AUC@-@ and C max in the @-h post-meal status were significantly higher than in the complete fasting status ( GMR = @ , P < @ ; GMR = @ , P < @ , respectively ) .


However , because the concentration of erlotinib did not reach the steady state within @days in the complete fasting state , we conducted analyses only on day @ , which showed no significant difference in AUC@-@ or C max between the two conditions .


The more rapid increase in AUC@-@ and C min did not produce any earlier and more severe toxic events .


The AUC@-@ increased significantly faster ( @-@ % greater ) in the @-h post-meal status than in complete fasting status , which suggested that the two gastric emptying states might differ in their absorption .


However , there was no clinically significant difference in bioavailability or toxicity between the two clinically used fed conditions at least in @days .


Percutaneous tunneling ( hydrodissection ) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate .


We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration ( EC@ ) of remifentanil needed to maintain hemodynamic stability during hydrodissection .


Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups-group D ( n = @ ) and group C ( n = @ ) patients received dexmedetomidine @g/kg and normal saline for @min before anesthetic induction , respectively .


The EC@ of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon 's up-and-down method with initial dose ( @and @ng/mL in groups D and C , respectively ) .


The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient , using increments or decrements of @ ng/mL .


Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure < @ % of baseline .


The EC@ of remifentanil for maintaining hemodynamic stability during hydrodissection was @ ng/mL in group D and @ ng/mL in group C ( p = @ ) .


A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy .


Prenatal lipid-based nutrient supplements ( LNS ) have been shown to improve birth anthropometry .


However , little is known about the effects of such supplements on infant health .


We hypothesized that prenatal LNS compared with multiple micronutrient supplement for pregnant and lactating women would improve survival , growth , and morbidity during infancy .


Infants ' weight , length , head , chest , and mid-upper arm circumferences were measured during monthly home visits from birth to @ months of age in the Micronutriments et Sant de la Mre et de l'Enfant -- @ trial .


Differences in stunting and wasting episodes between study arms were assessed by Cox regression for recurrent event models .


Morbidity signs during the @ weeks before the visits and death cases were also assessed by multilevel analysis accounting for repeated individual measurements .


Infant length-for-age growth ( -@ z score/month ; @ % confidence interval : -@ to -@ ; P = @ ) for the LNS group was inferior to that of the control group .


We did not find evidence of significant difference in mortality or morbidity between groups .


The previously reported positive effect of prenatal LNS on birth length was not sustained during the postnatal phase .


Prenatal LNS does not appear to make a long-lasting difference in child linear growth .


To assess the effect of pulsed electromagnetic fields ( PEMFs ) on balance ability of postmenopausal women with osteoporosis .


@ eligible patients were randomly divided into experimental ( n = @ ) and control ( n = @ ) groups .


Patients in both groups received conventional drug therapy .


Meanwhile , patients in the experimental group were given PEMFs once a day for @ days .


The Berg Balance Scale ( BBS ) scores increased and the timed upand to test ( TUG ) scores , sway index ( forward-backward ) , rectangle area and sway path decreased in the patients in the experimental group ( P < @ ) .


In the patients in the control group , only changes in BBS scores and sway path were statistically significant ( P < @ ) .


The decrease of sway index ( forward-backward ) in the experimental group was greater than that of the control group ( P < @ @ ) .


PEMFs can improve the balance ability of patients with post-menopausal osteoporosis .


The prognostic impact of improvement in health-related quality of life ( QoL ) and its relation to response in cardiac resynchronization therapy ( CRT ) recipients remains unknown .


To assess the correspondence between response to CRT and improvements in QoL and to verify if a change in QoL after pacing influences outcome in CRT patients .


Ninety-seven participants of the Triple-Site Versus Standard Cardiac Resynchronization Therapy Trial ( TRUST CRT ) randomized trial , in New York Heart Association class III-IV , QRS width @ ms , left ventricular ejection fraction @ % , and significant mechanical dyssynchrony were included .


Subjects filled out the Minnesota-QoL questionnaire prior to and @ months after CRT with defibrillator ( CRT-D ) implantation .


Data on major adverse cardiac events ( MACEs : death , heart failure hospitalization , heart transplant ) collected within the next @ years and adjudicated blindly constituted the censoring variables .


Within the first @ months of resynchronization QoL improved in @ % , while worsening in @ % of patients .


Clinical response , but not the echocardiographic one , was associated with improved QoL .


During subsequent @ years MACEs occurred in @ % of patients ( @ % died ) .


Subjects without QoL improvement were significantly ( both P < @ ) more prone to experience MACE ( @ % vs @ % ) and die ( @ % vs @ % ) within the follow-up .


Unimproved QoL increased the probability of future MACE by @ times ( @ % confidence intervals -LSB- CI -RSB- : @-@ @ ; P = @ ) and death by @ times ( @ % CI : @-@ @ ; P = @ ) independently from clinical and echocardiographic response .


Clinical response , but not the echocardiographic one , was associated with improved QoL in CRT recipients .


These preliminary data suggest that lack of improvement in QoL after CRT was associated with a strongly unfavorable prognosis , regardless of functional or echocardiographic response .


Our results merit further studies with a larger number of patients .


To investigate the effect of resin-modified , glass-ionomer cement lining on the quality of posterior resin composite restorations , bonded with a two-step , total-etch or self-etching adhesive , at @year .


Patients with @-@ moderate-to-deep , primary occlusal caries in molars were informed and recruited .


A total of @ composite restorations were placed in @ participants , with one of four restorative procedures : ( a ) bonded with a total-etch adhesive ( Single Bond @ ) ; ( b ) lined with glass-ionomer cement ( Fuji Lining LC ) , and then bonded with total-etch adhesive ; ( c ) bonded with a self-etching adhesive ( Clearfil SE Bond ) ; and ( d ) lined with glass-ionomer cement , and then bonded with self-etching adhesive .


At @year , @ patients ( @ restorations ) attended the recall .


Each of the restorations was evaluated and scored from @ ( clinically excellent ) to @ ( clinically poor ) using the following criteria : ( a ) patient satisfaction ; ( b ) fracture and retention ; ( c ) marginal adaptation ; ( d ) recurrent caries ; and ( e ) post-operative sensitivity .


At @year , the qualities of the restorations were not significantly affected by the placement of glass-ionomer cement lining , regardless of the adhesive used ( P > @ ) .


Most of the restorations were scored @ for all criteria .


The benefit of placing a glass-ionomer cement liner in resin composite restoration is questionable .


This was a prospective study of patients who underwent vertebroplasty ( VP ) at a single institute .


The aim of this study was to assess and compare the clinical outcomes and complications of unilateral and bilateral VP in treating severe vertebral compression fractures .


Typically , VP involves cement injection by bilateral transpedicular or extrapedicular approach .


Recently , several articles reported that unilateral VP can achieve comparable outcomes in most cases .


However , few prospective randomized studies compared the clinical outcomes and complications in treating severe vertebral compression fractures .


Thirty-nine patients with @ severe osteoporotic vertebral compression fractures ( OVCFs ) were randomly allocated into @ groups adopting unilateral or bilateral VP .


Preoperative and postoperative pain scores , back disability , and cement leakage were recorded and compared .


Significant improvement on the visual analog scale and Oswestry disability index scores were noted in each group , and there were no significant differences between the @ groups .


Cement leakage was seen more in bilateral VP .


Severe OVCFs should be candidates for VP .


The unilateral VP can get the same clinical results with fewer complications compared with the bilateral VP .


To investigate the impact of a @-week exercise programme in addition to usual care for post-traumatic stress disorder ( PTSD ) .


An assessor-blinded randomized controlled trial was conducted among @ participants with a DSM-IV-TR diagnosis of primary PTSD .


Participants were recruited after admission to an in-patient programme at a private hospital .


Participants were randomized to receive either usual care ( n = @ ) , or exercise in addition to usual care ( n = @ ) .


The exercise intervention involved three , @-min resistance-training sessions/week and a pedometer-based walking programme .


Usual care involved psychotherapy , pharmaceutical interventions , and group therapy .


Primary outcome was PTSD symptoms assessed via the PTSD checklist-civilian version ( PCL-C ) .


Secondary outcomes included symptoms of depression , anthropometry , physical activity , mobility , strength , and sleep quality .


Participants had a mean ( SD ) age of @ years ( @ ) , @ % male .


PTSD symptoms in the intervention group significantly reduced compared with the usual care group ( mean difference = -@ , @ % CI -@ to -@ , P = @ , n = @ ) .


There were significant between-group differences at follow-up for depressive symptoms , waist circumference , sleep quality , and sedentary time .


This study provides the first evidence that an exercise intervention is associated with reduced PTSD and depressive symptoms , reduced waist circumference , and improved sleep quality .


To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP ) versus percutaneous nephrolithotomy ( PCNL ) for large renal pelvic calculi using a randomized controlled trial .


Patients with large renal pelvic calculi were prospectively randomized using matched-pair analysis ( @:@ scenario ) into either the RLP group or the PCNL group .


The patients in each group underwent the procedure accordingly .


Treatment efficacy , safety , and complications were evaluated after surgery .


Finally , @ eligible patients were included and the demographics and mean stone size of two groups were similar .


We found no significant differences in the mean postoperative hospital stay ( @ vs. @ days ) , rate of blood transfusion ( @ % vs. @ % ) , conversion rate ( @ % vs. @ % ) , and rate of total postoperative complication ( p > @ ) .


The procedural duration and mean drop in hemoglobin levels were significantly lower in the RLP group as compared with the PCNL group ( @ vs. @ minutes , p < @ ; @ vs. @ g/dL , p < @ , respectively ) .


Significant differences were also observed in the stone-free rate ( @ % vs. @ % , p = @ ) and postoperative fever rate ( @ % vs. @ % , p = @ ) .


Current evidence suggests that PCNL and RLP are both effective and safe for the treatment of large renal pelvic calculi .


Our study shows that , compared with the PCNL approach , RLP for large renal pelvic stone resulted in shorter operative time , less bleeding , less postoperative fever , and a higher stone-free rate .


Data from larger , multicenter randomized controlled trials of high quality are needed to further confirm our findings .


Postoperative catheter-related bladder discomfort ( CRBD ) can be a distressing complication for patients in whom a urinary catheter was inserted during an operation .


Our randomized , dual-center , clinical trial investigated the effects of butylscopolamine on the prevention of postoperative CRBD in patients undergoing various operations .


Adult male patients undergoing elective operations requiring intraoperative urinary catheterization under general anesthesia were enrolled .


They were assigned randomly to @ groups : The butylscopolamine group ( n = @ ) received @ mg of butylscopolamine intravenously immediately before the end of the operation ; no medication was given for prevention of CRBD in the control group ( n = @ ) .


