Infants had significantly more normal stools ( soft or formed consistency ) with the TAAF ( @ vs. @ % ; p = @ ) .


From baseline , daily family life significantly improved with both AAFs : crying time decreased by @ ( p < @ ) and @ min ( p = @ ) and sleeping time increased by @ ( p = @ ) and @ min with TAAF and RAAF , respectively .


At day @ , weight and body mass index z-score gains were @ and @ with TAAF and @ and @ with RAAF .


Both AAFs were well tolerated by infants with CMPA and eHF intolerance and ensured appropriate growth , with the TAAF providing additional comfort .


The aim of this study was to investigate the influence of perioperative N-acetylcysteine ( NAC ) administration , a known antioxidant , on the incidence of acute kidney injury ( AKI ) after off-pump coronary bypass surgery ( OPCAB ) in patients with known risk factors of AKI .


One hundred and seventeen patients with @ of the following risk factors of AKI were randomized into either the control ( n = @ ) or the NAC ( n = @ ) group ; ( i ) preoperative serum creatinine > @ mg/dL ; ( ii ) left ventricular ejection fraction < @ % or congestive heart failure ( iii ) age > @ years ( iv ) diabetes or ( v ) re-operation .


Patients in the NAC group received @mg/kg of NAC IV bolus at anaesthetic induction followed by a continuous infusion at @mg/kg per day for @h .


AKI was diagnosed based on Acute Kidney Injury Network criteria during @h postoperatively .


The incidence of AKI was @ % ( @/@ ) and @ % ( @/@ ) in the control and the NAC group , respectively ( P = @ ) .


The serum concentrations of creatinine and cystatin C were similar between the groups throughout the study period .


Fluid balance including the amount of blood loss and transfusion requirement were similar between the groups except the amount of postoperative urine output , which was higher in the control group compared with the NAC group ( @mL vs. @mL , control vs. NAC , P = @ ) .


Perioperative administration of NAC did not prevent the development of postoperative AKI after OPCAB in highly susceptible patients to AKI .


To evaluate the efficacy of @ computer attention training systems administered in school for children with attention-deficit hyperactivity disorder ( ADHD ) .


Children in second and fourth grade with a diagnosis of ADHD ( n = @ ) were randomly assigned to neurofeedback ( NF ) ( n = @ ) , cognitive training ( CT ) ( n = @ ) , or control ( n = @ ) conditions .


A @-point growth model assessed change from pre-post intervention on parent reports ( Conners @-Parent -LSB- Conners @-P -RSB- ; Behavior Rating Inventory of Executive Function -LSB- BRIEF -RSB- rating scale ) , teacher reports ( Swanson , Kotkin , Agler , M-Flynn and Pelham scale -LSB- SKAMP -RSB- ; Conners @-Teacher -LSB- Conners @-T -RSB- ) , and systematic classroom observations ( Behavioral Observation of Students in Schools -LSB- BOSS -RSB- ) .


Paired t tests and an analysis of covariance assessed change in medication .


Children who received NF showed significant improvement compared with those in the control condition on the Conners @-P Attention , Executive Functioning and Global Index , on all BRIEF summary indices , and on BOSS motor/verbal off-task behavior .


Children who received CT showed no improvement compared to the control condition .


Children in the NF condition showed significant improvements compared to those in the CT condition on Conners @-P Executive Functioning , all BRIEF summary indices , SKAMP Attention , and Conners @-T Inattention subscales .


Stimulant medication dosage in methylphenidate equivalencies significantly increased for children in the CT ( @ mg ) and control ( @ mg ) conditions but not for those in the NF condition ( @ mg ) .


Neurofeedback made greater improvements in ADHD symptoms compared to both the control and CT conditions .


Thus , NF is a promising attention training treatment intervention for children with ADHD .


The efficacy of TCN-@ , a human monoclonal antibody targeting a conserved epitope on M@e , was explored in experimental human influenza .


Healthy volunteers were inoculated with influenza A/Wisconsin/@ / @ ( H@N@ ) and received a single dose of the study drug , TCN-@ , or placebo @ hours later .


Subjects were monitored for symptoms , viral shedding , and safety , including cytokine measurements .


Oseltamivir was administered @ days after inoculation .


Although the primary objective of reducing the proportion of subjects developing any grade @ influenza symptom or pyrexia , was not achieved , TCN-@-treated subjects showed @ % reduction ( P = @ ) in median total symptom area under the curve ( days @-@ ) and @ log reduction in median viral load area under the curve ( days @-@ ) by quantitative polymerase chain reaction ( P = @ ) compared with placebo-treated subjects .


TCN-@ was safe and well tolerated with no additional safety signals after administration of oseltamivir .


Serum cytokine levels ( interferon , tumor necrosis factor , and interleukin @ and @ ) were similar in both groups .


Genotypic and phenotypic analyses showed no difference between virus derived from subjects after TCN-@ treatment and parental strain .


These data indicate that TCN-@ may provide immediate immunity and therapeutic benefit in influenza A infection , with no apparent emergence of resistant virus .


TCN-@ was safe with no evidence of immune exacerbation based on serum cytokine expression .


Clinicaltrials.gov registry number.NCT@ .


To observe the impact of the diverse caloric energy intake on the outcomes and occurrence rate of complications in septic patients .


A prospective single-blind randomized controlled trial was conducted .


@ cases of septic patients in intensive care unit ( ICU ) were enrolled and randomly assigned to three groups according to their different target value of nutrition : group A -LSB- measurements of resting energy expenditure ( MREE ) < @ % J , B ( MREE @ % -@ % ) and C ( MREE > @ % ) .


The caloric intake , mechanical ventilation duration ( MVD ) , nosocomial infection rate , @-day and @-day mortality were analyzed .


Daily energy intake in @ days after ICU admission was as follows : the difference in target value of nutrition ( kJ/d : @ @ @ @ , @ @ @ @,@ @ @ @ ) , calory intake ( k -RSB- / d : @ @ @ @ , @ @ @ @ , @ @ @ @ ) , enteral nutrition value ( kJ/d : @ @ @ @ , @ @ @ @ , @ @ @ @ ) and average intake rate -LSB- ( @ @ ) % , ( @ @ ) % , ( @ @ ) % J , and they were statistically significant difference among A , B , C groups ( all P < @ ) .


The parenteral nutrition in group C were much higher than that in group A and group B ( kJ/d : @ @ @ vs. @ @ , @ @ , both P < @ ) .


The calories provided by glucose and diprivan were similar among three groups .


The MVD and ICU stay were shorter in group B than that in groups A and C -LSB- MVD ( days ) : @ @ vs. @ @ , @ @ , P > @ and P < @ ; ICU stay ( days ) : @ @ vs. @ @ , @ @ , respectively , P > @ and P < @ -RSB- .


The total hospital stay ( days : @ @ , @ @ , @ @ ) and nosocomial infection rate -LSB- @ % ( @ ) , @ % ( @/@ ) , @ % ( @@/@ ) J were similar among A , B , C groups ( all P > @ ) .


There was no difference in survival rate at @ days among three groups as shown by the Kaplan-Meier survival curve ( F = @ , P = @ ) .


The survival rate at @ days showed a tendency of lowering in groups A and C , especially in group C ( F = @ , P = @ ) .


Both higher and lower caloric energy intake may be associated with an adverse impact , but appropriate caloric intake would improve the outcome and reduce the complication rate in septic patients .


A prognostic model for @-year overall survival ( OS ) , consisting of recursive partitioning analysis ( RPA ) and a nomogram , was developed for patients with early-stage non-small cell lung cancer ( ES-NSCLC ) treated with stereotactic ablative radiation therapy ( SABR ) .


A primary dataset of @ ES-NSCLC SABR patients was randomly divided into a training ( @ % ) and an internal validation ( @ % ) dataset .


In the former group , @ unique parameters consisting of patient , treatment , and tumor factors were entered into an RPA model to predict OS .


Univariate and multivariate models were constructed for RPA-selected factors to evaluate their relationship with OS .


A nomogram for OS was constructed based on factors significant in multivariate modeling and validated with calibration plots .


Both the RPA and the nomogram were externally validated in independent surgical ( n = @ ) and SABR ( n = @ ) datasets .


RPA identified @ distinct risk classes based on tumor diameter , age , World Health Organization performance status ( PS ) and Charlson comorbidity index .


This RPA had moderate discrimination in SABR datasets ( c-index range : @-@ @ ) but was of limited value in the surgical validation cohort .


The nomogram predicting OS included smoking history in addition to RPA-identified factors .


In contrast to RPA , validation of the nomogram performed well in internal validation ( r ( @ ) = @ ) and external SABR ( r ( @ ) = @ ) and surgical cohorts ( r ( @ ) = @ ) .


The Amsterdam prognostic model is the first externally validated prognostication tool for OS in ES-NSCLC treated with SABR available to individualize patient decision making .


The nomogram retained strong performance across surgical and SABR external validation datasets .


RPA performance was poor in surgical patients , suggesting that @ different distinct patient populations are being treated with these @ effective modalities .


To investigate ( @ ) the effect of spray and stretch versus control on reducing postneedling soreness of @ latent myofascial trigger point ( MTrP ) and ( @ ) whether higher levels of psychological distress are associated with increased postneedling pain intensity .


A @-hour follow-up , single-blind randomized controlled trial .


University community .


Healthy volunteers ( N = @ ; @ men , @ women ) aged @ to @ years ( mean age , @y ) with latent MTrP in @ upper trapezius muscle .


All subjects received a dry needling application over the upper trapezius muscle .


Then , participants were randomly divided into @ groups : an intervention group , which received spray and stretch over the needled trapezius muscle , and a control group , which did not receive any intervention .


Visual analog scale ( at postneedling , posttreatment , and @ , @ , @ , @ , and @h after needling ) , pressure pain threshold ( at preneedling , postneedling , and @ and @h after needling ) .


Psychological distress was evaluated by using the Symptom Checklist-@-Revised .


Repeated-measures analysis of variance demonstrated a significant interaction between group and time ( F@ ,@ = @ ; P < @ ; p ( @ ) = @ ) for changes in postneedling soreness .


Between-group differences were significant only immediately after intervention ( P = @ ) , and there were no differences found between groups after @ hours of the intervention ( P > @ ) .


Repeated measures of covariance showed that none of the psychological covariates affected these results .


Somatization , anxiety , interpersonal sensitivity , and hostility were significantly correlated ( P < @ ) with postneedling pain intensity .


Repeated-measures analysis of variance did not show a significant effect of spray and stretch on mechanical hyperalgesia ( F@ @,@ = @ ; P = @ ; p ( @ ) = @ ) .


The spray and stretch had a short-term ( < @h ) effect in reducing postneedling soreness of a latent MTrP .


