Plasma volume ( PV ) and haemoglobin mass ( Hb ( mass ) ) were measured at similar times and @ weeks postcamp ( @WPost ) .


Sweat sodium concentration ( ( Na ( + ) ) ( sweat ) ) was measured Pre and Post during a heat-response test ( @C ) .


Both groups showed very large improvements in Yo-YoIR@ at Post ( +@ % ; @ % CL @ , @ ) , with no between-group differences in the changes ( -@ % ; -@ , @ ) .


Postcamp , large changes in PV ( +@ % ; -@ , @ ) and ( Na ( + ) ) sweat ( -@ % ; -@ , -@ ) were observed in both groups , while Hb ( mass ) only moderately increased in HYP ( +@ % ; @ , @ ) .


At @WPost , there was a likely slightly greater increase in Hb ( mass ) ( +@ % ; @ , @ ) and PV ( +@ % ; -@ , @ , unclear ) in HYP than in NORM .


The combination of heat and hypoxic exposure during sleep/training might offer a promising ` conditioning cocktail ' in team sports .


Probably related to immune dysfunction , psoriasis vulgaris is a chronic , painful , disfiguring and disabling dermatological disease , carrying an increased risk of serious comorbidities .


Current conventional therapies can be costly , show risks of side effects and have limited efficacy , with relapse common on treatment cessation .


Chinese herbal medicine is effective in treating psoriasis vulgaris .


However , any benefit of adding Chinese herbal medicine to conventional treatments when treating psoriasis vulgaris is yet to be determined .


This is a pilot randomized , placebo controlled , double-blinded trial .


The pilot is primarily to determine the feasibility of undertaking a full size randomized trial .


Thirty participants with psoriasis vulgaris and Psoriasis Area Severity Index ( PASI ) scores @ and @ will be included .


Participants will be randomized ( in a @:@ ratio ) to receive oral granulated Chinese herbal medicine YXBCM@ plus topical calcipotriol @ % or oral YXBCM@ placebo plus topical calcipotriol @ % treatment for @ weeks , with a @-week follow-up phase .


The Chinese herbal medicine or placebo will be administered orally as dissolvable granules .


The primary outcome measure will be PASI change ( % ) from baseline to the end of treatment phase .


Secondary outcomes will include safety , key psoriasis-related cytokine changes ( for example , IL@ , IL@ and IL @ ) during the entire trial and symptom relapse rates at the end of the follow-up phase .


The study will evaluate the feasibility of a randomized controlled trial investigating combined conventional and Chinese herbal medicine therapy for psoriasis vulgaris .


The ingredients of YXBCM@ were selected based on literature , the expert opinion on herbal medicine and pre-clinical evidence , for instance Chinese herbal medicine possesses anti-inflammatory or antiproliferative properties .


Haemodialysis patients suffer from accelerated vascular calcification .


The vitamin K-dependent matrix Gla protein ( MGP ) is one of the most powerful inhibitors of vascular calcification .


Haemodialysis patients have high levels of the inactive form of MGP ( desphosphorylated-uncarboxylated-MGP , dp-uc-MGP ) and may benefit from pharmacological doses of vitamin K@ ( menaquinone ) to improve the calcification inhibitory activity of MGP .


To determine the optimal dose of menaquinone-@ ( MK-@ ) for MGP activation , @ chronic haemodialysis patients were recruited to randomly receive @ , @ or @ g of MK-@ thrice weekly for @ weeks .


Dp-uc-MGP was measured at baseline and after @ weeks .


Dietary intake of vitamin K@ ( phylloquinone ) and menaquinone was estimated based on a detailed questionnaire .


At baseline , dp-uc-MGP was not associated with phylloquinone intake ( P = @ ) , but correlated inversely with menaquinone intake ( P = @ ) .


MK-@ supplementation dose dependently reduced dp-uc-MGP .


The levels decreased by @ , @ and @ % in the respective groups .


Drop-outs were mainly due to gastrointestinal side-effects related to the unpleasant smell of the tablets .


Chronic haemodialysis patients have high levels of inactive MGP , possibly related to a low dietary vitamin K intake .


Pharmacological doses of MK-@ dose-dependently reduce dp-uc-MGP .


Menaquinone supplementation may be a novel approach to prevent vascular calcifications in chronic haemodialysis patients .


To evaluate short term quality of life of patients with chronic rhinosinusitis by using Chinese version of the sinonasal outcome test-@ ( SNOT-@ ) and to formulate an ideal therapy system for patients with chronic rhinosinusitis .


Using prospective randomized controlled design , we chose the SNOT-@ to evaluate and compare @ CRS patients ' quality of life ( QOL ) before surgery , at @-month ,@ - month , @-month and @-month after functional endoscopic sinus surgery ( FESS ) .


At the same time , we randomly chose @ healthy controls to compare their QOL with those of CRS patients after FESS .


We found that except for @ items ( cough , ear expanding , otalgia , facail pain and weary ) , the grade of @ other items of CRS patients were significantly higher than those of the healthy controls ( P < @ ) .


There was no significant difference in @ items ( olfactory sensation , hypogeusis , backflow of nasal discharge , difficult to fall asleep , bad sleep , bad work efficiency , depression , embarrassment ) at @ months after FESS between chronic rhinosinusitis patients and healthy controls ( P > @ ) .


There was no significant difference in @ items ( blow noses , sneeze , rhinorrhea , nasal discharge thickness , dizziness , night wake , tired of wake , attention deficit , sense of loss ) at @ months after FESS between chronic rhinosinusitis patients and healthy controls ( P > @ ) .


There was no significant difference in nasal obstruction at @ months after FESS between chronic rhinosinusitis patients and healthy controls ( P > @ ) , at this time the totle grade was normal ( P > @ ) .


The recovery period of QOL in patients was about @ months ( P > @ ) .


The @ great items were nasal obstruction , olfactory sensation , hypogeusis , nasal discharge , nasal discharge thickness and blow noses .


There was no difference in items except for bad sleep replacing nasal discharge thickness between @-month and @-month after surgery .


The Chinese vesion of SNOT-@ could evaluate QOL of CRS patients in this area .


The recovery of QOL of CRS patients needs about @ months after FESS , but problems of olfactory sensation , hypogeusis , nasal discharge and difficult to sleeep still needs to be resolved .


Altered mental status ( AMS ) is a common presentation in the emergency department ( ED ) .


A previous study revealed @ % electroencephalogram ( EEG ) abnormalities , including nonconvulsive seizure ( NCS ; @ % ) , in ED patients with AMS .


The objective of this study was to assess the impact of EEG on clinical management and outcomes of ED patients with AMS .


This was a randomized controlled trial at two urban teaching hospitals .


Adult patients ( @ years old ) with AMS were included .


Excluded patients had immediately correctable AMS ( e.g. , hypoglycemia ) or were admitted before enrollment .


Patients were randomized to routine care ( control ) or routine care plus EEG ( intervention ) .


Research assistants used a scalp electrode set with a miniature , wireless EEG device ( microEEG ) to record standard @-minute EEGs at presentation , and results were reported to the ED attending physician by an off-site epileptologist within @ minutes .


Primary outcomes included changes in ED management ( differential diagnosis , diagnostic work-up , and treatment plan from enrollment to disposition ) as determined by surveying the treating physicians .


Secondary outcomes were length of ED and hospital stay , intensive care unit ( ICU ) requirement , and in-hospital mortality .


A total of @ patients were enrolled ( @ control and @ intervention ) .


Patients in the two groups were comparable at baseline .


EEG in the intervention group revealed abnormal findings in @ % ( @ % confidence interval -LSB- CI -RSB- = @ % to @ % ) , including NCS in @ % ( @ % CI = @ % to @ % ) .


Using microEEG was associated with change in diagnostic work-up in @ % ( @ % CI = @ % to @ % ) of cases and therapeutic plan in @ % ( @ % CI = @ % to @ % ) of cases immediately after the release of EEG results .


Changes in probabilities of differential diagnoses and the secondary outcomes were not statistically significant between the groups .


An EEG can be obtained in the ED with minimal resources and can affect clinical management of AMS patients .


To compare the efficacy of an oscillating-rotating power toothbrush with a novel brush head incorporating angled CrissCross bristles ( Oral-B Triumph with SmartGuide with Oral-B CrossAction brush head ) versus a sonic toothbrush ( Sonicare DiamondClean ) for plaque and gingivitis reduction over a six-week period .


This was a single-center , randomized , examiner-blind , two-treatment , parallel group study involving @ subjects per group .


Subjects presenting with mild-to-moderate gingivitis at Baseline were randomly assigned to either the oscillating-rotating brush or the sonic brush .


They were instructed to use their assigned toothbrush and a standard fluoride dentifrice for two minutes twice daily at home for six weeks .


Gingivitis and plaque were assessed at Baseline and Week @ using the Modified Gingival Index ( MGI ) , Gingival Bleeding Index ( GBI ) , and Rustogi Modified Navy Plaque Index ( RMNPI ) .


Data were analyzed using an Analysis of Covariance ( ANCOVA ) , with baseline as the covariate .


Subjects also completed a consumer perception questionnaire to evaluate their brushing experience .


One-hundred and thirty subjects were enrolled in the study and randomized to treatment .


Sixty-four subjects per group completed the trial .


Both brushes produced statistically significant reductions in gingivitis and plaque measures at Week @ relative to Baseline ( p < @ for all ) .


The oscillating-rotating brush with the novel brush head demonstrated statistically significantly greater reductions in all gingivitis and plaque measures compared to the sonic toothbrush .


The benefits for the oscillating-rotating brush over the sonic brush were @ % for gingivitis , @ % for gingival bleeding , @ % for number of bleeding sites , @ % for whole mouth plaque , @ % for gingival margin plaque , and @ % for approximal plaque ( p < or = @ for all measures except gingival margin plaque , where p = @ ) .


Analysis of the consumer perception questionnaire results showed subjects using the oscillating-rotating brush rated it higher for overall use experience and key attributes related to cleaning , gentleness , and brush head shape/size versus subjects in the sonic brush group .


There were no adverse events reported or observed for either brush .


This six-week randomized , examiner-blind , comparative clinical study showed the oscillating-rotating toothbrush , with a novel brush head incorporating angled CrissCross bristles , was significantly better than an advanced sonic power toothbrush at reducing gingival inflammation and bleeding , as well as reducing whole mouth plaque , plaque along the gumline , and in the approximal regions .


To compare the differences in the efficacy on distant version of naked eye in the patients of juvenile myopia between rotating manipulation and lifting-thrusting manipulation of acupuncture .


One hundred and twenty cases ( @ eyes ) were randomized into a rotating manipulation group and a lifting-thrusting manipulation group , @ cases ( @ eyes ) in each group .