The presence and severity of CRBD were assessed at @ , @ , and @ hours postoperatively .


Adverse effects of butylscopolamine were also examined .


The overall incidence of CRBD was less in the butylscopolamine group than in the control group ( @ % vs @ % , respectively ; P = @ ) .


The incidence of CRBD at @ , @ , and @ hours postoperatively was also less in the butylscopolamine group ( P = @ , @ , and @ , respectively ) .


In addition , the average severity of CRBD for @ hours postoperatively was significantly less in the butylscopolamine group than in the control group ( median , @ -LSB- interquartile range , @-@ -RSB- vs @ -LSB- interquartile range , @-@ -RSB- , respectively ; P = @ ) .


Adverse effects were comparable between the @ groups .


Intravenous administration of butylscopolamine at the end of an operation decreases effectively the incidence and severity of early postoperative CRBD without adverse effects .


Preclinical studies comparing paclitaxel formulated with polyethoxylated castor oil with the sonicated formulation of liposome-entrapped paclitaxel ( LEP ) have demonstrated that LEP was associated with reduced toxicity while maintaining similar efficacy .


Preliminary studies on the pharmacokinetics in patients support earlier preclinical data , which suggested that the LEP Easy-to-Use ( LEP-ETU ) formulation and paclitaxel formulated with castor oil may have comparable pharmacokinetic properties .


Our objectives were : ( @ ) to determine bioequivalence of paclitaxel pharmaceutically formulated as LEP-ETU ( test ) and paclitaxel formulated with castor oil ( reference ) ; and ( @ ) to assess the tolerability of LEP-ETU following intravenous administration .


Patients with advanced cancer were studied in a randomized , @-period crossover bioequivalence study .


Patients received paclitaxel @ mg/m ( @ ) administered as an intravenous infusion over @ minutes , either as a single-treatment cycle of the test formulation followed by a single-treatment cycle of the reference formulation , or vice versa .


Thirty-two of @ patients were evaluable and were included in the analysis for bioequivalence .


Mean total paclitaxel Cmax values for the test and reference formulations were @ and @ ng/mL , respectively .


Corresponding AUC@ - values were @,@ and @,@ ngh/mL , respectively .


Treatment ratios of the geometric means were @ % ( @ % CI , @ % -@ % ) for Cmax and @ % ( @ % CI , @ % -@ % ) for AUC@ - .


These results met the required @ % to @ % bioequivalence criteria .


The most frequently reported adverse events after LEP-ETU administration were fatigue , alopecia , and myalgia .


At the studied dose regimen , LEP-ETU showed bioequivalence with paclitaxel formulated with polyethoxylated castor oil .


To assess the efficacy and safety of rilonacept , an interleukin-@ inhibitor , in a randomized , double-blind , placebo-controlled trial .


An initial @-week double-blind placebo phase was incorporated into a @-week randomized multicenter design , followed by an open-label phase .


Seventy-one children who had active arthritis in @ joints were randomized ( @:@ ) to the @ arms of the study .


Patients in the rilonacept arm received rilonacept ( loading dose @ mg/kg followed by @ mg/kg weekly , subcutaneously ) beginning on day @ .


Patients in the placebo arm received placebo for @ weeks followed by a loading dose of rilonacept at week @ followed by weekly maintenance doses .


The primary end point was time to response , using the adapted American College of Rheumatology Pediatric @ criteria coupled with the absence of fever and taper of the dosage of systemic corticosteroids , using prespecified criteria .


The time to response was shorter in the rilonacept arm than in the placebo arm ( ( @ ) = @ , P = @ ) .


The secondary analysis , which used the same response criteria , showed that @ ( @ % ) of @ patients in the rilonacept arm had a response at week @ compared with @ ( @ % ) of @ patients in the placebo arm ( P = @ ) .


Exacerbation of systemic juvenile idiopathic arthritis ( JIA ) was the most common severe adverse event .


More patients in the rilonacept arm had elevated liver transaminase levels ( including levels more than @ times the upper limit of normal ) compared with those in the placebo arm .


Adverse events were similar in the @ arms of the study .


Rilonacept was generally well tolerated and demonstrated efficacy in active systemic JIA .


To evaluate the effectiveness of a multilevel and multimodal school-based education program .


A cluster randomized controlled trial with @ secondary schools in Hong Kong and a total of @ students ( intervention : @ vs control : @ ; @ % boys ; mean age SD : @ @ years ) were included in the final analysis .


The intervention included a town hall seminar , small class workshops , a slogan competition , a brochure , and an educational Web site .


Their parents and teachers were offered sleep education seminars .


The control schools did not receive any sleep program .


Data were collected before and @ weeks after the intervention .


The students in the intervention group had significantly improved sleep knowledge compared with the control group ( mean difference : @ -LSB- @ % confidence interval ( CI ) : @ to @ -RSB- ; Cohen 's d = @ ) as measured by using a sleep knowledge questionnaire .


Weekday sleep duration was reduced in both groups , and the significant difference in weekday sleep duration was lost in the intention-to-treat analysis ( mean difference : @:@ -LSB- @ % CI : -@:@ to @:@ -RSB- ) .


In addition , the intervention group had a lower incidence of consuming caffeine-containing energy drinks ( adjusted odds ratio : @ -LSB- @ % CI : @ to @ -RSB- ) and had better behavioral ( mean difference : -@ -LSB- @ % CI : -@ to -@ -RSB- ; Cohen 's d = @ ) and mental health ( mean difference : -@ -LSB- @ % CI : -@ to -@ -RSB- ; Cohen 's d = @ ) outcomes .


A school-based sleep education program was effective in enhancing sleep knowledge and improving behavioral and mental health , but it had no significant impact on sleep duration or pattern among adolescents .


Anaemia is a common health problem among pregnant women and a contributing factor with a major influence on maternal mortality in Indonesia .


The Four Pillars Approach is a new approach to anaemia in pregnancy , combining four strategies to improve antenatal and delivery care .


The primary objective of this study is to measure the effectiveness of the Four Pillars Approach .


The barriers , the facilitators , and the patients ' as well as the midwives ' satisfaction with the Four Pillars Approach will also be measured .


This study will use a cluster randomised controlled trial .


This intervention study will be conducted in the Public Health Centres with basic emergency obstetric care in Yogyakarta Special Province and in Central Java Province .


We will involve all the Public Health Centres ( @ ) with emergency obstetric care in Yogyakarta Special Province .


Another @ Public Health Centres with emergency obstetric care in Central Java Province which have similarities in their demographic , population characteristics , and facilities will also be involved .


Each Public Health Centre will be asked to choose two or three nurse-midwives to participate in this study .


For the intervention group , the Public Health Centres in Yogyakarta Special Province , training on the Four Pillars Approach will be held prior to the model 's implementation .


Consecutively , we will recruit @ pregnant women with anaemia to take part in part in the study to measure the effectiveness of the intervention .


The outcome measurements are the differences in haemoglobin levels between the intervention and control groups in the third trimester of pregnancy , the frequency of antenatal care attendance , and the presence of a nurse-midwife during labour .


Qualitative data will be used to investigate the barriers and facilitating factors , as to nurse-midwives ' satisfaction with the implementation of the Four Pillars Approach .


If the Four Pillars Approach is effective in improving the outcome for pregnant women with anaemia , this approach could be implemented nationwide and be taken into consideration to improve the outcome for other conditions in pregnancy , after further research .


Progressive Supranuclear Palsy ( PSP ) is a sporadic and progressive neurodegenerative disease which belongs to the family of tauopathies and involves both cortical and subcortical structures .


No effective therapy is to date available .


Autologous bone marrow ( BM ) mesenchymal stem cells ( MSC ) from patients affected by different type of parkinsonisms have shown their ability to improve the dopaminergic function in preclinical and clinical models .


It is also possible to isolate and expand MSC from the BM of PSP patients with the same proliferation rate and immuphenotypic profile as MSC from healthy donors .


BM MSC can be efficiently delivered to the affected brain regions of PSP patients where they can exert their beneficial effects through different mechanisms including the secretion of neurotrophic factors.Here we propose a randomized , placebo-controlled , double-blind phase I clinical trial in patients affected by PSP with MSC delivered via intra-arterial injection .


To our knowledge , this is the first clinical trial to be applied in a no-option parkinsonism that aims to test the safety and to exploit the properties of autologous mesenchymal stem cells in reducing disease progression .


The study has been designed to test the safety of this `` first-in-man '' approach and to preliminarily explore its efficacy by excluding the placebo effect .


The importance of using technologies such as e-learning in different disciplines is discussed in the literature .


Researchers have measured the effectiveness of e-learning in a number of fields.Considering the lack of research on the effectiveness of online learning in dental education particularly in Iran , the advantages of these learning methods and the positive university atmosphere regarding the use of online learning .


This study , therefore , aims to compare the effects of two methods of teaching ( virtual versus traditional ) on student learning .


This post-test only design study approached @ , fifth year dental students of Shiraz University of Medical Sciences .


From this group , @ students agreed to participate .


These students were randomly allocated into two groups , experimental ( virtual learning ) and comparison ( traditional learning ) .


To ensure similarity between groups , we compared GPAs of all participants by the Mann-Whitney U test ( P > @ ) .


The experimental group received a virtual learning environment courseware package specifically designed for this study , whereas the control group received the same module structured in a traditional lecture form .


The virtual learning environment consisted of online and offline materials .


Two identical valid , reliable post-tests that consisted of @ multiple choice questions ( MCQs ) and @ essay questions were administered immediately ( @ min ) after the last session and two months later to assess for knowledge retention .


Data were analyzed by SPSS version @ .


A comparison of the mean knowledge score of both groups showed that virtual learning was more effective than traditional learning ( effect size = @ ) .


The newly designed virtual learning package is feasible and will result in more effective learning in comparison with lecture-based training .


However further studies are needed to generalize the findings of this study .


Cerium oxide nanoparticles ( nanoceria ) are effective at quenching reactive oxygen species ( ROS ) in cell culture and animal models .


Although nanoceria reportedly deposit in lungs , their efficacy in conferring lung protection during oxidative stress remains unexplored .


Thus , the study evaluated the protective efficacy of nanoceria in rat lung tissue during hypobaric hypoxia .


A total of @ animals were randomly divided into four equal groups ( control -LSB- C -RSB- , nanoceria treated -LSB- T -RSB- , hypoxia -LSB- H -RSB- , and nanoceria treated plus hypoxia -LSB- T+H -RSB- ) .


Animals were injected intraperitoneally with either a dose of @ g/kg body weight/week of nanoceria ( T and T+H groups ) or vehicle ( C and H groups ) for @ weeks .