Pressure pain threshold did not significantly change after spray and stretch .


Psychological factors are related to postneedling pain .


To longitudinally examine gender and racial disparities in driving cessation among older adults .


Data came from the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) Study ( N = @,@ ) .


Logistic generalized estimating equations ( GEE ) were used to identify predictors of driving cessation ; stratified analysis and interaction terms were used to determine whether factors differed by gender and race .


Two hundred and five ( @ % ) participants stopped driving over the study period .


Education was associated with increased risk of cessation for men ( adjusted odds ratio -LSB- AOR -RSB- = @ , @ % confidence interval -LSB- CI -RSB- = @ to @ ) , but decreased risk for women ( AOR = @ , @ % CI = @-@ @ ) .


Being married was associated with lower risk of cessation for men ( AOR = @ , @ % CI = @-@ @ ) but was unrelated to cessation for women ( AOR = @ , @ % CI = @-@ @ ) .


Results were consistent with the hypothesis that racial disparities in cessation widen with increasing age .


Factors predictive of driving cessation vary by gender .


Racial disparities in cessation are wider at older ages .


Transportation policies and programs should account for social determinants and aim to address social disparities in driving mobility among older adults .


Noninvasive ventilation delivered as bilevel positive airway pressure ( BiPAP ) is often used to avoid reintubation and improve outcomes of patients with hypoxemia after cardiothoracic surgery .


High-flow nasal oxygen therapy is increasingly used to improve oxygenation because of its ease of implementation , tolerance , and clinical effectiveness .


To determine whether high-flow nasal oxygen therapy was not inferior to BiPAP for preventing or resolving acute respiratory failure after cardiothoracic surgery .


Multicenter , randomized , noninferiority trial ( BiPOP Study ) conducted between June @ , @ , and January @ , @ , at @ French intensive care units .


A total of @ patients who had undergone cardiothoracic surgery , of which coronary artery bypass , valvular repair , and pulmonary thromboendarterectomy were the most common , were included when they developed acute respiratory failure ( failure of a spontaneous breathing trial or successful breathing trial but failed extubation ) or were deemed at risk for respiratory failure after extubation due to preexisting risk factors .


Patients were randomly assigned to receive high-flow nasal oxygen therapy delivered continuously through a nasal cannula ( flow , @ L/min ; fraction of inspired oxygen -LSB- FiO@ -RSB- , @ % ) ( n = @ ) or BiPAP delivered with a full-face mask for at least @ hours per day ( pressure support level , @ cm H@O ; positive end-expiratory pressure , @ cm H@O ; FiO@ , @ % ) ( n = @ ) .


The primary outcome was treatment failure , defined as reintubation , switch to the other study treatment , or premature treatment discontinuation ( patient request or adverse effects , including gastric distention ) .


Noninferiority of high-flow nasal oxygen therapy would be demonstrated if the lower boundary of the @ % CI were less than @ % .


Secondary outcomes included mortality during intensive care unit stay , changes in respiratory variables , and respiratory complications .


High-flow nasal oxygen therapy was not inferior to BiPAP : the treatment failed in @ of @ patients with high-flow nasal oxygen therapy ( @ % ) and @ of @ patients with BiPAP ( @ % ) ( absolute difference , @ % ; @ % CI , -@ % to @ % ; P = @ ) .


No significant differences were found for intensive care unit mortality ( @ patients with BiPAP -LSB- @ % -RSB- and @ with high-flow nasal oxygen therapy -LSB- @ % -RSB- ; P = @ ) ( absolute difference , @ % -LSB- @ % CI , -@ % to @ % -RSB- .


Skin breakdown was significantly more common with BiPAP after @ hours ( @ % vs @ % ; @ % CI , @ % -@ % vs @ % -@ % ; P < @ ) .


Among cardiothoracic surgery patients with or at risk for respiratory failure , the use of high-flow nasal oxygen therapy compared with intermittent BiPAP did not result in a worse rate of treatment failure .


The findings support the use of high-flow nasal oxygen therapy in similar patients .


Treatment for hypertension with antihypertensive medication has been shown to reduce stroke , cardiovascular events , and mortality in older adults , but there is concern that such treatment may not be appropriate in frailer older adults .


To investigate whether there is an interaction between effect of treatment for hypertension and frailty in older adults , we calculated the frailty index ( FI ) for all available participants from the HYpertension in the Very Elderly Trial ( HYVET ) study , a double-blind , placebo-controlled study of antihypertensives in people with hypertension aged @ and over , and obtained frailty adjusted estimates of the effect of treatment with antihypertensive medication on risk of stroke , cardiovascular events , and mortality .


Participants in HYVET were randomised @:@ to active treatment with indapamide sustained release @ mgperindopril @ to @mg or to matching placebo .


Data relating to blood pressure , comorbidities , cognitive function , depression , and quality of life were collected at entry into the study and at subsequent follow-up visits .


The FI was calculated at entry , based on @ potential deficits .


The distribution of FI was similar to that seen in population studies of adults aged @years and above ( median FI , @ ; IQR , @-@ @ ) .


Cox regression was used to assess the impact of FI at entry to the study on subsequent risk of stroke , total mortality , and cardiovascular events .


Models were stratified by region of recruitment and adjusted for sex and age at entry .


Extending these models to include a term for a possible interaction between treatment for hypertension and FI provided a formula for the treatment effect as a function of FI .


For all three models , the point estimates of the hazard ratios for the treatment effect decreased as FI increased , although to varying degrees and with varying certainty .


We found no evidence of an interaction between effect of treatment for hypertension and frailty as measured by the FI .


Both the frailer and the fitter older adults with hypertension appeared to gain from treatment .


Further work to examine whether antihypertensive treatment modifies frailty as measured by the FI should be explored .


The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model .


The latest national evaluation study reported an average recovery rate of @ % .


However , this figure varied widely between services , with better outcomes associated with higher `` step-up '' rates between low and high intensity treatments .


This study aimed to compare the two intensity groups in an IAPT service in Suffolk .


This study adopted a between groups design .


A sample of @ service users was randomly selected from the data collected from an IAPT service in Suffolk between May @ and February @ .


The treatment outcomes , drop-out rate , and other characteristics were compared between those who received high and low intensity treatments .


The high intensity group received , on average , more sessions and contact time .


They received more CBT sessions and less guided self-help .


There were no group differences in terms of the drop-out and appointment cancellation rates .


Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of @ % and significant reduction in both depression and anxiety symptoms .


Despite methodological limitations , this study concludes that the service as a whole achieved above-average clinical outcomes .


Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery .


Falling in older age is a serious and costly problem .


At least one in three older people fall annually .


Although exercise is recognised as an effective fall prevention intervention , low numbers of older people engage in suitable programmes .


Health and exercise professionals play a crucial role in addressing fall risk in older adults .


This trial aims to evaluate the effect of participation in a fall prevention educational programme , compared with a wait-list control group , on health and exercise professionals ' knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people .


A randomised controlled trial involving @ consenting health and exercise professionals will be conducted .


Participants will be individually randomised to an intervention group ( n = @ ) to receive an educational workshop plus access to internet-based support resources , or a wait-list control group ( n = @ ) .


The two primary outcomes , measured @months after randomisation , are : ( @ ) knowledge about fall prevention and ( @ ) self-perceived change in fall prevention exercise prescription behaviour .


Secondary outcomes include : ( @ ) participants ' confidence to prescribe fall prevention exercises ; ( @ ) the proportion of people aged @ + years seen by trial participants in the past month who were prescribed fall prevention exercise ; and ( @ ) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines .


Outcomes will be measured with a self-report questionnaire designed specifically for the trial .


Diabetes self-management often involves the interpretation and application of oral , written , or quantitative information .


Numerous diabetes patients in China have limited health literacy , which likely leads to poorer clinical outcomes .


This study is designed to examine the efficacy and cost-effectiveness of addressing health literacy to improve self-management skills and glycemic control in Chinese diabetes patients .


This is a cluster randomized controlled trial ( RCT ) conducted in @ community healthcare sites in Shanghai , China .


Overall , @ diabetes patients will be randomized into intervention and control arms and will have a baseline hemoglobin A@c ( HbA@c ) assay and undergo a baseline survey which includes measures of health literacy and diabetes numeracy using revised Chinese versions of the Health Literacy Management Scale and Diabetes Numeracy Test Scale .


During the @-year period of intervention , while the control group will receive usual care , the intervention group will be supplemented with a comprehensive health literacy strategy which includes i ) training healthcare providers in effective health communication skills that address issues related to low literacy , and ii ) use of an interactive Diabetes Education Toolkit to improve patient understanding and behaviors .


Assessments will be conducted at both patient and healthcare provider levels , and will take place upon admission and after @ , @ , @ , and @ months of intervention .


The primary outcome will be the improvement in HbA@c between Intervention group and Control group patients .


Secondary outcomes at the patient level will include improvement in i ) clinical outcomes ( blood pressure , fasting lipids , body mass index , weight , smoking status ) , ii ) patient reported self-management behaviors , and iii ) patient-reported self-efficacy .


Outcomes at the provider level will include : i ) provider satisfaction and ii ) intensity and type of care provided .


The effects of the intervention will be examined in multivariable general linear models .


Both cost-effectiveness and cost-utility analyses will be performed .


The main strengths of this study are its large sample size and RCT design , involvement of both patients and healthcare providers , and the long term follow-up ( @-months ) .


This project will help to demonstrate the value of addressing health literacy and health communication to improve self-management and clinical outcomes among Chinese diabetes patients .


The patients with brain lesion have a high risk of pulmonary complication due to restrictive pulmonary impairment .


To investigate the effectiveness of active pulmonary rehabilitation on pulmonary functional improvement in these patients .


Twnety-two patients of hemiplegia or quadriplegia with brain lesion were recruited who had restrictive pulmonary impairment .


The patients were randomly assigned to an experimental group that receive active pulmonary rehabilitation training and a control group without it .


The active pulmonary rehabilitation training is composed of air-stacking exercise by ambu-bagging and functional electrical stimulation ( FES ) on phrenic nerve and abdominal muscle .


We examined respiration function test of all patients composed of peak cough flow ( PCF ) , pulmonary function test ( PFT ) , diaphragmatic motion evaluation and oxygen saturation ( SaO@ ) at the beginning and @ weeks after treatment .


There was no significant difference in pulmonary function between experimental group and control group at the beginning .


After @ weeks treatment , FVC and FEV@ of PFT , PCF , diaphragmatic motion , SaO@ have significantly improved ( p < @ ) in experimental group , but no significant changes were detected in control group .


It is suggested that active pulmonary rehabilitation with air-stacking exercise and FES would be useful to improve pulmonary function in patients with brain lesion .