Additionally , a corrective lenses group , @ cases ( @ eyes ) , was set up as the control .


In both manipulation groups , Cuanzhu ( BL @ ) , Yuyao ( EX-HN @ ) , Sizhukong ( TE @ ) , Taiyang ( EX-HN @ ) , Fengchi ( GB @ ) , Zusanli ( ST @ ) , Guangming ( GB @ ) and Sanyinjiao ( SP @ ) were punctured , but stimulated with rotating manipulation and lifting-thrusting manipulation respectively three times per week , @ times as a treatment session and totally one session was required .


In the corrective lenses group , the glasses were applied at daytime .


The clinical efficacy and the changes in distant vision of naked eye before and after treatment were compared among the three groups .


The total effective rate was @ % ( @/@ ) in the rotating manipulation group , which was better than @ % ( @/@ ) in the lifting-thrusting manipulation group ( P < @ ) .


The distant vision of naked eye was improved apparently in the rotating manipulation group and the lifting-thrusting manipulation group after treatment ( both P < @ ) .


But it was not improved in the corrective lenses group ( P > @ ) .


The distant vision of naked eye was improved more apparently after treatment in the rotating manipulation group as compared with that in the lifting-thrusting manipulation group ( @ + / - @ vs @ + / - @ , P < @ ) .


For @ cases ( @ eyes ) with acupuncture treatment , in @-month follow-up , @ % ( @/@ ) of the cases maintained the stable vision as the original level and @ % ( @/@ ) of them were reduced in the vision In the acupuncture groups , it was found that the improvement of distant vision of naked eye was more obvious after treatment with younger age , better basic vision and shorter duration of sickness ( all P < @ ) .


Acupuncture achieves the positive and sustainable clinical effect on juvenile myopia , and the results of rotating manipulation are superior to that of lifting-thrusting manipulation .


Age , basic vision and duration of sickness impact the clinical efficacy .


To evaluate the efficacy of pomegranate juice supplementation on matrix metalloproteinases@ and @ serum levels and improving antioxidant function in young healthy males during exhaustive exercise .


The study was conducted at Ardabil University of Medical Sciences , Iran , in @-@ and comprised @ healthy subjects in @-@ age bracket .


They were randomly divided into control and supplemented groups .


One cup of pomegranate juice and one cup of tap water were given to supplemented and control groups daily for two weeks respectively .


Fasting blood samples were taken at baseline and at the end of two weeks of intervention .


The subjects were given one exhaustive exercise and then fasting blood samples were taken for testing blood glutathione peroxidase and superoxide dismutase and serum levels of high sensitivity C-reactive protein , zinc , ceruloplasmin , matrix metalloproteinases @ and @ , malondialdehyde and total antioxidant capacity .


Data was analysed using descriptive statistical tests , paired and independent sample t-test .


The blood levels of glutathione peroxidase and superoxide dismutase and serum levels of total antioxidant capacity after exhaustive exercise in the supplemented group were significantly increased ( p < @ ) , while the content of matrix metalloproteinases @ and @ , ceruloplasmin and malondialdehyde showed a significant decrease in comparison to the control group ( p < @ ) .


Besides , there were no significant changes in other biochemical factors .


Regular intake of pomegranate juice significantly modulates matrix metalloproteinases @ and @and serum levels of some inflammatory factors and thus protects against exhaustive exercise-induced oxidative injury in young healthy males .


Chronic postoperative pain is probably the most significant complication of tension-free inguinal hernia repair as its presence can considerably affect the life quality of the patient .


Different mesh materials and different surgical techniques for mesh fixation have been applied to reduce chronic postoperative pain , with controversial , nevertheless , results .


The aim of this prospective randomized study was to evaluate the effect of a relatively new mesh with self-fixating properties , used to repair inguinal hernia with the Lichtenstein technique , on early and chronic postoperative pain .


Between June @ and June @ , @ patients with primary unilateral inguinal hernia were treated using the Lichtenstein technique .


Patients were randomly assigned to receive either a polypropylene mesh , fixed with polypropylene sutures ( n = @ ; group A ) , or a self-fixating polypropylene mesh with resorbable polylactic acid microgrips ( n = @ ; group B ) .


Demographic data were recorded .


Early and chronic postoperative pain was evaluated using the visual analog scale ( VAS ) .


Duration of surgery , complications , length of hospitalization and recurrence were also recorded .


No statistical difference was found between the two groups in association to demographic data .


Operating time was @ @ and @ @ min in groups A and B , respectively , and the difference was statistically significant ( p < @ ) .


No difference was observed between the groups regarding the postoperative complications .


The VAS of early postoperative pain was @ @ in group A and @ @ in group B , with the difference being not statistically significant ( p = @ ) .


Concerning chronic pain , no remarkable statistically significant difference was observed between the two groups at @-month , @ - and @-year follow-up period .


At the end of the study , no recurrence was reported in either group .


Self-fixating mesh can be safely and effectively used in inguinal hernia repair with the additional advantage of reducing the operative time compared to the classic Lichtenstein technique .


However , its use is not accompanied by reduced rates in early or chronic postoperative pain .


It has been shown that nasal saline irrigation ( NSI ) alone can be effective in children with infectious and/or allergic respiratory problems , but no study has assessed the awareness or clinical use of NSI among practising pediatricians .


The main aim of this study was to evaluate the use of NSI in pre-school children by primary care pediatricians working in northern Italy .


Nine hundred randomly selected National Health Service primary care pediatricians with an e-mail address were sent an e-mail asking whether they were willing to respond to a questionnaire regarding the use of NSI .


The @ who answered positively were sent an anonymous questionnaire by post and e-mail that had @ multiple-choice items .


Completed questionnaires were received from @ of the @ primary care pediatricians ( @ % ) .


NSI was used by almost all the respondents ( @ % ) , although with significant differences in frequency .


It was considered both a prophylactic and a therapeutic measure by most of the respondents ( @ % ) , who prescribed it every day for healthy children and more frequently when they were ill .


Most of the primary care pediatricians ( @ % ) indicated an isotonic solution as the preferred solution , and the most frequently recommended administration devices were a nasal spray ( @ % ) and bulb syringe ( @ % ) .


Most of the pediatricians ( @ % ) convinced parents to use NSI by explaining it could have various beneficial effects , and two-thirds ( @/@ ; @ % ) thought that most of the parents agreed about the importance of NSI .


Analysis of possible associations between NSI prescribing behaviour and the demographic data revealed an associations with age and gender , with pediatricians aged < @ years prescribing NSI more frequently than their older counterparts ( p < @ ) , and females prescribing NSI more frequently than males ( p < @ ) .


In Northern Italy , most primary care pediatricians prescribe NSI for both the prophylaxis and therapy of upper respiratory tract problems in pre-school children .


However , many aspects of the procedure are not clarified , and this reduces parental compliance .


Given the medical and economic advantages of NSI , this situation should be changed as soon as possible .


To determine whether the use and adjustment of antidepressant pharmacotherapy accounted for the beneficial effects of collaborative care treatment on the improvement of mood symptoms and health-related quality of life ( HRQoL ) after coronary artery bypass graft ( CABG ) surgery .


In a post-hoc analysis of data from the Bypassing the Blues ( BtB ) trial we tested the impact of antidepressant medication on changes in depression and HRQoL from the early postoperative period to @-month follow-up .


Two hundred fifty-nine depressed post-CABG patients scoring @ on the Patient Health Questionnaire-@ were classified in four groups according to whether or not they received antidepressants at baseline and @-months following randomization .


Patients using antidepressant pharmacotherapy at baseline and follow-up tended to be younger and female ( p@ @ ) , but were similar in various clinical characteristics .


Just @ % ( @/@ ) of patients were on an antidepressant at baseline which increased to @ % at follow-up ( @/@ ) .


Compared to other groups , patients on antidepressants at both baseline and follow-up assessment showed the smallest improvement in mood symptoms and HRQoL .


While multivariate analyses confirmed that randomization to collaborative care was associated with greater improvement in mood symptoms ( odds ratio -LSB- OR -RSB- = @ ; @ % - confidence interval -LSB- CI -RSB- = @-@ @ , p < @ ) and mental HRQoL ( OR = @ , CI = @-@ @ , p = @ ) , use of antidepressant medication had no differential impact on either measure ( p = @ and p = @ , respectively ) .


The beneficial effects of collaborative care for post-CABG depression were not generated by adjustments in antidepressant medication .


Many adolescents with obsessive-compulsive disorder ( OCD ) do not have access to evidence-based treatment .


A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy ( TCBT ) for adolescents with OCD compared to standard clinic-based , face-to-face CBT .


Seventy-two adolescents , aged @ through @ years with primary OCD , and their parents were randomized to receive specialist TCBT or CBT .


The intervention provided differed only in the method of treatment delivery .


All participants received up to @ sessions of CBT , incorporating exposure with response prevention ( E/RP ) , provided by experienced therapists .


The primary outcome measure was the Children 's Yale-Brown Obsessive-Compulsive Scale ( CY-BOCS ) .


Blind assessor ratings were obtained at midtreatment , posttreatment , @-month , @-month , and @-month follow-up .


Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment , @-month , and @-month follow-up .


At @-month follow-up , there were no significant between-group differences on the CY-BOCS , but the confidence intervals exceeded the non-inferiority threshold .


All secondary measures confirmed non-inferiority at all assessment points .


Improvements made during treatment were maintained through to @-month follow-up .


Participants in each condition reported high levels of satisfaction with the intervention received .


TCBT is an effective treatment and is not inferior to standard clinic-based CBT , at least in themidterm .


This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD .


Clinical trial registration information-Evaluation of telephone-administered cognitive-behaviour therapy ( CBT ) for young people with obsessive-compulsive disorder ( OCD ) ; http://www.controlled-trials.com; ISRCTN@ .


Many cannabinoid medications are approved in North America or in phase III trials , such as dronabinol , nabilone , or nabiximols .


Little is known about their subjective psychoactive effects when used for pain management .


We hypothesized that when used for pain , dronabinol has psychoactive effects in a dose-response relationship , whose peak effects are comparable with smoking marijuana .


This was a randomized controlled trial of single dose placebo , @ or @ mg dronabinol in @ chronic noncancer pain patients taking opioids and not using marijuana .


Participants completed the Addiction Research Center Inventory ( ARCI ) hourly for @ hours during @ monitored sessions .


Comparison sample was the ARCI ratings in participants with no pain ( N = @ ) , monitored every @ minutes after smoking a @ % THC ( low ) and a @ % ( high strength ) marijuana cigarette .


The @ and @ mg dronabinol doses had significantly elevated scores over time on @/@ subscales versus placebo ( P < @ ) .


