Participants were randomized to receive one of eight combinations of three interventions : a prior-notification postcard or no contact , a standard or professionally designed consent pack , and a phone or postal reminder .


The primary outcome was return of the consent form ( `` response '' ) , with consent decision being the secondary outcome .


Of @,@ participants , @ ( @ % ) responded .


Response rates were @ % higher ( @ % confidence interval : -@ , @ % ; P = @ ) among those receiving designed packs than among those receiving standard packs and @ % higher ( @ , @ % ; P = @ ) among those receiving phone reminders ( compared with postal reminders ) .


The prior-notification postcard did not influence response rates -LSB- difference = @ % ( -@ , @ % ; P = @ ) -RSB- , and we found no evidence that the communication method influenced consent decision .


This trial provides evidence that communication material design can influence response rates and that phone reminders have superior cost/benefit returns over designed materials .


Experimental evaluation of communications strategies and dissemination of findings may benefit cohort studies .


To evaluate the necessity of endoscopic nasobiliary drainage ( ENBD ) catheter placement after clearance of common bile duct ( CBD ) stones .


Patients enrolled in this study were randomly divided into two groups , according to whether or not they received ENBD after the removal of CBD stones .


Group @ ( ENBD group ) was then subdivided into three groups : G@a patients received an endoscopic papillary balloon dilatation ( EPBD ) , G@b patients received an endoscopic sphincterotomy ( EST ) , and G@c patients received neither .


Group @ ( non-ENBD group ) patients were also subdivided into three groups ( G@a , G@b , and G@c ) , similar to Group @ .


The maximum CBD diameter , the time for C-reactive protein ( CRP ) to normalize , levels of serum amylase , total serum bilirubin ( TB ) and alanine aminotransferase ( ALT ) , and postoperative hospitalization duration ( PHD ) were measured .


A total of @ patients ( @ males , @ females ) , with an average age of @ years , were enrolled in this study .


One hundred and thirteen patients who received ENBD were included in Group @ , and @ patients who did not receive ENBD were included in Group @ .


The baseline clinical characteristics were similar in both groups .


There were no significant differences in post-endoscopic retrograde cholangiopancreatography ( ERCP ) - related complications when Groups @ and @ were compared .


Seventy-seven patients underwent EPBD , and @ received an ENBD tube ( G@a ) and @ did not ( G@a ) .


Seventy-three patients underwent EST , and @ patients received an ENBD tube ( G@b ) and @ did not ( G@b ) .


The remaining @ patients underwent neither EPBD nor EST ; of these patients , @ received an ENBD tube ( G@c ) and @ did not ( G@c ) .


For each of the three pairs of subgroups ( G@a vs G@a , G@b vs G@b , G@c vs G@c ) , there were no significant differences detected in the PHD or the time to normalization of CRP , TB and ALT .


In the EPBD group , the incidence of post-ERCP pancreatitis , hyperamylasemia and overall patient complications was significantly higher for G@a ( post-ERCP pancreatitis : @/@ vs @/@ , P = @ ; hyperamylasemia : @/@ vs @/@ , P = @ ; overall patient complications : @/@ vs @/@ , P = @ ) .


After successful CBD stone clearance , ENBD is only beneficial when an EPBD procedure has been performed .


Asthma is the most prevalent chronic disease to complicate pregnancies worldwide , affecting around @ % of pregnant women in Australia .


Oxidative stress and inflammation manifest during pregnancy ; however asthma in pregnancies further intensifies oxidative stress .


Consumption of antioxidant-rich foods has been shown to be beneficial for asthma control in non-pregnant asthmatic adults .


It has not been investigated whether antioxidant-rich foods can improve the elevated oxidative stress that occurs with asthma in pregnancy , thereby improving asthma control .


The primary aim of this study is to determine whether increased consumption of antioxidant-rich foods for @ weeks will improve maternal asthma control , compared to standard dietary intake during pregnancy .


A @ week , parallel randomized controlled trial will be conducted .


One hundred and sixty eight pregnant women with mild , moderate , or severe asthma , currently using inhaled corticosteroids , and with poor diet quality , will be recruited at approximately@ weeks gestation .


Following a @ week run-in period , women will be randomized to either a @ week antioxidant intervention ( increased consumption of antioxidant-rich foods ( @ servings/day vegetables , @ servings/day fruit , @ servings/day grains ( mostly wholegrains ) , @-@ serving/week lean meat ) or standard pregnancy care .


The primary outcome is asthma control score ( decrease of @ , the minimally clinically significant change ) .


Secondary outcomes include plasma antioxidants , markers of oxidative stress , and time to , and number of , exacerbations .


With two-tailed t-tests at @ % power , a sample size of @ completions per group is required .


Allowing for a @ % retention including a @ % removal of women from the analysis due to non-compliance , we will recruit @ women .


It is expected that this @ week study will improve asthma control .


This is significant because asthma is the most prevalent condition to complicate pregnancies and contributes to poor maternal , neonatal and infant health outcomes .


Our research will provide the first evidence to show that , in pregnancy , consumption of antioxidant-rich foods is a key modifier of clinical asthma status .


This research is crucial for contributing to the evidence base to inform future guidelines given existing clinical and research gaps .


This study aimed to compare the clinical and radiographic success of preveneered posterior NuSmile and Kinder Krowns over one year and to assess the level of parental satisfaction with their esthetics .


Three trained operators placed @ crowns in a split-mouth design with a random allocation for @ participants ( mean age : @ years ) who received two , four , six , or eight crowns .


Blind assessment of the clinical and radiographic performance of the restorations was performed by four calibrated examiners after one year .


Results were analyzed by Fisher 's exact test and McNemar test .


Examiner reliability was determined by Cohen 's kappa score .


Visual analogue scale ( VAS ) was used to assess the level of parental satisfaction .


All crowns but one were retained , and the majority ( @ percent ) had no facing fractures .


Parental satisfaction was high ( @ / @ on the VAS ) .


Primary maxillary first molar crowns had more occlusal facing fractures than their mandibular counterparts ( P = @ ) .


Primary mandibular second molar crowns showed more facing fractures than their maxillary counterparts ( P = @ ) .


Both types showed no statistical difference in most categories , but Kinder Krowns had more facing fractures ( P < @ ) .


Posterior preveneered crowns have predictable durability at @ months while offering natural appearance to restored teeth .