The observation of movements increases primary motor cortex ( M@ ) excitability .


This exploratory study examined the effects of movement observation on pressure pain threshold ( PPT ) and transcranial magnetic stimulation ( TMS ) - indexed corticospinal excitability bilaterally .


Thirty healthy right-handed subjects were randomized to a left hand-movement observation task or a control task .


Statistical analyses were performed using ANOVA models and t-tests .


Results were not corrected for multiple comparisons .


Quantitative sensory assessments were measured in both hands , while M@ excitability has only been tested for the right ( non-dominant ) M@ corresponding to the observed left hand movements .


Analysis of pain and cortical silent period ( CSP ) outcomes demonstrated a significant interaction between task ( hand-movement group ) versus control group and time ( pre - / postintervention ) .


PPT increased in the left hand ( moving hand in the task ) and declined significantly in the contralateral hand ( still hand ) in the movement-observation-task-group , whereas PTT in the control group remained unchanged .


CSP was significantly shorter in the movement-observation group indicating decreased intracortical inhibition ( results uncorrected for multiple comparisons ) .


The observation of hand-movements led to a side-specific reduction in pain perception and a decrease in intracortical inhibition .


These exploratory findings support the notion that M@ is a robust modulator of pain-related neural networks .


This effect might be mediated through modulation of the GABAergic system and appears to differ from what is observed in chronic pain .


This study explored the effects of acupressure on fatigue of lung cancer patients undergoing chemotherapy .


For this experimental study , @ subjects were randomly assigned to three groups : acupressure with essential oils ( n = @ ) , acupressure only ( n = @ ) , and sham acupressure ( n = @ ) .


Acupoints were Hegu ( LI@ ) , Zusanli ( ST@ ) , and Sanyingjiao ( SP@ ) .


All subjects received acupressure once every morning for @ months , with each acupoint pressed for @ min .


Fatigue , functional status , anxiety , depression , and sleep quality were measured before initial chemotherapy ( T@ ) , on Day @ of third chemotherapy ( T@ ) , and on Day @ of sixth chemotherapy ( T@ ) .


Outcome differences between groups were analyzed at T@ , T@ , and T@ by general estimating equations .


After controlling for baseline outcome values , age , and adherence to acupressure , subjects who received acupressure with essential oils and acupressure had significantly less fatigue in daily living activities and sleep better quality at T@ than subjects who received sham acupressure .


Subjects who received acupressure with essential oils had significantly better sleep quality at T@ than the sham acupressure group .


Subjects who received acupressure with or without essential oils had greater odds of better functional status at T@ than the sham group .


It is plausible that acupressure with or without essential oils helps lung cancer patients undergoing chemotherapy reduce cancer-related fatigue and increase activity level .


Further study is wanted to test this hypothesis .


`` Outlet obstruction '' is a complex functional disorder compelling patients to exhausting uneffective attempts to void .


This study was designed to compare the effectiveness and a safety of the endorectal proctopexy ( internal Delorme ) vs STARR procedure in two groups of patients .


A total of @ patients with rectocele and associated mucosal prolapse or anorectal intussusception between January @ and June @ were randomly assigned to Group # @ Endorectal proctopexy with levatorplasty ( ERPP ) and Group # @ STARR .


Patients were assessed one week , six and twelve months after the operation .


Operative time , postoperative pain , day of discharge and late complications was recorded .


The time of recovery of work was also assessed .


The continence score was updated with a constipation questionnaire .


Quality of life after the operation and the overall grade of satisfaction were assessed and compared with radiological findings .


All patients were reassessed after one year .


The results in the two groups of patients show no significant difference between ERPP and STARR : the improvement in symptoms is similar but significant and well definite in both groups with a low incidence of postoperative complications .


STARR procedure is just faster to perform even if more expensive .


Dyspareunia slightly improved mainly in ERPP group , due probably to scar distention .


The results of our experience indicate a significant improvement of symptoms with both techniques .


The overall incidence rate of postoperative complications is low and similar between the two groups .


As economical consideration , ERPP is less expensive .


To study the effect of different protocols of collagen cross-linking on visual , refractive , and tomographic parameters in patients with progressive keratoconus .


Prospective randomized interventional study .


In this study , @ eyes of @ patients with progressive keratoconus underwent corneal collagen cross-linking ( CXL ) .


Following detailed preoperative examination , Group I underwent conventional cross-linking ( @ patients , @ mW/cm ( @ ) for @ min ) ; Group II ( @ patients , @ mW/cm ( @ ) for @ min ) , Group III ( @ patients , @ mW/cm ( @ ) for @ min ) , and Group IV ( @ patients , @ mW/cm ( @ ) for @ min ) underwent accelerated cross-linking .


Changes in corrected distance visual acuity ( CDVA ) , spherical equivalent ( SE ) , flat keratometry , steep keratometry , thinnest pachymetry , specular microscopy , and demarcation line were studied at @ and @ months .


Improvement in the mean CDVA and SE were statistically significant in all groups except Group IV ( P = @ at @ months , P = @ at @ months ) , with Group III ( P = @ at @ and @ months ) showing the best results .


Flattening of steep and flat keratometry was significant in Groups I ( P = @ ) and II ( P = @ ) as compared to the other groups .


There was no significant difference in the pachymetry or specular microscopy in any of the groups .


Groups I and II demonstrated a good demarcation line when compared to other groups .


Conventional CXL ( Group I ) and accelerated CXL with irradiations of @ mW/cm ( @ ) ( Group II ) and @ mW/cm ( @ ) ( Group III ) showed better visual , refractive , and tomographic improvements at the end of @ months .


Arginase competes with nitric oxide synthase for their common substrate L-arginine .


Up-regulation of arginase in coronary artery disease ( CAD ) and diabetes mellitus may reduce nitric oxide bioavailability contributing to endothelial dysfunction and ischemia-reperfusion injury .


Arginase inhibition reduces infarct size in animal models .


Therefore the aim of the current study was to investigate if arginase inhibition protects from endothelial dysfunction induced by ischemia-reperfusion in patients with CAD with or without type @ diabetes (


NCT@ ) .


Male patients with CAD ( n = @ ) or CAD + type @ diabetes ( n = @ ) , were included in this cross-over study with blinded evaluation .


Endothelium-dependent vasodilatation was assessed by flow-mediated dilatation ( FMD ) of the radial artery before and after @ min ischemia-reperfusion during intra-arterial infusion of the arginase inhibitor ( N-hydroxy-nor-L-arginine , @ mg/min ) or saline .


The forearm ischemia-reperfusion was well tolerated .


Endothelium-independent vasodilatation was assessed by sublingual nitroglycerin .


Ischemia-reperfusion decreased FMD in patients with CAD from @ % to @ % during saline administration ( P < @ ) .


N-hydroxy-nor-L-arginine administration prevented the decrease in FMD in the CAD group ( @ % at baseline vs. @ % at reperfusion ) .


Ischemia-reperfusion did not significantly reduce FMD in patients with CAD + type @ diabetes .


However , FMD at reperfusion was higher following nor-NOHA than following saline administration in both groups ( P < @ ) .


Endothelium-independent vasodilatation did not differ between the occasions .


Inhibition of arginase protects against endothelial dysfunction caused by ischemia-reperfusion in patients with CAD .


Arginase inhibition may thereby be a promising therapeutic strategy in the treatment of ischemia-reperfusion injury .


To evaluate the clinical and microbiological effects of the use of metronidazole ( MTZ ) + amoxicillin ( AMX ) as adjuncts to scaling and root planing ( SRP ) for the treatment of chronic periodontitis ( ChP ) in type @ diabetic subjects .


Fifty-eight type @ diabetic subjects ( n = @/group ) with generalized ChP were randomly assigned to receive SRP alone or with MTZ -LSB- @mg/thrice a day ( TID ) -RSB- + AMX ( @mg/TID ) for @days .


Subgingival biofilm samples were analyzed by qPCR for the presence of seven periodontal pathogens .


Subjects were monitored at baseline , @ , @ and @months post-therapies .


The group receiving SRP+MTZ+AMX presented greater mean probing depth ( PD ) reduction and clinical attachment gain , a lower number of sites with PD @mm ( primary outcome variable ) and a reduced number of subjects with @ of these residual pockets than the control group at @-year post-therapy ( p < @ ) .


The antibiotic-treated group also presented reduced levels and greater decreases of the three red complex species , Eubacterium nodatum and Prevotella intermedia , compared to the control group at @year ( p < @ ) .


The adjunctive use of MTZ+AMX significantly improved the clinical and microbiological outcomes of SRP in the treatment of type @ diabetic subjects with ChP .


To evaluate an intervention based on implementation intention principles designed to increase uptake of colorectal cancer screening , and to examine differential efficacy by socioeconomic deprivation .


In England , adults aged between @ and @ years are invited for biennial fecal occult blood testing .


A test kit and an information leaflet are mailed to each individual by the `` Hubs '' that deliver the national screening program .


In the intervention group , three preformulated implementation intentions , based on known barriers to carrying out the test , were added to the information leaflet .


Over a @-week period , each week was randomly allocated to either the intervention ( n = @,@ invitations ) or the control condition ( n = @,@ ) , with uptake recorded at the Hub .


Socioeconomic deprivation of each individual 's area of residence was categorized into tertiles .


There was no overall difference in uptake between control ( @ % ) and intervention ( @ % ) conditions , odds ratio ( OR ) = @ , @ % confidence interval ( CI ) -LSB- @ , @ -RSB- .


There was an interaction with deprivation , OR = @ , @ % CI -LSB- @ , @ -RSB- , but the positive effect observed in the lowest socioeconomic status ( SES ) tertile was small ( @ % vs. @ % ) , OR = @ , @ % CI -LSB- @ , @ -RSB- , and offset by a negative effect in the least deprived tertile ( @ % vs. @ % ) , OR = @ , @ % CI -LSB- @ , @ -RSB- .


The intervention had no significant effect in the middle tertile ( @ % vs. @ % ) , OR = @ , @ % CI -LSB- @ , @ -RSB- .


Preformulated implementation intentions did not increase overall colorectal cancer screening uptake and failed to make a sufficiently large impact on uptake among lower SES groups to merit their future use in this context .


Duchenne muscular dystrophy is caused by dystrophin deficiency and muscle deterioration and preferentially affects boys .


Antisense-oligonucleotide-induced exon skipping allows synthesis of partially functional dystrophin .


We investigated the efficacy and safety of drisapersen , a @ ' - O-methyl-phosphorothioate antisense oligonucleotide , given for @ weeks .


In this exploratory , double-blind , placebo-controlled study we recruited male patients ( @ years of age ; time to rise from floor @ s ) with Duchenne muscular dystrophy from @ specialist centres in nine countries between Sept @ , @ , and Sept @ , @ .


