Baseline cancer screening rates ( @ % vs @ % ) were similar among patients in the intervention ( n = @,@ ) and comparison group ( n = @,@ ) .


Most intervention providers used the IT application ( @ of @ , @ % ) and users reviewed @ patients overdue for at least @ cancer screening ( @ % sent reminder letter , @ % referred directly to a practice delegate or patient navigator , and @ % deferred screening ) .


In addition , @ letters were automatically sent to patients in the intervention group ( total of @,@ letters vs @,@ letters in comparison practices ; P < @ ) .


Adjusted average cancer screening rates did not differ among intervention and comparison practices for all cancers combined ( @ % vs @ % ; P = @ ) nor breast ( @ % vs @ % ; P = @ ) , cervical ( @ % vs @ % ; P = @ ) , or colorectal cancer ( @ % vs @ % ; P = @ ) .


Involving PCPs in a visit-independent population management IT application resulted in similar cancer screening rates compared with an automated reminder system , but fewer patients were sent reminder letters .


This suggests that PCPs were able to identify and exclude from contact patients who would have received automated reminder letters but not undergone screening .


Providing long-term follow-up of the natural history of age-related macular degeneration ( AMD ) and associated risk factors will facilitate future epidemiologic studies and clinical trials .


To describe @-year progression rates to intermediate or advanced AMD .


We observed the Age-Related Eye Disease Study ( AREDS ) participants for an additional @ years after a randomized clinical trial of antioxidant vitamins and minerals was completed .


Observation occurred at @ clinical sites of medical retinal practices from academic institutions and community medical centers .


Participants aged @ to @ years with no AMD or AMD of varying severity ( n = @ ) were followed up in the AREDS trial for a median duration of @ years .


When the trial ended , @ of the @ surviving participants were followed for @ additional years .


Treatment with antioxidant vitamins and minerals .


Development of varying stages of AMD and changes in visual acuity .


The rates of progression to large drusen and advanced AMD ( neovascular AMD or central geographic atrophy ) were evaluated using annual fundus photographs assessed centrally .


Best-corrected visual acuity was measured at annual study visits .


The risk of progression to advanced AMD increased with increasing age ( P = @ ) and severity of drusen .


Women ( P = @ ) and current smokers ( P < @ ) were at increased risk of neovascular AMD .


In the oldest participants with the most severe AMD status at baseline , the risks of developing neovascular AMD and central geographic atrophy by @ years were @ % and @ % , respectively .


Similarly , rates of progression to large drusen increased with increasing severity of drusen at baseline , with @ % of participants with bilateral medium drusen progressing to large drusen and @ % to advanced AMD in @ years .


Median visual acuity at @ years in eyes that had large drusen at baseline but never developed advanced AMD was @/@ ; eyes that developed advanced AMD had a median visual acuity of @/@ .


The natural history of AMD demonstrates relentless loss of vision in persons who developed advanced AMD .


These progression data and the risk factor analyses may be helpful to investigators conducting research in clinic populations .


Non-alcoholic fatty liver disease ( NAFLD ) represents a range of liver conditions from simple fatty liver to progressive end stage liver disease requiring liver transplantation .


NAFLD is common in the population and in certain sub groups ( e.g. type @ diabetes ) up to @ % of patients may be affected .


NAFLD is not only a cause of end stage liver disease and hepatocellular carcinoma , but is also an independent risk factor for type @ diabetes and cardiovascular disease .


Consequently , effective treatments for NAFLD are urgently needed .


The WELCOME study is testing the hypothesis that treatment with high dose purified long chain omega-@ fatty acids will have a beneficial effect on a ) liver fat percentage and b ) two histologically validated algorithmically-derived biomarker scores for liver fibrosis .


In a randomised double blind placebo controlled trial , @ participants with NAFLD were randomised to @-@months treatment with either @g/day purified long chain omega-@ fatty acids ( Omacor ) or @g/day olive oil as placebo .


Erythrocyte percentage DHA and EPA enrichment ( a validated proxy for hepatic enrichment ) was determined by gas chromatography .


Liver fat percentage was measured in three discrete liver zones by magnetic resonance spectroscopy ( MRS ) .


We also measured body fat distribution , physical activity and a range of cardiometabolic risk factors .


Recruitment started in January @ and ended in June @ .


We identified @ potential participants , and randomised @ participants who met the inclusion criteria .


The WELCOME study was approved by the local ethics committee ( REC : @/H@/@ ; www.clinicalTrials.gov registration number NCT@ ) .


Nasya/Prevalin is a natural , drug-free nasal spray for treatment and prevention of allergic rhinitis .


Because of its thixotropic property , it forms a barrier on the nasal mucosa , preventing allergen contact .


This study assesses the clinical efficacy and safety of Nasya/Prevalin in a nasal provocation test with house dust mite allergens .


In this randomised , double-blind , placebo-controlled trial , @ subjects suffering from allergic rhinitis because of house dust mite allergens received a single dose of Nasya/Prevalin or saline spray before allergen challenge .


Total nasal symptom score and total ocular symptom score were assessed @ , @ , @ , @ , @ , @ and @min after challenge .


Further , the appearance of the mucosa was examined by rhinoscopy .


A single treatment with Nasya/Prevalin led to a significant reduction of TNSS at @ , @ and @min after dust mite allergen challenge as compared with placebo ( pVCAS = @ , pVCAS = @ , pVCAS = @ , respectively ) .


Mucosa changes assessed by the rhinoscopic score ( on swelling , secretion and colour ) were significantly worse in the placebo group compared with the Nasya/Prevalin group ( P = @ ) .


Nasya/Prevalin was well tolerated , and the safety was comparable with placebo .


Treatment with Nasya/Prevalin was effective in preventing allergic reactions induced by dust mite allergen challenge .


To assess the efficacy of Yishen Jiejing Decoction ( YJD ) in treating poststroke shoulder-hand syndrome ( SHS ) patients of yin deficiency yang hyperactivity with blood stasis stagnation collaterals syndrome .


Totally @ SHS patients of yin deficiency yang hyperactivity with blood stasis stagnation collaterals syndrome were randomly assigned to two groups , the treatment group and the control group , @ cases in each group .


Conventional rehabilitation training and therapeutics were applied in all patients .


Besides , patients in the treatment group took @ mL YJD , twice a day .


One month without interruption consisted of one course of treatment .


The curative effects of each group were evaluated respectively before treatment and at one month after treatment .


The neurologic impairment , TCM syndrome , and the improvement of upper limbs movement were assessed by the neurologic impairment integral , scoring for TCM syndrome diagnostics , Fugl-Meyer Assessment ( U-FMA ) .


Adverse reactions were observed at the same time .


The effective rate of stroke was @ % and the effective rate of SHS was @ % in the treatment group , higher than those of the control group ( P < @ ) .


Both groups got improvement in neurologic impairment , stroke induced blood stasis syndrome , yin deficiency yang hyperactivity syndrome , and the improvement of upper limbs movement after treatment ( all P < @ ) .


Besides , all the improvement was obviously superior in the treatment group ( P < @ ) .


No adverse reaction occurred during the course of treatment .


The curative effect of YJD combined with conventional rehabilitation training was confirmative and superior to the control group .


Polyphonic music ( music consisting of several instruments playing in parallel ) is an intuitive way of embedding multiple information streams .


The different instruments in a musical piece form concurrent information streams that seamlessly integrate into a coherent and hedonistically appealing entity .


Here , we explore polyphonic music as a novel stimulation approach for use in a brain-computer interface .


In a multi-streamed oddball experiment , we had participants shift selective attention to one out of three different instruments in music audio clips .


Each instrument formed an oddball stream with its own specific standard stimuli ( a repetitive musical pattern ) and oddballs ( deviating musical pattern ) .


Contrasting attended versus unattended instruments , ERP analysis shows subject - and instrument-specific responses including P@ and early auditory components .


The attended instrument can be classified offline with a mean accuracy of @ % across @ participants .


This is a proof of concept that attention paid to a particular instrument in polyphonic music can be inferred from ongoing EEG , a finding that is potentially relevant for both brain-computer interface and music research .


Laparoscopic surgery requires certain specific skills .


There have been several attempts to minimize the learning curve with training outside the operation room .


Although simulators have been well validated as tools to teach technical skills , their integration into comprehensive curricula is lacking .


Several randomized controlled trials and systematic reviews have demonstrated that the technical skills learned on these simulators transfer to the operating room .


Currently , however , the integration of these simulated models into formal residency training curricula is lacking .


In our institute , we have adopted the Tuebingen Trainer devised by Professor GF Buess from Germany .


The purpose of this study was to evaluate the training of surgical residents on an ex vivo phantom model for basic laparoscopic skill acquisition and its transferability to the OR performance .


Seventeen general surgery residents were randomized into @ groups : Laparoscopic Training Group ( n = @ , Group A ) and Standard Training Group ( n = @ , Group B ) .


Group A underwent training in the Minimally Invasive Surgery Training Centre on the porcine phantom model and did @ laparoscopic cholecystectomies , whereas Group B did not undergo training in the Minimally Invasive Surgery Training Centre .


All the participants performed a laparoscopic cholecystectomy in the operation theater in the presence of a consultant who was blinded to the training status of the participants .


The performance of the residents in both groups in the operation theater was assessed using GOALS criteria , surgical performance assessment parameters , task-specific checklists , and visual analog scale for gallbladder perforation difficulty and overall competence .


The Laparoscopic Training Group had better performance than the Standard Training Group regarding operation time , GOALS criteria , and Task-specific checklists .


Although the surgical performance assessments , i.e. cystic duct and artery identification scores , gallbladder perforation scores , and liver injury scores , were better in the Laparoscopic Training Groups , they were not statistically significant .


The overall difficulty of the surgery was comparable in both the groups .


The Laparoscopic Training Group exhibited significant overall competence on visual analog scale scores .


Our study has clearly shown that training on the Tuebingen Trainer with integrated porcine organs results in a statistically significant improvement in the operating room performance of surgical residents as compared with the nontrained residents , thereby indicating a transfer of skills from training to the operating room .


Physical activity during childhood and adolescence is associated with substantial health benefits and tracks into adulthood .


Nevertheless , only @ % of German adolescents are sufficiently physically active .


Thus , the promotion of an active lifestyle in youth is an essential issue of public health.This study will evaluate the implementation and efficacy of the `` luft . ''


program to enhance physical activity in adolescence .


`` luft . ''


is a multicomponent school-based program developed on the basis of effective strategies for health interventions and behavioral change .


The `` luft . ''


physical activity program targets four different levels .


( a ) Each student receives a pedometer and documents his/her steps over @ weeks using an interactive user account on the `` luft . ''


homepage .