To determine whether physical activity may affect cognitive performance in patients with Parkinson 's disease by measuring reaction times in patients participating in the Berlin BIG study .


Randomized controlled trial , rater-blinded .


Ambulatory care .


Patients with mild to moderate Parkinson 's disease ( N = @ ) were randomly allocated to @ treatment arms .


Outcome was measured at the termination of training and at follow-up @ weeks after baseline in @ patients ( completers ) .


Patients received @ hours of individual Lee Silverman Voice Treatment-BIG training ( BIG ; duration of treatment , @wk ) , @ hours of group training with Nordic Walking ( WALK ; duration of treatment , @wk ) , or nonsupervised domestic exercise ( HOME ; duration of instruction , @hr ) .


Cued reaction time ( cRT ) and noncued reaction time ( nRT ) .


Differences between treatment groups in improvement in reaction times from baseline to intermediate and baseline to follow-up assessments were observed for cRT but not for nRT .


Pairwise t test comparisons revealed differences in change in cRT at both measurements between BIG and HOME groups ( intermediate : -@ ms ; @ % confidence interval -LSB- CI -RSB- , -@ / -@ ; P = @ ; follow-up : @ms ; CI , -@ / -@ ; P = @ ) and between WALK and HOME groups ( intermediate : -@ ms ; CI , -@ / -@ ; P = @ ; follow-up : -@ ms ; CI , -@ / -@ ; P = @ ) .


There was no difference between BIG and WALK groups ( intermediate : @ms ; CI , -@ / @ ; P = @ ; follow-up : @ms ; CI , -@ / @ ; P = @ ) .


Supervised physical exercise with Lee Silverman Voice Treatment-BIG or Nordic Walking is associated with improvement in cognitive aspects of movement preparation .


Curative treatment of upper gastrointestinal tract neoplasms is complex and associated with high morbidity and mortality .


In general , the patients are already malnourished , and early postoperative enteral nutrition is recommended .


However , there is no consensus concerning the best enteral access route in these cases .


A prospective randomized trial was performed from @ to @ with @ patients who underwent esophagectomy , total gastrectomy , or pancreaticoduodenectomy .


In all , @ patients declined to participate , and @ did not meet the inclusion criteria and were excluded .


Of the @ included patients , @ had nasoenteric tubes , and @ had a jejunostomy .


The two groups were similar in demographic and clinical aspects .


The nasoenteric ( NE ) and jejunostomy groups underwent early enteral therapy in @ and @ % of cases ( p > @ ) , respectively .


The median length of enteral therapy use was less in the NE group ( @ vs. @ days ) , but the difference was not statistically significant .


The NE group required introduction of parenteral therapy more frequently than the jejunostomy group ( p < @ ) .


Complications related to the enteral route occurred in @ and @ % of patients ( p > @ ) in the NE and jejunostomy groups , respectively .


In the NE group , there were four losses and four tube obstructions .


In the jejunostomy group , there were two losses , four obstructions , and two cases of leakage around the tube .


In the latter group , patients who underwent therapy for a longer time had tubal complications ( p < @ ) and longer intensive care unit and hospital stays ( p < @ ) .


The two enteral routes were associated with the same number of complications .


However , the presence of a jejunostomy allowed enteral therapy for longer periods , especially in patients with complications , thus avoiding the need for parenteral nutrition .


To assess the efficacy and safety of intravitreal bevacizumab ( IVB ) compared with ranibizumab ( IVR ) in the treatment of macular oedema due to branch retinal vein occlusion ( BRVO ) .


In this prospective , randomised , non-inferiority trial , @ participants with macular oedema due to BRVO received intravitreal injections of ranibizumab or bevacizumab after @:@ block randomisation .


The primary outcome measure was the difference in mean changes in best-corrected visual acuity ( BCVA ) at @months .


Secondary outcome measures included mean change in central retinal thickness ( CRT ) , the proportion of patients improving by > @ letters and the proportion of patients developing neovascularisation .


Participants received either IVR ( n = @ ) or IVB ( n = @ ) .


The mean BCVA at baseline was @ letters ( @/@ ) and @ letters ( @/@ ) ( p = @ ) in the ranibizumab and bevacizumab groups , respectively .


At @months , the mean gains in BCVA were +@ letters ( p < @ ; @ % CI , +@ to +@ ) in the ranibizumab group and +@ letters ( p < @ ; @ % CI +@ to +@ ) in the bevacizumab group .


The difference between the mean visual gains of the treated groups ( bevacizumab-ranibizumab ) was -@ letters ( @ % CI -@ to +@ ; p = @ ) .


Mean reductions in CRT at @months were @ m in the ranibizumab group ( p < @ ) and @ m in the bevacizumab group ( p < @ ) , with no significant difference between the two groups ( p = @ ) .


The mean numbers of ranibizumab and bevacizumab injections were @ and @ , respectively ( p = @ ) .


Two serious adverse events occurred in the ranibizumab group and one in the bevacizumab group but both were unrelated to intravitreal injections .


This study demonstrated significant gain in visual acuity in eyes with BRVO treated with either bevacizumab or ranibizumab .


Pro-re-nata strategy was effective in maintaining the visual gain .


To investigate the ability of the prostate genetic score ( PGS-@ ) , a germ-line biomarker of prostate cancer ( PCa ) risk , to categorize men participating in the Prostate , Lung , Colorectal and Ovarian ( PLCO ) Cancer Screening Trial .


We obtained the genetic data from the Cancer Genetic Markers of Susceptibility ( CGEMS ) , a nested case control study examining germ-line DNA in the screened arm of the PLCO trial .


A PGS-@ was calculated based on their genotype at @ PCa associated single nucleotide polymorphisms ( SNPs ) .


The primary outcome was the diagnosis of PCa and primary predictor was PGS-@ .


We identified @,@ subjects ( no cancer , N = @ ) and cases ( N = @ ) .


The PGS-@ ( P < @ ) , prostate specific antigen ( PSA ; P < @ ) , family history of PCa ( < @ ) , abnormal digital rectal exam ( DRE , P < @ ) , and history of ever smoking ( P = @ ) were associated with a PCa diagnosis .


In multivariable analysis , the log ( PGS-@ ) was associated with PCa diagnosis with an odds ratio of @ ( @ % CI @-@ @ , P < @ ) , log ( PSA ) ( OR @ ; @ % CI @-@ @ , P < @ ) , and family history of PCa ( OR @ ; @ % CI @-@ @ , P = @ ) .