By use of a computer-generated randomisation sequence , we randomly allocated patients ( @:@:@:@ ; block size of six ; no stratification ) to drisapersen @ mg/kg or placebo , each given subcutaneously and either continuously ( once weekly ) or intermittently ( nine doses over @ weeks ) .


The primary endpoint was change in @-min walk distance ( @MWD ) at week @ in patients in the intention-to-treat population for whom data were available .


Safety assessments included renal , hepatic , and haematological monitoring and recording of adverse events .


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


We recruited @ patients : @ were given continuous drisapersen , @ were given intermittent drisapersen , and @ were given placebo ( continuous and intermittent groups combined ) .


At week @ , mean @MWD had increased by @ m ( SE @ ) from baseline for continuous drisapersen , with a mean difference in change from baseline of @ m ( @ % CI @ to @ ; p = @ ) versus placebo .


We recorded no difference in @MWD changes from baseline between intermittent drisapersen ( mean change -@ -LSB- SE @ -RSB- ) and placebo ( mean difference @ m -LSB- -@ to @ -RSB- ) at week @ .


The most common adverse events in drisapersen-treated patients were injection-site reactions ( @ patients given continuous drisapersen , @ patients given intermittent drisapersen , and six given placebo ) and renal events ( @ for continuous drisapersen , @ for intermittent drisapersen , and seven for placebo ) , most of which were subclinical proteinuria .


None of the serious adverse events reported ( one for continuous , two for intermittent , and two for placebo ) resulted in withdrawal from the study .


Continuous drisapersen resulted in some benefit in @MWD versus placebo at week @ .


The safety findings are similar to those from previous studies .


Ambulation improvements in this young population with early-stage Duchenne muscular dystrophy are encouraging but need to be confirmed in larger studies .


Evidence from animal and in vitro models suggest a role of probiotic bacteria in improving glycaemic control and delaying the onset of type @ diabetes .


However , the evidence from controlled trials in humans is limited .


The objective was to determine if the probiotic bacteria L. acidophilus La@ and B. animalis subsp lactis Bb@ , supplemented in a whole food ( yoghurt ) or isolated ( capsules ) form , can improve biomarkers of glycaemic control .


Following a @-week washout period , @ overweight men and women over @ years ( mean age : @ @ years ; mean body mass index ( @ @ kg/m ( @ ) ) were randomized to a @-week double-blinded parallel study .


The four intervention groups were : ( A ) probiotic yoghurt plus probiotic capsules ; ( B ) probiotic yoghurt plus placebo capsules ; ( C ) control milk plus probiotic capsules ; and ( D ) control milk plus placebo capsules .


Outcome measurements , including fasting glucose , insulin , glycated haemoglobin and Homoeostasis Model Assessment of Insulin Resistance ( HOMA-IR ) , were performed at baseline and week @ .


Relative to the milk-control group , probiotic yoghurt resulted in a significantly higher HOMA-IR ( @ @ , P = @ ) , but did not have a significant effect on the other three measures of glycaemic control ( P > @ ) .


Relative to placebo capsules , probiotic capsules resulted in a significantly higher fasting glucose ( @ @ mmol/l , P = @ ) , with no significant effect on the other three measures of glycaemic control ( P > @ ) .


Further analyses did not identify other variables as contributing to these adverse findings .


Data from this study does not support the hypothesis that L. acidophilus La@ and B. animalis subsp lactis Bb@ , either in isolated form or as part of a whole food , benefit short-term glycaemic control .


Indeed , there is weak data for an adverse effect of these strains on glucose homoeostasis .


People who are physically active have at least a @ % lower risk of death during follow-up compared with those who are inactive .


However , the ideal dose of exercise for improving longevity is uncertain .


The aim of this study was to investigate the association between jogging and long-term , all-cause mortality by focusing specifically on the effects of pace , quantity , and frequency of jogging .


As part of the Copenhagen City Heart Study , @,@ healthy joggers and @,@ healthy nonjoggers have been prospectively followed up since @ .


Cox proportional hazards regression analysis was performed with age as the underlying time scale and delayed entry .


Compared with sedentary nonjoggers , @ to @ h of jogging per week was associated with the lowest mortality ( multivariable hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ) .


The optimal frequency of jogging was @ to @ times per week ( HR : @ ; @ % CI : @ to @ ) or @ time per week ( HR : @ ; @ % CI : @ to @ ) .


The optimal pace was slow ( HR : @ ; @ % CI : @ to @ ) or average ( HR : @ ; @ % CI : @ to @ ) .


The joggers were divided into light , moderate , and strenuous joggers .


The lowest HR for mortality was found in light joggers ( HR : @ ; @ % CI : @ to @ ) , followed by moderate joggers ( HR : @ ; @ % CI : @ to @ ) and strenuous joggers ( HR : @ ; @ % CI : @ to @ ) .


The findings suggest a U-shaped association between all-cause mortality and dose of jogging as calibrated by pace , quantity , and frequency of jogging .


Light and moderate joggers have lower mortality than sedentary nonjoggers , whereas strenuous joggers have a mortality rate not statistically different from that of the sedentary group .


In August @ , the Federal Joint Committee ( G-BA ) decided that negative pressure wound therapy ( NPWT ) would not be reimbursable in German ambulatory care .


This decision was based on reports from the Institute for Quality and Efficiency in Health Care ( IQWiG ) , which concluded that there is no convincing evidence in favor of NPWT .


The aim of this diabetic foot study ( DiaFu study ) is to evaluate whether the clinical , safety and economic results of NPWT are superior to the results of standard wound treatment .


The DiaFu study is designed as a national , multicenter , randomized controlled clinical superiority trial with a special focus on outpatient care in Germany .


Competent patients in inpatient and outpatient care suffering from a chronic diabetic foot wound for a minimum of four weeks may be included in the study .


The trial evaluates the treatment outcome of the application of a technical medical device which is based on the principle of NPWT ( intervention group ) in comparison to standard moist wound therapy ( control group ) .


All treatment systems used in the intervention group bear the symbol of free trade capacity in the European Union ( CE mark ) and will be operated within normal conditions of clinical routine and according to manufacturer 's instructions .


Primary endpoints are the time to complete wound healing and the rate of wound healing achieved in each group within the maximum study treatment time of @weeks .


Primary endpoints will be confirmed by blinded assessment of wound photographs .


The DiaFu study will provide solid evidence regarding the efficacy and effectiveness of NPWT until @ December @ , the date when G-BA plans to decide on future reimbursement of NPWT in both ambulatory and in-hospital care .


The study is designed to comply with all quality requirements of G-BA and IQWiG and will contribute to evidence-based wound care in Germany .


The study has been initiated by the statutory health insurance companies in Germany and is co-funded by two manufacturers of NPWT systems .


Self-testing for HIV infection may contribute to early diagnosis of HIV , but without necessarily increasing antiretroviral therapy ( ART ) initiation .


To investigate whether offering optional home initiation of HIV care after HIV self-testing might increase demand for ART initiation , compared with HIV self-testing accompanied by facility-based services only .


Cluster randomized trial conducted in Blantyre , Malawi , between January @ and November @ , @ , using restricted @:@ randomization of @ community health worker catchment areas .


Participants were all adult ( @ years ) residents ( n = @,@ ) who received access to home HIV self-testing through resident volunteers .


This was a second-stage randomization of clusters allocated to the HIV self-testing group of a parent trial .


Clusters were randomly allocated to facility-based care or optional home initiation of HIV care ( including @ weeks of ART if eligible ) for participants reporting positive HIV self-test results .


The preplanned primary outcome compared between groups the proportion of all adult residents who initiated ART within the first @ months of HIV self-testing availability .


Secondary outcomes were uptake of HIV self-testing , reporting of positive HIV self-test results , and rates of loss from ART at @ months .


A significantly greater proportion of adults in the home group initiated ART ( @/@ , @ % ) compared with the facility group ( @/@ , @ % ; risk ratio -LSB- RR -RSB- , @ , @ % CI , @-@ @ ; P < @ ) .


Uptake of HIV self-testing was high in both the home ( @/@ , @ % ) and facility groups ( @/@ , @ % ; RR , @ ; @ % CI , @-@ @ ; P = @ ) .


Significantly more adults reported positive HIV self-test results in the home group ( @/@ -LSB- @ % -RSB- vs the facility group , @/@ -LSB- @ % -RSB- ; RR , @ ; @ % CI , @-@ @ ; P = @ ) .


After @ months , @ of @ ART initiators ( @ % ) and @ of @ ART initiators ( @ % ) in the home and facility groups , respectively , were lost from ART ( adjusted incidence rate ratio , @ ; @ % CI , @-@ @ , P = @ ) .


Among Malawian adults offered HIV self-testing , optional home initiation of care compared with standard HIV care resulted in a significant increase in the proportion of adults initiating ART .


Fluorescence in situ hybridization ( FISH ) is currently the standard for diagnosing anaplastic lymphoma kinase ( ALK ) - rearranged ( ALK + ) lung cancers for ALK inhibitor therapies .


ALK immunohistochemistry ( IHC ) may serve as a screening and alternative diagnostic method .


The Canadian ALK ( CALK ) study was initiated to implement a multicenter optimization and standardization of laboratory developed ALK IHC and FISH tests across @ hospitals .


Twenty-eight lung adenocarcinomas with known ALK status were used as blinded study samples .


Thirteen laboratories performed IHC using locally developed staining protocols for @A@ , ALK@ , or D@F@ antibodies ; results were assessed by H-score .


Twelve centers conducted FISH using protocols based on Vysis ' ALK break-apart FISH kit .


Initial IHC results were used to optimize local IHC protocols , followed by a repeat IHC study to assess the results of standardization .


Three laboratories conducted a prospective parallel IHC and FISH analysis on @ consecutive clinical samples using post-validation optimized assays .


Among study samples , FISH demonstrated @ consensus ALK + and six ALK wild type tumors .


Preoptimization IHC scores from @ centers with @A@ and the percent abnormal cells by FISH from @ centers showed intraclass correlation coefficients of @ and @ , respectively .


IHC optimization improved the intraclass correlation coefficients to @ .


Factors affecting FISH scoring and outliers were identified .


Post-optimization concurrent IHC/FISH testing in @ informative cases revealed @ % sensitivity and specificity for IHC versus FISH .


Multicenter standardization study may accelerate the implementation of ALK testing protocols across a country/region .


Our data support the use of an appropriately validated IHC assay to screen for ALK + lung cancers .


To evaluate the changes in corneal sensation ( CS ) following two different port sizes vitrectomy in diabetic and non-diabetic patients .


