High velocity resistance training with low external resistance yields similar improvements in muscle power and physical performance compared to training with high external resistance in mobility-limited elders .


These findings may have important implications for optimizing exercise interventions for older adults with mobility limitations .


Low levels of cardiorespiratory fitness are associated with high risk of non-communicable diseases and all-cause mortality .


Physical activity level is the primary determinant of cardiorespiratory fitness in adults .


However , knowledge on how to motivate people to engage in physical activity and maintain an active lifestyle is lacking .


This study aims to investigate whether a motivational , individual , and locally anchored exercise intervention , in primary care , can improve cardiorespiratory fitness in @ to @ year olds with a low or very low cardiorespiratory fitness .


Two-armed randomised controlled trial with @ and @ months follow-up .


The primary outcome is cardiorespiratory fitness estimated via a maximal incremental exercise test .


Secondary outcomes include physical activity level and sedentary behavior ( objectively measured ) , self-reported physical activity , biochemical parameters ( HbA@C , HDL - and LDL-cholesterol , and triglyceride ) , anthropometric parameters and health-related quality of life .


A total of @ participants with low levels of cardiorespiratory fitness classified at a local health check programme will be randomised .


The intervention consists of four motivational interviews , a six months membership to a sport club , and a global positioning watch to upload training activity to Endomondo.com .


The comparison group will receive standard care : a one hour motivational interview followed by another interview if requested .


Effects will be estimated by evaluating the differences in mean changes in cardiorespiratory fitness between the two groups .


In new and innovative ways the focus of this study will be to improve cardiorespiratory fitness among a @-@ year-old at-risk group using social media , Global Positioning System-technology , on-going personal support and individually tailored physical activity .


Adherence to cardioprotective medication regimens in the year after hospitalization for acute coronary syndrome ( ACS ) is poor .


To test a multifaceted intervention to improve adherence to cardiac medications .


In this randomized clinical trial , @ patients from @ Department of Veterans Affairs medical centers located in Denver ( Colorado ) , Seattle ( Washington ) ; Durham ( North Carolina ) , and Little Rock ( Arkansas ) admitted with ACS were randomized to the multifaceted intervention ( INT ) or usual care ( UC ) prior to discharge .


The INT lasted for @ year following discharge and comprised ( @ ) pharmacist-led medication reconciliation and tailoring ; ( @ ) patient education ; ( @ ) collaborative care between pharmacist and a patient 's primary care clinician and/or cardiologist ; and ( @ ) @ types of voice messaging ( educational and medication refill reminder calls ) .


The primary outcome of interest was proportion of patients adherent to medication regimens based on a mean proportion of days covered ( PDC ) greater than @ in the year after hospital discharge using pharmacy refill data for @ cardioprotective medications ( clopidogrel , - blockers , @-hydroxy-@-methylglutaryl coenzyme A reductase inhibitors -LSB- statins -RSB- , and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers -LSB- ACEI/ARB -RSB- ) .


Secondary outcomes included achievement of blood pressure ( BP ) and low-density lipoprotein cholesterol ( LDL-C ) level targets .


RESULTS Of @ patients , @ ( @ % ) completed the study ( @ in INT and @ in UC ) .


In the INT group , @ % of patients were adherent compared with @ % in the UC group ( P = @ ) .


Mean PDC was higher in the INT group ( @ vs @ ; P < @ ) .


A greater proportion of intervention patients were adherent to clopidogrel ( @ % vs @ % ; P = @ ) , statins ( @ % vs @ % ; P < @ ) , and ACEI/ARB ( @ % vs @ % ; P = @ ) but not - blockers ( @ % vs @ % ; P = @ ) .


There were no statistically significant differences in the proportion of patients who achieved BP and LDL-C level goals .


A multifaceted intervention comprising pharmacist-led medication reconciliation and tailoring , patient education , collaborative care between pharmacist and patients ' primary care clinician and/or cardiologist , and voice messaging increased adherence to medication regimens in the year after ACS hospital discharge without improving BP and LDL-C levels .


Understanding the impact of such improvement in adherence on clinical outcomes is needed prior to broader dissemination of the program .


The Quality of Life-Bronchiectasis ( QOL-B ) , a self-administered , patient-reported outcome measure assessing symptoms , functioning and health-related quality of life for patients with non-cystic fibrosis ( CF ) bronchiectasis , contains @ items on @ scales ( Respiratory Symptoms , Physical , Role , Emotional and Social Functioning , Vitality , Health Perceptions and Treatment Burden ) .


Psychometric analyses of QOL-B V. @ used data from two double-blind , multicentre , randomised , placebo-controlled , phase III trials of aztreonam for inhalation solution ( AZLI ) in @ patients with non-CF bronchiectasis and Gram-negative endobronchial infection .


Excellent internal consistency ( Cronbach 's @ ) and @-week test-retest reliability ( intraclass correlation coefficients @ ) were demonstrated for each scale .


Convergent validity with @ min walk test was observed for Physical and Role Functioning scores .


No floor or ceiling effects ( baseline scores of @ or @ ) were found for the Respiratory Symptoms scale ( primary endpoint of trials ) .


Baseline Respiratory Symptoms scores discriminated between patients based on baseline FEV % predicted in only one trial .


The minimal important difference score for the Respiratory Symptoms scale was @ points .


AZLI did not show efficacy in the two phase III trials .


QOL-B responsivity to treatment was assessed by examining changes from baseline QOL-B scores at study visits at which protocol-defined pulmonary exacerbations were reported .


Mean Respiratory Symptoms scores decreased @ and @ points from baseline for placebo-treated and AZLI-treated patients with exacerbations , indicating that worsening respiratory symptoms were reflected in clinically meaningful changes in QOL-B scores .


Previously established content validity , reliability and responsivity of the QOL-B are confirmed by this final validation study .


The QOL-B is available for use in clinical trials and routine clinical practice .


To estimate the short-term effectiveness , feasibility and acceptability of a smoking cessation intervention ( the iQuit system ) that consists of tailored printed and Short Message Service ( SMS ) text message self-help delivered as an adjunct to cessation support in primary care to inform the design of a definitive trial .


A stratified two parallel-group randomized controlled trial comparing usual care ( control ) with usual care plus the iQuit system ( intervention ) , delivered by primary care nurses/healthcare assistants who were blinded to the allocation sequence .


Thirty-two general practice ( GP ) surgeries in England , UK .


A total of @ smokers initiating smoking cessation support from their local GP surgery were randomized ( control n = @ , intervention n = @ ) .


Primary outcome was self-reported @-week point prevalence abstinence at @ weeks follow-up .


Secondary smoking outcomes and feasibility and acceptability measures were collected at @ weeks after quit date , @ weeks and @ months follow-up .


There were no significant between-group differences in the primary outcome -LSB- control @ % , iQuit @ % ; odds ratio ( OR ) = @ , @ % confidence interval ( CI ) = @-@ @ -RSB- or in secondary short-term smoking outcomes .


Six-month prolonged abstinence was significantly higher in the iQuit arm ( control @ % , iQuit @ % ; OR = @ , @ % CI = @-@ @ ) .


iQuit support took on average @ minutes ( standard deviation = @ ) to deliver and @ % ( @ % CI = @-@ @ % ) of intervention participants discontinued the text message support during the programme .


Tailored printed and text message self-help delivered alongside routine smoking cessation support in primary care does not significantly increase short-term abstinence , but may increase long-term abstinence and demonstrated feasibility and acceptability compared with routine cessation support alone .


Compare HIV injecting and sex risk in patients being treated with methadone ( MET ) or buprenorphine-naloxone ( BUP ) .


Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed @ weeks of treatment and had @ or more blood draws .


The initial @:@ randomization was changed to @:@ ( BUP : MET ) after @ months due to higher dropout in BUP .


The Risk Behavior Survey measured HIV risk before @ days at baseline and weeks @ and @ .


Among @ patients randomized to MET , @ ( @ % ) were completers ; among @ randomized to BUP , @ ( @ % ) were completers ; @ completed the Risk Behavior Survey .


There were significant reductions in injecting risk ( P < @ ) with no differences between groups in mean number of times reported injecting heroin , speedball , other opiates , and number of injections ; or percent who shared needles ; did not clean shared needles with bleach ; shared cookers ; or engaged in front/back loading of syringes .


The percent having multiple sex partners decreased equally in both groups ( P < @ ) .


For males on BUP , the sex risk composite increased ; for males on MET , the sex risk decreased resulting in significant group differences over time ( P < @ ) .


For females , there was a significant reduction in sex risk ( P < @ ) with no group differences .


Among MET and BUP patients who remained in treatment , HIV injecting risk was equally and markedly reduced ; however , MET retained more patients .


Sex risk was equally and significantly reduced among females in both treatment conditions , but it increased for males on BUP and decreased for males on MET .


To explore the association of a functional germline variant in the @ ' - UTR of KRAS with endometrial cancer risk , as well as the association of microRNA ( miRNA ) signatures and the KRAS-variant with clinical characteristics and survival outcomes in two prospective RTOG endometrial cancer trials .


The association of the KRAS-variant with endometrial cancer risk was evaluated by case-control analysis of @ women with type @ or @ endometrial cancer and @ age-matched controls .


miRNA and DNA were isolated for expression profiling and genotyping from tumor specimens of @ women with type @ endometrial cancer enrolled in RTOG trials @ and @ .


miRNA expression levels and KRAS-variant genotype were correlated with patient and tumor characteristics , and survival outcomes were evaluated by variant allele type .


The KRAS-variant was not significantly associated with overall endometrial cancer risk ( @ % controls and @ % type @ cancers ) , although was enriched in type @ endometrial cancers ( @ % , p = @ ) .


In the combined analysis of RTOG @/@ , miRNA expression differed by age , presence of lymphovascular invasion and KRAS-variant status .


Overall survival rates at @ years for patients with the variant and wild-type alleles were @ % and @ % ( HR @ , p = @ ) , respectively , favoring the variant .


The KRAS-variant may be a genetic marker of risk for type @ endometrial cancers .


In addition , tumor miRNA expression appears to be associated with patient age , lymphovascular invasion and the KRAS-variant , supporting the hypothesis that altered tumor biology can be measured by miRNA expression , and that the KRAS-variant likely impacts endometrial tumor biology .


Thrombocytopenia in patients with myelodysplastic syndrome ( MDS ) is associated with shortened survival and an increased risk of evolution to acute myeloid leukemia ( AML ) .


In this study , the authors evaluated the efficacy of romiplostim in patients who had thrombocytopenia with low-risk/intermediate -@ - risk MDS .


Patients who had thrombocytopenia with low-risk/intermediate -@ - risk MDS ( N = @ ) were randomized @:@ to receive romiplostim or placebo weekly for @ weeks .