Average daily morphine use , total pain relief ( TOTPAR ) , age , sex , and baseline pain level were not significant covariates .


ARCI peak effects at @ hours were similar to peak effects of smoked marijuana at @ minutes ( P = @ , @ mg = low strength , @ mg = high strength ) .


In pain patients , oral dronabinol has similar psychoactive effects to smoking marijuana .


This risk must be considered in any decision to prescribe cannabinoid medications for pain .


Self-harm is a major risk factor for completed suicide .


To determine the efficacy of a brief psychological intervention - culturally adapted manual-assisted problem-solving training ( C-MAP ) - delivered following an episode of self-harm compared with treatment as usual ( TAU ) .


The study was a randomised controlled assessor-masked clinical trial ( trial registration : ClinicalTrials.gov NCT@ ) .


All patients admitted after an episode of self-harm during the previous @ days to the participating medical units of three university hospitals in Karachi , Pakistan , were included in the study .


A total of @ patients were screened and @ were randomly allocated to C-MAP plus treatment as usual ( TAU ) or to TAU alone .


All patients were assessed at baseline , at @ months ( end of intervention ) and at @ months after baseline .


The primary outcome measure was reduction in suicidal ideation at @ months .


The secondary outcome measures included hopelessness , depression , coping resources and healthcare utilisation .


A total of @ patients were randomised to the C-MAP group and @ to the TAU group .


Patients in the C-MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory , which was sustained at @ months after the completion of C-MAP .


There was also a significant reduction in symptoms of depression compared with patients receiving TAU .


The positive outcomes of this brief psychological intervention in patients attempting self-harm are promising and suggest that C-MAP may have a role in suicide prevention .


Bladder pain syndrome/interstitial cystitis ( BPS/IC ) is a chronic disease that highly degrades the quality of life for patients .


In the present study , Internet intervention was used to care for bladder pain syndrome/interstitial cystitis patients to alleviate their pain and bothering symptoms .


Healthcare education was carried out through the Internet by asking the patients , who were randomly divided into study ( @ patients ) and control ( @ patients ) groups , to check possible sensitive foods , habits , and behaviors weekly to remind and consolidate important rules for promoting quality of life .


The symptom flares consultation through short message service with the Internet used to elevate healthcare efficiency was undertaken .


Questionnaires , including Short Form @ health survey , O'Leary-Sant symptom and problem indices , as well as visual analog scales pain and urgency scales , were used to evaluate quality of life and disease severity improvements before and after information and communication technology intervention .


The outcome was evaluated at week @ .


The quality of life of both the control and study groups was significantly improved .


The quality of life and visual analog scales for the patients in the study group with information and communication technology intervention showed a much greater improvement compared with the patients in the control group ( P < @ ) .


The E-health system was shown to be effective in improving quality of life of bladder pain syndrome/interstitial cystitis patients through intervention of Internet healthcare education and short message service for the consolidation of healthy behavior and lifestyle in the @-week follow up .


Bleeding limits anticoagulant treatment in patients with acute coronary syndromes ( ACS ) .


We investigated whether background concomitant antiplatelet therapy influences the effects of apixaban after ACS .


This study examined high-risk ACS patients who were treated with aspirin or aspirin plus clopidogrel and who were randomized to apixaban @ mg twice daily or placebo .


In a post-hoc analysis , we assessed whether the effect of apixaban on efficacy and safety outcomes varied by the concomitant antiplatelet regimen by using simple Cox modeling and marginal structural models with propensity scores and antiplatelet therapy as a time-dependent covariate .


At baseline , of @,@ patients , @ % ( n = @,@ ) were on aspirin alone , and @ % ( n = @,@ ) were on aspirin plus clopidogrel .


A total of @ % ( n = @,@ ) switched antiplatelet therapy during follow-up .


No differential effect of apixaban versus placebo was observed for the composite endpoint of cardiovascular death , myocardial infarction , and ischemic stroke in patients taking aspirin ( @ per @ patient-years vs. @ per @ patient-years ; adjusted hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ) or aspirin plus clopidogrel ( @ vs. @ ; adjusted HR : @ ; @ % CI : @ to @ ; p ( interaction ) = @ ) .


Compared with placebo , apixaban increased Thrombolysis In Myocardial Infarction major bleeding in patients taking aspirin ( @ vs. @ ; adjusted HR : @ ; @ % CI : @ to @ ) and in patients taking aspirin plus clopidogrel ( @ vs. @ ; adjusted HR : @ ; @ % CI : @ to @ ; p ( interaction ) = @ ) .


Similar results were obtained with marginal structural models and in patients treated with and without percutaneous coronary intervention .


Post-ACS treatment with apixaban versus placebo showed no efficacy , but it increased bleeding regardless of concomitant therapy with aspirin alone or aspirin plus clopidogrel .


( Apixaban for Prevention of Acute Ischemic Events @ -LSB- APPRAISE-@ -RSB- ; NCT@ ) .


Cold water immersion ( CWI ) may be beneficial for acute recovery from exercise , but it may impair long-term performance by attenuating the stimuli responsible for adaptation to training .


We compared effects of CWI and passive rest on cycling performance during a simulated cycling grand tour .


Thirty-four male endurance-trained competitive cyclists were randomized to CWI for four times per week for @ min at @C or control ( passive recovery ) groups for @ d of baseline training , @ d of intensified training , and an @-d taper .


Criteria for completion of training and testing were satisfied by @ cyclists in the CWI group ( maximal aerobic power , @ @ Wkg ; mean SD ) and @ in the control group ( @ @ Wkg ) .


Each week , cyclists completed a high-intensity interval cycling test and two @-min bouts separated by @ min .


CWI was performed four times per week for @ min at @C .


Between baseline and taper , cyclists in the CWI group had an unclear change in overall @-min power relative to control ( @ % @ % ) , although mean power in the second effort relative to the first was likely higher for the CWI group relative to control ( @ % @ % ) .


The change in @-s maximum mean sprint power in the CWI group was likely beneficial compared with control ( @ % @ % ) .


Differences between groups for the @-min time trial were unclear ( -@ % @ % ) .


Although some effects of CWI on performance were unclear , data from this study do not support recent speculation that CWI is detrimental to performance after increased training load in competitive cyclists .


While self-report methods to collect exposure information have large practical advantages in many research contexts , little research has specifically investigated the reliability and validity of motorcyclists ' self-reported exposure .


The present study aimed to examine the reliability and validity of different self-report exposure measures and to provide recommendations on best practice self-report riding exposure questions .


The reliability and validity of different self-report exposure measures were examined amongst novice motorcyclists through t-tests , Bland Altman plots , coefficients of variation , and correlations .


The most valid and reliable data was provided when riding exposure was asked for the current average week rather than earlier and longer periods , and in units of time rather than distance or number of trips .


The greater reliability of riding exposure found amongst commuting and rural riders compared to recreational and metropolitan riders respectively and at the second interview compared to the first suggests that factors such as riding purposes , geographical locations , and riding experience can contribute to measurement error .


If self-reported odometer readings are used , questions on whether the respondents share their own bike or ride more than one bike , and a built-in process to ensure respondents report the exact odometer reading on their bike are recommended .


It is recommended that self-report riding exposure questions ask about the hours of riding for the current average week , and data on riding purposes , locations , and experience are also collected .


To determine whether gene expression profiles identified in peripheral whole blood samples could be used to determine therapeutic outcome in a cohort of children with newly diagnosed polyarticular juvenile idiopathic arthritis ( JIA ) .


Whole blood samples from the Trial of Early Aggressive Therapy ( TREAT ) in JIA patients were analyzed on Illumina microarrays , and differential gene expression was compared to expression in healthy controls .


Microarray results were validated by real-time quantitative polymerase chain reaction in an independent cohort of samples .


Pathway analysis software was used to characterize gene expression profiles .


Support vector machines were used to develop predictive models for different patient classes .


Differential gene expression profiles for rheumatoid factor ( RF ) - positive and RF-negative patients were remarkably similar .


Pathway analysis revealed a broad range of affected pathways , consistent with current mechanistic theories .


Modeling showed that the prognosis at @ months was strongly linked to gene expression at presentation , irrespective of treatment .


Gene expression is linked to therapeutic outcome , and gene expression in the peripheral blood may be a suitable target for a prognostic test .


To examine counterregulatory glucose kinetics and test the hypothesis that - adrenergic blockade impairs these in patients with type @ diabetes mellitus ( T@DM ) and advanced - failure .


Nine insulin-requiring T@DM subjects and six matched nondiabetic control subjects were studied .


- Cell function was assessed by the C-peptide response to arginine stimulation .


Counterregulatory hormonal responses and glucose kinetics were assessed by hyperinsulinemic euglycemic-hypoglycemic clamps with -LSB- @ - ( @ ) H -RSB- glucose infusion .


T@DM subjects underwent two clamp experiments in a randomized crossover fashion : once with infusion of the - adrenergic antagonist propranolol and once with infusion of normal saline .


Compared with the control subjects , T@DM subjects had threefold reduced C-peptide responses to arginine stimulation .


During the hypoglycemic clamp , glucagon responses were markedly diminished ( @ @ vs. @ @ ng/L , P < @ ) , but other hormonal responses and the decrement in the required exogenous glucose infusion rate ( GIR ) from the euglycemic clamp were normal ( -@ @ vs. -@ @ mol kg ( -@ ) min ( -@ ) in control subjects ) ; however , endogenous glucose production ( EGP ) did not increase ( -@ @ vs. @ @ mol kg ( -@ ) min ( -@ ) in control subjects , P < @ ) , whereas systemic glucose disposal decreased normally .


- Adrenergic blockade in the T@DM subjects increased GIR @ % during the euglycemic clamp ( P < @ ) , but neither increased GIR during the hypoglycemic clamp or decreased its decrement from the euglycemic clamp to the hypoglycemic clamp .


Overall glucose counterregulation is preserved in advanced T@DM , but the contribution of EGP is diminished .


- Adrenergic blockade may increase insulin sensitivity at normoglycemia but does not impair glucose counterregulation in T@DM patients , even those with advanced - cell failure .


Medical simulation training requires effective and efficient training strategies .


Dyad practice may be a training strategy worth pursuing because it has been proven effective and efficient in motor skills learning .


In dyad practice two participants collaborate in learning a task they will eventually perform individually .


In order to explore the effects of dyad practice in a medical simulation setting , this study examined the effectiveness and efficiency of dyad practice compared with individual practice in the learning of bronchoscopy through simulation-based training .


A total of @ students of medicine were randomly assigned to either individual practice or dyad practice .


The training setting included video-based instruction , @ bronchoscopy simulator cases and instructor feedback .


Participants in the dyad practice group alternated between physical and observational practice and hence physically undertook only half of the training cases undertaken by participants who practised individually .


