A social network improvement was observed at year @ in @ % of the patients allocated to routine treatment and in @ % of those allocated to the experimental arm ( OR @ , @ % CI @ to @ ; adjusted OR @ , @ % CI @ to @ ) .


The difference remained statistically significant at year @ .


No significant differences emerged for any of the other end points .


However , patients with @ or more other areas of improvement at year @ and @ showed a statistically significant social network improvement .


The activation of social networks as an activity integrated with standard psychiatric care is practicable , without added economic and organizational costs , and appears to produce an effect persisting well beyond its implementation .


Serotonin reuptake inhibitors ( SSRIs ) are commonly prescribed off-label for children with autism .


To date , clinical trials examining the use of SSRIs in autism have been limited by small sample sizes and inconclusive results .


The efficacy and safety of SSRIs for moderating autistic behaviors is yet to be adequately examined to provide evidence to support current clinical practice .


The aim of the Fluoxetine for Autistic Behaviors ( FAB ) study is to determine the efficacy and safety of low dose fluoxetine compared with placebo , for reducing the frequency and severity of repetitive stereotypic behaviors in children and adolescents with an autism spectrum disorder ( ASD ) .


The relationship between the effectiveness of fluoxetine treatment and serotonin transporter genotype will also be explored .


The FAB study is a multicenter , double-blinded , randomized controlled trial , funded by the Australian Government 's National Health and Medical Research Council ( NHMRC ) grant .


Participants will be aged between @ and @ years with a confirmed diagnosis of ASD .


Eligible participants will be randomized to either placebo or fluoxetine for a @-week period .


Medication will be titrated over the first four weeks .


Reponses to medication will be monitored fortnightly using the Clinical Global Impressions Scale ( CGI ) .


The primary outcome measure is the Children 's Yale-Brown Obsessive Compulsive Scale-Modified for Pervasive Developmental Disorders ( CYBOCS-PDD ) , administered at baseline and @ weeks .


Secondary outcome measures include the Aberrant Behaviour Scale ( ABC ) , the Spence Children 's Anxiety Scale Parent Report ( SCAS-P ) , and the Repetitive Behaviors Scale ( RBS-R ) , measured at baseline and @ weeks .


Participants will be invited to undergo genetic testing for SLC@A@ allele variants using a cheek swab .


Continuous outcomes , including the primary outcome will be compared between the active and placebo groups using unadjusted linear regression .


Binary outcomes will be compared using unadjusted logistic regression .


The FAB study is a large clinical trial to specifically investigate the efficacy of low dose fluoxetine for restricted , repetitive , and stereotyped behaviors in ASD .


The outcomes of this study will contribute to evidence-based interventions used in clinical practice to assist children with ASD .


Our study examined whether mindfulness-based stress reduction ( MBSR ) is noninferior to cognitive behavioral therapy for insomnia ( CBT-I ) for the treatment of insomnia in patients with cancer .


This was a randomized , partially blinded , noninferiority trial involving patients with cancer with insomnia recruited from a tertiary cancer center in Calgary , Alberta , Canada , from September @ to March @ .


Assessments were conducted at baseline , after the program , and after @ months of follow-up .


The noninferiority margin was @ points measured by the Insomnia Severity Index .


Sleep diaries and actigraphy measured sleep onset latency ( SOL ) , wake after sleep onset ( WASO ) , total sleep time ( TST ) , and sleep efficiency .


Secondary outcomes included sleep quality , sleep beliefs , mood , and stress .


Of @ patients screened , @ were randomly assigned ( CBT-I , n = @ ; MBSR , n = @ ) .


MBSR was inferior to CBT-I for improving insomnia severity immediately after the program ( P = @ ) , but MBSR demonstrated noninferiority at follow-up ( P = @ ) .


Sleep diary-measured SOL was reduced by @ minutes in the CBT-I group and by @ minutes in the MBSR group at follow-up .


Similar reductions in WASO were observed for both groups .


TST increased by @ hours for CBT-I and @ hours for MBSR .


CBT-I improved sleep quality ( P < @ ) and dysfunctional sleep beliefs ( P < @ ) , whereas both groups experienced reduced stress ( P < @ ) and mood disturbance ( P < @ ) .


Although MBSR produced a clinically significant change in sleep and psychological outcomes , CBT-I was associated with rapid and durable improvement and remains the best choice for the nonpharmacologic treatment of insomnia .


To observe the different concentrations of mycophenolic acid ( MPA ) during the early post-transplant phase for various combinations of cyclosporine A ( CsA ) and tacrolimus ( Tac ) with enteric-coated mycophenolate sodium ( EC-MPS ) .


A total of @ Chinese adults receiving live related donor kidney transplants were studied .


All received a triple immunosuppressive regimen of EC-MPS , CsA/Tac and corticosteroids and were divided randomly into CsA ( n = @ ) and Tac ( n = @ ) combination groups .


The dosage of EC-MPS was the same ( @mg/day ) in the two groups .


The MPA concentration was evaluated with an enzyme-multiplied immunoassay technique ( EMIT ) and the pharmacokinetic characteristics were investigated in both groups .


The mean maximum plasma concentrations ( Cmax ) of MPA in the CsA and Tac groups were @ and @ g/ml , respectively ( p = @ ) .


The maximum times to Cmax ( Tmax ) were @ and @ h , respectively ( p = @ ) .


The mean MPA @-h areas under the curve ( MPA-AUC@-@h ) were @ and @ gh/ml ( p = @ ) and the mean residence times ( MRT ) were @ and @ h ( p = @ ) .


Combined with the same EC-MPS dosage ( @mg/day ) , the MPA-AUC@-@ of the Tac group was higher than that of the CsA group , and the Tac group had a longer MRT after kidney transplantation .


Our data indicate that the concentration of MPA should be monitored in clinical therapy when EC-MPS is combined with different calcineurin inhibitors to reduce acute allograft rejection and avoid adverse events .


Functional dyspepsia ( FD ) is a complex disease with a variety of dyspeptic symptoms .


Little is known about the clinical efficacy of cinitapride , a @-HT agonist and D antagonist , in treating FD .


This randomized , double-blind , double-dummy , positive-controlled study compared the efficacy and safety of cinitapride ( @ mg ) and domperidone ( @ mg ) tid for @ weeks in @ consecutive patients with mild to moderate , postprandial distress syndrome-predominant dyspeptic symptoms according to Rome III criteria .


The primary endpoint was the noninferiority of cinitapride compared with domperidone in relief of symptoms .


The overall patient evaluation of treatment and open gastric emptying effects of both drugs were treated as the secondary endpoints .


The rates of symptom relief by cinitapride and domperidone after @ weeks did not differ significantly on intension-to-treat analysis ( @ % vs. @ % , P = @ ) .


Cinitapride significantly reduced the overall severity of postprandial fullness , early satiation , and bloating ( @ vs. @ , P < @ ) ; and it was superior to the effects of domperidone ( @ vs. @ , P < @ ; P = @ between groups ) .


Cinitapride also decreased the mean half-gastric emptying time from @ to @ minutes ( P = @ ) .


There was a positive relationship between symptoms and gastric emptying time ( r = @ , P = @ ) .


Cinitapride-related adverse events were observed in @ % of patients , including @ patient with extrapyramidal symptoms .


No patient experienced QT interval prolongation .


This phase III trial has confirmed a noninferior efficacy of cinitapride over domperidone for patients with mild to moderate , postprandial distress syndrome-predominant FD .


Cinitapride usage is well tolerated , but its cardiovascular events need further evaluation .


To conduct a randomized controlled trial of Students for Nutrition and eXercise , a @-week middle school-based obesity-prevention intervention combining school-wide environmental changes , multimedia , encouragement to eat healthy school cafeteria foods , and peer-led education .


We randomly selected schools ( five intervention , five waitlist control ) from the Los Angeles Unified School District .


School records were obtained for number of fruits and vegetables served , students served lunch , and snacks sold per attending student , representing an average of @,@ students ( SD = @ ) per intervention school and @,@ students ( SD = @ ) per control school .


A total of @,@ seventh-graders ( @ % of seventh-graders across schools ) completed pre - and postintervention surveys assessing psychosocial variables .


Consistent with community-based participatory research principles , the school district was an equal partner , and a community advisory board provided critical input .


Relative to control schools , intervention schools showed significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks at school .


Specifically , the intervention was associated with relative increases of @ % more fruits served ( p = @ ) , @ % more lunches served ( p < @ ) , and @ % fewer snacks sold ( p < @ ) than would have been expected in its absence .


Pre-to-post intervention , intervention school students reported more positive attitudes about cafeteria food ( p = @ ) and tap water ( p = @ ) , greater obesity-prevention knowledge ( p = @ ) , increased intentions to drink water from the tap ( p = @ ) or a refillable bottle ( p = @ ) , and greater tap water consumption ( p = @ ) compared with control school students .


Multilevel school-based interventions may promote healthy adolescent dietary behaviors .


Abnormal acid gastro-oesophageal reflux is common in patients with idiopathic pulmonary fibrosis ( IPF ) and is considered a risk factor for development of IPF .


Retrospective studies have shown improved outcomes in patients given anti-acid treatment .


The aim of this study was to investigate the association between anti-acid treatment and disease progression in IPF .


In an analysis of data from three randomised controlled trials , we identified patients with IPF assigned to receive placebo .


Case report forms had been designed to prospectively obtain data about diagnosis and treatment of abnormal acid gastro-oesophageal reflux in each trial .


The primary outcome was estimated change in forced vital capacity ( FVC ) at @ weeks ( mean follow-up ) in patients who were and were not using a proton-pump inhibitor or histamine-receptor-@ ( H@ ) blocker .


Of the @ patients randomly assigned to the placebo groups of the three trials , @ ( @ % ) were taking a proton-pump inhibitor or H@ blocker at enrolment .


After adjustment for sex , baseline FVC as a percentage of predicted , and baseline diffusing capacity of the lung for carbon monoxide as a percentage of predicted , patients taking anti-acid treatment at baseline had a smaller decrease in FVC at @ weeks ( -@ L , @ % CI -@ to -@ ) than did those not taking anti-acid treatment ( -@ L , -@ to -@ ; difference @ L , @ % CI @-@ ; p = @ ) .


Anti-acid treatment could be beneficial in patients with IPF , and abnormal acid gastro-oesophageal reflux seems to contribute to disease progression .


Controlled clinical trials of anti-acid treatments are now needed .


The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment .


Patient 's age , education , and depressive symptomatology were considered as potential moderators .


A secondary analysis of data of @ patients from two randomized clinical trials was performed .


Both trials enrolled patients with solid tumors undergoing chemotherapy .


