In the present study , it was established that alkalinization of prilocaine had no effect on the duration of sensory block and it prolonged the duration of motor block , increased patients ' satisfaction , and decreased tourniquet pain .


It is our suggestion that future studies should be carried out on the issue by using different volumes .


African Americans ( AAs ) experience higher age-adjusted morbidity and mortality than Whites for cardiovascular disease ( CVD ) .


Church-based health programs can reduce risk factors for CVD , including elevated blood pressure -LSB- BP -RSB- , excess body weight , sedentary lifestyle and diet .


Yet few studies have incorporated older adults and longitudinal designs .


The aims of this study are to : a ) describe a theory-driven longitudinal intervention study to reduce CVD risk in mid-life and older AAs ; b ) compare selected dietary ( fruit and vegetable servings/day , fat consumption ) , physical activity ( PA ) and clinical variables ( BMI , girth circumferences , systolic and diastolic BP , LDL , HDL , total cholesterol -LSB- CHOL -RSB- and HDL/CHOL ) between treatment and comparison churches at baseline ; c ) identify selected background characteristics ( life satisfaction , social support , age , gender , educational level , marital status , living arrangement and medication use ) at baseline that may confound results ; and d ) share the lessons learned .


This study incorporated a longitudinal pre/post with comparison group quasi-experimental design .


Community-based participatory research ( CBPR ) was used to discover ideas for the study , identify community advisors , recruit churches ( three treatment , three comparison ) in two-counties in North Florida , and randomly select @ mid-life and older AAs ( @ + ) ( n = @ in clinical subsample ) , stratifying for age and gender .


Data were collected through self-report questionnaires and clinical assessments .


Dietary , PA and clinical results were similar to the literature .


Treatment and comparison groups were similar in background characteristics and health behaviors but differed in selected clinical factors .


For the total sample , relationships were noted for most of the background characteristics .


Lessons learned focused on community relationships and participant recruitment .


Echocardiography-guided ( EG ) left ventricular ( LV ) lead placement at the site of latest mechanical activation improves outcome in heart failure ( HF ) patients receiving a cardiac resynchronization therapy ( CRT ) - defibrillator ( CRT-D ) .


The purpose of this study was to examine the effect of a strategy of EG LV lead placement in each of ischemic ( ICM ) vs nonischemic ( NICM ) cardiomyopathy patients .


Patients enrolled in the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region ( STARTER ) prospective , randomized trial who were treated with a CRT-D device ( @ EG strategy and @ routine strategy ) were followed to the end-points of death , appropriate CRT-D therapy , or HF hospitalization .


Of the patients enrolled in STARTER , @ had ICM and @ had NICM .


Over mean follow-up of @ @ years , @ patients died , @ received appropriate CRT-D therapy , and @ had HF hospitalizations .


Compared to NICM patients , patients with ICM had worse survival ( P = @ ) , worse survival free from implantable cardioverter-defibrillator therapy ( P = @ ) , and survival free from HF hospitalization ( P = @ ) .


A strategy of EG LV lead placement improved the outcome of CRT-D therapy-free survival primarily in ICM patients and the outcome of HF hospitalization-free survival in both ICM and NICM patients .


Achieving LV resynchronization was most critical in ICM patients in whom arrhythmic and HF outcomes improve with resynchronization to levels comparable to those of NICM patients .


A strategy of EG LV lead placement improves HF-free survival equally in ICM and NICM patients and CRT-D therapy-free survival more favorably in ICM patients to levels comparable to those of NICM patients .


Determine the efficacy of @ brief intervention strategies that address heavy drinking among injured patients .


The content or structure of brief interventions most effective at reducing alcohol misuse after traumatic injury is not known .


Injured patients from @ trauma centers were screened for heavy drinking and randomly assigned to brief advice ( n = @ ) , brief motivational intervention ( BMI ) ( n = @ ) , or BMI plus a telephone booster using personalized feedback or BMI + B ( n = @ ) .


Among those randomly assigned , @ % met criteria for moderate to severe alcohol problems .


The primary drinking outcomes were assessed at @ , @ , and @ months .


Compared with brief advice and BMI , BMI + B showed significant reductions in the number of standard drinks consumed per week at @ ( adjusted means : -@ , @ % confidence interval -LSB- CI -RSB- : -@ , approximately -@ , P = @ ) and @ months ( adjusted means : -@ , @ % CI : -@ , approximately -@ , P = @ ) , percent days of heavy drinking at @ months ( adjusted means : -@ , @ % CI : -@ , approximately -@ , P = @ ) , maximum number of standard drinks consumed in @ day at @ ( adjusted means : -@ , @ % CI : -@ , approximately -@ , P = @ ) and @ months ( adjusted means : -@ , @ % CI : -@ , approximately -@ , P = @ ) , and number of standard drinks consumed per drinking day at @ ( adjusted means : -@ , @ % CI : -@ , approximately -@ , P = @ ) and @ months ( adjusted means : -@ , @ % CI : -@ , approximately -@ , P = @ ) .


Brief interventions based on motivational interviewing with a telephone booster using personalized feedback were most effective at achieving reductions in alcohol intake across the @ trauma centers .


The optimal treatment for displaced intra-articular fractures of the calcaneus remains controversial .


This study aims to assess the clinical outcomes of a minimally invasive longitudinal approach compared with the sinus tarsi approach in the surgical treatment of these fractures .


Patients with a displaced intra-articular fracture of the calcaneus who were admitted to the trauma center of our hospital from September @ through April @ were randomly assigned to treatment using one of these two surgical techniques .


All patients underwent the same standardized postoperative rehabilitation protocol .


Functional outcome was assessed by using the American Orthopaedic Foot & Ankle Society scores .


Linear regression analysis was performed to identify the potential influencing factors for functional outcomes .


One hundred and sixty-seven patients who met the inclusion criteria were included in the study .


Thirty-seven patients were lost to follow-up for various reasons , and the remaining @ patients were followed for an average of twenty-seven months .


Sixty-nine fractures in sixty-three patients were treated using a minimally invasive longitudinal approach ( the MILA group ) , and seventy-two feet in sixty-seven patients were treated with a sinus tarsi approach ( the STA group ) .


The two groups were comparable in terms of age , sex , fracture type , and time from injury to operation .


The operative time in the MILA group was significantly shorter than that in STA group ( p < @ ) .


Wound-healing complications were @ % in the MILA group and @ % in the STA group .


The average time to the start of progressive weight-bearing exercise was @ weeks in the MILA group and @ weeks in the STA group ( p > @ ) .


The good and excellent results in the two groups were comparable for the Sanders type-II and III calcaneal fractures ( p > @ ) , but the good to excellent rate in the STA group was significantly higher for the Sanders type-IV fractures ( p < @ ) .


Linear regression analysis showed that surgical technique , Sanders classification , and the time to the start of weight-bearing activity have a significant influence on functional outcomes .


Outcomes are similar for the minimally invasive longitudinal and sinus tarsi surgical approaches in the treatment of Sanders type-II and III displaced intra-articular fractures of the calcaneus , with the benefit of a lower complication rate and shorter operative time for the minimally invasive technique .


For Sanders type-IV fractures , however , the sinus tarsi approach appears to be the treatment of choice .


The BOLERO-@ study previously demonstrated that adding everolimus ( EVE ) to exemestane ( EXE ) significantly improved progression-free survival ( PFS ) by more than twofold in patients with hormone-receptor-positive ( HR ( + ) ) , HER@-negative advanced breast cancer that recurred or progressed during/after treatment with nonsteroidal aromatase inhibitors ( NSAIs ) .


The overall survival ( OS ) analysis is presented here .


BOLERO-@ is a phase III , double-blind , randomized international trial comparing EVE @ mg/day plus EXE @ mg/day versus placebo ( PBO ) + EXE @ mg/day in postmenopausal women with HR ( + ) advanced breast cancer with prior exposure to NSAIs .


The primary end point was PFS by local investigator assessment ; OS was a key secondary end point .


At the time of data cutoff ( @ October @ ) , @ deaths had occurred and @ patients remained on treatment .


Median OS in patients receiving EVE + EXE was @ months -LSB- @ % confidence interval ( CI ) @-@ @ months -RSB- compared with @ months ( @ % CI @-@ @ months ) in patients receiving PBO + EXE ( hazard ratio = @ ; @ % CI @-@ @ ; log-rank P = @ ) .


Poststudy treatments were received by @ % of patients in the EVE + EXE arm versus @ % of patients in the PBO + EXE arm .


Types of poststudy therapies were balanced across arms , except for chemotherapy ( @ % EVE + EXE versus @ % PBO + EXE ) .


No new safety concerns were identified .


In BOLERO-@ , adding EVE to EXE did not confer a statistically significant improvement in the secondary end point OS despite producing a clinically meaningful and statistically significant improvement in the primary end point , PFS ( @-months prolongation in median PFS ; P < @ ) .


Ongoing translational research should further refine the benefit of mTOR inhibition and related pathways in this treatment setting .


ATLAS compared bevacizumab plus erlotinib ( B+E ) with bevacizumab plus placebo ( B+P ) as maintenance therapy after first-line bevacizumab plus chemotherapy ( B+C ) for advanced non-small-cell lung cancer ( NSCLC ) .


Prespecified biomarkers were prospectively evaluated .


Tumor samples were analyzed for : epidermal growth factor receptor ( EGFR ) expression ( immunohistochemistry -LSB- IHC -RSB- ) ; EGFR gene copy number ( fluorescence in-situ hybridization -LSB- FISH -RSB- ) ; EGFR mutations ( exon @ deletions/L@R mutations ) ; and KRAS mutations ( exons @/@ ) .


Progression-free survival ( PFS ) and overall survival ( OS ) were estimated .


Of @ patients randomized to receive maintenance treatment ( after four cycles of B+C without progression ) , @ ( B+E ) and @ ( B+P ) were evaluable for biomarker status .


Median PFS ( from randomization ) was @ months ( B+E ) versus @ months ( B+P ; hazard ratio -LSB- HR -RSB- , @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ) , which was numerically similar to the intent-to-treat PFS .


PFS benefit of B+E was observed across most biomarker subgroups .


EGFR IHC , EGFR FISH , and EGFR/KRAS mutation status were not predictive of outcome .


B+E - treated patients with EGFR mutation-positive NSCLC had longer PFS compared with B+P - treated patients ( HR , @ ; @ % CI , @-@ @ ; p = @ ) .


Patients with KRAS wild-type disease had significant PFS improvements with B+E , compared with B+P ( HR , @ ; @ % CI , @-@ @ ; p = @ ) .


No OS benefit of B+E was observed .


