A blinded analysis of physiologic data collected on the newborns in the delivery room was performed using a data acquisition system .


Heart rate ( HR ) , SpO@ , mean airway pressure ( MAP ) , and FiO@ in the delivery room were compared between infants receiving UCM and infants with ICC .


@ of @ neonates who were enrolled and randomized had data from analog tracings at birth .


@ of these infants received UCM and @ had ICC .


Infants receiving UCM had higher heart rates and higher SpO@ over the first @ minutes of life , were exposed to less FiO@ over the first @ minutes of life than infants with ICC .


UCM when compared to ICC had decreased need for support immediately following delivery , and in situations where resuscitation interventions were needed immediately , UCM has the advantage of being completed in a very short time to improve stability following delivery .


Dialectical Behavior Therapy has been initially designed and evaluated as an outpatient-treatment program for chronic suicidal female patients .


Within the last years , several adaptations of DBT for specific comorbidities , other settings or other disorders related to emotion dysregulation have been developed .


This report reviews conceptual aspects and the scientific evidence of initially designed Dialectical Behavior Therapy and the adaptations .


Systematic literature search and systematic review .


Recently , two meta-analyses which are based on randomized controlled trials conclude robust and stabile effects of DBT Evidence from further RCTs and other studies show promise for the properties of many DBT adaptations .


The current review of the literature suggests a good effectiveness of DBT , especially on complex disorders with deficits in the field of emotion regulation .


Breast cancer ( BC ) is the most common cancer among females in Turkey .


Predictors affecting the breast self-examination ( BSE ) performance vary in developing countries .


To determine the frequency of BSE performance and predictors of self-reported BSEs among women in the capital city of Turkey .


This cross-sectional study was conducted on @ Turkish women using a self - administered questionnaire covering socio-demographic variables and BSE-related features .


Of the participants , @ % ( N = @ ) reported practicing BSE , whereas @ % ( N = @ ) were implementing BSE regularly on a monthly basis , and only @ % ( N = @ ) were performing BSE regularly within a week after each menstrual cycle .


Multivariate logistic regression modeling revealed that BSE performance was more likely in younger age groups -LSB- @-@ years -RSB- ( p = @ , OR = @ ) and -LSB- @-@ years -RSB- ( p = @ , OR = @ ) , women having a family history of breast disease ( p = @ , OR = @ ) , and housewives ( p = @ , OR = @ ) .


Although it appears that the rates of BSE performers are high , the number of women conducting appropriate BSE on a regular time interval basis is lower than expected .


Younger age groups , family history of breast diseases and not being employed were identified as significant predictors of practicing BSE appropriately .


Older age and employment were risk factors for not performing BSE in this sample .


To analyze the results of the use of intra-articular cultured autologous bone marrow-derived mesenchymal stem cell ( MSC ) injections in conjunction with microfracture and medial opening-wedge high tibial osteotomy ( HTO ) .


Fifty-six knees in @ patients with unicompartmental osteoarthritic knees and genu varum were randomly allocated to the cell-recipient group ( n = @ ) or control group ( n = @ ) .


Patients who had a joint line congruity angle of more than @ , malalignment of the knee from femoral causes , a fixed flexion deformity , or age older than @ years were excluded .


All patients underwent HTO and microfracture .


The cell-recipient group received intra-articular injection of cultured MSCs with hyaluronic acid @ weeks after surgery , whereas the control group only received hyaluronic acid .


The primary outcome measure was the International Knee Documentation Committee ( IKDC ) score at intervals of @ months , @ year , and @ years postoperatively .


Secondary outcome measures were Tegner and Lysholm clinical scores and @-year postoperative Magnetic Resonance Observation of Cartilage Repair Tissue ( MOCART ) scores .


The median age of the patients was @ years , with a mean body mass index of @ .


Both treatment arms achieved improvements in Tegner , Lysholm , and IKDC scores .


After adjustment for age , baseline scores , and time of evaluation , the cell-recipient group showed significantly better scores .


The effect of treatment showed an added improvement of @ ( @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ) for IKDC scores , @ ( @ % CI , @ to @ ; P = @ ) for Lysholm scores , and @ ( @ % CI , @ to @ ; P = @ ) for Tegner scores .


Magnetic resonance imaging scans performed @ year after surgical intervention showed significantly better MOCART scores for the cell-recipient group .


The age-adjusted mean difference in MOCART score was @ ( @ % CI , @ to @ ; P < @ ) .


Intra-articular injection of cultured MSCs is effective in improving both short-term clinical and MOCART outcomes in patients undergoing HTO and microfracture for varus knees with cartilage defects .


Level II , randomized controlled trial .


This prospective study showed that the incidence of acute anterior uveitis , confirmed by ophthalmic examination , in patients receiving intravenous zoledronate infusions as part of a randomized controlled trial for fracture prevention is @ % .


We prospectively investigated the incidence of ocular side effects after a single intravenous zoledronate infusion .


In a secondary analysis of a double-blind , placebo-controlled trial in which early post-menopausal women ( N = @ ) with normal bone density or osteopenia were randomized to infusion of zoledronate @ mg ( N = @ ) or placebo ( N = @ ) , we analyzed significant adverse ocular events occurring within @ months .


Fourteen participants reported ocular symptoms after the infusion .


All were examined by an ophthalmologist and eight were diagnosed with acute anterior uveitis ( AAU ) and one with sectoral episcleritis .


The incidence of AAU and episcleritis was @ % ( @ % CI @-@ @ ) and @ % ( @ % CI @-@ @ ) , respectively , in the zoledronate group and @ % for both conditions in the placebo group ( @ % CI @-@ @ ) .


The mean time from infusion to symptom onset for AAU was @ days ( range @-@ ) .


Three cases were bilateral .


AAU was mild-moderate in seven participants and severe in one .


All affected eyes were treated with topical cyclopentolate @ % ( to break , or minimize , posterior synechiae ) , and intensive , potent , topical corticosteroids with a tapering regime based on treatment response .


The mean duration of topical corticosteroid was @ days ( range @-@ ) .


The mean , best corrected visual acuity was @/@ ( range @/@-@ / @ ) at presentation , which remained unchanged after AAU resolution .


None of the participants lost vision , and no long-term sequelae were reported at last follow-up ( range @-@ months post-infusion ) .


Prescribers should inform patients about the possibility of ocular side effects with zoledronate infusions and refer promptly to an ophthalmologist if symptoms develop .


To evaluate the outcomes of standard automated perimetry ( SAP ) in patients with obstructive sleep apnea ( OSA ) .


Eighty OSA patients and @ age-matched controls were consecutively and prospectively enrolled .


One eye per subject was randomly selected .


All participants underwent at least one reliable SAP ( @-@ SITA Standard algorithm ) .


The peripapillary retinal nerve fiber layer thickness ( RNFL ) was measured with spectral-domain optical coherence tomography ( OCT ) .


Patients with OSA were classified into three groups according to the apnea/hypopnea index : mild , moderate , or severe OSA .


Parameters of SAP and OCT were compared between healthy controls and OSA patients .


Correlation of apnea/hypopnea index with OCT and SAP measurements were calculated .


Mean age , best-corrected visual acuity , and central corneal thickness were similar between groups .


Intraocular pressure , however , was lower in the OSA group .


Mean deviation of SAP was -@ @ dB in the control group and -@ @ dB in the OSA group ( P < @ ) .


Thickness of RNFL measured with OCT did not differ significantly between groups .


Patients with OSA showed reduced sensitivity at most points tested by white-on-white perimetry compared with healthy individuals .


The threshold values were more depressed in the peripheral visual field .


The apnea/hypopnea index was related to the SAP indices : Pearson correlations were -@ with mean deviation , @ with pattern standard deviation , and -@ with the visual field index ( P < @ ) .


Patients with OSA exhibited reduced retinal sensitivity measured with SAP compared with healthy controls .


A fluoropyrimidine plus irinotecan or oxaliplatin , combined with bevacizumab ( a monoclonal antibody against vascular endothelial growth factor ) , is standard first-line treatment for metastatic colorectal cancer .


Before the introduction of bevacizumab , chemotherapy with fluorouracil , leucovorin , oxaliplatin , and irinotecan ( FOLFOXIRI ) showed superior efficacy as compared with fluorouracil , leucovorin , and irinotecan ( FOLFIRI ) .


In a phase @ study , FOLFOXIRI plus bevacizumab showed promising activity and an acceptable rate of adverse effects .


We randomly assigned @ patients with untreated metastatic colorectal cancer to receive either FOLFIRI plus bevacizumab ( control group ) or FOLFOXIRI plus bevacizumab ( experimental group ) .


Up to @ cycles of treatment were administered , followed by fluorouracil plus bevacizumab until disease progression .


The primary end point was progression-free survival .


The median progression-free survival was @ months in the experimental group , as compared with @ months in the control group ( hazard ratio for progression , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P = @ ) .


The objective response rate was @ % in the experimental group and @ % in the control group ( P = @ ) .


Overall survival was longer , but not significantly so , in the experimental group ( @ vs. @ months ; hazard ratio for death , @ ; @ % CI , @ to @ ; P = @ ) .


The incidences of grade @ or @ neurotoxicity , stomatitis , diarrhea , and neutropenia were significantly higher in the experimental group .


FOLFOXIRI plus bevacizumab , as compared with FOLFIRI plus bevacizumab , improved the outcome in patients with metastatic colorectal cancer and increased the incidence of some adverse events .


( Funded by the Gruppo Oncologico Nord Ovest and others ; ClinicalTrials.gov number , NCT@ . )


To determine whether graft patency after on-pump and off-pump coronary artery bypass surgery is similar when performed using the same heparinization protocol .


In a randomized , controlled , multicenter trial , @ patients more than @ years of age received either on-pump or off-pump coronary artery bypass surgery .


Heparin was given to achieve an activated clotting time of @ seconds before arteriotomy in both groups .


After the procedure , protamine sulfate was given to revert the activated clotting time to less than @ seconds .


Coronary angiography was performed @ months after the operation and graft patency was assessed by independent blinded observers .


A total of @ patients underwent angiography .


In the off-pump group , @ ( @ % ) of @ grafts were open , @ ( @ % ) were stenotic , and @ ( @ % ) were occluded .


In the on-pump group , @ ( @ % ) of @ grafts were open , @ ( @ % ) were stenotic , and @ ( @ % ) were occluded .


The difference between the proportion of open grafts was statistically significant in favor of on-pump surgery ( P = @ ) .


The proportion of open left internal thoracic artery grafts was @ % in both groups .


Perioperative use of intracoronary shunts did not increase the risk of stenosis of the coronary artery distal to the anastomosis .


Despite comparable heparinization , graft patency after off-pump surgery was inferior to that after on-pump surgery .


The recommended intake of clear liquids until @ hours before surgery is reportedly safe and effective .


We investigated whether oral rehydration therapy before surgery had improved satisfaction , stress response , and hemodynamics in patients during perioperative period .