The primary endpoint - the number of clinically significant bleeding events ( CSBEs ) per patient-had a hazard ratio for romiplostim : placebo of @ ( @ % confidence interval , @-@ @ ; P = @ ) .


CSBEs were reduced significantly in the romiplostim group for patients who had baseline platelet counts @ ( @ ) / L ( P < @ ) .


For patients who had baseline platelet counts < @ ( @ ) / L , there was no difference in the number of CSBEs , but the platelet transfusion rates were higher in the placebo group ( P < @ ) , which may have affected the overall CSBE results in this group with severe thrombocytopenia .


The incidence of bleeding events was reduced significantly in the romiplostim group ( relative risk , @ ) , as were protocol-defined platelet transfusions ( relative risk , @ ) .


Platelet response rates according to @ International Working Group criteria were higher for the group that received romiplostim ( odds ratio , @ ) .


On the basis of interim data , an independent data monitoring committee advised halting study drug because of concerns regarding excess blasts and AML rates with romiplostim ( interim hazard ratio , @ ) .


At @ weeks , the AML rates were @ % in the romiplostim group and @ % in the placebo group ( hazard ratio , @ ; @ % confidence interval , @-@ @ ) , and the overall survival rates were similar .


Romiplostim treatment in patients with low-risk/intermediate -@ - risk MDS increased platelet counts and decreased the number of bleeding events and platelet transfusions .


Although study drug was discontinued because of an initial concern of AML risk , survival and AML rates were similar with romiplostim and placebo .


Transcranial direct current stimulation ( tDCS ) has demonstrated efficacy for reducing neuropathic pain , but the respective mechanisms remain largely unknown .


The current study tested the hypothesis that pain reduction with tDCS is associated with an increase in the peak frequency spectrum density in the theta-alpha range .


Twenty patients with spinal cord injury and bilateral neuropathic pain received single sessions of both sham and anodal tDCS ( @ mA ) over the left primary motor area ( M@ ) for @ min .


Treatment order was randomly assigned .


Pre - to post-procedure changes in pain intensity and peak frequency of electroencephalogram spectral analysis were compared between treatment conditions .


The active treatment condition ( anodal tDCS over M@ ) but not sham treatment resulted in significant decreases in pain intensity .


In addition , consistent with the study hypothesis , peak theta-alpha frequency ( PTAF ) assessed from an electrode placed over the site of stimulation increased more from pre - to post-session among participants in the active tDCS condition , relative to those in the sham tDCS condition .


Moreover , we found a significant association between a decrease in pain intensity and an increase in PTAF at the stimulation site .


The findings are consistent with the possibility that anodal tDCS over the left M@ may be effective , at least in part , because it results in an increase in M@ cortical excitability , perhaps due to a pain inhibitory effect of motor cortex stimulation that may influence the descending pain modulation system .


Future research is needed to determine if there is a causal association between increased left anterior activity and pain reduction .


The results provide new findings regarding the effects of tDCS on neuropathic pain and brain oscillation changes .


Cerebral palsy ( CP ) is the most common motor disability in childhood ( @ to @ per @ live births ) , and is frequently accompanied by cognitive impairments and behavioural problems .


Children with CP are at increased risk of attention deficit disorder with or without hyperactivity ( Attention Deficit Disorder ( ADD ) / Attention Deficit Hyperactivity Disorder ( ADHD ) ) including working memory deficits .


The primary aim of this study is to evaluate if cognitive training may improve working memory in children with CP .


The study is an investigator-blinded , randomized controlled trial with a stepped-wedge design that will include @ schoolchildren with CP .


Eligible for participation are children with CP , aged @ to @years , who are able to follow instructions and handle a computer mouse .


Exclusion criteria are the presence of photosensitive epilepsy , Gross Motor Function Classification System ( GMFCS ) level V ( most severe CP ) ( Phys Ther @ : @-@ , @ ) and severe visual or hearing impairments .


Following assessment of eligibility and baseline cognitive assessment the participants will be randomized to either cognitive working memory training or treatment-as-usual ( ` control group ' ) .


The intervention is a computer-based working memory training program consisting of @ daily sessions to be performed over a @ to @-week period at home .


A neuropsychological assessment will be performed before and @ to @weeks after completed training .


When the latter assessment has been completed in the intervention group , the ` control group ' will start on the same training program .


Both groups will meet for a final neuropsychological assessment six months after completed training by an examiner unaware of group adherence .


There is limited evidence for the effect of most interventions in children with CP , and evidence is completely lacking for interventions aiming to improve deficits in cognition , learning and behaviour .


The proposed multicenter study , will bring forth comprehensive information about cognitive , neuropsychological , and daily-life functioning in children with CP aged between @ and @years .


In addition , the study will be the first to evaluate the effects of an intervention method to improve working memory in children with CP .


If successful , computer-based working memory training may represent an efficient and cost-effective intervention for this group of children .


The prognostic significance of response to induction therapy for rhabdomyosarcoma ( RMS ) by anatomic imaging -LSB- computerised tomographic ( CT ) or magnetic resonance imaging ( MRI ) scan -RSB- is controversial .


We previously reported no relationship between early response and failure-free survival ( FFS ) on Intergroup Rhabdomyosarcoma Study ( IRS ) - IV .


We repeated the same analysis using a more recent clinical trial as an independent cohort of patients with non-metastatic , initially unresected RMS .


A total of @ patients enrolled in Children 's Oncology Group ( COG ) study D@ met the inclusion criteria for this analysis : ( @ ) non-metastatic , initially unresected ( Group III ) ; ( @ ) embryonal ( ERMS ) or alveolar ( ARMS ) histology ; ( @ ) documented protocol week @ response to induction chemotherapy ( excluding progressive disease ) based on anatomic imaging ( CT/MRI ) and ( @ ) documented protocol therapy beyond week @ .


Response at week @ was determined by the treating institution as complete response ( CR ) , partial response ( PR ) or no response ( NR ) .


FFS was estimated using the Kaplan-Meier method and comparisons between patient subsets were made using the log-rank test .


Overall objective response rate ( CR+PR ) at week @ of therapy was @ % and was similar between ERMS and ARMS .


FFS was similar among all patients with CR , PR or NR ( p = @ ) .


Restricting the analysis to either ERMS or ARMS , there was no difference in FFS by response within either histology subset ( p = @ and p = @ , respectively ) .


These findings provide additional evidence that anatomic imaging to assess early response to therapy among patients with RMS does not predict outcome and has questionable use in tailoring subsequent therapy .


Multicenter randomized controlled trial .


To evaluate the effect of recombinant human bone morphogenetic protein ( rhBMP-@ ) on radiographical fusion rate and clinical outcome for surgical lumbar arthrodesis compared with iliac crest autograft .


In many types of spinal surgery , radiographical fusion is a primary outcome equally important to clinical improvement , ensuring long-term stability and axial support .


Biologic induction of bone growth has become a commonly used adjunct in obtaining this objective .


We undertook this study to objectify the efficacy of rhBMP-@ compared with traditional iliac crest autograft in instrumented posterolateral lumbar fusion .


Patients undergoing @ - or @-level instrumented posterolateral lumbar fusion were randomized to receive either autograft or rhBMP-@ for their fusion construct .


Clinical and radiographical outcome measures were followed for @ to @ years postoperatively .


One hundred ninety seven patients were successfully randomized among the @ participating institutions .


Adverse events attributable to the study drug were not significantly different compared with controls .


However , the control group experienced significantly more graft-site complications as might be expected .


@-Item Short Form Health Survey , Oswestry Disability Index , and leg/back pain scores were comparable between the @ groups .


After @ years of follow-up , radiographical fusion rates remained significantly higher in patients treated with rhBMP-@ ( @ % ) than those who received autograft ( @ % ) ( P = @ ) .


The use of rhBMP-@ for instrumented posterolateral lumbar surgery significantly improves the chances of radiographical fusion compared with the use of autograft .


However , there is no associated improvement in clinical outcome within a @-year follow-up period .


These results suggest that use of rhBMP-@ should be considered in cases where lumbar arthrodesis is of primary concern .


Informed and engaged parents and healthful home environments are essential for the health of youth .


Although research has shown health benefits associated with family meals , to date , no randomized controlled trial ( RCT ) has been developed to examine the impact of a family meals intervention on behavioral and health outcomes .


The Healthy Home Offerings via the Mealtime Environment ( HOME ) Plus study is a two-arm ( intervention versus attention-only control ) RCT being conducted in Minneapolis/St .


Paul .


Built on previous pilot research , HOME Plus aims to increase the frequency and healthfulness of family meals and snacks and reduce children 's sedentary behavior , particularly screen time , to promote healthier eating and activity behaviors and prevent obesity .


HOME Plus is delivered to families in community settings .


The program includes @ monthly sessions focused on nutrition and activity education , meal planning and preparation skill development .


In addition , five motivational goal-setting phone calls are conducted with parents .


The primary outcome measure is age - and gender-adjusted child BMI-z score at post-intervention by treatment group .


Secondary household-level outcomes include family meal frequency , home availability of healthful foods ( fruits/vegetables ) and unhealthful foods ( high-fat/sugary snacks ) and beverages ( sugar-sweetened beverages ) , and the quality of foods served at meals and snacks .


Secondary child outcomes include dietary intake of corresponding foods and beverages and screen time .


The HOME Plus RCT actively engages whole families of @-@ year old children to promote healthier eating and activity behaviors and prevent obesity through promotion of family meals and snacks and limited media use .


To determine the effect of active recovery ( AR ) , passive rest ( PR ) , and cold-water immersion ( CWI ) after @ min of intensive cycling on a subsequent @-min time trial ( TT@ ) and the applied pacing strategy in TT@ .


After a maximal test and familiarization trial , @ trained male subjects ( age @ @ y , VO@max @ @ mL min-@ kg-@ ) performed @ experimental trials in the heat ( @C ) .


Each trial consisted of @ exercise tasks separated by @ h.


The first was a @-min constant-load trial at @ % of the maximal power output followed by a @-min time trial ( TT@ ) .


The second comprised a @-min simulated time trial ( TT@ ) .


After TT@ , AR , PR , or CWI was applied for @ min .


No significant TT@ performance differences were observed , but a @-sample t test ( within each condition ) revealed different pacing strategies during TT@ .


CWI resulted in an even pacing strategy , while AR and PR resulted in a gradual decline of power output after the onset of TT@ ( P @ ) .


During recovery , AR and CWI showed a trend toward faster blood lactate ( -LSB- BLa -RSB- ) removal , but during TT@ significantly higher -LSB- BLa -RSB- was only observed after CWI compared with PR ( P = @ ) .