( b ) For classes there will be different competitions , with achieving the most steps in selected weeks , the highest increases of steps and developing the most inventive ideas to promote physical activity in school .


Besides , the intervention includes four educational lessons .


( c ) The headmasters and teaching staff of the participating schools will get information material with suggestions and encouragement to enhance physical activity in school .


Participating teachers will be invited to an introductory seminar .


( d ) Parents will be provided with informational material about the program and will be invited to a parent-teacher conference about the benefits of being physically active and how they can support their children in engaging in a physically active lifestyle.To evaluate the efficacy of the `` luft . ''


physical activity program , a two-arm cluster randomized controlled trial will be conducted in three waves : ( @ ) baseline assessment , January/February @ , ( @ ) post assessment , June/July @ and ( @ ) @-month follow-up assessment , June/July @ .


Data collection will include physical and medical testing , self-administered questionnaires , group discussions and document analyses .


aims at fostering a physically active lifestyle in adolescence while a considerable decline of physical activity is present .


Physical activity programs based in the school setting and following a multicomponent approach have been proven to be most successful .


Furthermore , the use of pedometers is promising to enhance physical activity during the entire day and targets a wide range of adolescents regarding fitness and weight .


Glycopyrronium is a once-daily ( od ) long-acting muscarinic antagonist for the maintenance treatment of chronic obstructive pulmonary disease ( COPD ) .


The GLOW@ study evaluated the efficacy and safety of od glycopyrronium @ g in predominantly Chinese patients with moderate-to-severe COPD .


In this @-week , multi-center , double-blind , placebo-controlled , parallel-group study , men and women @ years with moderate-to-severe COPD were randomized to glycopyrronium @ g od or placebo ( @:@ ) .


The primary objective was to confirm the significant improvement of trough forced expiratory volume in @ second ( FEV@ ) following @ weeks of treatment with glycopyrronium compared with placebo .


Secondary objectives included the effect of glycopyrronium on health status ( St George 's Respiratory Questionnaire ) , breathlessness ( Transition Dyspnea Index ) , other lung function parameters , rescue medication use , and COPD exacerbations .


Safety and tolerability were also evaluated .


Of the @ patients randomized , @ were included in the full analysis set ( glycopyrronium , n = @ ; placebo , n = @ ; mean age @ years ; mean post-bronchodilator FEV@ : @ % predicted ) ; @ ( @ % ) completed the study .


At Week @ , glycopyrronium signifcantly improved trough FEV@ with a least square means treatment difference of @ mL ( @ % confidence interval @ mL , @ mL ; P < @ ) compared with placebo .


The mean treatment effect of glycopyrronium was greater than the minimum clinically important difference versus placebo in both St George 's Respiratory Questionnaire total score ( -@ ; P < @ ) and Transition Dyspnea Index focal score ( @ ; P < @ ) at week @ .


Glycopyrronium reduced the risk of exacerbations in terms of time to first moderate or severe exacerbation by @ % ( P = @ ) and rate of moderate or severe COPD exacerbation by @ % ( P = @ ) compared with placebo .


Incidence of death was @ % with glycopyrronium and @ % in placebo during the treatment period .


Overall incidence of adverse events ( glycopyrronium @ % ; placebo @ % ) and serious adverse events ( glycopyrronium @ % ; placebo @ % ) were similar .


In predominantly Chinese patients with moderate-to-severe COPD , od glycopyrronium @ g significantly improved lung function , dyspnea , and health status compared with placebo .


The safety and tolerability profile of glycopyrronium was comparable to placebo .


Blood pressure normally declines during the night ( ` dipping ' ) ; a blunted nocturnal decline is an important cardiovascular risk factor .


Marriage may be associated with lower ambulatory blood pressure , although this may be confounded by socio-economic and dietary factors .


We examined the association of marital status with nocturnal dipping and night-time SBP amongst individuals on a controlled diet .


We analysed @ individuals enrolled in the Dietary Approaches to Stop Hypertension trial who had available @-h SBP data and who ingested a control diet .


Logistic and linear regression models were fit to estimate the association of marital status with nocturnal dipping and mean night-time SBP .


Of the @ individuals , @ % were men , the average age was @ years and @ % reported being married .


Compared with nonmarried individuals , those who were married had greater adjusted odds of dipping -LSB- odds ratio ( OR ) @ ; @ % confidence interval ( CI ) @-@ @ ; P = @ -RSB- .


In adjusted models , being married was associated with lower night-time SBP ( -@ mmHg ; @ % CI -@ to -@ mmHg ; P = @ ) , with the suggestion of a greater association in married men compared with married women ( -@ vs. -@ mmHg ) ; there was less difference for married nonblacks compared with married blacks ( -@ and -@ mmHg , respectively ) .


Being married is independently associated with a greater likelihood of nocturnal dipping and with lower night-time SBP among individuals participating in a controlled dietary intervention ; the association was particularly strong in married men .


Marital status is a variable that may be considered in future analyses of ambulatory blood pressure .


This study aimed to determine if preoperative oral administration of metoclopramide , chlorpromazine , gabapentin , or dexamethasone would effectively reduce postoperative nausea and vomiting ( PONV ) in the first @ hours after surgery in patients undergoing maxillofacial trauma surgery .


One hundred fifty patients with maxillofacial skeletal trauma that need open reduction and internal fixation were randomly assigned to receive one of the following drugs orally , @ hour preoperative : @ mg metoclopramide ( group A ) , @ mg gabapentin ( group B ) , @ mg chlorpromazine ( group C ) , @ mg dexamethasone ( group D ) , and placebo ( group E ) .


All patients were observed in the first @ hours for PONV .


Data analysis was done with the SPSS software ( version @ ) , using chi-square test , Fisher exact test , and multiple logistic regression methods .


The incidence of vomiting was significantly lower in groups A ( @/@ ) , B ( @/@ ) , and C ( @/@ ) compared with the placebo group ( @/@ ) ( P < @ ) .


Also , the incidence of postoperative nausea was significantly high in the placebo group ( @/@ ) as compared to treatment groups A ( @/@ ) , B ( @/@ ) , and C ( @/@ ) ( P < @ ) .


No significant differences in the incidence of PONV were found between groups D ( @/@ ) and E ( P > @ ) .


Of all demographic variables , anesthesia time ( P = @ ) and surgery time ( P = @ ) were predictors of PONV .


Our results demonstrated that premedication with oral metoclopramide , gabapentin , or chlorpromazine can significantly decrease the incidence of PONV in patients undergoing maxillofacial trauma surgery .


To understand whether combination antiretroviral therapy ( cART ) has been optimized , we asked whether @-drug protease inhibitor ( PI ) - based cART intensified with raltegravir and maraviroc and initiated during early infection would improve outcomes when compared with similarly applied @-drug PI-based cART .


Forty newly HIV-@-infected patients were randomized @:@ to receive @-drug ( N = @ ) or @-drug ( N = @ ) therapy .


The primary end point was the percent of subjects with undetectable plasma viremia using standard reverse transcriptase-polymerase chain reaction and the single copy assay after @ weeks .


Secondary end points included levels of cell-associated HIV-@ DNA and RNA and levels of infectious virus in resting CD@ T cells at week @ and quantitative and qualitative immunologic responses .


At @ weeks , @ subjects remained on study and are included in the as-treated analysis .


Three of @ ( @ % ) in the @-drug arm and @ of @ ( @ % ) in the @-drug arm had plasma HIV-@ RNA levels below detection by both standard reverse transcriptase-polymerase chain reaction and single copy assay ( P = @ , Fisher exact test ) .


No significant differences in absolute levels of proviral DNA or changes in cell-associated RNA were seen during @ weeks of therapy .


Mean levels of infectious HIV-@ in resting CD@ T cells at week @ in @ subjects treated with @-drugs and @ with @-drugs were @ and @ infectious units per million , respectively ( P = @ ) .


No differences were seen in quantitative or qualitative immunologic determinations including markers of immune activation .


Intensified @-drug cART initiated during early infection fails to significantly further impact virologic or immunologic responses beyond those achieved with standard @-drug PI-based cART .


To investigate the effects of different target plasma remifentanil concentrations on the minimum alveolar concentration of sevoflurane ( MAC ) for blocking adrenergic response ( BAR ) during laparoscopic gynaecological surgery with carbon dioxide insufflation .


Seventy-five gynaecological patients with ASA I-II undergoing laparoscopic surgery were randomly assigned to three groups .


Anaesthesia was induced by sevoflurane , and @ mg kg ( -@ ) of vecuronium i.v. was injected to facilitate tracheal intubation .


After intubation the target plasma concentrations of remifentanil in Groups @ , @ , and @ were adjusted to @ , @ , and @ ng ml ( -@ ) , respectively .


The changes in haemodynamics were observed before and after the creation of carbon dioxide pneumoperitoneum .


The MAC BAR of sevoflurane in each group was determined by using an up-and-down sequential-allocation technique , and blood samples were collected at corresponding time points to determine the concentrations of remifentanil , norepinephrine , and epinephrine .


In Groups @ , @ and @ , the MAC BAR of sevoflurane was @ % ( CI @ % : @-@ @ % ) , @ % ( CI @ % : @-@ @ % ) , and @ % ( CI @ % : @-@ @ % ) , respectively .


No significant differences were found in the increase of norepinephrine , epinephrine , and mean arterial pressure after compared with before insufflation of pneumoperitoneum among the three groups .


Remifentanil can effectively decrease the sevoflurane concentration to block sympathetic adrenergic response to CO@ pneumoperitoneum stimulus .


At similar MAC BAR the haemodynamic and adrenergic response is not affected by the infused remifentanil concentration .


Anesthesiologists use various medications to provide surgical patients with pain relief in the postoperative period .


Other modalities , such as music , could be used in conjunction with opioids and nonsteroidal anti-inflammatory drugs ( NSAIDs ) to decrease pain and lower heart rate and blood pressure .


Our hypothesis was that patients listening to jazz in a postanesthesia care unit ( PACU ) would have lower heart rates and blood pressures and reduced pain and anxiety .


The study objective was to determine if listening to jazz music in the PACU , when compared to wearing noise-canceling headphones with no music playing , would decrease heart rate , blood pressure , pain , or anxiety in patients undergoing a hysterectomy .


The research design was a prospective , randomized study .


The study was conducted in the PACU at the Penn State Hershey Medical Center in Hershey , PA , USA .


A total of @ patients , aged @-@ y , who were categorized as status @ or @ according to the American Society of Anesthesiologists ( ASA ) Physical Status Classification System , and who were undergoing elective laparoscopic or abdominal hysterectomies , were enrolled in the study .