PGS-@ quartiles noted an increasing rate of PCa detection in addition to PSA : @ % ( Q@ ) , @ % ( Q@ ) , @ % ( Q@ ) , and @ ( Q@ ) ( P < @ ) and improvement in PSA performance ( P < @ ) .


Germ-line DNA in the form of the PGS-@ is able to risk stratify men regarding their risk of PCa .


The PGS-@ may have implications regarding who may benefit most from PCa screening and possibly add to PSA performance .


Community-based health education programs may be helpful in improving health outcomes in patients with chronic illnesses .


This study aimed to evaluate community-based health education strategies in the management of hypertensive patients with low socioeconomic status in Dongguan City , China .


This was a randomized , non-blinded trial involving @ hypertensive patients enrolled in the community health service centre of Liaobu Town , Dongguan City , China .


Participants were randomized to receive one of the three community-based health education programs over @ years : self-learning reading ( Group @ ) , monthly regular didactic lecture ( Group @ ) , monthly interactive education workshop ( Group @ ) .


Outcomes included the changes in the proportion of subjects with normalized blood pressure ( BP ) , hypertension-related knowledge score , adherence to antihypertensive treatment , lifestyle , body mass index and serum lipids .


After the @-y intervention , the proportion of subjects with normalized BP increased significantly in Group @ ( from @ % to @ % , p < @ ) , and increased more substantially in Group @ ( from @ % to @ % , p < @ ) , but did not change significantly in Group @ .


Improvements in hypertension-related knowledge score , adherence to regular use of medications , appropriate salt intake and regular physical activity were progressively greater from group @ to group @ to group @ .


Group @ had the largest reductions in body mass index and serum LDL cholesterol levels .


Interactive education workshops may be the most effective strategy in community-based health promotion education programs for hypertensive patients in improving patients ' knowledge on hypertension and alleviating clinical risk factors for preventing hypertension-related complications .


Cocaine dependence is a major public health problem with no available robustly effective pharmacotherapy .


This study 's aim was to determine if treatment with sertraline ( SERT ) or SERT plus gabapentin ( GBP ) improved treatment retention , depressive symptoms , and/or cocaine use .


Depressed cocaine-dependent patients ( N = @ ) were enrolled in a @-week , double-blind , randomized , placebo ( PLA ) - controlled , clinical trial and placed in research beds at a residential treatment facility ( Recovery Centers of Arkansas ) .


They were randomized by depressive symptom severity and inducted onto @ of the following while residing at the Recovery Centers of Arkansas : SERT ( @ mg/d ) , SERT ( @ mg/d ) plus GBP ( @ mg/d ) , or PLA .


Participants transferred to outpatient treatment at the start of their third week , continued receiving study medications or PLA ( weeks @-@ ) , and participated in weekly individual cognitive behavioral therapy .


Compliance was facilitated through the use of contingency management procedures .


Supervised urine samples were obtained thrice weekly and self-reported mood weekly .


At the end of @ weeks , participants were tapered off the study medication over @ days and referred to a local treatment program .


Sertraline , but not SERT plus GBP , showed a significantly lower overall percentage of cocaine-positive urine samples compared with that of PLA .


A significantly greater percentage of participants experienced relapse in the PLA group ( @ % ) compared with that of the SERT group ( @ % ) .


Hamilton depression ratings decreased significantly over time regardless of the treatment group .


Retention in treatment did not differ significantly between the treatment groups .


Sertraline plus GBP may not be superior to SERT alone in delaying relapse among abstinent cocaine-dependent individuals undergoing cognitive behavioral therapy .


To evaluate and compare the efficacy of platelet-rich fibrin ( PRF ) with enamel matrix derivative ( EMD ; Emdogain ) in the treatment of periodontal intrabony defects in patients with chronic periodontitis , six months after surgery .


Forty-four ( @ ) intrabony defects in @ patients ( @ males ) were randomly allocated into two treatment groups : EMD ( n = @ ) and PRF ( n = @ ) .


Measurement of the defects was done using clinical and cone beam computed tomography at baseline and @ months .


Clinical and radiographic parameters such as probing depth , clinical attachment level , intrabony defect depth and defect angle , were recorded at baseline and @ months post-operatively .


Within group change was evaluated using the Wilcoxon signed rank test .


Intergroup comparisons were made using the Mann-Whitney U test .


Postsurgical measurements revealed that there was an equal reduction in probing depth and a greater but statistically non-significant attachment gain for the Emdogain group when compared to the platelet-rich fibrin group .


The Emdogain group presented with significantly greater percentage defect resolution ( @ % @ ) than did the platelet-rich fibrin group ( @ % @ ) .


Post-operatively the changes in defect width and defect angle were significant in both groups , but upon intergroup comparison they were found to be statistically non-significantly different .


Both Emdogain and platelet-rich fibrin were effective in the regeneration of intrabony defects .


Emdogain was significantly superior in terms of percentage defect resolution .


HM@ is a third generation P-glycoprotein ( P-gp ) inhibitor currently under development .


The objectives of this study were to evaluate the effects of a single dose of HM@ on the pharmacodynamics and pharmacokinetics of loperamide , a P-gp substrate , and to compare them with those of quinidine .


Eighteen healthy male subjects were administered loperamide alone ( period @ ) or with loperamide plus quinidine or HM@ in period @ or @ , respectively .


In period @ , subjects randomly received one of three HM@ doses : @ , @ or @mg .


Changes in pupil size , alertness , oxygen saturation and the oral bioavailability of loperamide were assessed in each period .


In addition , the pharmacokinetics of HM@ were determined .


Pupil size , alertness and oxygen saturation did not change over time when loperamide alone or loperamide plus HM@ was administered while HM@ significantly increased the systemic exposure to loperamide , i.e. the geometric mean ratio ( @ % confidence interval ) of AUC ( @ , tlast ) for loperamide with and without HM@ was @ ( @ , @ ) .


Co-administered quinidine significantly increased the systemic exposure to loperamide @-fold ( @ , @ ) , which also markedly reduced pupil size , resulting in a decrease of @ mmh in the area under the effect curve of pupil size change from baseline compared with loperamide alone .


HM@ inhibits P-gp mainly in the intestinal endothelium , which can be beneficial because pan-inhibition of P-gp , particularly in the brain , could lead to detrimental adverse events .


Further studies are warranted to investigate adequately the dose-exposure relationship of HM@ , along with its duration of effect .


