralysis with pain ( damp-heat type of liver and gallbladder ) .


A total of @ cases of acute facial paralysis with pain were randomly and equally divided into control group and treatment group .


Patients of the control group were treated by simple acupuncture therapy only , and patients of the treatment group treated by acupuncture plus bloodletting at the ipsilateral Yangbai ( GB @ ) and Quanliao ( SI @ ) , and Dazhui ( GV @ ) and Yifeng ( TE @ ) , alternatively .


Shallow-acupuncture stimulation of ipsilateral Cuanzhu ( BL @ ) , Sizhukong ( TE @ ) , Sibai ( ST @ ) , Dicang ( ST @ ) , Jiache ( ST @ ) , Yingxiang ( SP @ ) , and bilateral Hegu ( LI @ ) , Yanglingquan ( GB @ ) and Xingjian ( LR @ ) was administered for @ min , once daily for one month .


The patients ' facial pain degree was evaluated by visual analogue scale ( VAS ) , and the pain duration during acute stage was recorded .


The facial nerve function and facial nerve function recovery ( grade II ) time were determined by using Sunnybrook Facial Grading scale and House-Brackmann ( HB ) grading scale , respectively .


In comparison with pre-treatment , the post-aurem pain scores after the first treatment and after the acute stage were significantly decreased , and the facial nerve function scores after the treatment were significantly increased in both control and treatment groups ( P < @ ) , and the effects of the treatment group were significantly superior to those of the control group ( P < @ ) .


The post-aurem pain duration and the time of facial nerve function recovery ( HB ) of the treatment group were considerably lower than those of the control group ( P < @ ) .


Of the @ and @ facial palsy patients in the control and treatment groups , @ ( @ % ) and @ ( @ % ) were cured , @ ( @ % ) and @ ( @ % ) experienced marked improvement , @ ( @ % ) and @ ( @ % ) were improved , and @ ( @ % ) and @ ( @ % ) were failed , with the effective rate being @ % and @ % , respectively .


Bloodletting combined acupuncture is effective in the treatment of acute facial paralysis with pain .


Therapy for stroke prevention in older persons with atrial fibrillation ( AF ) is underutilized despite evidence to support its effectiveness .


To prevent stroke in this high-risk population , antithrombotic treatment is necessary .


Given the challenges and inherent risks of antithrombotic therapy , decision-making is particularly complex for clinicians , necessitating comprehensive risk : benefit assessments .


Targeted interventions are urgently needed to support clinicians in this context ; the Computerized Antithrombotic Risk Assessment Tool ( CARAT ) offers a unique approach to this clinical problem .


This study ( a prospective , cluster-randomized controlled clinical trial ) will be conducted across selected regions in the state of New South Wales , Australia .


Fifty GPs will be randomized to either the ` intervention ' or ` control ' arm , with each GP recruiting @ patients ( aged @ with AF ) ; target sample size is @ patients .


GPs in the intervention arm will use CARAT during routine patient consultations to : assess risk factors for stroke , bleeding and medication misadventure ; quantify the risk/benefit ratio of antithrombotic treatment , identify the recommended therapy , and decide on the treatment course , for an individual patient .


CARAT will be applied by the GP at baseline and repeated at @ months to identify any changes to treatment requirements .


At baseline , the participant ( patients and GPs ) characteristics will be recorded , as well as relevant practice and clinical parameters .


Patient follow up will occur at @ , @ , and @ months via telephone interview to identify changes to therapy , medication side effects , or clinical events .


This project tests the utility of a novel decision support tool ( CARAT ) in improving the use of preventative therapy to reduce the significant burden of stroke .


Importantly , it targets the interface of patient care ( general practice ) , addresses the at-risk population , evaluates clinical outcomes , and offers a tool that may be sustainable via integration into prescribing software and primary care services .


GP support and guidance in identifying at risk patients for the appropriate selection of therapy is widely acknowledged .


This trial will evaluate the impact of CARAT on the prescription of antithrombotic therapy , its longer-term impact on clinical outcomes including stroke and bleeding , and clinicians perceived utility of CARAT in practice .