The pacing strategy during subsequent cycling performance in the heat is influenced by the application of different postexercise recovery interventions .


Although power was not significantly altered between groups , CWI enabled a differently shaped power profile , likely due to decreased thermal strain .


Longitudinal assessment of bone marrow lesions ( BMLs ) in knee osteoarthritis ( KOA ) by MRI is usually performed using semi-quantitative grading methods .


Quantitative segmentation methods may be more sensitive to detect change over time .


The purpose of this study was to evaluate and compare the validity and sensitivity to detect changes of two quantitative MR segmentation methods for measuring BMLs in KOA , one computer assisted ( CAS ) and one manual ( MS ) method .


Twenty-two patients with KOA confined to the medial femoro-tibial compartment obtained MRI at baseline and follow-up ( median @ days in between ) .


STIR , T@ and fat saturated T@ post-contrast sequences were obtained using a @ T system .


The @ sagittal STIR sequences were assessed independently by two readers for quantification of BML .


The signal intensities ( SIs ) of the normal bone marrow in the lateral femoral condyles and tibial plateaus were used as threshold values .


The volume of bone marrow with SIs exceeding the threshold values ( BML ) was measured in the medial femoral condyle and tibial plateau and related to the total volume of the condyles/plateaus .


The @ % limits of agreement at baseline were used to determine the sensitivity to change .


The mean threshold values of CAS and MS were almost identical but the absolute and relative BML volumes differed being @ mm@/@ % and @ mm@/@ % in the femur and @ mm@/@ % and @ mm@/@ % in the tibia using CAS and MS , respectively .


The BML volumes obtained by CAS and MS were significantly correlated but the tissue changes measured were different .


The volume of voxels exceeding the threshold values was measured by CAS whereas MS included intervening voxels with normal SI.The @ % limits of agreement were narrower by CAS than by MS ; a significant change of relative BML by CAS was outside the limits of -@ % -@ % whereas the limits by MS were -@ % -@ % .


The BML changed significantly in @ knees using CAS and in @ knees by MS.


CAS was a reliable method for measuring BML and more sensitive to detect changes over time than MS. The BML volumes measured by the two methods differed but were significantly correlated .


Investigate the hypnotic effects of repeated doses of neurokinin-@ receptor antagonist , vestipitant , in primary insomnia .


Randomized , double-blind , placebo-controlled @-day parallel-group study .


Eleven sleep centers in Germany .


One hundred sixty-one patients with primary insomnia .


Patients received vestipitant ( @ mg ) or placebo for @ days ; @-night polysomnographic assessment occurred on nights @/@ and @/@ .


Wake after sleep onset ( WASO ) was improved on nights @/@ and @/@ ( ratio , vestipitant versus placebo -LSB- @ % confidence interval -RSB- : @ -LSB- @ , @ -RSB- , P = @ and @ -LSB- @ , @ -RSB- , P = @ , respectively ) , demonstrating maintenance of the effect following repeated dosing .


Latency to persistent sleep was shorter with vestipitant on nights @/@ ( P = @ versus placebo ) , but not on nights @/@ .


Total sleep time ( TST ) improved with vestipitant ( nights @/@ : P < @ , nights @/@ : P = @ versus placebo ) .


Next-day cognitive function tests demonstrated no residual effects of vestipitant ( P > @ versus placebo ) .


Adverse events ( AEs ) occurred in @ % of vestipitant patients versus @ % for placebo .


Headache was the most common AE ( @ % of vestipitant patients versus @ % for placebo ) .


Vestipitant improved sleep maintenance in patients with primary insomnia , with no associated next-day cognitive impairment .


The effects on wake after sleep onset and total sleep time were maintained following repeated dosing .


There are effective treatments of trichotillomania ( TTM ) , but access to expert providers is limited .


This study tested a stepped care model aimed at improving access .


Participants were @ ( @ % women , @ % Caucasian , @ % Hispanic ) adults ( M = @ years ) with TTM .


They were randomly assigned to immediate versus waitlist ( WL ) conditions for Step @ ( @ weeks of web-based self-help via StopPulling.com ) .


After Step @ , participants chose whether to engage in Step @ ( @ sessions of in-person habit reversal training -LSB- HRT -RSB- ) .


In Step @ , the immediate condition had a small ( d = @ ) but significant advantage , relative to WL , in reducing TTM symptom ratings by interviewers ( masked to experimental condition but not to assessment point ) ; there were no differences in self-reported TTM symptoms , alopecia , functional impairment , or quality of life .


Step @ was more effective for those who used the site more often .


Stepped care was highly acceptable : Motivation did not decrease during Step @ ; treatment satisfaction was high , and @ % enrolled in Step @ .


More symptomatic patients self-selected into HRT , and on average they improved significantly .


Over one third ( @ % ) made clinically significant improvement in self-reported TTM symptoms .


Considering the entire stepped care program , participants significantly reduced symptoms , alopecia , and impairment , and increased quality of life .


For quality of life and symptom severity , there was some relapse by @-month follow-up .


Stepped care is acceptable , and HRT was associated with improvement .


Further work is needed to determine which patients with TTM can benefit from self-help and how to reduce relapse .


Exercise programs targeting muscle strength and balance can reduce falls .


The study aimed to compare the Otago Exercise Program ( OEP ) , originally designed as supervised home training ( HT ) , with the same programme performed as GT , on functional balance and muscle strength , mobility , fall efficacy and self-reported health .


A single-blind randomized controlled trial with assessments at baseline ( T@ ) , following the @-week intervention ( T@ ) , and @ months following intervention ( T@ ) , was performed .


@ people , mean age @ ( SD = @ ) years , @ % women , referred to a Falls Outpatient Clinic , participated .


@ % had fallen , and @ % had a fall-related hospital stay during the previous year .


OEP supervised by physiotherapists was performed as GT twice weekly or as HT three times a week , for @ weeks .


Total exercise time was comparable between groups .


The primary outcome was the Berg Balance Scale assessed at T@ .


From T@-T@ , Berg Balance Scale improved significantly more in the GT group than in the HT group ( mean group difference in change of @ points , @ % CI = @-@ @ , p = @ ) .


Of the secondary outcomes , the @-second sit-to-stand test ( p = @ ) , and physical health measured by the Short Form-@ ( p = @ ) , improved significantly more for the GT group .


Change in mobility measured by the Timed Up and Go test , mental health by the Short Form-@ , and fall efficacy by the Fall Efficacy Scale International did not differ between groups .


The @-second sit-to-stand test and the Timed Up and Go , but not the Berg Balance Scale , was still better in the GT group at T@ .


In fall-prone home-dwelling older people , the OEP performed as GT is more effective for improving functional balance , muscle strength and physical health , but not fall efficacy and mental health than when performed as HT .


The OEP provided as GT should be considered in this population .


This was a prospective , randomized controlled clinical study .


To determine the efficacy of absorbable gelatin sponge in reducing blood loss , as well as shortening the length of hospital stay in patients undergoing multilevel posterior lumbar spinal surgery .


Absorbable gelatin sponge is reported to decrease postoperative drain output and the length of hospital stay after multilevel posterior cervical spine surgery .


However , there is a dearth of literature on prospective study of the efficacy of absorbable gelatin sponge in reducing postoperative blood loss , as well as shortening the length of hospital stay in patients undergoing multilevel posterior lumbar spinal surgery .


A total of @ consecutive patients who underwent multilevel posterior lumbar fusion or posterior lumbar interbody fusion between June @ and June @ were prospectively randomized into one of the @ groups according to whether absorbable gelatin sponge for postoperative blood management was used or not .


Demographic distribution , total drain output , blood transfusion rate , the length of stay , the number of readmissions , and postoperative complications were analyzed .


Total drain output averaged @ mL in the study group and @ mL in the control group ( P = @ ) .


Perioperative allogeneic blood transfusion rate were lower in the Gelfoam group ( @ % vs. @ % , P = @ ) ; moreover , length of stay in patients with the use of absorbable gelatin sponge ( @ d ) was significantly shorter ( P = @ ) than the patients in the control group ( @ d ) .


No patient developed adverse reactions attributable to the absorbable gelatin sponge .


Application of absorbable gelatin sponge at the end of multilevel posterior lumbar fusion can significantly decrease postoperative drain output and length of hospital stay .


The haemostatic system plays an important role in the process of cancer development and spread .


Anticoagulants , mainly low molecular weight heparins , could prolong survival in cancer patients , particularly in patients with lung cancer , beyond prevention of thromboembolic events .


In a multicenter , investigator-initiated , open-label , randomized , sequential study , @ patients with newly-diagnosed , limited-stage small-cell lung cancer were randomized to receive standard chemoradiotherapy or the same therapy plus @,@ IU daily of bemiparin for a maximum of @ weeks .


The primary outcome was progression-free survival .


The study was terminated early due to slow recruitment .


Median progression-free survival was @ days with chemoradiotherapy alone and @ days in the bemiparin group ; hazard ratio , @ ( @ % confidence interval -LSB- CI -RSB- , @-@ @ ) ; p = @ .


Median overall survival was @ days with chemoradiotherapy alone and @ days in the bemiparin group ; hazard ratio , @ ( @ % CI , @-@ @ ) ; p = @ .


The rate of tumor response was similar in both study arms .


There was no significant between-group difference in the rates of major bleeding .


Toxicity related with the experimental treatment was minimal .


The addition of bemiparin to first line therapy with chemoradiotherapy significantly increases survival in patients with newly-diagnosed , limited-stage small-cell lung cancer .


( Funded by the Instituto Cientfico y Tecnolgico , University of Navarra .


ClinicalTrials.gov identifier : NCT@ ) .


To evaluate and compare the results of bipedicle conjunctival flap ( CF ) and cryopreserved amniotic membrane graft ( AMG ) in the treatment of non-viral infectious keratitis resistant to medical treatment .


This prospective randomised interventional study included @ eyes of @ patients with resistant non-viral infectious keratitis .


Twenty eyes received CF and @ eyes received AMG .


In the CF group , there were @ eyes with fungal keratitis , @ eyes with bacterial keratitis and @ eye with Acanthamoeba keratitis .


In the AMG group there were @ eyes with fungal keratitis , @ eyes with bacterial keratitis and @ eyes with Acanthamoeba keratitis .


In the CF group , three ulcers had descemetocele and four ulcers were perforated .


In the AMG group , four ulcers had descemetocele and two ulcers were perforated .


In CF , @ peritomy was done and a bipedicle CF from the upper conjunctiva was dissected from Tenon 's capsule , mobilised to cover the cornea and sutured to episclera .


In AMG , one or two layers of AM were trimmed to fit the ulcer and sutured to the cornea .


The follow-up period was @months .