Most stroke rehabilitation studies have been performed in high-income countries .


The aim of this study was to identify the main barriers for patient inclusion in a research protocol performed in Brazil .


We evaluated reasons for exclusion of patients in a pilot , randomized , double-blinded clinical trial of stroke rehabilitation .


Descriptive statistical analysis was performed .


Only @ % of @ screened patients were included .


Recurrent stroke was responsible for exclusion of @ % of potentially eligible patients .


Recurrent stroke represented a big barrier to enroll patients in the protocol .


External validity of rehabilitation trials will benefit from definition of study criteria according to regional characteristics of patients , including rates of recurrent stroke .


Patients with colorectal cancer with liver metastases undergo hepatic resection with curative intent .


Positron emission tomography combined with computed tomography ( PET-CT ) could help avoid noncurative surgery by identifying patients with occult metastases .


To determine the effect of preoperative PET-CT vs no PET-CT ( control ) on the surgical management of patients with resectable metastases and to investigate the effect of PET-CT on survival and the association between the standardized uptake value ( ratio of tissue radioactivity to injected radioactivity adjusted by weight ) and survival .


A randomized trial of patients older than @ years with colorectal cancer treated by surgery , with resectable metastases based on CT scans of the chest , abdomen , and pelvis within the previous @ days , and with a clear colonoscopy within the previous @ months was conducted between @ and @ , involving @ surgeons at @ hospitals in Ontario , Canada , with PET-CT scanners at @ academic institutions .


Patients were randomized using a @ to @ ratio to PET-CT or control .


The primary outcome was a change in surgical management defined as canceled hepatic surgery , more extensive hepatic surgery , or additional organ surgery based on the PET-CT .


Survival was a secondary outcome .


Of the @ patients who underwent PET-CT , @ had a change in surgical management ( @ % ; @ % CI , @ % -@ % ) .


Specifically , @ patients ( @ % ) did not undergo laparotomy , @ ( @ % ) had more extensive hepatic surgery , @ ( @ % ) had additional organ surgery ( @ of whom had hepatic resection ) , and the abdominal cavity was opened in @ patient but hepatic surgery was not performed and the cavity was closed .


Liver resection was performed in @ % of patients in the PET-CT group and @ % of the control group .


After a median follow-up of @ months , the estimated mortality rate was @ ( @ % CI , @-@ @ ) events/@ person-months for the PET-CT group and @ ( @ % CI , @-@ @ ) events/@ person-months for the control group .


Survival did not differ between the @ groups ( hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- ; P = @ ) .


The standardized uptake value was associated with survival ( hazard ratio , @ -LSB- @ % CI , @-@ @ -RSB- per unit increase ; P < @ ) .


The C statistic for the model including the standardized uptake value was @ ( @ % CI , @-@ @ ) and without it was @ ( @ % CI , @-@ @ ) .


The difference in C statistics is @ ( @ % CI , @-@ @ ) .


The low C statistic suggests that the standard uptake value is not a strong predictor of overall survival .


Among patients with potentially resectable hepatic metastases of colorectal adenocarcinoma , the use of PET-CT compared with CT alone did not result in frequent change in surgical management .


These findings raise questions about the value of PET-CT scans in this setting .


Intravenous recombinant tissue-type plasminogen activator ( r-tPA ) , despite a risk of early symptomatic intracranial hemorrhage ( sICH ) , is of net clinical benefit to acute stroke patients .


We tested if predictive models could identify patients least likely to be harmed by sICH or those who gained no net benefit .


We used the Third International Stroke Trial ( IST-@ ) trial data set , an international , multicenter , open treatment randomized trial of @ mg/kg r-tPA versus control in @ patients with acute ischemic stroke .


We compared the discrimination and calibration of previously developed predictive models for ICH and poststroke poor outcome and developed a new model using variables selected by systematic review .


We calculated the absolute and relative risk reduction of death or dependency with r-tPA in patients at a low , medium , or high predicted risk of sICH or poor functional outcome .


Prediction models for sICH or poor outcome ( Hemorrhage After Thrombolysis -LSB- HAT -RSB- ; Sugar , Early Infarct Signs , Dense Artery , Age , National Institutes of Health ( NIH ) Stroke Score ( SEDAN ) ; Glucose Race Age Sex Pressure Stroke Severity -LSB- GRASPS -RSB- ; Stroke Thrombolytic Predictive Instrument ; Dense Artery , Rankin Score , Age , Glucose , Onset to Treatment Time , NIHSS -LSB- DRAGON -RSB- ; Totaled Health Risks in Vascular Events -LSB- THRIVE -RSB- ; our new model ; and a model with National Institutes of Health Stroke Scale and age ) had similar area under receiver operator characteristic curves ( AUROCC ) to predict sICH ( P for difference > @ ) .


The simplest model ( with covariates National Institutes of Health Stroke Scale and age ) predicted both sICH ( AUROCC , @ ; @ % CI , @-@ @ ) and poststroke poor functional outcome ( AUROCC , @ ; @ % CI , @-@ @ ) similarly to complex models .


There was no evidence that the effect of r-tPA in patients at high predicted risk of sICH or poor functional outcome after stroke was less than in those at lower risk .


There is a clinically relevant net positive effect of r-tPA in patients with acute stroke at a high predicted risk of sICH or poor functional outcome .


We sought to determine whether the design of @ different double-lumen endobronchial tubes ( DLT ) ( Rusch , Mallinckrodt , Fuji ) has an effect on the ease of placement over an airway exchange catheter ( AEC ) using a video laryngoscope .


A convenience sample of @ anesthesia residents and fellows with at least @ years of anesthesia training was recruited from teaching hospitals in Toronto for a randomized crossover trial .


Each participant passed each DLT over an AEC in an airway simulator , visualized and video recorded via a video laryngoscope ( GlideScope ) .


The order of exchange was randomized by blindly pulling the name of the manufacturer of a DLT from a box .


The primary outcome was time to intubate , defined as time from the bronchial lumen entering the GlideScope view to the bronchial lumen passing the vocal cords .


Also recorded were participants ' subjective rating of the ease of use and failure rate , defined as an attempt > @-second duration .


Time to intubate was faster with the Fuji-Phycon DLT ( median @ seconds ) compared with both the Rusch ( median @ seconds , P = @ ) and Mallinckrodt ( median @ seconds , P = @ ) .