After completing baseline interviews , patients were randomized to a nurse-delivered intervention versus intervention delivered by a ` coach ' in trial I and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II .


In each of the two trials , following a six-contact @-week intervention , patients were interviewed at week @ to assess the primary outcome of symptom severity .


Although nurse-delivered intervention proved no better than the coach or automated system in lowering symptom severity , important differences in the intervention by age were found in both trials .


Patients aged @ years responded better to the coach or automated system , whereas those aged @ years favored the nurse .


Education and depressive symptomatology did not modify the intervention effects in either of the two trials .


Depressive symptomatology had a significant main effect on symptom severity at week @ in both trials ( p = @ and p < @ , respectively ) .


Education was not associated with symptom severity over and above age and depressive symptomatology .


Clinicians need to carefully consider the age of the population when using or testing interventions to manage symptoms among cancer patients .


The Integrated Infectious Diseases Capacity Building Evaluation ( IDCAP ) designed two interventions : Integrated Management of Infectious Disease ( IMID ) training program and On-Site Support ( OSS ) .


We evaluated their effects on @ facility performance indicators , including malaria case management .


IMID , a three-week training with two follow-up booster courses , was for two mid - level practitioners , primarily clinical officers and registered nurses , from @ primary care facilities .


OSS was two days of training and continuous quality improvement activities for nine months at @ facilities , to which all health workers were invited to participate .


Facilities were randomized as clusters @ to parallel OSS `` arm A '' or control `` arm B '' .


Outpatient data on four malaria case management indicators were collected for @ months .


Analysis compared changes before and during the interventions within arms ( relative risk = RR ) .


The effect of OSS was measured with the difference in changes across arms ( ratio of RR = RRR ) .


The proportion of patients with suspected malaria for whom a diagnostic test result for malaria was recorded decreased in arm B ( adjusted RR ( aRR ) = @ ; @ % CI : @,@ ) during IMID , but increased @ % in arm A ( aRR = @ ; @ % CI :@ , @ ) during IMID and OSS relative to baseline ; ( aRRR = @ ; @ % CI :@ , @ ) .


The estimated proportion of patients that received an appropriate antimalarial among those prescribed any antimalarial increased in arm B ( aRR = @ ; @ % CI : @ , @ ) and arm A ( aRR = @ ; @ % CI : @ , @ ) ; ( aRRR = @ ; @ % CI : @ , @ ) .


The proportion of patients with a negative diagnostic test result for malaria prescribed an antimalarial decreased in arm B ( aRR = @ ; @ % CI : @ , @ ) and arm A ( aRR = @ ; @ % CI : @ , @ ) ; ( aRRR = @ ; @ % CI : @ , @ ) .


The proportion of patients with a positive diagnostic test result for malaria prescribed an antibiotic did not change significantly in either arm .


The combination of IMID and OSS was associated with statistically significant improvements in malaria case management .


Controlling alloimmune humoral response is a challenge in transplantation .


Few studies have evaluated the impact of maintenance immunosuppression on blood humoral parameters .


We performed a post-hoc analysis on @ kidney transplant recipients included in a prospective randomized trial comparing tacrolimus/mycophenolate mofetil ( Tac/MMF ) vs. cyclosporine/azathioprine ( CsA/AZA ) , both used with antithymocyte globulin induction and steroids .


Humoral parameters were analyzed at D@ , D@ , and M@ .


IgG , IgA , and IgM levels decreased significantly as soon as D@ in both groups ( @ % , @ % , and @ % respectively , vs. D@ ) .


At M@ , although peripheral B-cell counts did not differ between the groups , Tac/MMF regimen was associated with lower IgG , IgA , and IgM levels than CsA/AZA ( @ % , @ % , and @ % , respectively ) .


Hypogammaglobulinemia at D@ was not associated with an increased risk of infections during the first year .


The proportion of HLA-sensitized patients decreased in the Tac/MMF group ( @ % at D@ and @ % at M@ , p = @ ) and remained stable in the CsA/AZA group ( @ % at D@ and @ % at M@ , p = @ ) .


More patients sensitized at baseline became non-sensitized at M@ with Tac/MMF than with CsA/AZA .


Our results suggest humoral immunosuppression is better with Tac/MMF than with CsA/AZA during the first year of kidney transplantation .


Venous leg ulcers ( VLUs ) are a health problem in clinical care .


Several options can be employed as adjuvant to standard treatment .


We have aimed to analyze the effect of standard ulcer care alone with high-frequency ultrasound ( HFU ) and MIST ultrasound therapy on VLUs .


Ninety patients with VLUs were assigned into the standard treatment , HFU and MIST ultrasound groups .


All groups received the standard wound care .


In the ultrasound groups , HFU and MIST ultrasound therapy was administered to wounds @ times per week until the wound healed .


Time of complete wound healing was recorded .


Wound size , pain , and edema were assessed at baseline and after @ and @ months .


Also , patients were instructed to contact our clinic monthly , and recurrence of VLUs was recorded for @ months after complete wound healing .


The data was analyzed using a Student 's t-test , ANOVA , c@ , or Fisher 's exact test .


P < @ was considered significant .


Mean time duration of complete wound healing in the first , second and third groups was @ ( SD @ ) , @ ( SD @ ) and @ ( SD @ ) months , respectively ( p < @ ) .


Size of ulcer , mean degree of pain and edema in ultrasound therapy was decreased after the @-month visit in comparison to the standard-treatment group ( p = @ , p < @ and p < @ , respectively ) .


Also , our results do n't show any significant differences between groups in the recurrence of VLUs during a @-month follow up after complete wound healing ( p = @ ) .


Our results in the present study show the significant effectiveness of ultrasound therapy in wound healing .


Differences between the two ultrasound therapy groups were not statistically significant .


To evaluate the efficacy and safety of intraarticular sprifermin ( recombinant human fibroblast growth factor @ ) in the treatment of symptomatic knee osteoarthritis ( OA ) .


The study was a randomized , double-blind , placebo-controlled , proof-of-concept trial .


Intraarticular sprifermin was evaluated at doses of @ g , @ g , and @ g.


The primary efficacy end point was change in central medial femorotibial compartment cartilage thickness at @ months and @ months as determined using quantitative magnetic resonance imaging ( qMRI ) .


The primary safety end points were nature , incidence , and severity of local and systemic treatment-emergent adverse events ( AEs ) and acute inflammatory reactions , as well as results of laboratory assessments .


Secondary end points included changes in total and compartment femorotibial cartilage thickness and volume as assessed by qMRI , changes in joint space width ( JSW ) seen on radiographs , and pain scores on the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) .


One hundred ninety-two patients were randomized and evaluated for safety , @ completed the trial , and @ were evaluated for the primary efficacy end point .


We found no statistically significant dose response in change in central medial femorotibial compartment cartilage thickness .


Sprifermin was associated with statistically significant , dose-dependent reductions in loss of total and lateral femorotibial cartilage thickness and volume and in JSW narrowing in the lateral femorotibial compartment .


All groups had improved WOMAC pain scores , with statistically significantly less improvement at @ months in patients receiving the @-g dose of sprifermin as compared with those receiving placebo .


There was no significant difference in serious AEs , treatment-emergent AEs , or acute inflammatory reactions between sprifermin and placebo groups .


No statistically significant relationship between treatment group and reduction in central medial femorotibial compartment cartilage thickness was observed ; however , prespecified structural secondary end points showed statistically significant dose-dependent reductions after sprifermin treatment .


Sprifermin was not associated with any local or systemic safety concerns .


The @-adrenergic agonist dexmedetomidine is a sedative and can be used as an adjunct to anesthetics .


Our primary goal was thus to determine the extent to which dexmedetomidine reduces the requirement for propofol and remifentanil .


This double-blinded , randomized study ( NCT@ ) used an automated dual closed-loop administration to maintain the Bispectral Index between @ and @ .


Sixty-@ ASA physical status I and II patients were given either dexmedetomidine ( @ g/kg over @ minutes followed by a continuous infusion of @ g/kg/h throughout surgery ) or comparable volumes of saline as a placebo .


Propofol and remifentanil requirements were compared using nonparametric tests and expressed as medians ( interquartile ranges ) .


Twenty-eight patients in each group completed the study .


Patients given dexmedetomidine required less propofol ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ @ -RSB- mg/kg , P = @ ) and remifentanil ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ @ -RSB- g/kg , P = @ ) for anesthetic induction .


The propofol dosage required for anesthetic maintenance was @ % ( with a @ % confidence interval , @-@ ) lower in patients given dexmedetomidine ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ @ -RSB- mg/kg/h , P = @ ) , whereas the remifentanil dosage was not significantly different ( @ -LSB- @-@ @ -RSB- vs @ -LSB- @-@ @ -RSB- g/kg/h with P = @ ) .


The incidence of adverse events , including hemodynamic instability and delayed recovery , was comparable with and without dexmedetomidine .


The first postoperative request for morphine analgesia was delayed in patients given dexmedetomidine ( median fourth hour vs first hour , P = @ ) .


Dexmedetomidine administration significantly reduced the requirement for both propofol and remifentanil during anesthetic induction and reduced propofol use during maintenance of anesthesia .


Dexmedetomidine also delayed postoperative analgesic use .


Dexmedetomidine is a useful adjuvant that reduces anesthetic requirement and provides postoperative analgesia .


Few randomised controlled trials ( RCTs ) of interventions for the treatment of adolescent obesity have taken place outside the western world .


This RCT tested whether a simple ` good practice ' intervention for the treatment of adolescent obesity would have a greater impact on weight status and other outcomes than a referral to primary care ( control ) in adolescents in Kuwait City .


We report on an assessor-blinded RCT of a treatment intervention in @ obese @ - to @-year-olds ( mean age @ , SD @ years ) , randomised to a good practice treatment or primary care control group over @ months .


The good practice intervention was intended as relatively low intensity ( @ hours contact over @ weeks , group-based ) , aiming to change sedentary behaviour , physical activity , and diet .


The primary outcome was a change in body mass index ( BMI ) Z score ; other outcomes were changes in waist circumference and blood pressure .


The retention of subjects to follow up was acceptable ( n = @ from the intervention group , and n = @ from the control group ) , but engagement with both the intervention and control treatment was poor .


Treatment had no significant effect on BMI Z score relative to control , and no other significant benefits to intervention were observed .


The trial was feasible , but highlights the need to engage obese adolescents and their families in the interventions being trialled .


The trial should inform the development of future adolescent obesity treatment trials in the Gulf States with the incorporation of qualitative assessment in future intervention trials .


Reflex cough is a defensive response generated in the brainstem in response to chemical and mechanical stimulation of the airways .