Patients with KRAS wild-type or EGFR mutation-positive NSCLC derived PFS benefits from B+E .


However , EGFR IHC , EGFR FISH , and EGFR or KRAS mutation status were not strongly predictive of survival .


A larger sample size would be needed to confirm the initial trends observed in this study .


In light of the lately changes in regulations regarding teeth whitening in Europe , the use of @ % hydrogen peroxide using a dedicated device becomes the first choice treatment option .


The purpose of this controlled , randomized , parallel , blinded six months prospective study was to compare this method of teeth whitening treatment with that of in-office method using @ % hydrogen peroxide .


@ healthy american individuals , ages @-@ , participated in this study .


The participants were divided into @ groups : a @ % hydrogenperoxide group , a @ % hydrogen peroxide group and a placebo control group .


Whitening procedures were performed on intact frontal teeth with color shade of A@ or higher .


A controlled color measurement was performed before , immediately after , three and six months post treatment .


Clinical periodontal indices , oral mucosa changes , side effects and participant satisfaction , were recorded .


In the @ % group , the change in color shades immediately after treatment , three and six months after treatment were @ , @ and @ , respectively .


Tooth color changes in @ % group immediately after completion of treatment , three and six months after treatment were @ , @ and @ , respectively .


Statistical significant differences were found in both treatment groups between the baseline color shade and the post treatment color shade .


The results were stable three and six months after treatment .


Statistically significant difference between the groups immediately after treatment ( p < @ ) .


No statistically significant difference was found between the two groups three and six months after treatment ( p > @ ) .


Side effects such as oral mucosa irritation , burns or sensitive teeth were mild and resolved without intervention .


A high satisfaction level was recorded .


Tooth color shade can be substantially improved using a dedicated device with @ % hydrogen peroxide only .


This whitening method can be helpful for the dentist in : home continuing treatment post in - office whitening specially in case with severe staining , maintenance of in-office whitening treatment outcomes or as an OTC home whitening procedure for patients with limmited budget .


Commercialized cetylpyridinium chloride ( CPC ) mouthrinses were compared for antimicrobial substantivity/bioavailability in an in vitro disk retention assay ( DRA ) and clinical antimicrobial activity in vivo in the plaque glycolysis and regrowth method ( PGRM ) .


Formulations compared in this testing included commercially available CPC mouthrinses : Crest Pro Health ( CPH ) , ( containing @ ppm formulated CPC ) ; Colgate Total Puerto Rico ( CT@ ) , ( containing @ ppm formulated CPC ) ; Colgate Total US ( CT@ ) , ( containing @ ppm formulated CPC ) ; and Scope Mouthwash ( SCP ) , ( containing @ ppm formulated CPC ) .


A water control ( CTR ) was included in one of the PGRM clinical trials .


Two separate clinical PGRM studies employed a controlled , double-blind , randomized , crossover design where qualified adult PGRM panelists were supplied with acclimation NaF dentifrice for use throughout the trials .


On treatment days , subjects sampled baseline plaque and then rinsed with assigned mouthrinse following morning toothbrushing .


Treated plaque samples were collected @ and @ minutes after rinsing .


Sampled plaques were vortexed , normalized for biomass and incubated under standard conditions to assess glycolysis .


pH response of treated plaques in incubation buffers were compared to baseline untreated plaque values and an Area Under Curve ( AUC ) composite/aggregate analysis of glycolysis inhibition was used for treatment comparisons .


A laboratory disk retention substantivity/bioavailability assay measured adsorption affinity of CPC in mouthrinse for anionic cellulose disks in vitro .


Clinical PGRM studies showed significant differences in antibacterial clinical efficacy of commercialized mouthrinses .


Combining clinical study results reveals rank ordered efficacy CPH > CT@ > SCP > CT@ > CTR .


Comparison of DRA to PGRM glycolysis showed a linear relation highlighting correlation of CPC bioavailability to clinical antimicrobial performance of CPC mouthrinses .


Problem drinking , particularly risky single-occasion drinking is widespread among adolescents and young adults in most Western countries .


Mobile phone text messaging allows a proactive and cost-effective delivery of short messages at any time and place and allows the delivery of individualised information at times when young people typically drink alcohol .


The main objective of the planned study is to test the efficacy of a combined web - and text messaging-based intervention to reduce problem drinking in young people with heterogeneous educational level .


A two-arm cluster-randomised controlled trial with one follow-up assessment after @ months will be conducted to test the efficacy of the intervention in comparison to assessment only .


The fully-automated intervention program will provide an online feedback based on the social norms approach as well as individually tailored mobile phone text messages to stimulate ( @ ) positive outcome expectations to drink within low-risk limits , ( @ ) self-efficacy to resist alcohol and ( @ ) planning processes to translate intentions to resist alcohol into action .


Program participants will receive up to two weekly text messages over a time period of @ months .


Study participants will be @ students from approximately @ upper secondary and vocational schools in Switzerland .


Main outcome criterion will be risky single-occasion drinking in the past @ days preceding the follow-up assessment .


This is the first study testing the efficacy of a combined web - and text messaging-based intervention to reduce problem drinking in young people .


Given that this intervention approach proves to be effective , it could be easily implemented in various settings , and it could reach large numbers of young people in a cost-effective way .


Inflammatory status can increase the risk of adverse cardiovascular events linked to platelet activity and involvement of microparticles ( MP ) released from platelets ( PMP ) , leukocytes ( LMP ) , and monocytes ( MMP ) .


These MP carry host cell-derived antigens that may act as markers of metabolic health .


Subjects newly diagnosed with type @ diabetes are offered appropriate standard dietary advice ( SDA ) but this may not be optimal as specific inclusion of other nutrients , such as oats , may add benefit .


The effectiveness of such interventions can be tested by examination of MP activation markers .


Subjects ( n = @ ) with type @ diabetes participated in a randomized cross-over trial involving @ wk interventions with either an oat-enriched diet ( OAT ) or following reinforced SDA .


Responses were also compared with preintervention habitual ( HAB ) intake .


OAT reduced the concentrations and proportions of fibrinogen - and tissue factor-related PMP and MMP_@b .


The main effect of SDA was to reduce fibrinogen-activated PMP .


Regardless of chronic intake , a healthy test meal led to postprandial declines in total PMP as well as tissue factor - , fibrinogen - , and P-selectin-positive PMP .


OAT improved risk factors assessed by MP status , even in subjects with type @ diabetes already well-controlled by diet and life-style alone .


Higher whole-grain ( WG ) intake is associated with a lower prevalence of metabolic syndrome ( MetS ) ; however , there is inconsistent clinical evidence with regard to the benefit of WGs compared with refined grains ( RGs ) on MetS .


We hypothesized that consuming WGs in the place of RGs would improve MetS criteria in individuals with or at risk of MetS .


A randomized , controlled , open-label parallel study was conducted in @ overweight and obese individuals with increased waist circumference and one or more other MetS criteria .


Participants consumed a controlled weight-loss diet containing either WG or RG ( control ) products for @ wk .


Body composition , MetS criteria and related markers , and plasma alkylresorcinols ( compliance marker of WG intake ) were measured at baseline and at @ and @ wk .


A subgroup ( n = @ ) underwent magnetic resonance imaging to quantify subcutaneous and visceral adipose tissue ( AT ) .


Baseline variables were not significantly different between groups ; however , the RG group tended to have higher triglycerides and lower high-density lipoprotein ( HDL ) cholesterol ( P = @ ) .


Alkylresorcinols increased with consumption of the WG diet and did not change with consumption of the RG diet ( time treatment , P < @ ) , which showed dietary compliance .


There were no differences in anthropometric changes between groups ; however , weight , body mass index , and percentage of body AT decreased at both @ and @ wk ( P < @ ) , and reductions in percentage of abdominal AT occurred by @ wk and did not change between @ and @ wk ( P = @ ) .


Both glucose ( P = @ ) and HDL cholesterol ( P = @ ) were lower with the consumption of the WG compared with the RG diet .


However , when noncompliant individuals ( n = @ ) were removed , the glucose effect was stronger ( P = @ ) and the HDL-cholesterol effect was no longer significant ( P = @ ) .


Replacing RGs with WGs within a weight-loss diet does not beneficially affect abdominal AT loss and has modest effects on markers of MetS .


WGs appear to be effective at normalizing blood glucose concentrations , especially in those individuals with prediabetes .


Intensive poultry production systems depend on chemoprophylaxis with anticoccidial drugs to combat infection .


A floor-pen study was conducted to evaluate the anticoccidial effect of Artemisia annua and Foeniculum vulgare on Eimeria tenella infection .


Five experimental groups were established : negative control ( untreated , unchallenged ) ; positive control ( untreated , challenged ) ; a group medicated with @ ppm lasalocid and challenged ; a group medicated with A. annua leaf powder at @ % in feed and challenged ; and a group treated with the mixed oils of A. annua and Foeniculum vulgare in equal parts , @ % in water and challenged .


The effects of A. annua and oil extract of A. annua + F. vulgare on E. tenella infection were assessed by clinical signs , mortality , fecal oocyst output , faeces , lesion score , weight gain , and feed conversion .


Clinical signs were noticed only in three chickens from the lasalocid group , six from the A. annua group , and nine from the A. annua + F. vulgare group , but were present in @ infected chickens from the positive control group .


Bloody diarrhea was registered in only two chickens from A. annua group , but in @ chickens from the positive control group .


Mortality also occurred in the positive control group ( @/@ ) .


Chickens treated with A. annua had a significant reduction in faecal oocysts ( @ % ; P = @ ) and in lesion score ( @ % ; P = @ ) when compared to the positive control .


At the end of experiment , chickens treated with A. annua leaf powder had the highest body weight gain ( @ g/day ) , after the negative control group , and the best feed conversion ( @ ) among all experimental groups .


Our results suggest that A. annua leaf powder ( Aa-p ) , at @ % of the daily diet post-infection , can be a valuable alternative for synthetic coccidiostats , such as lasalocid .


Patients with non-transfusion-dependent thalassemia ( NTDT ) often develop iron overload and related complications , and may require iron chelation .


However , the risk of over-chelation emerges as patients reach low , near-normal body iron levels and dose adjustments may be needed .


In the THALASSA study , the threshold for chelation interruption was LIC < @mg Fe/g dw ( LIC < @ ) ; @ patients receiving deferasirox for up to @yr reached this target .


A post hoc analysis was performed to characterize the safety profile of deferasirox as these patients approached LIC < @ .


THALASSA was a randomized , double-blind , placebo-controlled study of two deferasirox regimens ( @ and @mg/kg/d ) versus placebo in patients with NTDT .