Pre - , post - and delayed ( @weeks ) retention tests were used to assess skills according to previously validated simulator measures .


Data were analysed using repeated-measures analysis of variance ( anova ) on each dependent measure .


A significant main effect of test was found for all measures ( F@ ,@ > @ , p < @ ) , indicating improvement in performance from pre-tests to post-tests and retention tests .


No interaction was found between test and group ( F@ ,@ < @ , p > @ ) , indicating parallel learning curves .


Most importantly , no main effect of group was found for any of the measures , indicating no difference between learning curves ( F@ ,@ = @ , p < @ ) .


Individual practice and dyad practice did not differ in their effectiveness for the acquisition of bronchoscopy skills through supervised simulation training .


However , dyad practice proved more efficient than individual practice because two participants practising in dyads learned as much as one participant practising individually but required the same instructor resources and training time as the single learner .


Dolutegravir has been shown to be non-inferior to an integrase inhibitor and superior to a non-nucleoside reverse transcriptase inhibitor ( NNRTI ) .


In FLAMINGO , we compared dolutegravir with darunavir plus ritonavir in individuals naive for antiretroviral therapy .


In this multicentre , open-label , phase @b , non-inferiority study , HIV-@-infected antiretroviral therapy-naive adults with HIV-@ RNA concentration of @ copies per mL or more and no resistance at screening were randomly assigned ( @:@ ) to receive either dolutegravir @ mg once daily or darunavir @ mg plus ritonavir @ mg once daily , with investigator-selected tenofovir-emtricitabine or abacavir-lamivudine .


Randomisation was stratified by screening HIV-@ RNA ( @,@ or > @,@ copies per mL ) and nucleoside reverse transcriptase inhibitor ( NRTI ) selection .


The primary endpoint was the proportion of patients with HIV-@ RNA concentration lower than @ copies per mL ( Food and Drug Administration -LSB- FDA -RSB- snapshot algorithm ) at week @ with a @ % non-inferiority margin .


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


Recruitment began on Oct @ , @ , and was completed on May @ , @ , in @ research centres in nine countries worldwide .


Of @ patients screened , @ patients were included in the analysis ( @ in each group ) .


At week @ , @ ( @ % ) patients receiving dolutegravir and @ ( @ % ) patients receiving darunavir plus ritonavir had HIV-@ RNA of less than @ copies per mL ( adjusted difference @ % , @ % CI @-@ ) , non-inferiority and on pre-specified secondary analysis dolutegravir was superior ( p = @ ) .


Confirmed virological failure occurred in two ( < @ % ) patients in each group ; we recorded no treatment-emergent resistance in either group .


Discontinuation due to adverse events or stopping criteria was less frequent for dolutegravir ( four -LSB- @ % -RSB- patients ) than for darunavir plus ritonavir ( ten -LSB- @ % -RSB- patients ) and contributed to the difference in response rates .


The most commonly reported ( @ % ) adverse events were diarrhoea ( dolutegravir @ -LSB- @ % -RSB- patients vs darunavir plus ritonavir @ -LSB- @ % -RSB- patients ) , nausea ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , and headache ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


Patients receiving dolutegravir had significantly fewer low-density lipoprotein values of grade @ or higher ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; p = @ ) .


Once-daily dolutegravir was superior to once-daily darunavir plus ritonavir .


Once-daily dolutegravir in combination with fixed-dose NRTIs represents an effective new treatment option for HIV-@-infected , treatment-naive patients .


Nerve-preserving surgery has been provided for patients with rectal cancer ; however , sexual dysfunction remains a common complication of rectal cancer surgery .


This study explored the efficacy of udenafil to treat erectile dysfunction in male patients who underwent total mesorectal excision ( TME ) for rectal cancer .


We conducted a randomized , double-blind , placebo-controlled clinical trial involving @ male patients who had decreased International Index of Erectile Function-@ ( IIEF-@ ) scores after TME for rectal cancer .


Patients received placebo ( @ mg ) or udenafil ( @ mg ) for @ weeks .


The primary outcome variable was the change in IIEF-@ scores .


The secondary outcome variables were Sexual Encounter Profile ( SEP ) questions @ ( Q@ ) and @ ( Q@ ) , and the Global Assessment Question ( GAQ ) .


Baseline IIEF-@ scores , SEP Q@ and Q@ responses , and spontaneous erection rates were consistent in both groups .


At the end of treatment , the change in IIEF-@ scores from the baseline was significantly higher in the udenafil group than it was in the placebo group ( mean IIEF-@ score , @ @ vs @ @ ; P < @ ) .


Responses to SEP Q@ , SEP Q@ , and GAQ were significantly higher in the udenafil group than they were in the placebo group ( SEP Q@ , P = @ ; SEP Q@ , P = @ ; GAQ , P < @ ) .


Treatment-related adverse events ( n = @ ) were all mild in severity .


Oral udenafil was deemed safe and effective for the treatment of erectile dysfunction in patients who underwent TME for rectal cancer .


The aim of this study was to compare the effect of continuous care model with routine care on the quality of life among patients who receive a kidney transplant .


In a randomized clinical trial , @ kidney transplant patients were selected from @ hospitals in Tehran , Iran , and were randomly assigned to @ group .


In the experimental group , continuous care model was applied for @ months and the control group received routine care .


The scale scores of the Kidney Transplant Questionnaire concerning quality of life were monthly compared between the two groups .


Of @ patients , @ in the experimental and @ in the control group were excluded from the study .


Final analysis was performed on @ in the experimental and @ in the control groups .


No significant difference was found between the two groups in terms of demographic variables .


Although the quality of life scores increased in both groups , the mean scores of the experimental group were significantly higher than those in the control group at @ , @ , and @ months .


Continuous care model may improve the kidney transplant patients ' quality of life .


Hilar cholangiocarcinoma is an uncommon cancer and its overall incidence is increasing .


Photodynamic therapy ( PDT ) has been proposed as palliative management for unresectable hilar cholangiocarcinoma ( UHC ) .


To date , little is known about the role of the addition of systemic chemotherapy to PDT for UHC .


We performed a prospective , randomised , phase II trial to compare PDT plus S-@ and PDT alone for UHC .


Patients with UHC were randomly assigned ( in a @:@ ratio ) to PDT plus S-@ or PDT alone .


The primary end-point was overall survival .


The secondary end-points were progression-free survival , complications , re-intervention rate and quality of life .


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


Between February @ and May @ , we randomly assigned @ patients to receive PDT plus S-@ and @ to receive PDT alone .


The UHC patients treated with PDT plus S-@ showed higher @-year survival rate compared with the patients treated with PDT alone ( @ % versus @ % , P = @ ) and prolonged overall survival ( median @ months , @ % confidence interval -LSB- CI -RSB- : @-@ @ , versus @ months , @ % CI : @-@ , P = @ , hazard ratio -LSB- HR -RSB- , @ ; @ % CI : @-@ @ ) .


Regarding the secondary end-points , PDT plus S-@ was associated with prolonged progression-free survival compared with PDT alone ( median @ months -LSB- @ % CI : @-@ -RSB- versus @ months -LSB- @ % CI : @-@ @ -RSB- , P = @ ( HR for progression @ , @ % CI : @-@ @ ) .


There were no differences in the number of PDT sessions , the frequency of cholangitis , overall adverse events or the quality of life in either group .


PDT plus S-@ was well tolerated and was associated with a significant improvement of overall survival and progression-free survival compared with PDT alone in patients with UHC .


These findings warrant further clinical investigation of PDT plus S-@ in patients with UHC .


Patient centred and individually-tailored counselling of older people with a chronic condition who live at home is a useful intervention to support their independence .


The paper presents the development and psychometric testing of the APN-BQ Instrument , to measure patient-centeredness .


To measure the quality of an in-home counselling intervention , a @-item questionnaire was developed and tested with @ people @ years and older .


Principal component analysis with Varimax Rotation was conducted ( n = @ ) .


Analysis revealed a four factor ( fs = @ ) model scoring in @ items .


All factors loaded > @ .


Cronbach 's alpha was @ .


The utility and acceptance of the instrument was confirmed by the high response rate ( @ % ) and the fact that participants answered @ % of all questions .


The APN-BQ has shown to be a reliable Instrument with good content and construct validity .


It is a tool for APNs to measure structure , process , and outcome quality of a patient-centred and individually-tailored counselling program , including the degree of patient participation , and patient empowerment .


To compare the efficacy of two different techniques for vertical bone regeneration at implant placement with particulate autogenous bone at @ years after loading by means of a double-blind , superiority , parallel-group randomized clinical trial .


The study was conducted in a private center in Italy between April @ and December @ .


Patients in whom vertical bone augmentation was indicated in combination with the placement of single or multiple implants were eligible for inclusion in this trial .


Patients were randomized to receive either resorbable collagen barriers supported by an osteosynthesis plate ( test group ) or nonresorbable titanium-reinforced expanded polytetrafluoroethylene barriers ( control group ) .


The outcome variables-radiographic bone variation at implant sites , implant failures , and complications - were evaluated @ years after loading .


Randomization was done by computer , with allocation concealed by opaque sequentially numbered sealed envelopes .


The patients and the radiographic examiner were blinded to group assignment .


Twenty-two patients were randomized : @ to the resorbable barrier group and @ to the nonresorbable ( control ) group .


One control group patient dropped out .


The mean bone level @ years after surgery was @ mm for the resorbable group and @ mm for the nonresorbable group .


The adjusted difference in bone changes between groups was @ mm ( @ % confidence interval , -@ to @ , P = @ ) .


No implant failures or complications occurred after loading .


No differences were observed in this comparison of resorbable and nonresorbable barriers with simultaneous implant placement for vertical ridge augmentation .


Effective maintenance therapies after chemoradiotherapy for lung cancer are lacking .


Our aim was to investigate whether the MUC@ antigen-specific cancer immunotherapy tecemotide improves survival in patients with stage III unresectable non-small-cell lung cancer when given as maintenance therapy after chemoradiation .


The phase @ START trial was an international , randomised , double-blind trial that recruited patients with unresectable stage III non-small-cell lung cancer who had completed chemoradiotherapy within the @-@ week window before randomisation and received confirmation of stable disease or objective response .


Patients were stratified by stage ( IIIA vs IIIB ) , response to chemoradiotherapy ( stable disease vs objective response ) , delivery of chemoradiotherapy ( concurrent vs sequential ) , and region using block randomisation , and were randomly assigned ( @:@ , double-blind ) by a central interactive voice randomisation system to either tecemotide or placebo .


Injections of tecemotide ( @ g lipopeptide ) or placebo were given every week for @ weeks , and then every @ weeks until disease progression or withdrawal .