However , converging evidence shows that reflex cough is also influenced by central neural control processes .


In this study , we investigate whether reflex cough can be modulated by attentional focus on either external stimuli or internal cough-related stimuli .


Healthy volunteers ( N = @ ; seven men ; age range , @-@ years ) completed four blocks of citric acid-induced cough challenges while , simultaneously , auditory stimuli were presented .


Within each block , four concentrations were administered ( @ , @ , @ and @,@ mM , randomized ) .


During two subsequent blocks , participants focused their attention externally ( counting tones ) .


During the other two blocks , participants focused their attention internally ( counting coughs ) .


The order of attentional focus was counterbalanced across participants .


Ratings of the urge to cough were collected after each challenge .


Cough frequency was determined by audio recording .


Cough frequency was higher when participants focused their attention internally vs externally ( P < @ ) .


Also urge to cough was greater during internal vs external focus ( P < @ ) , but the effect was smaller in later blocks of trials .


Reflex cough can be modulated by attentional focus .


Internally focused attention may be a mechanism involved in excessive ( idiopathic ) cough , while an external focus may be introduced as part of treatments targeting excessive cough .


Subcutaneous APF@ provides controlled sustained release of granisetron to prevent acute ( @-@ h ) and delayed ( @-@ h ) chemotherapy-induced nausea and vomiting ( CINV ) .


This randomized , double-blind phase @ trial compared APF@ and palonosetron in preventing acute and delayed CINV after moderately ( MEC ) or highly emetogenic chemotherapy ( HEC ) .


Patients receiving single-day MEC or HEC received single-dose APF@ @ or @ mg subcutaneously ( SC ) ( granisetron @ or @ mg ) or intravenous palonosetron @ mg .


Primary objectives were to establish APF@ noninferiority to palonosetron for preventing acute CINV following MEC or HEC and delayed CINV following MEC and to determine APF@ superiority to palonosetron for preventing delayed CINV following HEC .


The primary efficacy end point was complete response ( CR -LSB- using CI difference for APF@-palonosetron -RSB- ) .


A lower confidence bound greater than -@ % indicated noninferiority .


In the modified intent-to-treat population ( MEC = @ ; HEC = @ ) , both APF@ doses were noninferior to palonosetron in preventing acute CINV after MEC ( CRs @ % -LSB- -@ , @ -RSB- and @ % -LSB- -@ , @ -RSB- , respectively , vs. @ % palonosetron ) and after HEC ( CRs @ % -LSB- -@ , @ -RSB- and @ % -LSB- -@ , @ -RSB- , respectively , vs. @ % palonosetron ) .


APF@ @ mg was noninferior to palonosetron in preventing delayed CINV after MEC ( CR @ % -LSB- -@ , @ -RSB- vs. @ % palonosetron ) but not superior in preventing delayed CINV after HEC .


Adverse events were generally mild and unrelated to treatment , the most common ( excluding injection-site reactions ) being constipation .


A single subcutaneous APF@ injection offers a convenient alternative to palonosetron for preventing acute and delayed CINV after MEC or HEC .


Patients with psychiatric illness have increased somatic morbidity and increased mortality .


Knowledge of how to integrate the prevention and care of somatic illness into the treatment of psychiatric patients is required .


The aims of this study were to investigate whether an intervention programme to improve physical health is effective .


An extension of the European Network for Promoting the Health of Residents in Psychiatric and Social Care Institutions ( HELPS ) project further developed as a @-month controlled cluster-randomized intervention study in the Danish centre .


Waist circumference was a proxy of unhealthy body fat in view of the increased risk of cardiovascular diseases and type @ diabetes .


Waist circumference was @ cm for men and @ cm for women .


Controlled for cluster randomization , sex , age , and body fat , the intervention group showed a small , but not significant , reduction in waist circumference , while participants in the control group showed a significant increase in waist circumference .


The intervention had a positive effect on the physical health of the patients measured by a reduction in the increase of waist circumference .


In resource-constrained settings of developing countries , promotion of community-based health interventions through community health workers ( CHWs ) is an important strategy to improve child health .


However , there are concerns about the sustainability of such programmes owing to the high rate of CHW attrition .


This study examined factors influencing retention of volunteer CHWs in a cluster randomised trial on community management of under-@ fever in a rural Ghanaian district .


Data were obtained from structured interviews ( n = @ ) and focus group discussions ( n = @ ) with CHWs .


Factors influencing CHWs ' decisions to remain or leave the programme were analysed using a probit model , and focus group discussion results were used to elucidate the findings .


The attrition rate among CHWs was @ % .


Attrition was comparatively higher in younger age groups ( @ % in @-@ years group , @ % in @-@ years group and @ % in @ years group ) .


Approval of a CHW by the community ( p < @ ) and the CHW 's immediate family ( p < @ ) were significant in influencing the probability of remaining in the programme .


Motivation for retention was related to the desire to serve their communities as well as humanitarian and religious reasons .


The relatively moderate rate of attrition could be attributed to the high level of community involvement in the selection process as well as other aspects of the intervention leading to high community approval and support .


Attention for these aspects could help improve CHW retention in community-based health interventions in Ghana , and the lessons could be applied to countries within similar settings .


Short-term studies have suggested beneficial effects of a Palaeolithic-type diet ( PD ) on body weight and metabolic balance .


We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women , in comparison with a diet according to the Nordic Nutrition Recommendations ( NNR ) .


Seventy obese postmenopausal women ( mean age @ years , body mass index @ kg/m ( @ ) ) were assigned to an ad libitum PD or NNR diet in a @-year randomized controlled trial .


The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry .


Both groups significantly decreased total fat mass at @ months ( -@ and-@ @ kg ) and @ months ( -@ and-@ @ kg ) , with a more pronounced fat loss in the PD group at @ months ( P < @ ) but not at @ months ( P = @ ) .


Waist circumference and sagittal diameter also decreased in both the groups , with a more pronounced decrease in the PD group at @ months ( -@ vs-@ @ cm , P = @ and-@ @ vs-@ @ cm , P < @ , respectively ) .


Triglyceride levels decreased significantly more at @ and @ months in the PD group than in the NNR group ( P < @ and P = @ ) .


Nitrogen excretion did not differ between the groups .


A PD has greater beneficial effects vs an NNR diet regarding fat mass , abdominal obesity and triglyceride levels in obese postmenopausal women ; effects not sustained for anthropometric measurements at @ months .


Adherence to protein intake was poor in the PD group .


The long-term consequences of these changes remain to be studied .


To investigate whether an infancy-onset , low saturated fat-oriented dietary intervention influences serum adiponectin concentration in adolescents , and to study the association of adiponectin with subclinical markers of vascular health , and cardio-metabolic risk factors .


The longitudinal , randomized Special Turku Coronary Risk Factor Intervention Project aimed to modify child 's dietary fat quality replacing saturated fat with unsaturated fat .


Serum adiponectin ( n = @ ) along with weight , height , high-density lipoprotein cholesterol , C-reactive protein ( CRP ) , triglycerides , and insulin were measured at age @ years .


Adiposity was assessed using body mass index , waist circumference , and abdominal fat thickness measured with ultrasound .


Metabolic syndrome was defined according to International Diabetes Foundation criteria .


Vascular ultrasound measures including carotid intima-media thickness ( IMT ) were assessed .


Adiponectin concentrations were similar in the intervention and control groups ( P = @ ) .


Adiponectin associated with carotid IMT ( r = -@ , P = @ ) , high-density lipoprotein cholesterol ( r = @ , P < @ ) , triglycerides ( r = -@ , P = @ ) , CRP ( r = -@ , P = @ ) , insulin ( r = -@ , P = @ ) , and adiposity ( r = -@ -@ , P @ ) .


When adjusted for adiposity indices , the association with carotid IMT was only marginally diluted ( P = @ -@ ) , but the associations with insulin and CRP became nonsignificant .


Adolescents with adiponectin median had @-fold risk of metabolic syndrome than peers with adiponectin > median ( CI @-@ @ , P = @ ) .


In healthy adolescents , low serum adiponectin is related with carotid IMT and metabolic syndrome .


We found no evidence that repeated low saturated fat-oriented dietary counseling would influence serum adiponectin in adolescence .


Alcohol dependence is common in bipolar disorder ( BPD ) and associated with treatment nonadherence , violence , and hospitalization .


Quetiapine is a standard treatment for BPD .


We previously reported improvement in depressive symptoms , but not alcohol use , with quetiapine in BPD and alcohol dependence .


However , mean alcohol use was low and a larger effect size on alcohol-related measures was observed in those with higher levels of alcohol consumption .


In this study , efficacy of quetiapine in patients with BPD and alcohol dependence was examined in patients with higher mean baseline alcohol use than in the prior study .


Ninety outpatients with bipolar I or II disorders , depressed or mixed mood state , and current alcohol dependence were randomized to @ weeks of sustained release quetiapine ( to @ mg/d ) add-on therapy or placebo .


Drinking was quantified using the Timeline Follow Back method .


Additional assessment tools included the Hamilton Rating Scale for Depression , Inventory of Depressive Symptomatology-Self-Report , Young Mania Rating Scale , Penn Alcohol Craving Scale , liver enzymes , and side effects .


Alcohol use and mood were analyzed using a declining-effects random-regression model .


Baseline and demographic characteristics in the @ groups were similar .


No significant between-group differences were observed on the primary outcome measure of drinks per day or other alcohol-related or mood measures ( p > @ ) .


Overall side effect burden , glucose , and cholesterol were similar in the @ groups .


However , a significant weight increase was observed with quetiapine at week @ ( +@ lbs -LSB- SE @ -RSB- quetiapine vs. -@ lbs -LSB- SE @ -RSB- , p = @ ) , but not at week @ .


Scores on the Barnes Akathisia Scale increased significantly more ( p = @ ) with quetiapine ( +@ -LSB- SE @ -RSB- ) than placebo ( -@ -LSB- SE @ -RSB- ) at week @ but not week @ .


Retention ( survival ) in the study was similar in the groups .


Findings suggest that quetiapine does not reduce alcohol consumption in patients with BPD and alcohol dependence .


To assess the longitudinal curative effect and improvement of subjective symptoms by using intratympanic injection of Budesonide ( BUD ) for otitis media with effusion ( OME ) patients older than @ years and adults .


A single-blind , randomized , parallel-controlled prospective study .


Hospital , outpatient .


Ninety patients ( @ ears ) who were diagnosed as having OME were recruited and then randomized to BUD , dexamethasone ( DEX ) , and sodium chloride ( NS ) groups , the latter two served as controls .