Patients randomized to deferasirox or placebo in the core could enter a @-yr extension , with all patients receiving deferasirox ( extension starting doses based on LIC at end-of-core and prior chelation response ) .


The deferasirox safety profile was assessed between baseline and @months before reaching LIC < @ ( Period @ ) , and the @months immediately before achieving LIC < @ ( Period @ ) .


Mean SD deferasirox treatment duration up to reaching LIC < @ was @d , and deferasirox dose was @ mg/kg/d .


The exposure-adjusted AE incidence regardless of causality was similar in periods @ ( @ ) and @ ( @ ) .


There were no clinically relevant differences in renal and hepatic laboratory parameters measured close to the time of LIC < @ compared with measurements near the previous LIC assessment .


The deferasirox safety profile remained consistent as patients approached the chelation interruption target , indicating that , with appropriate monitoring and dose adjustments in relation to iron load , low iron burdens may be reached with deferasirox with minimal risk of over-chelation .


Epidemiologic evidence suggests a link between short sleep duration and cardiovascular risk , although the nature of any relationship and mechanisms remain unclear .


Short sleep duration has also been linked to an increase in cardiovascular events .


Endothelial dysfunction has itself been implicated as a mediator of heightened cardiovascular risk .


We sought to determine the effect of @ days/@ nights of partial sleep restriction on endothelial function in healthy humans .


Sixteen healthy volunteers underwent a randomized study of usual sleep versus sleep restriction of two-thirds normal sleep time for @ days/@ nights in a hospital-based clinical research unit .


The main outcome was endothelial function measured by flow-mediated brachial artery vasodilatation ( FMD ) .


Those randomized to sleep restriction slept @ hours/night during the experimental period compared with @ hours/night in the control group .


Sleep restriction was associated with significant impairment in FMD ( @ % during the initial pre-randomization acclimation phase versus @ % during the randomized experimental phase , P = @ ) whereas no change was seen in the control group ( @ during the acclimation phase versus @ % during the experimental phase , P = @ ) for a between-groups difference of -@ % ( @ % CI -@ to -@ % , P = @ ) .


No change was seen in non-flow mediated vasodilatation ( NFMD ) in either group .


In healthy individuals , moderate sleep restriction causes endothelial dysfunction .


To evaluate a single-use fiberscope , the Ascope-Trainer , for the training in the intubation under fiberscope .


Prospective randomized study approved by the local ethic committee .


After evaluation of their level of expertise , `` experienced '' or `` novices '' in intubation under fiberscope , the doctors attending the Training for Referents in Difficult Airway Management performed a test on labyrinth with a standard fiberscope ( T@ ) .


After they were assigned to two groups , training with the Ascope-Trainer ( group A , n = @ ) or with a classic fiberscope ( group C , n = @ ) , they trained during @ minutes and performed a new test ( T@ ) .


An analysis of variance was used to compare means .


A goal for the training was determined according to the `` experienced '' doctors ' mean T@ .


A test of Khi ( @ ) was used for the comparison of the number of participants having reached this goal as well as the progress in both groups A and C.


The T@ in the `` experienced '' group was @ @ s and the training improved significantly T@ ( @ @ s ) .


Considering the novices , T@ was significantly lower than T@ in the group A ( @ @ s versus @ @ s ) as well as in C ( @ @ s versus @ @ s ) , and the proportion of the novices having reached the goal of training was comparable in both groups .


Because its use is similar to the standard fiberscope , the Ascope-Trainer may be interesting for this type of training .


The purpose of this study was to assess the efficacy of supervised tooth-brushing with xylitol toothpaste to prevent early childhood caries ( ECC ) and reduce mutans streptococci .


In this cluster-randomized efficacy trial , @ four - to five-year-old children in four Head Start classrooms in the Marshall Islands were randomly assigned to supervised toothbrushing with @,@ ppm/@ percent fluoride xylitol or @,@ ppm fluoride sorbitol toothpaste .


We hypothesized that there would be no difference in efficacy between the two types of toothpaste .


The primary outcome was the surface-level primary molar caries increment ( d ( @-@ ) mfs ) after six months .


A single examiner was blinded to classroom assignments .


Two classrooms were assigned to the fluoride-xylitol group ( @ children ) , and two classrooms were assigned to the fluoride-sorbitol group ( @ children ) .


The child-level analyses accounted for clustering .


There was no difference between the two groups in baseline or end-of-trial mean d ( @-@ ) mfs .


The mean d ( @-@ ) mfs increment was greater in the fluoride-xylitol group compared to the fluoride-sorbitol group ( @ and @ d ( @-@ ) mfs , respectively ) , but the difference was not significant ( @ % confidence interval : -@ , @ ; P = @ ) .


No adverse effects were reported .


After six months , brushing with a low-strength xylitol/fluoride tooth-paste is no more efficacious in reducing ECC than a fluoride-only toothpaste in a high caries-risk child population .


Intraventricular hemorrhage ( IVH ) with spontaneous intracerebral hemorrhage indicates a poor prognosis but uncertainty exists over the pattern of association .


We aimed to elucidate risk associations of IVH and outcome in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial ( INTERACT@ ) data set .


INTERACT@ was an international prospective , open-blinded end point , randomized controlled trial in @ patients with intracerebral hemorrhage ( < @ hours ) with elevated systolic blood pressure randomly assigned to intensive ( target systolic blood pressure < @ mm Hg ) or guideline-based ( systolic blood pressure < @ mm Hg ) blood pressure management .


Associations of baseline IVH in @ of @ ( @ % ) patients and poor outcomes ( death and major disability defined on the modified Rankin Scale ) at @ days were determined in linear and logistic regression models .


Patients with IVH were significantly older and with greater neurological impairment , history of ischemic stroke , and larger hematomas more often deep hemisphere located at presentation , after adjustment for other baseline variables .


Death or major disability occurred in @ % with IVH versus @ % in intracerebral hemorrhage-alone patients ( adjusted odds ratio , @ ; @ % confidence interval , @-@ @ ; P < @ ) .


Associations of IVH volume and clinical outcomes were strong and near continuous .


Adjusted analyses by thirds of IVH volume indicate thresholds of @ and @ mL for significantly increased odds of death and death or major disability , respectively .


A strong association exists between the amount of IVH and poor outcome in intracerebral hemorrhage .


An IVH volume of @ to @ mL emerges as a significant threshold for decision making on prognosis in these patients .


To identify risk factors and morbidity associated with suboptimal instrument placement at instrumental delivery .


Observational study , nested within a randomised controlled trial .


Two university-affiliated maternity hospitals .


A cohort of @ nulliparous women at term ( @ weeks of gestation ) undergoing instrumental delivery .


Univariable and multivariable logistic regression analyses were performed .


Risk factors for suboptimal application of vacuum or forceps , maternal and neonatal morbidity , and the sequential use of instruments , second operator , and caesarean section following failed instrumental delivery .


Instrument placement was suboptimal in @ of @ ( @ % ) deliveries .


Factors associated with suboptimal instrument placement included fetal malposition ( OR @ , @ % CI @-@ @ ) , mid-cavity station ( OR @ , @ % CI @-@ @ ) , and forceps as the primary instrument ( OR @ , @ % CI @-@ @ ) .


Compared with optimal instrument placement , suboptimal placement was associated with prolonged hospital stay ( adjusted OR @ , @ % CI @-@ @ ) and neonatal trauma ( adjusted OR @ , @ % CI @-@ @ ) .


Suboptimal placement was associated with a greater use of sequential instruments ( adjusted OR @ , @ % CI @-@ @ ) and caesarean section for failed instrumental delivery ( adjusted OR @ , @ % CI @-@ @ ) .


The mean decision to delivery interval ( DDI ) was @ minutes longer in the suboptimal group ( @ % CI @-@ @ minutes ) .


Suboptimal instrument placement is associated with increased maternal and neonatal morbidity and procedural complications .


Greater attention should be focused on instrument placement when training obstetricians for instrumental delivery .


To examine the representativeness of participants attending a lifestyle intervention study addressing obese pregnant women .


Retrospective comparison of baseline data , attendance to oral glucose tolerance test ( OGTT ) during pregnancy , and pregnancy outcome in eligible women stratified according to study participation .


Of @ eligible women with a self-reported BMI > @ kg/m ( @ ) , and a live singleton pregnancy , @ were eligible for inclusion and @ were randomized to either active intervention ( n = @ ) or to standard obstetric care ( n = @ ) including two standard OGTT .


The @ women who declined participation or were excluded due to competing diseases and @ women who did not respond to the initial invitation received the same standard care .


The randomized women had similar BMI but a lower parity and age , and were more frequently non-smokers , born in Denmark and married or cohabitating with their partner than the non-participants .


Women participating in the trial had a higher compliance to the second OGTT compared to non-participants , also after correcting for age and nationality .


There was no difference in pregnancy outcome , i.e. , fetal weight and length , gestational age as well as mode of delivery .


Women declining participation in a randomized lifestyle intervention study in pregnancy have characteristics indicating they are those who might benefit the most from lifestyle intervention .


Gait deficits are very common after stroke and improved therapeutic interventions are needed .


The objective of this study was therefore to investigate the therapeutic use of the nociceptive withdrawal reflex to support gait training in the subacute post-stroke phase .


Individuals were randomly allocated to a treatment group that received physiotherapy-based gait training supported by withdrawal reflex stimulation and a control group that received physiotherapy-based gait training alone .


Electrical stimuli delivered to the arch of the foot elicited the withdrawal reflex at heel-off with the purpose of facilitating the initiation and execution of the swing phase .


Gait was assessed before and immediately after finishing treatment , and one month and six months after finishing treatment .


Assessments included the Functional Ambulation Category ( FAC ) test , the preferred and maximum gait velocities , the duration of the stance phase in the hemiparetic side , the duration of the gait cycle , and the stance time symmetry ratio .


The treatment group showed an improved post treatment preferred walking velocity ( p < @ ) and fast walking velocity ( p < @ ) compared to the control group .


Furthermore , subjects in the treatment group with severe walking impairment at inclusion time showed the best improvement as assessed by a longer duration of the stance phase in the hemiparetic side ( p < @ ) and a shorter duration of the gait cycle ( p < @ ) .


The stance time symmetry ratio was significantly better for the treatment than the control group after finishing training ( p < @ ) .


No differences between groups were detected with the FAC test after finishing training ( p = @ ) .


Withdrawal reflex-based functional electrical therapy was useful in the rehabilitation of the hemiparetic gait of severely impaired patients .


The authors evaluated the effectiveness of brief cognitive-behavioral therapy ( CBT ) for the prevention of suicide attempts in military personnel .