On a scale of @ to @ , with @ being very easy to use and @ being very difficult , the Fuji-Phycon was judged to be easier to use ( median @ seconds ) compared with the Rusch ( median @ , P = @ ) and the Mallinckrodt ( median @ seconds , P = @ ) .


The Rusch was associated with significantly more failures than the other DLTs , P = @ .


The Fuji-Phycon DLT was easier to pass over an AEC in this simulator trial and warrants consideration in patients with difficult airways who require @-lung ventilation .


Acute kidney injury ( AKI ) after cardiac surgery procedures is associated with poor patient outcomes .


Cystatin C as a marker for renal failure has been shown to be of prognostic value ; however , a wide range of its predictive accuracy has been reported .


The aim of the study was to evaluate whether the measurement of pre - and postoperative serum cystatin C improves the prediction of AKI .


In a single-centre , prospective study of @ patients ( @ @ ys ; range @-@ ys ; @ % male ) , cystatin C was measured six times : ( T@ = preoperative , T@ = start cardiopulmonary bypass ( CPB ) , T@ = @ min after CPB , T@ = end of operation ; T@ = @ h postoperatively ; T@ = @d postoperatively ) .


Predictive property , in terms of the need for renal replacement therapy ( RRT ) , was analysed by receiver operating characteristics ( ROC ) statistics and described by the area under the curve ( AUC ) .


With respect to RRT ( n = @ ) , serum cystatin C was significantly higher at the end of the operation ( T@ ) , @ h postoperatively at T@ and at T@ .


The AUCs for preoperative T@ and intraoperative T@/@ cystatin C were < @ ( @ % CI , @-@ @ ) .


The earliest significant predictive AUCs were found at the end of the operation ( T@ : p = @ @ % CI @-@ @ AUC @ ) and @ h postoperatively ( T@ : p = @ @ % CI @-@ @ AUC @ ) .


Early postoperative serum cystatin C increase appears to be a moderate biomarker in the prediction of AKI , whereas a preoperative and intraoperative cystatin C increase has only a limited diagnostic and predictive value .


To examine whether @ weeks of treatment with a dipeptidyl peptidase-@ ( DPP-@ ) inhibitor , sitagliptin , influences the insulin secretion induced by glucose , glucose-dependent insulinotropic polypeptide ( GIP ) and glucagon-like peptide-@ ( GLP-@ ) during a hyperglycaemic clamp in patients with type @ diabetes ( T@DM ) .


A randomized , double-blind , placebo-controlled study was conducted over @ weeks , during which @ patients with T@DM completed treatment with either sitagliptin ( @mg once daily ) or placebo as add-on therapy to metformin -LSB- sitagliptin group ( n = @ ) : meanstandard error of the mean ( s.e.m. ) age @ years , means.e.m .


HbA@c @ % ; placebo group ( n = @ ) : means.e.m .


age : @ years , means.e.m .


HbA@c @ % -RSB- .


In weeks @ and @ , the patients underwent three @-h @-mM hyperglycaemic clamp experiments with infusion of either saline , GLP-@ or GIP .


- cell function was evaluated according to first-phase , second-phase , incremental and total insulin and C-peptide responses .


In the sitagliptin group , the mean HbA@c concentration was significantly reduced by @ % ( p = @ ) .


The total - cell response during GIP infusion improved significantly from week @ to week @ , both within the sitagliptin group ( p = @ ) and when compared with the placebo group ( p = @ ) .


The total - cell response during GLP-@ infusion was significantly higher ( p = @ ) when compared with saline and GIP infusion , but with no improvement from week @ to week @ .


No significant changes in - cell function occurred in the placebo group .


Treatment with the DPP-@ inhibitor sitagliptin over @ weeks in patients with T@DM partially restored the lost insulinotropic effect of GIP , whereas the preserved insulinotropic effect of GLP-@ was not further improved .


A gradual enhancement of the insulinotropic effect of GIP , therefore , possibly contributes to the antidiabetic actions of DPP-@ inhibitors .


Fluticasone and formoterol are effective in the treatment of asthma .


When a corticosteroid alone fails to control asthma , combination therapy is the treatment of choice .


The objective of this study was to compare the efficacy and safety of formulations containing budesonide/formoterol ( BUD/FOR ) , fluticasone alone ( FLU ) , and the single-capsule combination of fluticasone/formoterol ( FLU/FOR ) on lung function in patients with mild-to-moderate persistent asthma .


This was a randomized , multicenter , open phase III trial conducted in Brazil .


The primary efficacy analysis was the assessment of non-inferiority between FLU/FOR and BUD/FOR combinations regarding FEV@ ( in L ) at the final visit .


The secondary analyses were PEF , level of asthma control , serum cortisol levels , frequency of adverse events , adherence to treatment , and appropriate inhaler use .


We randomized @ patients to three groups : FLU/FOR ( n = @ ) , BUD/FOR ( n = @ ) , and FLU ( n = @ ) .


In terms of the mean FEV@ after @ weeks of treatment , the difference between the FLU/FOR and BUD/FOR groups was @ L ( @ % CI : -@ to @ ) , whereas the difference between the FLU/FOR and FLU groups was @ L ( @ % CI : -@ to @ ) .


Non-inferiority was demonstrated by the difference between the lower limits of the two @ % CIs ( -@ vs. -@ ) .


The level of asthma control and PEF were significantly greater in the FLU/FOR and BUD/FOR groups than in the FLU group .


There were no significant differences among the groups regarding patient adherence , patient inhaler use , or safety profile of the formulations .


The single-capsule combination of FLU/FOR showed non-inferiority to the BUD/FOR and FLU formulations regarding efficacy and safety , making it a new treatment option for persistent asthma .


Atrial fibrillation is associated with decline of cognitive function .


Observational evidence suggests that anticoagulation might protect against this decline .


We report the first randomized controlled trial evidence on the effect of anticoagulation on cognitive function in elderly patients with atrial fibrillation .


A total of @ patients aged@ years with atrial fibrillation were recruited from primary care and randomly assigned to warfarin ( n = @ ; target international normalized ratio , @-@ ) or aspirin ( n = @ ; @ mg/d ) .


Neither participants nor investigators were masked to group assignment .


Follow-up was for a mean of @ years ( SD , @ ) .


Cognitive outcome was assessed using the Mini-Mental State Examination at @ - , @ - , and @-month follow-up .


Participants who had a stroke were censored from the analysis , which was by intention to treat with imputation for missing data .