The randomly allocated patients received intratympanic injection of BUD ( @ mg/@ ml ) , DEX ( @ mg/@ ml ) , or @ % NS solution ( @ ml ) once a week .


Survival analysis was applied to compare the longitudinal curative effects among the @ groups .


Meanwhile , the @ main subjective symptoms were scored by @-point visual scale , and physician 's evaluations were preformed during treatment and follow-up .


After adjustment for course of disease , volume , and characters of effusion , the relative risk ( RR ) of BUD is @ ( @ % CI , @-@ @ ) when compared with NS .


Survival curve demonstrated that the rank of longitudinal therapeutic efficacy was BUD , DEX , and NS ( p < @ ) .


Both BUD and DEX showed improvements in subjective symptoms and quality of life compared with NS ( p < @ ) .


In the aspect of improving the symptom of stuffy ear , BUD showed advantage over both DEX and NS .


During and after treatment , no serious complications or sequelae were observed .


Intratympanic injection with BUD for OME patients showed advantages in improving long-term therapeutic efficacy , it was a safe and effective intervention for adolescents and adults with OME .


To determine the nutrition risk status and factors associated with nutrition risk among older adults enrolled in the Brief Risk Identification Geriatric Health Tool ( BRIGHT Trial ) .


A cluster randomised controlled trial .


Three main centres in New Zealand .


A total of @,@ older adults were recruited from @ general practices in three of the District Health Board ( DHB ) regions aged @ years and older ( or @ years and older if Mori ) .


Nutrition risk was assessed using the Australian Nutrition Screening Initiative ( ANSI ) .


Validated questionnaires were used to establish quality of life ( WHOQOL-BREF ) , physical function ( the Nottingham Extended Activities of Daily Living ) and depressive symptoms ( @ item Geriatric Depression Scale ) .


Demographic , standard of living and health data were established .


Sixty two percent of participants were identified to be at moderate or high nutrition risk .


The mean ANSI score was @ ( range @-@ , maximum @ ) .


Factors which independently predicted moderate or high nutrition risk were female gender , being Mori and other ethnicities versus European , not being married , taking multiple medications , having more depressive symptoms , cardiovascular disease and diabetes .


Protective factors independently related to low nutrition risk were living with others , higher physical and social health related QOL and higher functional status .


WHOQOL environmental and psychological factors were not associated with nutrition risk when other predictive factors were taken into account .


Nearly two thirds of participants were identified to be at higher nutrition risk .


Women , living alone , taking multiple medications , with depressive symptoms , cardiovascular disease and ndiabetes were factors associated with higher nutrition risk .


Those at low nutrition risk had a better functional status and physical and social health related QOL .


Computer-tailored physical activity ( PA ) interventions delivered through the Internet represent a promising and appealing method to promote PA at a population level .


However , personalized advice is mostly provided based on subjectively measured PA , which is not very accurate and might result in the delivery of advice that is not credible or effective .


Therefore , an innovative computer-tailored PA advice was developed , based on objectively pedometer-measured PA. .


The study aim was to evaluate the effectiveness of a computer-tailored , pedometer-based PA intervention in working adults .


Participants ( @ years ) were recruited between May and December @ from eight Flemish workplaces .


These workplaces were allocated randomly to an intervention or control group .


Intervention group participants ( n = @ ) received ( @ ) a booklet with information on how to increase their steps , ( @ ) a non-blinded pedometer , and ( @ ) an Internet link to request computer-tailored step advice .


Control group participants ( n = @ ) did not receive any of the intervention components .


Self-reported and pedometer-based PA were assessed at baseline ( T@ ) , and @ month ( T@ ) and @ months ( T@ ) months post baseline .


Repeated measures analyses of covariance were used to examine intervention effects for both the total sample and the at-risk sample ( ie , adults not reaching @,@ steps a day at baseline ) .


The recruitment process resulted in @ respondents ( response rate of @ % ) who agreed to participate , of whom @ ( @ % ) belonged to the at-risk sample .


Between T@ and T@ ( @-month post baseline ) , significant intervention effects were found for participants ' daily step counts in both the total sample ( P = @ ) and the at-risk sample ( P = @ ) .


In the at-risk sample , the intervention effects showed a daily step count increase of @ steps in the intervention group , compared to a decrease of @ steps in the control group .


Comparison of participants ' self-reported PA revealed a significant intervention effect for time spent walking in the at-risk sample ( P = @ ) .


Intervention effects were still significant @ months post baseline for participants ' daily step counts in both the total sample ( P = @ ) and the at-risk sample ( P = @ ) ; however , self-reported PA differences were no longer significant .


A computer-tailored , pedometer-based PA intervention was effective in increasing both pedometer-based and self-reported PA levels , mainly in the at-risk participants .


However , more effort should be devoted to recruit and retain participants in order to improve the public health impact of the intervention .


In a multicenter , randomized , open-label phase III study , patients @ years with newly diagnosed AML received decitabine @ mg/m ( @ ) once daily for @ days every @ weeks ( n = @ ) or treatment choice ( supportive care or cytarabine @ mg/m ( @ ) once daily for @ days every @ weeks ; n = @ ) .


Decitabine use demonstrated greater response rates ( P = @ ) and OS data favored decitabine .


In a post hoc sensitivity analysis of mature data of patients in the intent-to-treat population ( N = @ ) , OS at @ , @ , @ , @ , and @ months after randomization was estimated for each arm using Kaplan-Meier methods .


Age , cytogenetic risk , and Eastern Cooperative Oncology Group performance status were used as stratification factors in the Cox regression model to estimate the hazard ratio .


A survival advantage was seen with decitabine at each cutoff time point ; hazard ratios for OS for decitabine vs. treatment choice were @ , @ , @ , @ , and @ at @ , @ , @ , @ , and @ months , respectively .


A trend toward improved OS with decitabine was observed at fixed time points over @ years .


Decitabine should be considered as a treatment option for older patients with AML and poor prognostic risk factors .


The aim of this study was to compare the time to initial alignment and extraction space closure using conventional brackets and active and passive self-ligating brackets .


One hundred adolescent patients @ to @ years of age undergoing maxillary and mandibular fixed appliance therapy after the extraction of @ premolars were randomized with stratification of @ age ranges ( @-@ and @-@ years ) and @ maxillomandibular plane angles ( high , medium , and low ) with an allocation ratio of @:@:@ .


Restrictions were applied using a block size of @ .


Allocation was to @ of @ treatment groups : conventional brackets , active self-ligating , or passive self-ligating brackets .


All subjects were treated with the same archwire sequence and space-closing mechanics in a district general hospital setting .


The trial was a @-arm parallel design .


Labial-segment alignment and space closure were measured on study models taken every @ weeks throughout treatment .


All measurements were made by @ operator who was blinded to bracket type .


The patients and other operators were not blinded to bracket type during treatment .


Ninety-eight patients were followed to completion of treatment ( conventional , n = @ ; active self-ligating brackets , n = @ ; passive self-ligating brackets , n = @ ) .


The data were analyzed using linear mixed models and demonstrated a significant effect of bracket type on the time to initial alignment ( P = @ ) , which was shorter with the conventional brackets than either of the self-ligating brackets .


Sidak 's adjustment showed no significant difference in effect size ( the difference in average response in millimeters ) between the active and passive self-ligating brackets ( the results are presented as effect size , @ % confidence intervals , probabilities , and intraclass correlation coefficients ) ( -@ -LSB- -@ , @ -RSB- , @ , @ ) , but the conventional bracket was significantly different from both of these ( -@ -LSB- -@ , -@ -RSB- , @ , @ ; and -@ -LSB- -@ , -@ -RSB- , @ , @ ) .


There was no statistically significant difference between any of the @ bracket types with respect to space closure .


Space-closure times were shorter in the mandible , except for the Damon @MX bracket ( Ormco , Orange , Calif ) , where active and total space-closure times were shorter in the maxilla .


No adverse events were recorded in the trial .


Time to initial alignment was significantly shorter for the conventional bracket than for either the active or passive self-ligating brackets .


There was no statistically significant difference in passive , active , or total space-closure times among the @ brackets under investigation .


To date there has been no research investigating moderators of response to micronutrient treatment of mental illness , specifically baseline nutrient levels .


We conducted analyses of data from a randomized placebo-controlled trial ( RCT ) of @ adults ( @years ) with Attention-Deficit/Hyperactivity Disorder ( ADHD ) , whereby participants were treated acutely ( @weeks ) with micronutrients or placebo followed by an open-label ( OL ) phase of @weeks whereby all participants received micronutrients .


To ensure that all participants had been exposed to the micronutrients for @weeks , only those @ who had adhered to the treatment protocol and completed @weeks on nutrients were included in the data analysis : @ from the group that had been randomized to the micronutrient arm , and @ from the group that had been randomized to the placebo group and hence had only received nutrients in the OL phase .


Six outcomes were examined : change in ADHD symptoms ( self/clinician ) , ADHD responder , Clinical Global Impression-Improvement ( CGI-I ) , change in mood , and change in Global Assessment of Functioning ( GAF ) .


Demographic , developmental and psychiatric history , current clinical characteristics , and baseline nutrient levels were all considered as putative predictors .


There were significant changes in all outcome variables after @weeks exposure to the micronutrients .


Among the nutrients recorded at baseline , substantial deficiencies ( @ % ) were only observed for vitamin D. However , other than an association showing that higher iron at baseline was correlated with higher baseline depression scores , baseline nutrient levels were not correlated with baseline psychiatric variables/current clinical characteristics .


Regression analyses revealed that higher baseline ferritin and lower baseline copper and vitamin D levels were associated with a better response to treatment for some but not all outcomes .


None of the other nutrient levels was found to be associated with outcome , including zinc , vitamin B@ , iron , and folate .


There were no childhood risk factors , demographic variables or clinical correlates that contraindicated micronutrient treatment ; more severe symptoms at baseline and greater number of developmental risk factors predicted greater treatment response .


Further research looking at nutrients more broadly is required to confirm these initial observations about ferritin , vitamin D and copper ; however , the results suggest that serum nutrient levels have limited value for identifying who will respond to treatment .


To explore the feasibility and safety of enteral nutrition in preoperative bowel preparation for rectal cancer patients undergoing radical operation .


Sixty rectal cancer patients undergoing selective low anterior resection were randomized into the trial group ( n = @ ) and the control group ( n = @ ) .


Patients in the trial group received clean liquid integral protein diet for @ days before operation without mechanical bowel preparation .


Patients in the control group received traditional diet and mechanical bowel preparation .


The intraoperative and postoperative clinical data , the quality of bowel preparation , postoperative complications , and nutritional parameters were compared between the two groups .


There were no significant differences in clinicopathological characteristics between the two groups before operation .