Cyclophosphamide @ mg/m ( @ ) ( before tecemotide ) or saline ( before placebo ) was given once before the first study drug administration .


The primary endpoint was overall survival in a modified intention-to-treat population .


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


From Feb @ , @ , to Nov @ , @ , @ patients were randomly assigned ( @ to tecemotide and @ to placebo ) .


@ patients were excluded from the primary analysis population as a result of a clinical hold , resulting in analysis of @ patients in the tecemotide group and @ in the placebo group in the modified intention-to-treat population .


Median overall survival was @ months ( @ % CI @-@ @ ) with tecemotide versus @ months ( @-@ @ ) with placebo ( adjusted HR @ , @-@ @ ; p = @ ) .


In the patients who received previous concurrent chemoradiotherapy , median overall survival for the @ ( @ % ) of @ patients assigned to tecemotide was @ months ( @ % CI @-@ @ ) compared with @ months ( @-@ @ ) for the @ ( @ % ) of @ patients assigned to placebo ( adjusted HR @ , @-@ @ ; p = @ ) .


In patients who received previous sequential chemoradiotherapy , overall survival did not differ between the @ ( @ % ) patients in the tecemotide group and the @ ( @ % ) patients in the placebo group ( @ months -LSB- @ % CI @-@ @ -RSB- vs @ months -LSB- @-@ @ -RSB- , respectively ; adjusted HR @ , @-@ @ ; p = @ ) .


Grade @-@ adverse events seen with a greater than @ % frequency with tecemotide were dyspnoea ( @ -LSB- @ % -RSB- of @ patients in the tecemotide group vs @ -LSB- @ % -RSB- of @ patients in the placebo group ) , metastases to central nervous system ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , and pneumonia ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


Serious adverse events with a greater than @ % frequency with tecemotide were pneumonia ( @ -LSB- @ % -RSB- in the tecemotide group vs @ -LSB- @ % -RSB- in the placebo group ) , dyspnoea ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) , and metastases to central nervous system ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


Serious immune-related adverse events did not differ between groups .


We found no significant difference in overall survival with the administration of tecemotide after chemoradiotherapy compared with placebo for all patients with unresectable stage III non-small-cell lung cancer .


However , tecemotide might have a role for patients who initially receive concurrent chemoradiotherapy , and further study in this population is warranted .


To determine efficacy and safety of treatment with Rituximab and Etanercept plus Methotrexate in patients with active Rheumatoid Arthritis ( RA ) , who had an inadequate response to nonbiologic DMARDS therapies and to explore the pharmacogenetics and pharmacodynamics of Rituximab and Etanercept in our populations .


Study was done at Rheumatology Clinic of University Clinical Centre in Prishtina during @-@ years .


We evaluated primary efficacy and safety at @ weeks in patients enrolled in the study of long-term efficacy of Rituximab and Etanercept .


Patients with active Rheumatoid Arthritis and an inadequate response to @ or more non biologic DMARDS were randomized to receive intravenous Rituximab ( @ course consisting of @ infusions of @ mg each - one group , and Etanercept @ mg twice weekly - second group , but both groups with background MTX .


The primary efficacy end point was a response on the ACR @ % , improvement criteria at @ weeks , Secondary end points were responses on the ACR @ and ACR @ , improvement criteria , the DAS @ , and EULAR response criteria at @ weeks .


During our investigations we treated @ patients , @ females and @ males , in the treated group with RTX and @ patients @ females and @ males in the treated group with ETN .


Patients of group @ and group @ were of ages @-@ years old and @-@ years old ( average @-@ ) Most of the patients belong in @nd and @rd functional stage according to Steinbrocker .


All ACR response parameters were significantly improved in RTX treated patients who also had clinically meaningful improvement in fatigue , disability and quality of life .


Patients showed a trend less progression in radiographic end points .


Most adverse events occurred with the first RTX infusion and were mild to moderate severity .


At @ weeks , a single course of RTX and ETN provided significant and clinically meaningful improvements in disease activity in patients with active , longstanding RA who had an inadequate response to @ or more nonbiologic DMARDS .


Oesophageal squamous cell carcinoma ( ESCC ) is a fatal disease with @-year survival rates of < @ % in Northern Iran .


Oesophageal squamous dysplasia ( ESD ) is the precursor histologic lesion of ESCC .


This pilot study was conducted to assess the feasibility , safety , and acceptability of non-endoscopic cytological examination of the oesophagus and to provide initial data on the accuracy of cytological atypia for identifying patients with ESD in this very-high-risk area .


Randomly selected asymptomatic participants of the Golestan Cohort Study were recruited .


A cytological specimen was taken using a capsule sponge device and evaluated for atypical cells .


Sections of the cytological specimen were also stained for p@ protein .


Patient acceptability was assessed using a visual analogue scale .


The cytological diagnosis was compared with a chromoendoscopic examination using Lugol 's solution .


Three hundred and forty-four subjects ( @ % male , mean ( s.d. ) age @ ( @ ) years ) were referred to the study clinic .


Three hundred and twelve met eligibility criteria and consented , of which @ subjects ( @ % ) completed both cytological and endoscopic examinations .


There were no complications .


Most of the participants ( @ ; @ % ) were satisfied with the examination .


The sensitivity and specificity of the cytological examination for identifying subjects with high-grade ESD were @ and @ % , respectively .


We found an accuracy of @ % ( @ % CI = @-@ % ) for a combination of cytological examination and p@ staining to detect high-grade ESD .


The capsule sponge methodology seems to be a feasible , safe , and acceptable method for diagnosing precancerous lesions of the oesophagus in this population , with promising initial accuracy data for the detection of high-grade ESD .


To study the possibility of desflurane use for induction of anesthesia .


We analysed the intra - and immediate postoperative periods in @ patients .


Depending on the intended anesthesia method patients were randomised ( the method of the envelopes ) and included in one of two study groups : @ -- volatile desflurane-based anesthesia ( n = @ ) ; @ -- volatile sevoflurane-based anesthesia ( n = @ ) .


Desflurane based anesthesia led to apnea until the installation of laryngeal mask in @ % of patients ( of @ ) , for whom a completion of inhalation induction was possible , whereas sevoflurane based anesthesia.led to apnea occurred only in one patient ( @ % ) .


`` Step up '' desflurane-based inhalational induction and sevoflurane-based maximum concentration inhalational induction `` without primaryfilling of the circuit '' showed no significant in time necessary for achieving an anesthetic concentration essential for LMA installation .


In both groups it was @-@ min .


desflurane-based volatile induction with addition of fentanyl led to apnea in @ % of patients and associates with a higher risk of bronchospasm .


Social psychological theories provide bases for understanding how social comparison processes may impact peer influence .


This study examined two peer characteristics that may impact peer influence on adolescent girls ' weight-related behavior intentions : body size and popularity .


A school-based sample of @ @th grade girls ( @-@ years old ) completed an experimental paradigm in which they believed they were interacting with other students ( i.e. , `` e-confederates '' ) .


The body size and popularity of the e-confederates were experimentally manipulated .


Participants were randomly assigned to one of the three experimental conditions in which they were exposed to identical maladaptive weight-related behavior norms communicated by ostensible female peers who were either : ( @ ) Thin and Popular ; ( @ ) Thin and Average Popularity ; or ( @ ) Heavy and Average Popularity .


Participants ' intent to engage in weight-related behaviors was measured pre-experiment and during public and private segments of the experiment .


A significant effect of condition on public conformity was observed .


Participants exposed to peers ' maladaptive weight-related behavior norms in the Heavy and Average condition reported significantly less intent to engage in weight-related behaviors than participants in either of the thin-peer conditions ( F ( @ ) = @ , p = @ ) .


Peer influence on private acceptance of weight-related behavior intentions was similar across conditions ( F ( @ ) = @ , p = @ ) .


Body size comparison may be the most salient component of peer influence processes on weight-related behaviors .


Peer influence on weight-related behavior intention also appears to impact private beliefs .


Considering peer norms in preventive interventions combined with dissonance-based approaches may be useful .


To compare the capability to aid prediction of clinical outcome measures , including progression-free survival ( PFS ) and overall survival ( OS ) , between volumetric estimates from contrast material-enhanced ( CE ) T@-weighted subtraction maps and traditional segmentation in a randomized multicenter clinical trial of recurrent glioblastoma ( GBM ) patients treated with bevacizumab .


All patients participating in this study signed institutional review board-approved informed consent at their respective institutions prior to enrolling in the multicenter clinical trial .


One-hundred sixty patients with recurrent GBM enrolled as part of a HIPAA-compliant , multicenter clinical trial ( AVF@ g , BRAIN trial ) .


Contrast-enhancing tumor volumes and change in volumes as a response to therapy were quantified by using either conventional segmentation or CE T@-weighted subtraction maps created by voxel-by-voxel subtraction of intensity-normalized nonenhanced T@-weighted images from CE T@-weighted images .


These volumes were then tested as predictors of PFS and OS by using log-rank univariate analysis , the multivariate Cox proportional hazards regression model , and receiver operating characteristic analysis .


Use of CE T@-weighted subtraction maps qualitatively improved visualization and improved quantification of tumor volume after bevacizumab treatment .


Significant trends between the volume of tumor and change in tumor volume after therapy on CE T@-weighted subtraction maps were found for both PFS and OS ( pretreatment volume < @ cm ( @ ) , P < @ ; posttreatment volume < @ cm ( @ ) , P < @ ; percentage change in volume > @ % , P = @ for PFS and P = @ for OS ) .


CE T@-weighted subtraction maps were significantly better at aiding prediction of @-month PFS and @-month OS compared with conventional segmentation by using receiver operating characteristic analysis ( P < @ ) .


Use of CE T@-weighted subtraction maps improved visualization and aided better prediction of patient survival in recurrent GBM treated with bevacizumab compared with conventional segmentation of CE T@-weighted images .


Clinical trial registration no .


NCT@ .


Online supplemental material is available for this article .


The objective was to explore the role of specific patient-related and operator-related factors in pain perception during flexible laryngoscopy , which is one of the most common ENT procedures .


Monocentric , randomized , individual prospective study .


A total of @ patients ( @ men and @ women ) , without any relevant ENT diseases , underwent laryngoscopy performed by otolaryngologists with various degrees of experience .


Patient discomfort was reported using visual analog scores , and willingness to repeat the experience was also recorded .


Statistical analysis showed that greater pain was significantly associated with female patients and female otolaryngologists , whereas the pain was less severe in the cases of experienced laryngologists and older patients .


Pain plays an important role in determining the willingness to repeat the examination ; in fact , patients who experienced lower levels of pain during laryngoscopy were more prone to repeat the experience .


This article explores the importance of the extrinsic factors that are related to the patient and the otolaryngologist in determining the level of pain associated with laryngoscopy .