To evaluate the clinical effectiveness of indirect composite restorations in permanent molars with excessive substance loss in pediatric patients who have undergone root canal treatments .


Molars of @ pediatric patients underwent endodontic treatment .


Sixteen molars were restored with an indirect posterior composite resin restoration and @ molars were restored with a direct posterior composite resin restoration .


The success of the restorations was evaluated for @ years based on United States Public Health Service ( USPHS ) criteria , photographs after staining with basic fuchsine , and radiographic data .


Data obtained from both groups were compared using the Mann-Whitney U-test and Wilcoxon signed rank test .


Evaluation of the clinical and radiographic data revealed no observable , statistically significant differences between the posterior and the indirect posterior composites ( p > @ ) .


However , evaluation of photos taken of the patients ' molars after staining with basic fuchsin revealed that direct posterior composites showed increased staining on the margins of the restorations after six months ( p < @ ) .


Considering the difficulties of restoring endodontically treated permanent teeth with excessive substance loss in child patients , indirect restorations may be seen as a better option .


Salt intake has been implicated in the pathogenesis of abdominal aortic aneurysm ( AAA ) through studies in rodent models but not previously studied in humans .


The aim of this study was to examine the association between reported addition of salt to food and the prevalence of AAA .


A risk factor questionnaire which contained a question about salt intake was included as part of a population screening study for AAA in @ older men .


AAA presence was assessed by abdominal ultrasound imaging using a reproducible protocol .


The prevalence of AAA was @ , @ and @ % in men who reported adding salt to food never , sometimes and always , respectively , p = @ .


Addition of salt to food sometimes ( odds ratio -LSB- OR -RSB- : @ , @ % confidence interval -LSB- CI -RSB- : @-@ @ ) or always ( OR : @ , @ % CI @-@ @ ) was independently associated with AAA after adjustment for other risk factors including age , waist-hip ratio , blood pressure , history of hypertension , high cholesterol , angina , diabetes , myocardial infarction and stroke .


Salt intake was also independently associated with aortic diameter ( beta @ , p = @ ) .


In men with no prior history of hypertension , high cholesterol , angina , myocardial infarction or stroke ( n = @ ) , the association between addition of salt to food sometimes ( OR : @ , @ % CI @-@ @ ) or always ( OR : @ , @ % CI @-@ @ ) and AAA remained evident .


Reported salt intake is associated with AAA in older men .


Additional studies are needed to determine whether reducing salt intake would protect against AAA .


This study investigated how performance was affected after soccer players , in a postprandial state , ingested a @ % carbohydrate ( CHO ) solution compared to a placebo ( @ % CHO ) during a simulated soccer match .


Using a double-blind placebo-controlled design , @ trained male league soccer players ( age : @ @ years , wt : @ @ kg , VO@max : @ @ mL O@/kg/min ) completed two trials , separated by @ days , during which they ingested , in random order , @ mL of either a @ % CHO or placebo drink during a simulated soccer match .


Ratings of perceived exertion ( RPE ) , agility , timed and run to fatigue were measured during the trials .


Change in agility times was not altered by CHO vs. placebo ingestion ( @ @ vs. @ @ , p = @ ) .


Timed runs to fatigue were @ @ s vs. @ @ s for the CHO and placebo drinks , respectively ( p = @ ) .


Body mass modified the relationship between time to fatigue and drink ingestion ( p = @ for drink body mass ) , such that lower body mass was associated with increased time to fatigue when the players ingested CHO , but not placebo .


RPE values for the final stage of the simulated soccer match were @ @ and @ @ for the CHO and placebo drinks respectively ( p = @ ) .


The group data showed that the @ % CHO solution ( @ g CHO ) did not significantly improve performance during a simulated soccer match in league soccer players who had normal pre-match nutrition .


However , when adjusting for body mass , increasing CHO intake was associated with improved time to fatigue during the simulated soccer match .


To show the noninferiority of silodosin @-mg once-daily ( QD ) to @-mg twice-daily ( BID ) in efficacy and safety in patients with lower urinary tract symptoms or benign prostatic hyperplasia in the Korean population .


A prospective , multicenter , double-blind , randomized , comparative study was conducted .