Patients were randomly assigned either to listen to jazz music where the beats per min ( BPM ) was < @ ( experimental group , n = @ ) or to wear noise-canceling headphones ( control group , n = @ ) for @ min while in the PACU after their surgery .


Heart rate was the primary outcome , and secondary outcomes included systolic and diastolic blood pressure , an anxiety score , and a pain score .


All outcome measures were initially recorded at baseline upon the patient 's arrival in the PACU .


Heart rate and blood pressure were recorded postoperatively every @ min for the initial @ min that a patient was in the PACU .


Pain was checked every @ min during the @-min period ; anxiety was checked at @ min .


Heart rates of patients in the noise-cancellation group were significantly lower when compared with baseline ( P < @ ) , at all time points .


For patients in the jazz group , heart rates were significantly lower at @ , @ , @ , and @ min when compared with baseline .


The pain scores were significantly lower ( P < @ ) in the noise-cancellation group compared with the jazz group at @ min into the recovery period .


Overall , the results showed that patients responded not only to music but also to silence in the PACU .


Using music and/or noise reduction could decrease opioid administration , promote relaxation , and improve patient satisfaction .


Cold Water Immersion ( CWI ) is commonly used to manage delayed onset muscle soreness ( DOMS ) resulting from exercise .


Scientific evidence for an optimal dose of CWI is lacking and athletes continue to use a range of a treatment protocols and water temperatures .


To compare the effectiveness of four different water immersion protocols and a passive control intervention in the management of DOMS .


Randomised controlled trial with blinded outcome assessment .


University Research Laboratory .


@ healthy participants with laboratory induced DOMS randomised to one of five groups : Short contrast immersion ( @min @C/@min @C@ ) , Short intermittent CWI ( @min@ at @C ) ; @min CWI in @C ; @min CWI in @C ; or control ( seated rest ) .


muscle soreness , active range of motion , pain on stretch , muscle strength and serum creatine kinase .


@min of CWI in @C was associated with the lowest levels of muscle soreness and pain on stretch however values were not statistically different to any of the other groups .


There were no statistically significant differences between groups for any other outcomes .


Altering the treatment duration , water temperature or dosage of post exercise water immersion had minimal effect on outcomes relating to DOMS .


The aim of this study was to investigate the efficacy of rikkunshito ( RKT ) , a traditional Japanese medicine , combined with proton pump inhibitor ( PPI ) in patients with PPI-refractory non-erosive reflux disease ( NERD ) .


Patients with PPI-refractory NERD ( n = @ ) were randomly assigned to the RKT group -LSB- rabeprazole ( @ mg/day ) + RKT ( @ g/t .


i.d. ) for @ weeks -RSB- or the placebo group ( rabeprazole + placebo ) .


After the @ - and @-week treatments , we assessed symptoms and quality of life ( QOL ) using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease ( FSSG ) , Gastrointestinal Symptom Rating Scale ( GSRS ) , and Short-Form Health Survey-@ ( SF-@ ) .


There were no significant differences in FSSG and GSRS score improvement between these groups after the @ - and @-week treatments .


The mental component summary ( MCS ) scores of the SF-@ improved more in the RKT group ( from @ @ to @ @ ) than in the placebo group ( from @ @ to @ @ ) after the @-week treatment ( P < @ ) .


The @-week treatment with RKT was more effective for improvement of the degree of MCS score in patients with a low body mass index ( < @ ) ( P < @ ) and significantly improved the acid-related dysmotility symptoms of FSSG in female and elderly patients ( @ years ) .


There were no significant differences in improvement of GERD symptoms in patients with PPI-refractory NERD between these groups .


However , RKT may be useful for improving mental QOL in non-obese patients and acid-related dyspeptic symptoms , especially in women and the elderly .


Beta-adrenergic blockade has been shown to improve left ventricular function , reduce hospital admissions and improve survival in chronic heart failure with reduced ejection fraction ( HFrEF ) , with mortality reduction starting early after beta-adrenergic receptor blocker initiation and being dose-related .


The aim of this pilot study was to determine the effectiveness of a nurse-led titration clinic in improving the time required for patients to reach optimal doses of the beta-adrenergic receptor blocking agents .


We conducted a prospective pilot randomized controlled trial .


Twenty eight patients with CHF were randomized to optimisation of beta-adrenergic receptor blocker therapy over six months by either a nurse-led titration ( NLT ) clinic , led by a nurse specialist with the support of a cardiologist in a CHF clinic , or by their primary care physician ( usual care ( UC ) ) .


The primary endpoint was time to maximal beta-adrenergic receptor blocker dose .


The secondary end-point was the proportion of patients reaching the target dose of beta-adrenergic receptor blocker by six months .


The patients were predominantly men ( @ % ) , age @ @ years ; New York Heart Association ( NYHA ) functional class I ( @ % ) , II ( @ % ) and III ( @ % ) ; baseline left ventricular ejection fraction @ @ % , and a low mean Charlson co-morbidity score of @ @ .


The time to maximum dose was shorter in the NLT group compared to the UC group ( @ @ vs @ @ days , p < @ ) .


At six months , in the NLT group there were nine patients ( @ % ) on high dose and one patient ( @ % ) on low dose beta-adrenergic receptor blocker compared to the UC group with five ( @ % ) patients reaching maximum dose and five ( @ % ) patients on low dose ( p = @ ) .


The patients allocated to the NLT group also had significantly less worsening of depression between baseline and six months ( p = @ ) .


A NLT clinic improves optimisation of beta-adrenergic receptor blocker therapy through increasing the proportion of patients reaching maximal dose and facilitating rapid up-titration of beta-adrenergic receptor blocker agents in patients with chronic HFrEF .


Recombinant leptin ( metreleptin ) treatment restores bone mineral density in women with hypothalamic amenorrhea ( HA ) , a condition characterized by hypoleptinemia , which has adverse impact on bone health .


The objective of the study was to investigate how metreleptin exerts its positive effect on bone metabolism in humans .


This was a randomized , double-blinded , placebo-controlled study .


The study was conducted at Beth Israel Deaconess Medical Center ( Boston , Massachusetts ) .


Women ( n = @ ) with HA and hypoleptinemia for at least @ months were randomized to receive either metreleptin or placebo for @ weeks .


Serum samples were obtained at baseline and @ , @ , and @ weeks of treatment .


Circulating levels of leptin , intact PTH ( iPTH ) , receptor activator of nuclear factor-B ligand ( RANKL ) , osteoprotegerin ( OPG ) , sclerostin , dickkopf-@ , and fibroblast growth factor-@ .


Metreleptin administration significantly increased leptin levels throughout the treatment period ( P = @ ) .


iPTH decreased over the @ weeks of treatment ( P = @ ) .


There was a trend toward a decrease in serum RANKL and increase in serum OPG in the metreleptin-treated group .


The RANKL to OPG ratio was significantly decreased within the metreleptin ( P = @ ) but not the placebo group .


Metreleptin had no effect on serum sclerostin , dickkopf-@ , and fibroblast growth factor-@ .


Metreleptin treatment over @ weeks decreases iPTH and RANKL to OPG ratio levels in hypoleptinemic women with HA .


We have previously found that sarcosine , a glycine transporter I inhibitor , can improve the psychiatric symptoms of schizophrenia .


In this study , we aimed to investigate whether the agent can also ameliorate neuropsychiatric symptoms of Parkinson 's disease ( PD ) patients with dementia .


An @-week , double-blind , placebo-controlled trial was conducted in patients who had PD with dementia ( PD-D ) .


Neuropsychiatric manifestations were measured before and at week @ ( V@ ) , week @ ( V@ ) and week @ ( V@ ) after treatment .


Linear regression with the generalized estimating equations was applied for data analysis .


Fifteen patients were randomized into a sarcosine group ; the other @ into a placebo group .


The generalized estimating equations model revealed significant differences in Hamilton Depression Rating Scale score ( P = @ ) at V@ and Neuropsychiatry Inventory ( P = @ ) at V@ between the treatment and placebo groups .


By excluding the advanced patients from analysis , there were significant differences in Unified Parkinson 's Disease Rating Scale V@ ( P = @ ) and V@ ( P = @ ) , Hamilton Depression Rating Scale V@ ( P = @ ) and V@ ( P = @ ) , Neuropsychiatry Inventory V@ ( P = @ ) and V@ ( P < @ ) and Behavior Pathology in Alzheimer 's Disease Rating Scale V@ ( P = @ ) in favor of sarcosine .


Sarcosine temporally improved depression and neuropsychiatric symptoms in PD-D patients without exacerbating the motor or cognitive features ; the beneficial effects were more prominent in patients with mild-moderate severity .


Enhancement of N-methyl-D-aspartate receptor-glycine cascade may lead to a novel path for the management of PD-D .


To compare the astigmatic outcomes of LASIK with a single excimer laser platform using either wavefront-guided ( WFG ) or wavefront-optimized ( WFO ) modes .


Sixty-eight eyes of @ patients underwent LASIK for myopia with the Wavelight Allegretto Eye-Q @-Hz laser platform ( Alcon Laboratories , Inc. , Henberg , Switzerland ) .


One eye underwent WFG-LASIK and the contralateral eye underwent WFO-LASIK .


Alpins vector analysis of astigmatism was performed using manifest refraction measured preoperatively and @ months postoperatively and vertexed to the corneal plane .


Eyes were stratified for subgroup analysis based on preoperative manifest astigmatism .


WFG-LASIK and WFO-LASIK were similar with regard to surgically induced astigmatism , difference vector , magnitude of error , correction index , flattening index , and index of success .


The angle of error was @ % less in the WFG group compared to the WFO group ( @ @ vs @ @ , P = @ ) .


WFG-LASIK and WFO-LASIK using the Alcon WaveLight Allegretto Eye-Q @-Hz excimer laser platform produce similar astigmatic results in myopic patients ; however , the WFG mode may produce slightly more predictable astigmatic corrections .


Painful oral mucositis ( OM ) is a significant toxicity during radiotherapy for head and neck cancers .


The aim of this randomized , double-blind , placebo-controlled trial was to test the efficacy of doxepin hydrochloride in the reduction of radiotherapy-induced OM pain .


In all , @ patients were randomly allocated to a doxepin oral rinse or a placebo for the treatment of radiotherapy-related OM pain .


Patients received a single dose of doxepin or placebo on day @ and then crossed over to receive the opposite agent on a subsequent day .


Pain questionnaires were administered at baseline and at @ , @ , @ , @ , @ , and @ minutes .


Patients were then given the option to continue doxepin .


The primary end point was pain reduction as measured by the area under the curve ( AUC ) of the pain scale using data from day @ .


Primary end point analysis revealed that the AUC for mouth and throat pain reduction was greater for doxepin ( -@ ) than for placebo ( -@ ; P < @ ) .