Successful results were observed in @/@ eyes ( @ % ) in each group .


Postoperatively , no significant differences between the two groups were found regarding success rate ( p = @ ) , epithelialisation time ( p = @ ) or visual acuity improvement ( p = @ ) .


CF and AMG are effective in treatment-resistant infectious keratitis .


They could restore ocular surface integrity and provide metabolic and mechanical support for corneal healing .


For large corneal perforation , it may be better to use another procedure such as penetrating keratoplasty to restore ocular integrity .


Reductions on the clearance from plasma of chylomicrons are associated with atherosclerosis .


Statins improve the removal from plasma of chylomicrons in a dose dependent manner .


There is controversy whether ezetimibe modifies the plasma clearance of chylomicrons .


Effects of ezetimibe alone or in combination with simvastatin were compared with low and high dose of the latter , upon the kinetics of a chylomicron-like emulsion in coronary heart disease ( CHD ) patients .


@ CHD patients were randomized for treatment with ezetimibe @ mg ( group @ ) or simvastatin @ mg ( group @ ) with progression to ezetimibe + simvastatin @/@ mg or simvastatin @ mg , respectively .


Kinetic studies were performed at baseline and after each treatment period of @ weeks .


The fractional catabolic rates ( FCR ) of the emulsion labeled with ( @ ) C-CE and ( @ ) H-TG , that represent respectively chylomicron remnant and triglyceride removal , were calculated .


Comparisons were made by ANOVA .


The ( @ ) CE-FCR in group @ were @ @ , @ @ and @ @ min ( -@ ) and in group @ were @ @ , @ @ and @ @ min ( -@ ) respectively at baseline , after @ and @ weeks ( p < @ vs. baseline , and @ vs. @ weeks ) .


The ( @ ) H-TG-FCR in group @ were @ @ , @ @ and @ @ min ( -@ ) and in group @ were @ @ , @ @ and @ @ min ( -@ ) at baseline , after @ and @ weeks ( p < @ vs. baseline , and @ vs. @ weeks ) .


There were no differences between groups in time .


Both treatments increased similarly the removal from plasma of chylomicron and remnants in CHD patients .


Many older adults are both highly sedentary ( that is , spend considerable amounts of time sitting ) and physically inactive ( that is , do little physical activity ) .


This protocol describes an exploratory trial of a theory-based behaviour change intervention in the form of a booklet outlining simple activities ( ` tips ' ) designed both to reduce sedentary behaviour and to increase physical activity in older adults .


The intervention is based on the ` habit formation ' model , which proposes that consistent repetition leads to behaviour becoming automatic , sustaining activity gains over time .


The intervention is being developed iteratively , in line with Medical Research Council complex intervention guidelines .


Selection of activity tips was informed by semi-structured interviews and focus groups with older adults , and input from a multidisciplinary expert panel .


An ongoing preliminary field test of acceptability among @ older adults will inform further refinement .


An exploratory randomized controlled trial will be conducted within a primary care setting , comparing the tips booklet with a control fact sheet .


Retired , inactive and sedentary adults ( n = @ ) aged @ to @ years , with no physical impairments precluding light physical activity , will be recruited from general practices in north London , UK .


The primary outcomes are recruitment and attrition rates .


Secondary outcomes are changes in behaviour , habit , health and wellbeing over @ weeks .


Data will be used to inform study procedures for a future , larger-scale definitive randomized controlled trial .


Mexico has the highest adult overweight and obesity prevalence in the Americas ; @ % of children < @ years old are at risk for overweight and @ % are already overweight or obese .


Creciendo Sanos was a pilot intervention to prevent obesity among preschoolers in Instituto Mexicano del Seguro Social ( IMSS ) clinics .


We randomized @ IMSS primary care clinics to either @ weekly educational sessions promoting healthful nutrition and physical activity or usual care .


We recruited @ parent-child pairs : @ intervention , @ usual care .


Children were @-@ years old with WHO body mass index ( BMI ) z-score @-@ .


We measured children 's height and weight and parents reported children 's diet and physical activity at baseline and @ and @-month follow-up .


We analyzed behavioral and BMI outcomes with generalized mixed models incorporating multiple imputation for missing values .


@ ( @ % ) intervention and @ ( @ % ) usual care families completed @ and @-month follow-up .


At @ months , intervention v. usual care children increased vegetables by @ servings/week ( @ % CI , @ , @ ) .


In stratified analyses , intervention participants with high program adherence ( @-@ sessions ) decreased snacks and screen time and increased vegetables v. usual care .


No further effects on behavioral outcomes or BMI were observed .


Transportation time and expenses were barriers to adherence .


@ % of parents who completed the post-intervention survey were satisfied with the program .


Although satisfaction was high among participants , barriers to participation and retention included transportation cost and time .


In intention to treat analyses , we found intervention effects on vegetable intake , but not other behaviors or BMI .


The aim of this study is to evaluate dentoskeletal effects of Herbst and Twin Block ( TB ) appliance therapies in Skeletal Class II malocclusion .


Herbst group consisted of @ girls and @ boys ( mean age = @ @ years ) , TB group comprised of @ girls and @ boys ( mean age = @ @ years ) , and control group included @ girls and @ boys ( mean age = @ @ years ) .


Mean treatment/observation times were @ @ months for Herbst , @ @ months for TB , and @ @ months for control group .


Pre-treatment ( T@ ) and post-treatment ( T@ ) lateral cephalograms were traced using a modified Pancherz 's cephalometric analysis .


Inter-group differences were evaluated with one-way analysis of variance , and intra-group differences were assessed with paired samples t-test at the P < @ level .


In control group , all sagittal and vertical skeletal measurements increased as a result of continuing growth .


However , skeletal discrepancy and overjet remained unchanged .


After functional appliance therapy , greater increases were recorded in TB group for all mandibular skeletal measurements compared with those in control group .


Upper dental arch distalization and lower incisor protrusion were significant in Herbst group , compared with control .


All face height measurements increased after functional appliance therapy .


In TB group , the treatment effects were mainly due to mandibular skeletal changes .


Both skeletal and dental changes contribute to Class II correction with Herbst appliance therapy .


Herbst appliance may be especially useful in Skeletal Class II patients with maxillary dentoalveolar protrusion and mandibular dentoalveolar retrusion , whereas TB appliance may be preferred for skeletal mandibular retrognathy patients .


Neuropsychological interventions have been mainly applied with clinical populations , in spite of the need of preventing negative changes across life span .


Among the few studies of cognitive stimulation in elderly , surprisingly there is no enough research comparing direct and indirect active stimulation programs .


This study aims to verify wheter there are differences between two cognitive interventions approaches in older adults : a structured Working Memory ( WM ) Training Program versus a Poetry-based Stimulation Program .


Fourteen older adults were randomly assigned to participate into one of the two intervention groups .


The assessed neurocognitive components were attention , episodic and working memory , communicative and executive functions .


WM Training activities were based on Baddeley 's model ; Poetry-based Stimulation Program was composed by general language activities .


Data were analyzed with one-way ANCOVA with Delta scores and pre and post-training tests raw scores .


WM group improved performance on WM , inhibition , and cognitive flexibility measures , while Poetry group improved on verbal fluency and narrative discourse tasks .


Both approaches presented benefits ; however WM Training improved its target function with transfer effects to executive functions , being useful for future studies with a variety of dementias .


Poetry-based Stimulation also improved complex linguistic abilities .


Both approaches may be helpful as strategies to prevent dysfunctional aging changes .


Caregiver involvement is critical in ensuring optimal adolescent asthma management .


The study investigated whether multisystemic therapy ( MST ) , an intensive home-based family therapy , was superior to family support for changing beliefs regarding asthma-related positive parenting among caregivers of African-American youth with poorly controlled asthma .


The relationship between parenting beliefs and asthma management at the conclusion of the intervention was also assessed .


A randomized controlled trial was conducted with @ adolescents with moderate-to-severe , persistent , poorly controlled asthma and their primary caregivers .


Families were randomly assigned to MST or family support ( FS ) , a home-based family support condition .


Data were collected at baseline and @-month posttest .


Changes in caregiver ratings of importance and confidence for engaging in asthma-related positive parenting were assessed through questionnaire .


Illness management was assessed by the Family Asthma Management System Scale .


Participation in MST was associated with more change in caregiver beliefs as compared with FS for both importance ( t = @ , p = @ ) and confidence ( t = @ , p = @ ) .


Caregiver beliefs were also significantly related to youth controller medication adherence at the conclusion of treatment ( importance : r = @ , p = @ ; confidence : r = @ , p = @ ) .


Results support the effectiveness of MST for increasing parental beliefs in the value of asthma-related positive parenting behaviors and parental self-efficacy for these behaviors among families of minority adolescents with poorly controlled asthma .


To evaluate the effect of moderate intensity aerobic exercise ( @ % -@ % of Heart Rate Reserve ( HRR ) ) on diabetic peripheral neuropathy .


A parallel-group , randomized controlled trial was carried out in a tertiary health care setting , India .


The study comprised of experimental ( moderate intensity aerobic exercise and standard care ) and control groups ( standard care ) .


Population with type @ diabetes with clinical neuropathy , defined as a minimum score of seven on the Michigan Diabetic Neuropathy Score ( MDNS ) , was randomly assigned to experimental and control groups by computer generated random number tables .


RANOVA was used for data analysis ( p < @ was significant ) .


A total of @ patients with DPN were evaluated in the study .


After randomization there were @ patients in the control group and @ patients in the experimental group .


A comparison of two groups using RANOVA for anthropometric measures showed an insignificant change at eight weeks .


For distal peroneal nerve 's conduction velocity there was a significant difference in two groups at eight weeks ( p < @ ) , Degrees of freedom ( Df ) = @ , @ , F = @ , and p = @ .


Sural sensory nerve at eight weeks showed a significant difference in two groups for conduction velocity , Df = @ , @ , F = @ , and p = @ .


Significant differences in mean scores of MDNS were also observed in the two groups at eight weeks ( p value significant < @ ) .


Moderate intensity aerobic exercises can play a valuable role to disrupt the normal progression of DPN in type @ diabetes .


Regular physical activity is known to help prevent and treat numerous non-communicable diseases .


Smartphone applications ( apps ) have been shown to increase physical activity in primary care but little is known regarding the views of patients using such technology or how such technology may change behaviour .


To explore patients ' views and experiences of using smartphones to promote physical activity in primary care .


This qualitative study was embedded within the SMART MOVE randomised controlled trial , which used an app ( Accupedo-Pro Pedometer ) to promote physical activity in three primary care centres in the west of Ireland .


Taped and transcribed semi-structured interviews with a purposeful sample of @ participants formed the basis of the investigation .


Framework analysis was used to analyse the data .