A total of @ male patients aged @ years with lower urinary tract symptoms or benign prostatic hyperplasia were included .


All patients received silodosin QD or BID for @ weeks .


The primary end point was the change from baseline in total International Prostate Symptom Score ( IPSS ) at @ weeks .


Adverse drug reactions , vital signs , and laboratory tests were recorded .


A total of @ patients were randomized to the silodosin QD or BID groups .


These groups were not significantly different in baseline characteristics .


The mean total IPSS change in QD group was not inferior to that in BID group ( -@ and -@ , respectively ; @ % confidence interval , -@ to @ ) .


The QD and BID groups did not significantly differ in the following : percentages of patients with @ % ( @ % and @ % , respectively ; P = @ ) or @-point improvement in total IPSS ( @ % and @ % , respectively ; P = @ ) , maximum urinary flow rate improvement @ % ( @ % and @ % , respectively ; P = @ ) , changes in IPSS voiding subscore ( -@ @ and -@ @ ; P = @ ) , IPSS storage subscore ( -@ @ and -@ @ ; P = @ ) , quality of life ( -@ @ and -@ @ ; P = @ ) , maximum urinary flow rate ( @ @ and @ @ mL/s ; P = @ ) , International Continence Society male questionnaire score , Patient Goal Achievement Score , or Treatment Satisfaction Question .


The @ groups had similar frequencies of adverse drug reactions .


QD administration of silodosin was not inferior to BID in efficacy .


The @ groups had similar adverse drug reaction profiles .


Analgesic and wound-healing effects of cinnamon , a widely used spice , have been shown in laboratory rats .


However , we found no human studies in this area .


The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision .


In this double-blind , randomized , placebo-controlled trial , @ postpartum women were allocated into two groups , using stratified block randomization , @ h after completion of episiotomy repair .


They received cinnamon or placebo ointment , @ mL every @ h for @ d.


Perineal pain and wound healing were assessed using visual analogue scale ( @-@ ) and Redness , Edema , Ecchymosis , Discharge , Approximation scale ( @-@ ) , respectively .


General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors .


Follow-up rate was @ % up to the @ h time point in both groups , and @ % ( @ of @ ) in the cinnamon group and @ % ( @ of @ ) in the placebo group at day @-@ after delivery .


Pain score in the cinnamon group was significantly lower than that in the placebo group at ( @ ) h ( adjusted difference : -@ , @ % confidence interval : -@ to -@ ) and ( @ ) h ( -@ , -@ to -@ ) after intervention , and on the @-@th day after delivery ( -@ , -@ to -@ ) .


Also the cinnamon group showed significantly more improvement than the control group in healing score at ( @ ) h ( -@ , -@ to -@ ) and the @-@th day after delivery ( -@ , -@ to -@ ) .


Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision .


Research suggests that the food environment influences individual eating practices .


To date , little is known about effective interventions to improve the food environment of restaurants and food stores and promote healthy eating in rural communities .


We tested `` Waupaca Eating Smart '' ( WES ) , a pilot intervention to improve the food environment and promote healthy eating in restaurants and supermarkets of a rural community .


WES focused on labeling , promoting , and increasing the availability of healthy foods .


We conducted a randomized community trial , with two Midwestern U.S. communities randomly assigned to serve as intervention or control site .


We collected process and outcome data using baseline and posttest owner and customer surveys and direct observation methods .


The RE-AIM framework was used to guide the evaluation and organize the results .


Seven of nine restaurants and two of three food stores invited to participate in WES adopted the intervention .


On a @-@ scale , the average level of satisfaction with WES was @ ( SD = @ ) for restaurant managers and @ ( SD = @ ) for store managers .


On average , @ ( SD = @ ) out of @ possible intervention activities were implemented in restaurants and @ ( SD = @ ) out of @ possible activities were implemented in food stores .


One month after the end of the pilot implementation period , @ ( SD = @ ) and @ ( SD = @ ) activities were still in place at restaurants and food stores , respectively .


The intervention reached @ % of customers in participating food outlets .


Restaurant food environment scores improved from @ to @ ( p < @ ) in the intervention community and did not change significantly in the control community .


Food environment scores decreased slightly in both communities .