The operative time , blood loss , quality of bowel preparation as well as postoperative hospital stay were not significantly different ( all P > @ ) .


While the time to first flatus -LSB- ( @ ) d vs. ( @ ) d -RSB- and semi-liquid diet intake -LSB- ( @ ) d vs. ( @ ) d -RSB- were significantly shorter in the trial group as compared with the control group ( all P < @ ) .


There were no death and no significant difference in postoperative complications -LSB- @ % ( @/@ ) vs. @ % ( @/@ ) , P > @ -RSB- .


The levels of postoperative total protein , albumin , and prealbumin decreased significantly .


Meanwhile , the levels of postoperative albumin -LSB- ( @ ) g/L vs. ( @ ) g/L , P < @ -RSB- and prealbumin -LSB- ( @ ) mg/L vs. ( @ ) mg/L , P < @ -RSB- in the trial group were significantly higher than those in the control group .


Preoperative enteral nutrition can replace the mechanical bowel preparation with better efficacy , and improve the postoperative nutritional status without increasing surgical risk in rectal cancer patients undergoing radical operation .


In resource-poor areas of China and India , the cardiovascular disease burden is high , but availability of and access to quality healthcare is limited .


Establishing a management scheme that utilizes the local infrastructure and builds healthcare capacity is essential for cardiovascular disease prevention and management .


The study aims to develop , implement , and evaluate the feasibility and effectiveness of a simplified , evidence-based cardiovascular management program delivered by community healthcare workers in resource-constrained areas in Tibet , China and Haryana , India .


This yearlong cluster-randomized controlled trial will be conducted in @ villages in Tibet and @ villages in Haryana .


Randomization of villages to usual care or intervention will be stratified by country .


High cardiovascular disease risk individuals ( aged @ years or older , history of heart disease , stroke , diabetes , or measured systolic blood pressure of @ mmHg or higher ) will be screened at baseline .


Community health workers in the intervention villages will be trained to manage and follow up high-risk patients on a monthly basis following a simplified ' @ +@ ' intervention model involving two lifestyle recommendations and the appropriate prescription of two medications .


A customized electronic decision support system based on the intervention strategy will be developed to assist the community health workers with patient management .


Baseline and follow-up surveys will be conducted in a standardized fashion in all villages .


The primary outcome will be the net difference between-group in the proportion of high-risk patients taking antihypertensive medication pre - and post-intervention .


Secondary outcomes will include the proportion of patients taking aspirin and changes in blood pressure .


Process and economic evaluations will also be conducted .


To our knowledge , this will be the first study to evaluate the effect of a simplified management program delivered by community health workers with the help of electronic decision support system on improving the health of high cardiovascular disease risk patients .


If effective , this intervention strategy can serve as a model that can be implemented , where applicable , in rural China , India , and other resource-constrained areas .


The purpose of this study was to evaluate the effectiveness of the academic asthma education and counseling Staying Healthy-Asthma Responsible and Prepared ( SHARP ) program on fostering psychosocial acceptance of asthma .


This was a phase III , two-group , cluster-randomized , single-blinded , longitudinal study .


Students from grades @ and @ ( N = @ ) with asthma and their caregivers completed surveys at pre-intervention and at @ - , @ - , and @-months post-intervention .


Analysis involved multilevel modeling .


All students demonstrated significant improvement in aspects of acceptance ; students in SHARP demonstrated significant improvement in openness to sharing and connectedness with teachers over students in the control condition .


The SHARP program offers a well-tested , effective program for psychosocial acceptance of asthma , which is welcomed by schools .


Posterior sagittal anorectoplasty ( PSARP ) has become the standard surgical treatment for males rectourethral fistula ( RUF ) at most surgical centers worldwide .


We aimed to define the long-term bowel functional outcomes following PSARP for RUF at our institution between @ and @ , with comparison to age - and gender-matched controls .


Patients were invited to answer a detailed , previously validated Bowel Function Score ( BFS ) questionnaire by post .


Respondents were matched by age and gender to three controls from the general population who had answered identical questionnaires .


Case records were reviewed retrospectively for operative details .


Ethical approval was obtained .


Social continence was defined as soiling or fecal accidents < @/week and no requirement for changes of underwear or protective aids .


Of @ ( @ % ) respondents ( median age @ ( range , @-@ ) years ) , @ % had voluntary bowel movements ( VBMs ) , @ % were reliant on anterograde continence enema ( ACE ) washouts , and @ patient had a colostomy .


Impairment of bowel function was significantly higher in all aspects of fecal control among patients than controls ( p < @ ) .


A statistically significant decline in fecal accidents and soiling was observed with age ( p @ ) .


Thirty-one percent of patients with VBMs had constipation managed with diet or laxatives ( vs @ % of controls , p = @ ) .


Of patients with VBMs followed up for > @ years ( n = @ ) , @ % were completely continent ( vs @ % of controls ; p = NS ) .


Overall , @ % of respondents were socially continent with or without artificial means in the form of ACE washouts .


By BFS score , @ % had a good functional outcome , @ % had a moderate outcome , @ % had a clearly poor score and @ % were living with an ACE .


Our results suggest that in the long-term , functional symptoms remain highly prevalent among patients treated for RUF with PSARP .


However , the majority can be expected to achieve social continence , although for some this will require intervention with ACE bowel management .


Approximately one third may report VBMs and complete continence .


To test the feasibility , acceptability and initial effectiveness of a text message-based aftercare treatment programme among alcohol outpatients .


Clients treated for alcohol use disorders from three Swiss outpatient alcohol treatment centres were invited by their counsellors to participate in a study testing an interactive aftercare programme employing the use of text messages and personal phone calls .


Fifty study participants were randomly assigned to either the @-month aftercare programme ( n = @ ) or treatment as usual ( n = @ ) .


The intervention consisted of ( a ) monitoring of self-selected drinking goals at regular intervals , ( b ) motivational text messages to stick to self-selected drinking goals and ( c ) proactive telephone calls from counsellors when participants neglected to stick to their drinking goals or expressed a need for support .


Follow-up interviews were conducted @ months after randomization .


Throughout the programme , participants received a total of @ text message prompts .


Out of these , participants provided valid replies to @ ( @ % ) within @ h. Out of the @ participants in the intervention group , @ ( @ % ) sent at least one call-for-help reply .


Based on complete case data , at risk alcohol use at follow-up was @ % in the control group and @ % in the intervention group ( OR = @ , @ % CI = @-@ @ , P = @ ) .


The interactive low-intensive aftercare programme was well accepted by the participants .


Testing its efficacy within an adequately powered randomized controlled trial might be reasonable .


Weaning is typically regarded as a process of discontinuing mechanical ventilation in the daily practice of an intensive care unit ( ICU ) .


Among the ICU patients , @ % -@ % need mechanical ventilator for sustaining their lives .


The predictive rate of successful weaning achieved only @-@ % for decisions made by physicians .


Clinical decision support systems ( CDSSs ) are promising in enhancing diagnostic performance and improve healthcare quality in clinical setting .


To our knowledge , a prospective study has never been conducted to verify the effectiveness of the CDSS in ventilator weaning before .


In this study , the CDSS capable of predicting weaning outcome and reducing duration of ventilator support for patients has been verified .


A total of @ patients admitted to the respiratory care center of the hospital were randomly assigned to either control or study group .


In the control group , patients were weaned with traditional weaning method , while in the study group , patients were weaned with CDSS monitored by physicians .


After excluding the patients who transferred to other hospitals , refused further treatments , or expired the admission period , data of @ and @ patients in the study and control groups , respectively , were used for analysis .


The results show that a sensitivity of @ % has been achieved , which is significantly higher ( p < @ ) than the weaning determined by physicians ( sensitivity : @ % ) .


Furthermore , the days using mechanical ventilator for the study group ( @ @ ) is significantly ( p < @ ) shorter than the control group ( @ @ ) , with a decrease of @ days in average , resulting in a saving of healthcare cost of NT$ @,@ ( US$ @,@ ) per patient in the current Taiwanese National Health Insurance setting .


The CDSS is demonstrated to be effective in identifying the earliest time of ventilator weaning for patients to resume and sustain spontaneous breathing , thereby avoiding unnecessary prolonged ventilator use and decreasing healthcare cost .


Subjective tinnitus is the perception of sound in the absence of a corresponding external sound for which there is no known medical etiology .


For a minority of individuals with tinnitus , the condition impacts their ability to lead a normal lifestyle and is severely debilitating .


There is no known cure for tinnitus , so current therapy focuses on reducing the effect of tinnitus on the patient 's quality of life .


Tinnitus retraining therapy ( TRT ) uses nonpsychiatric tinnitus-specific educational counseling and sound therapy in a habituation-based protocol to reduce the patient 's tinnitus-evoked negative reaction to , and awareness of , the tinnitus , with the ultimate goal of reducing the tinnitus impact on the patient 's quality of life .


Some studies support the efficacy of TRT , but no trial to date has compared TRT with the current standard of care or evaluated the separate contributions of TRT counseling and sound therapy .


The Tinnitus Retraining Therapy Trial ( TRTT ) is a randomized , double-blind , placebo-controlled , multicenter trial for individuals with intolerable tinnitus .


The TRTT is enrolling active-duty and retired military personnel and their dependents with functionally adequate hearing sensitivity and severe tinnitus at US Air Force , Navy , and Army medical centers .


Eligible study participants are randomized to TRT , partial TRT , or standard care to determine the efficacy of TRT and its components ( TRT counseling and sound therapy ) .


The primary outcome is change in score on the Tinnitus Questionnaire assessed longitudinally between baseline and follow-up ( @ , @ , @ , and @ months following treatment ) .


Secondary outcomes include subscale score changes in the Tinnitus Questionnaire , overall and subscale score changes in the Tinnitus Functional Index and Tinnitus Handicap Inventory , and change in the visual analog scale of the TRT Interview Form .


Audiological outcomes include tinnitus pitch and loudness match and measures of loudness discomfort levels .


The incidence of depression as a safety measure is assessed at each visit using the Beck Depression Inventory Fast Screen .


Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke .


This prospective , randomized , controlled study of gait training tested the feasibility and potential efficacy of using a robotic-assisted gait device , Lokomat , for treadmill training with partial body weight support in subjects with chronic hemiplegia ; the device was also compared with conventional home exercise .


Twenty-two male ambulatory ischemic or hemorrhagic induced stroke patients with chronic hemiplegia lasting at least @ months were enrolled in this prospective study .


The patients were assigned to either the Lokomat group or the conventional exercise group .


The Lokomat group underwent active robotic training for ten sessions ( five sessions per week for two weeks ) .