After the final dose , H and T+H animals were challenged with hypobaric hypoxia , while C and T animals were maintained at normoxia .


Lungs were isolated and homogenate was obtained for analysis of ROS , lipid peroxidation , glutathione , protein carbonylation , and @-hydroxynonenal-adduct formation .


Plasma was used for estimating major inflammatory cytokines using enzyme-linked immunosorbent assay .


Intact lung tissues were fixed and both transmission electron microscopy and histopathological examinations were carried out separately for detecting internalization of nanoparticles as well as altered lung morphology .


Spherical nanoceria of @-@ nm diameter were synthesized using a microemulsion method , and the lung protective efficacy of the nanoceria evaluated during hypobaric hypoxia .


With repeated intraperitoneal injections of low micromole concentration , we successfully localized the nanoceria in rodent lung without any inflammatory response .


The lung-deposited nanoceria limited ROS formation , lipid peroxidation , and glutathione oxidation , and prevented oxidative protein modifications like nitration and carbonyl formation during hypobaric hypoxia .


We also observed reduced lung inflammation in the nanoceria-injected lungs , supporting the anti-inflammatory properties of nanoceria .


Cumulatively , these results suggest nanoceria deposit in lungs , confer protection by quenching noxious free radicals during hypobaric hypoxia , and do not evoke any inflammatory response .


The Alvarado score is a clinical scoring system used in the diagnosis of acute appendicitis .


This study aimed to compare the reliability of the Alvarado score and clinical judgment and to refine the score to make it easier to use .


In this prospective , randomized study , patients presenting at the authors ' outpatient department with suspected appendicitis during a @-year period were assigned in weekly alternation to either group A or group B.


The group A patients were treated on the basis of their Alvarado score , and the group B patients underwent treatment based on clinical judgment .


The correctness of the methods was assessed by evaluation of the final histology .


Statistical comparison of the data was performed using SPSS @ .


The study investigated @ patients ( @ in group A and @ in group B ) .


The groups were homogeneous in terms of mean age , gender , body mass index , and American Society of Anesthesiologists score .


The number of negative appendectomies was @ ( @ % ) in group A versus @ ( @ % ) in group B ( p = @ ) .


The clinical judgment had better specificity and sensitivity than the Alvarado score .


For that reason , the specificity of the Alvarado score was refined using statistical methods , with weighting of certain clinical data and inclusion of new ones ( e.g. , ultrasound investigation ) .


Consequently , the area under the curve by receiver operating characteristic analysis gradually increased , and the Alvarado score became more accurate .


The study findings showed clinical judgment to be more reliable in the diagnosis of acute appendicitis than the Alvarado score , but the score is a useful diagnostic aid , especially for young colleagues .


The use of the new scoring system has become easier .


It includes fewer criteria as well as an important and sensitive predictor : the ultrasound investigation .


Sirtuin @ influences gene expression and other cellular functions through deacetylation of histone and nonhistone proteins .


We here sought to determine the effects of a small molecule sirtuin @ activator , SRT@ , on inflammation and coagulation induced by lipopolysaccharide in humans .


A randomized , double-blind , placebo-controlled study .


An academic hospital .


Twenty-four healthy humans .


All subjects received an intravenous injection with lipopolysaccharide .


Subjects were randomized to one of three groups ( n = @ per group ) : @ ) pretreatment with oral SRT@ for @ days ( @ g/d ) , @ ) pretreatment with a single SRT@ dose ( @ g ) , or @ ) placebo .


SRT@ attenuated lipopolysaccharide-induced release of the cytokines interleukin-@ ( mean peak levels of @ % -LSB- p < @ -RSB- and @ % -LSB- p = @ -RSB- after single and repeated SRT@ administration , respectively , relative to those measured after placebo treatment ) and interleukin-@ ( mean peak levels of @ % -LSB- p < @ vs placebo -RSB- and @ % -LSB- p < @ vs placebo -RSB- after single and repeated SRT@ ingestion , respectively , while not affecting tumor necrosis factor - and interleukin-@ release ) .


SRT@ also reduced the lipopolysaccharide-induced acute phase protein response ( C-reactive protein ) .


SRT@ inhibited activation of coagulation , as reflected by lower plasma levels of the prothrombin fragment F@ +@ ( mean peak levels @ % -LSB- p < @ -RSB- and @ % -LSB- p < @ -RSB- after single and repeated SRT@ administration , respectively , relative to those measured after placebo treatment ) .


Activation of the vascular endothelium ( plasma von Willebrand levels ) and the fibrinolytic system ( plasma tissue-type plasminogen activator and plasminogen activator inhibitor type I ) was not influenced by SRT@ .


This is the first human study to demonstrate biological anti-inflammatory and anticoagulant responses consistent with the activation of sirtuin @ by a small molecule .


The objective of this study was to compare the long-term outcome of patients with metastatic melanoma vaccinated with @MHP to that of a group of unvaccinated historical controls .


A multipeptide vaccine ( @MHP ) , designed to induce helper T cells against melanocytic and cancer-testis antigens , has been shown to induce specific Th@-dominant CD@ + T cell responses .


The @MHP vaccine was administered to patients with metastatic melanoma .


Circulating CD@ + T cell responses were measured by proliferation or direct IFN-gamma ELIspot assay .


Overall survival of vaccinated patients was compared to a group of clinically comparable historical controls using multivariable Cox regression analysis and Kaplan-Meier survival analysis , taking into account age , metastatic site , and resection status .


Across @ vaccinated patients and @ controls , resection status ( HR @ , P = @ ) and vaccination ( HR @ , P < @ ) were associated with improved overall survival .


Forty pairs of vaccinated patients and controls were matched by metastatic site , resection status , and age within @ years .


Median survival was significantly longer for vaccinated patients ( @ vs @ years , P < @ ) .


Among the vaccinated patients , the development of a specific immune response after vaccination was associated with improved survival ( HR @ , P = @ ) .


Helper peptide vaccination is associated with improved overall survival among patients with metastatic melanoma .


These data support a randomized prospective trial of the @MHP vaccine .


To examine the effect of reducing questionnaire length on the response rate in a physician survey .


A postal four double-page questionnaire on end-of-life decision making was sent to a random sample of @,@ general practitioners , @ elderly care physicians , and @ medical specialists .


Another random sample of @ medical specialists received a shorter questionnaire of two double pages .


After @months and one reminder , all nonresponding physicians received an even shorter questionnaire of one double page .


Total response was @ % ( @,@ of @,@ eligible respondents ) .


Response rate of medical specialists for the four double-page questionnaire was equal to that of the two double-page questionnaire ( @ and @ questionnaires were returned , respectively ) .


The total response rate increased from @ % to @ % after sending a short one double-page questionnaire ( @,@-@ ,@ respondents ) .


The results of our study suggest that reducing the length of a long questionnaire in a physician survey does not necessarily improve response rate .


To improve response rate and gather more information , researchers could decide to send a drastically shortened version of the questionnaire to nonresponders .


In mouse models for atopic dermatitis ( AD ) hypothalamus pituitary adrenal axis ( HPA ) dysfunction and neuropeptide-dependent neurogenic inflammation explain stress-aggravated flares to some extent .


Lately , cholinergic signaling has emerged as a link between innate and adaptive immunity as well as stress responses in chronic inflammatory diseases .


Here we aim to determine in humans the impact of acute stress on neuro-immune interaction as well as on the non-neuronal cholinergic system ( NNCS ) .


Skin biopsies were obtained from @ individuals ( AD patients and matched healthy control subjects ) before and after the Trier social stress test ( TSST ) .


To assess neuro-immune interaction , nerve fiber ( NF ) - density , NF-mast cell contacts and mast cell activation were determined by immunohistomorphometry .


To evaluate NNCS effects , expression of secreted mammal Ly-@ / urokinase-type plasminogen activator receptor-related protein ( SLURP ) @ and @ ( endogenous nicotinic acetylcholine receptor ligands ) and their main corresponding receptors were assessed by quantitative RT-PCR .


With respect to neuro-immune interaction we found higher numbers of NGF + dermal NF in lesional compared to non-lesional AD but lower numbers of Gap@ + growing NF at baseline .


Mast cell-NF contacts correlated with SCORAD and itch in lesional skin .


With respect to the NNCS , nicotinic acetylcholine receptor @ ( @nAChR ) mRNA was significantly lower in lesional AD skin at baseline .


After TSST , PGP @ + NF numbers dropped in lesional AD as did their contacts with mast cells .


NGF + NF now correlated with SCORAD and mast cell-NF contacts with itch in non-lesional skin .


At the same time , SLURP-@ levels increased in lesional AD skin .


In humans chronic inflammatory and highly acute psycho-emotional stress interact to modulate cutaneous neuro-immune communication and NNCS marker expression .


These findings may have consequences for understanding and treatment of chronic inflammatory diseases in the future .


The HOT ( Healthy Outcome for Teens ) Project is an innovative online educational intervention for middle school children for prevention of diabetes and obesity by balancing food intake with physical activity .


The objective was to improve knowledge , outcome expectations , self-efficacy , and self-reported food intake and skills and to compare a passive online learning ( POL ) control group with an active online learning ( AOL ) treatment group by implementing a social cognitive theory ( SCT ) - grounded online intervention .


In total , @ participants were recruited from three middle schools .


Full data were secured for @ students .


Six valid , reliable questionnaires were administered online , pre/post , to both the AOL and POL groups to assess knowledge gain , self-reported intake , and meal planning skills , as well as change in SCT constructs .


Subjects in the AOL group improved significantly for all five categories of planning a meal questionnaire ( P = @ ) and also for outcome expectations for exercise ( P = @ ) .


At postintervention , no significant differences were found for composite scores of exercise self-efficacy , weight efficacy lifestyle , and rapid eating assessment plan questionnaires between AOL versus POL ( by Mann-Whitney test ) .


We conclude that teens participating in the AOL version of the HOT Project intervention acquired skills for planning a meal and improved outcome expectations for exercise .


Vegetative dysfunction is observed in @-@ % of the children presenting with chronic respiratory diseases .


Its timely identification and correction increases the effectiveness of the combined rehabilitative treatment of such patients .


The vegetative regulation was dynamically evaluated by the analysis of the heart rate variability in @ patients presenting with bronchial asthma and chronic nonspecific lung diseases .


The age of the patients varied from @ to @ years .


Sixty children received the combined treatment including enteral oxygen therapy , the control group was comprised of @ patients .


The enteral oxygen therapy eliminated the vegetative disbalance in @ % of the children with bronchial asthma and in @,@ % of those suffering from chronic nonspecific lung diseases .


The results of the spectral analysis of heart rate variability indicate that the total spectrum power ( TSP ) was significantly increased in the patients of the study group .