No or minimal changes in customer behaviors were observed after a @-month implementation period .


The intervention achieved high levels of reach , adoption , implementation , and maintenance , suggesting the feasibility and acceptability of restaurant-and food store-based interventions in rural communities .


Pilot outcome data indicated very modest levels of effectiveness , but additional research adequately powered to test the impact of this intervention on food environment scores and customer behaviors needs to be conducted in order to identify its potential to promote healthy eating in rural community settings .


Shortening the pulse width to @ millisecond holds neurophysiological and clinical promise of making electroconvulsive therapy ( ECT ) safer by reducing cognitive adverse effects .


The exclusive effects of pulse width on autobiographical and subjective memory are largely unstudied .


The aim was to principally investigate during the acute ECT course and at @ months after ECT autobiographical and subjective memory effects of @-millisecond ultrabrief and @-millisecond brief-pulse ECT .


Patient with severe depression were randomized to @-millisecond brief-pulse ( n = @ ) or @-millisecond ultrabrief-pulse ( n = @ ) right unilateral ECT , both at @ times the threshold stimulus dose given thrice weekly .


Autobiographical Memory Interview ( Kopelman ) and Squire Subjective Memory Questionnaire were administered at baseline , after @ sessions , end of the acute course , and @ months later .


Early adult semantic memory worsened significantly over time with brief-pulse compared with ultrabrief ECT : F@ ,@ = @ , P = @ .


There was a significant decline in brief-pulse treatment vis -- vis a significant improvement with ultrabrief-pulse treatment with childhood semantic memory ( P = @ ) , early adult semantic ( P = @ ) , and recent semantic memory ( P = @ ) only at @ hours after the eighth ECT treatment .


Clinically meaningful and significant improvement in semantic autobiographical memory occurred in ultrabrief treatment vis -- vis brief-pulse ECT after @ treatments .


Ultrabrief treatment offered a small but significant advantage over @-millisecond brief-pulse high-dose right unilateral ECT with early adult semantic autobiographical memory , which persisted up to @ months .


Although femoral nerve block provides good analgesia after total knee arthroplasty ( TKA ) , residual posterior knee pain may decrease patient satisfaction .


We compared the efficacy of periarticular infiltration analgesia ( PIA ) and sciatic nerve block ( SNB ) for posterior knee pain .


Forty-nine patients scheduled for TKA were prospectively randomized into the PIA group ( n = @ ) or SNB group ( n = @ ) and received general anesthesia with ultrasound-guided femoral nerve block ( FNB ) .


In the PIA group , @ ml @ % ropivacaine and @ mg epinephrine were injected intraoperatively into the periarticular soft tissue before inserting the components .


In the SNB group , patients received ultrasound-guided SNB with @ ml @ % ropivacaine and periarticular infiltration with @ ml normal saline and @ mg epinephrine .


We evaluated postoperative pain scores , posterior knee pain , frequency of rescue analgesics for @ h , and performance time of PIA and SNB .


Visual analogue pain scores at @-@ h were significantly lower in the PIA group than in the SNB group ( p < @ ) .


The majority of patients had no posterior knee pain .


There were no significant differences between the groups in frequency and time of first administration of rescue analgesics and in side effects .


Time for performance of periarticular infiltration was significantly shorter than that for SNB ( p < @ ) .


The dose of intraoperative remifentanil was significantly lower in the SNB group than in the PIA group ( p < @ ) .


The combination of FNB and PIA provides sufficient analgesia after TKA .


The rapid and convenient periarticular infiltration technique could be a good alternative to SNB .


In Canada , cesarean delivery rates have increased substantially over the past decade .


Effective , safe strategies are needed to reduce these rates .


We conducted a cluster-randomized , controlled trial of a multifaceted @-year intervention at @ hospitals in Quebec .


The intervention involved audits of indications for cesarean delivery , provision of feedback to health professionals , and implementation of best practices .


The primary outcome was the cesarean delivery rate in the @-year postintervention period .


Among the @,@ participants , @,@ women delivered in the year before the intervention and @,@ women delivered in the year following the intervention .