Crossover analysis of patients completing both phases confirmed that patients experienced greater mouth and throat pain reduction with doxepin ( intrapatient changes of @ for doxepin-placebo arm and -@ for placebo-doxepin arm ; P < @ ) .


Doxepin was associated with more stinging or burning , unpleasant taste , and greater drowsiness than the placebo rinse .


More patients receiving doxepin expressed a desire to continue treatment than did patients with placebo after completion of each of the randomized phases of the study .


A doxepin rinse diminishes OM pain .


Further studies are warranted to determine its role in the management of OM .


Biomarkers may contribute to risk stratification in coronary heart disease ( CHD ) .


We examined whether plasma midregional proadrenomedullin ( MR-proADM ) concentration at baseline and its change over one year predicts long-term outcomes in stable CHD patients .


The LIPID study randomised patients @-@ months after an acute coronary syndrome with total cholesterol @-@ @ mmol/L ( @-@ mg/dL ) , to placebo or pravastatin @ mg .


Follow-up was @ years .


MR-proADM plasma concentrations at baseline and one year later were determined in @ and @ patients , respectively .


These were categorised into quartiles to perform Cox regression analysis , adjusting for baseline parameters .


Baseline MR-proADM concentrations predicted major CHD events ( non-fatal myocardial infarction or CHD death ; hazard ratio ( HR ) @ , @-@ @ for Q@-Q@ ) , CHD death ( HR @ , @-@ @ ) , heart failure ( HR @ , @-@ @ ) and all-cause mortality ( HR @ , @-@ @ ) .


Associations were still significant after adjustment for baseline B-type natriuretic peptide ( BNP ) concentration .


Increase in MR-proADM after one year was associated with increased risk of subsequent CHD events ( HR @ , @-@ @ ) , non-fatal myocardial infarction ( HR @ , @-@ @ ) , heart failure ( HR @ , @-@ @ ) and all-cause mortality ( HR @ , @-@ @ ) .


Associations with heart failure and all-cause mortality remained significant after adjusting for baseline and change in BNP concentration .


Change in MR-proADM moderately improved risk reclassification for major CHD events ( net reclassification improvement ( NRI ) @ % ) but strongly improved risk reclassification for heart failure ( NRI @ % ) .


Baseline and change in MR-proADM concentrations over one year are associated with risk of major clinical events , even after adjustment for BNP concentrations .


Developing efficacious medications to treat methamphetamine dependence is a global challenge in public health .


Topiramate ( TPM ) is undergoing evaluation for this indication .


The molecular mechanisms underlying its effects are largely unknown .


Examining the effects of TPM on genome-wide gene expression in methamphetamine addicts is a clinically and scientifically important component of understanding its therapeutic profile .


In this double-blind , placebo-controlled clinical trial , @ individuals who met the DSM-IV criteria for methamphetamine dependence were randomized to receive either TPM or placebo , of whom @ consented to participate in our genome-wide expression study .


The RNA samples were collected from whole blood for @ TPM - and @ placebo-treated participants at three time points : baseline and the ends of weeks @ and @ .


Genome-wide expression profiles and pathways of the two groups were compared for the responders and non-responders at Weeks @ and @ .


To minimize individual variations , expression of all examined genes at Weeks @ and @ were normalized to the values at baseline prior to identification of differentially expressed genes and pathways .


At the single-gene level , we identified @ , @ , @ , and @ genes at nominal P values < @ in the responders vs. non-responders at Weeks @ and @ for the TPM and placebo groups , respectively .


Among them , expression of @ , @ , @ , and @ genes was still significantly different after Bonferroni corrections for multiple testing .


Many of these genes , such as GRINA , PRKACA , PRKCI , SNAP@ , and TRAK@ , which are involved in glutamate receptor and GABA receptor signaling , are direct targets for TPM .


In contrast , no TPM drug targets were identified in the @ significant genes for the Week @ placebo group .


Pathway analyses based on nominally significant genes revealed @ enriched pathways shared by the Weeks @ and @ TPM groups .


These pathways are involved in relevant physiological functions such as neuronal function/synaptic plasticity , signal transduction , cardiovascular function , and inflammation/immune function .


Topiramate treatment of methamphetamine addicts significantly modulates the expression of genes involved in multiple biological processes underlying addiction behavior and other physiological functions .


We explored psychometric properties of the Osteoporosis Assessment Questionnaire @ in terms of reliability , validity , and responsiveness with generic , clinical , demographic , and preference-based data collected from a population of postmenopausal women with osteoporosis .


The Multiple Outcomes of Raloxifene Evaluation study was a randomized , placebo-controlled , multinational clinical trial evaluating efficacy and safety of raloxifene .


The Osteoporosis Assessment Questionnaire @ , a generic quality of life measure ( Nottingham Health Profile ) , and a preference-based measure ( Health Utilities Index ) were administered at baseline and annually .


Psychometric properties of the @ Osteoporosis Assessment Questionnaire @ domains were evaluated by standard statistical techniques .


This study included a subset of @ women from the Multiple Outcomes of Raloxifene Evaluation study population completing the questionnaires .


Mean ( standard deviation ) age was @ ( @ ) years .


Prevalent vertebral fractures were found in @ % ( n = @ ) of women .


Internal consistency was > @ in @ Osteoporosis Assessment Questionnaire @ domains .


Correlations were moderate and significant for similar Osteoporosis Assessment Questionnaire @ domain scores , Nottingham Health Profile domains , and Health Utilities Index scores .


All but @ Osteoporosis Assessment Questionnaire @ domains distinguished between patients with or without prevalent vertebral fractures and detected worsening with increased number of vertebral fractures .


Women with @ incident vertebral fracture generally had a greater worsening in Osteoporosis Assessment Questionnaire @ scores ( excluding social activity and support of family and friends ) from baseline to study endpoint compared with women without incident vertebral fractures .


Most domains in the Osteoporosis Assessment Questionnaire @ demonstrated robust psychometric properties ; however , several domains not showing these criteria may need to be reassessed and removed for a potentially shorter and validated version of the Osteoporosis Assessment Questionnaire .


There is growing evidence suggesting that prolonged sitting has negative effects on people 's weight , chronic diseases and mortality .


Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure .


The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients .


The study is a randomized controlled trial ( RCT ) .


Professionals from thirteen primary health care centers ( PHC ) will randomly invite to participate mild obese or overweight patients of both gender , aged between @ and @ years old , who spend @ hours at least daily sitting .


A total of @ subjects will be randomly allocated to an intervention ( IG ) and control group ( CG ) ( @ individuals each group ) .


In addition , @ subjects with fibromyalgia will be included.Primary outcome is : ( @ ) sitting time using the activPAL device and the Marshall questionnaire .


The following parameters will be also assessed : ( @ ) sitting time in work place ( Occupational Sitting and Physical Activity Questionnaire ) , ( @ ) health-related quality of life ( EQ-@D ) , ( @ ) evolution of stage of change ( Prochaska and DiClemente 's Stages of Change Model ) , ( @ ) physical inactivity ( catalan version of Brief Physical Activity Assessment Tool ) , ( @ ) number of steps walked ( pedometer and activPAL ) , ( @ ) control based on analysis ( triglycerides , total cholesterol , HDL , LDL , glycemia and , glycated haemoglobin in diabetic patients ) and ( @ ) blood pressure and anthropometric variables .


All parameters will be assessed pre and post intervention and there will be a follow up three , six and twelve months after the intervention .


A descriptive analysis of all variables and a multivariate analysis to assess differences among groups will be undertaken .


Multivariate analysis will be carried out to assess time changes of dependent variables .


All the analysis will be done under the intention to treat principle .


If the SEDESTACTIV intervention shows its effectiveness in reducing sitting time , health professionals would have a low-cost intervention tool for sedentary overweight and obese patients management .


This study investigated the effects of low-dose tranexamic acid on post-coronary artery bypass surgery bleeding .


Diffuse microvascular bleeding is still a common problem after cardiac procedures .


This study was designed to evaluate the hemostatic effects of low-dose tranexamic acid in on-pump coronary artery bypass graft surgery .


In this prospective randomized placebo-controlled study , @ patients who were candidates for coronary artery bypass were enrolled and randomly assigned to @ of @ groups ( tranexamic acid or placebo ) .


Total drainage volume and the need for transfusion as well as surgical complications were recorded and compared in the @ groups .


There was significantly less mediastinal chest tube drainage up to @h in the tranexamic acid group ( @mL ) compared to the placebo group ( @mL , p = @ ) .


In the placebo group , @ ( @ % ) patients were given allogeneic blood during hospital stay compared to @ ( @ % ) in the tranexamic acid group ( p < @ ) .


No significant difference in postoperative complications was seen .


The use of low-dose tranexamic acid can significantly reduce blood loss and need for transfusion , with no increase in complications .


The aim of this study was to investigate the relationship between intraoperative vasopressin infusion and postoperative cardiac enzymes .


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


A single tertiary cardiac center .


One hundred consecutive patients undergoing cardiac surgery with or without cardiopulmonary bypass .


The study was approved by the Institutional Review Board , and patients provided informed consent to participate .


Patients were randomized by computer into @ equal groups : Vasopressin or control .


The blinded study included vasopressin administered at a dose of @ U/h or @ mL/h of normal saline , along with catecholamines .


The drug was administered continually during surgery while patients needed catecholamines .


The intervention was discontinued upon admission to the intensive care unit when information regarding the true character of the drug was reported to the doctor in charge of patients in the intensive care unit by one of the investigators .


Primary outcomes were CK-MB and troponin T levels measured at @ , @ , and @ hours postoperatively .


Of the @ patients , @ were excluded ; the remaining @ were randomized to either the vasopressin ( n = @ ) or control ( n = @ ) group .


There were no significant differences in demographic data between the groups .


Postoperatively at @ , @ , and @ hours , there were no differences in CK-MB ( U/l ) ( @ @ v @ @ , @ @ v @ @ , and @ @ v. @ @ , respectively ) and troponin T ( @ @ v @ @ , @ @ v @ @ , and @ @ v @ @ , respectively ) values .


Vasopressin infusion has been used to treat catecholamine-unresponsive shock .


In this study , intraoperative vasopressin was used safely as a possible first-line drug for treating hypotension ; however , it did not increase the levels of cardiac enzymes after cardiac surgery .


Functional Strength Training ( FST ) could enhance recovery late after stroke .


The aim of this study was to evaluate the feasibility of a subsequent fully powered , randomized controlled trial .


The study was designed as a randomized , observer-blind trial .


Both interventions were provided for up to one hour a day , four days a week , for six weeks .