This effect was accompanied by the restructuring of wave frequency ranges pointing out to the enhancement of the activity of the sympathetic-adrenal system .


The integral index of adaptive reserves ( AR ) increased from @,@ to @,@ points ( p < @ ) under the influence of enteral oxygen therapy ; this parameter remained practically unaltered in the patients of the control group where it varied from @,@ to @,@ points ( p > @ ) .


More manifest pronounced positive dynamics was observed in the patients presenting with initial vagotonia and the severe or moderate form of the disease .


The present study has demonstrated the favourable influence of enteral oxygen therapy on the vegetative regulation mechanisms and the adaptive potential of the organism .


Analysis of the heart rate variability may be a screening method for the evaluation of the effectiveness of the proposed therapeutic modality .


To compare the efficacy difference in the treatment of senile insomnia among western , medication , acupuncture and the integrated therapy of acupuncture and western medication .


Ninety-eight patients of senile insomnia were randomized into a western medication group ( @ cases ) , an acupuncture group ( @ cases ) and an integrated acupuncture and medication group ( @ cases ) .


In the western medication group , estazolam @mg was prescribed , taken @ min before going to bed , oryzanol @ mg , oral administration , three times a day , for @ weeks totally .


In the acupuncture group , the simple acupuncture therapy was applied at Shenmen ( HT @ ) , Sanyinjiao ( SP @ ) , Anmian ( Extra ) , Baihui ( GV @ ) and Sishencong ( EX-HN @ ) , as well as the supplementary points selected according to the differentiation .


The acupuncture treatment was given once a day , @ treatments a week , for @ weeks totally .


In the integrated acupuncture and medication group , the western medication was combined with acupuncture .


The dosage and usage of western medication were same as those in the western medication group ; and acupoints in acupuncture treatment were same as those in the acupuncture group .


The treatment lasted for @ weeks in the three groups .


Pittsburgh sleep quality index ( PSQI ) and clinical efficacy were observed before treatment , after @ weeks ' treatment and in @ weeks after discontinuity of treatment in the three groups .


Four weeks after treatment , the clinical curative rates were @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) in the western medication group , the acupuncture group and the integrated acupuncture and medicines group separately .


The total effective rates were @ % ( @/@ ) , @ % ( @/@ ) and @ % ( @/@ ) in the three groups separately .


The curative rates and the total effective rates in the integrated acupuncture and medication group and the acupuncture group were higher than those in the western medication group separately ( all , P < @ ) .


PSQI scores after @ Weeks ' treatment were all improved as compared with those before treatment in the three groups ( all P < @ ) .


PSQI score in either the integrated acupuncture and medication group or the acupuncture group was lower than that in the western medication group , indicating the significant difference ( both P < @ ) .


Four weeks after discontinuity of treatment , the efficacy was stable in the acupuncture group and the integrated acupuncture and medication group .


PSQI score did not change as compared with that in the @th week of treatment .


The score in the western medication group ran back , close to that before treatment ( P > @ ) .


During the treatment , a few patients had dry mouth in the western medication group .


The adverse reactions were not discovered in the other two groups .


The integrated therapy of acupuncture and medication achieves the quick efficacy on senile insomnia and rapidly relieves the symptoms , with quite high clinical curative rate and total effective rate obtained .


The long-term efficacy is better than that of western medication .


The integrated therapy is the first option among the three therapeutic programs .


Sexual risk is an important , oft-neglected area in addiction treatment .


This report examines computerized sexual risk assessment and client feedback at intake as means of enhancing counselor awareness of client risk behavior during early treatment , as well as any clinical impact of that counselor awareness .


In @-@ , new clients at both opiate treatment and drug-free treatment programs endorsed in a computer-assisted assessment at intake @-day retrospective indices for : being sexually active , having multiple partners , having sex under drug influence , and inconsistently using condoms .


Clients were randomly assigned in a @:@ ratio to receive or not receive a personal feedback report , and those receiving a report chose if a counselor copy was also distributed .


Ninety days later , retained clients ( N = @ ) repeated the assessment and their counselors concurrently reported perceptions of recent client risk behavior .


Based on client reports , pretreatment risk behaviors were prevalent among men and women and remained so during treatment .


A general linear model revealed greater counselor awareness of subsequent client risk behavior with mutual distribution of intake feedback reports to client and counselor , and at the opiate treatment program .


A repeated-measures analysis of variance indicated that counselor awareness did not predict change in temporally stable patterns of sexual risk behavior .


CONCLUSIONS/IMPORTANCE : Findings document that computerized intake assessment of sexual risk and mutually distributed feedback reports prompt greater counselor awareness of clients ' subsequent risk behavior .


Future research is needed to determine how best to prepare counselors to use such awareness to effectively prompt risk reduction in routine care .


To assess the sealing properties of four luting materials used for cementation of full cast crowns .


@ human premolars were prepared with a chamfer finish line .


Stone dies were fabricated and copings were waxed , invested and cast in gold .


Ten samples ( n = @ ) were randomly assigned to four groups .


In two groups , resin modified glass-ionomer cements were used , ACTIVA BioACTIVE-CEMENT/BASE/LINER and FujiCem@ ; the third group received the self-adhesive resin cement Embrace WetBond , while the fourth group served as control with a zinc phosphate cement .


After cementation , excess cement was removed followed by bench-set for @ minutes .


All samples were stored in water at @ degrees C and subjected to thermal cycling ( x@ between @ and @ degrees C ) .


Subsequently the occlusal surface was reduced exposing the dentin .


After sterilization the specimens were subjected to bacterial microleakage with E. faecalis in a dual chamber apparatus for a period of @ days .


Bacterial leakage was checked daily .


Data were analyzed using the Kaplan-Meyer survival test .


Significant pairwise differences were analyzed using the Log Rank test and the Fishers ' exact test at P < @ .


ACTIVA BioACTIVE-CEMENT/BASE/LINER , FujiCem@ and Embrace WetBond showed the lowest microleakage scores and differed statistically significantly ( P < @ ) from zinc phosphate cement .


There is no current consensus on the optimal technique for subarachnoid anesthesia in morbidly obese parturients even though some providers prefer the combined spinal-epidural ( CSE ) over single-shot spinal ( SSS ) technique .


In this randomized controlled study , we compared the time required for initiation of subarachnoid anesthesia between SSS and CSE techniques in morbidly obese parturients undergoing elective cesarean delivery .


Morbidly obese parturients presenting for elective cesarean delivery were randomized to receive subarachnoid anesthesia performed either with a SSS or a CSE technique .


The spinal procedure in the sitting position was attempted by an experienced resident for up to @ minutes , and if unsuccessful , the attending obstetric anesthesiologist assumed control of the procedure .


The primary outcome was the time it took from the insertion of the introducer needle ( SSS group ) or insertion of the epidural needle ( CSE group ) to the end of intrathecal injection of drugs ( procedure time ) .


Forty-four patients were enrolled and completed the study .


Three were excluded due to protocol violations .


Of the remaining , @ patients were in the SSS group and @ in the CSE group .


Demographic variables and mean ( SD ) body mass index ( @ @ kg/m for SSS ; @ @ kg/m for CSE ) were not different between groups .


The median -LSB- interquartile range -RSB- for procedure time was @ -LSB- @-@ -RSB- seconds and @ -LSB- @-@ -RSB- seconds for SSS and CSE groups , respectively ( P = @ ) , while the @ % confidence interval ( CI ) of the difference was -@ to +@ seconds .


The first operator completed the procedure in < @ minutes in @ % of subjects in the SSS group and @ % of those in the CSE group ( P = @ ) and the @ % CI of the difference was -@ % to +@ % .


There were more attempts to successful completion of the procedure in the SSS group ( P = @ ) with its @ % CI of the difference being +@ to +@ .


Our results suggest that the CSE technique is noninferior to the SS technique in morbidly obese parturients for time of initiation of subarachnoid anesthesia and may be accomplished with fewer attempts than the SSS technique with experienced residents .


In the acute respiratory distress syndrome ( ARDS ) , inflammation in the lungs and other organs can cause life-threatening organ failure .


Inhibitors of @-hydroxy-@-methylglutaryl coenzyme A reductase ( statins ) can modulate inflammatory responses .


Previous observational studies suggested that statins improved clinical outcomes in patients with sepsis .


We hypothesized that rosuvastatin therapy would improve clinical outcomes in critically ill patients with sepsis-associated ARDS .


We conducted a multicenter trial in which patients with sepsis-associated ARDS were randomly assigned to receive either enteral rosuvastatin or placebo in a double-blind manner .


The primary outcome was mortality before hospital discharge home or until study day @ if the patient was still in a health care facility .


Secondary outcomes included the number of ventilator-free days ( days that patients were alive and breathing spontaneously ) to day @ and organ-failure-free days to day @ .


The study was stopped because of futility after @ of an estimated @ patients had been enrolled .


There was no significant difference between study groups in @-day in-hospital mortality ( @ % with rosuvastatin and @ % with placebo , P = @ ) or in mean ( SD ) ventilator-free days ( @ with rosuvastatin and @ with placebo , P = @ ) .


The groups were well matched with respect to demographic and key physiological variables .


Rosuvastatin therapy , as compared with placebo , was associated with fewer days free of renal failure to day @ ( @ vs. @ , P = @ ) and fewer days free of hepatic failure to day @ ( @ vs. @ , P = @ ) .


Rosuvastatin was not associated with an increased incidence of serum creatine kinase levels that were more than @ times the upper limit of the normal range .


Rosuvastatin therapy did not improve clinical outcomes in patients with sepsis-associated ARDS and may have contributed to hepatic and renal organ dysfunction .


( Funded by the National Heart , Lung , and Blood Institute and the Investigator-Sponsored Study Program of AstraZeneca ; ClinicalTrials.gov number , NCT@ . )


Determining sample sizes for metabolomic experiments is important but due to the complexity of these experiments , there are currently no standard methods for sample size estimation in metabolomics .


Since pilot studies are rarely done in metabolomics , currently existing sample size estimation approaches which rely on pilot data can not be applied .


In this article , an analysis based approach called MetSizeR is developed to estimate sample size for metabolomic experiments even when experimental pilot data are not available .


The key motivation for MetSizeR is that it considers the type of analysis the researcher intends to use for data analysis when estimating sample size .


MetSizeR uses information about the data analysis technique and prior expert knowledge of the metabolomic experiment to simulate pilot data from a statistical model .


Permutation based techniques are then applied to the simulated pilot data to estimate the required sample size .


The MetSizeR methodology , and a publicly available software package which implements the approach , are illustrated through real metabolomic applications .


Sample size estimates , informed by the intended statistical analysis technique , and the associated uncertainty are provided .