There was no difference between mean Mini-Mental State Examination scores in people assigned to warfarin or aspirin at @ or @ months .


At @-month follow-up , there was a nonsignificant difference of @ in favor of warfarin that decreased to @ ( @ % confidence interval , -@ to @ ) after imputation .


We found no evidence that anticoagulation confers clinically important protection over aspirin against cognitive decline as measured by the Mini-Mental State Examination in atrial fibrillation in the first @ months of treatment other than that provided by preventing clinical stroke .


The aim of this study was to identify the effects of a communication skills training ( CST ) program for oncologists , developed based on patient preferences regarding oncologists ' communication .


Thirty oncologists were randomly assigned to either an intervention group ( IG ; @-day CST workshop ) or control group ( CG ) .


Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up .


A total of @,@ patients ( response rate , @ % ) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale , satisfaction with the consultation , and trust in their oncologist after the consultation .


At the follow-up survey , the performance scores of the IG had improved significantly , in terms of their emotional support ( P = @ ) , setting up a supportive environment ( P = @ ) , and ability to deliver information ( P = @ ) , compared with those of the CG .


Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves ( P = @ ) .


Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG ( P = @ ) .


However , the CST program did not affect patient satisfaction with oncologists ' style of communication .


A CST program based on patient preferences is effective for both oncologists and patients with cancer .


Oncologists should consider CST as an approach to enhancing their communication skills .


Attention bias modification treatment ( ABMT ) is a promising novel treatment for anxiety disorders , but clinical trials have focused largely on stand-alone formats among adults .


This randomized controlled trial examined the augmenting effects of threat-based ABMT on cognitive behavioral therapy ( CBT ) in clinically anxious youth .


Sixty-three treatment-seeking children with anxiety disorder were randomly assigned to @ of the following @ treatment groups : ABMT + CBT ; ABMT placebo + CBT ; and CBT-alone .


Participants in the @ ABMT conditions received repeated training on dot-probe tasks either designed to shift attention away from threats ( active ) or designed to induce no changes in attention patterns ( placebo ) .


Primary outcome measures were frequency and severity of anxiety symptoms as determined by a clinician using a semi-structured interview .


Self - and parent-rated anxiety measures and threat-related attention bias scores were also measured before and after treatment .


Both the active and placebo ABMT groups showed greater reductions in clinician-rated anxiety symptoms than the CBT-alone group .


Furthermore , only the active ABMT group showed significant reduction in self - or parent-rated anxiety symptoms .


Finally , all groups showed a shift in attention patterns across the study , starting with a bias toward threat at baseline and shifting attention away from threat after treatment .


Active and placebo ABMT might augment the clinical response to CBT for anxiety .


This effect could arise from benefits associated with performing computer-based paradigms such as the dot-probe task .


Given the absence of group differences in attention-bias changes during treatment , possible mechanisms and methodological issues underlying the observed findings are discussed .


Clinical trial registration information-Augmenting Effects of ABMT on CBT in Anxious Children : A Randomized Clinical Trial ; http://clinicaltrials.gov/; NCT@ .


To analyze the effect of psychological intervention on reducing performance anxiety and the consequences of the intervention on first-year pharmacy students .


In this experimental study , @ first-year undergraduate pharmacy students from a private university in Malaysia were approached between weeks @ and @ of their first semester to participate in the study .


The completed responses for the Westside Test Anxiety Scale ( WTAS ) , the Kessler Perceived Distress Scale ( PDS ) , and the Academic Motivation Scale ( AMS ) were received from @ students .


Out of @ students , @ exhibited moderate to high test anxiety according to the WTAS ( score ranging from @ to @ ) and were randomly placed into either an experiment group ( n = @ ) or a waiting list control group ( n = @ ) .


The prevalence of test anxiety among pharmacy students in this study was lower compared to other university students in previous studies .


The present study 's anxiety management of psychoeducation and systematic education for test anxiety reduced lack of motivation and psychological distress and improved grade point average ( GPA ) .


Psychological intervention helped significantly reduce scores of test anxiety , psychological distress , and lack of motivation , and it helped improve students ' GPA .


Treatment for patients with chronic lymphocytic leukaemia who are elderly or who have comorbidities is challenging because fludarabine-based chemoimmunotherapies are mostly not suitable .


Chlorambucil remains the standard of care in many countries .


We aimed to investigate whether the addition of ofatumumab to chlorambucil could lead to better clinical outcomes than does treatment with chlorambucil alone , while also being tolerable for patients who have few treatment options .


We carried out a randomised , open-label , phase @ trial for treatment-naive patients with chronic lymphocytic leukaemia in @ centres in @ countries .


We included patients who had active disease needing treatment , but in whom fludarabine-based treatment was not possible .


We randomly assigned patients ( @:@ ) to receive oral chlorambucil ( @ mg/m ( @ ) ) on days @-@ of a @ day treatment course or to receive chlorambucil by this schedule plus intravenous ofatumumab ( cycle @ : @ mg on day @ and @ mg on day @ ; subsequent cycles : @ mg on day @ ) for three to @ cycles .


Assignment was done with a randomisation list that was computer generated at GlaxoSmithKline , and was stratified , in a block size of two , by age , disease stage , and performance status .


The primary endpoint was progression-free survival in the intention-to-treat population and assessment was done by an independent review committee that was masked to group assignment .


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


We enrolled @ patients , median age @ years ( range @-@ ) .


Between Dec @ , @ , and May @ , @ , we randomly assigned @ patients to chlorambucil plus ofatumumab and @ patients to chlorambucil alone .


Median progression-free survival was @ months ( @ % CI @-@ ) in the group assigned to chlorambucil plus ofatumumab compared with @ months ( @-@ ) in the group assigned to chlorambucil only ( hazard ratio @ , @ % CI @-@ ; p < @ ) .


Grade @ or greater adverse events were more common in the chlorambucil plus ofatumumab group ( @ -LSB- @ % -RSB- patients ; vs @ -LSB- @ % -RSB- given chlorambucil alone ) , with neutropenia being the most common event ( @ -LSB- @ % -RSB- vs @ -LSB- @ % -RSB- ) .


Grade @ or greater infections had similar frequency in both groups .


Grade @ or greater infusion-related adverse events were reported in @ ( @ % ) patients given chlorambucil plus ofatumumab .


Five ( @ % ) patients died during treatment in each group .