In a randomized controlled trial , active-duty Army soldiers at Fort Carson , Colo. , who either attempted suicide or experienced suicidal ideation with intent , were randomly assigned to treatment as usual ( N = @ ) or treatment as usual plus brief CBT ( N = @ ) .


Assessment of incidence of suicide attempts during the follow-up period was conducted with the Suicide Attempt Self-Injury Interview .


Inclusion criteria were the presence of suicidal ideation with intent to die during the past week and/or a suicide attempt within the past month .


Soldiers were excluded if they had a medical or psychiatric condition that would prevent informed consent or participation in outpatient treatment , such as active psychosis or mania .


To determine treatment efficacy with regard to incidence and time to suicide attempt , survival curve analyses were conducted .


Differences in psychiatric symptoms were evaluated using longitudinal random-effects models .


From baseline to the @-month follow-up assessment , eight participants in brief CBT ( @ % ) and @ participants in treatment as usual ( @ % ) made at least one suicide attempt ( hazard ratio = @ , @ % CI = @-@ @ , number needed to treat = @ ) , suggesting that soldiers in brief CBT were approximately @ % less likely to make a suicide attempt during follow-up than soldiers in treatment as usual .


There were no between-group differences in severity of psychiatric symptoms .


Brief CBT was effective in preventing follow-up suicide attempts among active-duty military service members with current suicidal ideation and/or a recent suicide attempt .


Acupuncture anesthesia was created in the @ 's in China and continues to be used there today during most major surgeries .


It is widely used in China for such complex operations as brain , heart , and abdominal surgery .


It is popular in China because it is economical , practical , and beneficial to the patients .


With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery .


This randomized prospective study aims at comparing the effect of two acupoints ( Yongquan , KI@ and Renzhong , DU@ ) with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor ( BIS ) .


This is a prospective randomized controlled study .


We randomly assigned @ patients to @ groups during recovery from surgical anesthesia .


Four groups had acupuncture on KI@ ( group A ) , DU@ ( groups B ) , both KI@ and DU@ ( group C ) , and sham points ( group D ) , and one had no acupuncture ( group E ) .


Bispectral Index ( BIS ) , time to spontaneous eye opening , time to tracheal extubation , and time to following commands were measured as the main outcome measures .


Time to spontaneous eye opening differed among groups ( P = @ ) , as well as time to tracheal extubation ( P < @ @ ) and time to following commands ( P = @ @ ) .


BIS values differed significantly among groups both @ and @ min after the end of anesthesia ( P < @ @ and P = @ @ , respectively ) .


BIS values of groups D and E were lower than those of the other groups and those of group C were higher .


The same pattern was observed also @ and @ min after the end of anesthesia , although the difference among groups was not significant at these time points ( P = @ and P = @ , respectively ) .


Acupuncture on DU@ and KI@ accelerates recovery of consciousness after general anesthesia .


Moreover , a possible synergistic effect of DU@ and KI@ is suggested .


This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature .


Early respiratory support and airway ( AW ) control with endotracheal intubation ( ETI ) are crucial in mass toxicology events and must be performed while wearing chemical personal protective equipment ( C-PPE ) .


The aim of this study is to evaluate the efficiency of AW control by using second-generation supraglottic AW devices ( SADs ) as compared with ETI and first-generation SAD while wearing C-PPE .


This is a randomized crossover trial involving @ medical practitioners .


Four AW management devices were examined : endotracheal tube , the first-generation SAD , laryngeal mask AW unique and @ second-generation SAD , the laryngeal tube suction disposable , and supreme laryngeal mask AW ( SLMA ) .


Primary end point measured were success or failure , number of attempts , and time needed to achieve successful device insertion .


Secondary end point was a subjective appraisal of the AW devices by study population .


More attempts were required to achieve AW control with endotracheal tube , with and without C-PPE ( P < @ ) .


Time to achieve AW control with ETI was , on average , @ % longer than required with other devices and improved with practice .


The mean times to achieve an AW were longer when operators were equipped with C-PPE as compared with standard clothing .


Subjectively , difficulty levels were significantly higher for ETI than for all other devices ( P < @ ) .


When compared with ETI , the use of SADs significantly shortened the time for AW control while wearing C-PPE .


Second-generation SAD were superior to laryngeal mask AW unique .


These finding suggest that SADs may be used in a mass toxicology event as a bridge , until definite AW control is achieved .


Dietary fat influences systemic inflammatory status , which determines the progression of age-associated diseases .


Since somatostatin ( SST ) , cortistatin ( CORT ) , and ghrelin systems modulate inflammatory response , we aim to comprehensively characterize the presence and regulation of the components of these systems in the peripheral blood mononuclear cells ( PMBCs ) , a subset of white blood cells placed at the crossroad between diet and inflammation , in response to diets with different fat composition , and during the postprandial phase in elderly subjects .


The applied nutrigenomic , inflammation-related PBMC-based approach revealed that the majority of components of SST/CORT and ghrelin systems are present in the human PBMCs .


Particularly , CORT , SST/CORT receptors ( sst@ , sst@ , sst@ , and sst@TMD@ ) , ghrelin , its acylating enzyme ( GOAT ) , In@-ghrelin variant , and GHSR@b were detected in PBMCs .


Their expression was altered in the long-term by diet composition , and in the short-term , during the postprandial phase .


Of particular relevance is the postprandial elevation of CORT , sst@ , and sst@ expression in PBMCs of subjects under n-@ PUFAs-enriched diet .


Our results suggest a potential relevant role of CORT/ssts and ghrelin systems in regulating PBMCs response to nutrient intake , which could help to explain the positive effects of n-@ PUFAs-enriched diets in reducing the inflammatory response .


Delayed cord clamping allows for the passage of blood from the placenta to the baby and reduces the risk of iron deficiency in infancy .


To hold the infant for more than @ min at the level of the vagina ( as is presently recommended ) , on the assumption that gravity affects the volume of placental transfusion , is cumbersome , might result in low compliance , and interferes with immediate contact of the infant with the mother .


We aimed to assess whether gravity affects the volume of placental transfusion


We did a multicentre non-inferiority trial at three university-affiliated hospitals in Argentina .


We obtained informed consent from healthy mothers with normal term pregnancies admitted early in labour .


Vigorous babies born vaginally were randomly assigned in a @:@ ratio by computer-generated blocks and sequentially numbered sealed opaque envelopes to be held for @ min before clamping the umbilical cord , at the level of the vagina ( introitus group ) or on the mother 's abdomen or chest ( abdomen group ) .


Newborn babies were weighed immediately after birth and after cord clamping .


The primary outcome was the difference in weight ( as a proxy of placental transfusion volume ) .


The prespecified non-inferiority margin was @ g ( @ % ) .


We used t test and ( @ ) test for group comparison , and used a multivariable linear regression analysis to control for covariables .


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


Between Aug @ , @ , and Aug @ , @ , we allocated @ newborn babies to the introitus group and @ to the abdomen group .


@ newborn babies in the introitus group and @ in the abdomen group were ineligible after randomisation ( eg , caesarean section , forceps delivery , short umbilical cord or nuchal cord ) .


Mean weight change was @ g ( SD @ , @ % CI @-@ ) for @ babies in the introitus group compared with @ g ( @ , @-@ ) for @ babies in the abdomen group , supporting non-inferiority of the two approaches ( difference @ g , @ % CI -@ to @ ; p = @ ) .


We did not note any serious adverse events during the study .


Position of the newborn baby before cord clamping does not seem to affect volume of placental transfusion .


Mothers could safely be allowed to hold their baby on their abdomen or chest .


This change in practice might increase obstetric compliance with the procedure , enhance maternal-infant bonding , and decrease iron deficiency in infancy .


To investigate the clinical effect and safety of chiropractic in treating cervicogenic sudden hearing loss .


From January @ to October @ , @ patients with cervicogenic sudden hearing loss were randomly divided into treatment group and control group according to the random number table produced by SPSS @ software .


In the treatment group , there were @ males and @ females , aged from @ to @ years old with an average of ( @ ) years ; course of disease was from @ to @ days with an average of ( @ ) days ; pure-tone audiometry score was from @ to @ dB with the mean of ( @ ) dB ; Northwick Park Neck Pain Questionnaire ( NPQ ) score was from @ to @ scores with an average of ( @ ) scores .


In the control group , there were @ males and @ females , aged from @ to @ years old with an average of ( @ ) years ; course of disease was from @ to @ days with an average of ( @ ) days ; pure-tone audiometry score was from @ to @ dB with the mean of ( @ ) dB ; Northwick Park Neck Pain Questionnaire ( NPQ ) score was from @ to @ scores with an average of ( @ ) scores .


The patients of control group were treated with dexamethasone intravenous drip of @ mg , @ days later , decreased to @ mg , @ days again .


And with the methycobal intravenous drip of @ g , treatment continued for @ days .


The patients of treatment group were treated with chiropractic additionally except for the therapeutic methods of control group .


Chiropractic included local muscle loosening , attacking point , bilateral pulling atlanto-axial joint , and continuous treatment for @ days .


The pure-tone audiometry score and NPQ score were compared between two groups after treatment .


After the treatment , pure-tone audiometry score and NPQ score in treatment group improved to ( @ @ ) dB and ( @ ) scores respectively , which were obviously better than that of control group 's ( @ ) dB and ( @ ) scores ( P < @ ) .


Compared with routine method for cervicogenic sudden hearing loss , additional chiropractic can improve hearing and relieve neck pain effectively .


The right ventricular mid-septum and inflow tract are alternative pacing sites that are potentially less harmful to cardiac function .


This study aimed to analyze the influence of these two alternative pacing sites on the clinical course of patients with chronic Chagas disease , who underwent definitive pacemaker implantation .


A total of @ patients with Chagas disease and classical indications for definitive pacemaker implantation were randomized into two groups between October @ and August @ : @ received inflow tract implantation and @ patients received mid-septum implantation .


The analyzed parameters included : ( @ ) progression stage of chronic chagasic cardiomyopathy ( CCC ) , ( @ ) electrocardiographic analysis , ( @ ) left ventricular remodeling , and ( @ ) electromechanical dyssynchrony .


The assessment was performed @-@ hours after implantation and a follow-up period of @ months .


Compared with inflow tract implantation , mid-septum implantation was associated with slower CCC progression and the generation of narrower QRS complexes ( @ @ milliseconds vs @ @ milliseconds ; P < @ ) .


No left ventricular remodeling was detected .


Intraventricular dyssynchrony was more frequent in the inflow tract group than in the mid-septum group ( @ % vs @ % , respectively ; odds ratio -LSB- OR -RSB- , @ ; P = @ ) as was interventricular dyssynchrony ( @ % vs @ % , respectively ; OR , @ ; P < @ ) .