Patients prepared for pars plana vitrectomy were randomly assigned to four groups : diabetics to either @G or @G and non-diabetics to either @G or @G vitrectomy systems .


CS was measured using the Cochet-Bonnet aesthesiometer at baseline preoperatively , and at @ day , @ week , and @ month postoperative .


A total of @ eyes of @ patients were included in this study ; @ patients ( @ eyes ) in each of the @-G and @-G groups .


The mean age was @ years and male/female ratio was @:@ .


There were no significant difference between CS at baseline , and at @ day , @ week , and @ month between both the @-G and @-G groups .


There were significant drops in CSs at @ day and @ week for both groups ( @G and @G ) with incomplete recovery for the @-G group and complete recovery for the @-G group .


Comparing the two diabetic subgroups ( @G and @G ) and two non-diabetic subgroups ( @G and @G ) , there were no significant differences in CS between subgroups .


Diabetics ' eyes had lower CSs throughout the study period in the @-G and @-G groups , which was significant at day@ and week @ postoperatively .


The vitrectomy procedure showed reduction in CS in the postoperative period with minimal nonsignificant difference between @G and @G systems .


However , diabetics ' eyes showed compromised CS preoperatively and a further significant reduction for @ month postoperatively compared with non-diabetics .


Steady-state visually evoked potential ( SSVEP ) - based brain-computer interfaces ( BCIs ) allow healthy subjects to communicate .


However , their dependence on gaze control prevents their use with severely disabled patients .


Gaze-independent SSVEP-BCIs have been designed but have shown a drop in accuracy and have not been tested in brain-injured patients .


In the present paper , we propose a novel independent SSVEP-BCI based on covert attention with an improved classification rate .


We study the influence of feature extraction algorithms and the number of harmonics .


Finally , we test online communication on healthy volunteers and patients with locked-in syndrome ( LIS ) .


Twenty-four healthy subjects and six LIS patients participated in this study .


An independent covert two-class SSVEP paradigm was used with a newly developed portable light emitting diode-based ` interlaced squares ' stimulation pattern .


Mean offline and online accuracies on healthy subjects were respectively @ @ % and @ @ % , with eight out of twelve subjects succeeding to communicate efficiently with @ @ % accuracy .


Two out of six LIS patients reached an offline accuracy above the chance level , illustrating a response to a command .


One out of four LIS patients could communicate online .


We have demonstrated the feasibility of online communication with a covert SSVEP paradigm that is truly independent of all neuromuscular functions .


The potential clinical use of the presented BCI system as a diagnostic ( i.e. , detecting command-following ) and communication tool for severely brain-injured patients will need to be further explored .


In the BOLERO-@ trial , everolimus ( EVE ) , an inhibitor of mammalian target of rapamycin , demonstrated significant clinical benefit with an acceptable safety profile when administered with exemestane ( EXE ) in postmenopausal women with hormone receptor-positive ( HR ( + ) ) advanced breast cancer .


We report on the incidence , time course , severity , and resolution of treatment-emergent adverse events ( AEs ) as well as incidence of dose modifications during the extended follow-up of this study .


Patients were randomized ( @:@ ) to receive EVE @ mg/day or placebo ( PBO ) , with open-label EXE @ mg/day ( n = @ ) .


The primary end point was progression-free survival .


Secondary end points included overall survival , objective response rate , and safety .


Safety evaluations included recording of AEs , laboratory values , dose interruptions/adjustments , and study drug discontinuations .


The safety population comprised @ patients ( EVE + EXE , @ ; PBO + EXE , @ ) .


The median follow-up was @ months .


Class-effect toxicities , including stomatitis , pneumonitis , and hyperglycemia , were generally of mild or moderate severity and occurred relatively early after treatment initiation ( except pneumonitis ) ; incidence tapered off thereafter .


EVE dose reduction and interruption ( @ and @ events , respectively ) required for AE management were independent of patient age .


The median duration of dose interruption was @ days .


Discontinuation of both study drugs because of AEs was higher with EVE + EXE ( @ % ) versus PBO + EXE ( @ % ) .


Most EVE-associated AEs occur soon after initiation of therapy , are typically of mild or moderate severity , and are generally manageable with dose reduction and interruption .


Discontinuation due to toxicity was uncommon .


Understanding the time course of class-effect AEs will help inform preventive and monitoring strategies as well as patient education .


The retrospective comparison of test and reference treatment arms in a randomized prospective clinical trial is potentially useful in economic modeling seeking to assess the cost effectiveness of alternative therapies .


To enhance the credibility of such retrospective comparisons , we propose the application of the following adjustments to significance levels obtained from standard statistical methodology : ( @ ) a significance test for the lower bound of the @ % confidence interval for the observed difference , ( @ ) a conservative Bonferroni method of adjustment for multiple comparisons , ( @ ) an adjusted p-value calculated using Scheffe 's single-step method , and ( @ ) Bayesian @ % credibility intervals with a prior centered at zero .


These adjustments were applied to data from a randomized double-blind concurrent trial ( SPD@-@ ) that established the efficacy and safety of lisdexamfetamine dimesylate ( LDX ) in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) .


Prospectively planned analyses demonstrated that the reduction in the symptoms of ADHD was significantly greater than placebo in patients treated with either LDX or the reference treatment , osmotic-release oral system methylphenidate ( OROS-MPH ) .


Retrospective analyses showed that the improvement in the symptoms of ADHD was greater in patients treated with LDX than OROS-MPH .


We now show that this observation remained significant after the application of the four statistical penalties .


By adjusting the significance level , it is possible to compare quantitatively such retrospective results with prospectively defined comparisons .


However , the qualitative level of such retrospective evidence should remain secondary to that obtained from prospectively specified comparisons in a randomized clinical trial .


Alzheimer 's disease is characterised by a loss of cognitive function and behavioural problems as set out in the term `` Behavioural and Psychological Symptoms of Dementia '' .


These behavioural symptoms have heavy consequences for the patients and their families .


A greater understanding of behavioural symptoms risk factors would allow better detection of those patients , a better understanding of crisis situations and better management of these patients .


Some retrospective studies or simple observations suggested that personality could play a role in the occurrence of behavioural symptoms .


Finally , performance in social cognition like facial recognition and perspective taking could be linked to certain personality traits and the subsequent risks of behavioural symptoms .


We propose to clarify this through a prospective , multicentre , multidisciplinary study .


Main Objective : - To assess the effect of personality and life events on the risk of developing behavioural symptoms .


Secondary Objectives : - To evaluate , at the time of inclusion , the connection between personality and performance in social cognition tests ; - To evaluate the correlation between performance in social cognition at inclusion and the risks of occurrence of behavioural symptoms ; - To evaluate the correlation between regional cerebral atrophy , using brain Magnetic Resonance Imaging at baseline , and the risk of behavioural symptoms .


Study type and Population : Prospective multicentre cohort study with @ patients with Alzheimer 's disease at prodromal or mild dementia stage .


The inclusion period will be of @ months and the patients will be followed during @ months .


The initial evaluation will include : a clinical and neuropsychological examination , collection of behavioural symptoms data ( Neuropsychiatric-Inventory scale ) and their risk factors , a personality study using both a dimensional ( personality traits ) and categorical approach , an inventory of life events , social cognition tests and an Magnetic Resonance Imaging .


Patients will be followed every @ months ( clinical examination and collection of behavioural symptoms data and risk factors ) during @ months .


This study aims at better identifying the patients with Alzheimer 's disease at high risk of developing behavioural symptoms , to anticipate , detect and quickly treat these disorders and so , prevent serious consequences for the patient and his caregivers .


To explore the effective therapeutic method for reducing adductor muscle tension in the children of spasmodic cerebral palsy .


One hundred and forty cases of spasmodic cerebral palsy met the inclusive criteria were randomized into an observation group and a control group , @ cases in each one .


In the control group , the conventional physical therapies ( Bobath therapy and lower extremities therapy ) and scalp acupuncture ( seven-intelligent needles , motor area , sensory area , foot-motor-sensory area and balance area ) were adopted .


In the observation group , on the basis of the treatment as the control group , the three-spasm-needle therapy was applied to Jiejian , Xuehaishang and Houxuehai .


The physical therapies were given once every day , acupuncture was given once every two days , the treatment of @ days made one session .


There were @ to @ days at the interval among the sessions and @ sessions were required totally .


Separately before and after treatment , the modified Ashworth scale was used to evaluate the adductor muscle tension , and measure the adductor muscle angle , and D and E regions of gross motor function measure ( GMFM-@ ) were adopted for clinical efficacy evaluation .


After treatment , the scores of the adductor muscle tension were decreased to different extends in the two groups ( both P < @ ) , the adductor muscle angle was increased as compared with that before treatment ( both P < @ ) and the scores of D and F regions in GMFM-@ were all improved ( all P < @ ) .


The efficacy in the observation group was more significant than that in the control group ( all P < @ ) .


The three-spasm-needle therapy effectively reduces adductor muscle tension and improves the range of motion in hip joint , independent walking , running and jumping abilities in the children of spasmodic cerebral palsy .


We hypothesized that in patients with stable coronary artery disease and stenosis , percutaneous coronary intervention ( PCI ) performed on the basis of the fractional flow reserve ( FFR ) would be superior to medical therapy .


In @ patients with stable coronary artery disease , we assessed the FFR in all stenoses that were visible on angiography .


Patients who had at least one stenosis with an FFR of @ or less were randomly assigned to undergo FFR-guided PCI plus medical therapy or to receive medical therapy alone .


Patients in whom all stenoses had an FFR of more than @ received medical therapy alone and were included in a registry .


The primary end point was a composite of death from any cause , nonfatal myocardial infarction , or urgent revascularization within @ years .


The rate of the primary end point was significantly lower in the PCI group than in the medical-therapy group ( @ % vs. @ % ; hazard ratio , @ ; @ % confidence interval -LSB- CI -RSB- , @ to @ ; P < @ ) .


This reduction was driven by a lower rate of urgent revascularization in the PCI group ( @ % vs. @ % ; hazard ratio , @ ; @ % CI , @ to @ ; P < @ ) , with no significant between-group differences in the rates of death and myocardial infarction .


Urgent revascularizations that were triggered by myocardial infarction or ischemic changes on electrocardiography were less frequent in the PCI group ( @ % vs. @ % , P = @ ) .


In a landmark analysis , the rate of death or myocardial infarction from @ days to @ years was lower in the PCI group than in the medical-therapy group ( @ % vs. @ % , P = @ ) .


Among registry patients , the rate of the primary end point was @ % at @ years .


In patients with stable coronary artery disease , FFR-guided PCI , as compared with medical therapy alone , improved the outcome .


Patients without ischemia had a favorable outcome with medical therapy alone .