Our study indicated that laryngoscopy is generally a well-tolerated procedure , causing little overall discomfort , but that a subgroup of patients may experience more pain than others , which may affect the patient 's perspective toward undergoing a similar future experience .


Our analysis may be helpful for clinicians in understanding pain perception during a routine procedure , enabling them to focus more on that subgroup of patients who are more prone to pain .


The efficacy and safety of sublingual immunotherapy in house dust mite-induced asthma have yet to be firmly established .


We report the results of a double-blind , placebo-controlled , randomized clinical trial performed in mainland China .


After a three-month baseline period , @ asthmatic adults were randomized @:@ to @months of daily treatment with either an aqueous , standardized , @ index of reactivity mixture of Dermatophagoides pteronyssinus and Dermatophagoides farinae extracts or a placebo .


The primary efficacy criterion was well-controlled asthma for at least @ of the last @weeks of treatment .


In the active ( n = @ ) and placebo ( n = @ ) groups , well-controlled asthma was achieved by @ % and @ % of the patients , respectively ( P = @ ) .


A subsequent post hoc analysis by asthma severity revealed significant clinical benefits in actively treated subjects with moderate , persistent asthma at baseline -LSB- @-@g budesonide/day ( n = @ ) -RSB- , with greater achievement of well-controlled asthma ( @ % and @ % for the active treatment and placebo groups , respectively ; P = @ ) and totally controlled asthma ( @ % and @ % , respectively , P = @ ) , a higher percentage of patients with an asthma control questionnaire score < @ ( @ % and @ % , respectively ; P = @ ) and a greater mean reduction in inhaled corticosteroid use ( @ g and @ g , respectively ; P = @ ) .


The active vs placebo differences in disease control and corticosteroid use were not significant for mild , persistent asthma .


No treatment-related serious adverse events were reported .


Sublingual mite allergen immunotherapy was well tolerated in adult asthmatics and effectively controlled disease in patients with moderate ( but not mild ) persistent asthma ( ClinicalTrials.gov : NCT@ ) .


The high prevalence and incidence of obesity and eating disorders in US adolescent girls are serious health problems .


Because of the shared risk factors for obesity and eating disorders , a targeted prevention of both conditions is a priority .


We determined whether an adapted interpersonal psychotherapy prevention program is more efficacious for reducing excess weight gain and worsening disordered eating than health education in adolescent girls at high risk of obesity and eating disorders .


A parallel-group , randomized controlled trial was conducted between September @ and January @ in a university-based laboratory and a federal research hospital .


The study included @ adolescent ( @-@-y-old ) girls deemed at high risk of adult obesity and eating disorders because of a body mass index ( BMI ) between the @th and @th percentiles and reports of episodes of a loss of control over their eating .


Girls were randomly assigned to participate in an adapted interpersonal psychotherapy or a health-education group program for @ weekly @-min group sessions .


Follow-up assessments occurred immediately after group programs and at @ and @ mo. .


Participation in both conditions was associated with decreases in expected BMI gain , age-adjusted BMI metrics , the percentage of fat by using dual-energy X-ray absorptiometry , symptoms of depression and anxiety , and the frequency of loss-of-control eating over @ mo of follow-up ( Ps < @ ) with no group difference .


In follow-up analyses , interpersonal psychotherapy was more efficacious than health education at reducing objective binge eating at the @-mo follow-up ( P < @ ) .


The intervention with adolescent girls with loss-of-control eating is associated with lower age-adjusted BMI and percentage of adiposity as well as improved mood symptoms over @ y. Interpersonal psychotherapy further reduced objective binge eating .


Additional research is needed to elucidate the mechanisms by which physical and psychological improvements were observed .


This trial was registered at clinicaltrials.gov as NCT@ .


Conservative orthotic treatments rely on different mechanisms , such as three-point bending systems or hinges forcing external rotation of the leg and knee stabilization , to alter the biomechanics of the lower limbs and thus reduce knee loading on the affected compartment in patients with knee osteoarthritis ( KOA ) .


No previous study had compared the effects of these mechanisms on external loading and leg kinematics in patients with KOA .


Twenty-four patients with medial KOA ( Kellgren-Lawrence grade II or III ) wore three custom knee braces : a valgus brace with a three-point bending system ( V@P-brace ) , an unloader brace with valgus and external rotation functions ( VER-brace ) and a functional knee brace used in ligament injuries ( ACL-brace ) .


Pain relief , comfort , lower extremity kinematics and kinetics during walking were compared with and without each knee brace .


Knee pain was alleviated with all three braces ( p < @ ) .


The VER - and ACL-braces allowed a significant reduction in peak knee adduction moment ( KAM ) during terminal stance from @ to @ Nm/BwHt ( p < @ ) and @ to @ ( p < @ ) , respectively , while no significant reduction was observed with the V@P-brace ( p = @ ) .


Reduced knee adduction and lower ankle and knee external rotation were observed with the V@P-brace but not with the VER-brace .


The ACL-brace did not modify lower limb kinematics .


No difference between the knee braces was found for pain reduction , discomfort or KAM .


The VER-brace was slightly more comfortable , which could ensure better compliance with treatment over the long term .


Preoperative oral carbohydrate ( CHO ) drink may improve patients ' comfort .


However , whether it prevents or reduces postoperative nausea and vomiting ( PONV ) is questionable .


Evaluate the effect of oral rehydration with @ % CHO drink before anesthesia on incidence and severity of postoperative nausea and vomiting ( PONV ) after spinal morphine injection .


One hundred patients scheduled for unilateral total knee replacement ( TKR ) were randomly divided into two equal groups ( n = @ each ) .


Group I patients received @ ml @ % CHO drink the preoperative night and @-hour before anesthesia , whereas Group II patients served as control .


Spinal anesthesia for all patients contained @ % bupivacaine @ to @ ml plus morphine @ mg .


Pain therapy was standardized with femoral nerve block , local infiltration , intravenous parecoxib , and oral paracetamol .


Incidence and severity of PONV within @ hours were recorded In addition , preoperative intensity of thirst and hunger , dry lips and throat , and anxiety was also recorded


Incidence and severity of PONV ( @ % vs. @ % , p = @ ) as well as preoperative thirst , hunger dry lips , and throat were not different between the groups .


Preoperative oral rehydration with carbohydrate drinks had no positive effect on PONV nor patients ' comfort .


Vitamin D is hypothesized to have some roles in innate and adaptive immunity , inflammation reduction , and remodeling ; therefore , it is supposed to affect the asthma phenotype , severity , and response to inhaled corticosteroid ( ICS ) .


To explore the synergistic effects of vitamin D supplementation in addition to asthma controllers ( ICS or ICS plus long-acting - agonist ) on airway functions .


A randomized clinical trial was conducted in @ individuals aged @ to @ years who lived in Tehran during a @-week period .


Data on age , sex , body mass index , stage of asthma , serum total IgE , history of allergic rhinitis , atopic dermatitis , food allergy , and urticaria were collected .


Spirometric parameters ( forced expiratory volume in @ second -LSB- FEV@ -RSB- and ratio of FEV@ to forced vital capacity ) and serum vitamin D measurement were obtained before and @ and @ weeks after the intervention .


Patients were divided in @ groups randomly .


Both groups received asthma controllers ( budesonide or budesonide plus formoterol ) according to their stage , but the intervention group received vitamin D supplementation ( @,@-U bolus intramuscularly plus @,@ U orally weekly ) in addition to asthma controllers .


FEV@ improved significantly in both groups after @ weeks , but no significant difference was found between the @ groups at baseline ( P = @ ) or after @ weeks ( P = @ ) ; however , a significant improvement was seen in the intervention group in the last @ weeks , and FEV@ was significantly better in the intervention group than the other group after @ weeks ( P < @ ) .


Vitamin D supplementation associated with asthma controllers could significantly improve FEV@ in mild to moderate persistent asthma after @ weeks .


We report the first-in-human safety and immunogenicity assessment of a prototype hexon chimeric adenovirus ( Ad ) serotype @ ( Ad@ ) vector containing the hexon hypervariable regions of Ad serotype @ ( Ad@ ) and expressing human immunodeficiency virus ( HIV ) type @ EnvA .


Forty-eight Ad@ and Ad@ seronegative , HIV-uninfected subjects were enrolled in a randomized , double-blind , placebo-controlled , dose escalation phase @ study .


Four groups of @ subjects received @ ( @ ) to @ ( @ ) viral particles ( vp ) of the Ad@HVR@.EnvA @ vaccine ( n = @ per group ) or placebo ( n = @ per group ) at week @ or weeks @ , @ , and @ .


Safety and immunogenicity were assessed .


Self-limited reactogenicity was observed after the initial immunization in the highest ( @ ( @ ) vp ) dose group .


Responses in vaccinees included Ad@ neutralizing antibody ( nAb ) titers higher than Ad@ nAb titers , EnvA-specific enzyme-linked immunosorbent assay titers , and EnvA-specific enzyme-linked immunospot assay responses , and these responses generally persisted at week @ .


At week @ in the @ ( @ ) , @ ( @ ) , and @ ( @ ) vp @-dose groups , geometric mean EnvA enzyme-linked immunosorbent assay titers were @ , @ @ , and @ , respectively , and Ad@ nAb titers were a median of @-fold higher than for Ad@ .


Ad@HVR@.ENVA @ was safe , well tolerated , and immunogenic at all doses tested .


Vector-elicited nAb responses were greater for Ad@ than Ad@ , confirming that Ad-specific nAbs in humans are primarily , but not exclusively , directed against the hexon hypervariable regions .


Clinical Trials Registration.NCT@ .


This study compared two methods of expanding the uterine incision at the time of cesarean delivery , which is associated with the risk of unintended extension .


This randomized trial included @,@ women who underwent elective cesarean delivery .


The primary outcome measure was the incidence of unintended extension related to the method used for expanding the uterine incision .


Participants in both groups ( blunt vs. sharp ) had similar demographic and clinical characteristics .


The incidence of unintended extension ( @ % vs. @ % ; p = @ ) , mean estimated blood loss ( @ @ mL vs. @ @ mL ; p = @ ) , and blood loss > @ mL ( @ % vs. @ % ; p = @ ) was significantly higher in the sharp group compared with the blunt group .


No difference in transfusions ( @ % vs. @ % ; p = @ ) or the need for additional supertonic agents ( @ % vs. @ % ; p = @ ) was noted .


Sharp expansion of the uterine incision was related to a higher risk of unintended extension and maternal blood loss .


Because blunt expansion is associated with a lower risk for unintended extension and maternal blood loss , it should be the first option during elective cesarean delivery .