Mid-septum implantation was associated with slower CCC progression , generation of narrower QRS complexes , and lower electromechanical dyssynchrony , suggesting that this pacing site could be less harmful to cardiac function than the inflow tract site in patients with CCC .


Obesity is associated with low-intensity chronic systemic inflammation .


To evaluate the efficacy of two different doses of metformin in comparison with placebo on increased serum levels of high molecular weight ( HMW ) adiponectin .


An experimental design was developed with a crossover complete treatment and balanced design ; @ female and eight male nondiabetic obese adults participated .


All participants received , during a week and in randomized order : placebo or metformin @ or @ mg twice daily ; there was a week washout period between each treatment .


The HMW adiponectin serum concentration ( @ and @ minutes ) at the end of each treatment was measured .


Analyses of variance ( ANOVA ) , Bonferroni test , and size effect calculations were performed .


Differences in concentrations of HMW adiponectin ( t@ ' , t@ ' ) were measured for each treatment by ANOVA , having values of p = @ and @ , respectively .


The post hoc analysis reported differences favoring treatment with metformin @ mg ( p = @ ) .


The sizes of the effect at times t@ and t@ for metformin @ mg were @ and @ % , and for metformin @ mg , @ and @ % , respectively .


The Dutch Obesity Intervention in Teenagers ( DOiT ) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands .


The initial programme showed promising results during an effectiveness trial .


The programme was adapted and prepared for nationwide dissemination .


To gain more insight into the process of translating evidence-based approaches into ` real world ' ( i.e. , ` natural ' ) conditions , our research aims were to evaluate the impact of the DOiT-implementation programme on adolescents ' adiposity and energy balance-related behaviours during natural dissemination and to explore the mediating and moderating factors underlying the DOiT intervention effects .


We conducted a cluster-controlled implementation trial with @ voluntary intervention schools ( n = @ adolescents ) and @ comparable control schools ( n = @ adolescents ) .


We measured adolescents ' body height and weight , skinfold thicknesses , and waist circumference .


We assessed adolescents ' dietary and physical activity behaviours by means of self-report .


Data were collected at baseline and at @-months follow-up .


We used multivariable multilevel linear or logistic regression analyses to evaluate the intervention effects and to test the hypothesised behavioural mediating factors .


We checked for potential effect modification by gender , ethnicity and education level .


We found no significant intervention effects on any of the adiposity measures or behavioural outcomes .


Furthermore , we found no mediating effects by any of the hypothesised behavioural mediators .


Stratified analyses for gender showed that the intervention was effective in reducing sugar-containing beverage consumption in girls ( B = -@ ml/day ; @ % CI = -@ ; -@ ) .


In boys , we found a significant positive intervention effect on breakfast frequency ( B = @ days/week ; @ % CI = @ ; @ ) .


Stratified analyses for education level showed an adverse intervention effect ( B = @ ; @ % CI = @ ; @ ) on BMI z-scores for adolescents attending the vocational education track .


Although not successful in changing adolescents ' adiposity , the DOiT-implementation programme had some beneficial effects on specific obesity-related behaviours in subgroups .


This study underlines the difficulty of translating intervention effectiveness in controlled settings to real world contexts .


Adaptations to the implementation strategy are needed in order to promote implementation as intended by the teachers .


To assess the effect of using simulation in pharmacy student training on correct device technique .


A single-blinded , repeated measures , parallel group design study was conducted in @ , involving all final-year pharmacy students in year @ ( final year ) enrolled in the Clinical Pharmacy and Therapeutics course .


Students were assessed on device technique at baseline based on previously published checklists for Diskus ( DIS ) , Turbuhaler ( TH ) , and pressurized Metered Dose Inhaler ( pMDI ) .


Students were randomly assigned to @ groups : Intervention A , which included supervised hands-on education in groups and peer assessment/education ; and Intervention B , which included supervised hands-on education in groups , peer assessment/education , and a simulated scenario counseling real asthma patients .


The simulation involved groups of @ students counseling @ asthma patients on inhaler device technique .


The counseling involved verbal information and physical demonstration until the patient performed all steps correctly .


Student assessments on device technique were repeated @ week postintervention .


At baseline , none of the students in Intervention A ( n = @ ) or Intervention B ( n = @ ) performed correct technique for any of the @ devices .


One week following the intervention , a significantly higher proportion of students in Intervention B demonstrated correct technique for the Diskus , Turbuhaler , and pMDI ( @ % , @ % , and @ % , respectively ) than did students in Intervention A ( @ % , @ % , and @ % , respectively , p < @ ) .


Engaging pharmacy students with real asthma patients in a simulated scenario involving correct device technique education resulted in better device technique demonstration skills among students .


Alterations in serotonergic ( @-HT ) metabolism and/or intestinal integrity have been associated with irritable bowel syndrome ( IBS ) .


To assess the effects of the precursor of @-HT , @-hydroxytryptophan ( @-HTP ) , on mucosal @-HT availability and intestinal integrity , and to assess potential differences between healthy controls and IBS patients .


Fifteen IBS patients and @ healthy volunteers participated in this randomised double-blind placebo-controlled study .


Intestinal integrity was assessed by dual-sugar test and by determining the mucosal expression of tight junction proteins after ingestion of an oral bolus of @ mg @-HTP or placebo .


Mucosal serotonergic metabolism was assessed in duodenal biopsy samples .


@-HTP administration significantly increased mucosal levels of @-HIAA , the main metabolite of @-HT , in both healthy controls ( @ @ vs. @ @ pmol/mg , @-HTP vs. placebo , P = @ ) and IBS patients ( @ @ vs. @ @ pmol/mg , @-HTP vs. placebo , P = @ ) , with the latter group showing a significantly larger increase .


Lactulose/L-rhamnose ratios were significantly lower after administration of @-HTP ( P < @ ) in healthy controls and were accompanied by redistribution of zonula occludens-@ ( ZO-@ ) , pointing to reinforcement of the barrier .


In IBS , expression of the tight junction proteins was significantly lower compared to healthy controls , and @-HTP resulted in a further decrease in occludin expression .


Oral @-HTP induced alterations in mucosal @-HT metabolism .


In healthy controls , a reinforcement of the intestinal barrier was seen whereas such reaction was absent in IBS patients .


This could indicate the presence of a serotonin-mediated mechanism aimed to reinforce intestinal barrier function , which seems to dysfunction in IBS patients .


To evaluate the effects of immediate postoperative submucosal dexamethasone administration on postoperative pain , edema , trismus , and mandibular functions after open reduction and internal fixation ( ORIF ) for mandibular fractures .


We conducted a prospective , randomized , controlled , double-blind study of @ patients who required ORIF for mandibular fractures under general anesthesia .


The patients were divided into @ groups , an experimental group ( n = @ ) who received immediate postoperative submucosal @mg ofdexamethasone through the surgical incision site , and a control group ( n = @ ) who did not receive dexamethasone .


Pain was assessed using a visual analog scale ( VAS ) score and the frequency of analgesic consumption at the various postoperative intervals .


The maximum interincisal distance and facial measurements were compared before surgery and at @ , @ , and @hours and @days after surgery .


The difficulty in mandibular function after surgery was graded as mild , moderate , or severe .


The analgesic drugs required @hours after surgery and the VAS score @hours after surgery were significantly less ( P < @ ) in the experimental group than in the control group .


The total number of diclofenac tablets required by the experimental group was less than that for the control group , but the difference was not statistically significant .


The control group had significantly increased swelling ( P < @ ) compared with the experimental group from preoperatively to @hours postoperatively ( experimental group @ @ , control group @ @ ) .


No statistically significant difference was present in the mouth opening or difficulty in mandibular function at the different follow-up intervals between the @ groups ( P > @ ) .


The results of our study suggest that submucosal administration of dexamethasone after ORIF for mandibular fractures is effective in reducing postoperative pain and edema .


Paired associative stimulation ( PAS ) is a widely used method to study spike timing dependent plasticity in motor cortex .


Repeated pairing of an electrical stimulus to the median nerve with transcranial magnetic stimulation ( TMS ) over the contralateral motor cortex at interstimulus intervals ( ISIs ) of @-@ms leads to a long term potentiation ( LTP ) - like synaptic plasticity in the corticospinal system .


Previously we found that concurrent transcranial direct current stimulation ( TDCS ) over cerebellum blocked the effect of PAS@ but not PAS@ @ , implying that two separate mechanisms were involved .


We hypothesized that if PAS@ @ and PAS@ increased corticospinal excitability by two entirely separate mechanisms then their effects might summate if we intermixed them in the same session .


Twenty-four healthy volunteers were studied .


Eight subjects were selected who showed the expected facilitation after both standard PAS@ @ and PAS@ with @ pairs .


They participated to two sessions in which PAS consisted of @ electrical stimuli of the right median nerve paired with a single TMS over the hotspot of right APB at randomly delivered ISIs of @ms and of @ ms ( @ pairs for each ISI ) ( PASvar@p ) .


Either sham or anodal TDCS ( @mA , @min ) was applied to the cerebellum simultaneously with PASvar@p .


Subsequently , we applied a protocol with @ pairs for each ISI ( PASvar@p ) .


We measured motor evoked potentials ( MEPs ) before and after each intervention .


Although PAS@ @ and PAS@ each produce corticospinal facilitation when applied alone , the after-effects disappeared if we randomly intermixed PAS@ @ and PAS@ using either @ pairs ( PASvar@p ) or @ pairs ( PASvar@p ) for each ISI .


Facilitation is restored if anodal but not sham TDCS is applied concurrently over the cerebellum to block the effect of PAS@ .


PAS@ @ and PAS@ not only engage two separate mechanisms but also they are mutually inhibitory .


To assess patient-reported outcomes ( PROs ) for tofacitinib , an oral JAK inhibitor for the treatment of rheumatoid arthritis ( RA ) , in a @-month , phase III , randomized controlled trial .


Patients ages @ years with active RA with an inadequate response to @ tumor necrosis factor inhibitor ( TNFi ) and receiving stable background methotrexate were randomized @:@:@:@ to tofacitinib @ mg or @ mg twice daily , or placebo advanced to tofacitinib @ mg or @ mg twice daily at month @ .


PROs measured at month @ included patient global assessment of disease activity ( PtGA ) , pain , Health Assessment Questionnaire ( HAQ ) disability index ( DI ) , Medical Outcomes Study ( MOS ) Short Form @ Health Survey version @ ( SF-@v@ ; acute ) , Functional Assessment of Chronic Illness Therapy-Fatigue ( FACIT-F ) , and MOS Sleep Scale .