Four themes emerged from the analysis : transforming relationships with exercise ; persuasive technology tools ; usability ; and the cascade effect .


The app appeared to facilitate a sequential and synergistic process of positive change , which occurred in the relationship between the participants and their exercise behaviour ; the study has termed this the ` Know-Check-Move ' effect .


Usability challenges included increased battery consumption and adjusting to carrying the smartphone on their person .


There was also evidence of a cascade effect involving the families and communities of participants .


Notwithstanding technological challenges , an app has the potential to positively transform , in a unique way , participants ' relationships with exercise .


Such interventions can also have an associated cascade effect within their wider families and communities .


The failure of subacromial decompression may be attributed to persistent symptoms of acromioclavicular joint ( ACJ ) arthritis , while inferior clavicular spurs of the ACJ may be associated with failed healing of repaired rotator cuffs .


To evaluate the clinical effectiveness of arthroscopic distal clavicle resection ( DCR ) in patients with rotator cuff tears and concomitant asymptomatic radiological ACJ arthritis .


Randomized controlled trial ; Level of evidence , @ .


A total of @ patients with rotator cuff tears in addition to radiological and asymptomatic ACJ arthritis who were scheduled for arthroscopic rotator cuff repair were prospectively randomized into @ groups .


Patients underwent arthroscopic rotator cuff repair with acromioplasty .


Patients in group @ ( @ patients ) underwent additional arthroscopic DCR , while patients in group @ ( @ patients ) did not .


Clinical outcomes of the @ groups were compared using the visual analog scale ( VAS ) for pain , range of motion , Constant score , and American Shoulder and Elbow Surgeons ( ASES ) score up to at least @ months .


The structural integrity of repaired rotator cuffs was assessed using ultrasonography , computed tomography arthrography , or MRI at least @ months after surgery .


To evaluate ACJ instability , weighted stress radiography of the ACJ was studied at @ and @ months postoperatively .


Patients in both groups showed significant improvement in the VAS score and all functional scores at final follow-up ( mean , @ months ; range , @-@ months ) without significant differences between the @ groups ( P > @ ) .


Results ( mean SD ) for preoperative group @/group @ and postoperative group @/group @ were as follows , respectively : @ @ / @ @ ( P = @ ) and @ @ / @ @ ( P = @ ) for the VAS score , @ @ / @ @ ( P = @ ) and @ @ / @ @ ( P = @ ) for the Constant score , and @ @ / @ @ ( P = @ ) and @ @ / @ @ ( P = @ ) for the ASES score .


Failed cuff healing occurred in @ patients ( @ % ) in group @ and @ patients ( @ % ) in group @ , with no significant difference ( P = @ ) .


In group @ , there were @ patients ( @ % ) with ACJ subluxation on weighted stress radiography at @ months postoperatively .


These patients complained of gross protrusion and ACJ tenderness .


Preventive arthroscopic DCR in patients with rotator cuff tears and concomitant asymptomatic radiological ACJ arthritis did not result in better clinical or structural outcomes , and it did lead to symptomatic ACJ instability in some patients .


Preventive arthroscopic DCR is not recommended in patients with radiological but asymptomatic ACJ arthritis .


Further long-term follow-up is needed to confirm the development of symptoms in ACJ arthritis .


A prospective double-blind randomized control trial ( RCT ) to evaluate the benefit of a combinatorial , five gene pharmacogenomic test and interpretive report ( GeneSight ) for the management of psychotropic medications used in the treatment of major depression in an outpatient psychiatric practice .


Depressed adult outpatients were randomized to a treatment as usual ( TAU , n = @ ) arm or a pharmacogenomic-informed GeneSight ( n = @ ) arm .


Subjects were blinded to their treatment group and depression severity was assessed by blinded study raters .


Within two days of enrollment , clinicians of subjects in the guided group received the GeneSight report that categorized each of @ psychotropic medications within a green , yellow , or red `` bin '' based on the relationship of each medication to a subject 's pharmacokinetic and pharmacodynamic combinatorial gene variant profile .


Antidepressant medication changes began within @ weeks after baseline assessments .


Depression severity was assessed by blinded study raters using the HAMD-@ , PHQ-@ , QIDS-SR , and QIDS-CR administered @ , @ , and @ weeks after baseline assessment .


Between-group trends were observed with greater than double the likelihood of response and remission in the GeneSight group measured by HAMD-@ at week @ .


Mean percent improvement in depressive symptoms on HAMD-@ was higher for the GeneSight group over TAU ( @ % vs @ % ; p = @ ) .


TAU subjects who had been prescribed medications at baseline that were contraindicated based on the individual subject 's genotype ( i.e. , red bin ) had almost no improvement ( @ % ) in depressive symptoms measured by HAMD-@ at week @ , which was far less than the @ % improvement ( p = @ ) in the pharmacogenomic guided subjects who started on a red bin medication and the @ % improvement in GeneSight subjects overall ( p = @ ) .


Pharmaco-genomic-guided treatment with GeneSight doubles the likelihood of response in all patients with treatment resistant depression and identifies @ % of patients with severe gene-drug interactions who have the greatest improvement in depressive symptoms when switched to genetically suitable medication regimens .


To determine the relation between time to surgery ( TTS ) after neoadjuvant chemoradiotherapy ( nCRT ) and pathologically complete response ( pCR ) , surgical outcome , and survival in patients with esophageal cancer .


Standard treatment for potentially curable esophageal cancer is nCRT plus surgery after @ to @ weeks .


In rectal cancer patients , evidence suggests that prolonged TTS is associated with a higher pCR rate and possibly with better survival .


We identified patients treated with nCRT plus surgery for esophageal cancer between @ and @ .


TTS ( last day of radiotherapy to day of surgery ) varied mainly for logistical reasons .


Minimal follow-up was @ months .


The effect of TTS on pCR rate , postoperative complications , and survival was determined with ( ordinal ) logistic , linear , and Cox regression , respectively .


In total , @ patients were included .


Median TTS was @ days ( p@-p@ = @-@ ) .


After @ days , TTS was associated with an increased probability of pCR -LSB- odds ratio ( OR ) = @ per additional week of TSS , P = @ -RSB- and a small increased risk of postoperative complications ( OR = @ , P < @ ) .


Prolonged TTS had no effect on disease-free and overall survivals ( HR = @ and HR = @ per additional week of TSS , P = @ and P = @ , respectively ) .


Prolonged TTS after nCRT increases the probability of pCR and is associated with a slightly increased probability of postoperative complications , without affecting disease-free and overall survivals .


We conclude that TTS can be safely prolonged from the usual @ to @ weeks up to at least @ weeks , which facilitates a more conservative wait-and-see strategy after neoadjuvant chemoradiotherapy to be tested .


Overnight lens wear is associated with increased lens contamination and risk of developing a corneal infiltrate or infectious event .


Antibacterial lenses have been proposed as a potential strategy for reducing lens contamination .


A proof-of-principle study was conducted to investigate what effect control of potential pathogens , through the use of antibiotic eye drops , would have on the incidence of corneal infiltrative events ( CIEs ) and on the ocular microbiota and lens contamination .


This is a prospective , open-label , controlled , parallel-group , @-month clinical study in which @ subjects were dispensed with lotrafilcon A silicone hydrogel lenses for @ days of continuous wear .


Subjects were randomized into either test ( moxifloxacin @ % ) or control ( rewetting solution ) group .


One drop was instilled into each eye on waking and before sleeping , while lenses were on-eye .


Follow-ups were conducted after one night and @ month .


Lid margin swabs were taken at baseline and at @ month and worn lenses were aseptically collected at @ month .


The incidence of CIEs was not significantly different between the test ( @ % ) and control ( @ % ) groups ( p = @ ) .


Microorganism levels from the test group swabs were significantly lower than those from the control group ( p = @ ) .


Gram-positive bacteria were less frequently recovered from lower lid swabs from the test group ( @ % vs. @ % -LSB- p < @ -RSB- , test vs. control , respectively ) or from contact lens samples ( @ % vs. @ % -LSB- p = @ -RSB- , test vs. control , respectively ) , but there was no difference in gram-negative bacteria ( GNB ) .


Corneal infiltrative events were associated with higher levels of lens contamination ( p = @ ) and contamination of lenses with GNB ( CIE : @ % vs. @ % -LSB- p = @ -RSB- , GNB contamination vs. no GNB contamination , respectively ) .


Twice-daily antibiotic instillation during continuous wear of lenses did not significantly influence the rate of inflammatory events .


Corneal infiltrative events were associated with higher levels of lens contamination in general and with contamination by GNB specifically .


We aimed to investigate the effect of electroacupuncture at Zusanli ( ST@ ) and Sanyinjiao ( SP@ ) on adrenocortical function in patients with etomidate anesthesia .


We randomly divided @ patients who underwent elective surgery into @ groups : group etomidate ( ETO ) , group etomidate + electroacupuncture ( ETO+EA ) , group etomidate + sham acupuncture ( ETO+SEA ) , and group propofol ( PRO ) .


The patients in group ETO , ETO+EA , and ETO+SEA were induced with etomidate and sufentanil and maintained with intravenous infusion of etomidate and remifentanil .


Group PRO was induced with propofol and sufentanil and maintained with propofol and remifentanil .


Group ETO+EA received electro-acupuncture stimulation at Zusanli and Sanyinjiao throughout the operation , while group ETO+SEA received electro-acupuncture stimulation at non-acupoints .


We recorded the values of MAP , HR , BIS , CVP , cortisol , ACTH , epinephrine , norepinephrine , and arterial blood gas during the perioperative period .


Cortisol concentrations were significantly higher at all times except T@ in group ETO+EA compared with group ETO .


The ACTH concentrations were lower in group ETO+EA than that in group ETO at point T@ .


Electroacupuncture at ST @ and SP @ can mitigate the adrenal cortical inhibition induced by etomidate and can reduce the secretion of catecholamines during surgery .


The main component in tocotrienols ( T@ ) from barley ( Hordeum vulgare L. ) is - T@ , the vitamer with the highest bioavailability , while palm oil T@ is particularly rich in - T@ .


Unlike tocopherols , T@ are known for their cholesterogenesis-inhibiting , neuroprotective and anticarcinogenic properties .


In this study the oral bioavailabilities of T@ from barley oil ( @ mgday ) and T@ from palm oil ( @ mgday ) in nanoemulsified formulations ( NE ) and self-emulsifying systems ( SES ) were compared using hen 's eggs as a bioindicator .


In addition , the transfer efficiencies of barley oil T@ and palm oil T@ into egg yolk were compared , as well as their effects on egg cholesterol levels .