Each session lasted @ minutes .


If a patient missed three consecutive training sessions , he was removed from the study .


The Timed Up and Go Test is used to assess mobility and requires both static and dynamic balance .


The @-m Timed Walking Speed Test is designed to determine the patient 's overground walking speed .


The Mini-Mental State Examination and Hospital Anxiety and Depression Scale were used for mental and psychological evaluation ; the Functional Ambulation Categories was used to assess ambulatory status .


Within each eight-week interval , the patients undergoing the Lokomat training demonstrated significantly greater improvement on the Timed Up and Go Test and @-m Timed Walking Speed Test than those undergoing conventional training .


Despite the small number of patients in the study , the present data suggests that the robotic-assisted device , Lokomat , provides innovative possibilities for gait training in chronic hemiplegia rehabilitation by training at higher intensity levels for longer durations than traditional home exercise .


Patients with cardiac arrhythmias are generally instructed to avoid caffeine intake .


A comprehensive evaluation of the electrophysiological effects of caffeine on atrial and ventricular tissues in humans has not previously been performed .


Eighty patients ( @men , mean age @years ) with symptomatic supraventricular tachycardia ( SVT ) undergoing an electrophysiologic study ( EPS ) prior to catheter ablation were randomized to receive oral caffeine or placebo .


Caffeine at a dosage of @mg/kg ( moderate intake ) or placebo tablets were administered orally at a mean time of @ minutes prior to the EPS .


The median ( IQR ) caffeine level in patients receiving caffeine was @ g/mL ( @-@ @ ) , as compared with @ ( @-@ @ ) in patients receiving placebo , P < @ .


Caffeine was associated with a significant increase in resting systolic and diastolic blood pressures as compared with placebo , while the resting heart rate was not significantly different between both groups .


Caffeine was not associated with significant effects on the effective refractory period of the atrium or ventricle , as well as on AV node conduction .


SVT was induced in all but @ patients ; there was no significant difference between groups receiving placebo or caffeine on SVT inducibility or the cycle length of induced tachycardias .


Caffeine , at moderate intake , was associated with significant increases in systolic and diastolic blood pressures , but had no evidence of a significant effect on cardiac conduction and refractoriness .


Furthermore , no effect of caffeine on SVT induction or more rapid rates of induced tachycardias was found .


Bipolar disorder often co-occurs with anxiety disorders .


Evidence suggests that second-generation antipsychotics ( SGAs ) may be useful in treating both conditions .


This study examined the efficacy of ziprasidone in the treatment of these disorders .


This @-site , randomized , double-blind , placebo-controlled , parallel group , @-week trial of ziprasidone monotherapy examined @ subjects with bipolar disorder and lifetime panic disorder ( with or without agoraphobia ) or generalized anxiety disorder ( GAD ) experiencing moderately severe anxiety symptoms at entrance into the study .


Both bipolar disorder and anxiety diagnoses were based on DSM-IV-TR criteria .


Patients were screened and randomized from June @ , @ , through August @ , @ .


Primary outcome measures were the Clinical Global Impressions-@ Anxiety Scale ( CGI-@ Anxiety ) and the Sheehan Disability Scale ( SDS ) , with secondary measures monitoring anxiety and mood symptoms .


Last-observation-carried-forward analyses demonstrated that patients in the ziprasidone group did not improve significantly more than those in the placebo group on the CGI-@ Anxiety ( F@ = @ ; P = @ ) or SDS ( F@ = @ ; P = @ ) .


Secondary analysis using hierarchical linear modeling found similar results ( CGI-@ Anxiety : F@ = @ ; P = @ ; and SDS : F@ = @ ; P = @ ) .


Regardless of group , time in the study was associated with significant decrease in anxiety ( F@ = @ ; P = @ ) and total disability ( F@ = @ ; P < @ ) .


Patients in the ziprasidone group showed a greater increase in abnormal involuntary movement , and @ % ( n = @ ) of the subjects who withdrew from the study due to adverse events , serious adverse events , or side effects were in the ziprasidone group .


Results suggest that ziprasidone monotherapy was not associated with a clinically significant improvement in anxiety symptoms or improved function for patients with bipolar disorder , lifetime panic disorder or GAD , and concurrent moderately severe anxiety symptoms , and it was associated with a more negative side-effect profile relative to placebo .


Epinastine hydrochloride is a selective histamine H@ receptor antagonist that also inhibits IgE receptor-mediated histamine release from mast cells .


To show the superiority of epinastine @ % ophthalmic solution ( epinastine ) to placebo ophthalmic solution ( placebo ) and noninferiority to olopatadine @ % ophthalmic solution ( olopatadine ) for cedar pollen antigen-induced ocular itching and conjunctival hyperemia .


The study was conducted in ophthalmologically asymptomatic adult volunteers with seasonal allergic conjunctivitis using a conjunctival allergen challenge test .


Subjects were randomized into @ groups ( n = @ ) to evaluate superiority to placebo ( visits @ to @ ) and @ groups ( n = @ ) to evaluate noninferiority to olopatadine ( visit @ ) .


At each visit , a single administration of the study medication was instilled at @ minutes ( visit @ ) , @ hours ( visit @ ) , @ hours ( visit @ ) , and @ hours ( visit @ ) before the conjunctival allergen challenge test .


Ocular itching and conjunctival hyperemia of allergic conjunctivitis were assessed after the conjunctival allergen challenge test .


For the primary end point , epinastine showed superiority to placebo for the inhibition of ocular itching and conjunctival hyperemia induced at @ hours after the dose ( equivalent to @-times-daily dosing ) .


For the secondary end points , epinastine significantly inhibited itching and conjunctival hyperemia induced at @ minutes and @ hours after the dose ( equivalent to @-times-daily dosing ) compared with placebo .


In addition , epinastine demonstrated noninferiority to olopatadine for ocular itching and conjunctival hyperemia .


No adverse drug reactions or serious adverse events were reported throughout the study , indicating that epinastine has a good safety profile .


Epinastine is effective and safe for the treatment of allergic conjunctivitis .


Sarcopenia is a defining feature of cancer cachexia associated with physical decline , poor quality of life and poor prognosis .


Thus , maintaining muscle mass is an important aim of cachexia treatment .


Many patients at risk for developing cachexia or with cachexia experience side effects of chemotherapy that might aggravate the development of cachexia .


However , achieving tumor control might reverse the catabolic processes causing cachexia .


There is limited knowledge about muscle mass changes during chemotherapy or whether changes in muscle mass are associated with response to chemotherapy .


In this pilot study , patients with advanced non-small cell lung cancer ( NSCLC ) receiving three courses of palliative chemotherapy were analyzed .


Muscle mass was measured as skeletal muscle cross sectional area ( SMCA ) at the level of the third lumbar vertebrae using CT images taken before and after chemotherapy .


In total @ patients , @ % women , mean age @ years ( range @-@ ) , participated ; @ % had stage IV disease and @ % were sarcopenic at baseline .


Mean reduction in SMCA from pre - to post-chemotherapy was @ cm@ ( CI @ % -@ -- @ ; p < @ ) , corresponding to a @ kg loss of whole body muscle mass .


Sixteen patients remained stable or gained SMCA .


Of these , @ ( @ % ) responded to chemotherapy , while two progressed ( p = @ ) .


Maintaining or gaining SMCA resulted in longer median overall survival ( loss : @ months , stable/gain : @ months ; p = @ ) .


Stage of disease ( p = @ ) , treatment regimen ( p = @ ) , response to chemotherapy ( p = @ ) and SMCA change ( p = @ ) , but not sarcopenia at baseline , were significant prognostic factors in the multivariate survival analyses .


Almost half of the patients had stable or increased muscle mass during chemotherapy without receiving any cachexia treatment .


Nearly all of these patients responded to the chemotherapy .


Increase in muscle mass , but not sarcopenia at baseline , was a significant prognostic factor .


The effectiveness of commonly suggested public health interventions to control childhood iron-deficiency anemia has been low .


To determine whether iron provided in Sprinkles daily or in a higher dose once weekly affected hemoglobin , serum ferritin levels , and serum transferrin receptor levels , and to determine whether there were differences in the effects of the two regimens .


In this cluster-randomized , community-based trial conducted in rural areas of Bangladesh , @ children aged @ to @ months with mild to moderate anemia ( hemoglobin @-@ g/L ) were randomly allocated to receive Sprinkles daily ( @ mg of elemental iron , n = @ ) or once weekly ( @ mg of elemental iron , n = @ ) for @ weeks .


Hemoglobin , serum ferritin , and serum transferrin receptor were assessed at the start and end of the intervention .


In both groups , there were significant increases in hemoglobin and serum ferritin and a significant decrease in serum transferrin receptor ( p < @ ) .


There were no significant differences between the groups in the increases in hemoglobin ( @ + / - @ g/L for the group receiving Sprinkles daily and @ + / - @ g/L for the group receiving Sprinkles once weekly ) and serum ferritin ( @ and @ microg/L , respectively ) .


The decrease in serum transferrin receptor also did not significantly differ between the groups ( median , -@ and -@ mg/L , respectively ) .


The prevalence rates of iron-deficiency anemia , depleted iron stores , and tissue iron deficiency decreased significantly within each group ( p < @ ) , with no significant differences between the groups .


Home fortification of complementary foods with Sprinkles given either daily or once weekly improved iron-deficiency anemia and iron status among young children .


Refinements in stent design affecting strut thickness , surface polymer , and drug release have improved clinical outcomes of drug-eluting stents .


We aimed to compare the safety and efficacy of a novel , ultrathin strut cobalt-chromium stent releasing sirolimus from a biodegradable polymer with a thin strut durable polymer everolimus-eluting stent .


We did a randomised , single-blind , non-inferiority trial with minimum exclusion criteria at nine hospitals in Switzerland .


We randomly assigned ( @:@ ) patients aged @ years or older with chronic stable coronary artery disease or acute coronary syndromes undergoing percutaneous coronary intervention to treatment with biodegradable polymer sirolimus-eluting stents or durable polymer everolimus-eluting stents .


Randomisation was via a central web-based system and stratified by centre and presence of ST segment elevation myocardial infarction .


Patients and outcome assessors were masked to treatment allocation , but treating physicians were not .


The primary endpoint , target lesion failure , was a composite of cardiac death , target vessel myocardial infarction , and clinically-indicated target lesion revascularisation at @ months .


A margin of @ % was defined for non-inferiority of the biodegradable polymer sirolimus-eluting stent compared with the durable polymer everolimus-eluting stent .


Analysis was by intention to treat .