Addition of ofatumumab to chlorambucil led to clinically important improvements with a manageable side-effect profile in treatment-naive patients with chronic lymphocytic leukaemia who were elderly or had comorbidities .


Chlorambucil plus ofatumumab is therefore an important treatment option for these patients who can not tolerate more intensive therapy .


To compare the efficacy and safety of weekly albiglutide with daily sitagliptin , daily glimepiride , and placebo .


Patients with type @ diabetes receiving metformin were randomized to albiglutide ( @ mg ) , sitagliptin ( @ mg ) , glimepiride ( @ mg ) , or placebo .


Blinded dose titration for albiglutide ( to @ mg ) and glimepiride ( to @ mg ) was based on predefined hyperglycemia criteria .


The primary end point was change in HbA@c from baseline at week @ .


Secondary end points included fasting plasma glucose ( FPG ) , weight , and time to hyperglycemic rescue .


Baseline characteristics were similar among the albiglutide ( n = @ ) , glimepiride ( n = @ ) , sitagliptin ( n = @ ) , and placebo ( n = @ ) groups .


Baseline HbA@c was @ % ( @ mmol/mol ) ; mean age was @ years .


The mean doses for albiglutide and glimepiride at week @ were @ and @ mg , respectively .


At week @ , albiglutide significantly reduced HbA@c compared with placebo ( -@ % -LSB- -@ mmol/mol -RSB- ; P < @ ) , sitagliptin ( -@ % -LSB- -@ mmol/mol -RSB- ; P = @ ) , and glimepiride ( -@ % -LSB- -@ mmol/mol -RSB- ; P = @ ) .


Outcomes for FPG and HbA@c were similar .


Weight change from baseline for each were as follows : albiglutide -@ kg ( @ % CI -@ to -@ ) , placebo -@ kg ( @ % CI -@ to -@ ) , sitagliptin -@ kg ( @ % CI -@ to -@ ) , glimepiride @ kg ( @ % CI @-@ @ ) .


The difference between albiglutide and glimepiride was statistically significant ( P < @ ) .


Hyperglycemic rescue rate at week @ was @ % for albiglutide compared with @ % ( P < @ ) , @ % ( P = @ ) , and @ % ( P = @ ) for placebo , sitagliptin , and glimepiride , respectively .


Rates of serious adverse events in the albiglutide group were similar to comparison groups .


Diarrhea ( albiglutide @ % , other groups @-@ @ % ) and nausea ( albiglutide @ % , other groups @-@ @ % ) were generally the most frequently reported gastrointestinal events .


Added to metformin , albiglutide was well tolerated ; produced superior reductions in HbA@c and FPG at week @ compared with placebo , sitagliptin , and glimepiride ; and resulted in weight loss compared with glimepiride .


Despite a favorable clinical experience , little evidence exists for the efficacy of greater occipital nerve block ( GONB ) in migraine treatment .


Considering such a premise , we wished to evaluate the therapeutic efficacy of GONB in patients affected by migraine headaches .


A randomized double-blinded controlled trial was conducted on @ patients suffering from migraine headaches .


A syringe containing @ mL of lidocaine @ % , @ mL of either saline ( control group , N = @ ) or triamcinolone @ mL ( intervention group , N = @ ) was prepared for each patient .


Patients were assessed prior to the injection , and also @ weeks , @ month , and @ months thereafter for severity and frequency of pain , times to use analgesics and any appeared side effects .


No significant differences were revealed in pain severity , pain frequency , and analgesics use between the two groups at the four study time points including at baseline , and @ , @ , and @ weeks after the intervention .


However , in both groups , the indices of pain severity , pain frequency , and analgesics use were significantly reduced at the three time points after the intervention compared with before the intervention .


GONB with triamcinolone in combination with lidocaine or normal saline with lidocaine results in reducing pain severity and frequency as well as use of analgesics up to two months after the intervention , however any difference attributed to the drug regimens by assessing of the trend of pain characteristics changes .


The aim of the article was to investigate the effect of ondansetron preloading with crystalloid infusion after spinal anesthesia during cesarean delivery .


A total of @ parturient women scheduled for elective caesarean sections were randomly assigned to two groups .


Five minutes before spinal anesthesia , Group O patients were injected with @ mg of ondansetron , while Group S patients were injected with @ mL physiological saline .


Maternal blood pressure and heart rate were measured at @ minute intervals for @ minutes .


After delivery , umbilical cord blood samples were analyzed .


Maternal hypotension and nausea were significantly lower in ondansetron-treated patients versus placebo ( p = @ vs. @ ) .


Umbilical venous pH was significantly higher in ondansetron-treated patients ( p = @ ) , while partial pressure of carbon dioxide ( Pco @ ) was significantly lower ( p = @ ) .


Decreases in maternal systolic and mean arterial blood pressures were significantly lower in ondansetron-treated patients ( p = @ vs. @ ) , with less requirement for phenylephrine administration compared with controls ( p = @ ) .


Ondansetron preloading combined with crystalloid infusion significantly reduced hypotension and nausea , while improving acid-base status , as well as reducing vasoconstrictor use .


The common bean is a staple crop in many African and Latin American countries and is the focus of biofortification initiatives .


Bean iron concentration has been doubled by selective plant breeding , but the additional iron is reported to be of low bioavailability , most likely due to high phytic acid ( PA ) concentrations .


The present study evaluated the impact of PA on iron bioavailability from iron-biofortified beans .


Iron absorption , based on erythrocyte incorporation of stable iron isotopes , was measured in @ Rwandese women who consumed multiple , composite bean meals with potatoes or rice in a crossover design .


Iron absorption from meals containing biofortified beans ( @ mg Fe , @ mg PA/@ g ) and control beans ( @ mg Fe , @ mg PA/@ g ) was measured with beans containing either their native PA concentration or with beans that were @ % dephytinized or > @ % dephytinized .


The iron concentration of the cooked composite meals with biofortified beans was @ % higher than in the same meals with control beans .


With native PA concentrations , fractional iron absorption from the control bean meals was @ % , @ % higher than that from the biofortified bean meals ( P < @ ) .


The quantity of iron absorbed from the biofortified bean meals ( @ g ) was @ % higher ( P < @ ) than that from the control bean meals .


With @ % and > @ % dephytinization , the quantity of iron absorbed from the biofortified bean meals increased to @ and @ g , respectively , which was @ % ( P < @ ) and @ % ( P < @ ) higher than from the control bean meals .