There was a significant but small reduction in the rate of cesarean delivery from the preintervention period to the postintervention period in the intervention group as compared with the control group ( change , @ % to @ % in the intervention group and @ % to @ % in the control group ; odds ratio for incremental change over time , adjusted for hospital and patient characteristics , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ; adjusted risk difference , -@ % ; @ % CI , -@ to -@ ) .


The cesarean delivery rate was significantly reduced among women with low-risk pregnancies ( adjusted risk difference , -@ % ; @ % CI , -@ to -@ ; P = @ ) but not among those with high-risk pregnancies ( P = @ ; P = @ for interaction ) .


The intervention group also had a reduction in major neonatal morbidity as compared with the control group ( adjusted risk difference , -@ % ; @ % CI , -@ to -@ ; P = @ ) and a smaller increase in minor neonatal morbidity ( adjusted risk difference , -@ % ; @ % CI , -@ to -@ ; P < @ ) .


Changes in minor and major maternal morbidity did not differ significantly between the groups .


Audits of indications for cesarean delivery , feedback for health professionals , and implementation of best practices , as compared with usual care , resulted in a significant but small reduction in the rate of cesarean delivery , without adverse effects on maternal or neonatal outcomes .


The benefit was driven by the effect of the intervention in low-risk pregnancies .


( Funded by the Canadian Institutes of Health Research ; QUARISMA Current Controlled Trials number , ISRCTN@ . )


To determine the effect of elastic taping on patients with patellofemoral pain and its impact on the onset time of vastusmedialis and vastuslateralis .


Eligible patients were assigned into the treatment and control groups randomly .


Patients in the treatment group received a @-day taping with therapeutic stretch .


Patients in the control group were give placebo taping without therapeutic stretch .


Ultrasound therapy was applied to all of the participants as a basic treatment .


The levels of pain and surface electromyography were evaluated before treatment , after the first taping and on the Gh day ( without taping ) .


Patients in the treatment group experienced immediate improvement in pain and onset time of vastusmedialis and vastuslateralis compared with the controls .


On the @th day ( without taping ) , further improvement was achieved in pain and onset time of vastusmedialis and vastuslateralis in the treatment group compared with the controls ( P < @ ) .


Elastic taping can effectively improve pain and onset time of vastusmedialis and vastuslateralis .


Heparin is often prescribed during pregnancy with the intention of improving perinatal outcomes on the basis that it exerts an anticoagulant action in the inter-villous space .


Accumulating in-vitro and in-vivo evidence indicates that heparin 's beneficial effects in pregnancy may result from ` non-anticoagulant ' effects including the promotion of angiogenesis .


To study the effect of heparin within the placenta , we performed secondary analyses on a pilot trial where @ women with negative thrombophilia screens and second-trimester evidence of placental insufficiency were randomized to standard care or antenatal self-administration of unfractionated heparin ( UFH ) @ IU twice-daily .


Serial placental ultrasound images were reviewed and compared with histo-pathologic findings following delivery .


There were no differences between the two arms in either the evolution of abnormal placental lesions on ultrasound ( p = @ ) or evidence of maternal vascular under-perfusion on histopathology ( p = @ ) .


In pregnancies considered at increased risk for adverse pregnancy outcomes based on previous history or abnormal serum marker screen , early ( second-trimester ) placental ultrasound , reflecting developmental pathology had better test characteristics ( sensitivity @ % ; positive predictive value @ % ) for predicting adverse pregnancy outcomes than third-trimester ultrasound that is reflective of placental thrombotic injury .


Administration of UFH did not prevent the development or evolution of abnormal placental lesions on placental ultrasound or evidence of maternal vascular underperfusion on placental histo-pathology .


Second-trimester placental ultrasound may be of value in predicting those at greatest risk of adverse outcomes .


Benefits of plant sterols ( PS ) for cholesterol lowering are compromised by large variability in efficacy across individuals .


High fractional cholesterol synthesis measured by deuterium incorporation has been associated with nonresponse to PS consumption ; however , prospective studies that show this association have yet to be conducted .


The goal was to test whether the lathosterol-to-cholesterol ratio ( L : C ratio ) , a surrogate marker of endogenous cholesterol synthesis , serves as an a priori predictor of cholesterol lowering in response to PS consumption .