Evaluation points were before randomization ( baseline ) , after six weeks intervention ( outcome ) , and six weeks thereafter ( follow-up ) .


The study took place in participants ' own homes .


Participants ( n = @ ) were a mean of @ months after stroke with a mean age of @ years with @ % male .


All had difficulty using their paretic upper ( UL ) and lower limb ( LL ) .


Participants were allocated to FST-UL or FST-LL by an independent randomization service .


The outcome measures were recruitment rate , attrition rate , practicality of recruitment strategies , occurrence of adverse reactions , acceptability of FST , and estimation of sample size for a subsequent trial .


Primary clinical efficacy outcomes were the Action Research Arm Test ( ARAT ) and the Functional Ambulation Categories ( FAC ) .


Analysis was conducted using descriptive statistics and thematic analysis of participants ' views of FST .


A power calculation used estimates of clinical efficacy variance to estimate sample size for a subsequent trial .


The screening process identified @,@ stroke survivors of whom @ ( @ % ) were recruited .


The recruitment rate was higher for referral from community therapists than for systematic identification of people discharged from an acute stroke unit .


The attrition rate was @ % at the outcome and follow-up time-points .


None of the participants experienced an adverse reaction .


The participants who remained in the study at outcome had received @ % of the total possible amount of therapy .


Participants reported that their experience of FST provided a sense of purpose and involvement and increased their confidence in performing activities .


The power calculation provides estimation that @ participants in each group will be required for a subsequent clinical trial .


This study found that a subsequent clinical trial was feasible with modifications to the recruitment strategy to be used .


To evaluate the usefulness of antibiotic + steroid irrigation of the middle ear in patients with otitis media with small perforation and pulsatile discharge .


A prospective , randomised , evaluator-blinded study was carried at a single tertiary care centre over eight years , looking at @ patients with chronic suppurative otitis media involving small tympanic membrane perforations and pulsatile mucopurulent discharge .


The patients were randomised and divided into two groups .


In group A , the examination under microscope , with suction cleaning of the external canal , was followed by irrigation of the middle ear with antibiotic + steroid solution for up to one week , while group B was prescribed self-administration of the same drops with systemic antibiotics .


The patients were followed up daily for @ days to monitor otorrhoea relief and on a weekly basis subsequently to monitor the healing of the tympanic membrane .


Forty-nine patients in group A had a dry ear after @-@ days of daily suction and the irrigation of middle ear with the antibiotic + steroid solution and @ had a healed tympanic membrane after an average three months of follow-up .


Five patients with dry ear but persistent perforation underwent tympanoplasty , while only one patient with a persistent ear discharge underwent mastoid exploration .


In group B , eight patients on oral antibiotics and self-administration of the same drops had dry ear while @ had dry ear after receiving intravenous antibiotics .


Thirty perforations healed spontaneously and @ required tympanoplasty .


In @ patients , the tympano-mastoid was explored and these patients had dry , hearing ears only after surgery .


Patients with chronic suppurative otitis media involving small perforations and pulsatile discharge can be managed conservatively with simple suction cleaning + middle ear irrigation with antibiotics + steroid drops .


Nutrients such as -@ fatty acids including fish oil components eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) suppress the growth and promote apoptosis of tumor cells , improve immune function and reduce the effects of systemic inflammatory response syndrome .


We sought to investigate the effect of -@ fish oil fat emulsion-based parenteral nutrition ( PN ) on nutritional state , immune function , inflammatory reaction , expression of tumor factors and complication incidence in patients after surgical resection of gastric cancer .


Forty-eight patients after surgical operation of gastric tumor in hospital were randomly divided into the control group and intervention group .


Patients in both groups were treated with iso-nitrogen and iso-caloric parenteral nutrition support .


In addition , the intervention group received -@ fish oil fat emulsion and the control group received soybean oil .


The indicators of nutrition , immune function and inflammation in the two groups were detected on the day before the operation and postoperative day @ .


The rate of complication was compared between the two groups .


There was no significant difference in nutritional state , liver function and renal function between the two groups ( P > @ ) .


However , the levels of inflammatory markers were significantly decreased ( P < @ ) , and the rate of complication was also decreased in the intervention group as compared with the control group .


-@ fish oil fat emulsion-based parenteral nutrition alleviates the inflammatory reaction and reduces the rate of inflammatory complications .


Cryolipolysis is a noninvasive and well-tolerated treatment for reduction of localized subcutaneous fat .


Although several studies demonstrate the safety and efficacy of this procedure , volumetric fat reduction from this treatment has not been quantified .


This prospective study investigated the change in volume of fat after cryolipolysis treatment using three-dimensional ( @D ) photography .


A prospective study of subjects treated with cryolipolysis on the flank ( love handle ) was performed at Massachusetts General Hospital .


Volume measurements were performed with a Canfield Scientific Vectra three-dimensional camera and software to evaluate the amount of post procedure volume change .


Clinical outcomes were assessed with caliper measurements , subject surveys , and blinded physician assessment of photographs .


Eleven subjects were enrolled in this study .


Each subject underwent a single cycle of cryolipolysis to one flank .


The untreated flank served as an internal control .


The follow-up time after treatment was @ months .


The mean amount of calculated absolute fat volume loss using @D photography from baseline to @ months follow-up visit was @ from the treatment site and @ cc from the control ( P < @ ) .


A mean absolute difference of @ cc between the treated and untreated sides was calculated at @ months post-treatment .


Comparison of caliper measurements from baseline to @ months post-treatment demonstrated significant reduction of the treated flank from @ mm at baseline to @ mm at @ months post-treatment ( P < @ ) .


The untreated flank did not show significant reduction with caliper measurements demonstrating @ mm at baseline and @ mm at @ months post-treatment ( P = @ ) .


No unexpected side effects or adverse events were reported .


Post-treatment satisfaction surveys demonstrated @ % of subjects were satisfied with the results .


Cryolipolysis is a safe , well-tolerated , and effective noninvasive fat removal methodology that on average leads to @ cc of fat loss of the treated flank at @ months after a single treatment cycle .


Samatasvir is a pan-genotypic inhibitor of the hepatitis C ( HCV ) non-structural protein @A ( NS@A ) .


This study evaluated the antiviral activity , pharmacokinetics and safety of samatasvir monotherapy in treatment-nave subjects infected with HCV genotype @-@ .


Thirty-four genotype @ and thirty genotype @ , @ or @ subjects were randomized to receive for @days placebo or samatasvir @-@mg per day .


Plasma samples for HCV RNA , pharmacokinetics and sequencing were collected up to day @ .


Samatasvir achieved potent antiviral activity across genotypes : mean maximum reductions from baseline were @-@ @ ( genotype @a ) , @-@ @ ( genotype @b ) , @-@ @ ( genotype @ ) , and @-@ @ ( genotype @ ) log@/ml respectively ; no viral rebound was observed during the @-day treatment period .


For genotype @ HCV , samatasvir was active in subjects with NS@A L@ polymorphism at baseline ( individual range @-@ @ log@/ml ) , but showed minimal activity in those with baseline M@ polymorphism .


Samatasvir exhibited a long plasma half-life of approximately @h which supports once daily dosing .


Samatasvir was well tolerated in all subjects with no safety-related discontinuations or serious adverse events .


The most common adverse events included constipation , nausea and headache and occurred at similar frequency in active and placebo subjects .


All events were mild or moderate in intensity .


There were no patterns or dose dependence of adverse events , vital signs , laboratory parameters or electrocardiograms .


Samatasvir @-@mg monotherapy for @days was well tolerated and induced a rapid and profound reduction in plasma HCV RNA in subjects infected with HCV genotype @-@ .


Samatasvir is being evaluated in combination with other direct-acting antiviral agents in subjects with HCV infection .


Hospital to Home ( H@H ) is a national quality improvement ( QI ) initiative composed of three recommended hospital interventions to improve the transition of care for hospitalized patients with heart disease .


A study was conducted to determine if enrollment of Department of Veterans Affairs ( VA ) hospitals in H@H and adoption of the recommended interventions would both increase following facilitation of an existing Heart Failure ( HF ) provider-based community of practice ( COP ) within the VA health care system .


The VA HF COP includes more than @ VA providers and other VA staff from VA inpatient medical centers .


In @ , @ VA hospitals were randomized to facilitation using the VA HF COP ( intervention ) or no facilitation ( control ) .


COP members from intervention hospitals were invited to periodic teleconferences promoting H@H and received multiple e-mails asking members to report interest and then progress in H@H implementation .


Among the @ hospitals randomized to HF COP facilitation , @ ( @ % ) enrolled in H@H , compared with @ ( @ % ) of @ control hospitals ( p < @ ) at five months after randomization .


Of @ intervention hospitals responding to the follow-up survey , @ stated they had initiated @ QI projects as a result of the H@H campaign .


Another @ hospitals had planned H@H projects .


Of @ control hospitals that responded , @ had initiated @ projects as a result of H@H , and no additional hospitals had plans to do so .


Facilitation using the VA HF COP was successful in increasing enrollment in the H@H initiative and providing implementation support for recommended QI projects .


Multihospital provider groups are a potentially valuable tool for implementation of national QI campaigns .


To assess the relationship between infant feeding , triple-antiretroviral prophylaxis and weight from @ weeks ( baseline ) to @ months postpartum among HIV-infected mothers in a mother-to-child transmission ( MTCT ) of HIV-prevention trial in five sub-Saharan African sites .


HIV-infected pregnant women with CD@ cell counts of @-@cells / l were counselled to choose breastfeeding to @ months or replacement feeding from delivery .


They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation .


Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode .


Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers .


Among @ mothers , @ ( @ % ) initiated breastfeeding .


Wasting ( BMI < @ ) was rare at baseline ( @ % ) , whereas overweight/obesity ( BMI@ ) was common ( @ % ) .


In the model including all women , breastfeeding was not associated with weight loss up to @ months , irrespective of baseline BMI and antiretroviral prophylaxis .


Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least @ ( +@ kg/month ; P < @ ) .


In the model including breastfeeding mothers only , triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least @ who ceased breastfeeding before @ months postpartum ( +@ kg/month ; P = @ ) .


The results suggest that breastfeeding up to @ months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage .


In the absence of breastfeeding or after weaning , triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI , even after cessation of prophylaxis .


To compare the effectiveness of adding cyclobenzaprine , tizanidine , or placebo to patient education and a self-care management program for patients with myofascial pain and specifically presenting with jaw pain upon awakening .


Forty-five patients with a diagnosis of myofascial pain based on the guidelines of the American Academy of Orofacial Pain participated in this @-week study .


The subjects were randomly assigned into one of three groups : placebo group , TZA group ( tizanidine @ mg ) , or CYC group ( cyclobenzaprine @ mg ) .