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


Between Feb @ , @ , and May @ , @ , we randomly assigned @ patients with @ lesions to treatment with sirolimus-eluting stents ( @ patients , @ lesions ) or everolimus-eluting stents ( @ patients , @ lesions ) .


@ ( @ % ) patients presented with ST-segment elevation myocardial infarction .


Target lesion failure with biodegradable polymer sirolimus-eluting stents ( @ cases ; @ % ) was non-inferior to durable polymer everolimus-eluting stents ( @ cases ; @ % ) at @ months ( absolute risk difference -@ % , upper limit of one-sided @ % CI @ % , p for non-inferiority < @ ) .


No significant differences were noted in rates of definite stent thrombosis ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- , rate ratio -LSB- RR -RSB- @ , @ % CI @-@ , p = @ ) .


In pre-specified stratified analyses of the primary endpoint , biodegradable polymer sirolimus-eluting stents were associated with improved outcome compared with durable polymer everolimus-eluting stents in the subgroup of patients with ST-segment elevation myocardial infarction ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- , RR @ , @ % CI @-@ , p = @ , p for interaction = @ ) .


In a patient population with minimum exclusion criteria and high adherence to dual antiplatelet therapy , biodegradable polymer sirolimus-eluting stents were non-inferior to durable polymer everolimus-eluting stents for the combined safety and efficacy outcome target lesion failure at @ months .


The noted benefit in the subgroup of patients with ST-segment elevation myocardial infarction needs further study .


Besides the classical role of vitamin D on calcium and bone homeostasis , vitamin D deficiency has recently been identified as a contributing factor in the onset of insulin resistance in type @ diabetes mellitus .


However , it is uncertain whether vitamin D deficiency and poor glycaemic control are causally interrelated or that they constitute two independent features of type @ diabetes mellitus .


There are limited clinical trials carried out which measured the effect of vitamin D supplementation on glycaemic control.The objective of this study is to investigate the effect of vitamin D supplementation on glycaemic control and quality of life in patients with type @ diabetes mellitus .


In a randomised double-blind placebo-controlled trial conducted in five general practices in the Netherlands three hundred patients with type @ diabetes mellitus treated with lifestyle advises or metformin or sulphonylurea-derivatives are randomised to receive either placebo or @,@ IU Vitamin D@ at monthly intervals .


The primary outcome measure is the change in glycated haemoglobin level between baseline and six months .


Secondary outcome measures include blood pressure , anthropometric parameters , lipid profile , insulin resistance , quality of life , advanced glycation end products and safety profiles .


Quality of life will be measured by The Short Form ( SF-@ ) Health Survey questionnaire .


Advanced glycation end products are measured by an AGE-reader .


This trial will be the first study exploring the effect of vitamin D supplementation on both glycaemic control and quality of life in patients with type @ diabetes mellitus .


Our findings will contribute to the knowledge of the relationship between vitamin D status and insulin resistance in patients with type @ diabetes mellitus .


While performing a lateral nasal wall osteotomy during a rhinoplasty , an intentional fracture is produced and the fractured segments are medialized to narrow a wide nasal base .


The purpose of this study was to investigate the effect of size , shape , and extension of the external nasal splint on the osteotomy , brow lines , and long-term results of rhinoplasty .


The authors designed a randomized prospective clinical trial .


The study population was composed entirely of patients who were voluntarily referred to the authors ' department from May @ to May @ .


They were randomly divided into @ equal groups .


The primary predictor variable was splint type .


For group @ , the external splint was extended beyond the osteotomy lines laterally and covered the overlying skin of the frontal process of the maxillary bone .


For group @ , the external splint was trimmed above the osteotomy lines .


The primary outcome variables were the levels of satisfaction with the dorsal esthetic lines , brow lines , and distinct osteotomy lines at @ months after the operation .


Demographic variables were gender and age .


Mann-Whitney U test , ( @ ) test , and t test were used to analyze the data .


Results with a P value less than @ were considered significant .


Forty healthy patients ( American Society of Anesthesiologists status I and II ; @ men and @ women ; age range , @ to @ yr ; mean , @ yr ) were selected .


Although the level of satisfaction with the dorsal esthetic lines was higher in group @ , it was not significantly different from group @ ( P > @ ) .


The levels of satisfaction with the brow lines and the distinct osteotomy lines were significantly higher in group @ ( P < @ ) .


The results of this study showed that when a nasal splint is extended beyond the frontal process of the maxilla rather than the base of the nasal bones , positioning of the bones and long-term results are unpredictable .


The complex relationship between left atrial ( LA ) structure and function , electrical burden of atrial fibrillation ( AF ) and stroke risk is not well understood .


We aimed to describe LA structure and function in AF .


Left atrial structure and function was assessed in @ subjects enrolled in the echocardiographic substudy of ENGAGE AF-TIMI @ .


Left atrial size , emptying fraction ( LAEF ) , and contractile function were compared across AF types ( paroxysmal , persistent , or permanent ) and CHADS@ scores as an estimate of stroke risk .


The majority of AF patients ( @ % ) had both LA enlargement and reduced LAEF , with an inverse relationship between LA size and LAEF ( R = -@ , P < @ ) .


With an increasing electrical burden of AF and higher CHADS@ scores , LA size increased and LAEF declined .


Moreover , @ % of AF subjects had impaired LAEF despite normal LA size , and LA contractile dysfunction was present even among the subset of AF subjects in sinus rhythm at the time of echocardiography .


In a contemporary AF population , LA structure and function were increasingly abnormal with a greater electrical burden of AF and higher stroke risk estimated by the CHADS@ score .


Moreover , LA dysfunction was present despite normal LA size and sinus rhythm , suggesting that the assessment of LA function may add important incremental information in the evaluation of AF patients .


Mammography is considered the best imaging technique for breast cancer screening , and the radiographer plays an important role in its performance .


Therefore , continuing education is critical to improving the performance of these professionals and thus providing better health care services .


Our goal was to develop an e-learning course on breast imaging for radiographers , assessing its efficacy , effectiveness , and user satisfaction .


A stratified randomized controlled trial was performed with radiographers and radiology students who already had mammography training , using pre - and post-knowledge tests , and satisfaction questionnaires .


The primary outcome was the improvement in test results ( percentage of correct answers ) , using intention-to-treat and per-protocol analysis .


A total of @ participants were assigned to the intervention ( @ students plus @ radiographers ) with @ controls ( @ +@ ) .


The intervention was completed by @ participants ( @ +@ ) , with @ ( @ +@ ) discontinued interventions , and @ ( @ +@ ) lost to follow-up .


Differences in the primary outcome were found between intervention and control : @ versus @ percentage points ( pp ) , P < @ .


Stratified analysis showed effect in radiographers ( @ pp vs @ pp ; P = @ ) but was unclear in students ( @ pp vs @ pp ; P = @ ) .


Nonetheless , differences in students ' posttest results were found ( @ % vs @ % ; P = @ ) , which were absent in pretest ( @ % vs @ % ; P = @ ) .


The per-protocol analysis showed a higher effect ( @ pp vs @ pp ; P < @ ) , both in students ( @ pp vs @ pp ; P = @ ) and radiographers ( @ pp vs @ pp ; P < @ ) .


Overall , @ % were satisfied with the course , and @ % considered it successful .


This e-learning course is effective , especially for radiographers , which highlights the need for continuing education .


The Internet is used to deliver information on many psychiatric disorders such as bipolar disorder .


This paper reports on the results of a @-months randomised controlled trial , which examined the efficacy of an Internet-based preventive program for bipolar disorder , adjunctive to usual pharmacological management .


Participants were recruited by completing an online screening questionnaire accessed through the Black Dog Institute and Sentiens websites based in Australia .


The treatment was predominantly psycho-educational with cognitive behavioral therapy optional elements .


The attention control treatment comprised directing subjects to a variety of websites focused on ` healthy living ' .


Time to recurrence was determined using Kaplan-Meier survival analysis .


The main outcome measures were recurrence as defined by : ( i ) depressive and/or hypomanic symptomatology and functional capacity ( using Beck Depression Inventory , Internal State Scale and Sheehan Disability Scale ) and ( ii ) hospitalization .


Two-hundred-and-thirty-three subjects were randomized to the active or control treatment groups .


There were no significant differences between the active and control treatment groups on any of the definitions of recurrence .


Reliance on an online self-report tool to confirm diagnosis and hospitalization rates may have potentially allowed for inclusion of individuals with other diagnoses such as borderline personality disorder .


The ` attention control ' treatment may have included more ` active ' components than intended .


This is the first report examining the efficacy of a randomized controlled web-based psychological intervention in a large sample of subjects with bipolar disorder .


The potential reasons for failing to demonstrate a significant difference compared to the active control are discussed .


Early enteral fat supplementation and fish oil ( FO ) stimulates post-resection intestinal adaptation in rats and increases fat absorption in premature infants with bowel resection and an enterostomy .


To test the hypothesis that early fat supplement and FO increases post-resection protein absorption , intestinal RNA , protein without decreasing intestinal arachidonic acid ( AA ) in premature infants with an enterostomy .


@ premature infants ( < @ months old ) with an enterostomy after surgical treatment for necrotizing enterocolitis or spontaneous intestinal perforation who tolerated enteral feeding at @ ml/kg/day were randomized to usual care ( control , n = @ ) or early supplementing enteral Microlipid ( ML ) and FO ( treatment , n = @ ) .


Intralipid was decreased as the dose of enteral fat was increased .


Daily weight , ostomy output and nutritional intake were recorded .


Weekly @-hour ostomy effluent was collected to measure fecal protein .


Protein absorption was calculated by subtracting fecal protein from dietary protein .


Tissue samples from the functional stoma and the nonfunctional distal diverted end were collected during bowel reanastomosis to measure RNA , protein , and fatty acid ( FA ) profile .


Compared to controls , the treatment group had higher protein absorption ( g/kg/day ) and intestinal RNA and protein ( g/mg tissue ) proximal to the ostomy .


The two groups had similar FA profiles except that the treatment group had higher n-@ eicosapentaenoic acid ( EPA , g/mg tissue ) proximal to the ostomy .


Early supplementation of enteral ML and FO to premature infants with an enterostomy increased dietary protein absorption , intestinal RNA , protein and n-@ EPA content without altering other FA content .


We studied the effect of maternal HIV-exposure and timing of antiretroviral treatment ( ART ) in HIV-infected infants on antibody responses to combined diphtheria-toxoid-tetanus-toxoid-whole cell pertussis and Haemophilus influenzae type b conjugate vaccine ( HibCV ) and monovalent hepatitis B vaccine ( HBV ) .