There is limited available information for treatment of acute coronary syndrome ( ACS ) with respect to outcomes , therapeutic agents and treatment practices .


Our retrospective registry study collected and evaluated varying anti-platelet treatment strategies and outcomes of ACS patients who were admitted to @ different tertiary care hospitals in India .


This study was carried out to provide an insight to anti-platelet treatment patterns and analyze outcomes of ACS patients in India .


All the relevant data , including anti-platelet treatment strategies , outcomes and patient treatment compliance were collected from @ ACS ( defined as STEMI , NSTEMI and unstable angina -LSB- UA -RSB- ) cases from January @ to December @ .


These ACS cases were randomly collected from the hospital records and included in the analysis .


The patient follow up data was acquired either from the hospital records or via telephonic contact for a period of one year following the event .


Out of @ ACS patients , @ % had UA/NSTEMI and @ % had STEMI .


On hospital admission , aspirin , clopidogrel , statins , beta-blockers and angiotensin converting enzyme inhibitors ( ACE-Is ) were used by @ % , @ % , @ % , @ % and @ % patients , respectively .


On discharge , aspirin , clopidogrel , statins and beta-blockers were used by @ % , @ % , @ % , and @ % patients , respectively .


The average patient compliance to statins , clopidogrel and aspirin was recorded as @ % , @ % and @ % , respectively during discharge and follow-up visits .


Greater than @ % of ACS patients after discharge were lost to follow-up and as a result there was significant drop in the number of clinical events reported .


This pilot study conducted in tertiary care centers in India showed that patients with ACS were more often diagnosed with UA/NSTEMI as compared to STEMI and reported maximum compliance to statins , clopidogrel and aspirin after discharge over @ year follow-up .


More ACS patients were lost to follow up that resulted in low reporting of clinical outcomes , following discharge upto @ year .


To our knowledge , there is no evidence to support the use of local infiltration analgesia ( LIA ) for postoperative pain relief after periacetabular osteotomy ( PAO ) .


We investigated the effect of wound infiltration with a long-acting local anesthetic ( ropivacaine ) for postoperative analgesia after PAO .


We performed a randomized , double-blind , placebo-controlled trial ( ClinicalTrials.gov : NCT@ ) in @ patients undergoing PAO to evaluate the effect of local anesthetic infiltration on postoperative pain and on postoperative opioid consumption .


All subjects received intraoperative infiltration followed by @ postoperative injections in @-hour intervals through a multi-holed catheter placed at the surgical site .


@ patients received ropivacaine and @ received saline .


The intervention period was @ days and the observational period was @ days .


All subjects received patient-controlled opioid analgesia without any restrictions on the total daily dose .


Pain was assessed at specific postoperative time points and the daily opioid usage was registered .


Infiltration with @ mL ( @ mg ) of ropivacaine did not reduce postoperative pain or opioid requirements during the first @ days .


The clinical importance of ropivacaine as single component in postoperative treatment of pain is questionable , and we are planning further studies to explore the potential of LIA in larger volume-and also a multimodal regimen-to treat pain in this category of patients .


Patients with Becker muscular dystrophy ( BMD ) and Duchenne muscular dystrophy lack neuronal nitric oxide synthase ( nNOS ) .


nNOS mediates physiological sympatholysis , thus ensuring adequate blood supply to working muscle .


In mice lacking dystrophin , restoration of nNOS effects by a phosphodiesterase @ ( PDE@ ) inhibitor ( sildenafil ) improves skeletal and cardiac muscle performance .


Sildenafil also improves blood flow in patients with BMD .


We therefore hypothesized that sildenafil would improve blood flow , maximal work capacity , and heart function in patients with BMD .


A randomized , double-blind , placebo-controlled crossover design with two @-week periods of treatment , separated by @-week washout was used .


We assessed brachial artery blood flow during maximal handgrip exercise , @-minute walk test , maximal oxidative capacity , and life quality ; cardiac function was evaluated by magnetic resonance imaging ( MRI ) at rest and during maximal handgrip exercise .


Muscle nNOS and PDE@ were tested with Western blotting in @ patients .


Sixteen patients completed all skeletal muscle evaluations , and @ completed the cardiac MRI investigations .


Sildenafil had no effect on any of the outcome parameters .


No serious adverse effects were recorded .


PDE@ and nNOS were deficient in @ of @ biopsies .


Despite positive evidence from animal models of dystrophinopathy and physiological findings in patients with BMD , this double-blind , placebo-controlled clinical study showed no effect of sildenafil on blood flow , maximal work capacity , and heart function in adults with BMD .


This discrepancy may be explained by a significant downregulation of PDE@ in muscle .


Contrast-induced nephropathy ( CIN ) is an important complication in the use of iodinated contrast media .


The present study aimed to assess the safety and efficacy of prostaglandin E@ ( PGE@ ) in prevention of CIN in patients with high-risk factors undergoing percutaneous coronary intervention ( PCI ) .


The study group consisted of @ patients who had undergone a coronary intervention procedure between January @ , @ and October @ , @ .


Study participants were randomly assigned to either the PGE@ group ( @ patients ) or the control group ( @ patients ) .


Patients in the PGE@ group received PGE@ intravenous infusion of @ ng/kg/min for @ h before and after the administration of contrast media .


The control group received @ % sodium chloride solution for routine hydration only .


A nonionic , low-osmolality contrast agent was used in our laboratory at this time .


Serum creatinine ( Scr ) values and estimated glomerular filtration rate were measured before and within @ h of the administration of contrast agents .


CIN was defined as an increase of @ mg/dL or a @ % increase in Scr concentrations over baseline within @ h of angiography .


The amount of contrast agent administered was similar for the PGE@ and control groups ( @ @ vs. @ @ mL , P > @ ) .


The incidence of CIN was lower in the PGE@ group than in the control group ( @ vs. @ % , P < @ ) .


No serious adverse effects were observed .


In patients with high-risk factors undergoing PCI , the use of PGE@ for prevention of CIN is safe and efficacious .


To explore the efficacy and the reproductive endocrinal mechanism of herbal-partitioned moxibustion in the treatment of primary dysmenorrhea .


One hundred and seventy-one cases of primary dysmenorrhea were randomized into an herbal-partitioned moxibustion group ( group A ) , an starch-partitioned moxibustion group ( group B ) and an acupuncture group ( group C ) , @ cases in each one .


In the group A , moxibustion isolated with herbal medicine was applied to Shenque ( CV @ ) .


In the group B , moxibustion isolated with starch was used at Shenque ( CV @ ) .


In the group C , acupuncture was given at Sanyinjiao ( SP @ ) .


The changes of estradiol ( E@ ) , progesterone ( P ) and prostaglandin levels ( PGF@alpha ) were observed before and after treatment , and the therapeutic effects were compared among the @ groups .


The therapeutic effect in the group A was better than those in the other two groups -LSB- compared the cured rate : @ % ( @/@ ) vs @ % ( @/@ ) , @ % ( @/@ ) , both P < @ -RSB- .


In the group A , E@ level -LSB- ( @ + / - @ ) pg/mL vs ( @ + / - @ ) pg/mL , P < @ -RSB- and PGF@alpha level -LSB- ( @ + / - @ ) pg/mL vs ( @ + / - @ ) pg/mL , P < @ -RSB- were decreased and P level was increased -LSB- ( @ + / - @ ) ng/mL vs ( @ + / - @ ) pg/mL , P < @ -RSB- .


In the group B and C , PGF@alpha level were reduced .


Concerning to the regulating of E@ and PGF@alpha levels , the results in the group A were better than those in the group B and C -LSB- ( -@ + / - @ ) pg/mL vs ( @ + / - @ ) pg/mL , ( @ + / - @ ) pg/mL ; ( -@ + / - @ ) pg/mL vs ( -@ + / - @ ) pg/mL , ( -@ + / - @ ) pg/mL , ( see text ) P < @ -RSB- .


Concerning to the regulation of P level , the results in the group A and B were better than that in the group C ( all P < @ ) .


The herbal-partitioned moxibustion achieves the significant efficacy on primary dysmenorrhea , which could be related to regulating the reproductive endocrinal level .


It decreases E@ and PGF@alpha levels and increases P level .


To determine if using freshest available rather than standard-issue red blood cells ( RBCs ) can reduce mortality in critically ill intensive care unit patients .


Our study is the largest ongoing randomised controlled trial ( RCT ) of RBC age in critically ill patients and will help determine if the use of the freshest available RBCs should become standard policy for the critically ill .


A double-blind , multicentre , Phase III RCT of @ adult ICU patients in Australia , New Zealand , Europe and the Middle East .


Transfusion of the freshest available RBCs in place of standard-care RBCs until hospital discharge .


The primary outcome measure is @-day all-cause mortality .


Secondary outcome measures are time to death , @-day and @-day mortality , persistent organ dysfunction combined with death , days alive and free of mechanical ventilation and renal replacement therapy , bloodstream infection in the ICU , length of stay in the ICU and in hospital , proportion of patients with febrile non-haemolytic transfusion reactions , and quality of life at Day @ .


A detailed statistical analysis plan with predefined subgroups and secondary analyses has been finalised before results being available , to ensure an unbiased final analysis .


The pragmatic protocol design has been chosen to facilitate translation of the trial results into practice .


The TRANSFUSE trial will have important clinical and policy implications , regardless of the outcome .


To investigate whether acute total sleep deprivation ( TSD ) leads to decreased cognitive control when food cues are presented during a task requiring active attention , by assessing the ability to cognitively inhibit prepotent responses .


Fourteen males participated in the study on two separate occasions in a randomized , crossover within-subject design : one night of TSD versus normal sleep ( @ hours ) .


Following each nighttime intervention , hunger ratings and morning fasting plasma glucose concentrations were assessed before performing a go/no-go task .


Following TSD , participants made significantly more commission errors when they were presented `` no-go '' food words in the go/no-go task , as compared with their performance following sleep ( +@ % ; P < @ ) .


In contrast , response time and omission errors to `` go '' non-food words did not differ between the conditions .


Self-reported hunger after TSD was increased without changes in fasting plasma glucose .


The increase in hunger did not correlate with the TSD-induced commission errors .


Our results suggest that TSD impairs cognitive control also in response to food stimuli in healthy young men .


Whether such loss of inhibition or impulsiveness is food cue-specific as seen in obesity-thus providing a mechanism through which sleep disturbances may promote obesity development-warrants further investigation .


Our objective was to demonstrate the effects of platelet-rich fibrin ( PRF ) for the healing of acute ear drum perforation .


Thirty-two patients with acute traumatic ear drum perforations were randomly separated into @ groups .


In group @ ( n = @ ) , PRF was used for the repair of ear drum perforation ; in group @ ( n = @ ) , we did not make any intervention .