To assess the long-term effects of physical activity on irritable bowel syndrome ( IBS ) symptoms and on quality of life , fatigue , depression and anxiety .


Seventy-six patients from a previous randomized controlled interventional study on increased physical activity in IBS were asked to participate in this long-term follow-up study .


The included patients attended one visit in which they filled out questionnaires and they underwent a submaximal cycle ergometer test .


The primary end point was the change in the IBS Severity Scoring System ( IBS-SSS ) at baseline , i.e. , before the intervention and at follow-up .


The secondary endpoints were changes in quality of life , fatigue , depression and anxiety .


A total of @ -LSB- @ women , median age @ ( @-@ ) years -RSB- patients were included in this follow-up .


Median follow-up time was @ ( range : @-@ @ ) years .


The IBS symptoms were improved compared with baseline -LSB- IBS-SSS : @ ( @-@ ) vs @ ( @-@ ) , P = @ -RSB- .


This was also true for the majority of the dimensions of psychological symptoms such as disease specific quality of life , fatigue , depression and anxiety .


The reported time of physical activity during the week before the visit had increased from @ ( @-@ @ ) h at baseline to @ ( @-@ @ ) h at follow-up , P = @ .


The most common activities reported were walking , aerobics and cycling .


There was no significant difference in the oxygen uptake @ ( @-@ @ ) mL per min per kg at baseline vs @ ( @-@ @ ) mL/min per kg at follow-up .


An intervention to increase physical activity has positive long-term effects on IBS symptoms and psychological symptoms .


Streptococcus mutans is one of the most common cariogenic microorganisms .


Use of natural anticariogenic agents , such as Xylitol has been well-established in the literature .


On the other hand , there is a scarcity of studies that have reported the antimicrobial potential of Propolis as an anticariogenic chewing agent ; hence , the present study was designed .


To evaluate and compare the anticariogenic action of two commercial chewing gums Propolis and Xylitol on the salivary S. mutans count in a group of children from Bengaluru city .


Clinical setting and experimental design .


Thirty healthy children aged @-@ years with decayed , missing , and filled teeth ( dmft ) / DMFT index score@ were included in the study .


Before the test , unstimulated saliva was collected .


Children divided into Group I and II were given Propolis and Xylitol chewing gums respectively ; to chew for @ min .


Saliva samples were then collected at @ min ( just after spitting ) and after @ h.


The amount of S. mutans in saliva was evaluated using a selective media ( MSAB ) .


In addition , compliance of the two chewing gums among the children was tested with a questionnaire .


Student 's t-test .


Six samples out of @ were excluded due to no growth .


The total number of bacterial colonies was significantly reduced when compared to baseline in both the groups .


Propolis gum showed statistically significant reduction in the number of colonies as compared to Xylitol .


Xylitol gum was more preferred than Propolis gum by the children .


Propolis chewing gum can be used as an anticariogenic agent in children .


To evaluate the effect of a dance-based therapy on depressive symptoms among institutionalized older adults .


Randomized controlled trial .


Nursing homes .


Older adults ( @ years or older ) permanently living in a nursing home .


Exercise Dance for Seniors ( EXDASE ) Program designed for the use in long-term care settings performed once a week for @ minutes for @ months .


Baseline measures included sociodemographic characteristics , ability to perform basic as well as instrumental activities of daily living , basic mobility , self-rated health , and cognitive status .


Outcome measures were collected before and after the intervention and included assessment of depressive symptoms using the geriatric depression scale ( GDS ) .


Comparison of participants with MMSE of @ or higher showed that GDS scores in the intervention group significantly improved ( P = @ ) , whereas the control group had a trend of further worsening of depressive symptoms ( P = @ ) .


GLM analysis documented highly statistically significant effect of dance therapy ( P = @ ) that was not influenced by controlling for intake of antidepressants and nursing home location .


Dance therapy may have decreased depressive symptoms even in participants with MMSE lower than @ and resulted in more discontinuations and fewer prescriptions of antidepressants in the intervention group than in the control group .


This study provides evidence that dance-based exercise can reduce the amount of depressive symptoms in nursing home residents .


In general , this form of exercise seems to be very suitable and beneficial for this population .


This study aimed to investigate the efficacy of UPPP combined with an oral appliance ( OA ) in the treatment of obstructive sleep apnea-hypopnea syndrome ( OSAHS ) .


Forty patients diagnosed with severe OSAHS were randomly divided into two groups : @ patients in the pure surgery group treated by uvulopalatopharyngoplasty ( UPPP ) surgery and the remaining @ patients in the combined treatment group for the combined application of UPPP and OA .


Nocturnal PSG monitoring was performed in postoperative @ and @ a. AHI , SaO , and sleep structure improvement were calculated to compare the treatment efficiency of the two groups .


The AHI of the combined treatment group in the postoperative @ was lower than that of the pure surgery group , whereas the lowest SaO value was higher than that of the pure surgery group ( P < @ ) .


The sleep structure improvement of the combined treatment group in the postoperative @a was possibly more normal than that of the pure surgery group .


The long-term efficacy of the combined UPPP and OA for the treatment of OSAHS was higher than that of pure UPPP treatment .


To describe specific causes of death and evaluate whether bleeding events and infection contributed to mortality in all ticagrelor-treated and clopidogrel-treated patients with acute coronary syndromes .


In the PLATelet inhibition and patient Outcomes ( PLATO ) trial , ticagrelor significantly reduced rates of vascular and total death compared with clopidogrel .


In the @ patients who died postenrolment in the PLATO trial ( n = @ ) , reviewers , blinded to study treatment , subclassified direct causes of death and evaluated whether infection or bleeding events contributed to fatal events .


Among vascular deaths , there were significantly fewer sudden deaths ( @ ( @ % ) vs @ ( @ % ) , p < @ ) but no significant difference in deaths caused by acute myocardial infarction ( @ ( @ % ) vs @ ( @ % ) , p = @ ) or heart failure ( @ ( @ % ) vs @ ( @ % ) , p = @ ) with ticagrelor compared with clopidogrel .


For non-vascular deaths , there was no difference between treatments in deaths directly caused by infection .


Although , patients treated with ticagrelor were at lower risk for death where infection was either a direct cause or contributed to death ( @ ( @ % ) vs @ ( @ % ) , HR @ ( @ to @ ) , p < @ ) but not for bleeding ( @ ( @ % ) vs @ ( @ % ) , HR @ ( @ to @ ) , p = @ ) .


In this post hoc analysis , ticagrelor compared with clopidogrel reduced total and cardiovascular mortality , which appeared to be mainly mediated by a reduction in sudden death .


Importantly , bleeding causing or contributing to death did not differ between treatments .


Many studies have failed to show an effect of parent-supervised practice driving on the driving performance of teenagers ; nevertheless , most Graduated Driver Licensing programs have provisions that require supervised practice .


To determine whether a web-based intervention , the Teen Driving Plan ( TDP ) , can improve the driving performance of teenagers before licensure as measured by the Teen On-road Driving Assessment ( tODA ) .


Randomized , single-blind , clinical trial among @ dyads ( @ parent : @ teenaged learner 's - permit holder ) to test TDP effectiveness on increasing the quantity and diversity of supervised practice and improving the teenagers ' prelicensed driving performance .


The study was conducted from December @ through January @ in Southeastern Pennsylvania .


Dyads were randomized ( @:@ ) to receive the TDP or the Pennsylvania driver 's manual ( control group ) .


The TDP is a psychoeducational intervention designed to increase the quantity and diversity of parent-supervised practice .


Materials are grouped by the following driving environments : empty parking lots , suburban residential streets , intermediate ( @ - or @-lane ) roads , highways , rural roads with curves and elevation changes , and commercial districts .


The main outcomes were self-reported practice driving across @ environments and @ conditions and driving performance as measured by the teenagers ' completion of the standardized and validated tODA @ weeks after enrollment .


Certified professional driving evaluators blinded to randomization status terminated the tODA if they determined that the teenager could not safely complete it .


We examined mean differences in the quantity of supervised practice , differences in the overall proportion of teenagers in each group that had assessments terminated for unsafe driving , and the point of termination during the assessment .


The TDP dyads reported more practice in @ of the @ environments and at night and in bad weather compared with the control dyads .


Overall , @ of @ TDP teenagers ( @ % ) had the tODA terminated compared with @ of @ control teenagers ( @ % ) ( risk difference -LSB- TDP-control -RSB- , -@ % -LSB- @ % CI , -@ % to @ % -RSB- ; P = @ ) .


The hazard ratio for exposure to TDP was @ ( @ % CI , @-@ @ ; P = @ , log-rank test ) .


Preliminary evidence suggests that the TDP improves supervised practice and the driving performance of prelicensed teenaged drivers .


Future studies can explore how to revise the TDP to enhance the treatment effect and how best to disseminate the TDP without compromising implementation fidelity .


Hypoglycemia is a major cause of morbidity and mortality among preterm infants and its management remains a challenge in resource limited settings .


Use of dextrose infusion by the recommended infusion pumps is not feasible in our environment due to their high costs and yet the current use of mini dextrose boluses with syringes as adapted at Mulago national referral and tertiary teaching hospital has unknown efficacy in prevention of hypoglycemia .


We determined the efficacy of dextrose infusions by burettes versus two hourly dextrose boluses in prevention of hypoglycemia among preterms admitted in the first @ hours at Special Care Unit , Mulago Hospital .


One hundred and forty preterms aged @ to @ hours of life were randomized to receive @ % IV dextrose either as mini boluses or by infusion using burettes in an open label clinical trial .


Blood glucose was measured at @ , two hourly for next @ hours , @ hourly for next @ hours and thereafter @ hourly until end of @ hours following admission .


Primary end point was incidence of hypoglycemia ( random blood sugar ( RBS ) < @ mmol/l ) which was expressed as relative risk ( RR ) .


Efficacy of the dextrose infusion was computed using @-RR .


From February @ to April @ , @ preterms in the bolus arm and @ in the infusion arm were studied .


Hypoglycemia was detected in @ % ( @/@ ) .


The incidence of hypoglycemia in the bolus arm was @ % ( @/@ ) compared to @ % ( @/@ ) in the infusion arm ( RR ; @ , @ % CI ; @-@ @ ) .


Efficacy ( @-RR ) of infusion by burettes versus boluses in prevention of hypoglycemia among preterms was @ ( @ % CI ; @-@ @ ) .


Continuous @ % dextrose infusion by burettes reduced the incidence of hypoglycemia by @ % in the first @ hours of admission compared to two hourly @ % mini dextrose boluses among preterms admitted at Special Care Unit , Mulago Hospital .


( ClinicalTrials.gov Identifier : NCT@ ) .