Patients received tofacitinib @ mg ( n = @ ) or @ mg ( n = @ ) or placebo advanced to tofacitinib @ mg ( n = @ ) or @ mg ( n = @ ) .


HAQ DI ( reported previously ) , PtGA ( P < @ ) , and SF-@v@ physical and mental component summary ( P < @ ) scores were improved for both tofacitinib doses versus placebo .


Furthermore , improvements greater than or equal to the minimum clinically important difference were more frequently reported by tofacitinib-treated patients versus placebo for PtGA ( P < @ ) , pain ( P < @ ) , HAQ DI ( P < @ ) , SF-@v@ physical and mental component summary scores ( P < @ ) , and FACIT-F ( P < @ for @ mg twice daily ) .


No statistical differences were observed in the MOS Sleep Scale .


Tofacitinib treatment resulted in significant , clinically meaningful improvements in multiple PROs versus placebo over @ months of treatment in patients with active RA and a previous inadequate response to TNFi .


Previous studies have shown that central obesity is associated with chronic kidney disease ( CKD ) .


We hypothesized that the association of central obesity with CKD is modified by the presence of inflammation .


To test this hypothesis , we performed this study .


This was a cross-sectional study in southern China .


Waist-to-height ratio ( WHtR ) was used as a central obesity index and C-reactive protein ( CRP ) was used as an index for inflammation .


CKD was defined as estimated glomerular filtration rate ( eGFR ) < @ ml/min/@ @ m ( @ ) or albuminuria-to-creatinine ratio ( ACR ) > @mg/g .


Multivariable logistic regressions were used and logistic regression models were adjusted for potential confounders and other components of metabolic syndrome .


@ subjects were included in the current study .


WHtR , body mass index and waist circumference were significantly associated with the level of CRP .


When adjustment for potential confounders , only central obesity with a higher CRP level was associated with CKD ( Relavitve-risk Ratio , @ % CI : @ , @ - @ , P = @ ) .


In multivariate logistic models , WHtR was associated with CKD .


The odd ratio for WHtR ( every SD increment ) , was @ ( @ % CI @ , @ , P < @ ) .


Further adjustment for log-transformed CRP had an impact on the odd ratios .


Central obesity is associated with CKD , independently of other MetS components .


Central obesity is also associated with inflammation and the presence of inflammation modifies the associations of central obesity and CKD .


This study is based on a community-based chinese population , and the results may only be applicable for Chinese population .


Lumbar puncture ( LP ) is usually associated with anxiety and apprehension in children and their parents .


This study was performed for controlling children 's anxiety before and during LP and increasing the success of LP due to relaxation of the child following the use of sedative drugs and to compare the efficacy and side effects of oral midazolam and oral chloral hydrate .


This prospective randomized controlled clinical trial included @ children aged @-@ years , candidates for LP .


They were divided into two randomized groups of @ children each : group I received @ mg/kg oral chloral hydrate and group II received @ mg/kg oral midazolam before LP .


The results indicated that the mean sedation grade was @ + / - @ in chloral hydrate group and @ + / - @ in midazolam group ( P < @ ) .


The mean onset of sedative effect was @ + / - @ min in midazolam group and @ + / - @ min in chloral hydrate group ( P < @ ) .


Prolonged sedation was the most common side effect in oral midazolam group ( @ % ) versus @ % in chloral hydrate group .


Based on the level of sedation , side effects , time to onset of sedation and recovery time from sedation , oral chloral hydrate is a better sedative medication than oral midazolam .


Previous heart failure ( HF ) trials suggested that age influences patient characteristics and outcome ; however , under-representation of elderly patients has limited characterization of this cohort .


Whether standard prognostic variables have differential utility in various age groups is unclear .


The PROTECT trial investigated @ patients ( median age @ years ) with acute HF randomized to rolofylline or placebo .


Patients were divided into five groups based on the quintiles of age : @ , @-@ , @-@ , @-@ , and @years .


Baseline characteristics , medications , and outcomes ( @-day death or cardiovascular/renal hospitalization , and death at @ and @ days ) were explored .


The prognostic utility of baseline characteristics for outcomes was investigated in the different groups and in those aged < @years vs. @years .


With increasing age , patients were more likely to be women with hypertension , AF , and higher EF .


Increased age was associated with increased risk of @ - and @-day outcomes , which persisted after multivariable adjustment ( hazard ratio for @-day death = @ ; @ % confidence interval @-@ @ for each @-year increase ) .


The prognostic utility of baseline characteristics such as previous HF hospitalization and serum sodium , systolic blood pressure , and NYHA class was attenuated in the elderly for the endpoint of @-day mortality .


An increase in albumin was associated with a greater reduction in risk in patients aged @years vs. < @years .


In a large trial of acute HF , there were differences in baseline characteristics and outcomes amongst patients of different ages .


Standard prognostic variables exhibit different utility in elderly patients .


Restenosis following extracranial artery stenting is a limitation that affects long-term outcomes .


Effective and satisfying pharmacological strategies in preventing restenosis have not been established .


This study aimed to evaluate whether argatroban , a direct thrombin inhibitor , could reduce the risk of in-stent restenosis after extracranial artery stenting .


One hundred and fourteen patients hospitalized between August @ and August @ were enrolled .


Patients were randomly assigned to argatroban ( n = @ ) and blank control groups ( n = @ ) .


The patients in the argatroban arm were treated with @ mg of intravenous argatroban twice daily @ days before and @ days after the stenting procedures .


Patients were followed for @ months after the procedure .


During follow-up , restenosis and target revascularization were analyzed .


Recurrent cerebrovascular and cardiovascular events and deaths were also compared between the groups .


One patient in the stenting group withdrew immediately after the procedure due to unsuccessful stenting .


Restenosis occurred in @ patients ( @ % ) in the argatroban group and in @ patients ( @ % ) in the control group during the @ - to @-month angiographic follow-up period ( p = @ ) .


Nine months after the procedures , argatroban-treated patients had a trend towards a lower incidence of target revascularization compared with the controls ( @ vs. @ % , p = @ ) .


No major bleeding events or other adverse events occurred in the argatroban group .


This pilot clinical trial is the first that uses argatroban to prevent restenosis in ischemic cerebrovascular disease , and suggests that intravenous administration of argatroban is effective and safe in preventing restenosis after extracranial artery stenting .


Larger randomized controlled clinical trials are warranted .


Several studies have demonstrated skills transfer after virtual reality ( VR ) simulation training in laparoscopic surgery .


However , the impact of VR simulation training on transfer of skills related to laparoscopic colectomy remains not investigated .


The present study aimed at determining the impact of VR simulation warm-up on performance during laparoscopic colectomy in the porcine model .


Fourteen residents naive to laparoscopic colectomy as surgeons were randomly assigned in block to two groups .


Seven trainees completed a @-h VR simulator training in the laparoscopic sigmoid colectomy module ( study group ) .


The remaining seven surgeons ( control group ) underwent no intervention .


On the same day , all participants performed a sigmoid colectomy with anastomosis on a pig .


All operations were video recorded .


Two board-certified expert colorectal surgeons independently assessed performance during the colectomy on the swine .


Examiners were blinded to group assignment .


The two examiners used a previously validated clinical instrument specific to laparoscopic colectomy .


The primary outcome was the generic and specific skills score values .


Surgeons undergoing short-duration training on the VR simulator performed significantly better during laparoscopic colectomy on the pig regarding general and specific technical skills evaluation .


The average score of generic skills was @ ( @-@ ) for the control group and @ ( @-@ ) for the study group ( p = @ ) .


The specific skills average score for the control group was @ ( @-@ @ ) and @ ( @-@ @ ) for the study group ( p = @ ) .


There was acceptable concordance ( Kendall ` sW ) regarding the video assessment of generic ( W = @ ) and specific skills ( W = @ ) between the two examiners .


A single short-duration VR simulator practice positively impacted surgeons ' generic and specific skills performance required to accomplish laparoscopic colectomy in the swine model .


To evaluate the safety and efficacy of a new multipurpose disinfecting solution ( MPDS ) with a formulation that includes aloe vera on its composition .


This is a prospective , randomized , double-masked clinical trial with a crossover design that included seven examinations .


Two different MPDSs , Avizor Alvera ( study solution ) and All Clean Soft ( control solution ) , each were used for @ month .


Comfilcon A silicone hydrogel contact lenses were used during the trial .


The main outcome variables were corneal staining and deposits on the surfaces of the contact lenses .


Other parameters including ocular surface response , contact lens wettability , user satisfaction , and adverse events , were analyzed according to the International Organization for Standardization ( ISO ) @:@ guidance for clinical investigation .


Twenty subjects ( @ women , @ men ) ( mean age , @ years ; range , @-@ ) were included .


No differences between both MPDSs were found in the percentage of subjects with corneal staining > @ at day @ ( study : @ % , control : @ % ; p = @ ) ; neither in the percentage of subjects with deposits on the surface of the contact lens > @ at day @ ( study : @ % , control : @ % ; p = @ ) .


The study MPDS received higher rates in comfort ( study : @ , control : @ ; p = @ ) and satisfaction at day @ ( study : @ , control : @ ; p = @ ) , however the scores were not significantly different with the control MPDS .


The clinical trial showed that the study MPDS is safe , efficient , and has acceptable physiologic tolerance , according to the ISO @:@ guidance for clinical investigation .


Sclerostin is an osteocyte-derived inhibitor of osteoblast activity .


The monoclonal antibody romosozumab binds to sclerostin and increases bone formation .


In a phase @ , multicenter , international , randomized , placebo-controlled , parallel-group , eight-group study , we evaluated the efficacy and safety of romosozumab over a @-month period in @ postmenopausal women , @ to @ years of age , who had low bone mineral density ( a T score of -@ or less at the lumbar spine , total hip , or femoral neck and -@ or more at each of the three sites ) .


Participants were randomly assigned to receive subcutaneous romosozumab monthly ( at a dose of @ mg , @ mg , or @ mg ) or every @ months ( @ mg or @ mg ) , subcutaneous placebo , or an open-label active comparator -- oral alendronate ( @ mg weekly ) or subcutaneous teriparatide ( @ g daily ) .


The primary end point was the percentage change from baseline in bone mineral density at the lumbar spine at @ months .


Secondary end points included percentage changes in bone mineral density at other sites and in markers of bone turnover .


All dose levels of romosozumab were associated with significant increases in bone mineral density at the lumbar spine , including an increase of @ % with the @-mg monthly dose , as compared with a decrease of @ % with placebo and increases of @ % with alendronate and @ % with teriparatide .