Patients were evaluated for changes in pain intensity , frequency , and duration by using the modified Severity Symptoms Index and changes in sleep quality with the use of the Pittsburgh Sleep Quality Index .


Data were analyzed by ANOVA and post-hoc or nonparametric statistical tests as appropriate .


All three groups had a reduction in pain symptoms and improvement of sleep quality based on a comparison of pretreatment and treatment scores .


However , no significant differences among the groups were observed at the posttreatment evaluation .


The use of tizanidine or cyclobenzaprine in addition to self-care management and patient education was not more effective than placebo for the management of patients with myofascial jaw pain upon awakening .


A controlled , clinical , double blind study was conducted to assess the efficacy of a sugar-free chewing gum containing calcium hydroxyapatite on dentin hypersensitivity , versus a placebo chewing gum with no active ingredients , after one and two weeks .


One hundred and seven subjects joined the trial and were allocated into the test or the control ( placebo ) group by a random table .


The test chewing gum contained calcium hydroxyapatite and dicalcium phosphate dihydrate ; the control chewing gum was identical , but without those ingredients .


Participants were required to chew two pieces of their assigned chewing gum three times a day .


Dentin hypersensitivity was evaluated following three clinical test indexes ( tactile , air blast , cold water ) and one subjective index .


One hundred subjects completed the study with @ allocated to each group .


The clinical test index reductions after one and two weeks in the test group were , respectively , @ % and @ % for tactile , @ % and @ % for air blast , and @ % and @ % for cold water .


The clinical test index reductions after one and two weeks in the control group were , respectively , @ % and @ % for tactile , @ % and @ % for air blast , and @ % and @ % for cold water .


These reductions at one and two weeks were significant for the test group ( p < @ ) .


For the control group they were significant ( p < @ ) only at two weeks .


The comparisons between the groups at two weeks showed a significant statistical difference between the test and the control gum for tactile ( p < @ ) , for air blast ( p < @ ) , for cold water ( p < @ ) , and for the subjective index ( p < @ ) .


In this trial , the group using the chewing gum containing calcium hydroxyapatite had a statistically significant reduction in all clinical test indexes for dentin hypersensitivity after one and two weeks , and a statistically significant reduction compared to the control gum group .


To compare the effectiveness ofradial extracorporeal shock wave therapy ( rSWET ) and ultrasound therapy ( US ) in the treatment of chronic plantar fasciitis .


Randomized controlled trial .


Department of Rehabilitation Medicine , King Chulalongkorn Memorial Hospital .


Thirty patients who were diagnosed with plantar fasciitis for at least @ months and who had not responded to other forms of conservative treatment were recruited for this study .


They were randomly divided into two groups of @ patients .


The rESWT group was treated with @ session per week and the US group with @ sessions per week , with both groups undergoing a total of @ consecutive weeks of treatment .


Visual analog scale ( VAS ) assessments were performed before and after treatment at @ , @ , @ , @ , and @ weeks .


The mobility subscale of the plantar fasciitis pain and disability scale ( PFPS ) was measured before and after treatment .


Patient satisfaction was evaluated at the conclusion of the @-week treatment protocol .


VAS pain intensity scores were significantly decreased in both groups ( p < @ ) , when measured after treatment at @ , @ , @ , @ , and @ weeks .


The VAS pain scores for the rESWT group dropped significantly more than those of the US group ( p < @ ) .


At the end of treatment , the PFPS mobility subscale scores in both groups were significantly decreased ( p < @ ) .


Similar to the VAS pain score outcome , the PFPS mobility subscale score for the rESWT group decreased significantly more than that of the US group ( p < @ ) .


Patient satisfaction was significantly higher in the rESWT group , relative to the US group ( p = @ ) .


In chronic plantar fasciitis treatment , both rESWT and US were found to be effective in reducing pain and increasing mobility ; however , statistical analysis showed that rESWT is significantly more effective than US .


For older adults , the damaging effects of aging and stress can impair the ability to learn and sustain memory .


Humor , with its associated mirthful laughter , can reduce stress and cortisol , a stress hormone .


Chronic release of cortisol can damage hippocampus neurons , leading to impairment of learning and memory .


The primary goal of this study was to determine whether watching a humorous video had an effect on short-term memory in an older population .


The research team designed a randomized , controlled trial .


The study took place at Loma Linda University in Loma Linda , California .


The research team recruited @ normal , healthy , older adults , @ males and @ females .


The humor group ( n = @ , mean = @ @ y ) self-selected @ of @ humorous videos -- a Red Skelton comedy or a montage of America 's Funniest Home Videos -- and watched it for @ min .


A control group ( n = @ , mean = @ @ y ) sat calmly for @ min and were not allowed to read , sleep , or talk on a cell phone .


The Rey Auditory Verbal Learning Test was used to assess short-term memory -- learning ability , delayed recall , and visual recognition .


Salivary cortisol levels were measured at predetermined times .


Learning ability improved by @ % and @ % in the humor and control groups , respectively ( P = @ ) .


Delayed recall improved by @ % and @ % in the humor and control groups , respectively ( P = @ ) .


Within the humor group , delayed recall ( @ % ) was significant compared with learning ability ( @ % ) ( P = @ ) .


At @ predetermined time points , significant decreases in salivary cortisol were observed in the humor group ( P = @ , P = @ , and P = @ , respectively ) .


The study 's findings suggest that humor can have clinical benefits and rehabilitative implications and can be implemented in programs that support whole-person wellness for older adults .


Learning ability and delayed recall are important to these individuals for a better quality of life -- considering mind , body , spirit , social , and economic aspects .


Older adults may have age-associated memory deficiencies .


However , medical practitioners now can offer positive , enjoyable , and beneficial humor therapies to improve these deficiencies .


The purpose of this study was to investigate whether probiotics had an effect on proinflammatory markers and cytokines in overweight and obese individuals and whether they could have synergistic effects with weight-loss diets .


A total of @ healthy overweight and obese individuals completed this randomized doubled-blind controlled clinical trial .


Participants were randomly assigned to groups consuming regular yogurt with a low-calorie diet ( LCD , RLCD ; n = @ ) or receiving probiotic yogurt with LCD ( PLCD ; n = @ ) or consuming probiotic yogurt without LCD ( PWLCD ; n = @ ) for @ weeks .


The pribiotic regimen contained @ g/day yogurt , enriched by Lactobacillus acidophilus La@ , Bifidobacterium BB@ , and Lactobacillus casei DN@ @ ( @ ) colony-forming units/g .


Body fat percentage , high-sensitive C-reactive protein ( hs-CRP ) , tumor necrosis factor-alpha ( TNF - ) , leptin , and mRNA levels of inflammation-related genes ( TNF - and RAR-related orphan receptor gamma -LSB- ROR-t -RSB- ) in peripheral blood mononuclear cells ( PBMCs ) were measured .


A reduction in body mass index ( BMI ) , fat percentage , and leptin level was observed that was more obvious in groups who received the weight-loss diet with probiotic yogurt .


Reduction in the gene expression of ROR-t was significant in the PLCD group ( p < @ ) .


The expression of TNF - did not change among all groups after intervention .


The mean concentration of leptin was significantly decreased in all groups after the dietary intervention , but the mean changes in leptin level in the PLCD group was more prominent compared to the other two groups ( -@ , p < @ -LSB- PLCD -RSB- vs -@ , p = @ -LSB- RLCD -RSB- and -@ ng/mL , p = @ -LSB- PWLCD -RSB- ) .


The reduction in serum levels of hs-CRP was more evident in the PWLCD group compared to the PLCD and RLCD groups after the @-week intervention ( -@ , p = @ vs -@ , p < @ and -@ pg/mL , p < @ , respectively ) .


Our results suggested that the weight-loss diet and probiotic yogurt had synergistic effects on T-cells subset specific gene expression in PBMCs , fat percentage , and body weight among overweight and obese individuals .


Media literacy programs have shown potential for reduction of adolescent tobacco use .


We aimed to determine if an anti-smoking media literacy curriculum improves students ' media literacy and affects factors related to adolescent smoking .


We recruited @ @th-grade students from @ classrooms in @ public urban high schools .


Students were randomized by classroom to a media literacy curriculum versus a standard educational program .


In an intent-to-treat analysis , we used multilevel modeling to determine if changes in study outcomes were associated with the curricular intervention , controlling for baseline student covariates and the clustering of students within classrooms .


Among participants , mean age was @ years and @ % were male , with no significant differences in baseline characteristics between groups .


Smoking media literacy changed more among intervention participants compared with control participants ( @ vs. @ , p < @ ) .


Compared with controls , intervention students exhibited a greater reduction in the perceived prevalence of smoking ( -@ % vs. -@ % , p < @ ) .


Among those initially susceptible to smoking , intervention participants more commonly reverted to being nonsusceptible post-intervention ( @ % vs. @ % , p = @ ) .


A school-based media literacy curriculum is more effective than a standard educational program in teaching media literacy and improving perceptions of the true prevalence of smoking among adolescents .


We sought to determine and compare clinical profile and management of outpatients with heart failure with reduced ejection fraction ( HFREF ) treated by cardiologists and general practitioners ( GPs ) in Poland .


All the @ randomly selected cardiologists and GPs in the DATA-HELP registry , which included @ patients , filled out questionnaires about @ consecutive outpatients with HFREF .


Outpatients managed by GPs were older ( @ vs @ years ) , and the prevalence of men was less marked ( @ % vs @ % ) .


They also had higher left ventricular ejection fraction ( @ % vs @ % ) and had more pulmonary congestion ( @ % vs @ % ) and peripheral oedema ( @ % vs @ % ) , compared with those treated by cardiologists ( all p < @ ) .


Hypertension ( @ % vs @ % ) , previous stroke and/or transient ischaemic attack ( @ % vs @ % ) , diabetes ( @ % vs @ % ) , and chronic obstructive pulmonary disease ( @ % vs @ % ) were more common in outpatients of GPs ( all p < @ ) .


GPs were less likely to prescribe - blocker ( @ % vs @ % , p < @ ) , mineralocorticoid receptor antagonist ( MRA ) ( @ % vs @ % , p < @ ) , and loop diuretic ( @ % vs @ % , p < @ ) or use PCI ( @ % vs @ % , p < @ ) , CABG ( @ % vs @ % , p < @ ) , ICD ( @ % vs @ % , p < @ ) , or CRT ( @ % vs @ % , p < @ ) .


Prescription of renin-angiotensin system inhibitors ( @ % vs @ % , p > @ ) and digoxin ( @ % vs @ % , p > @ ) by GPs and cardiologists was similar .


In contemporary Poland , most outpatients with HFREF receive drugs that improve survival and undergo revascularisation procedures , although devices are rare , but the clinical profiles and management of those treated by GPs and cardiologists differ .