Patients scheduled to undergo laparoscopic colectomy were enrolled and randomly divided into @ groups .


The oral rehydration therapy ( ORT ) group ( @ cases ) was allowed to drink clear liquids until @ hours before anesthesia induction and the control group ( @ cases ) fasted from @ : @ the night before surgery .


All patients entered the operating room at @ : @ .


Patient satisfaction was examined after admission to the operating room .


The volume and pH of gastric fluid were measured after anesthetic induction .


The serum concentrations of cortisol and catecholamine were measured as stress response indicators after anesthetic induction and at the completion of surgery .


Intraoperative hemodynamics was also recorded .


There were no differences in patient satisfaction , stress response , and hemodynamics between the @ groups .


Intraoperative urine volume was significantly larger in the ORT group .


Vomiting and aspiration were not observed in any patient


Oral rehydration therapy until @ hours before surgery seemed safe but did not improve satisfaction , stress response , and hemodynamics in perioperative patients .


Residual proteinuria during renin-angiotensin-aldosterone system ( RAAS ) blockade is a major renal and cardiovascular risk factor in chronic kidney disease .


Dietary sodium restriction potentiates the antiproteinuric effect of RAAS blockade , but residual proteinuria remains in many patients .


Previous studies linked high fibroblast growth factor @ ( FGF-@ ) levels with volume overload ; others linked higher serum phosphate levels with impaired RAAS-blockade efficacy .


We hypothesized that FGF-@ reduces the capacity of dietary sodium restriction to potentiate RAAS blockade , impairing the antiproteinuric effect .


Post hoc analysis of cohort data from a randomized crossover trial with two @-week study periods comparing proteinuria after a regular-sodium diet with proteinuria after a low-sodium diet , both during background angiotensin-converting enzyme inhibition .


@ nondiabetic patients with CKD with residual proteinuria ( median protein excretion , @ -LSB- IQR , @-@ @ -RSB- g/d ; mean age , @ -LSB- SD -RSB- years ; creatinine clearance , @ -LSB- IQR , @-@ -RSB- mL/min ) .


Plasma carboxy-terminal FGF-@ levels .


Difference in residual proteinuria at the end of the regular-sodium versus low-sodium study period .


Residual proteinuria during the low-sodium diet period adjusted for proteinuria during the regular-sodium diet period .


Higher baseline FGF-@ level was associated with reduced antiproteinuric response to dietary sodium restriction ( standardized = -@ ; P = @ ; model R ( @ ) = @ ) .


For every @-RU/mL increase in FGF-@ level , the antiproteinuric response to dietary sodium restriction was reduced by @ % .


Higher baseline FGF-@ level was a determinant of more residual proteinuria during the low-sodium diet ( standardized = @ ; P = @ ) in linear regression analysis adjusted for baseline proteinuria ( model R ( @ ) = @ ) .


There was no interaction with creatinine clearance ( P interaction = @ ) .


Baseline FGF-@ level did not predict changes in systolic or diastolic blood pressure upon intensified antiproteinuric treatment .


Observational study , limited sample size .


FGF-@ levels are associated independently with impaired antiproteinuric response to sodium restriction in addition to RAAS blockade .


Future studies should address whether FGF-@-lowering strategies may further optimize proteinuria reduction by RAAS blockade combined with dietary sodium restriction .


Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous thromboembolism ( VTE ) in patients with active cancer largely based on results of a single , large trial .


To study the efficacy and safety of tinzaparin vs warfarin for treatment of acute , symptomatic VTE in patients with active cancer .


A randomized , open-label study with blinded central adjudication of study outcomes enrolled patients in @ centers in Asia , Africa , Europe , and North , Central , and South America between August @ and November @ .


Adult patients with active cancer ( defined as histologic diagnosis of cancer and receiving anticancer therapy or diagnosed with , or received such therapy , within the previous @ months ) and objectively documented proximal deep vein thrombosis ( DVT ) or pulmonary embolism , with a life expectancy greater than @ months and without contraindications for anticoagulation , were followed up for @ days and for @ days after the last study medication dose for collection of safety data .


Tinzaparin ( @ IU/kg ) once daily for @ months vs conventional therapy with tinzaparin ( @ IU/kg ) once daily for @ to @ days followed by warfarin at a dose adjusted to maintain the international normalized ratio within the therapeutic range ( @-@ @ ) for @ months .


Primary efficacy outcome was a composite of centrally adjudicated recurrent DVT , fatal or nonfatal pulmonary embolism , and incidental VTE .


Safety outcomes included major bleeding , clinically relevant nonmajor bleeding , and overall mortality .


Nine hundred patients were randomized and included in intention-to-treat efficacy and safety analyses .


Recurrent VTE occurred in @ of @ patients treated with tinzaparin and @ of @ patients treated with warfarin ( @-month cumulative incidence , @ % for tinzaparin vs @ % for warfarin ; hazard ratio -LSB- HR -RSB- , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


There were no differences in major bleeding ( @ patients for tinzaparin vs @ patients for warfarin ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) or overall mortality ( @ patients for tinzaparin vs @ patients for warfarin ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


A significant reduction in clinically relevant nonmajor bleeding was observed with tinzaparin ( @ of @ patients for tinzaparin vs @ of @ patients for warfarin ; HR , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


Among patients with active cancer and acute symptomatic VTE , the use of full-dose tinzaparin ( @ IU/kg ) daily compared with warfarin for @ months did not significantly reduce the composite measure of recurrent VTE and was not associated with reductions in overall mortality or major bleeding , but was associated with a lower rate of clinically relevant nonmajor bleeding .


Further studies are needed to assess whether the efficacy outcomes would be different in patients at higher risk of recurrent VTE .


The role of body mass index ( BMI ) in survival outcomes is controversial among lymphoma patients .


We evaluated the association between BMI at study entry and failure-free survival ( FFS ) and overall survival ( OS ) in three phase III clinical trials , among patients with diffuse large B-cell lymphoma ( DLBCL ) , follicular lymphoma ( FL ) and Hodgkin 's lymphoma ( HL ) .


A total of @ , @ and @ patients with DLBCL , HL and FL were included in the analysis .


Baseline patient and clinical characteristics , treatment received and clinical outcomes were compared across BMI categories .


Among patients with DLBCL , HL and FL , the median age was @ , @ and @ ; @ % , @ % and @ % were obese and @ % , @ % and @ % were overweight , respectively .


Age was significantly different among BMI groups in all three studies .


Higher BMI groups tended to have more favorable prognosis factors at study entry among DLBCL and HL patients .


BMI was not associated with clinical outcome with P-values of @ , @ and @ for FFS , and @ , @ and @ for OS , for patients with DLBCL , HL and FL , respectively .


The association remains non-significant after adjusting for other clinical factors in the Cox model .


A subset analysis of males with DLBCL treated on R-CHOP revealed no differences in FFS ( P = @ ) or OS ( P = @ ) .


BMI was not significantly associated with clinical outcomes among patients with DLBCL , HD or FL , in three prospective phase III clinical trials .


The findings contradict some previous reports of similar investigations .


Further work is required to understand the observed discrepancies .


Although transcatheter arterial chemoembolization ( TACE ) is the most common treatment option in patients with hepatocellular carcinoma ( HCC ) , its clinical benefits remain still controversial .


Since TACE induces hypoxic necrosis in tumors , hypoxia-inducible factor @ ( HIF-@ ) could critically affect biology in residual tumors after TACE treatment and subsequent prognosis .


However , HIF-@ and its prognostic relevance in TACE have rarely been examined in human specimens .


In the current study , we investigated the prognosis and expression of genes regulated by HIF-@ in HCC patients receiving preoperative TACE for the first time .


In total , @ patients with HCC ( @ patients undergoing preoperative TACE ) were retrospectively studied .


The prognostic significance of TACE was analyzed using Kaplan-Meier and Cox regression models .


Protein levels of HIF-@ and mRNA levels of HIF-@-associated genes were examined using immunohistochemistry ( IHC ) and real-time RT-PCR , respectively .


Preoperative TACE was significantly associated with increased @-year recurrence rate ( @ vs. @ % , P = @ ) and shorter disease-free survival ( DFS ) time ( @ vs. @ months , P = @ ) .


TACE was an independent prognostic factor for recurrence ( P = @ ) and poor DFS ( P = @ ) in a multivariate analysis .


Immunohistochemical staining revealed in vivo activation of HIF-@ in human specimens treated with TACE .


Notably , protein levels of HIF-@ were significantly increased in TACE tissues demonstrated by IHC .


Transcriptional targets of HIF-@ showed mRNA expression patterns consistent with activation of HIF-@ in TACE tissues .


Our findings collectively demonstrate that preoperative TACE confers poor prognosis in HCC patients through activation of HIF-@ .


There are conflicting reports on the impact of soy on breast carcinogenesis .


This study examines the effects of soy supplementation on breast cancer-related genes and pathways .


Women ( n = @ ) with early-stage breast cancer were randomly assigned to soy protein supplementation ( n = @ ) or placebo ( n = @ ) for @ to @ days , from diagnosis until surgery .


Adherence was determined by plasma isoflavones : genistein and daidzein .


Gene expression changes were evaluated by NanoString in pre - and posttreatment tumor tissue .


Genome-wide expression analysis was performed on posttreatment tissue .


Proliferation ( Ki@ ) and apoptosis ( Cas@ ) were assessed by immunohistochemistry .


Plasma isoflavones rose in the soy group ( two-sided Wilcoxon rank-sum test , P < @ ) and did not change in the placebo group .


In paired analysis of pre - and posttreatment samples , @ genes ( out of @ ) showed altered expression ( two-sided Student 's t-test , P < @ ) .


Several genes including FANCC and UGT@A@ revealed different magnitude and direction of expression changes between the two groups ( two-sided Student 's t-test , P < @ ) .


A high-genistein signature consisting of @ differentially expressed genes was identified from microarray analysis of tumors .


This signature was characterized by overexpression ( > @-fold ) of cell cycle transcripts , including those that promote cell proliferation , such as FGFR@ , E@F@ , BUB@ , CCNB@ , MYBL@ , CDK@ , and CDC@ ( P < @ ) .


Soy intake did not result in statistically significant changes in Ki@ or Cas@ .


Gene expression associated with soy intake and high plasma genistein defines a signature characterized by overexpression of FGFR@ and genes that drive cell cycle and proliferation pathways .


These findings raise the concerns that in a subset of women soy could adversely affect gene expression in breast cancer .


The aim of this study was to examine the effect of yeast hydrolysate on the abdominal fat in obese humans .


We observed the effects of yeast hydrolysate that had a molecular weight below @ kDa on the anti-abdominal fat accumulation in obese men and women ages @ to @ y for @ wk .


The abdominal fat mass was assessed by computed tomographic scans .


By the sixth week , the reductions in energy intake in the yeast group ( yeast hydrolysate @ g/d ) were significantly greater than those in the control group ( placebo @ g/d ) ( P < @ ) .