The aim of our study was to investigate the inhibitory effects on gastric acid secretion of a single oral dose of a proton pump inhibitor , esomeprazole @ mg and omeprazole @ mg .


A total of @ Helicobacter pylori-negative male subjects participated in this study .


Intragastric pH was monitored continuously for @ hours after a single oral dose of omeprazole @ mg and a single oral dose of esomeprazole @ mg .


Each administration was separated by a @-day washout period .


During the @-hour study period , the average pH after administration of esomeprazole was higher than that after the administration of omeprazole .


Also during the @-hour study period , each of pH > @ , @ , @ , @ , and @ was maintained for a longer duration after administration of esomeprazole @ mg than after administration of omeprazole @ mg ( median : @ % vs. @ % , p = @ ; @ % vs. @ % , p = @ ; @ % vs. @ % , p = @ ; @ % vs. @ % , p = @ ; @ % vs. @ % , p = @ ; respectively ) .


In Helicobacter pylori-negative healthy male subjects , single oral administration of esomeprazole @ mg increased the intragastric pH more rapidly than single oral administration of omeprazole @ mg .


Procedural sedation by non-anaesthesiologists with GABAergic anaesthetics has the potential risk of fatal respiratory depression .


Dexmedetomidine works its sedative action via @-adrenergic receptors , and is less associated with respiratory depression .


We tested the usability of dexmedetomidine as a procedural sedative during ablation of atrial fibrillation ( AF ) .


Consecutive patients were randomized to be treated with dexmedetomidine ( n = @ ) or thiamylal ( n = @ ) as sedatives during AF ablation .


Apnoeic and body movement events were monitored using a novel portable respiratory monitor , the SD-@ , during the procedure .


Although the majority of the patients receiving dexmedetomidine required rescue sedations with thiamylal , the respiratory disturbance index ( RDI ) defined as the total number of sleep-disordered breathing events divided by the recording time ( @ @ vs. @ @ events/h ; P < @ ) and movement index defined as the number of body movement events per hour ( @ @ vs. @ @ events/h ; P = @ ) were both significantly lower in the dexmedetomidine arm than in the thiamylal arm .


A multivariate linear regression analysis including potential factors revealed that dexmedetomidine vs. thiamylal was solely and independently associated with the RDI ( = -@ ; P = @ ) .


The occurrence of hypotension -LSB- @ ( @ % ) vs. @ ( @ % ) ; P = @ -RSB- and bradycardia -LSB- @ ( @ % ) vs. @ ( @ % ) ; P = @ -RSB- were similar in the patients with dexmedetomidine and thiamylal .


Procedural sedation with dexmedetomidine may assure safety and patient immobility during AF ablation , and therefore may be a potential alternative for that with GABAergic anaesthetics .


The goal of this study was to examine the longitudinal trajectories of posttraumatic stress disorder ( PTSD ) symptoms in a sample of acutely injured hospitalized civilian trauma survivors who participated in a randomized clinical trial .


Prior longitudinal descriptive research has shown that there are distinct trajectories of PTSD symptoms over time in trauma survivors .


Limited clinical trial research exists that describes the patterns of the trajectories as well as the risk factors that influence the trajectories for seriously injured trauma-exposed patients .


Semiparametric , group-based approach trajectory modeling was used to examine four group trajectories of a subset of data obtained from a previous longitudinal clinical trial .


Trajectories examined included resilience , recovery , relapsing/remitting , and chronic symptom patterns .


One hundred and ninety-four patients who participated in the randomized clinical trial were assessed at baseline in the days and weeks after injury and then randomized .


The associations between previously identified PTSD risk factors and the four trajectories were examined .


The risk factors of ethnocultural minority status , psychiatric history , additional life stressors , and depressive symptoms , as well as intervention versus control group status , were found to significantly affect the probability of trajectory group membership for PTSD symptom severity .


These findings suggest that there is a need for early PTSD interventions that anticipate differences in injured patients ' PTSD trajectory profiles .


Stepped care intervention procedures may optimally address the diverse PTSD trajectory patterns observed in injured trauma survivors through the tailoring of intervention timing and dosing .


Postoperative pain control remains a major challenge for surgical procedures , including laparoscopic gastric bypass .


Pain management is particularly relevant in obese patients who experience a higher number of cardiovascular and pulmonary events .


Effective pain management may reduce their risk of serious postoperative complication , such as deep vein thrombosis and pulmonary emboli .


The objective of this study is to evaluate the efficacy of intraperitoneal local anaesthetic , ropivacaine , to reduce postoperative pain in patients undergoing laparoscopic Roux-en-Y gastric bypass .


A randomised controlled trial will be conducted to compare intraperitoneal ropivacaine ( intervention ) versus normal saline ( placebo ) in @ adult patients undergoing bariatric bypass surgery .


Ropivacaine will be infused over the oesophageal hiatus and throughout the abdomen .


Patients in the control arm will undergo the same treatment with normal saline .


The primary end point will be postoperative pain at @ , @ and @h postoperatively .


Pain measurements will then occur every @h for @h and every @h until discharge .


Secondary end points will include opioid use , peak expiratory flow , @min walk distance and quality of life assessed in the immediate postoperative period .


Intention-to-treat analysis will be used and repeated measures will be analysed using mixed modelling approach .


Post-hoc pairwise comparison of the treatment groups at different time points will be carried out using multiple comparisons with adjustment to the type @ error .


Results of the study will inform the feasibility of recruitment and inform sample size of a larger definitive randomised trial to evaluate the effectiveness of intraperitoneal ropivacaine .


Mild therapeutic hypothermia ( TH ) is recommended as soon as possible after the return of spontaneous circulation to improve outcomes after out-of-hospital cardiac arrest ( OHCA ) .


Preclinical data suggest that the benefit of TH could be increased if treatment is started during cardiac arrest .


We aimed to study the impact of intra-arrest therapeutic hypothermia ( IATH ) on neurological injury and inflammation following OHCA .


We conducted a @:@ randomized , multicenter study in three prehospital emergency medical services and four critical care units in France .


OHCA patients , irrespective of the initial rhythm , received either an infusion of cold saline and external cooling during cardiac arrest ( IATH group ) or TH started after hospital admission ( hospital-cooling group ) .


The primary endpoint was neuron-specific enolase ( NSE ) serum concentrations at @ h. Secondary endpoints included IL-@ , IL-@ , and IL-@ concentrations , and clinical outcome .


Of the @ patients included , @ were analyzed in the IATH group and @ in the hospital-cooling group .


IATH decreased time to reach temperature @ C by @ min ( @ % CI : @ ; @ ) .


The rate of patients admitted alive to hospital was not different between groups -LSB- IATH n = @ ( @ % ) vs. hospital cooling n = @ ( @ % ) ; p = @ -RSB- .


Levels of NSE and inflammatory biomarkers were not different between groups -LSB- median NSE at @ h : IATH @ g/l ( IQR : @-@ @ ) vs. hospital cooling @ g/l ( IQR : @-@ @ ) , p = @ -RSB- .


No difference in survival and cerebral performance were found at @ month .


IATH did not affect biological markers of inflammation or brain damage or clinical outcome .


Standard first-line chemotherapy for elderly non-small cell lung cancer ( NSCLC ) patients has been monotherapy with vinorelbine or gemcitabine .


Docetaxel has also been considered as an alternative option for the elderly population in Japan .


We have previously demonstrated the high efficacy of carboplatin plus weekly paclitaxel for elderly NSCLC patients .


Consequently , we conducted a randomized phase II study to select the proper regimen for a future phase III trial .


Eligible patients were aged @ years or older with newly diagnosed advanced NSCLC .


Patients were randomly assigned either to a combination of carboplatin ( area under the curve : @ mg/mL per minute ) with weekly paclitaxel ( @ mg/m ) ( CP regimen ) or to single-agent docetaxel ( @ mg/m ) .


The primary endpoint of this study was objective response rate .


Secondary endpoints were progression-free survival , overall survival , and toxicity profile .


Among @ eligible patients ( @ to CP , @ to docetaxel ) , the objective response rates were @ % ( @ % confidence interval : @ % -@ % ) and @ % ( @ % confidence interval : @ % -@ % ) and median progression-free survival was @ months and @ months in the CP arm and the docetaxel arm , respectively .


Severe neutropenia , febrile neutropenia , and nausea were significantly frequent in the docetaxel arm , whereas toxicities in the CP arm were generally moderate .


One treatment-related death was observed in the docetaxel arm .


The CP regimen achieved higher activity with less toxicity than single-agent docetaxel .


Considering the results of this phase II trial and the IFCT-@ trial , we have selected the CP regimen for a future phase III trial in elderly patients with advanced NSCLC .


Field vaccination trials with Mycobacterium bovis BCG , an attenuated mutant of M. bovis , are ongoing in Spain , where the Eurasian wild boar ( Sus scrofa ) is regarded as the main driver of animal tuberculosis ( TB ) .


The oral baiting strategy consists in deploying vaccine baits twice each summer , in order to gain access to a high proportion of wild boar piglets .


The aim of this study was to assess the response of wild boar to re-vaccination with BCG and to subsequent challenge with an M. bovis field strain .


BCG re-vaccinated wild boar showed reductions of @ % in lesion score and @ % in culture score , as compared to unvaccinated controls .


Only one of nine vaccinated wild boar had a culture-confirmed lung infection , as compared to seven of eight controls .


Serum antibody levels were highly variable and did not differ significantly between BCG re-vaccinated wild boar and controls .


Gamma IFN levels differed significantly between BCG re-vaccinated wild boar and controls .


The mRNA levels for IL-@b , C@ and MUT were significantly higher in vaccinated wild boar when compared to controls after vaccination and decreased after mycobacterial challenge .


Oral re-vaccination of wild boar with BCG yields a strong protective response against challenge with a field strain .


Moreover , re-vaccination of wild boar with BCG is not counterproductive .


These findings are relevant given that re-vaccination is likely to happen under real ( field ) conditions .


In this study , we examined the effects of Brucella infection on endothelial dysfunction .


Flow-mediated dilatation ( FMD ) measurement is indicator of the endothelial function , and abnormal values indicating endothelial dysfunction are accepted as the first stage of atherosclerosis .


Twenty-four patients who had been treated for acute brucellosis two years before , and who had had no relapses in the follow-up , were prospectively included in the study , along with @ healthy individuals in the control group .


While the highly sensitive C-reactive protein ( hs-CRP ) value was @ @ in the patient group , it was @ @ in the control group ( p = @ ) .


While the FMD value was @ @ in the patient group , it was @ @ in the control group ( p < @ ) .


While the percentage increase in FMD was @ @ in the patient group , it was @ @ in the control group ( p < @ ) .