Outpatients treated by GPs are older and have more co-morbidities .


Outpatients treated by cardiologists more commonly receive - blocker , MRA , ICD , and CRT , and undergo coronary revascularisations .


Robust clinical data evaluating fibrosis progression in hepatitis C virus ( HCV ) liver transplant patients receiving an mTOR inhibitor vs. calcineurin inhibitor ( CNI ) are lacking .


To evaluate fibrosis progression in maintenance liver transplant patients receiving everolimus - or CNI-based immunosuppression .


In a randomised , multicentre , open-label study , @ maintenance liver transplant patients with recurrent HCV infection were randomised to continue CNI-based immunosuppression or switch to everolimus .


For patients with biopsy data at month @ , mean Ishak-Knodell fibrosis score at baseline was @ @ ( n = @ ) with everolimus vs. @ @ ( n = @ ) with CNI ( P = @ ) , and @ @ vs. @ @ at month @ .


Ishak-Knodell fibrosis score decreased from baseline to month @ by a mean of -@ @ with everolimus , but increased by @ @ with CNI ( P = @ ) .


No acute rejection or graft losses occurred up to month @ .


Estimated GFR at month @ was @ ml/min/@ @ m with everolimus and @ ml/min/@ @ m with CNI -LSB- mean difference @ ml/min/@ @ m compared to CNI control group , @ % CI -@ , @ ml/min/@ @ m , P = @ ( analysis of covariance adjusting for baseline GFR ) -RSB- .


Adverse events occurred in @ % of everolimus patients and @ % of CNI patients ( serious adverse events @ % and @ % , respectively ) .


Adverse events led to everolimus discontinuation in five patients ( @ % ) .


This exploratory study suggests that conversion from CNI to everolimus reduces progression of liver fibrosis , and preserves renal function without jeopardising efficacy in liver transplant recipients with recurrent HCV , but is associated with a higher incidence of adverse events and serious adverse events .


These preliminary findings merit examination in a larger trial .


In this study , we evaluated the effect on cognitive function of memantine , behavioral and psychological symptoms of dementia , and the care burden , in patients with moderate-to-severe Alzheimer 's disease ( AD ) .


Furthermore , with near-infrared spectroscopy ( NIRS ) , we examined the association between effect of memantine and brain blood flow .


We evaluated the effect of memantine administration from baseline on Clinical Global Impression-Improvement scale , mini mental state examination ( MMSE ) , Clock Drawing Test ( CDT ) , Neuropsychiatric Inventory ( NPI ) , Japanese version of the Zarit Burden Interview ( J-ZBI ) and NIRS in two groups , donepezil administration memantine combination group ( combination group , n = @ ) donepezil administration memantine non-administration group ( control group , n = @ ) were assessed at weeks @ , @ , @ , and @ .


Significant difference was found between the combination group and the control group in the score variation of Clinical Global Impression-Improvement scale , MMSE , CDT , NPI , and J-ZBI .


In the NIRS measurements , trend oxyhemoglobin reduced suppression was observed in some channels centered on the superior frontal gyrus .


A significant correlation was observed in the scores of MMSE , CDT , NPI , and J-ZBI .


In addition , a significant positive correlation was also observed between the number of words in NIRS and scores of MMSE and CDT .


In this study , by administering memantine in AD patients that inhibit the reduction of cerebral blood flow in the prefrontal area and improve clinical symptoms overall cognitive function , behavioral and psychological symptoms of dementia , thereby reducing the care burden of caregivers was suggested .


This study compared the timing of onset of antiplatelet action after treatment with clopidogrel and prasugrel at first medical contact in patients with ST-segment elevation myocardial infarction ( STEMI ) scheduled for primary percutaneous coronary intervention ( PPCI ) .


Little is known about the timing of onset of antiplatelet action after a pre-percutaneous coronary intervention ( PCI ) loading dose of clopidogrel or prasugrel in patients with STEMI .


This double-blind , prospective study randomized @ patients with STEMI scheduled for PPCI in the ambulance or the emergency department to @ mg prasugrel ( n = @ ) or @ mg clopidogrel ( n = @ ) .


The primary endpoint was the platelet reactivity index ( PRI ) measured with the vasodilator-stimulated phosphoprotein assay @ h after intake of the study medication .


Secondary endpoints were PRI after @ h , TIMI ( Thrombolysis In Myocardial Infarction ) patency of the infarct-related artery before and after PCI , and clinical events until day @ .


The PRI after @ h ( @ @ % vs. @ @ % ; p = @ ) and after @ h ( @ @ % vs. @ @ % ; p = @ ) were significantly lower with prasugrel compared with clopidogrel .


In addition , the rate of patients with a PRI < @ % tended to be higher with prasugrel compared with clopidogrel after @ h ( @ % vs. @ % ; p = @ ) and after @ h ( @ % vs. @ % ; p = @ ) .


There were no significant differences in TIMI @/@ patency before PCI ( @ % vs. @ % ; p = @ ) and TIMI @ patency after PCI ( @ % vs. @ % ; p = @ ) .


The pre-PCI administration of prasugrel in patients with STEMI undergoing PPCI was associated with a significant faster platelet inhibition compared with clopidogrel .


Therefore , prasugrel should be preferred to clopidogrel in this setting .


( ETAMI-Study : Early Thienopyridine Treatment to Improve Primary PCI in Patients With Acute Myocardial Infarction ; NCT@ ) .


To test the effectiveness of cognitive-behavioral counseling on the rate and duration of exclusive breastfeeding ( EBF ) during the first @ months of an infant 's life compared with routine counseling .


A single blind cluster-randomized controlled trial was undertaken in @ Union Councils of a rural district in the northwest province of Pakistan between May @ and April @ .


By simple unmatched randomization , @ Union Councils were each allocated to intervention and control arms .


Two hundred twenty-four third trimester pregnant women in the intervention and @ third trimester pregnant women in the control arm were enrolled and followed-up biweekly until @ months postpartum .


Analyses were by intention to treat .


Mothers in the intervention group received @ sessions of cognitive-behavioral counseling from antenatal to @ months postpartum , whereas the control group received an equal number of routine sessions .


Proportion of mothers exclusively breastfeeding at @ months postpartum and duration of EBF through these @ months was assessed .


At @ months postpartum , @ % of mothers in the intervention arm and @ % in the control arm were exclusively breastfeeding .


This translates into a @ % reduced risk of stopping exclusively breastfeeding during the first @ months ( adjusted hazard ratio , @ -LSB- @ % confidence interval : @-@ @ -RSB- , P < @ ) .


Mothers in the intervention group were half as likely to use prelacteal feeds with their infants ( adjusted relative risk , @ -LSB- @ % confidence interval : @-@ @ -RSB- ) .


Compared with routine counseling , cognitive-behavioral counseling significantly prolonged the duration of EBF , doubling the rates of EBF at @ months postpartum .


The aim of this study was to determine the incidence and seasonal pattern of malaria in children in South-West Burkina Faso , and to compare , in a randomized trial , characteristics of cases detected by active and passive surveillance .


This study also enabled the planning of a malaria vaccine trial .


Households with young children , located within @ kilometers of a health facility , were randomized to one of two malaria surveillance methods .


In the first group , children were monitored actively .


Each child was visited twice weekly ; tympanic temperature was measured , and if the child had a fever or history of fever , a malaria rapid diagnostic test was performed and a blood smear collected .


In the second group , children were monitored passively .


The child 's parent or caregiver was asked to bring the child to the nearest clinic if he was unwell .


Follow up lasted @ months from September @ .


Incidence of malaria ( Fever with parasitaemia @,@ / L ) was @ episodes/child/year in the active cohort and @ in the passive cohort ( rate ratio @ , @ % CI @-@ @ ) .


Malaria cases in the passive cohort were more likely to have high grade fever ; but parasite densities were similar in the two groups .


Incidence was highly seasonal ; when a specific case definition was used , about @ % of cases occurred within the @ months June-September .


Passive case detection required at least a @ % -@ % increase in the sample size for vaccine trials , compared to active detection , to achieve the same power .


However we did not find any evidence that parasite densities were higher with passive than with active detection .


The incidence of malaria is highly seasonal and meets the WHO criteria for Seasonal Malaria Chemoprevention ( SMC ) .


At least half of the malaria cases in these children could potentially be prevented if SMC was effectively deployed .


To study the effects of topical intranasal mometasone furoate nasal spray for management of otitis media with effusion in children aged @-@ years with adenoidal hypertrophy and its impact on change in quality of life .


A prospective randomized double blind interventional placebo control study was conducted .


Hundred patients of endoscopic grade @ or @ adenoidal hypertrophy aged @-@ years were enrolled in this study .


Among these sixty two patients had persistent bilateral otitis media with effusion more than three months .


These were randomly divided into two groups , group A and group B. Group A received mometasone nasal spray for six months and group B received saline nasal spray for the same period .


Patients were evaluated with symptom , pure tone audiometry wherever possible , pneumatic otoscopic examination and tympanogram at @ , @ and @ weeks .


Resolution of otitis media with effusion in study group ( @ out of @ ) was significantly higher as compared control group ( @ out of @ ) ( p value @ ) .


A significant improvement in hearing and symptoms was seen in the study group ( p < @ ) .


Statistically significant change in quality of life was seen with mometasone nasal spray ( @ ) as compared to saline nasal spray ( @ ) ( p value @ ) .


Mometasone nasal spray appears to be effective for the treatment of otitis media with effusion in patients of adenoidal hypertrophy .


Conventional methods of caries removal are commonly associated with pain , fear and discomfort .


Chemomechanical methods were introduced to instill a positive dental attitude .


Agents like GK-@ , Caridex , Carisolv did not prove effective alternatives owing to their high cost , need of special instruments and taste of chlorine .


A new chemomechanical agent , Papacarie , has been introduced to overcome these deficiencies .


This study was aimed to compare the effectiveness and tolerance of Papacrie with the conventional method .


@ children with at least two primary teeth with broad cavitated occlusal or cervical lesion were selected .


One carious tooth from each patient was randomly treated with each of Papacarie and conventional drilling method , one after the other .


Time taken for caries excavation , child 's pain perception , change in anxiety levels , microbial flora and child 's preference of treatment were recorded separately for both the methods .


Although the mean time taken for caries removal by the Papacarie method was slightly longer ( P@ @ ) but it led to reduction in pain and anxiety ( p < @ ) .


The viable bacterial counts were significantly reduced by either of the two methods ( P < @ ) .


More patients preferred Papacarie over conventional method of treatment ( P < @ ) .


Papacrie method seems to be a better alternative to conventional method of caries removal .