( Funded by St. Jude Medical ; FAME @ ClinicalTrials.gov number , NCT@ . )


Advertising has been implicated in the declining quality of the American diet , but much of the research has been conducted with children rather than adults .


This study tested the effects of televised food advertising on adult food choice .


Participants ( N = @ ) were randomized into one of @ experimental conditions : exposure to food advertising vs. exposure to non-food advertising , and within each of these groups , exposure to a task that was either cognitively demanding or not cognitively demanding .


The number of unhealthy snacks chosen was subsequently measured , along with total calories of the snacks chosen .


Those exposed to food advertising chose @ % more unhealthy snacks than those exposed to non-food-advertising ( @ % CI : @ % - @ % ) , with a total caloric value that was @ kcal higher ( @ % CI : @-@ ) .


The effect of advertising was not significant among those assigned to the low-cognitive-load group , but was large and significant among those assigned to the high-cognitive-load group : @ % more unhealthy snacks ( @ % CI : @ % - @ % ) and @ more total calories ( @ % CI : @-@ ) .


Televised food advertising has strong effects on individual food choice , and these effects are magnified when individuals are cognitively occupied by other tasks .


To evaluate of efficacy of transgluteal ( supine ) approach for shock wave lithotripsy ( SWL ) in treatment of distal ureteric stones .


This prospective , randomized , comparative study was conducted on @ patients .


Patients were randomly assigned into @ groups : group A ( n = @ ; prone position ) and group B ( n = @ ; supine position , transgluteal ) .


Inclusion criteria included patients with radiopaque lower ureteric stones @ mm .


Exclusion criteria included radiolucent stones , stones > @ mm , the need for any auxiliary procedure , and any contraindication for SWL .


Post-SWL evaluation included plain x-ray of kidney , ureter , and bladder at @ weeks after treatment and then at monthly intervals after treatment for @ months .


Stone-free status was defined as no residual stone fragments visible on plain x-ray .


Treatment failure was defined as persistence of stone fragments at @ months or the need for ureteroscopy .


Stone-free rate after @ treatment session was achieved in @ % and @ % for prone and supine positions , respectively .


Proceeding to ureteroscopy , after failure of the second SWL session to clear the stones , was done in @ % and @ % for prone and supine positions , respectively .


The overall success rate for SWL treatment in prone and supine groups was @ % and @ % , respectively ( P < @ ) .


Transgluteal SWL while patient in supine position proved efficacy for treatment of distal ureteric stones .


Larger group studies comparing the results of SWL in supine position with those of prone position and also with those of ureteroscopy may enrich our data to reach a consensus for the ideal management of distal ureteric stones .


Transcatheter aortic valve replacement ( TAVR ) is an effective treatment option for high-risk patients with severe aortic stenosis .


Different from surgery , transcatheter deployment of valves requires either a balloon-expandable or self-expandable system .


A randomized comparison of these @ systems has not been performed .


To determine whether the balloon-expandable device is associated with a better success rate than the self-expandable device .


The CHOICE study was an investigator-initiated trial in high-risk patients with severe aortic stenosis and an anatomy suitable for the transfemoral TAVR procedure .


One hundred twenty-one patients were randomly assigned to receive a balloon-expandable valve ( Edwards Sapien XT ) and @ were assigned to receive a self-expandable valve ( Medtronic CoreValve ) .


Patients were enrolled between March @ and December @ at @ centers in Germany .


Transfemoral TAVR with a balloon-expandable or self-expandable device .


The primary end point was device success , which is a composite end point including successful vascular access and deployment of the device and retrieval of the delivery system , correct position of the device , intended performance of the heart valve without moderate or severe regurgitation , and only @ valve implanted in the proper anatomical location .


Secondary end points included cardiovascular mortality , bleeding and vascular complications , postprocedural pacemaker placement , and a combined safety end point at @ days , including all-cause mortality , major stroke , and other serious complications .


Device success occurred in @ of @ patients ( @ % ) in the balloon-expandable valve group and @ of @ patients ( @ % ) in the self-expandable valve group ( relative risk -LSB- RR -RSB- , @ , @ % CI , @-@ @ , P < @ ) .


This was attributed to a significantly lower frequency of residual more-than-mild aortic regurgitation ( @ % vs @ % ; RR , @ ; @ % CI , @-@ @ ; P < @ ) and the less frequent need for implanting more than @ valve ( @ % vs @ % , P = @ ) in the balloon-expandable valve group .


Cardiovascular mortality at @ days was @ % in the balloon-expandable valve group and @ % in the self-expandable valve group ( RR , @ ; @ % CI , @-@ @ ; P = @ ) .


Bleeding and vascular complications were not significantly different , and the combined safety end point occurred in @ % of those in the balloon-expandable valve group and @ % of the self-expandable valve group ( RR , @ ; @ % CI , @-@ @ ; P = @ ) .


Placement of a new permanent pacemaker was less frequent in the balloon-expandable valve group ( @ % vs @ % , P = @ ) .


Among patients with high-risk aortic stenosis undergoing TAVR , the use of a balloon-expandable valve resulted in a greater rate of device success than use of a self-expandable valve .


There is limited information about the effect of erythropoietin or a high hemoglobin transfusion threshold after a traumatic brain injury .


To compare the effects of erythropoietin and @ hemoglobin transfusion thresholds ( @ and @ g/dL ) on neurological recovery after traumatic brain injury .


Randomized clinical trial of @ patients ( erythropoietin , n = @ ; placebo , n = @ ) with closed head injury who were unable to follow commands and were enrolled within @ hours of injury at neurosurgical intensive care units in @ US level I trauma centers between May @ and August @ .


The study used a factorial design to test whether erythropoietin would fail to improve favorable outcomes by @ % and whether a hemoglobin transfusion threshold of greater than @ g/dL would increase favorable outcomes without increasing complications .


Erythropoietin or placebo was initially dosed daily for @ days and then weekly for @ more weeks ( n = @ ) and then the @ - and @-hour doses were stopped for the remainder of the patients ( n = @ ) .


There were @ patients assigned to a hemoglobin transfusion threshold of @ g/dL and @ patients assigned to @ g/dL .


Intravenous erythropoietin ( @ IU/kg per dose ) or saline .


Transfusion threshold maintained with packed red blood cells .


Glasgow Outcome Scale score dichotomized as favorable ( good recovery and moderate disability ) or unfavorable ( severe disability , vegetative , or dead ) at @ months postinjury .


There was no interaction between erythropoietin and hemoglobin transfusion threshold .


Compared with placebo ( favorable outcome rate : @/@ -LSB- @ % ; @ % CI , @ % to @ % -RSB- ) , both erythropoietin groups were futile ( first dosing regimen : @/@ -LSB- @ % ; @ % CI , @ % to @ % -RSB- , P = @ ; second dosing regimen : @/@ -LSB- @ % ; @ % CI , @ % to @ % -RSB- , P < @ ) .


Favorable outcome rates were @/@ ( @ % ) for the hemoglobin transfusion threshold of @ g/dL and @/@ ( @ % ) for @ g/dL ( @ % CI for the difference , -@ to @ , P = @ ) .


There was a higher incidence of thromboembolic events for the transfusion threshold of @ g/dL ( @/@ -LSB- @ % -RSB- vs @/@ -LSB- @ % -RSB- for the threshold of @ g/dL , odds ratio , @ -LSB- @ % CI , @ to @ -RSB- , P = @ ) .


In patients with closed head injury , neither the administration of erythropoietin nor maintaining hemoglobin concentration of greater than @ g/dL resulted in improved neurological outcome at @ months .


The transfusion threshold of @ g/dL was associated with a higher incidence of adverse events .


These findings do not support either approach in this setting .


Poor adherence to evidence-based medications in heart failure ( HF ) is a major cause of avoidable hospitalizations , disability , and death .


To test the feasibility of improving medication adherence , we performed a randomized proof-of-concept study of a self-management intervention in high-risk patients with HF .


Patients with HF who screened positively for poor adherence ( < @ Morisky Medication Adherence Scale @-item ) were randomized to either the intervention or attention control group .


In the intervention group ( n = @ ) , a nurse conducted self-management training before discharge that focused on identification of medication goals , facilitation of medication-symptom associations , and use of a symptom response plan .


The attention control group ( n = @ ) received usual care ; both groups received follow-up calls at @ week .


However , the content of follow-up calls for the attention control group was unrelated to HF medications or symptoms .


General linear mixed models were used to evaluate the magnitude of change in adherence and symptom-related events at @ - , @ - , and @-month follow-up clinic visits .


Efficacy was measured as improved medication adherence using nurse-assessed pill counts at each time point .


Pooled over all time points , patients in the intervention group were more likely to be adherent to medications compared with patients in the attention control group ( odds ratio @ , t = @ , P = @ ) .


A nurse-delivered , self-care intervention improved medication adherence in patients with advanced HF .


Further work is needed to examine whether this intervention can be sustained to improve clinical outcomes .


The Rho-kinase pathway has been shown to be involved in the pathogenesis of PAH .


As yet , however , the acute effects of the Rho-kinase inhibitor fasudil have not been compared with established pulmonary selective vasodilators in patients with PAH .


We compared the acute effects of intravenous fasudil with inhaled iloprost in patients with pulmonary arterial hypertension ( PAH ) .


Using a crossover design , @ patients with PAH ( idiopathic PAH , PAH associated with repaired left-to-right cardiac shunts , or connective tissue disease ) were randomized to iloprost inhalation ( @ g ) and intravenous fasudil ( @ mg over @ min ) .


Hemodynamic data were collected at baseline and during acute drug exposure .


Comparable decreases were observed in mean pulmonary artery pressure ( -@ @ mmHg vs. -@ @ mmHg ) and pulmonary vascular resistance ( -@ @ Wood U vs. -@ @ Wood U ) with fasudil infusion and iloprost inhalation , respectively , during acute challenge .


However , fasudil infusion resulted in a more pronounced increase in mean cardiac output and mixed venous oxygen saturation compared with iloprost inhalation ( @ @ % vs. @ @ % ; p = @ and @ @ % vs. @ @ % ; p = @ , respectively ) .


Whereas inhaled iloprost resulted in a non-significant increase in mean systemic arterial oxygen saturation ( @ @ % ) , infused fasudil resulted in a non-significant reduction ( -@ @ % ) .


Infused fasudil improved pulmonary hemodynamics in patients with PAH without significant toxicity .


Prior research has shown that youth with co-occurring tic disorders and obsessive-compulsive disorder ( OCD ) may differ from those with non-tic-related OCD in terms of clinical characteristics and treatment responsiveness .