Romosozumab was also associated with large increases in bone mineral density at the total hip and femoral neck , as well as transitory increases in bone-formation markers and sustained decreases in a bone-resorption marker .


Except for mild , generally nonrecurring injection-site reactions with romosozumab , adverse events were similar among groups .


In postmenopausal women with low bone mass , romosozumab was associated with increased bone mineral density and bone formation and with decreased bone resorption .


( Funded by Amgen and UCB Pharma ; ClinicalTrials.gov number , NCT@ . )


In the UK , chronic disease , including chronic kidney disease ( CKD ) is largely managed in primary care .


We developed a tool to assess practitioner confidence and knowledge in managing CKD compared to other chronic diseases .


This questionnaire was part of a cluster randomised quality improvement interventions in chronic kidney disease ( QICKD ; ISRCTN@ ) .


The questionnaire was developed by family physicians , primary care nurses , academics and renal specialists .


We conducted three focus groups ( n = @ , @ , and @ ) to refine the questionnaire using groups of general practitioners , practice nurses and trainees in general practice .


We used paper based versions to develop the questionnaire and online surveys to test it .


Practitioners in a group of volunteer , trial practices received the questionnaire twice .


We measured its reliability using Cohen 's Kappa ( K ) .


The practitioners in the focus groups reached a consensus as to the key elements to include in the instrument .


We achieved a @ % ( n = @/@ ) initial response rate for our questionnaire ; of these @ , @ completed the questionnaire a second time .


Family physicians made up the largest single group of respondents ( @ % , n = @ ) .


Initial response showed more female ( @ % , n = @ ) than male ( @ % , n = @ ) respondents .


The reliability results from retesting showed that there was moderate agreement ( k > @ ) on all questions ; with many showing substantial agreement ( k > @ ) .


There was substantial agreement in the questions about loop diuretics ( k = @ , CI @-@ @ , p < @ ) , confidence in managing hypertension ( k = @ , @ % CI @-@ @ , p < @ ) , diastolic blood pressure treatment thresholds in CKD ( k = @ , @ % CI @-@ @ , p < @ ) and the rate of decline of eGFR that would prompt referral ( k = @ , @ % CI @-@ @ , p < @ ) .


The QICKD-CCQ is a reliable instrument for measuring confidence and knowledge among primary care practitioners on CKD management in the context of UK primary care .


Aging-related reduced spinal mobility can interfere with the execution of important functional skills and activities in elderly women .


Although several studies have shown positive outcomes in response to spinal flexibility training programs , little is known about the management of sets and repetitions in training protocols .


The purpose of this study was to investigate the effects of an @-week specific and standardized flexibility training program on the range of spinal motion in elderly women .


PARTICIPANTS WERE RECRUITED IN A SENIOR CENTER OF PALERMO AND RANDOMLY ASSIGNED IN TWO GROUPS : trained group ( TG ) and control group ( CG ) , which included @ and @ women , respectively .


TG was trained for @ weeks at two sessions/week .


In particular , every session included three phases : warm up ( ~ @ minutes ) , central period ( ~ @ minutes ) , and cool down ( ~ @ minutes ) .


CG did not perform any physical activity during the experimental period .


Spinal ranges of motion ( ROM ) were measured from neutral standing position to maximum bending position and from neutral standing position to maximum extension position before and after the experimental period , using a SpinalMouse device ( Idiag , Volkerswill , Switzerland ) .


After the training period , TG showed an increase in spinal inclination by @ % ( P < @ ) , in sacral/hip ROM by @ % ( P < @ ) , and in thoracic ROM by @ % ( P > @ ) compared with CG from maximum extension position to maximum bending position .


We did not observe any significant difference in TG 's lumbar ROM compared with CG after the training period ( P > @ ) .


We found that an @-week flexibility training program improved ROMs of the spine in elderly women .


The training protocol appeared to be practicable for active elderly people with autonomy and the capability for self-care .


Encouraging dog walking may increase physical activity in dog owners .


This cluster-randomized controlled trial investigated whether a social networking Web site ( Meetup ) could be used to deliver a multicomponent dog walking intervention to increase physical activity .


Sedentary dog owners ( n = @ ) participated .


Eight neighborhoods were randomly assigned to the Meetup condition ( Meetup ) or a condition where participants received monthly e-mails with content from the American Heart Association regarding increasing physical activity .


The Meetup intervention was delivered over @ months and consisted of newsletters , dog walks , community events , and an activity monitor .


The primary outcome was steps ; secondary outcomes included social support for walking , sense of community , perceived dog walking outcomes , barriers to dog walking , and feasibility of the intervention .


Mixed-model analyses examined change from baseline to postintervention ( @ months ) and whether change in outcomes differed by condition .


Daily steps increased over time ( P = @ , d = @ ) , with no differences by condition .


The time-condition interaction was significant for the perceived outcomes of dog walking ( P = @ , d = @ ) , such that the Meetup condition reported an increase in the perceived positive outcomes of dog walking , whereas the American Heart Association condition did not .


Social support , sense of community , and dog walking barriers did not significantly change .


Meetup logins averaged @ per week ( SD , @ ) .


Within @ months of the intervention ending , organization of the Meetup groups transitioned from the study staff to Meetup members .


Results suggest that a Meetup group is feasible for increasing physical activity in dog owners .


Further research is needed to understand how to increase participation in the Meetup group and facilitate greater connection among dog owners .


A wireless motility capsule is a new method for ambulatory assessment of transit times and motility throughout the gastrointestinal tract .


The objective of this study was to evaluate the ability of a wireless motility capsule to detect drug effects on gastric emptying time ( GET ) and gastric contractility .


@ healthy adults were administered in random order saline , erythromycin IV @ mg , or morphine IV @ mg/kg BW .


Subjects ate a standard meal after each infusion , and subsequently ingested the motility capsule .


Data were recorded for @ hours , and the results were analyzed using the manufacturer 's software .


GET was significantly faster after erythromycin than either saline or morphine .


Morphine tended to delay emptying of the capsule compared to saline .


There was a trend toward a greater frequency of gastric contractions with erythromycin and a reduced frequency of gastric contractions with morphine that did not reach statistical significance .


A wireless motility capsule successfully detected acceleration of gastric emptying induced by erythromycin , and retardation of gastric motility caused by morphine .


These results indicate that a wireless motility capsule is a promising technique to assess pharmacologic effects on gastric transit and contractility and aid in development of drugs for gastric motor disorders .


The steep ramp test ( SRT ) can be used to provide an indication of exercise capacity when gas exchange measurements are not possible .


This study evaluated the clinical usefulness of the SRT in adolescents with cystic fibrosis ( CF ) and compared the physiological responses of the SRT with the standard cardiopulmonary exercise test ( CPET ) .


Forty patients with CF ( @ boys and @ girls ; mean SD age , @ @ years ; forced expiratory volume in @ s , @ % @ % of predicted ) performed an SRT and a CPET with respiratory gas analysis in a randomized balanced design .


Peak work rate ( WRpeak ) , HRpeak , peak minute ventilation ( VEpeak ) , and peak oxygen uptake ( VO@peak ) were the main outcome measures .


Patients with CF attained values for absolute and relative WRpeak during the SRT of @ % @ % and @ % @ % of predicted .


Nutritional status and degree of airway obstruction did not influence SRT performance .


Significantly higher values were attained for WRpeak during the SRT compared with those during the CPET ( @ @ vs @ @ W ; P < @ ) , whereas significantly lower values were achieved for HRpeak ( @ @ vs @ @ bpm ; P < @ ) , VEpeak ( @ @ vs @ @ Lmin ( -@ ) ; P = @ ) , and VO@peak ( @ @ vs @ @ mLkg ( -@ ) min ( -@ ) ; P = @ ) .


A strong correlation between WRpeak attained at the SRT and the VO@peak achieved during the CPET was found ( r = @ , P < @ ) .


The SRT seems to be a quick , convenient , and low-cost exercise test that is well-tolerated in patients with CF with mild-to-moderate airway obstruction .


It provides an indication of exercise capacity and can potentially be used when exercise testing using gas exchange measurements is not possible .


Depression is a prevalent disorder , associated with a high disease burden and substantial societal , economic and personal costs .


Cognitive behavioural treatment has been shown to provide adequate treatment for depression .


By offering this treatment in a blended format , in which online and face-to-face treatment are combined , it might be possible to reduce the number of costly face-to-face sessions required to deliver the treatment protocol .


This could improve the cost-effectiveness of treatment , while maintaining clinical effects .


This protocol describes the design of a pilot study for the evaluation of the feasibility , acceptability and cost-effectiveness of blended cognitive behavioural therapy for patients with major depressive disorder in specialized outpatient mental health care .


In a randomized controlled trial design , adult patients with major depressive disorder are allocated to either blended cognitive behavioural treatment or traditional face-to-face cognitive behavioural treatment ( treatment as usual ) .


We aim to recruit one hundred and fifty patients .


Blended treatment will consist of ten face-to-face and nine online sessions provided alternately on a weekly basis .


Traditional cognitive behavioural treatment will consist of twenty weekly sessions .


Costs and effects are measured at baseline and after @ , @ and @ weeks .


Evaluations are directed at cost-effectiveness ( with depression severity and diagnostic status as outcomes ) , and cost-utility ( with costs per quality adjusted life year , QALY , as outcome ) .


Costs will encompass health care uptake costs and productivity losses due to absence from work and lower levels of efficiency while at work .


Other measures of interest are mastery , working alliance , treatment preference at baseline , depressive cognitions , treatment satisfaction and system usability .


The results of this pilot study will provide an initial insight into the feasibility and acceptability of blended cognitive behavioural treatment in terms of clinical and economic outcomes ( proof of concept ) in routine specialized mental health care settings , and an indication as to whether a well-powered clinical trial of blended cognitive behavioural treatment for depression in routine practice would be advisable .


This will be determined based on the perspective of various stakeholders including patients , mental health service providers and health insurers .


Strengths and limitations of the study are discussed .


To assess vision-related quality of life in Fuchs ' dystrophy and changes in vision-related quality of life after @ types of keratoplasty ( penetrating keratoplasty -LSB- PK -RSB- , deep lamellar endothelial keratoplasty -LSB- DLEK -RSB- , and Descemet stripping endothelial keratoplasty -LSB- DSEK -RSB- ) .


Prospective , observational case series .


Sixty-three subjects with Fuchs ' endothelial dystrophy : @ subjects ( @ eyes ) received PK , @ subjects ( @ eyes ) received DLEK , and @ subjects ( @ eyes ) received DSEK .


Subjects were examined before keratoplasty and at regular intervals through @ years after keratoplasty .