The body weight and body mass index ( BMI ) were significantly reduced by week @ compared with baseline in the yeast group , and these differences were significantly greater than those in the control group : body weight @ kg versus -@ k g ( P < @ ) , BMI @ kg/m ( @ ) versus -@ kg/m ( @ ) ( P < @ ) .


Despite the increased loss of body weight in the yeast group , lean body mass did not significantly differ between the two groups .


Body fat mass in the control group did not significantly change between baseline and week @ .


However , the yeast group lost a significant amount of body fat mass after @ wk of treatment ( P < @ ) .


The differences in abdominal fat thickness and abdominal circumference between the two groups were significant after @ wk of treatment ( P < @ ) .


The total abdominal fat area in the yeast group was significantly lower than in the control group after @ wk of treatment ( -@ cm ( @ ) versus -@ cm ( @ ) ; P < @ ) .


Yeast hydrolysate can reduce body weight and the accumulation of abdominal fat without an adverse effect on lean body mass in obese adults , regardless of sex , via the reduction of energy intake .


Delirium is a frequent disorder in intensive care unit ( ICU ) patients with serious consequences .


Therefore , preventive treatment for delirium may be beneficial .


Worldwide , haloperidol is the first choice for pharmacological treatment of delirious patients .


In daily clinical practice , a lower dose is sometimes used as prophylaxis .


Some studies have shown the beneficial effects of prophylactic haloperidol on delirium incidence as well as on mortality , but evidence for effectiveness in ICU patients is limited .


The primary objective of our study is to determine the effect of haloperidol prophylaxis on @-day survival .


Secondary objectives include the incidence of delirium and delirium-related outcome and the side effects of haloperidol prophylaxis .


This will be a multicenter three-armed randomized , double-blind , placebo-controlled , prophylactic intervention study in critically ill patients .


We will include consecutive non-neurological ICU patients , aged @ years with an expected ICU length of stay > @ day .


To be able to demonstrate a @ % increase in @-day survival time with a power of @ % and alpha of @ in both intervention groups , a total of @,@ patients will be randomized ; @ in each group .


The anticipated mortality rate in the placebo group is @ % .


The intervention groups will receive prophylactic treatment with intravenous haloperidol @ mg/q@h or @ mg/q@h , and patients in the control group will receive placebo ( sodium chloride @ % ) , both for a maximum period of @-days .


In patients who develop delirium , study medication will be stopped and patients will subsequently receive open label treatment with a higher ( therapeutic ) dose of haloperidol .


We will use descriptive summary statistics as well as Cox proportional hazard regression analyses , adjusted for covariates .


This will be the first large-scale multicenter randomized controlled prevention study with haloperidol in ICU patients with a high risk of delirium , adequately powered to demonstrate an effect on @-day survival .


Intranasal ( IN ) insulin acutely improves verbal memory in mild cognitive impairment ( MCI ) / Alzheimer 's disease ( AD ) , but its therapeutic effects may be attenuated in apolipoprotein E@ ( ApoE@ ) carriers .


Furthermore , rapid-acting ( RA ) insulins may have superior therapeutic effects compared with regular insulin types .


To measure the safety and efficacy of intranasally delivered RA glulisine in ApoE@ carriers with mild-moderate AD .


We performed a double-blinded , randomized , cross-over study of RA insulin glulisine in nine mild-moderate AD subjects to better understand the relationship between RA insulin , ApoE@ carrier status and memory performance .


IN glulisine was well tolerated but failed to have an acute impact on cognition in ApoE@ carriers with AD .


Serum insulin levels acutely dropped following treatment , but peripheral glucose levels remained unchanged .


Larger clinical trials of longer duration are necessary to better understand the relationships between RA insulin , ApoE@ carrier status and cognitive performance in AD .


Health-promoting lifestyle choices of adolescents are closely related to current and subsequent health status .


However , parsimonious yet reliable and valid screening tools are scarce .


The original @-item adolescent health promotion ( AHP ) scale was developed by our research team and has been applied to measure adolescent health-promoting behaviors worldwide .


The aim of our study was to examine the psychometric properties of a newly developed short-form version of the AHP ( AHP-SF ) including tests of its reliability and validity .


The study was conducted in nine middle and high schools in southern Taiwan .


Participants were @ adolescents randomly divided into two subgroups with equal size and homogeneity of baseline characteristics .


The first subsample ( calibration sample ) was used to modify and shorten the factorial model while the second subsample ( validation sample ) was utilized to validate the result obtained from the first one .


The psychometric testing of the AHP-SF included internal reliability of McDonald 's omega and Cronbach 's alpha , convergent validity , discriminant validity , and construct validity with confirmatory factor analysis ( CFA ) .


The results of the CFA supported a six-factor model and @ items were retained in the AHP-SF with acceptable model fit .


For the discriminant validity test , results indicated that adolescents with lower AHP-SF scores were more likely to be overweight or obese , skip breakfast , and spend more time watching TV and playing computer games .


The AHP-SF also showed excellent internal consistency with a McDonald 's omega of @ ( Cronbach 's alpha @ ) in the calibration group .


The current findings suggest that the AHP-SF is a valid and reliable instrument for the evaluation of adolescent health-promoting behaviors .


Primary health care providers and clinicians can use the AHP-SF to assess these behaviors and evaluate the outcome of health promotion programs in the adolescent population .


We ( @ ) evaluated the impact of an evidence-based HIV prevention program with and without a parent component among mid-adolescents living in the Caribbean and ( @ ) determined the effect of prior receipt of a related intervention during preadolescence on intervention response .


A randomized , controlled @-cell trial of a @-session , theory-based HIV prevention intervention involving @ Bahamian grade-@ youths ( some of whom had received a comparable intervention in grade @ ) was conducted ( @-@ ) .


Randomization occurred at the level of the classroom with follow-up at @ , @ , and @ months after intervention .


The @ experimental conditions all included the youths ' curriculum and either a youth-parent intervention emphasizing adolescent-parent communication , a parent-only goal-setting intervention , or no parent intervention .


An intervention delivered to mid-adolescents in combination with a parent-adolescent sexual-risk communication intervention increased HIV/AIDS knowledge , condom-use skills , and self-efficacy and had a marginal effect on consistent condom use .


Regardless of prior exposure to a similar intervention as preadolescents , youths benefited from receipt of the intervention .


Preadolescents and mid-adolescents in HIV-affected countries should receive HIV prevention interventions that include parental participation .


Childhood cancer survivors have an increased risk of developing cardiovascular disease following treatment , yet few interventions have been evaluated to reduce this risk .


Purple grape juice ( pGJ ) , a rich source of flavonoids with antioxidant properties , has been shown in adults to reduce oxidative stress and improve endothelial function .


We examined the effects of supplementing meals with pGJ on microvascular endothelial function and markers of oxidative stress and inflammation in @ cancer survivors ( ages @-@ years ) .


In a randomized controlled crossover trial consisting of two , @ week intervention periods , each preceded by a @ week washout period , subjects received in random order @ ounces twice daily of pGJ and clear apple juice ( cAJ ; similar in calories but lower in flavonoids ) .


Measurements were obtained before and after each supplementation period ; change was evaluated using mixed effects ANOVA .


pGJ did not improve endothelial function , measured using digital reactive hyperemia , compared with cAJ ( mean change : pGJ @ , cAJ @ ; difference of mean change -LSB- @ % CI -RSB- : -@ -LSB- -@ - @ -RSB- , P = @ ) .


No significant changes in plasma concentrations of oxidized-LDL , myeloperoxidase , or high sensitivity C-reactive protein were observed .


After @ weeks of daily consumption of flavonoid-rich pGJ , no measurable change in vascular function was observed in these childhood cancer survivors .


The development of secondary non-response ( SNR ) to botulinum neurotoxin type-A ( BoNT-A ) is considered a key issue in the management of cervical dystonia ( CD ) .


This case-controlled study was performed to systematically identify factors influencing SNR during BoNT-A therapy .


This was a retrospective , international , non-interventional study of CD patients .


Patients with SNR were matched with up to three responder patients ( control ) on the basis of duration of therapy and number of injection cycles .


Factors influencing the development of SNR were screened using a univariate logistic regression model and confirmed using a multivariate conditional logistic regression model .


@ patients were enrolled , and @ ( SNR = @ ; responder = @ ) were matched and subdivided into blocks ( doublets , triplets or quadruplets ) .


At baseline , a significantly higher proportion of SNR patients had received previous or concomitant therapies ( p = @ ) and surgery for CD ( p = @ ) compared with controls .


Although disease severity at onset was similar between groups , a significantly higher proportion of SNR patients experienced severe CD at the time of SNR compared with controls at the last documented visit .


Multivariate analyses identified five factors that were significantly associated in predicting SNR ( odds ratio -LSB- OR -RSB- > @ indicated higher chances for being SNR ) : previous surgical procedure for CD ( OR @ , p = @ ) , previous BoNT-A related severe adverse event ( AE ) ( OR @ p = @ ) , physical therapy ( OR @ , p = @ ) , neuroleptic use ( OR @ , p = @ ) and average BoNT-A dose ( OR @ , p = @ ) .


These findings suggest that SNR may not reflect true pharmacological resistance to BoNT-A therapy , but may be related to underlying disease severity .


Acupuncture has been widely used as a treatment for stroke in China for more than @,@ years .


However , previous research has not yet shown that acupuncture is effective as a stroke treatment .


We report a protocol for a multicenter , randomized , controlled , and outcome assessor-blind trial to evaluate the efficacy and safety of acupuncture on acute ischemic stroke .


In a prospective trial involving three hospitals in the Zhejiang Province ( China ) @ patients with a recent ( less than @ week previous ) episode of ischemic stroke will be included .


Patients will be randomized into two groups : an acupuncture group given scalp acupuncture and electroacupuncture , and a control group given no acupuncture .


Eighteen treatment sessions will be performed over a three-week period .


The primary outcome will be measured by changes in the National Institutes of Health Stroke Scale score at the one , three , and four-week follow-up .


Secondary outcome measures will be : @ ) the Fugl-Meyer assessment scale for motor function ; @ ) the mini-mental state examination and Montreal cognitive assessment for cognitive function ; @ ) the video-fluoroscopic swallowing study for swallowing ability ; and @ ) the incidence of adverse events .


This trial is expected to clarify whether or not acupuncture is effective for acute stroke .


It will also show if acupuncture can improve motor , cognitive , or swallowing function .


The extant literature on predictors of treatment response to behavioral treatments for insomnia is equivocal and limited in scope .


The current study examined demographic , clinical , and sleep characteristics as predictors of clinically significant treatment response to brief behavioral treatment of insomnia ( BBTI ) in older adults with insomnia .


Thirty-nine older adults with insomnia ( @ % females , mean age : @ years ) were randomized to BBTI treatment .