Nanoemulsification led to T@ levels ( @ g per egg ) higher than with non-emulsified barley oil ( @ g per egg ) and barley oil SES ( @ g per egg ) owing to the high proportions of - T@ ( @-@g per egg ) , which has a particularly high transfer efficiency ( @-@ @ % ) .


T@ contents of eggs from hens fed barley oil supplements ( @-@g per egg ) were significantly higher than those of eggs from hens fed palm oil supplements ( @-@g per egg ) .


Addition of barley and palm oils to laying hen feed decreased egg yolk cholesterol by @ and @ % respectively .


Results from this animal study may help to establish T@ from barley as a dietary supplement and to develop nutritionally improved hen 's eggs .


We aimed to determine the persistence of glycaemic control @ year after a limited period of intensive glycaemic management of type @ diabetes .


@ ACCORD Trial participants randomised to target HbA@c < @ % ( @ mmol/mol ) for @ @ years were systematically transitioned to target HbA@c @-@ @ % ( @-@ mmol/mol ) and followed for an additional @ @ years .


Characteristics of participants with HbA@c < @ % ( @ mmol/mol ) or @ % at transition were compared .


Changes in BMI and glucose-lowering medications were compared between those ending with HbA@c < @ % vs @ % .


Poisson models were used to assess the independent effect of attaining HbA@c < @ % before transition on ending with HbA@c < @ % .


Participants with pre-transition HbA@c < @ % were older with shorter duration diabetes and took less insulin but more non-insulin glucose-lowering agents than those with higher HbA@c .


A total of @ participants achieved a final HbA@c < @ % , and had greater post-transition reductions in BMI , insulin dose and secretagogue and acarbose use than those with higher HbA@c ( p < @ ) .


HbA@c < @ % at transition predicted final HbA@c < @ % ( crude RR @ -LSB- @ % CI @ , @ -RSB- ; RR @ -LSB- @ % CI @ , @ -RSB- adjusted for demographics , co-interventions , pre-intervention HbA@c , BMI and glucose-lowering medication , and post-transition change in both BMI and glucose-lowering medication ) .


Progressively lower pre-transition HbA@c levels were associated with a greater likelihood of maintaining a final HbA@c of < @ % .


Follow-up duration was not associated with post-transition rise in HbA@c .


Time-limited intensive glycaemic management using a combination of agents that achieves HbA@c levels below @ % in established diabetes is associated with glycaemic control more than @ year after therapy is relaxed .


Despite amiodarone 's established safety profile in the setting of heart failure , it is unknown whether its impact on cardiovascular outcomes in patients with atrial fibrillation is modulated by left ventricular function .


A pooled analysis of @,@ patients ( age @ @ years ; @ % female ) enrolled in AFFIRM and AF-CHF trials was conducted to assess the effect of rhythm control with amiodarone on cardiovascular outcomes , according to left ventricular systolic function .


In amiodarone-treated patients ( N = @,@ ) , freedom from recurrent atrial fibrillation was @ % and @ % at @ and @ years , respectively , with no differences according to left ventricular function ( P = @ ) .


Similarly , the adjusted proportion of time spent in atrial fibrillation ( @ @ % ) did not vary according to ventricular function ( P = @ ) .


Over @ @ months of follow-up , @,@ ( @ % ) patients required at least one hospitalization , @,@ ( @ % ) of whom had cardiovascular-related hospitalizations .


Adjusted all-cause and cardiovascular hospitalization rates were similar with amiodarone versus rate control in all patients and in subgroups with and without severe left ventricular dysfunction .


A total of @ ( @ % ) patients died , @ ( @ % ) from cardiovascular causes .


Adjusted all-cause and cardiovascular mortality rates were similar with amiodarone versus rate control overall and in subgroups with and without severe left ventricular dysfunction .


Amiodarone 's efficacy in maintaining sinus rhythm and reducing the burden of atrial fibrillation is similar in the presence or absence of severe left ventricular dysfunction .


Rhythm control with amiodarone is associated with comparable hospitalization and mortality rates to rate control in patients with and without left ventricular dysfunction .


Although ablative fractional laser is the gold standard for acne scars , evidence is still lacking for other types of scars .


To evaluate the efficacy and safety of the ablative fractional @,@-nm CO@ laser in the treatment of various scar types .


The authors performed an intraindividual single-blinded randomized controlled split-lesion trial .


Adult patients received @ laser treatments at @-week intervals for scars existing at least @ year .


Primary end points were the Physician Global Assessment ( PhGA ) and the assessment of adverse effects .


Twenty-five consecutive patients with atrophic ( @ % ) or hypertrophic ( @ % ) scars located mainly on the body ( @ % ) were included in the study .


At @-month follow-up of @ patients , the PhGA showed no statistically significant difference between the treated and untreated side of the scar ( p = @ ) .


Persistent erythema , postinflammatory pigmentary changes , and scarring after ulceration ( n = @ ) were observed as side effects .


In this trial involving various types of scars , the efficacy of ablative fractional CO@ laser could not be confirmed .


The authors presume that different types of scars have a different response to treatment .


Future studies should aim to identify the type of scars that may benefit from ablative fractional laser therapy .


Left ventricular dysfunction ( LVD ) is a complex , multifactorial condition , caused by mechanical , neurohormonal , and genetic factors .


We have previously observed association of renin-angiotensin-aldosterone system ( RAAS ) , matrix metalloproteinases ( MMPs ) and inflammatory pathway genes with LVD .


Therefore the present study was undertaken to identify the combination of genetic variants and their possible interactions contributing towards genetic susceptibility to LVD in the background of coronary artery disease ( CAD ) .


The study included @ healthy controls and @ consecutive patients with angiographically confirmed CAD .


Among them , @ with reduced left ventricle ejection fraction ( LVEF@ % ) were categorized as having LVD .


We analyzed @ polymorphisms of RAAS , MMPs and inflammatory pathways .


Single locus analysis showed that AT@ A@C ( p value < @ ; OR = @ ) , MMP@ R@Q ( p value = @ ; OR = @ ) and NFKB@-@ ATTG ins/del ( p value = @ ; OR = @ ) polymorphisms were independently associated with LVD when compared with both non-LVD patients and healthy controls .


High-order gene-gene interaction analysis , using classification and regression tree ( CART ) and multifactor dimensionality reduction ( MDR ) revealed that AT@ A@C and NFKB@-@ ATTG ins/del polymorphisms jointly increased the risk of LVD to great extent ( p-value = @ ; OR = @ ) and best four-factor interaction model consisted of AT@ A@C , MMP@ A-@G , MMP@ R@Q and NFKB@-@ ATTG ins/del polymorphisms with testing accuracy of @ and cross validation consistency ( CVC ) = @/@ ( permutation p < @ ) showed increased risk for LVD respectively .


AT@ A@C independently and in combination with MMP@ R@Q and NFKB@-@ ATTG ins/del polymorphisms plays important role in conferring genetic susceptibility to LVD in CAD patients .


Percutaneous treatment of complex coronary bifurcation lesions remains challenging , even in the drug-eluting stent era .


We sought to evaluate the baseline and @ months intravascular ultrasound ( IVUS ) analysis of the Axxess stent , a self-expanding , Biolimus A@-eluting , and dedicated bifurcation stent .


We enrolled the first @ patients from selected sites of the @ patients large DIVERGE trial ( a prospective , single-arm , multicenter trial evaluating the safety and efficacy of the Axxess stent ) .


Both baseline and @ months IVUS images were collected for serial two-dimensional ( @D ) and @D analysis .


A minimal amount and a low percentage of neointimal volume index were seen in the Axxess stent at @ months ( @ mm ( @ ) / mm and @ % , respectively ) .


Vessel , lumen , and stent volume indices increased significantly ( respectively , @ to @ mm ( @ ) / mm , P < @ ; @ to @ mm ( @ ) / mm , P < @ ; and @ to @ mm ( @ ) / mm , P < @ ) .


This resulted in minimum lumen area ( MLA ) enlargement ( @ to @ mm ( @ ) , P < @ ) , whereas peristent plaque area decreased ( @ to @ mm ( @ ) / mm , P = @ ) .


At @ months , @ ( @ % ) incomplete stent apposition ( ISA ) persisted from baseline , while six resolved ( @ % ) .


Only one ( @ % ) ISA was late acquired .


In the additional distal sirolimus-eluting stents , MLA decreased from @ to @ mm ( @ ) ( P = @ ) at @ months for the main branch , and from @ to @ mm ( @ ) ( P = @ ) for the side branch .


The dedicated bifurcation Axxess stent system demonstrates significant stent volume increase with minimal neointimal formation and a low incidence of late-acquired ISA at @ months .


The efficacy and safety of collagenase clostridium histolyticum ( CCH ) in patients with Dupuytren 's contracture ( DC ) was demonstrated in a program including two pivotal phase @ clinical trials ( CORD I and II ) which included patients with a broad range of disease severity .


This analysis assessed the efficacy and safety of CCH in the subpopulation of DC patients with up to two joints affected and moderate disease according to British Society of Surgery of the Hand classification .


This was in support of a resubmission to the Scottish Medicines Consortium .


A post-hoc analysis that included data from patients with up to two joints affected and moderate disease treated with CCH during the randomized and open-label phases of CORD I and II .


Of @ patients who received CCH during the two trials , @ had one or two joints affected and moderate disease .


Sixty-seven joints were treated ; @ patients received treatment for one joint , and @ patients received treatment for two joints .


Each patient received an average of @ injections of CCH per joint .


Of @ evaluable joints , @ % met the primary endpoint of clinical success ( reduction in contracture to @ of full extension @ days after the last injection ) .


This was similar if only primary joints were considered ( @ % achieved clinical success ) .


Recurrence at @ months ( increase in joint contracture to @ in the presence of a palpable cord in joints that had attained clinical success ) was observed in @ % of joints .


Reported adverse events were mild to moderate in intensity ; none resulted in discontinuation .


CORD I and II show that CCH is well tolerated and effective in the treatment of DC in a broad population .


The present analysis suggests that CCH has particular value in patients with moderate severity disease and up to two joints affected .


This analysis used data from both the randomized and open-label phases of CORD I and II ; therefore , it is not possible to present comparative data for this subpopulation .


As this was a post-hoc analysis in a relatively small patient subpopulation , statistical comparisons with the full population were not considered appropriate .


Furthermore , the small sample size means that additional subgroup analyses , for example of patients by previous treatment or number of injections administered , are not appropriate .


Nevertheless , the data presented demonstrate that CCH is both well tolerated and effective in this population when managed by appropriately trained individuals .


International guidelines recommend use of targeted temperature management following resuscitation from out-of-hospital cardiac arrest .


This treatment , however , is often neglected or delayed .


To determine whether multifaceted quality improvement interventions would increase the proportion of eligible patients receiving successful targeted temperature management .