HIV-uninfected infants born to HIV-infected ( HEU ) or HIV-uninfected ( HUU ) mothers were enrolled in parallel with HIV-infected children with CD@ @ % , who were randomized to initiate ART immediately upon confirmation of HIV-infection ( ART-Immed ) or when clinically and/or immunologically indicated ( ART-Def ) .


Infants received three doses of diphtheria-toxoid-tetanus-toxoid - wP-HibC/HBV at @ , @ and @ weeks of age .


Antibody to diphtheria-toxoid , tetanus-toxoid , pertussis toxin , filamentous hemagglutinin ( FHA ) and hepatitis B surface antigen ( HBsAg ) were measured by Luminex multiplex-immunoassay and polyribosyl-ribitol phosphate ( PRP ) antibodies by standard ELISA and bactericidal assay .


Prevaccination antibody geometric mean concentrations ( GMCs ) were higher in HUU than HEU infants for tetanus-toxoid , but lower for HBsAg , diphtheria-toxoid and FHA .


Postvaccination GMCs and proportion with seroprotective antibody levels or sero-conversion rates were similar between HUU and HEU infants for all vaccines .


Postvaccination GMCs were higher in HUU for tetanus-toxoid , diphtheria-toxoid , HBsAg and FHA than ART-Immed infants ; and for tetanus-toxoid , HBsAg and pertussis-toxoid than ART-Def infants .


Nevertheless , there was no difference in proportion of HUU and HIV-infected infants who developed sero-protective vaccine-specific antibody levels postvaccination .


The timing of ART initiation generally did not affect immune responses to vaccines between HIV-infected groups .


Vaccination with DTwP-HibCV/HBV of HEU and HIV-infected infants initiated on early-ART confers similar immunity compared with HUU children .


Previous analyses of the International Subarachnoid Aneurysm Trial ( ISAT ) cohort have reported on the risks of recurrent subarachnoid haemorrhage and death or dependency for a minimum of @ years and up to a maximum of @ years after treatment of a ruptured intracranial aneurysm with either neurosurgical clipping or endovascular coiling .


At @ year there was a @ % absolute and a @ % relative risk reduction of death and dependency in the coiling group compared with the clipping group , but the medium-term results showed the increased need for re-treatment of the target aneurysm in the patients given coiling .


We report the long-term follow-up of patients in this UK cohort .


In ISAT , patients were randomly allocated to either neurosurgical clipping or endovascular coiling after a subarachnoid haemorrhage , assuming treatment equipoise , between Sept @ , @ , and May @ , @ .


We followed up @ patients in @ UK neurosurgical centres for death and clinical outcomes for @-@ years .


We assessed dependency as self-reported modified Rankin scale score obtained through yearly questionnaires .


Data for recurrent aneurysms and rebleeding events were collected from questionnaires and from hospital and general practitioner records .


The Office for National Statistics supplied data on deaths .


This study is registered , number ISRCTN@ .


At @ years , @ ( @ % ) of @ patients allocated endovascular coiling and @ ( @ % ) of @ patients allocated neurosurgical clipping were alive ( odds ratio -LSB- OR -RSB- @ , @ % CI @-@ ) .


Of @ individuals who returned a questionnaire at @ years , @ ( @ % ) patients treated with endovascular coiling and @ ( @ % ) patients treated with neurosurgical clipping were independent ( modified Rankin scale score @-@ ; OR @ ; @ % CI @-@ ) .


Patients in the endovascular treatment group were more likely to be alive and independent at @ years than were patients in the neurosurgery group ( OR @ , @ % CI @-@ ) .


@ patients had a recurrent subarachnoid haemorrhage more than @ year after their initial haemorrhage ( @ from the target aneurysm ) .


Although rates of increased dependency alone did not differ between groups , the probability of death or dependency was significantly greater in the neurosurgical group than in the endovascular group .


Rebleeding was more likely after endovascular coiling than after neurosurgical clipping , but the risk was small and the probability of disability-free survival was significantly greater in the endovascular group than in the neurosurgical group at @ years .


HIV and other STIs are major public health concerns for women , and risky sexual behaviors increase the risk of transmission .


Risky sexual behaviors include sexual abdication , that is , willingness to let a partner decide how far to go sexually .


Alcohol intoxication is a risk factor for risky sexual behavior , and the Inhibition Conflict Model of Alcohol Myopia may help explain this relationship .


This model suggests that in order for intoxication to influence behavior there must be high conflict , meaning the strength of the instigatory cues and inhibitory cues are both high .


Recent research indicates that the degree to which cues are experienced as high in instigation or inhibition is subject to individual difference factors .


One individual difference factor associated with alcohol-related sexual risk taking is child sexual abuse ( CSA ) history .


The current study examined the influence of acute alcohol intoxication , CSA , and inhibition conflict on sexual abdication with @ women ( mean age @ ) randomized into a @ ( alcohol , control ) @ ( high conflict , low conflict ) experimental design .


Regression analyses yielded a significant @-way interaction , F ( @,@ ) = @ , R ( @ ) = @ , p < @ .


When there was high conflict , intoxicated CSA women were more likely to abdicate than sober CSA women , however , sober CSA women were less likely to abdicate than sober NSA women , when there was low conflict , CSA history and alcohol intoxication had no influence on abdication .


These results may help explain the association between alcohol and risky sexual decision making among women with CSA .


To test the efficacy of a Stress Management and Resiliency Training ( SMART ) program for decreasing stress and anxiety and improving resilience and quality of life among Department of Radiology physicians .


The study was approved by the institutional review board .


A total of @ Department of Radiology physicians were randomized in a single-blind trial to either the SMART program or a wait-list control arm for @ weeks .


The program involved a single @-min group session in the SMART training with two follow-up phone calls .


Primary outcomes measured at baseline and week @ included the Perceived Stress Scale , Linear Analog Self-Assessment Scale , Mindful Attention Awareness Scale , and Connor-Davidson Resilience Scale .


A total of @ physicians completed the study .


A statistically significant improvement in perceived stress , anxiety , quality of life , and mindfulness at @ weeks was observed in the study arm compared to the wait-list control arm ; resilience also improved in the active arm , but the changes were not statistically significant when compared to the control arm .


A single session to decrease stress among radiologists using the SMART program is feasible .


Furthermore , the intervention afforded statistically significant and clinically meaningful improvement in anxiety , stress , quality of life , and mindful attention .


Further studies including larger sample size and longer follow-up are warranted .


Colorectal cancer ( CRC ) is the second most common malignancy in Europe and a leading cause of cancer-related death .


Almost @ % of patients with CRC develop liver metastases , which heralds a poor prognosis unless metastases can be downsized to surgical resection or ablation .


The FOXFIRE trial examines the hypothesis that combining radiosensitising chemotherapy ( OxMdG : oxaliplatin , @-fluorouracil and folic acid ) with Selective Internal Radiation Therapy ( SIRT or radioembolisation ) using yttrium-@ resin microspheres ( SIR-Spheres ; Sirtex Medical Limited , North Sydney , Australia ) as a first-line treatment for liver-dominant metastatic CRC will improve clinical outcomes when compared to OxMdG chemotherapy alone .


FOXFIRE is an open-label , multicentre , randomised controlled trial of OxMdG with or without the addition of SIRT ( @:@ randomisation ) .


Eligible adult patients have histologically confirmed colorectal adenocarcinoma , liver metastases measurable on computed tomography scan and untreatable by either surgical resection or local ablation , and they may have limited extra-hepatic disease , defined as @ nodules in the lung and/or one other metastatic site which is amenable to future definitive treatment .


Eligible patients may have received adjuvant chemotherapy following resection of the primary tumour , but are not permitted to have previously received chemotherapy for metastatic disease , and must have a life expectancy of @ months and a WHO performance status of @-@ .


The primary outcome is overall survival .


Secondary outcomes include progression free survival ( PFS ) , liver-specific PFS , patient-reported outcomes , safety , response rate , resection rate and cost-effectiveness .


FOXFIRE shares a combined statistical analysis plan with an international sister trial called SIRFLOX .


This trial is establishing a network of SIRT centres and ` feeder ' chemotherapy-only centres to standardise the delivery of SIRT across the whole of the UK and to provide greater equity of access to this highly specialised liver-directed therapy .


The FOXFIRE trial will establish the potential role of adding SIRT to first-line chemotherapy for unresectable liver metastatic colorectal cancer , and the impact on current treatment paradigms for metastatic CRC .


To compare adipose tissue concentration among obese women receiving @ g compared with @ g of precesarean cefazolin prophylaxis .


This was a double-blind randomized controlled trial of women with singleton gestations and body mass indexes ( BMIs ) of @ or greater at their first prenatal visit undergoing cesarean delivery at term .


Women were randomly allocated , stratified by BMI , to receive @ g or @ g of cefazolin .


Subcutaneous adipose tissue was harvested twice : before ( opening ) fascial incision and after ( closing ) fascial closure .


The primary outcome was opening adipose tissue cefazolin concentration , measured by high-pressure liquid chromatography .


From April @ to July @ , @ women were enrolled , @ included in the analysis : @ in the @-g group and @ in the @-g group .


Baseline characteristics were similar between groups .


Median opening adipose tissue concentration was similar between the @-g and @-g groups ( @ -LSB- interquartile range @-@ @ -RSB- compared with @ -LSB- interquartile range @-@ @ -RSB- micrograms/g , P = @ ) .


The percentage of women with opening concentrations above @ micrograms/g , the minimally inhibitory concentration of cefazolin for Staphylococcus species , was similar ( @ % compared with @ % , P = @ ) .


All samples were above @ micrograms/g , the minimally inhibitory concentration for Enterobacteriaceae .


Closing adipose tissue concentrations and stratified analyses were consistent with the overall analysis .


In obese women undergoing cesarean delivery , prophylaxis with @ g of cefazolin did not significantly increase adipose tissue concentration .


Thus , our data do not support recommendations for @-g dosing .


Liraglutide can modulate insulin secretion by directly stimulating beta cells or indirectly through weight loss and enhanced insulin sensitivity .


Recently , we showed that liraglutide treatment in overweight individuals with prediabetes ( impaired fasting glucose and/or impaired glucose tolerance ) led to greater weight loss ( -@ % vs -@ % ) and improvement in insulin resistance compared with placebo .


The current study evaluates the effects on beta cell function of weight loss augmented by liraglutide compared with weight loss alone .


This was a parallel , randomised study conducted in a single academic centre .


Both participants and study administrators were blinded to treatment assignment .


Individuals who were @-@ years old , overweight ( BMI @-@ kg/m ( @ ) ) and with prediabetes were randomised ( via a computerised system ) to receive liraglutide ( n = @ ) or matching placebo ( n = @ ) , and @ participants were analysed .


All were instructed to follow an energy-restricted diet .