Sixty-three mildly hypercholesterolemic adults who were preselected as possessing either high endogenous cholesterol synthesis -LSB- HS ; n = @ ; L : C = @ @ mol/mmol ( mean SD ) -RSB- or low endogenous cholesterol synthesis ( LS ; n = @ ; L : C = @ @ mol/mmol ) on the basis of baseline L : C consumed @ g PS/d or a placebo for @ d with the use of a dual-center , single-blind , randomized crossover design .


Plasma lipid and noncholesterol sterol concentrations were measured at the end of each phase .


PS consumption lowered total cholesterol ( TC ; -@ @ mmol/L ; P < @ ) and LDL cholesterol ( -@ @ mmol/L ; P < @ ) overall .


Specifically , LS individuals responded to PS treatment with a reduction in TC ( -@ @ mmol/L ; P < @ ) and LDL cholesterol ( -@ @ mmol/L ; P = @ ) , whereas HS individuals failed to show cholesterol lowering ( TC : -@ @ mmol/L ; P = @ ; LDL cholesterol : -@ @ mmol/L ; P = @ ) .


The odds of LS participants responding to PS consumption with cholesterol lowering better than the mean cholesterol lowering in all participants were @ ( @ % CI : @ , @ ; P = @ ) for TC and @ ( @ % CI : @ , @ ; P = @ ) for LDL cholesterol , which was higher than for HS participants .


The L : C ratio predicts the extent of reduction in circulating TC and LDL cholesterol in response to PS consumption .


Cholesterol synthesis assessment may thus have a use in identifying responders and nonresponders to PS therapy .


Immunization quality improvement programs are often limited by the cost and inconvenience associated with delivering face-to-face consultations to primary care providers .


To investigate a more efficient mode of intervention delivery , we conducted a process evaluation that compared in-person consultations to those delivered via interactive webinar .


The Centers for Disease Control and Prevention 's Assessment , Feedback , Incentives , and eXchange ( AFIX ) Program is an immunization quality improvement program implemented in all @ states .


In @ , we randomly assigned @ high-volume primary care clinics in North Carolina to receive an in-person or webinar AFIX consultation focused on adolescent immunization .


We used surveys of participating vaccine providers and expense tracking logs to evaluate delivery modes on participation , satisfaction , and cost .


Clinics served @,@ patients , ages @ to @ .


Clinics that received in-person and webinar consultations reported similar levels of participation on key programmatic activities with one exception : more webinar clinics reported improving documentation of previously administered , ` historical ' vaccine doses .


Both in-person and webinar clinics showed sustained improvement in confidence to use reminder/recall systems ( both p < @ ) .


Participants rated delivery modes equally highly on satisfaction measures such as convenience ( mean = @ of @ ) .


Delivery cost per clinic was $ @ for in-person consultations versus $ @ for webinar consultations .


In-person and webinar delivery modes were both well received , but webinar AFIX consultations cost substantially less .


Interactive webinar delivery shows promise for considerably extending the reach of immunization quality improvement programs .


Recent evidence has indicated that flavanol consumption may have many health benefits in humans , including improved cognitive activities .


The aim was to evaluate the effect of flavanol consumption on cognitive performance in cognitively intact elderly subjects .


This was a double-blind , controlled , parallel-arm study conducted in @ elderly individuals without clinical evidence of cognitive dysfunction who were randomly assigned to consume daily for @ wk a drink containing @ mg -LSB- high flavanol ( HF ) -RSB- , @ mg -LSB- intermediate flavanol ( IF ) -RSB- , or @ mg -LSB- low flavanol ( LF ) -RSB- cocoa flavanols ( CFs ) .


Cognitive function was assessed at baseline and after @ wk by using the Mini-Mental State Examination ( MMSE ) , the Trail Making Test ( TMT ) A and B , and the Verbal Fluency Test ( VFT ) .


The changes in MMSE score in response to the @ different treatments were not different .


In contrast , there was a positive impact of the intervention on specific aspects of cognitive function .


Mean changes ( SEs ) in the time required to complete the TMT A and B after consumption of the HF ( -@ @ and -@ @ s , respectively ) and IF ( -@ @ and -@ @ s , respectively ) drinks significantly ( P < @ ) differed from that after consumption of the LF drinks ( -@ @ and -@ @ s , respectively ) .