It was observed that FMD value , the percentage increase in FMD , and basal radius were correlated with hs-CRP ( r = -@ , p < @ ; r = - @ , p = @ ; r = @ , p = @ , respectively ) .


The carotid artery intima media thickness ( IMT ) value was found to be @ @ in the patient group and @ @ in the control group ( p = @ ) .


The abnormal FMD and IMT values observed in brucellosis patients might be an indicator of more frequent arterial dysfunction , increased cardiovascular risk , and atherosclerosis .


Undercarboxylated osteocalcin ( ucOC ) has been shown to affect glucose metabolism in mice .


We recently randomized patients with hypoparathyroidism to treatment with PTH or placebo and demonstrated a marked increase in total osteocalcin .


To investigate whether there was a similar increase in ucOC and whether that increase affected glucose metabolism .


A @-week randomized , placebo-controlled trial .


Ambulatory patients in a research facility .


Sixty-two patients aged @-@ years with hypoparathyroidism , of which @ completed the trial .


@ g/d of PTH ( @-@ ) .


Change in ucOC .


ucOC increased by @ @ % ( mean SD ) in the PTH-treated group and by @ @ % in the placebo group ( P < @ ( -@ ) ) .


In addition , body weight decreased by @ @ % in the treatment group and increased @ @ % in the placebo group ( P = @ ) .


Glucose , adiponectin , leptin , homeostasis model of assessment for insulin resistance , total body fat mass , or truncal fat did not change significantly .


In addition , the number of hypercalcemic episodes per patient was @ @ ( mean SD ) in the PTH-treated group but only @ @ in the placebo group ( P < @ ) .


Moreover , there was a significant and negative correlation between the change in ucOC and change in body weight ( P = @ ) or change in total body fat mass ( P = @ ) , and a negative but nonsignificant correlation between the number of hypercalcemic episodes and percentage change in body weight ( r = -@ ; P = @ ) .


Change in ucOC did not significantly correlate with changes in other parameters .


An explanation for the weight loss may be subtle hypercalcemia in PTH treatment inhibiting appetite .


Our data do not support a role for ucOC in energy metabolism in humans .


Despite the benefits of endoscopic nasobiliary drainage ( NBD ) in endoscopic retrograde cholangiopancreatography ( ERCP ) , post-ERCP pancreatitis ( PEP ) and nose/throat discomfort can result .


We aimed to determine whether the use of a smaller catheter alleviates these complications .


A randomized , controlled trial at a tertiary care center compared @ Fr and @ Fr NBD catheters ; @ ERCP patients with nave papillae were randomly assigned to a catheter-size group .


The prevalence of PEP was significantly lower in the @ Fr group ( @ % ; @/@ ) than in the @ Fr group ( @ % ; @/@ ; P = @ ) .


No spontaneous catheter displacement occurred within @h .


Discomfort visual analog scores were @ and @ in the @ Fr and @ Fr groups , respectively ( P = @ ) on procedure day ; on the following day , the scores were @ and @ ( P = @ ) .


Bile output was @ mL/h and @ mL/h in the @ Fr and @ Fr groups ( P = @ ) .


On obstructive jaundice subgroup analysis , bile drainage was @ mL/h and @ mL/h in the @ Fr and @ Fr groups ( P = @ ) .


The @ Fr group required @ days to reduce bilirubin levels versus @ days in the @ Fr group ( P = @ ) .


In patients with nave papillae , lower rates of PEP and less nose/throat discomfort are associated with the use of @ Fr NBD catheters .


In patients with obstructive jaundice , @ Fr and @ Fr catheters are comparable with regard to bile output and bilirubin level reduction .


Telephone-based interventions can be effective in increasing child fruit and vegetable intake in the short term ( < @ mo ) .


The long-term efficacy of such interventions , however , is unknown .


The primary aim of this study was to determine whether the short-term ( < @ mo ) impact of a telephone-based intervention on children 's fruit and vegetable intake was sustained over a longer term .


A secondary aim of the study was to assess the long-term impact of the intervention on the intake of foods high in fat , salt , or sugar ( noncore foods ) .


The study used a cluster randomized controlled trial design .


Parents were recruited from Australian preschools between February and August @ and allocated to receive an intervention consisting of print materials and @ telephone-counseling calls delivered over @ mo or to a print information-only control group .


The primary endpoint for the trial was the @-mo postbaseline follow-up .


Linear regression models were used to assess between-group differences in child consumption of fruit and vegetables and noncore foods by subscales of the Children 's Dietary Questionnaire .


Fruit and vegetable subscale scores were significantly higher , indicating greater child fruit and vegetable intake , among children in the intervention group at the @-mo ( @ compared with @ ; P < @ ) but not the @-mo ( @ compared with @ ; P = @ ) follow-up .


There were no significant differences between groups at either of the follow-up periods in the noncore food subscale score .


Further research to identify effective maintenance strategies is required to maximize the benefits of telephone-based interventions on child diet .


To assess and compare the intra-arterial injection-associated discomfort of iodinated contrast media ( CM ) and the impact on diagnostic efficacy in diabetics with critical limb ischemia ( CLI ) .


Arterial revascularization is a mainstay in patients with CLI .


Previous diagnostic angiography is a crucial step that can be affected by CM injection discomfort compromising the revascularization results , and it could vary related to the CM agents .


One hundred forty-eight patients received Iodixanol @ mg iodine pro ml or Ioversol @ mg iodine pro ml in a prospective , double-blind , randomized , parallel-group clinical trial .


Injection-associated discomfort was assessed by Visual Analogic Scale ( VAS ) .


Diagnostic efficacy and safety up to @ week were evaluated .


The incidence of pain has been around @ % of the all population in study , with lesser incidence of pain ( @ % vs @ % ; P < @ ) and of heat sensation ( @ % vs @ % ; P < @ ) , after Iodixanol than after Ioversol injection .


Discomfort mean score , according to VAS assessment , was less in the Iodixanol group ( @ ) than in the Ioversol group ( @ ) , after first injection ( P < @ ) and for all injections ( P < @ ) .


A significant difference was also observed in favor of Iodixanol ( P < @ ) , respect to mean score of discomfort and heat sensation , assessed by the operators after all the CM injections .


Iodixanol caused less frequent and severe discomfort , characterized as pain and heat during intra-arterial administration compared with Ioversol .


The pain severity is tightly related to image and diagnosis quality with an impact on the patients for additional injections and larger CM volumes .


Barbed sutures have unidirectional circumferential shallow barbs , which distribute tension throughout the wound and close wound securely without the need to tie knots .


We compare two different methods of wound closure in elective plastic surgical cases : barbed @/@V-Loc @ suture and smooth @/@Maxon sutures , both polyglyconate monofilament synthetic absorbable sutures .


We assessed the aesthetic long-term results with a minimum two year follow up .


This is a prospective , randomized controlled study with internal control .


A single surgeon performed all cases .


Patients who underwent elective operations that involved long wound closure were enrolled in the study .


Each patient acted as their own internal control with half their wound being sutured with @/@V-Loc @ barbed suture and the other half with smooth @/@Maxon deep dermal sutures and then a subcuticular skin closure .


In both groups , the superficial fascial system was closed with @ Vicryl interrupted sutures on both sides .


Long-term cosmesis was evaluated using the modified Hollander cosmesis score by review of standardized postoperative photographs by @ blinded plastic surgeons and specialist registrars .


The study reports on @ female patients .


The time taken for wound closure was significantly reduced using the barbed suture ( p < @ ) .


There was no difference in the complication ratio in either group .


Two-year aesthetic outcome was significantly superior when using the barbed suture ( p = @ ) .


Barbed sutures closure of long wounds is faster and produces a better long-term aesthetic outcome than smooth sutures .


To investigate the effects of Sini decoction on function of hypothalamic-pituitary-adrenal axis in patients with sepsis .


A prospective single-blind randomized controlled trial was conducted .


@ septic patients were divided into three groups with the method of random number table , @ cases in the control group , @ in the Chinese herb group , and @ in corticoid group .


All of them received routine treatment .


Patients in Chinese herb group were given Sini decoction in addition ( decoction of monkshood @ g , dried ginger @ g , honey-fried licorice @ g ) @ mL/d orally or by nasal feeding , while patients in corticoid group were given hydrocortisone @ mg/d intravenously instead , both for @ days .


Before the treatment , @ days and @ days after treatment , blood was collected to determine the levels of adrenocorticotropic hormone ( ACTH ) and cortisol , and the result of ACTH stimulating test was observed .


At the same time , acute physiology and chronic health evaluation II ( APACHEII ) score was recorded , and @-day shock recovery rate and @-day death rate were also compared among these groups .


None of the three groups showed different result in ACTH stimulating test ( ( @ ) = @ , P = @ ) .


ACTH in three groups was gradually decreased .


Compared with that before treatment , ACTH in Chinese herb group and corticoid groups began to decrease obviously on day @ ( @ ng/L vs. @ ng/L , @ ng/L vs. @ ng/L , both P < @ ) , while in control group declined ACTH appeared later ( on day @ ) compared with before treatment ( @ ng/L vs. @ ng/L , P < @ ) .


No obvious difference in ACTH level was showed between the Chinese herb group and the cortical group ( both P > @ ) .


Cortisol level in both Chinese herb and cortical groups showed a raise-fall biphase trend while there was no change in the control .


The cortical levels on day @ in Chinese herb and cortical groups were much higher than that before treatment ( @ g/L vs. @ g/L , @ g/L vs. @ g/L , both P < @ ) and that of control group ( @ g/L , both P < @ ) , though no significant statistical difference was observed between two groups ( both P > @ ) .


APACHEII score on day @ in control , Chinese herb and cortical groups was significantly lower than that before treatment ( @ vs. @ , @ vs. @,@ vs. @ , all P < @ ) , and the score was much lower in Chinese herb group comparing with that of control group ( P < @ ) .


No statistical difference was observed among control , Chinese herb and cortical groups in lowering @-day death rate -LSB- @ % ( @/@ ) , @ % ( @/@ ) , @ % ( @/@ ) -RSB- and improving @-day shock recovery rate -LSB- @ % ( @/@ ) , @ % ( @/@ ) , @ % ( @/@ ) , all P > @ -RSB- .


Sini decoction could elevate cortisol while lower ACTH at the early stage of sepsis .


Sini decoction could also effectively improve symptoms and hypothalamic-pituitary-adrenal axis function in septic patients without affecting death rate .


To investigate the efficacy of pregabalin for the relief of postoperative shoulder pain after laparoscopic gynecologic surgery .


Prospective , randomized , double-blind , placebo-controlled trial ( Canadian Task Force classification I ) .


Tertiary referral center , university hospital .


Fifty-six women undergoing elective laparoscopic gynecologic surgery between June @ and March @ .