Treatment outcomes were defined according to @ criteria : ( @ ) `` response , '' defined as change in Pittsburgh Sleep Quality Index ( PSQI ) score @ points or increase in sleep diary sleep efficiency @ % ) ; or ( @ ) remission , defined as absence of a clinical diagnosis of insomnia according to standard diagnostic criteria .


Logistic regression examined whether baseline demographic , clinical , or sleep characteristics predicted treatment outcomes at @ month follow-up .


Demographic variables did not predict treatment outcomes for either criterion .


Higher anxiety , depression , poorer sleep quality , and longer polysomnography ( PSG ) - assessed sleep latency predicted greater likelihood of response at follow-up ( p < @ ) .


Longer sleep duration at baseline ( measured by sleep diary and PSG ) predicted greater likelihood of the remission at follow-up ( p < @ ) .


Patients with insomnia who have greater distress at baseline or prolonged sleep latency are more likely to show positive response to BBTI .


In contrast , short sleepers at baseline are less likely to have resolution of insomnia diagnosis following BBTI , perhaps due to the sleep restriction component of the treatment .


Identifying the characteristics that predict positive BBTI treatment outcomes can facilitate personalized behavioral treatments to improve outcomes .


To compare the effects on health-related quality of life ( HRQoL ) of a @-year intervention with a low-fat diet ( LFD ) or a low-carbohydrate diet ( LCD ) based on four group-meetings to achieve compliance .


To describe different aspects of taking part in the intervention following the LFD or LCD .


Prospective , randomized trial of @ adults with Type @ diabetes mellitus .


The SF-@ questionnaire was used at baseline , @ , @ and @ months .


Patients on LFD aimed for @-@ energy percent ( E % ) and those on LCD for @ E % from carbohydrates .


The patients were interviewed about their experiences of the intervention .


Mean body-mass-index was @ @ kg/m ( @ ) at baseline .


Weight-loss did not differ between groups and was maximal at @ months , LFD : -@ @ kg , LCD : -@ @ kg ( p < @ within groups ) .


There was an increase in the physical component score of SF-@ from @ ( @ ) to @ ( @ ) at @ months in the LCD group ( p < @ ) while no change occurred in the LFD group ( p < @ between groups ) .


At @ months the physical function , bodily pain and general health scores improved within the LCD group ( p values @-@ @ ) while there was no change within the LFD group .


Weight-changes did not differ between the diet groups while improvements in HRQoL only occurred after one year during treatment with LCD .


No changes of HRQoL occurred in the LFD group in spite of a similar reduction in body weight .


Antifibrinolytics have been used for @ decades to reduce bleeding in cardiac surgery .


MDCO-@ is a novel , synthetic , serine protease inhibitor .


We describe the first experience with this drug in patients .


In this phase II , double-blind , placebo-controlled study , @ patients undergoing isolated primary coronary artery bypass grafting with cardiopulmonary bypass were randomly assigned to @ of @ increasing dosage groups of MDCO-@ .


The primary aim was to evaluate pharmacokinetics ( PK ) with assessment of plasmatic concentrations of the drug , short-term safety , and tolerance of MDCO-@ .


Secondary end points were influence on coagulation , chest tube drainage , and transfusion requirements .


PK analysis showed linear dosage-proportional correlation between MDCO-@ infusion rate and PK parameters .


Blood loss was significantly reduced in the @ highest dosage groups compared with control ( P = @ , @ and @ , respectively ) .


The incidence of allogeneic blood product transfusions was lower with MDCO-@ @/@ ( @ % ) vs @/@ ( @ % ) in the control group .


MDCO-@ exhibited dosage-dependent antifibrinolytic effects through suppression of D-dimer generation and inhibition of tissue plasminogen activator-induced lysis in ROTEM analysis as well as anticoagulant effects demonstrated by prolongation of activated clotting time and activated partial thromboplastin time .


No systematic differences in markers of end organ function were observed among treatment groups .


Three patients in the MDCO-@ groups experienced serious adverse events .


One patient experienced intraoperative thrombosis of venous grafts considered possibly related to the study drug .


No reexploration for mediastinal bleeding was required , and there were no deaths .


This first-in-patient study demonstrated dosage-proportional PK for MDCO-@ and reduction of chest tube drainage and transfusions in patients undergoing primary coronary artery bypass grafting .


Antifibrinolytic and anticoagulant effects were demonstrated using various markers of coagulation .


MDCO-@ was well tolerated and showed an acceptable initial safety profile .


Larger multi-institutional studies are warranted to further investigate the safety and efficacy of this compound .


In patients with brain tumors , the choice of antiepileptic medication is guided by tolerability and pharmacokinetic interactions .


This study investigated the effectiveness of levetiracetam ( LEV ) and pregabalin ( PGB ) , @ non-enzyme-inducing agents , in this setting .


In this pragmatic , randomized , unblinded phase II trial ( NCT@ ) , patients with primary brain tumors and epilepsy were titrated to a monotherapy of LEV or PGB .


Efficacy and tolerability were assessed using structured questionnaires .


The primary composite endpoint was the need to discontinue the study drug , add-on of a further antiepileptic treatment , or occurrence of at least @ seizures with impaired consciousness during @ year follow-up .


Over @ months , @ patients were randomized to LEV , and @ to PGB .


Most were middle-aged men , with a high-grade tumor and at least one generalized convulsion .


Mean daily doses were @ mg ( LEV ) and @ mg ( PGB ) .


Retention rates were @ % in the LEV group , and @ % in the PGB group .


The composite endpoint was reached in @ LEV and @ PGB patients-need to discontinue : side effects , @ LEV , @ PGB ; lack of efficacy , @ and @ ; impaired oral administration , @ and @ ; add-on of another agent : @ LEV , @ PGB ; and seizures impairing consciousness : @ in each .


Seven LEV and @ PGB subjects died of tumor progression .


This study shows that LEV and PGB represent valuable monotherapy options in this setting , with very good antiepileptic efficacy and an acceptable tolerability profile , and provides important data for the design of a phase III trial .


Influenza causes substantial morbidity and mortality worldwide .


Few data exist for the efficacy of neuraminidase inhibitors , which are the only readily available influenza treatment options , especially in low-income settings .


We assessed the efficacy of treatment with the neuraminidase inhibitor oseltamivir to reduce patient illness and viral shedding in people with influenza , in whom treatment was started within @ days of symptom onset , in an urban setting in Bangladesh .


We undertook a double-blind , randomised , controlled trial between May , @ , and December , @ .


Patients with a positive rapid influenza test identified by surveillance of households in Kamalapur , Bangladesh were randomly allocated on a @:@ basis to receive oseltamivir or placebo twice daily for @ days .


Randomisation lists for individuals enrolled less than @ h and @ h or longer since illness onset were generated with permuted blocks of variable length between two and eight .


Participants and study staff were masked to treatment group .


Participants provided nasal wash specimens at enrolment and @ , @ , and @ days later , and were visited daily to record symptoms .


All specimens were tested for influenza with reverse-transcriptase PCR , and if the result was positive , we isolated the virus .


The primary endpoints were duration of clinical illness and viral shedding in patients treated less than and more than @ h since illness onset and the frequency of oseltamivir resistance during treatment .


Analyses were intention to treat unless otherwise specified .


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


Overall , @ people with a median age of @ years ( IQR @-@ ) were enrolled : @ ( @ % ) less than @ h since symptom onset and @ ( @ % ) @ h or longer since symptom onset .


@ participants were assigned to placebo and @ to oseltamivir .


The median duration of symptoms was shorter in the oseltamivir group ( @ days , IQR @-@ ) than in the placebo group ( @ days , @-@ ; p = @ ) .


When stratified by timing of treatment initiation , in participants enrolled @ h or longer since illness onset , the median duration of symptoms was similar in both groups ( oseltamivir @ days -LSB- IQR @-@ -RSB- , placebo @ days -LSB- @-@ -RSB- ; p = @ ) .


The median duration of symptoms was reduced by @ day in the group given oseltamivir who were enrolled less than @ h since symptom onset compared with those given placebo , but this difference was not significant .


In those with all swab specimens ( n = @ ) , oseltamivir significantly reduced virus isolation on days @ ( placebo @ -LSB- @ % -RSB- vs oseltamivir @ -LSB- @ % -RSB- ; difference @ % , @ % CI @-@ @ , p = @ ) , @ ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; difference @ % , @ % CI @-@ @ , p < @ ) , and @ ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ; difference @ % , @ % CI @-@ @ , p = @ ) .


In participants enrolled @ h or longer since illness onset , oseltamivir treatment significantly reduced virus isolation on days @ and @ , but not day @ .


In participants enrolled less than @ h since illness onset , oseltamivir treatment significantly reduced virus isolation on days @ , @ , and @ .


The emergency of resistance to oseltamivir during treatment was rare overall ( < @ % ) and in influenza A H@N@pdm@ viruses ( @ % ) .


Oseltamivir treatment resulted in a modest reduction in the duration of symptoms and virus shedding in people with uncomplicated influenza infections , even when treatment was started @ h or longer after illness onset .


The severity and course of spinal pain is poorly understood in adolescents .


The study aimed to determine the prevalence and two-year incidence , as well as the course , frequency , and intensity of pain in the neck , mid back , and low back ( spinal pain ) .


This study was a school-based prospective cohort study .


All @th and @th grade students ( @-@ years ) at @ schools in the Region of Southern Denmark were invited to participate ( N = @,@ ) .


Data were collected in @ and again two years later , using an e-survey completed during school time .


The lifetime prevalence of spinal pain was @ % and @ % at baseline and follow-up , respectively .


A group of @ % ( @ % CI : @ , @ ) at baseline and @ % ( @ % CI : @ , @ ) at follow-up reported that they had pain frequently .


The frequency of pain was strongly associated with the intensity of pain , i.e. , the majority of the participants reported their pain as relatively infrequent and of low intensity , whereas the participants with frequent pain also experienced pain of higher intensity .


The two-year incidence of spinal pain varied between @ % and @ % across the physical locations .


Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period .


Spinal pain is common at the age of @-@ years , but some have more pain than others .


The pain is likely to progress , i.e. , to more locations , higher frequency , and higher pain intensity over a two-year period .


To evaluate the cardiorespiratory effects of IV administration of propofol ( @ mg/kg ) , ketamine hydrochloride and propofol ( @ mg/kg each ; K-P ) , or ketamine hydrochloride ( @ mg/kg ) and diazepam ( @ mg/kg ; K-D ) before and after induction of anesthesia ( IoA ) in dogs sedated with acepromazine maleate and oxymorphone hydrochloride .


@ healthy adult Beagles .


Each dog was randomly allocated to receive @ of @ treatments ( @-week interval ) .


For instrumentation prior to each treatment , each dog was anesthetized with isoflurane .


After full recovery , acepromazine ( @ mg/kg ) and oxymorphone ( @ mg/kg ) were administered IV .


Fifteen minutes later ( before IoA ) , each dog received treatment IV with propofol , K-P , or K-D .


Cardiorespiratory and arterial blood gas variables were assessed before , immediately after , and @ minutes after IoA .