To determine whether functional electrical stimulation ( FES ) - assisted active cycling is more effective than active cycling without FES concerning walking and balance .


Specifically , walking ability was classified as to the amount of personal assistance needed to be able to walk and balance was evaluated for static and dynamic balance tasks .


Monocentric , randomized , single-blinded , controlled trial .


Neurologic rehabilitation hospital .


Patients with severe hemiparesis due to stroke ( N = @ ) .


Twenty minutes of active leg cycling with or without FES applied to the paretic vastus medialis and rectus femoris of quadriceps and to the biceps femoris and semitendinosus muscles , @ times/wk for @ weeks .


Functional ambulation classification ( FAC ) and performance-oriented mobility assessment ( POMA ) were the primary outcome measures .


The leg subscale of the motricity index ( MI ) and the modified Ashworth scale were the secondary outcome measures .


Evaluation was done before and after the intervention period and after an additional @ weeks .


After the intervention , the FAC , POMA , and the MI ( P < @ ) for both intervention groups improved significantly .


The FAC of the control group increased by a median of @ category and that of the FES group by @ categories .


The median change in POMA was @ and @ points for the control group and the FES group , respectively .


The Mann-Whitney U test between-group comparisons revealed that these gains were significantly better in the FES group for both the FAC ( U = @ ; z = -@ ; P = @ ; r = -@ ) and the POMA ( U = @ ; z = -@ ; P < @ ; r = -@ ) .


Because of missing data and slightly decreased effect sizes during the follow-up phase ( FAC , r = -@ ; POMA , r = -@ ) , differences did not reach statistically significant P values .


The MI leg subscale showed significant improvements in both groups .


However , there were no significant differences between the groups at any time .


No changes were observed on the modified Ashworth scale .


FES-assisted active cycling seems to be a promising intervention during rehabilitation in patients with stroke .


We previously reported the initial results of the first multicenter , randomized , double-blind , placebo-controlled clinical trial of peanut sublingual immunotherapy ( SLIT ) , observing a favorable safety profile associated with modest clinical and immunologic effects in the first year .


We sought to provide long-term ( @-year ) clinical and immunologic outcomes for our peanut SLIT trial .


Key end points were ( @ ) percentage of responders at @ years ( ie , could consume @ g of peanut powder or a @-fold increase from baseline ) , ( @ ) percentage reaching desensitization at @ years , ( @ ) percentage attaining sustained unresponsiveness after @ years , ( @ ) immunologic end points , and ( @ ) assessment of safety parameters .


Response to treatment was evaluated in @ subjects aged @ to @ years by performing a @-g peanut powder oral food challenge after @ and @ years of daily peanut SLIT therapy .


At @ years , SLIT was discontinued for @ weeks , followed by another @-g oral food challenge and an open feeding of peanut butter to assess sustained unresponsiveness .


Approximately @ % of the @,@ doses were tolerated without adverse reactions beyond the oropharynx , with no severe symptoms or uses of epinephrine .


A high rate ( > @ % ) discontinued therapy .


By study 's end , @ ( @ % ) of @ SLIT-treated participants were fully desensitized to @ g of peanut powder , and all @ achieved sustained unresponsiveness .


Responders at @ years showed a significant decrease in peanut-specific basophil activation and skin prick test titration compared with nonresponders .


Peanut SLIT induced a modest level of desensitization , decreased immunologic activity over @ years in responders , and had an excellent long-term safety profile .


However , most patients discontinued therapy by the end of year @ , and only @ % of subjects achieved sustained unresponsiveness .


To compare the safety and efficacy of U.S. Food and Drug Administration ( FDA ) - recommended doses of labetalol and nicardipine for hypertension ( HTN ) management in a subset of patients with renal dysfunction ( RD ) .


Randomized , open label , multicenter prospective clinical trial .


Thirteen United States tertiary care emergency departments .


Subgroup analysis of the Evaluation of IV Cardene ( Nicardipine ) and Labetalol Use in the Emergency Department ( CLUE ) clinical trial .


The subjects were @ patients with RD ( i.e. , creatinine clearance < @ mL/min ) who presented to the emergency department with a systolic blood pressure ( SBP ) @ mmHg on @ consecutive readings and for whom the emergency physician felt intravenous antihypertensive therapy was desirable .


The FDA recommended doses of either labetalol or nicardipine for HTN management .


The number of patients achieving the physician 's predefined target SBP range within @ minutes of treatment .


Patients treated with nicardipine were within target range more often than those receiving labetalol ( @ % vs. @ % , P = @ ) .


On @ SBP measures , patients treated with nicardipine were more likely to achieve the target range on either @ or all @ readings than were patients treated with labetalol ( @ % vs. @ % , P = @ ) .


Labetalol patients were more likely to require rescue medication ( @ % vs. @ % , P = @ ) .


Adverse events thought to be related to either treatment group were not reported in the @-minute active study period , and patients had slower heart rates at all time points after @ minutes ( P < @ ) .


In severe HTN with RD , nicardipine-treated patients are more likely to reach a target blood pressure range within @ minutes than are patients receiving labetalol .


Within @ minutes of administration , nicardipine is more efficacious than labetalol for acute blood pressure control in patients with RD. .


Dementia affects @ million people worldwide and is currently incurable .


Many cases may be preventable because regular participation in physical , mental and social leisure activities during middle age is associated with up to @ % dementia risk reduction .


However , the majority of middle-aged adults are not active enough .


MCI is therefore a clear target for activity interventions aimed at reducing dementia risk .


An active lifestyle during middle age reduces dementia risk but it remains to be determined if increased activity reduces dementia risk when MCI is already evident .


Before this can be investigated conclusively , complex multimodal activity programmes are required that ( @ ) combine multiple health promoting activities , ( @ ) engage people with MCI , and ( @ ) result in sufficient adherence rates .


We designed the ThinkingFit programme to engage people with MCI in a complex intervention comprised of three activity components : physical activity , group-based cognitive stimulation ( GCST ) and individual cognitive stimulation ( ICST ) .


Engagement and adherence was promoted by applying specific psychological techniques to enhance behavioural flexibility in an early pre-phase and during the course of the intervention .


To pilot the intervention , participants served as their own controls during a @ - to @-week run-in period , which was followed by @weeks of activity intervention .


Out of @ MCI patients screened , @ were eligible , @ consented and @ completed the intervention ( mean age @years ) .


Activity adherence rates were high : physical activity = @ % ; GCST = @ % ; ICST = @ % .


Significant treatment effects ( p < @ ) were evident on physical health outcomes ( decreased BMI and systolic blood pressure , -LSB- pre/post values of @ / @ kg/m@ and @/@mmHg respectively -RSB- ) , fitness ( decreased resting and recovery heart rate -LSB- @/@bpm and @/@bpm -RSB- ) , and cognition ( improved working memory -LSB- @ / @ items -RSB- ) .


We found satisfactory recruitment , retention and engagement rates , coupled with significant treatment effects in elderly MCI patients .


It appears feasible to conduct randomized controlled trials of the dementia prevention potential of complex multimodal activity programmes like ThinkingFit .


To evaluate the clinical and microbiological effects of systemic levofloxacin ( LFX ) in subjects with Aggregatibacter actinomycetemcomitans-associated chronic periodontitis ( AA-ACP ) .


Subjects with severe periodontitis with subgingival detection of A. actinomycetemcomitans were randomly divided into two treatment groups ; a test group ( n = @ ) that received scaling and root planing ( SRP ) and LFX ( @ mg o.d. ) and a control group ( n = @ ) that received SRP and placebo ( o.d. ) for @ days .


Plaque index ( PI ) , gingival index ( GI ) , percent of sites with bleeding on probing ( % BoP ) , probing depth ( PD ) and clinical attachment level ( CAL ) were recorded and subgingival plaque samples were cultivated for detection of A. actinomycetemcomitans at baseline to @ months at various intervals .


Subjects receiving LFX showed the greatest improvements in mean PD and CAL .


The difference in the reduction of PD and CAL in the two groups was significant at @ , @ and @ months for PD and @ and @ months for CAL ( p < @ ) .


The inter-group difference in PI , GI and % BoP was not significant at any interval .


Detectable levels of A. actinomycetemcomitans were significantly less in the test group @ and @ months post-therapy .


Systemic LFX as an adjunct to SRP improves clinical outcomes and suppresses A. actinomycetemcomitans below detectable levels .


Driving under the influence ( DUI ) enforcement practices and sanctions contribute differentially to the certainty , swiftness , and severity of punishment , which are the key components of general deterrence theory .


This study used a conjoint experiment to understand the decision-making process of potential DUI offenders and tested how variation in enforcement and legal punishment affects drinking and driving decisions .


It sought to verify and quantify the unique deterrent effects of certainty , severity , and swiftness and to predict the rates of drinking and driving in different legal environments .


One hundred twenty-one college seniors and graduate students at the University of Maryland participated in the Web-based conjoint experiment .


They were randomly assigned to @ blocks , each of which included @ hypothetical scenarios composed of different levels of DUI enforcement and penalties .


Respondents were asked to state their likelihood of drinking and driving under each scenario , as well as their estimated chance of being caught by the police for DUI .


Intensified enforcement , harsh jail penalty , and immediate long license suspension were found to be the strongest deterrents to drinking and driving .


Alternative ways to get home were also important in reducing people 's willingness to drive .


These factors accounted for most of the attribute effect on the DUI decision , whereas delayed punishment due to judicial processing , fine penalty , and legal blood alcohol concentration ( BAC ) limit had negligible effects .


For the personal characteristics , college seniors and those who had previously driven after drinking were more likely to choose to drink and drive , whereas those who expect a jail penalty for a DUI offense were less likely to drive .


Our research confirmed and quantified certainty of punishment as the greatest deterrent to DUI , but it also indicated the equally important effect of a severe jail penalty .


It provides evidence on the feasibility of using a conjoint experiment in future studies to understand the general driver population and , with the help of a simulation tool , to predict DUI decisions in different legal environments .


Such predictions can be used to better inform policy decisions on developing targeted general deterrence programs in different communities .


Infant responses to vaccines can be impeded by maternal antibodies and immune system immaturity .


It is therefore unclear whether human immunodeficiency virus type @ ( HIV-@ ) vaccination would elicit similar responses in adults and infants .


HIV-@ Env-specific antibody responses were evaluated in @ completed pediatric vaccine trials .


In the Pediatric AIDS Clinical Trials Group ( PACTG ) @ protocol , infants were vaccinated with @ doses of Chiron rgp@ with MF@ ( n = @ ) , VaxGen rgp@ with aluminum hydroxide ( alum ; n = @ ) , or placebo ( n = @ ) between @ and @ weeks of age .