A network of @ regional emergency medical services systems and @ academic and community hospitals serving a population of @ million people providing post arrest care to out-of-hospital cardiac arrest .


Comparing interventions improve the implementation of targeted temperature management post out-of-hospital cardiac arrest through passive ( education , generic protocol , order set , local champions ) versus additional active quality improvement interventions ( nurse specialist providing site-specific interventions , monthly audit-feedback , network educational events , internet blog ) versus no intervention ( baseline standard of care ) .


The primary process outcome was proportion of eligible patients receiving successful targeted temperature management , defined as a target temperature of @-@C within @ hours of emergency department arrival .


Secondary clinical outcomes included survival and neurological outcome at hospital discharge .


Four thousand three hundred seventeen out-of-hospital cardiac arrests were transported to hospital ; @,@ ( @ % ) achieved spontaneous circulation , and @ ( @ % ) were eligible for targeted temperature management .


After accounting for secular trends , patients admitted during the passive quality improvement phase were more likely to achieve successful targeted temperature management compared with those admitted during the baseline period ( @ % passive vs @ % baseline ; odds ratio , @ ; @ % CI , @-@ @ ; p < @ ) .


Active quality improvement interventions conferred no additional improvements in rates of successful targeted temperature management ( @ % active vs @ % passive ; odds ratio , @ ; @ % CI , @-@ @ ; p = @ ) .


Despite a significant increase in rates of successful targeted temperature management , survival to hospital discharge was unchanged .


Simple quality improvement interventions significantly increased the rates of achieving successful targeted temperature management following out-of-hospital cardiac arrest in a large network of hospitals but did not improve clinical outcomes .


To investigate the efficacy and adverse effect of DCF regimen with subsequent S-@ maintenance chemotherapy in patients with advanced gastric cancer ( AGC ) .


Sixty AGC patients without disease progression after @ to @ cycles of DCF regimen as the first-line chemotherapy were randomized into maintenance group and control group ( @ patients each ) .


The patients in the maintenance group received maintenance chemotherapy with S-@ ( @ mg/m ( @ ) , twice daily for @ days ; @ days for a treatment cycle ) until disease progression or with intolerant toxicity , and those in the control group received optimal supportive care .


The response rate ( CR+PR ) was @ % in the maintenance group , significantly higher than that in the control group ( @ % , P < @ ) , and the disease control rate ( CR+PR+SD ) also differed significantly between the two groups ( @ % vs @ % , P < @ ) .


The median time to progression was @ months in the maintenance group and @ months in the control group , with median overall survival time of @ and @ months , respectively ( P > @ ) .


The most common adverse effect in the maintenance group included nausea , vomiting , leucocytopenia , and hand-foot syndrome ; no death occurred in relation to the therapy .


S-@ maintenance chemotherapy , with a tolerable toxicity profile , can improve the RR , DCR and median time to progression in AGC patients who respond to DCF regimen , but its efficacy still awaits further evaluation .


Those affected by advanced fibrotic interstitial lung diseases ( ILDs ) have considerable unmet symptom and psychological needs .


Case conferencing has been proposed to address these issues , but requires evaluation .


To obtain preliminary information on the impact of a case conference intervention delivered in the home ( Hospital@Home ) on palliative care concerns of patients and their carers , and to evaluate feasibility and acceptability .


Hospital@Home was trialled at a specialist centre using a Phase II fast-track randomised controlled trial with qualitative interviews .


The primary outcome for effect was mean change from baseline of Palliative Care Outcome Scale ( POS ) ( a measure of symptoms and concerns ) at @weeks .


Secondary outcomes included symptom control , quality of life , consent and recruitment rates and percentage of patients in the fast-track group receiving case conferences within @days .


@ patients were recruited ( @ fast-track , @ controls ) .


Mean ( SD ) POS scores at @weeks were -@ ( @ ) fast-track vs -@ ( @ ) control , ( mean change difference between the two arms was -@ ( @ % CI -@ to -@ ) independent t test p = @ ) ; effect size ( @ % CI ) -@ ( -@ to -@ ) .


The secondary outcomes of quality of life , anxiety and depression were superior in the fast-track arm , and none were worse .


Qualitative findings corroborate these data .


Recruitment was successful and @/@ ( @ % ) of eligible patients consented .


@/@ ( @ % ) had case conferences within @days .


Community case conferences improve palliative symptoms and quality of life after @weeks .


Hospital@Home for the most part is both feasible and acceptable .


It now requires further testing in multicentre trials .


To compare the efficacy of mitiglinide and sitagliptin , alone or in combination , on postprandial excursion and glycemic variability assessed by continuous glucose monitoring ( CGM ) in a single-day treatment setting .


This was a post hoc analysis of a randomized crossover study comparing the efficacy of sitagliptin , mitiglinide and the combination of these two drugs .


Twenty-four hour CGM was performed before and after a single-day treatment with each drug alone or in combination .


Mean glucose levels were decreased in all groups .


The average of three postprandial glucose excursions AUC ( average of all three @-h postprandial periods throughout the day ) ( AUCpp-average ) decreased in the mitiglinide and combination treatment groups , but not in the sitagliptin group .


The lowering effect on AUCpp-average was greater in patients given mitiglinide ( -@ mg/dl , p < @ ) or combination treatment ( -@ mg/dl , p < @ ) compared with sitagliptin alone ( -@ mg/dl ) .


The reduction in mean amplitude of glycemic excursion was greater with mitiglinide ( -@ mg/dl , p < @ ) and combination treatment ( -@ mg/dl , p < @ ) than with sitagliptin alone ( -@ mg/dl ) .


Mitiglinide or combination treatment resulted in lower glycemic variability and postprandial glucose excursion than sitagliptin alone ; however , the results of this single-day pharmacodynamics study can not be generalized to a clinical setting .


Patients undergoing coronary bypass grafting ( CABG ) are at higher risk if they suffer from atrial fibrillation ( AF ) .


It was suggested that performing CABG without the use of cardiopulmonary bypass ( off-pump ) would reduce perioperative risk .


We assessed the influence of preoperative AF on outcome in a randomized cohort of patients above the age of @ undergoing either on-pump or off-pump CABG .


The German Off-Pump Coronary Artery Bypass grafting in the Elderly trial , a randomized , controlled multicentre trial conducted at @ German institutions , enrolled @ patients between @ and @ .


The presence of AF was recorded at admission and discharge .


There was no record on the rhythm status during hospital stay .


AF at admission was present in @ % in the on-pump ( @/@ ) and @ % in the off-pump ( @/@ ) group .


The number of patients with AF at discharge was not different between these two groups ( @ % on pump , @ % off pump ) .


As expected , AF patients had worse preoperative conditions , which had a negative impact on outcome : The combined end-point of death , infarction , stroke , dialysis and revascularization occurred more often ( @ vs @ % , P = @ ) and @-day mortality was significantly higher ( @ vs @ % , P = @ ) in AF patients .


However , the operative technique used for CABG did not affect these outcome parameters .


AF at admission is a significant risk factor for elderly patients undergoing coronary bypass grafting .


However , this risk is not altered by performing bypass grafting off pump .


The purpose is to determine whether patching during carotid endarterectomy ( CEA ) affects the perioperative and long-term risks of restenosis , stroke , death , and myocardial infarction as compared with primary closure .


We identified all patients who were randomized and underwent CEA in Carotid Revascularization Endarterectomy versus Stenting Trial .


CEA patients who received a patch were compared with patients who underwent CEA with primary closure without a patch .


We compared periprocedural and @-year event rates , @-year restenosis rates , and rates of reoperation between the @ groups .


We further analyzed results by surgeon specialty .


There were @ patients who underwent CEA ( @ -LSB- @ % -RSB- with patch and @ -LSB- @ % -RSB- with primary closure ) .


We excluded @ patients who underwent eversion CEA and @ patients missing CEA data ( @ % ) .


Patch use differed by surgeon specialty : @ % of vascular surgeons , @ % of neurosurgeons , and @ % of thoracic surgeons patched .


Comparing patients who received a patch versus those who did not , there was a significant reduction in the @-year risk of restenosis , and this persisted after adjustment by surgeon specialty ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


There were no significant differences in the rates of periprocedural stroke and death ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) , in immediate reoperation ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) , or in the @-year risk of ipsilateral stroke ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P = @ ) .


Patch closure in CEA is associated with reduction in restenosis although it is not associated with improved clinical outcomes .


Thus , more widespread use of patching should be considered to improve long-term durability .


Both acute myocardial ischemia and reperfusion contribute to cardiomyocyte death in ST-elevation myocardial infarction ( STEMI ) .


The final infarct size is the principal determinant of subsequent clinical outcome in STEMI patients .


In a proof-of-concept phase II trial , the administration of cyclosporine prior to primary percutaneous coronary intervention ( PPCI ) has been associated with a reduction of infarct size in STEMI patients .


CIRCUS is an international , prospective , multicenter , randomized , double-blinded , placebo-controlled trial .


The study is designed to compare the efficacy and safety of cyclosporine versus placebo , in addition to revascularization by PPCI , in patients presenting with acute anterior myocardial infarction within @ hours of symptoms onset and initial TIMI flow @ in the culprit left anterior descending coronary artery .


Patients are randomized in a @:@ fashion to @ mg/kg intravenous infusion of cyclosporine or matching placebo performed in the minutes preceding PCI .


The primary efficacy end point of CIRCUS is a composite of @-year all-cause mortality , rehospitalization for heart failure or heart failure worsening during initial hospitalization , and left ventricular adverse remodeling as determined by sequential transthoracic echochardiography .


Secondary outcomes will be tested using a hierarchical sequence of left ventricular ( LV ) ejection fraction and absolute measurements of LV volumes .


The composite of death and rehospitalization for heart failure or heart failure worsening during initial hospitalization will be further assessed at three years after the initial infarction .


Recruitment lasted from April @ to February @ .


The CIRCUS trial has recruited @ patients with acute anterior myocardial infarction .


The @-months results are expected to be available in @ .


The CIRCUS trial is testing the hypothesis that cyclosporine in addition to early revascularization with PPCI compared to placebo in patients with acute anterior myocardial infarction reduces the incidence of death , heart failure and adverse LV remodeling at one-year follow-up .


Patients with frequent asthma exacerbations resulting in emergency department ( ED ) visits are at increased risk for future exacerbations .


We examined the ability of @ dose of benralizumab , an investigational antiinterleukin @ receptor monoclonal antibody , to reduce recurrence after acute asthma exacerbations .


In this randomized , double-blind , placebo-controlled study , eligible subjects presented to the ED with an asthma exacerbation , had partial response to treatment , and greater than or equal to @ additional exacerbation within the previous year .