Compared with findings before IoA , dogs receiving the K-P or K-D treatment had increased cardiac output , oxygen delivery , and heart rate @ minutes after IoA ; K-P administration did not change mean arterial blood pressure or stroke volume and decreased systemic vascular resistance .


Propofol decreased mean arterial blood pressure and systemic vascular resistance immediately after IoA but did not change heart rate , cardiac output , or oxygen delivery .


All treatments caused some degree of apnea , hypoventilation , and hypoxemia ( Pao@ < @ mm Hg ) .


In dogs , K-P treatment maintained mean arterial blood pressure better than propofol alone and increased heart rate , cardiac output , or oxygen delivery , as did the K-D treatment .


Supplemental @ % oxygen should be provided during IoA with all @ treatments .


Antibiotic resistance is the main reason for failure of Helicobacter pylori ( H. pylori ) treatment .


Currently , guidelines recommend a treatment guided by antimicrobial susceptibility testing after two failures .


However , microbial culture is not feasible everywhere , and the limited number of effective antibiotics against the bacterium narrows the options ; thus a rescue therapy combining antibiotics with a low resistance may be fitting .


Patients who have failed a first-line treatment ( either prolonged triple or sequential regimens ) and , successively , a levofloxacin-based triple therapy were considered for the study .


Subjects underwent urea breath test ( UBT ) , stool antigen test ( ST ) and endoscopy/histology to confirm the diagnosis .


Cytopenia and impaired liver and kidney function were exclusion criteria .


Fifty-four subjects were randomized @:@ to two regimens : RMB Rabeprazole/Rifabutin/Minocycline / Bismuth sub-citrate or MTB Rabeprazole/Tinidazole/Minocycline / Bismuth sub-citrate both for @ days .


The results were checked @ weeks after the end of therapy with ST/UBT plus endoscopy when indicated .


RMB eradicated the bacterium in @ patients .


Two subjects dropped out .


The eradication rate was @ % ( CI @-@ @ % ) at intention-to-treat and @ % ( CI @-@ @ % ) at per-protocol analysis .


MTB was successful in @ patients ( @ % , CI @-@ @ % ) .


No patient withdrew from the treatment for adverse events .


Drug-related side effects were reported only in @ subjects , but in all cases the treatment was carried on .


The association minocycline/rifabutin seems to have a synergic effect and a good therapeutic outcome in patients who have failed at least two previous regimens , although a trial on a large population is needed .


To assess the effect of automated adjustment of the inspired oxygen fraction ( FiO@ ) on arterial oxygen saturation ( SpO@ ) and cerebral tissue oxygen saturation ( SctO@ ) in very low birth weight infants with frequent fluctuations in oxygenation .


Fifteen infants ( median gestational age , @ weeks -LSB- range , @-@ weeks -RSB- ; median age , @ days -LSB- range , @-@ days -RSB- ) were assigned in random sequence to @ hours of automated adjustment of FiO@ or manual adjustment of FiO@ .


Primary outcome measurements were time within the SpO@ target range and the area under the curve above and below a defined SctO@ range .


Percentage of time within the SpO@ target range increased during automated FiO@ control ( @ % @ % vs @ % @ % for manual ; P < @ ) .


Prolonged episodes with SpO@ < @ % of > @ seconds duration ( median , @ episodes -LSB- range , @-@ -RSB- vs @ episodes -LSB- range , @-@ -RSB- ; P < @ ) and of > @ seconds duration ( median , @ episodes -LSB- range , @-@ -RSB- vs @ episodes -LSB- range , @-@ -RSB- ; P < @ ) decreased significantly during the automated period .


Percentage of time with SpO@ > @ % decreased during automated control ( @ % @ % vs @ % @ % ; P < @ ) .


There was no significant difference in FiO@ exposure .


The area ( deviation time ) below and above the defined SctO@ threshold did not differ between the @ periods ( median , @ % * seconds -LSB- range , @ % -@ % -RSB- for manual vs @ % * seconds -LSB- range , @ % -@ % -RSB- for automated ; P = @ ) .


Automated FiO@ control in preterm infants with frequent SpO@ fluctuations significantly increased the time within the SpO@ target range and reduced the incidence of prolonged hypoxemic events compared with manual FiO@ adjustment , but did not significantly affect cerebral tissue oxygenation .


In patients with severe sepsis , no randomized clinical trial has tested the concept of de-escalation of empirical antimicrobial therapy .


This study aimed to compare the de-escalation strategy with the continuation of an appropriate empirical treatment in those patients .


This was a multicenter non-blinded randomized noninferiority trial of patients with severe sepsis who were randomly assigned to de-escalation or continuation of empirical antimicrobial treatment .


Recruitment began in February @ and ended in April @ in nine intensive care units ( ICUs ) in France .


Patients with severe sepsis were assigned to de-escalation ( n = @ ) or continuation of empirical antimicrobial treatment ( n = @ ) .


The primary outcome was to measure the duration of ICU stay .


We defined a noninferiority margin of @ days .


If the lower boundary of the @ % confidence interval ( CI ) for the difference in patients assigned to the de-escalation group was less than @ days , as compared with that of patients assigned to the continuation group , de-escalation was considered to be noninferior to the continuation strategy .


Secondary outcomes included mortality at @ days , occurrence of organ failure , number of superinfections , and number of days with antibiotics during the ICU stay .


The median duration of ICU stay was @ -LSB- interquartile range ( IQR ) @-@ -RSB- days in the de-escalation group and @ -LSB- IQR @-@ -RSB- days in the continuation group , respectively ( P = @ ) .


The mean difference was @ ( @ % CI -@ to @ ) .


A superinfection occurred in @ ( @ % ) patients in the de-escalation group and six ( @ % ) patients in the continuation group ( P = @ ) .


The numbers of antibiotic days were @ -LSB- @-@ -RSB- and @ -LSB- @-@ -RSB- in the de-escalation group and continuation group , respectively ( P = @ ) .


Mortality was similar in both groups .


As compared to the continuation of the empirical antimicrobial treatment , a strategy based on de-escalation of antibiotics resulted in prolonged duration of ICU stay .


However , it did not affect the mortality rate .


To evaluate the effect of a hamstring block for postoperative pain management using @ mL of @ % bupivacaine compared with placebo after anterior cruciate ligament ( ACL ) reconstruction with a hamstring autograft .


In a @-month period , @ patients undergoing ACL reconstruction with a hamstring autograft who all received a femoral nerve block were randomized to receive either @ mL of @ % bupivacaine or @ mL of saline water administered through a catheter into the donor-site space .


The patients and recovery staff were blinded to the treatment .


Postoperative donor-site pain was evaluated subjectively by the patients using a pain score ( Likert scale from @ to @ ) .


The pain was registered for each hour in the first @ hours and thereafter once daily for @ days .


Furthermore , the requirement for postoperative analgesic medicine was registered .


The hamstring block group ( n = @ ) had significantly less pain for each of the first @ postoperative hours .


The pain score was reduced from @ to @ ( @ % confidence interval , @ to @ ) ( P = @ ) in the first hour and from @ to @ ( @ % confidence interval , @ to @ ) in the sixth hour , and there was a significantly lower overall requirement for early postoperative fentanyl , reduced from a mean of @ to @ g ( P = @ ) , and morphine , reduced from a mean of @ to @ mg ( P = @ ) .


After @ hours , there was no difference in the pain level and use of analgesics between the @ groups .


With the use of a donor-site block in hamstring ACL reconstruction , the donor-site pain level , as well as the overall requirement for fentanyl and morphine , was significantly reduced in the first @ postoperative hours .


No effect of the donor-site block was seen after @ hours .


Level I , therapeutic , randomized controlled study .


The aim of this study was to evaluate the effect of a low tube voltage technique and hybrid iterative reconstruction ( HIR ) on image quality at @-dimensional computed tomographic angiography ( @D-CTA ) of the liver .


Before hepatic surgery , we randomly assigned @ patients ( @ women , @ men ; mean SD age , @ @ years ) who had undergone @D-CTA to @ of @ protocols ; @ patients underwent scanning under the conventional @-kilovolt ( peak ) protocol with filtered back projection ( P@ ) ; and @ patients , under an @-kilovolt ( peak ) protocol with HIR ( P@ ) .


The estimated effective radiation dose , computed tomographic attenuation , image noise , contrast-to-noise ratio , and figure of merit were calculated , and the visual image quality of @D-CTA was scored on a @-point scale .


The mean effective radiation dose was significantly lower under P@ than P@ ( @ @ vs @ @ mSv , P < @ ) .


P@ and P@ did not significantly differ with respect to the image noise ( @ @ vs @ @ Hounsfield units ; P = @ ) .


Computed tomographic attenuation , contrast-to-noise ratio , figure of merit , and the visual scores for image quality were higher under P@ than P@ ( P < @ ) .


The use of low tube voltage and HIR can yield significantly improved image quality at @D-CTA of the liver .


To improve arterial catheter ( AC ) securement and reduce AC failure ; to assess feasibility of a large randomised controlled trial .


A four-arm , parallel , randomised , controlled , non-blinded pilot trial with @ intensive care patients taking part , in a tertiary referral hospital in Brisbane , Australia from May to November @ .


Standard polyurethane ( SPU ) dressing ( controls ) ; bordered polyurethane ( BPU ) + SPU dressing ; tissue adhesive ( TA ) + SPU dressing ; and sutureless securement device ( SSD ) + SPU dressing ( no sutures used ) .


AC failure , ie , complete dislodgement , occlusion ( monitor failure , inability to infuse or fluid leaking ) , pain or infection ( local or blood ) .


Median AC dwell time was @ hours and was comparable between groups .


AC failure occurred in @/@ patients ( @ % ) .


AC failure was significantly worse with SPU dressings ( @/@ -LSB- @ % -RSB- ) than with BPU + SPU dressings ( @ / @ -LSB- @ % -RSB- ; P = @ ) , but not significantly different to TA + SPU ( @/@ -LSB- @ % -RSB- ; P = @ ) or SSD + SPU ( @/@ -LSB- @ % -RSB- ; P = @ ) .


The dressing applied at AC insertion lasted until AC removal in @ % of controls ; @ % of BPU + SPU dressings ; @ % of TA + SPU dressings ; and @ % of SSD + SPU dressings ( all P > @ ) .


There were no infections or serious adverse events .


Patient and staff satisfaction with all products was high .


Median costs ( labour and materials ) for securement per patient were significantly higher in all groups compared with the control group ( SPU , $ @ -LSB- IQR , $ @ - $ @ -RSB- ; BPU + SPU , $ @ -LSB- IQR , $ @ - $ @ -RSB- ; SSD + SPU , $ @ -LSB- IQR , $ @ - $ @ -RSB- ; TA + SPU , $ @ -LSB- IQR , $ @ - $ @ -RSB- ; all P < @ ) .


AC failure occurred significantly less often with BPU + SPU dressings than with SPU dressings .