A broad definition of `` tic-related '' was used to examine whether children with tics in the Pediatric OCD Treatment Study II differed from those without tics in terms of demographic and phenomenological characteristics and acute treatment outcomes .


Participants were @ youth aged @ to @ years , inclusive , with a primary diagnosis of OCD who were partial responders to an adequate serotonin reuptake inhibitor ( SRI ) trial .


Participants were randomized to medication management , medication management plus instructions in cognitive-behavioral therapy ( CBT ) , or medication management plus full CBT .


Tic status was based on the presence of motor and/or vocal tics on the Yale Global Tic Severity Scale .


Tics were identified in @ % of the sample .


Those with tic-related OCD did not differ from those with non-tic-related OCD in terms of age , family history of tics , OCD severity , OCD-related impairment , or comorbidity .


Those with tics responded equally in all treatment conditions .


Tic-related OCD was very prevalent using a broad definition of tic status .


Results suggest that youth with this broad definition of tic-related OCD do not have increased OCD severity or inference , higher comorbidity rates or severity , or worsened functioning , and support the use of CBT in this population .


This highlights the importance of not making broad assumptions about OCD symptoms most likely to occur in an individual with comorbid tics .


Clinical trial registration information-Treatment of Pediatric OCD for SRI Partial Responders ; http://clinicaltrials.gov; NCT@ .


Since clinical non-response to @mg rituximab has previously been found to be associated with incomplete B cell depletion , we determined , in a randomised controlled proof of concept study , whether patients with initial incomplete B cell depletion would benefit from an additional infusion of rituximab at week @ .


Patients with active rheumatoid arthritis despite methotrexate received a first infusion of rituximab @mg and were tested for persistent B cells using highly sensitive flow cytometry on day @ .


All received a second infusion of @g ( according to license ) , but patients with persistent B cells were subsequently randomised double-blind to receive , @weeks later , either a third infusion of @mg rituximab or placebo .


Clinical response was determined by European League Against Rheumatism ( EULAR ) and American College of Rheumatology ( ACR ) criteria .


Baseline characteristics were balanced between groups .


Treatment with @mg rituximab resulted in significantly greater depletion ( lower B cell and plasmablast numbers between @ and @weeks ) paralleled by significantly better EULAR and ACR@ response rates at @weeks ( p = @ and p = @ , respectively ) and @weeks ( p = @ and p = @ , respectively ) compared with @mg .


Immunoglobulin titres remained stable in both arms , and adverse event rates were balanced .


In rituximab-treated patients with incomplete B cell depletion ( predictive of poor response ) , an extra @mg infusion of rituximab at @weeks produced both better depletion and clinical responses than placebo with no worsening of safety .


Degree of depletion is an important , but modifiable , determinant of response .


To compare treatment effects when patients with insomnia and depression receive treatment for either insomnia or depression .


A @-w randomized controlled trial with @ - and @-mo follow-up .


Internet Psychiatry Clinic , Stockholm , Sweden .


Forty-three adults in whom comorbid insomnia and depression were diagnosed , recruited via media and assessed by psychiatrists .


Guided Internet-delivered cognitive behavior therapy ( ICBT ) for either insomnia or depression .


Primary outcome measures were symptom self-rating scales ( Insomnia Severity Index -LSB- ISI -RSB- and the Montgomery sberg Depression Rating Scale -LSB- MADRS-S -RSB- ) , assessed before and after treatment with follow-up after @ and @ mo. .


The participants ' use of sleep medication and need for further treatment after completion of ICBT was also investigated .


The insomnia treatment was more effective than the depression treatment in reducing insomnia severity during treatment ( P = @ ) , and equally effective in reducing depression severity .


Group differences in insomnia severity were maintained during the @-mo follow-up period .


Post treatment , participants receiving treatment for insomnia had significantly less self-rated need for further insomnia treatment ( P < @ ) and used less sleep medication ( P < @ ) than participants receiving treatment for depression .


The need for depression treatment was similar in both groups .


In this study , Internet-delivered treatment with cognitive behavior therapy ( ICBT ) for insomnia was more effective than ICBT for depression for patients with both diagnoses .


This indicates , in line with previous research , that insomnia when comorbid with depression is not merely a symptom of depression , but needs specific treatment .


To identify an early treatment milestone that optimizes sensitivity and specificity for predicting @ % weight loss at Week ( W ) @ in patients with and without type @ diabetes on lorcaserin or placebo .


Post hoc area under the curve for receiver operating characteristic analyses of data from three phase @ trials comparing lifestyle modification + placebo with lifestyle modification + lorcaserin .


A total of @ patients ( @-@ years ; BMI , @-@ or @-@ @ kg/m ( @ ) with @ comorbidity ) were randomized to placebo or lorcaserin @ mg bid .


Changes ( baseline to W@ ) in cardiometabolic parameters were assessed .


Response ( @ % weight loss from baseline ) at W@ was a strong predictor of W@ response .


Lorcaserin patients with a W@ response achieved mean W@ weight losses of @ kg ( without diabetes ) and @ kg ( with diabetes ) .


Proportions achieving @ % and @ % weight loss at W@ were @ % and @ % ( without diabetes ) , and @ % and @ % ( with diabetes ) .


Lorcaserin patients who did not achieve a W@ response lost @ kg ( without diabetes ) and @ kg ( with diabetes ) at W@ .


Responders had greater improvements in cardiometabolic risk factors than the modified intent-to-treat ( MITT ) population , consistent with greater weight loss .


@ % weight loss by W@ predicts robust response to lorcaserin at @ year .


We evaluated a novel visual representation for current and near-term prosthetic vision .


Augmented depth emphasizes ground obstacles and floor-wall boundaries in a depth-based visual representation .


This is achieved by artificially increasing contrast between obstacles and the ground surface via a novel ground plane extraction algorithm specifically designed to preserve low-contrast ground-surface boundaries .


The effectiveness of augmented depth was examined in human mobility trials compared against standard intensity-based ( Intensity ) , depth-based ( Depth ) and random ( Random ) visual representations .


Eight participants with normal vision used simulated prosthetic vision with @ phosphenes and eight perceivable brightness levels to traverse a course with randomly placed small and low-contrast obstacles on the ground .


The number of collisions was significantly reduced using augmented depth , compared with intensity , depth and random representations ( @ % , @ % and @ % less collisions , respectively ) .


These results indicate that augmented depth may enable safe mobility in the presence of low-contrast obstacles with current and near-term implants .


This is the first demonstration that an augmentation of the scene ensuring key objects are visible may provide better outcomes for prosthetic vision .


From the empirical study , light-emitting diode ( LED ) phototherapy is effective for treatment of neonatal hyperbilirubinemia .


However commercial LED phototherapy equipment is still expensive .


Thus , in-house LED phototherapy equipment has been developed .


To compare efficacy between in-house LED to conventional phototherapy equipment in the treatment of neonatal hyperbilirubinemia at Mae Sot Hospital .


This was a randomized controlled trial .


Fifty newborns with hyperbilirubinemia were allocated to LED phototherapy group and conventional group .


Baseline characteristics were compared and analyzed by descriptive statistics , exact probability and student t-test , and change in serum bilirubin level was analyzed by multilevel regression analysis .


There were @ patients in each of the two groups .


The median duration of phototherapy in LED group was @ hours , whereas the conventional group required @ hours ( p < @ ) and the average serum bilirubin level in LED group decreased more rapidly than in conventional group ( p = @ ) .


Hyperthermia were found in @ infants from conventional group ( @ % ) compared to @ infants from LED group ( @ % ) ( p = @ ) .


In-house LED phototherapy equipment is more effective than conventional phototherapy in the reduction of serum bilirubin level and occurrence of hyperthermia during treatment is less .


The CHRNA@-CHRNA@-CHRNB@ locus is associated with self-reported smoking behavior and also harbors the strongest genetic associations with chronic obstructive pulmonary disease ( COPD ) and lung cancer .


Because the associations with lung disease remain after adjustment for self-reported smoking behaviors , it has been asserted that CHRNA@-CHRNA@-CHRNB@ variants increase COPD and lung cancer susceptibility independently of their effects on smoking .


To compare the genetic associations of exhaled carbon monoxide ( CO ) , a biomarker of current cigarette exposure , with self-reported smoking behaviors .


A total of @,@ European American and @ African American current smokers recruited into smoking cessation studies were assessed for CO at intake before smoking cessation .


DNA samples were genotyped using the Illumina Omni@ @ microarray .


Genetic associations with CO and smoking behaviors ( cigarettes smoked per day , Fagerstrom test for nicotine dependence ) were studied .


Variants in the CHRNA@-CHRNA@-CHRNB@ locus , including rs@ , a nonsynonymous variant in CHRNA@ , are genomewide association study-significantly associated with CO ( = @ ; @ % confidence interval -LSB- CI -RSB- , @-@ @ ; P = @ @ ( -@ ) ) , and this association remains strong after adjusting for smoking behavior ( = @ ; @ % CI , @-@ @ ; P = @ @ ( -@ ) ) .


The correlation between CO and cigarettes per day is statistically significantly lower ( z = @ ; P = @ @ ( -@ ) ) in African Americans ( r = @ ; @ % CI , @-@ @ ; P = @ ) than in European-Americans ( r = @ ; @ % CI , @-@ @ ; P = @ ) .


Exhaled CO , a biomarker that is simple to measure , captures aspects of cigarette smoke exposure in current smokers beyond the number of cigarettes smoked per day .


Behavioral measures of smoking are therefore insufficient indices of cigarette smoke exposure , suggesting that genetic associations with COPD or lung cancer that persist after adjusting for self-reported smoking behavior may still reflect genetic effects on smoking exposure .


The core clinical and neuropathological feature of the autosomal dominant spinocerebellar ataxias ( SCAs ) is cerebellar degeneration .


Mutations in the known genes explain only @ % to @ % of SCA cases .


To date , no effective treatments exist , and the knowledge of drug-treatable molecular pathways is limited .


The examination of overlapping mechanisms and the interpretation of how ataxia genes interact will be important in the discovery of potential disease-modifying agents .


To address the possible relationships among known SCA genes , predict their functions , identify overlapping pathways , and provide a framework for candidate gene discovery using whole-transcriptome expression data .


We have used a systems biology approach based on whole-transcriptome gene expression analysis .


As part of the United Kingdom Brain Expression Consortium , we analyzed the expression profile of @ brain samples obtained from @ neuropathologically healthy individuals ( @ distinct brain regions each ) .


Weighted gene coexpression network analysis was used to cluster @ SCA genes into gene coexpression modules in an unsupervised manner .


The overrepresentation of SCA transcripts in modules identified in the cerebellum was assessed .


Enrichment analysis was performed to infer the functions and molecular pathways of genes in biologically relevant modules .