Subjects received @ intravenous infusion of placebo ( n = @ ) or benralizumab ( @ mg/kg , n = @ or @ mg/kg , n = @ ) added to outpatient management .


The primary outcome was the proportion of subjects with greater than or equal to @ exacerbation at @ weeks in placebo vs the combined benralizumab groups .


Other outcomes included the time-weighted rate of exacerbations at week @ , adverse events , blood eosinophil counts , asthma symptom changes , and health care resource utilization .


The proportion of subjects with greater than or equal to @ asthma exacerbation at @ weeks was not different between placebo and the combined benralizumab groups ( @ % vs @ % ; P = @ ) .


However , compared with placebo , benralizumab reduced asthma exacerbation rates by @ % ( @ vs @ ; P = @ ) and exacerbations resulting in hospitalization by @ % ( @ vs @ ; P = @ ) in the combined groups .


Benralizumab reduced blood eosinophil counts but did not affect other outcomes , while demonstrating an acceptable safety profile .


When added to usual care , @ dose of benralizumab reduced the rate and severity of exacerbations experienced over @ weeks by subjects who presented to the ED with acute asthma .


The aim was to study the impact of dietary intervention on the properties of paraffin-stimulated saliva , and on dental caries .


At @ months of age @ infants ( @ intervention ; @ controls ) started in the prospective , randomized Special Turku Intervention Project ( STRIP ) aimed at restricting the child 's saturated fat and cholesterol intake to prevent atherosclerosis of adult age ( www.clinicaltrials.gov NCT @ ) .


At @ years of age , every fifth child was invited to an oral sub-study , and @ ( @ boys ) children attended .


At @ , @ , @ and @ years of age @ , @ , @ and @ children were restudied , respectively .


Dietary intakes of carbohydrates , protein , saturated fat , calcium , phosphate , and fibre were regularly recorded using @-day food records .


Height and weight were regularly monitored .


Paraffin-stimulated saliva samples were collected at @ , @ , @ and @ years of age , and analyzed for flow rate , buffer capacity , calcium , phosphate and proteins .


Dental health was recorded and expressed as d@mft/D@MFT , and as time of caries onset .


Dietary intakes of calcium , phosphate and fibre , and salivary flow rate increased with time in both groups ( p < @ , GLM for repeated measures ) .


Fibre intake and salivary flow rate were higher in the intervention than in the control group ( p = @ and p = @ , respectively , GLM for repeated measures ) .


There were no correlations between dietary intakes and salivary concentrations of calcium or phosphate .


Children who did not have caries experience ( d@mft/D@MFT = @ ) during the entire follow-up had higher salivary calcium than those who had caries already at @ years of age .


The association between salivary calcium and caries onset was significant up to @ years of age .


Toothbrushing frequency was statistically significantly associated with caries-onset at ages @ ( gamma statistic @ , p = @ ) and @ years ( gamma statistic @ , p = @ ) .


The current long-term dietary intervention increased children 's paraffin-stimulated salivary flow rate .


The concentration of salivary calcium was directly correlated to dental health .


Higher salivary flow rate in the intervention group is believed to be due to higher fibre intake in the intervention group .


Dulaglutide and liraglutide , both glucagon-like peptide-@ ( GLP-@ ) receptor agonists , improve glycaemic control and reduce weight in patients with type @ diabetes .


In a head-to-head trial , we compared the safety and efficacy of once-weekly dulaglutide with that of once-daily liraglutide in metformin-treated patients with uncontrolled type @ diabetes .


We did a phase @ , randomised , open-label , parallel-group study at @ sites in nine countries between June @ , @ , and Nov @ , @ .


Patients with inadequately controlled type @ diabetes receiving metformin ( @ mg/day ) , aged @ years or older , with glycated haemoglobin ( HbA@c ) @ % or greater ( @ mmol/mol ) and @ % or lower ( @ mmol/mol ) , and body-mass index @ kg/m ( @ ) or lower were randomly assigned to receive once-weekly dulaglutide ( @ mg ) or once-daily liraglutide ( @ mg ) .


Randomisation was done according to a computer-generated random sequence with an interactive voice response system .


Participants and investigators were not masked to treatment allocation .


The primary outcome was non-inferiority ( margin @ % ) of dulaglutide compared with liraglutide for change in HbA@c ( least-squares mean change from baseline ) at @ weeks .


Safety data were collected for a further @ weeks ' follow-up .


Analysis was by intention to treat .


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


We randomly assigned @ patients to receive once-weekly dulaglutide ( @ patients ) or once-daily liraglutide ( @ patients ) .


@ participants in each group completed treatment at week @ .


Least-squares mean reduction in HbA@c was -@ % ( SE @ ) in the dulaglutide group and -@ % ( @ ) in the liraglutide group .


Mean treatment difference in HbA@c was -@ % ( @ % CI -@ to @ , pnon-inferiority < @ ) between the two groups .


The most common gastrointestinal adverse events were nausea ( @ -LSB- @ % -RSB- in dulaglutide group vs @ -LSB- @ % -RSB- in liraglutide group ) , diarrhoea ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , dyspepsia ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , and vomiting ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , with similar rates of study or study drug discontinuation because of adverse events between the two groups ( @ -LSB- @ % -RSB- in each group ) .


The hypoglycaemia rate was @ ( SE @ ) and @ ( @ ) events per patient per year , respectively , and no severe hypoglycaemia was reported .


Once-weekly dulaglutide is non-inferior to once-daily liraglutide for least-squares mean reduction in HbA@c , with a similar safety and tolerability profile .


Intense physical exercise provoke muscle damage , that in sedentary people can increase cardiovascular risk .


Phlebodium decumanum ( PD ) has shown to have immunomodulator effects in models of moderate intense physical activities in well conditioned groups .


To evaluate the PD effects during eccentric exercise , as a model of muscle inflammation protocol , on a sedentary population with cardiovascular risk .


This is an experimental , double-blind , multigroup randomized study .


Experimental Group @ ( n = @ ) received PD , @ doses of @ mg ( total amount @ g ) every @ hours during @ days , and Control Group @ ( n = @ ) received a placebo .


All the subjects performed two treadmill ergoespirometry tests : first , a modified Bruce protocol to discard ischemic responses during exercise and to evaluate VO@max before the experimental phase ; and second , with an eccentric protocol ( @ % descending ramp test ) during @ minutes in stable state at @-@ % VO@max , as experimental inflammatory protocol.We compared intra and inter groups to evaluate differences in the pre and post-test differences results on blood muscle damage variables .


The study shown statistically significant differences in all pre-post intra-groups results in muscle damage variables ( CK , LDH and Myoglobin , but not in Cardiac Troponin ) , and in functional lower-limb test ( SJand CMJ ) .


The comparison of inter-group results shown less muscle damage and less functional lower-limb deterioration in Group @ compared with Control group , with statistical significance in both cases .


Differences in handgrip dynamometry were no statistically significant .


The eccentric exercise protocol in that study has proven to be a good model to induce muscle and functional damage in sedentary people .


Short PD treatment has shown to reduce muscle and functional acute damages compared with placebo control group in this specific population .


Stair climbing is a challenging task to the elderly being the task with the first complaint in patients with mild to moderate knee osteoarthritis .


Stair climbing results in around six times more compressive load transmitted through the knee joint than walking on level ground .


The purpose of this study was to assess whether lateral wedge insoles would reduce medial compartment knee loading when ascending and descending stairs in patients with medial knee osteoarthritis .


Eight patients with medial knee osteoarthritis were tested in random order with and without a pair of @ off-the-shelf lateral wedge insoles for two separate activities ( stair ascent and stair descent ) .


Kinematic and kinetic data were collected for the lower extremity using a sixteen camera motion capture system and two force plates .


Primary outcome measures were the external knee adduction moment and the knee adduction angular impulse .


During stair ascent and descent , lateral wedge insoles significantly ( P < @ ) reduced the @st peak external knee adduction moment in early stance ( ascent @ % , descent @ % ) , the trough in mid stance ( ascent @ % , descent @ % ) , @nd peak in the late stance ( ascent @ % , descent @ % ) and the knee adduction angular impulse compared to the control ( standard shoe ) with large effect sizes ( @-@ @ ) .


In this first study on stairs , lateral wedge insoles consistently reduced the overall magnitude of medial compartment loading during stair ascent and descent .


Further research is needed to determine the relationship of this with clinical results when ascending and descending stairs with lateral wedge insoles .


Previous studies have shown that in psychotherapy alliance is a predictor of symptomatic change , even while accounting for the temporal precedence between alliance and symptoms .


However , the extent to which alliance predicts outcomes in psychopharmacology is yet to be fully investigated considering the fact that alliance can be the result , rather than the cause , of symptomatic change .


The current prospective study examined whether the alliance predicts outcomes in psychopharmacology , while controlling for previous symptomatic change throughout the course of treatment .


Data from a psychopharmacological randomized controlled trial for the treatment of adult major depression ( n = @ ) , including the patients ' rating of the alliance with the physicians , were analyzed .


Multilevel models controlling for autoregressive lag of the dependent variable were used in all analyses to examine the effect of alliance on outcome .


The effect of alliance on outcome , while controlling for prior symptomatic levels , was significant and restricted to the middle phase of treatment ( week @ , p = @ ) , when most of the reductions in symptoms were observed .


Exploratory analyses of the differences between placebo and medication conditions suggest that the differences between the patients in their average alliance levels predicted a greater reduction in symptoms in the placebo compared to the medication conditions ( p = @ ) .


The main limitation is the small cohort size .


The findings suggest an effect of alliance on outcome in psychopharmacology , which is not merely the result of previous symptomatic levels .


This effect may be more robust in conditions that do not include active treatment ( placebo ) , possibly serving as a compensatory effect .


To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction ( MGD ) after @ months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone .


Randomized controlled trial .


Patients with moderate and severe MGD were randomized into @ groups : topical loteprednol etabonate and eyelid scrubs with warm compresses ( Group I , @ eyes ) or eyelid scrubs with warm compresses ( Group II , @ eyes ) .


We evaluated cytokine levels , tear film break-up time ( TBUT ) , corneal and conjunctival fluorescein staining , biomicroscopic examination of lid margins and meibomian glands , and the Ocular Surface Disease Index before initiating treatment and @ month and @ months after treatment .


There were significant decreases in the levels of interleukin ( IL ) -@ , IL-@ , and IL-@ in Group I , and IL-@ and IL-@ in Group II .


Moreover , the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and @ month after treatment .


In Group I , there were improvements in all of the clinical outcomes , with prominent improvement in TBUT , corneal and conjunctival fluorescein staining , and meibum quality after @ month of treatment , compared with Group II .


An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.