TA + SPU and SSD + SPU dressings should be further investigated and compared with BPU + SPU dressings as controls .


The novel approach of TA + SPU dressings appeared safe and feasible .


To evaluate the veterinary student learning outcome of @ methods of equine rectal examination training .


Randomized prospective study .


Veterinary students ( @rd and @th year ; n = @ ) and practicing equine veterinarians ( n = @ ) .


Year @ : Group @ ( n = @ ) and Group @ students ( n = @ ) received skilled instructor ( SI ) and laparoscopic-guidance ( LG ) , respectively , during rectal exam instruction .


All students were tested on rectal identification of @ abdominal organs .


Year @ : One group of students ( n = @ ) was trained and subsequently tested using each technique , first SI , followed by LG .


Subjective evaluation of laparoscopy as a teaching tool was achieved with veterinary students and equine practitioners .


A significantly greater percentage of students having LG compared to SI were able to correctly identify the left kidney ( Year @ ) and the spleen , cecum , and right ovary ( Year @ ) .


A significantly greater proportion of LG trained students in years @ and @ ( @ % and @ % , respectively ) were also able to identify @ % of organs compared with SI ( @ % and @ % , respectively ) .


Both students and veterinarians uniformly provided favorable feedback for LG in teaching rectal palpation skills .


The LG method of equine rectal examination instruction resulted in improved learning for identification of several key abdominal organs compared with SI .


We report our experience with a modified mini-maze procedure and pulmonary vein isolation using radiofrequency energy for treating persistent atrial fibrillation during coronary artery bypass grafting ( CABG ) .


Ninety-five patients with persistent atrial fibrillation and coronary heart disease underwent open heart surgery combined with intraoperative irrigated radiofrequency ablation .


Patients were randomized into the following three groups : CABG and irrigated radiofrequency pulmonary vein isolation ( CABG+PVI , n = @ ) ; CABG and an irrigated radiofrequency modified mini-maze procedure ( CABG+MM , n = @ ) ; and isolated CABG ( CABG alone , n = @ ) .


All patients received implantable loop recorders .


No reoperation and no hospital mortality were recorded .


Mean follow-up was @ @ months .


The implantable loop recorder-determined freedom from atrial fibrillation was @ % in the CABG+PVI group , @ % in the CABG+MM group and @ % in the CABG alone group .


Patients with concomitant atrial fibrillation and coronary heart disease may benefit from intraoperative ablation to prevent relapse of arrhythmia .


Dystrophinopathy is a rare , severe muscle disorder , and nonsense mutations are found in @ % of cases .


Ataluren was developed to enable ribosomal readthrough of premature stop codons in nonsense mutation ( nm ) genetic disorders .


Randomized , double-blind , placebo-controlled study ; males @ years with nm-dystrophinopathy received study drug orally @ times daily , ataluren @ , @ , @ mg/kg ( N = @ ) ; ataluren @ , @ , @ mg/kg ( N = @ ) ; or placebo ( N = @ ) for @ weeks .


The primary endpoint was change in @-Minute Walk Distance ( @MWD ) at Week @ .


Ataluren was generally well tolerated .


The primary endpoint favored ataluren @ , @ , @ mg/kg versus placebo ; the week @ @MWD = @ meters , post hoc P = @ .


Secondary endpoints ( timed function tests ) showed meaningful differences between ataluren @ , @ , @ mg/kg , and placebo .


As the first investigational new drug targeting the underlying cause of nm-dystrophinopathy , ataluren offers promise as a treatment for this orphan genetic disorder with high unmet medical need .


Increased coagulation activation may contribute to the high incidence of cardiovascular complications observed in obese and type @ diabetes ( T@D ) subjects .


Although tissue factor ( TF ) , the primary initiator of coagulation is increased in obesity , its expression in adipose tissues and its association with metabolic parameters are unclear .


We sought to compare TF expression in plasma and adipose tissues of obese subjects with and without T@D , its correlation with metabolic parameters , and regulation in response to antidiabetic drugs .


Subjects were recruited from diabetes clinics and adipose tissue was obtained by needle biopsy of lower subcutaneous abdominal depot .


For the intervention study , subjects were randomized into treatment groups with rosiglitazone or metformin for @ months .


Plasma TF antigen , activity , and adipose TF mRNA were greater in obese T@D subjects compared with obese nondiabetics .


Plasma TF activity correlated with fasting insulin , glucose , and free fatty acids , ( FFAs ) , and adipose TF mRNA correlated with plasma FFA .


Plasma TF activity was reduced by metformin and increased with rosiglitazone treatment .


Specific diabetes-related metabolic parameters , but not obesity per se , are correlated with TF expression .


Regulation of TF activity by different classes of antidiabetic drugs may relate to protective or adverse cardiovascular outcomes .


To observe the effects of Liuwei Dihuang Granule ( -LSB- symbols ; see text -RSB- , LDG ) for tonifying Kidney ( Shen ) on the outcomes of in vitro fertilization pre-embryo transfer ( IVF-ET ) of infertility women with Kidney-yin deficiency syndrome and to explore its mechanism by detecting the proteome expression in the follicular fluid .


Sixty-six infertility patients of Kidney-yin deficiency syndrome who would undergo IVF-ET , were randomly assigned to a treatment group and a control group according to a random number table , @ cases in each group .


Another @ cases of non-Kidney-yin deficiency syndrome was taken as a syndrome-control group .


Besides Western routine therapy , LDG was given @ menstrual cycles before IVF to the treatment group , and a placebo granule to the control and syndrome-control groups .


The scores of Kidney-yin deficiency symptoms ( sore waist and knees , dry vagina , dysphoria with feverish sensation in the chest , palms and soles , etc. ) were assessed , the number of retrieved oocytes , rates of high quality oocytes and embryos , fertility rate and clinical pregnancy rate were recorded , and the follicular fluid was collected on the day when the ovum was picked up , the differential protein expression was detected using two-dimensional gel electrophoresis , and then , matrix assisted laser desorption ionization time-of flight mass spectrometry ( MALDI-TOF-MS ) was applied to identify the proteins .


The syndrome score in the treatment group decreased significantly from @ to @ , while it changed insignificantly in the control group , with a significant difference in the lowering score between the two groups ( P < @ ) ; the high quality rates of oocytes and embryos and clinical pregnancy rate were all superior in the treatment group to the control group ( @ % vs @ % , @ % vs @ % , @ % vs @ % , all P < @ ) .


The protein expression map from the follicular fluid showed that compared with the control group , @ differential protein expressions were found in the syndrome-control group , among which @ were down-regulated , and @ up-regulated ; in the treatment group @ differential protein expressions were found , among which @ were down-regulated , and @ up-regulated .


Through MALDI-TOF-MS , @ proteins were identified ( P < @ ) .


For the infertility patients undergoing IVF , LDG could alleviate clinical symptoms , improve rates of high quality oocytes and embryos , so as to raise clinical pregnancy rate .


The mechanism may be through regulating proteome expression in the follicular fluid to improve the developmental microenvironment for oocytes which would lead to a successful embryo implantation .


We evaluated the impact of influenza vaccine text message reminders in a low-income obstetric population .


We conducted a randomized controlled trial that enrolled @ obstetric patients from @ community-based clinics in New York City .


The intervention group received @ weekly text messages regarding influenza vaccination starting mid-September @ and @ text message appointment reminders .


Both groups received standard automated telephone appointment reminders .


The prespecified endpoints were receipt of either pre - or postpartum influenza vaccination calculated cumulatively at the end of each month ( September-December @ ) .


After adjusting for gestational age and number of clinic visits , women who received the intervention were @ % more likely to be vaccinated as of December @ ( adjusted odds ratio -LSB- AOR -RSB- = @ ; @ % confidence interval -LSB- CI -RSB- = @ , @ end of September : AOR = @ ; @ % CI = @ , @ ; October : AOR = @ ; @ % CI = @ , @ ; November : AOR = @ ; @ % CI = @ , @ ) .


The subgroup of women early in the third trimester at randomization showed the greatest intervention effect ( December @ : @ % intervention vs @ % control ; AOR = @ ; @ % CI = @ , @ ) .


In this low-income obstetric population , text messaging was associated with increased influenza vaccination , especially in those who received messages early in their third trimester .


Despite the large number of Latinos living in the United States , little research has evaluated the effectiveness of different vocational rehabilitation programs for individuals with severe mental illness in this rapidly growing minority population .


This article presents a secondary analysis of a randomized , controlled trial comparing supported employment with @ other vocational rehabilitation programs in @ ethnic/racial groups of participants with severe mental illness : Latinos , non-Latino African Americans , and non-Latino Whites .


The data were drawn from a previously published randomized , controlled trial comparing supported employment with standard vocational rehabilitation services and a psychosocial clubhouse program in persons with severe mental illness ( Mueser et al. , @ ) , including @ Latinos , @ non-Latino African Americans , and @ non-Latino Whites .


Comparisons were made between the @ groups at baseline on demographic characteristics , clinical and psychosocial functioning , and quality of life .


Within each ethnic/racial group , competitive employment and all paid employment outcomes were compared between the @ vocational rehabilitation programs over the @-year study period .


At baseline , the Latino participants had lower levels of education and disability income , were less likely to have worked competitively over the previous @ years , had more severe symptoms , and worse psychosocial functioning than the non-Latino African American or non-Latino White participants .


Latinos randomized to supported employment had better competitive and all-paid work outcomes than those assigned to either standard services or the psychosocial clubhouse program , similar to the non-Latino consumers .


Rates of competitive work for consumers in supported employment were comparable across all @ racial/ethnic groups .


Supported employment is effective at improving competitive work in Latinos with severe mental illness .


Efforts should be made to increase access to supported employment in the growing population of Latinos with severe mental illness .


A new , novel product , Cynatine HNS , was evaluated for its effects as a supplement for improving various aspects of hair and nails in a randomized , double-blind , placebo-controlled clinical trial .


A total of @ females were included and randomized into two groups .


The active group ( n = @ ) received @ capsules containing Cynatine HNS , comprised of Cynatine brand keratin ( @ mg ) plus vitamins and minerals , per day , and the placebo group ( n = @ ) received @ identical capsules of maltodextrin per day for @ days .


End points for hair loss , hair growth , hair strength , amino acid composition , and hair luster were measured .


End points were also measured for nail strength and the appearance of nails .


The results show that subjects taking Cynatine HNS showed statistically significant improvements in their hair and nails when compared to placebo .


Cynatine HNS is an effective supplement for improving hair and nails in @ days or less .


EudraCT number is @-@-@ .


Individuals with schizophrenia have functionally significant deficits in automatic and controlled social cognition , but no currently available pharmacologic treatments reduce these deficits .


The neuropeptide oxytocin has multiple prosocial effects when administered intranasally in humans and there is growing interest in its therapeutic potential in schizophrenia .


We administered @ IU of oxytocin and saline placebo intranasally to @ male subjects with schizophrenia and @ age-matched , healthy controls in a randomized , double-blind , placebo-controlled , cross-over study .