Women in the study group received @ mg pregabalin @ hours before surgery and then every @ hours for @ doses , and women in the control group received an identical capsule and the same dosage of placebo .


Visual analog scale ( VAS ) scores for shoulder pain and surgical pain at @ and @ hours after surgery were evaluated as primary outcome .


Postoperative analgesics used and drug-related adverse events were also monitored .


Patients in the pregabalin group had significantly lower postoperative VAS scores for shoulder pain at @ hours , compared with the placebo group ( median , @ -LSB- range , @-@ @ -RSB- vs. @ -LSB- @-@ @ -RSB- ; p = @ ) , and required less analgesic ( p = @ ) .


There were no significant differences in VAS scores for surgical pain and adverse events between the @ groups ( p = @ ) .


Perioperative administration of @ mg pregabalin significantly reduced postoperative laparoscopic shoulder pain and amount of analgesic used .


With technological advances in NICUs the survival rate of preterm infants has been increased .


Because NICU environment is a potent source of stress for infants , its modification is an essential measure to decrease infants ' morbidity .


The purposes of this study were to compare the effects of wearing earmuff and provision silence for infants on their motor responses and gaining weight .


In a randomized clinical trial @ preterm infants were enrolled .


Their motor responses were evaluated for two consecutive days in the morning and afternoon shifts , in the groups of earmuff and silence , and at similar time points in the control group .


Also their weight was measured at days @ and @ .


In the two intervention groups , means of motor responses in infants were significantly less than in the control group , and weight gain of infants was more than the control group .


However weight gain was more pronounced in the earmuff group .


Both interventions led to decreasing number of motor responses and improvement of weight gain pattern , but these effects were more pronounced in earmuff group ; thus because implementation of silence in NICUs has many barriers , it is suggested to use earmuff for preterm infants in these units .


This trial obtained IRCT registration number IRCT@N@ .


Unlike free pneumococcal polysaccharide vaccines ( PPSVs ) , pneumococcal conjugate vaccines ( PCVs ) induce a T-cell-dependent immune response .


The study assessed potential influence of initial @-valent PCV ( PCV@ ) or @-valent PPSV ( PPSV@ ) on subsequent vaccine administrations .


We conducted a randomized , modified double-blind study in @ pneumococcal vaccine-nave adults @-@ years of age .


Subjects received either PCV@ at year @ and PCV@ at year @ ; PCV@ at year @ and PPSV@ at year @ ; or PPSV@ at year @ and PCV@ at year @ .


Antipneumococcal opsonophagocytic activity ( OPA ) titers were measured before and @ month after each vaccination .


OPA titers following PPSV@ given @ year after PCV@ ( PCV@/PPSV@ ) ( a ) were noninferior for the @ common serotypes and significantly higher for @ of @ common serotypes than those following only an initial PPSV@ ; and ( b ) were significantly higher for @ of @ common serotypes compared with PPSV@ followed by PCV@ ( PPSV@/PCV@ ) .


In addition , PPSV@ followed @ year later by PCV@ ( PPSV@/PCV@ ) elicited significantly lower OPA titers than after only an initial dose of PCV@ for all @ serotypes .


Responses after a second vaccination with either PCV@ ( PCV@/PCV@ ) or PPSV@ ( PCV@/PPSV@ ) were noninferior for @ of @ and @ of @ common serotypes compared with the initial PCV@ dose .


In pneumococcal vaccine-nave adults @-@ years of age , an initial PCV@ augmented the antipneumococcal response to subsequent administration of PPSV@ for many of the serotypes in common to both vaccines .


In contrast , an initial PPSV@ resulted in a diminished response to subsequent administration of PCV@ for all serotypes .


With a relatively short @-year interval between doses , responses after a second vaccination with PCV@ ( PCV@/PCV@ ) or PPSV@ ( PCV@/PPSV@ ) were noninferior for a majority of serotypes compared with the initial PCV@ dose , probably reflecting the need for a longer interval between vaccine administrations .


ClinicalTrials.gov Identifier : NCT@ .


Nilotinib and dasatinib have shown superior rates of molecular response ( MR ) compared to imatinib for the treatment of newly diagnosed chronic myeloid leukemia ( CML ) in chronic phase ( CP ) .


This study indirectly compares MR in patients taking nilotinib @mg bid with that in those taking dasatinib @mg qd by @ months and through @ months .


Patients in ENESTnd were re-weighted to match published baseline characteristics reported for DASISION using a propensity score model .


After matching , differences in rates of major MR ( MMR , measured as a @log reduction on the International Scale -LSB- IS -RSB- ) , MR ( @ ) ( @log reduction on IS ) , and MR ( @ ) ( @ log reduction on IS ) relative to imatinib were indirectly compared between nilotinib and dasatinib .


Hazard ratios ( HRs ) were used to indirectly compare MR outcomes between nilotinib and dasatinib through @ months of follow-up , while rate differences were used to compare progression to AP/BC between nilotinib and dasatinib by @ months .


After matching , rates of MR by @ months were higher with nilotinib vs dasatinib by @ % for MMR ( p = @ ) , @ % for MR ( @ ) ( p = @ ) , and @ % for MR ( @ ) ( p < @ ) .


Higher rates of MMR ( HR = @ , p = @ ) and MR ( @ ) ( HR = @ , p = @ ) achievement were maintained with nilotinib compared to dasatinib through @ months of follow-up .


No statistically significant differences were observed for MR ( @ ) through @ months or progression to AP/BC by @ months .


LIMITATIONS include comparisons based solely on indirect evidence and HRs for MR ( @ ) and MR ( @ ) from the DASISION trial being extracted from cumulative incidence curves .


This indirect comparison suggests that nilotinib is associated with higher rates of achieving MMR , MR ( @ ) , and MR ( @ ) by @ months compared to dasatinib for the treatment of newly diagnosed CML-CP .


In addition , higher rates of MR achievement with nilotinib were also maintained through @ months of follow-up .


Motor cortex excitability was found to be changed after repetitive transcranial magnetic stimulation ( rTMS ) of the temporal cortex highlighting the occurrence of cross-modal plasticity in non-invasive brain stimulation .


Here , we investigated the effects of temporal low-frequency rTMS on motor cortex plasticity in a large sample of tinnitus patients .


In @ patients with chronic tinnitus different parameters of cortical excitability were assessed before and after ten rTMS treatment sessions .


Patients received one of three different protocols all including @ Hz rTMS over the left temporal cortex .


Treatment response was defined as improvement by at least five points in the tinnitus questionnaire ( TQ ) .


Variables of interest were resting motor threshold ( RMT ) , short-interval intra-cortical inhibition ( SICI ) , intracortical facilitation ( ICF ) , and cortical silent period ( CSP ) .


After rTMS treatment RMT was decreased by about @ % of stimulator output near-significantly in the whole group of patients .


SICI was associated with significant changes with respect to treatment response .


The group of treatment responders showed a decrease of SICI over the course of treatment , the group of non-responders the reverse pattern .


Minor RMT changes during rTMS treatment do not necessarily suggest the need for systematic re-examination of the RMT for safety and efficacy issues .


Treatment response to rTMS was shown to be related to changes in SICI that might reflect modulation of GABAergic mechanisms directly or indirectly related to rTMS treatment effects .


Fibre intake among North Americans is currently less than half the recommended amount .


Consumers are interested in food products that could promote weight loss and improve health .


Consequently , evaluation of unique fibre sources with potential gut-mediated benefits for metabolic health warrants investigation .


Our objective is to assess the effects of yellow pea fibre supplementation on weight loss and gut microbiota in an overweight and obese adult population .


In a double blind , placebo controlled , parallel group study , overweight and obese ( BMI = @-@ ) adults will be randomized to either a @ g/d yellow pea fibre supplemented group or isocaloric placebo group for @ weeks ( n = @/group ) .


The primary outcome measure is a change in body fat from baseline to @ weeks .


Secondary outcomes include glucose tolerance , appetite regulation , serum lipids and inflammatory markers .


Anthropometric data ( height , weight , BMI , and waist circumference ) and food intake ( by @-day weighed food records ) will be measured at baseline and every @ weeks thereafter .


Subjective ratings of appetite will be recorded by participants at home on a weekly basis using validated visual analogue scales .


At week @ and at the end of the study ( week @ ) , an ad libitum lunch buffet protocol for objective food intake measures and dual-energy X-ray absorptiometry ( DXA ) scan for body composition will be completed .


Participants will be instructed not to change their exercise habits during the @ week study .


Glucose and insulin will be measured during an oral glucose tolerance test at weeks @ and @ .


Levels of lipids and CRP will be measured and inflammatory markers ( adiponectin , leptin , TNF - , IL-@ and IL-@ ) in the serum will be quantified using Milliplex kits .


Mechanisms related to changes in gut microbiota , serum and fecal water metabolomics will be assessed .


Globally the development of functional foods and functional food ingredients are critically needed to curb the rise in metabolic disease .


This project will assess the potential of yellow pea fibre to improve weight control via gut-mediated changes in metabolic health in overweight and obese adults .


The effect of oral anxiolytics in diminishing patient discomfort and pain perception has been demonstrated in GI endoscopy , percutaneous coronary interventions , and various procedures in the emergency department setting , but has not been prospectively studied in the setting of prostate biopsy .


The purpose of this study was to investigate the effect of diazepam on pain perception during and after prostate biopsy .


Sixty patients undergoing prostate biopsy at a single academic institution were enrolled into a prospective , randomized , placebo-controlled study .


A questionnaire was administered prebiopsy to determine baseline discomfort and pain history .


A visual analog pain scale was used to determine pain associated with each step of the transrectal Ultrasonography-guided prostate biopsy and was administered @ minutes after biopsy and @ week later .


Responses were compared between groups using the Mann-Whitney U test , Fisher exact test , and Wilcoxon signed rank test as appropriate .


A total of @ patients ( @ diazepam , @ placebo ) completed pre - and postbiopsy surveys for analysis .


The number of cores sampled during biopsy was controlled during analysis and was found to have no correlation with total pain measured .


There were no differences between diazepam and placebo groups in age , prebiopsy survey results , immediate and @ week postbiopsy survey results .


There was no difference in the patients ' willingness to undergo a repeated procedure in the control and treatment groups .


Complications of taking diazepam prebiopsy included drowsiness , chills , and ankle injury .


Diazepam does not improve patient pain perception immediately after or at @-week recall after prostate biopsy .


Omitting diazepam simplifies the biopsy regimen and allows the patient to drive himself home .


Based on these results , routine use of diazepam in prostate biopsy is not recommended .


External trigeminal nerve stimulation ( eTNS ) is an emerging noninvasive therapy for drug-resistant epilepsy ( DRE ) .