At initial inspection , perforation sizes were measured as @ @ mm in group @ and @ @ mm in group @ .


After @ month , perforation sizes were @ @ mm in group @ and @ @ mm in group @ ( P < @ ) .


In the study group , the rate of ear drum closure was @ % and in the control group it was @ % ( P < @ ) .


Here we found that PRF is a biomaterial that quickens the healing of ear drum which is autogenous and simply prepared .


To investigate the effectiveness of educational poster on improving secondary school students ' knowledge of emergency management of dental trauma .


A cluster randomised controlled trial was conducted .


@ schools with total @ secondary students who can read Chinese or English were randomised into intervention ( poster , @ schools , @ students ) and control groups ( @ schools , @ students ) at the school level .


Baseline knowledge of dental trauma was obtained by a questionnaire .


Poster containing information of dental trauma management was displayed in a classroom for @ weeks in each school in the intervention group whereas in the control group there was no display of such posters .


Students of both groups completed the same questionnaire after @ weeks .


Two-week display of posters improved the knowledge score by @ ( p-value = @ ) on average .


Educational poster on dental trauma management significantly improved the level of knowledge of secondary school students in Hong Kong .


To describe the design , methods , and challenges encountered during a randomized clinical trial aimed to promote water intake for reducing risks of metabolic syndrome in Mexican women .


In a randomized clinical trial in Cuernavaca , Mexico , overweight and obese ( body mass index -LSB- BMI -RSB- @ < @ ) women , @ - < @ years old with an intake of sugar-sweetened beverages @ kilocalories per day ( kcal/day ) were randomly allocated to the water and education provision group ( n = @ ) or the education provision only group ( n = @ ) .


We screened @ @ women .


The main difficulties encountered were identifying participants with the recruitment criteria , delivering water to participants , and the time demanded from the study participants .


The trial 's main challenges were difficulties surrounding recruitment , delivery of the intervention , and the time demanded from the study participants .


Modifications were effectively implemented without jeopardizing the original protocol .


Early decompressive hemicraniectomy reduces mortality without increasing the risk of very severe disability among patients @ years of age or younger with complete or subtotal space-occupying middle-cerebral-artery infarction .


Its benefit in older patients is uncertain .


We randomly assigned @ patients @ years of age or older ( median , @ years ; range , @ to @ ) with malignant middle-cerebral-artery infarction to either conservative treatment in the intensive care unit ( the control group ) or hemicraniectomy ( the hemicraniectomy group ) ; assignments were made within @ hours after the onset of symptoms .


The primary end point was survival without severe disability ( defined by a score of @ to @ on the modified Rankin scale , which ranges from @ -LSB- no symptoms -RSB- to @ -LSB- death -RSB- ) @ months after randomization .


Hemicraniectomy improved the primary outcome ; the proportion of patients who survived without severe disability was @ % in the hemicraniectomy group , as compared with @ % in the control group ( odds ratio , @ ; @ % confidence interval , @ to @ ; P = @ ) .


This difference resulted from lower mortality in the surgery group ( @ % vs. @ % ) .


No patients had a modified Rankin scale score of @ to @ ( survival with no disability or slight disability ) ; @ % of patients in the surgery group and @ % of patients in the control group had a score of @ ( moderate disability ) ; @ % and @ % , respectively , had a score of @ ( moderately severe disability -LSB- requirement for assistance with most bodily needs -RSB- ) ; and @ % and @ % , respectively , had a score of @ ( severe disability ) .


Infections were more frequent in the hemicraniectomy group , and herniation was more frequent in the control group .


Hemicraniectomy increased survival without severe disability among patients @ years of age or older with a malignant middle-cerebral-artery infarction .


The majority of survivors required assistance with most bodily needs .


( Funded by the Deutsche Forschungsgemeinschaft ; DESTINY II Current Controlled Trials number , ISRCTN@ . )


To observe the clinical efficacy of tetrandrine combined with acetylcysteine effervescent tablets in the treatment of silicosis .


A total of @ patients with silicosis were randomly divided into treatment group ( @ cases ) and control group ( @ cases ) .


Both groups were given routine therapy including anti-inflammatory , antitussive , and antiasthmatic drugs , and the patients in treatment group were given tetrandrine combined with acetylcysteine effervescent tablets at the same time .


Tetrandrine ( @ mg ) was orally administrated twice a day , and there was a one-day interval between every @ days ' continuous administration ; totally , there were four courses of treatment , with @ months for each course , and there was a one-month break between each course .


Acetylcysteine effervescent tablets ( @ mg ) were taken twice a day ; each course of treatment was @ days , and there were four courses ; for the first two months , there was one course per month , and then one course every other two months for the rest of time .


Clinical symptoms , pulmonary ventilation function , serum superoxide dismutase ( SOD ) and changes in X-ray findings were observed .


After treatment , the treatment group had significantly increased rates of improvements in cough , expectoration , chest congestion and pain , and dyspnea compared with the control group ( P < @ ) .


Compared with the control group ( serum SOD level : @ U/ml ) and the treatment group before therapy ( serum SOD level : @ U/ml ) , the treatment group after therapy had significantly increased serum SOD level ( @ U/ml ?


, forced vital capacity , and forced expiratory volume in one second ( P < @ ) .


Eight patients in treatment group showed improvement in the chest X-ray findings of silicosis .


The combination of tetrandrine and acetylcysteine effervescent tablets show some effect in the treatment of silicosis .


It can be an effective option for treating silicosis as there are no other specific remedies .


Chronic subdural hematoma ( cSDH ) is a common neurosurgical disease .


It is often considered to be a rather benign entity .


In spite of well established surgical procedures cSDH is complicated by a recurrence rate up to @ % .


Since glucocorticoids have been used for treatment of cSDH in @ their role is still discussed controversially in lack of evident data .


On the basis of the ascertained inflammation cycle in cSDH dexamethasone will be an ideal substance for a short lasting , concomitant treatment protocol .


to test the efficacy of dexamethasone on reduction inthe reoperation rate of cSDH .


The study is designed as a double-blind randomized placebo-controlled trial @ patients who are operated for cSDH and from the age of @ years are included after obtaining informed consent .


They are randomized for administration of dexamethasone ( @-@-@-@-@-@mg / d ) or placebo ( maltodextrin ) during the first @ hours after surgery .


The type I error is @ % and the type II error is @ % .


The primary endpoint is the reoperation within @ weeks postoperative .


This study tests whether dexamethasone administered over @ days is a safe and potent agent in relapse prevention for evacuated cSDH .


In this randomized , placebo-controlled clinical trial , we investigated the effect of noninvasive extracorporeal shock waves on the stability of temporary anchorage devices ( TADs ) under orthodontic loading .


Thirty adult orthodontic patients of the Bernhard Gottlieb University Clinic in Vienna , Austria , were enrolled in this clinical trial and allocated by block randomization ( size , @ ) in a @:@ ratio to either the treatment or the placebo group .


Randomization was performed with software , and the allocations were concealed in sealed envelopes .


Eligibility criteria included healthy adult patients with mesially directed orthodontic movement of the mandibular second molar into the extraction site of the mandibular first molar .


The fixed orthodontic devices included active superelastic coil springs ( @cN ) and TADs in the mandibular alveolar bone .


Blinding was performed for the subjects and the outcome assessor .


The treatment group received @ shock-wave application with @ impulses at @ to @ mJ per square millimeter in the region of the TADs .


The placebo group was treated with a deactivated shock-wave applicator and acoustic sham .


The TADs positions were evaluated at placement and after @months .


The reliability and precision of the impression process of the TADs were evaluated in an in-vitro model .


Thirteen participants finished the investigation successfully in the treatment group but only @ finished in the placebo group because @ TAD loosened .


The difference of the total TAD displacement for the @-month time period between the placebo and treatment groups was @ mm ( @ % CI : -@ , @ ) .


No statistically significant difference between the @ groups was found when sex was evaluated .


Primary stability of the TADs as measured by placement torque , amount of tooth movement , and age of the patients did not influence displacement of the TADs .


The reliability and precision of TAD impressions were confirmed .


No unintended pernicious effects occurred after shock-wave treatment during the study period .


A single application of extracorporeal shock-wave treatment did not improve the stability of the TADs during orthodontic loading .


Sufficient interradicular space should be provided to minimize the risk of periodontal and dental root defects .


This trial was registered at https://clinicaltrials.gov .


The protocol was published before trial commencement , NCT@ .


To investigate the reliability and agreement of measures of lower extremity muscle strength , power and functional performance in patients with hip osteoarthritis at different time intervals , and to compare these with the same measures in healthy peers .


Intra-rater test-retest separated by @ , @ , or @ weeks in patients , and @ week in healthy peers .


Patients with hip osteoarthritis ( age range @-@ years ) with @ ( n = @ ) , @ ( n = @ ) , or @ weeks ( n = @ ) between tests , and @ healthy peers ( age range @-@ years ) .


Maximal isometric hip and thigh strength , leg extensor power , and functional performance ( @-foot Up & Go , stair climbing , chair stand and @-min walk ) were measured in patients , and quadriceps strength , leg extensor power and functional performance were measured in healthy peers .


Systematic error , reliability and agreement were calculated .


Most hip strength measurements for the most symptomatic extremity , and nearly all strength measurements for the least symptomatic lower extremity , declined after @ week ( p < @ ) , but not after a @-week interval .


In healthy peers , quadriceps strength was unchanged .


Regardless of the time interval , leg extensor power was unchanged , while functional performances improved at retest for all participants .


In patients with hip osteoarthritis leg extensor power is unaffected by the time interval between tests , in contrast to muscle strength and functional performance .


To observe the efficacy and the influence on quality of life ( QOL ) of syndrome differentiation treatment with Chinese medicine ( CM ) for opioid-induced constipation as well as the safety and influence on analgesic effect of opioids .


Totally @ cases enrolled from @ collaborating medical centers were randomly assigned to a CM group and a control group .


The CM group were treated with CM decoction based on syndrome differentiation , and the control group were treated with Phenolphthalein Tablet .


Both groups were treated for @ days .


Cleveland constipation score ( CCS ) , numerical rating scale ( NRS ) of pain and Chinese version of European Organisation for Research and Treatment of Cancer , Quality of Life Questionnaire-C@ V@ @ ( EORTC QLQ-C@ V@ @ ) were used to evaluate the efficacy , pain controlled and QOL status .


The comparisons of CCS score reduction and QOL between the two groups after treatment suggested that the improvements of constipation and QOL in the CM group were better than that in the control group ( P < @ ) .


The total efficiency of the CM group was better than the control group ( @ % vs. @ % , P < @ ) .


There was no significant difference in NRS scores between before and after treatment in both groups .


There was no serious drug-related adverse event during the course of study .