Social cognition was assessed with The Awareness of Social Inference Test ( TASIT ) and the Reading the Mind in the Eyes Test ( RMET ) .


We examined the effects of oxytocin administration on automatic social cognition ( the ability to rapidly interpret and understand emotional cues from the voice , face , and body ) ; controlled social cognition ( the ability to comprehend indirectly expressed emotions , thoughts , and intentions through complex deliberations over longer time periods ) ; and a control task ( the ability to comprehend truthful dialog and perform general task procedures ) in individuals with and without schizophrenia using mixed factorial analysis of variance models .


Patients with schizophrenia showed significant impairments in automatic and controlled social cognition compared to healthy controls , and administration of oxytocin significantly improved their controlled , but not automatic , social cognition , F ( @ , @ ) = @ ; p = @ .


Conversely , oxytocin administration had limited effects on social cognition in healthy participants .


Patients and controls performed equally well and there were no effects of oxytocin administration on the control task .


Intact social cognitive abilities are associated with better functional outcomes in individuals with schizophrenia .


Our data highlight the potentially complex effects of oxytocin on some but not all aspects of social cognition , and support the exploration of intranasal oxytocin as a potential adjunct treatment to improve controlled social cognition in schizophrenia .


To investigate associations between timing of adiposity rebound ( AR ; the period in childhood where BMI begins to increase from its nadir ) and adiposity ( BMI , fat mass ) at age @ years in the Avon Longitudinal Study of Parents and Children ( ALSPAC ) .


The sample consisted of @ children with AR derived in childhood and BMI and fat mass index ( FMI ; fat mass measured by dual-energy radiograph absorptiometry/height in m ( @ ) ) measured at @ years .


Multivariable linear regression models were based on standardized residuals of log BMI and log FMI to allow comparison of regression coefficients across outcomes .


There were strong dose-response associations between timing of AR and both adiposity outcomes at @ years independent of confounders .


BMI was markedly higher in adolescence for those with very early AR ( by @ years ; = @ ; @ % confidence interval -LSB- CI -RSB- : @-@ @ ; P @ ) and was also higher for those with early AR ( between @ and @ years ; = @ ; @ % CI : @-@ @ ; P = @ ) compared with those with later AR ( > @ years ) after full adjustment for a range of potential confounders .


Similar magnitudes of association were found for FMI after full adjustment for confounders ( compared with later AR : very early AR = @ ; @ % CI : @-@ @ ; P @ ; early AR = @ ; @ % CI : @-@ @ ; P = @ ) .


Early AR is strongly associated with increased BMI and FMI in adolescence .


Preventive interventions should consider targeting modifiable factors in early childhood to delay timing of AR .


Randomized clinical trial .


To compare the effects of functional stabilization training ( FST ) versus standard training on knee pain and function , lower-limb and trunk kinematics , trunk muscle endurance , and eccentric hip and knee muscle strength in women with patellofemoral pain .


A combination of hip - and knee-strengthening exercise may be more beneficial than quadriceps strengthening alone to improve pain and function in individuals with patellofemoral pain .


However , there is limited evidence of the effectiveness of these exercise programs on the biomechanics of the lower extremity .


Thirty-one women were randomized to either the FST group or standard-training group .


Patients attended a baseline assessment session , followed by an @-week intervention , and were reassessed at the end of the intervention and at @ months after the intervention .


Assessment measures were a @-cm visual analog scale for pain , the Lower Extremity Functional Scale , and the single-leg triple-hop test .


A global rating of change scale was used to measure perceived improvement .


Kinematics were assessed during the single-leg squat .


Outcome measures also included trunk endurance and eccentric hip and knee muscle strength assessment .


The patients in the FST group had less pain at the @-month follow-up and greater global improvement and physical function at the end of the intervention compared to those in the standard-training group .


Lesser ipsilateral trunk inclination , pelvis contralateral depression , hip adduction , and knee abduction , along with greater pelvis anteversion and hip flexion movement excursions during the single-leg squat , were only observed in the FST group after the intervention .


Only those in the FST group had greater eccentric hip abductor and knee flexor strength , as well as greater endurance of the anterior , posterior , and lateral trunk muscles , after training .


An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was more beneficial in improving pain , physical function , kinematics , and muscle strength compared to a program of quadriceps-strengthening exercises alone .


To evaluate the @-year results following a randomised controlled trial ( RCT ) comparing open ( ONF ) and laparoscopic ( LNF ) Nissen fundoplication in children .


It is assumed that long-term results of ONF and LNF are comparable .


No randomised studies have been performed in children .


A follow-up study was performed in children randomised to ONF or LNF ( clinicaltrials.gov identifier NCT@ ) .


Recurrent gastro-oesophageal reflux ( GER ) was documented by upper gastrointestinal contrast study and/or @-h pH study .


Nutritional status , retching and other symptoms were investigated .


A questionnaire was used to assess the quality of life before and after surgery .


Thirty-nine children were randomised to ONF ( n = @ ) or LNF ( n = @ ) .


There were @ ONF and @ LNF neurologically impaired children .


One patient ( ONF group ) was lost to follow-up .


Follow-up was @ years ( @-@ @ ) for ONF group and @ years ( @-@ @ ) for LNF group ( p = @ ) .


Seven neurologically impaired children had died by the time of follow-up ( @ ONF , @ LNF ) .


Incidence of recurrent GER was @ % in the ONF and @ % in the LNF ( p = ns ) .


One patient in each group underwent redo-Nissen fundoplication .


Nutritional status improved in both groups , as indicated by a significant increase in weight Z-score ( p < @ ) .


Gas bloat and dumping syndrome were present in both groups ( p = ns ) .


Incidence of retching was lower in the laparoscopic group ( p = @ ) .


Quality of life improved in both groups ( p = ns ) .


Open and laparoscopic Nissen provide similar control of reflux and quality of life at follow-up .


LNF is associated with reduced incidence of retching persisting at @-year follow-up .


To determine the efficacy of consolidation chemotherapy ( CC ) with docetaxel and cisplatin ( DP ) after concurrent chemoradiotherapy ( CCRT ) with the same agents in locally advanced non-small-cell lung cancer ( LA-NSCLC ) .


Patients were randomly assigned to either CCRT alone ( observation arm ) or CCRT followed by CC ( consolidation arm ) .


CCRT with docetaxel ( @ mg/m ( @ ) ) and cisplatin ( @ mg/m ( @ ) ) was administered every week for @ weeks with a total dose of @ Gy of thoracic radiotherapy in @ fractions .


In the consolidation arm , patients were further treated with three cycles of DP ( @ mg/m ( @ ) each on days @ and @ , every @ weeks ) .


The primary end point was @ % improvement in progression-free survival ( PFS ) compared with observation .


From October @ to April @ , @ patients were randomly assigned .


Seventeen patients did not start CCRT as a result of consent withdrawal or ineligibility reasons after random assignment , leaving @ patients for this analysis ( n = @ for observation ; n = @ for consolidation ) .


Patient characteristics were similar in both arms .


In the consolidation arm , @ patients ( @ % ) received CC , of whom @ ( @ % ) completed three planned cycles .


The median PFS was @ months in the observation arm and @ months in the consolidation arm ( hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) .


Median overall survival times were @ and @ months in the observation and consolidation arms , respectively ( HR , @ ; @ % CI , @ to @ ; P = @ ) .


CC with DP after CCRT with weekly DP in LA-NSCLC failed to further prolong PFS .


CCRT alone should remain the standard of care .


In mainland China , peginterferon ( PEG-IFN ) alfa-@b @ g/kg/wk for @ weeks is the approved treatment for HBeAg-positive chronic hepatitis B.


This multicenter , randomized trial evaluated the safety and efficacy of regimens utilizing increased dose or treatment duration in treatment-naive Chinese patients with chronic hepatitis B.


@ HBeAg-positive patients from China , Malaysia , Taiwan area , Singapore , and Thailand were enrolled .


Patients received PEG-IFN alfa-@b @ g/kg/wk ( arm A ) or @ g/kg/wk ( arm B ) for @ weeks , or @ g/kg/wk for @ weeks ( arm C ) .


The primary end point was loss of HBeAg @ weeks after end of treatment .


At the end of follow-up , HBeAg loss was significantly greater in arm C compared with arm A ( @ % vs. @ % ; P = @ ) and arm B ( @ % vs. @ % ; P = @ ) .


No significant difference in the rate of HBeAg loss was observed between arms A and B.


The proportions of patients with HBe seroconversion , HBV DNA levels < @,@ IU/mL , and ALT normalization at the end of follow-up were significantly higher in arm C compared with arm A and arm B.


In arms A , B , and C , rates of early treatment discontinuation were @ % , @ % , and @ % ; of discontinuation due to an AE , @ % , @ % , and @ % ; and of AEs requiring dose modification , @ % , @ % , and @ % , respectively .


In Chinese patients with HBeAg-positive chronic hepatitis B , PEG-IFN alfa-@b @ g/kg/wk for @ weeks is more efficacious compared with @ and @ g/kg/wk for @ weeks .


To evaluate the impact of contact lens ( CL ) - induced corneal swelling on the optical quality of the eye by means of the double-pass technique .


Measurements of @ healthy subjects were obtained in @ visits over @ week , at baseline and after sleeping with @ different CLs of +@ D , +@ D , +@ D and +@ D ( Acuvue@ ) , randomly fitted on @ different days .


The control eye wore no CL .


Corneal pachymetry and optical quality of the eye ( OQAS , Visiometrics ) were measured once at baseline and at three interval times in the follow-up visits : immediately after CL removal , and @ and @ h after CL removal .


Optical quality was evaluated by means of the Strehl ratio and OQAS values at @ % , @ % and @ % contrasts .


Intraocular scattering was evaluated with the objective scatter index ( OSI ) .


Mean overnight swelling was @ @ % in CL-eyes versus @ @ % in control eyes ( p < @ ) .


Corneal swelling was maximal immediately after CL removal and decreased with time ( p < @ ) .


A significant worsening in all optical quality parameters and a significant increase of the OSI were found in eyes with corneal swelling ( p < @ ) .


Two hours after CL removal there were no statistically significant differences ( p > @ ) between CL-eyes and control eyes in any of the measured parameters .


Corneal swelling has a significant impact on the optical quality of the eye and on intraocular scattering as assessed with the double-pass technique .


Everolimus and cyclosporine A ( CsA ) exhibit synergistic immunosuppressive activity when used in combination .


We examined the safety and efficacy of the use of everolimus with a cyclosporine-sparing strategy in de novo renal transplant recipients .


A comparative , parallel , randomized , open-label @-year study has been performed in @ patients from five transplant centers to compare the efficacy and tolerability of everolimus and reduced exposure CsA ( the investigational group ) or enteric-coated mycophenolate sodium and standard-exposure CsA ( the control group ) in combination with basiliximab and steroids .


The eligible subjects were randomly assigned at @ month after transplantation .