Similarly , VFT scores significantly improved among all treatment groups , but the magnitude of improvement in the VFT score was significantly ( P < @ ) greater in the HF group ( @ @ words/@ s ) than in the IF ( @ @ words/@ s ) and LF ( @ @ words/@ s ) groups .


Significantly different improvements in insulin resistance ( P < @ ) , blood pressure ( P < @ ) , and lipid peroxidation ( P = @ ) were also observed for the HF and IF groups in comparison with the LF group .


Changes in insulin resistance explained @ % of changes in composite z score ( partial r = @ , P < @ ) .


This dietary intervention study provides evidence that regular CF consumption can reduce some measures of age-related cognitive dysfunction , possibly through an improvement in insulin sensitivity .


These data suggest that the habitual intake of flavanols can support healthy cognitive function with age .


Authors have reported better outcomes , by reducing surgical dissection for carpal tunnel syndromes requiring surgery .


Recently , a new sonographically guided technique for ultra minimally invasive ( Ultra-MIS ) carpal tunnel release ( CTR ) through @mm incision has been described .


We hypothesized that a clinical trial for comparing Ultra-MIS versus Mini-open Carpal Tunnel Release ( Mini-OCTR ) was feasible .


To test our hypothesis , we conducted a pilot study for studying Ultra-MIS versus Mini-OCTR respectively performed through a @mm or a @ cm incision .


We defined success if primary feasibility objectives ( safety and efficacy ) as well as secondary feasibility objectives ( recruitment rates , compliance , completion , treatment blinding , personnel resources and sample size calculation for the clinical trial ) could be matched .


Score for Quick-DASH questionnaire at final follow-up was studied as the primary variable for the clinical trial .


Turnover times were studied for assessing learning curve stability .


Forty patients were allotted .


Primary and secondary feasibility objectives were matched with the following occurrences : @ % of eligible patients finally recruited ; @ % of randomization refusals ; @ patients/month recruited ; @ % patients receiving a blinded treatment ; @ % compliance and @ % completion .


A sample size of @ patients was calculated for clinical trial validation .


At final follow-up , preliminary results for Quick-Dash substantially favored Ultra-MIS over Mini-OCTR ( average @ versus @ ) and complication rates were lower for Ultra-MIS ( @ % versus @ % ) .


A stable learning curve was observed for both groups .


The clinical trial is feasible .


There is currently no evidence to contraindicate nor withhold the use of Ultra-MIS for CTR .


To investigate the effectiveness of polycystic ovary syndrome ( PCOS ) of damp-phlegm constitution treated with embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng ( EX-UE @ ) .


Eighty-five patients were randomly divided into @ groups of observation group ( @ cases ) and control group ( @ cases ) .


Embedding therapy on back-shu points and front-mu points and needle-pricking therapy on Sifeng ( EX-UE @ ) were applied to the observation group .


Points such as Zhongwan ( CV @ ) , Guanyuan ( CV @ ) , Tianshu ( ST @ ) , Zhangmen ( LR @ ) , Jingmen ( GB @ ) , Qimen ( LR @ ) , Ganshu ( BL @ ) , Weishu ( BL @ ) , Pishu ( BL @ ) , Shenshu ( BL @ ) , Dachangshu ( BL @ ) and Xiaochangshu ( BL @ ) , etc. were adopted for embedding therapy .


At the same time , needle-pricking therapy on Sifeng ( EX-UE @ ) was also applied once a week .


@ g metformin hydrochloride tablet was given to the control group , once a day for the first week , and twice a day from the second week .


Estimation on therapeutic effect was made for both groups after @ months treatment .


Change of symptoms and signs scores , fasting insulin ( FINS ) , @ hour insulin after meal ( @hINS ) and insulin resistance index ( HOMA-IR ) of both groups before and after treatment were observed , and therapeutic effect estimated .


The total effective rate of the observation group is @ % ( @/@ ) , and that of the control group was @ % ( @/@ ) .


There was no significant difference between the two groups ( P > @ ) .