At each examination , vision-related quality of life was assessed using the @-item National Eye Institute Visual Functioning Questionnaire ; best spectacle-corrected and uncorrected visual acuities were measured by using the electronic Early Treatment of Diabetic Retinopathy Study protocol ; keratometric cylinder was measured by a manual keratometer .


Disability glare was measured with a straylight meter .


Vision-related quality of life composite score .


Vision-related quality of life composite score for all eyes with Fuchs ' dystrophy before keratoplasty was @ @ ( n = @ ) and did not differ between groups ( P = @ ) .


Vision-related quality of life improved by @ months ( PK , P = @ ; DLEK , P = @ ; DSEK , P < @ ) , with continued improvement between @ months and @ years after PK ( P = @ ) and DSEK ( P = @ ) .


At @ months , the composite score was higher after DSEK than after PK ( P = @ ) .


At @ years , there were no differences in composite scores between the @ treatments ( P = @ ; mean minimum detectable difference , @ -LSB- = @ ; = @ -RSB- ) .


After keratoplasty , quality of life was correlated with uncorrected visual acuity at @ year ( r = -@ ; P = @ ) and at @ years ( r = -@ ; P = @ ) , with disability glare at @ years ( r = -@ ; P = @ ) , and with best-corrected visual acuity at @ months ( r = -@ ; P = @ ) , but not thereafter .


Vision-related quality of life in patients with Fuchs ' endothelial dystrophy is significantly impaired but improves after keratoplasty , irrespective of the technique .


The improvement is faster after DSEK than after PK , and this might be explained in part by rapid improvement in uncorrected visual acuity after DSEK .


This study affirms an advantage of endothelial keratoplasty over PK with respect to patient-reported outcomes .


Recent studies suggest that excessive gestational weight gain ( GWG ) leads to adverse maternal and fetal outcomes including weight retention in the mother and an increased risk of childhood obesity in the offspring.The aim of the GeliS study is to examine the effect of a lifestyle intervention programme during pregnancy to avoid excessive GWG and , hence , to reduce pregnancy and obstetric complications as well as the risk of maternal and offspring obesity .


The GeliS study is a multicentre cluster-randomized controlled trial .


A total number of @ pregnant women ( singleton pregnancy ) with a pre-pregnancy BMI @ kg/m@ and @ kg/m@ will be recruited in practices of gynaecologists and midwives in ten Bavarian regions .


The intervention comprises three structured and individualised counselling sessions on a healthy diet , regular physical activity as well as weight monitoring during pregnancy and one session after delivery , respectively .


The counselling sessions are attached to routine pre - and postnatal visits using standardised materials and procedures .


In the control regions , general recommendations for a healthy lifestyle are given .


An oral glucose tolerance test is offered to all participants.The primary outcome is the proportion of participants with excessive GWG .


Secondary outcomes include pregnancy and obstetric complications such as frequency of gestational diabetes , preeclampsia and caesarean sections as well as weight retention in the mothers and BMI and other health variables in the offspring .


A @-year follow-up of both mothers and their infants is planned .


The GeliS lifestyle intervention programme has been adapted to the existing routine health care system for pregnant women .


If shown to be effective , it could be immediately implemented in routine care .


Despite the popularity and an increased use of bone morphogenetic protein to improve bone healing in patients with congenital pseudoarthrosis of the tibia ( CPT ) , no previous study has compared its efficacy against any other procedure .


We randomised @ consecutive patients ( mean age @ years ) with CPT ( Crawford type IV ) associated with neurofibromatosis type @ ( NF@ ) and no previous history of surgery into two groups .


Group @ received recombinant human bone morphogenetic protein-@ ( rhBMP-@ ) along with intramedullary Kirschner ( K ) - wire fixation and autologous bone grafting ; group @ received only K wire and grafting .


Outcome measures were time to achieve union , Johnston grade , tibial length and the American Orthopaedic Foot and Ankle Society ( AOFAS ) score , which were evaluated preoperatively and at five year follow-up .


Study results showed that patients in group @ achieved primary bone union at a mean of @ months -LSB- standard error ( SE ) @ -RSB- , whereas group @ took a mean of @ months ( SE @ ) .


However , the log-rank test showed no difference in healing times between groups at all time points ( P = @ ) .


There was a statistically significant pre - to post operative improvement ( P < @ ) within groups for the other outcome measures .


In a five year follow-up , these results suggest that rh-BMP-@ and autologous bone grafting is no better than autologous grafting alone .


Researchers have increasingly begun to gather ecological momentary assessment ( EMA ) data on smoking , but new statistical methods are necessary to fully unlock information from such data .


In this paper , we use a new technique , the logistic time-varying effect model ( logistic TVEM ) , to examine the odds of smoking in the @ weeks after a quit attempt .


Data are from a subsample of participants from a randomized , placebo-controlled trial of smoking cessation pharmacotherapies who achieved initial abstinence ( N = @,@ , @ % female ) .


Participants completed up to @ EMA assessments per day during the @ weeks after their quit day .


Predictors include baseline nicotine dependence , EMA measures of craving and negative affect , and whether an individual was assigned to a placebo , monotherapy , or combination therapy condition .


Time-varying effects of these predictors were estimated using logistic TVEM .


Cravings were a significant predictor of smoking throughout the entire @ weeks postquit , whereas the effect of baseline dependence became nonsignificant by the second week , and the effect of negative affect increased over time .


Individuals in the monotherapy and combination therapy conditions had decreased odds of smoking compared with placebo in the first week postquit , but these differences were nonsignificant in the second week .


Findings suggest that pharmacotherapies are more effective compared with placebo earlier in a quit attempt , when the effect of baseline nicotine dependence on smoking is stronger , whereas the effect of craving and negative affect increased over time .


Future cessation therapies may be more successful by providing additional support in the second week after quit attempt .


Hospital-acquired pneumonia is common after traumatic brain injury , and might be partly a result of traumatic brain injury-induced adrenal insufficiency .


We tested the efficacy of low-dose hydrocortisone with fludrocortisone for the prevention of hospital-acquired pneumonia .


We did this double-blind , phase @ , placebo-controlled trial in @ intensive care units in France .


We enrolled patients aged @-@ years in the first @ h after severe traumatic brain injury ( Glasgow coma scale score @ and trauma-associated lesion on brain CT scan ) .


Patients were randomly assigned ( @:@ ; fixed blocks of @ , stratified by centre and mechanism , Glasgow coma scale , age , and arterial pressure -LSB- MGAP -RSB- score ) to receive either hydrocortisone ( @ mg per day tapered ) and fludrocortisone ( @ g tablet once per day ) or matching placebo for @ days .


Before receiving study drug , adrenal function was assessed with a short corticotropin test .


Treatment was stopped if patients had no adrenal insufficiency .


The primary outcome was the occurrence of hospital-acquired pneumonia within @ days after randomisation .


We did an intention-to-treat analysis and a modified intention-to-treat analysis including only patients with adrenal insufficiency ( adjusted for etomidate use ) .


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


From Sept @ , @ , to Nov @ , @ , we enrolled @ patients ( @ assigned to each group ) .


Eight patients withdrew consent .


At day @ , @ of @ patients ( @ % ) in the steroid group and @ of @ ( @ % ) in the placebo group had developed one or more episodes of hospital-acquired pneumonia ( hazard ratio -LSB- HR -RSB- @ ; @ % CI @-@ @ , p = @ ) .


In intention-to-treat analysis , we recorded @ episodes of hospital-acquired pneumonia in the steroid group versus @ in the placebo group ( median @ , IQR @-@ vs median @ , IQR @-@ cases per patient , p = @ ) .


In modified intention-to-treat analyses , the HR for hospital-acquired pneumonia with steroids versus placebo was @ ( @ % CI @-@ @ , p = @ ) in patients with adrenal insufficiency , and , in an exploratory preplanned analysis , @ ( @-@ ; p = @ ) in patients with normal adrenal function .


We recorded no adverse events related to treatment .


Low-dose hydrocortisone with fludrocortisone did not improve the outcome of patients with traumatic brain injury .


However , the study was underpowered because the proportion of patients with hospital-acquired pneumonia in the placebo group was lower than expected .


The results were close to statistical significance for efficacy , meaning that further studies are therefore needed .


To determine whether social media , specifically Facebook , is an effective tool for improving contraceptive knowledge .


English-speaking women aged @-@ years receiving care at an urban academic center obstetrics and gynecology clinic were included and randomized to a trial of standard contraceptive education and pamphlet ( n = @ ) compared with standard contraceptive education and Facebook ( n = @ ) information for contraception counseling .


Contraceptive knowledge was evaluated preintervention and postintervention by the Contraceptive Knowledge Inventory .


We evaluated the effect of the intervention by raw score and percent increase in Contraceptive Knowledge Inventory score , participant satisfaction with counseling method , and contraceptive preference postintervention .


All analyses were stratified by age group .


The median raw postintervention Contraceptive Knowledge Inventory score was significantly higher in the Facebook compared with the pamphlet group ( @ compared with @ , P < @ ) as was percentage increase in the Contraceptive Knowledge Inventory score ( @ % compared with @ % , P < @ ) .


Participant satisfaction with counseling method was significantly higher in the Facebook group ( median @ compared with @ , P < @ ) .


Participant contraceptive preference for long-acting reversible contraceptives ( LARCs ; intrauterine device or implant ) postintervention was significantly greater in the Facebook compared with the pamphlet group ( @ % compared with @ % , P = @ ) .


Among women currently using none or barrier contraception , contraceptive preference for implants was significantly greater in the Facebook compared with the pamphlet group ( @ % compared with @ % , P = @ ) , although , when analysis was extended to include implant or intrauterine device , LARCs were not significantly higher in the Facebook compared with the pamphlet group ( @ % compared with @ % , P = @ ) .


Social media as an adjunct to traditional in-office counseling improves patient contraceptive knowledge and increases patient preference for LARCs .


Multiple micronutrient deficiencies are prevalent in India .


The study aims to establish the efficacy of multi-micronutrient fortified salt in addressing multiple micronutrient deficiencies among children compared to nutrition education and no intervention in Tamilnadu .


The study employed a community based randomized controlled trial designed to study the impact of multiple micronutrient salt ( micronutrient group ) in comparison with nutrition education ( education group ) and no intervention ( control group ) on haemoglobin , serum ferritin , soluble transferrin receptor , body iron stores , serum retinol and urinary iodine outcomes over a period of @ months .


The fortified salt contained iron , iodine , vitamin A , vitamin B@ and folic acid .


All the children were dewormed at baseline and at the end of the study just before the biochemical measurements .


There was a significant improvement in most biochemical parameters studied in the micronutrient group when compared with the control group whereas this was not seen between the education and control .