Efficacy failure ( biopsy-proven acute rejection , death , graft loss , or loss to follow-up ) , safety , and renal function were evaluated .


One graft loss has been reported in the control group and no patient death were reported in either group .


The incidence of biopsy-proven acute rejection until @ months after transplantation of the investigational group was @ % , compared to @ % of the control group ( P = @ ) .


The mean estimated glomerular filtration rates of the investigational group at @ months after transplantation was significantly higher ( @ @ ml/min/@ @ m ( @ ) ) than that of the control group ( @ @ ml/min/@ @ m ( @ ) ; P = @ ) .


There was no significant difference ( P > @ ) in the incidence of discontinuations and serious adverse events between the groups .


The results of this study provide the evidences that ( @ ) the calcineurin inhibitor ( CNI ) minimization by the introduction of everolimus after @-month posttransplantation keeps the incidences of acute rejection and additional risks as low as the conventional immunosuppression ; ( @ ) it allows minimizing CNI exposure , consequently reducing CNI nephrotoxicity and preserving renal function .


The purpose of this randomized controlled study was to examine and compare the immediate and retention effects of speed-dependent treadmill training ( SDTT ) and rhythmic auditory-cued ( RAC ) overground walking on gait function and fall risk in individuals with Parkinson 's disease ( PD ) .


Twenty participants ( mean age @ yrs ) with idiopathic PD were randomized into either SDTT ( n = @ ) or RAC ( n = @ ) progressive , interval-based locomotor training protocols .


Immediate and retention training effects on gait function and fall risk were measured by comfortable and fast gait speed ( CGS , FGS ) , @-Minute Walk Test ( @MWT ) , and Functional Gait Assessment ( FGA ) .


Immediate within-group training effects revealed significant gains in CGS , @MWT , and FGA for the RAC group , and in FGS , @-MinuteWalk Test , and FGA for the SDTT group .


Retention effects were found at @-month follow-up for all gait measures in the RAC group , and for FGS and FGA in the SDTT group .


No statistically significant differences in immediate or retention training effects on gait measures were found between groups .


Externally-cued locomotor training with progressive and interval-based speed challenges , either with RAC overground or on a treadmill , produced significant improvements in walking speed , endurance , and dynamic balance during walking .


High-sensitivity troponin-I ( hs-TnI ) measurement improves risk assessment for cardiovascular events in many clinical settings , but the added value in atrial fibrillation patients has not been described .


At randomization , hs-TnI was analyzed in @ @ atrial fibrillation patients in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation ( ARISTOTLE ) trial comparing apixaban with warfarin .


The associations between hs-TnI concentrations and clinical outcomes were evaluated by using adjusted Cox analysis .


The hs-TnI assay detected troponin ( @ ng/L ) in @ % patients , @ % had levels > @ , @ % had levels > @ , and @ % had levels @ ng/L ( the @th percentile in healthy individuals ) .


During a median of @ years follow-up , annual rates of stroke or systemic embolism ranged from @ % in the lowest hs-TnI quartile to @ % in the highest quartile ( > @ ng/L ) .


In multivariable analysis , hs-TnI was significantly associated with stroke or systemic embolism , adjusted hazard ratio @ ( @-@ @ ) , P = @ .


hs-TnI was also significantly associated with cardiac death ; annual rates ranged from @ % to @ % , hazard ratio @ ( @-@ @ ) , P < @ , in the corresponding groups , and for major bleeding hazard ratio @ ( @-@ @ ) , P = @ .


Adding hs-TnI levels to the CHA@DS@VASc score improved c-statistics from @ to @ for stroke or systemic embolism , and from @ to @ for cardiac death .


There were no significant interactions with study treatment .


Troponin-I is detected in @ % and elevated in @ % of atrial fibrillation patients .


The hs-TnI level is independently associated with a raised risk of stroke , cardiac death , and major bleeding and improves risk stratification beyond the CHA@DS@VASc score .


The benefits of apixaban in comparison with warfarin are consistent regardless of hs-TnI levels .


Heavy drinking among individuals with HIV is associated with major health concerns ( liver disease , medication nonadherence , immune functioning ) , but little is known about cognitive-motivational factors involved in alcohol consumption in this population , particularly reasons for limiting drinking .


Urban HIV primary care patients ( N = @ ; @ % male ; @ % African American or Hispanic ) in a randomized trial of brief drinking-reduction interventions reported on reasons for limiting drinking , alcohol consumption , and alcohol dependence symptoms prior to intervention .


Exploratory factor analysis indicated @ main domains of reasons for limiting drinking : social reasons ( e.g. , responsibility to family ) , lifestyle reasons ( e.g. , religious/moral reasons ) , and impairment concerns ( e.g. , hangovers ) .


These factors evidenced good internal consistency ( s = @ to @ ) .


Higher scores on social reasons for limiting drinking were associated with lower typical quantity , maximum quantity , and binge frequency ( ps < @ ) , and higher scores on lifestyle reasons were associated with lower maximum quantity , binge frequency , and intoxication frequency ( ps < @ ) .


In contrast , higher scores on impairment concerns were associated with more frequent drinking and intoxication , and higher risk of alcohol dependence ( ps < @ ) , likely because dependent drinkers are more familiar with alcohol-induced impairment .


The current study is the first to explore reasons for limiting drinking among individuals with HIV and how these reasons relate to alcohol involvement .


This study yields a scale that can be used to assess reasons for limiting drinking among HIV-positive drinkers and provides information that can be used to enhance interventions with this population .


Discussing social and lifestyle reasons for limiting drinking among less extreme drinkers may support and validate these patients ' efforts to limit engagement in heavy drinking ; discussion of impairment reasons for limiting drinking may be a way to engage dependent drinkers in efforts to decrease their alcohol consumption .


Advanced type @ diabetes mellitus ( T@DM ) needing insulin therapy is common .


Most conventional anti-hyperglycemic drugs have limited efficacies and significant side effects , so that better anti-hyperglycemic agents are needed .


Urtica dioica L. ( nettle ) leaves have insulin secretagogue , PPARgamma agonistic , and alpha-glucosidase inhibitory effects .


Moreover , nettle leaves are used in traditional medicine as an anti-hyperglycemic agent to treat diabetes mellitus .


Thus , efficacy and safety of nettle in the treatment of patients with advanced type @ diabetes mellitus needing insulin were studied .


In this randomized double-blind placebo-controlled clinical trial , we evaluated the effects of taking nettle leaf extract ( one @ mg capsule every @ hours for @ months ) combined with the conventional oral anti-hyperglycemic drugs on the blood levels of fasting glucose , postprandial glucose , glycosylated hemoglobin ( HbA@c ) , creatinine and liver enzymes SGOT and SGPT , and systolic and diastolic blood pressures in @ patients and compared with the placebo group ( n = @ ) .


At the endpoint , the extract lowered the blood levels of fasting glucose , @ hours postprandial glucose , and HbA@c significantly ( p < @ , p = @ , and p = @ , respectively ) without any significant effects on the other parameters ( p > @ ) compared with placebo .


Nettle may safely improve glycemic control in type @ diabetic patients needing insulin therapy .


In women with mixed urinary incontinence , pelvic floor muscle training and solifenacin is the recommended conservative treatment , while electroacupuncture is a safe , economical and effective option .


In this prospective , multi-center , randomized controlled trial , five hundred women with mixed urinary incontinence , from @ centers will be randomized to receive either electroacupuncture or pelvic floor muscle training plus solifenacin .


Women in the acupuncture group will receive electroacupuncture for @ sessions per week , over @ weeks , while women in the control group will receive pelvic floor muscle training plus solifenacin ( @ mg once daily ) for @ weeks .


The primary outcome measure is the proportion of change in @-hour incontinence episode frequency from baseline to week @ .


The secondary outcome measures include eleven items , including proportion of participants with @ % decrease in average @-h incontinence episode frequency , change from baseline in the amount of urine leakage and proportion of change from baseline in @-h incontinence episode frequency in week @-@ , and so forth .


Statistical analysis will include covariance analysis , nonparametric tests and t tests .


The objective of this trial is to compare the efficacy and safety of electroacupuncture versus pelvic floor muscle training plus solifenacin in women with moderate and severe mixed urinary incontinence .


In addition to their effects on bone health , high doses of cholecalciferol may have beneficial non-classic effects including the reduction of incidence of type @ diabetes mellitus , cardiovascular disease , and cancer .


These pleiotropic effects have been documented in observational and experimental studies or in small intervention trials .


Vitamin D insufficiency is a frequent finding in renal transplant recipients ( RTRs ) , and this population is at risk of the previously cited complications .


The VITALE study is a prospective , multicentre , double-blind , randomized , controlled trial with two parallel groups that will include a total of @ RTRs .


RTRs with vitamin D insufficiency , defined as circulating @-hydroxyvitamin D levels of less than @ ng/ml ( or @ nmol/l ) , will be randomized between @ and @ months after transplantation to blinded groups to receive vitamin D@ ( cholecalciferol ) either at high or low dose ( respectively , @,@ UI or @,@ UI every @ weeks for @ months then monthly for @ months ) with a follow-up of @ years .


The primary objective of the study is to evaluate the benefit/risk ratio of high-dose versus low-dose cholecalciferol on a composite endpoint consisting of de novo diabetes mellitus ; major cardiovascular events ; de novo cancer ; and patient death .


Secondary endpoints will include blood pressure ( BP ) control ; echocardiography findings ; the incidences of infection and acute rejection episodes ; renal allograft function using estimated glomerular filtration rate ; proteinuria ; graft survival ; bone mineral density ; the incidence of fractures ; and biological relevant parameters of mineral metabolism .


We previously reported that the intensive cholecalciferol treatment ( @ @ IU every @ weeks for @ months ) was safe in RTR .


Using a pharmacokinetic approach , we showed that cholecalciferol @,@ IU monthly should maintain serum @-hydroxyvitamin D at above @ ng/ml but below @ ng/ml after renal transplantation .


Taken together , these results are reassuring regarding the safety of the cholecalciferol doses that will be used in the VITALE study .


Analysis of data collected during the VITALE study will demonstrate whether high or low-dose cholecalciferol is beneficial in RTRs with vitamin D insufficiency .


The aim of the study was to evaluate the effectiveness and safety of @ different polyethylene glycol ( PEG ) doses for the maintenance treatment of functional constipation in children .


Children with functional constipation according to the Rome III criteria were randomly assigned to receive PEG @ at a dose of either @ g/kg ( high-dose group ; n = @ ) or @ g/kg ( low-dose group ; n = @ ) for @ weeks .


Adjustment of the therapy was recommended in the event of < @ bowel movements ( BM ) per week or @ BM per day .


The primary outcome measure was treatment success , defined as @ BM per week with no fecal soiling during the last week of the intervention .


A total of @ of @ randomized children , with a mean age of @ years , completed the study .


In the analysis based on allocated treatment , treatment success was similar in both groups ( relative risk @ , @ % confidence interval @-@ @ ) .