Molecular functions and mechanisms implicating SCA genes , as well as lists of relevant coexpressed genes as potential candidates for novel SCA causative or modifier genes .


Two cerebellar gene coexpression modules were statistically enriched in SCA transcripts ( P = @ for the tan module and P = @-@ for the light yellow module ) and contained established granule and Purkinje cell markers , respectively .


One module includes genes involved in the ubiquitin-proteasome system and contains SCA genes usually associated with a complex phenotype , while the other module encloses many genes important for calcium homeostasis and signaling and contains SCA genes associated mostly with pure ataxia .


Using normal gene expression in the human brain , we identified significant cell types and pathways in SCA pathogenesis .


The overrepresentation of genes involved in calcium homeostasis and signaling may indicate an important target for therapy in the future .


Furthermore , the gene networks provide new candidate genes for ataxias or novel genes that may be critical for cerebellar function .


To assess the effectiveness of supreme laryngeal mask airway ( SLMA ) over face mask ventilation for preventing need for endotracheal intubation at birth .


We report a prospective , randomized , parallel @:@ , unblinded , controlled trial .


After a short-term educational intervention on SLMA use , infants @-week gestation and/or expected birth weight @ g requiring positive pressure ventilation ( PPV ) at birth were randomized to resuscitation by SLMA or face mask .


The primary outcome was the success rate of the resuscitation devices ( SLMA or face mask ) defined as the achievement of an effective PPV preventing the need for endotracheal intubation .


We enrolled @ patients ( @ in SLMA and @ in face mask group , respectively ) .


Successful resuscitation rate was significantly higher with the SLMA compared with face mask ventilation ( @ % vs @ % ; P = @ ) .


Apgar score at @ minutes was significantly higher in SLMA than in face mask group ( P = @ ) .


Neonatal intensive care unit admission rate was significantly lower in SLMA than in face mask group ( P = @ ) .


No complications related to the procedure occurred .


In newborns with gestational age @ weeks and/or expected birth weight @ g needing PPV at birth , the SLMA is more effective than face mask to prevent endotracheal intubation .


The SLMA is effective in clinical practice after a short-term educational intervention .


To determine the optimum mode of delivery for women in preterm breech labour at a gestational age of @ to @ weeks .


A multicentre randomised controlled trial .


Twenty-six hospitals in England , UK .


Women with a singleton breech fetus in spontaneous preterm labour between @ and @ completed weeks of gestation , with no clear indication for a caesarean section or vaginal breech delivery .


Random allocation to either ` intention to delivery vaginally ' or ` intention to deliver by caesarean section ' .


Perinatal mortality , neonatal morbidity , maternal morbidity and gestation at delivery .


The trial was closed after @ months because of low recruitment , by which time substantial numbers of women had been in the eligible gestation period .


Thirteen women from six hospitals were recruited .


One infant , randomised to and delivered vaginally , was stillborn .


Three fetal presentations were cephalic at delivery despite a diagnosis of breech presentation at trial entry .


No formal statistical analysis was performed due to the small numbers .


No conclusions about the optimum mode of delivery for women in preterm labour with a fetus presenting by the breech can be drawn from this trial .


The low accrual rate was due to clinicians ' reluctance to randomise eligible women , reflecting the circumstances and nature of the trial .


This randomized controlled study tested the effectiveness of individualized activities , led by certified nursing assistants ( CNAs ) , to increase positive and reduce negative affect and behavior among nursing home residents with dementia .


Nursing home residents with mild to advanced dementia ( N = @ ) were randomly assigned to usual care ( UC , n = @ ) or @ of @ experimental conditions .


Residents in the attention control group ( AC , N = @ ) participated in standardized one-to-one activities with their CNAs .


Individualized Positive Psychosocial Intervention ( IPPI ) participants ( n = @ ) received a CNA-led activity matched to their interests and ability .


Outcomes were residents ' positive and negative affect and verbal and nonverbal behavior .


The IPPI and AC groups experienced similar benefits-more pleasure , alertness , engagement , positive touch , and positive verbal behavior-compared with UC .


The AC group displayed more anger , uncooperativeness , and very negative verbal behavior than UC or IPPI .


This study demonstrates the value of individualized activities for nursing home residents with dementia .


In a stringent test , residents were happier and less angry during a customized intervention compared with a standardized intervention .


Even brief individualized CNA-led activities bring pleasure to nursing home residents and constitute an effective strategy to enhance positive affect and engagement in persons with dementia .


Evolocumab , a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type @ ( PCSK@ ) , significantly reduced low-density lipoprotein ( LDL ) cholesterol levels in short-term studies .


We conducted two extension studies to obtain longer-term data .


In two open-label , randomized trials , we enrolled @ patients who had completed @ of @ phase @ or @ studies ( `` parent trials '' ) of evolocumab .


Regardless of study-group assignments in the parent trials , eligible patients were randomly assigned in a @:@ ratio to receive either evolocumab ( @ mg every @ weeks or @ mg monthly ) plus standard therapy or standard therapy alone .


Patients were followed for a median of @ months with assessment of lipid levels , safety , and ( as a prespecified exploratory analysis ) adjudicated cardiovascular events including death , myocardial infarction , unstable angina , coronary revascularization , stroke , transient ischemic attack , and heart failure .


Data from the two trials were combined .


As compared with standard therapy alone , evolocumab reduced the level of LDL cholesterol by @ % , from a median of @ mg per deciliter to @ mg per deciliter ( P < @ ) .


Most adverse events occurred with similar frequency in the two groups , although neurocognitive events were reported more frequently in the evolocumab group .


The risk of adverse events , including neurocognitive events , did not vary significantly according to the achieved level of LDL cholesterol .


The rate of cardiovascular events at @ year was reduced from @ % in the standard-therapy group to @ % in the evolocumab group ( hazard ratio in the evolocumab group , @ ; @ % confidence interval , @ to @ ; P = @ ) .


During approximately @ year of therapy , the use of evolocumab plus standard therapy , as compared with standard therapy alone , significantly reduced LDL cholesterol levels and reduced the incidence of cardiovascular events in a prespecified but exploratory analysis .


( Funded by Amgen ; OSLER-@ and OSLER-@ ClinicalTrials.gov numbers , NCT@ and NCT@ . )


Previous metoprolol studies in myocardial infarction patients were performed with immediate-release ( IR ) metoprolol .


This study aims to evaluate if extended-release metoprolol CR/XL once daily gives a similar - blockade over @ h compared to multiple dosing of metoprolol IR .


After @ days of routine metoprolol treatment , @ patients with suspected acute myocardial infarction were randomized to open-label treatment with metoprolol IR ( @ mg four times daily or @ mg twice daily ) or metoprolol CR/XL @ mg once daily for @ days .


Metoprolol CR/XL @ mg once daily gave more pronounced suppression of peak heart rate , with lower peak and less variation in peak to trough plasma levels .


There were no differences in AUC between the CR/XL and IR formulations , although the trough plasma metoprolol levels were comparable for metoprolol CR/XL @ mg once daily and metoprolol IR @ mg four times daily , but lower for metoprolol IR @ mg twice daily .


Both treatments were well tolerated .


Metoprolol CR/XL @ mg once daily showed lower peak and less variation in peak to trough plasma levels compared to multiple dosing of metoprolol IR with the same AUC .


This was accompanied by a more uniform - blockade over time , which was reflected by heart rate , and a more pronounced suppression of peak heart rate with similar tolerability .


This suggests metoprolol CR/XL may be used as an alternative to metoprolol IR in patients with myocardial infarction .


Antiretroviral ( ARV ) - based pre-exposure prophylaxis ( PrEP ) is a promising new HIV prevention strategy .


However , variable levels of adherence have yielded mixed results across several PrEP trials and populations .


It is not clear how taking ARV - traditionally used for HIV treatment - is perceived and how that perception may affect the use of these products as preventives .


We explored the views and experiences of VOICE participants , their male partners and community members regarding the use of ARV as PrEP in the VOICE trial and the implications of these shared meanings for adherence .


VOICE-C was a qualitative ancillary study conducted at the Johannesburg site of VOICE , a multisite , double-blind , placebo-controlled randomised trial testing tenofovir gel , oral tenofovir and oral Truvada for HIV PrEP .


We interviewed @ randomly selected female VOICE participants , @ male partners and @ community members through in-depth interviews , serial ethnography , or focus group discussions .


All interviews were audiotaped , transcribed , translated and coded thematically for analysis .


The concept of ARV for prevention was understood to varying degrees across all study groups .


A majority of VOICE participants understood that the products contained ARV , more so for the tablets than for the gel .


Although participants knew they were HIV negative , ARV was associated with illness .


Male partners and community members echoed these sentiments , highlighting confusion between treatment and prevention .


Concerned that they would be mistakenly identified as HIV positive , VOICE participants often concealed use of or hid their study products .


This occasionally led to relationship conflicts or early trial termination .


HIV stigma and its association with ARV , especially the tablets , was articulated in rumour and gossip in the community , the workplace and the household .


Although ARV were recognised as potent and beneficial medications , transforming the AIDS body from sickness to health , they were regarded as potentially harmful for those uninfected .


VOICE participants and others in the trial community struggled to conceptualise the idea of using ARV for prevention .


This possibly influenced willingness to adopt ARV-based prevention in the VOICE clinical trial .


Greater investments should be made to increase community understanding of ARV for prevention and to mitigate pervasive HIV stigma .


Specific genetic or biological markers may predict inadequate response to therapy for major depressive disorder ( MDD ) .


The objective of the current post hoc analysis was to evaluate the effect of specific biological and genetic markers on the antidepressant efficacy of adjunctive L-methylfolate @ mg versus placebo from a trial of inadequate responders to selective serotonin reuptake inhibitors ( SSRIs ) .


The double-blind , randomized , placebo-controlled trial used the sequential parallel comparison design .


Outpatients with SSRI-resistant MDD ( DSM-IV criteria ) received L-methylfolate @ mg/d for @ days , placebo for @ days followed by L-methylfolate @ mg/d for @ days , or placebo for @ days .


The effects of baseline levels of select biological and genetic markers individually and combined on treatment response to L-methylfolate versus placebo were evaluated ; the primary response measure was the @-Item Hamilton Depression Rating Scale ( HDRS-@ ) .


The first patient was enrolled July @ , @ , and the last patient completed April @ , @ .


Seventy-five patients were enrolled .


Patients with specific biological ( body mass index @ kg/m , elevated plasma levels of high-sensitivity C-reactive protein or @-hydroxy-@-nonenal , low S-adenosylmethionine/S-adenosylhomocysteine ratio ) and genetic markers at baseline had significantly ( P @ ) greater pooled mean change from baseline on the HDRS-@ with L-methylfolate versus placebo .