PA strongly decreases iron bioavailability from iron-biofortified beans , and a high PA concentration is an important impediment to the optimal effectiveness of bean iron biofortification .


Plant breeders should focus on lowering the PA concentration of high-iron beans .


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


The exact force systems as well as their progressions generated by removable thermoplastic appliances have not been investigated .


Thus , the purposes of this experimental study were to quantify the forces and moments delivered by a single aligner and a series of aligners ( Invisalign ; Align Technology , Santa Clara , Calif ) and to investigate the influence of attachments and power ridges on the force transfer .


We studied @ aligners of the Invisalign system ( @ series of aligners ) .


The aligners came from @ consecutive patients , of which @ tooth movements ( incisor torque , premolar derotation , molar distalization ) with @ movements each were analyzed .


The @ movement groups were subdivided so that @ movements were supported with an attachment and @ were not .


The patients ' ClinCheck ( Align Technology , Santa Clara , Calif ) was planned so that the movements to be investigated were performed in isolation in the respective quadrant .


Resin replicas of the patients ' intraoral situation before the start of the investigated movement were taken and mounted in a biomechanical measurement system .


An aligner was put on the model , the force systems were measured , and the calculated movements were experimentally performed until no further forces or moments were generated .


Subsequently , the next aligners were installed , and the measurements were repeated .


The initial mean moments were about @ Nmm for maxillary incisor torque and about @ N for distalization .


Significant differences in the generated moments were measured in the premolar derotation group , whether they were supported with an attachment ( @ Nmm ) or not ( @ Nmm ) .


All measurements showed an exponential force change .


Apart from a few maximal initial force systems , the forces and moments generated by aligners of the Invisalign system are within the range of orthodontic forces .


The force change is exponential while a patient is wearing removable thermoplastic appliances .


This study aims to evaluate the treatment effects of physical exercise on menopausal symptoms in middle-aged female medical staff experiencing perimenopausal syndrome .


A total of @ female medical staff aged @ to @ years and with a Kupperman index score of @ points or higher were randomized @:@ into an intervention group ( n = @ ) or a control group ( n = @ ) .


Women in the intervention group were asked to perform aerobic physical exercise ( walking with strides ) three times a week or more , whereas those in the control group continued as normal .


Measurements were taken at baseline and on weeks @ , @ , and @ , with total Kupperman index score , scores on individual elements of the scale , weight , and waist circumference recorded .


In addition , fasting blood glucose , triglycerides , total cholesterol , high-density lipoprotein cholesterol , and low-density lipoprotein cholesterol were recorded at baseline and on week @ .


The effects of physical exercise therapy on perimenopausal syndrome were evaluated by comparing changes in these parameters between the control group and the intervention group .


Fifty-four and @ women completed all three follow-ups in the intervention and control groups , respectively .


On week @ , the mean ( SD ) change in total Kupperman index score ( -@ -LSB- @ -RSB- ) from baseline to week @ ; the mean ( SD ) changes in individual scores for paresthesia ( -@ -LSB- @ -RSB- ) , insomnia ( -@ -LSB- @ -RSB- ) , irritability ( -@ -LSB- @ -RSB- ) , joint or muscle pain ( -@ -LSB- @ -RSB- ) , fatigue ( -@ -LSB- @ -RSB- ) , headache ( -@ -LSB- @ -RSB- ) , formication ( -@ -LSB- @ -RSB- ) , and sexual life ( -@ -LSB- @ -RSB- ) ; and the mean ( SD ) changes in total cholesterol ( -@ -LSB- @ -RSB- mmol/L ) and triglycerides ( -@ -LSB- @ -RSB- mmol/L ) were significantly higher in the intervention group than in the control group ( P < @ ) .


In the intervention group , total Kupperman index score , weight , body mass index , waist circumference , triglycerides , and total cholesterol were significantly lower on week @ compared with baseline ( P < @ ) .


Physical exercise can substantially reduce menopausal symptoms and improve blood lipid status and body weight .


In-hospital cardiac arrest ( IHCA ) outcomes vary widely between hospitals , even after adjusting for patient characteristics , suggesting variations in practice as a potential etiology .


However , little is known about the standards of IHCA resuscitation practice among US hospitals .


To describe current US hospital practices with regard to resuscitation care .


A nationally representative mail survey .


A random sample of @ hospitals from the American Hospital Association database , stratified into @ categories by hospital volume tertile and teaching status ( major teaching , minor teaching , and nonteaching ) .


Surveys were addressed to each hospital 's cardiopulmonary resuscitation ( CPR ) committee chair or chief medical/quality officer .


A @-item questionnaire .


Responses were received from @ hospitals with a similar distribution of admission volume and teaching status as the sample population ( P = @ ) .


Of the @ ( @ % ) hospitals with a CPR committee , @ ( @ % ) were chaired by a hospitalist .


High frequency practices included having a rapid response team ( @ % ) and standardizing defibrillators ( @ % ) .


Low frequency practices included therapeutic hypothermia and use of CPR assist technology .


Other practices such as debriefing ( @ % ) and simulation training ( @ % ) were more variable and correlated with the presence of a CPR committee and/or dedicated personnel for resuscitation quality improvement .


The majority of hospitals ( @ % ) reported at least @ barrier to quality improvement , of which the lack of a resuscitation champion and inadequate training were the most common .


There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement .


Medications for respiratory disorders including asthma and chronic obstructive pulmonary disease ( COPD ) are typically delivered to the lung by means of a handheld inhaler .


Patient preference for and ability to use the inhaler may influence their adherence to maintenance therapy , and adherence may affect treatment outcomes .


In this study , patient experience of using a dry powder inhaler ( DPI ) , the ELLIPTA DPI , in clinical trials of a new maintenance therapy for asthma and COPD was investigated .


The ELLIPTA DPI has been designed to contain two separate blister strips from which inhalation powder can be delivered , and to be simple to use with a large , easy-to-read dose counter .


Semi-structured , in-depth , qualitative interviews were carried out @-@ weeks after patients had completed one of six phase IIIa clinical trials using the ELLIPTA DPI .


Interview participants were asked about their satisfaction with various attributes of the inhaler and their preference for the ELLIPTA DPI relative to currently-prescribed inhalers , and responses were explored using an inductive content analysis approach .


Participants also rated the performance of the inhaler on several criteria , using a subjective @-@ scale .


Participants with asthma ( n = @ ) and COPD ( n = @ ) reported high levels of satisfaction with the ELLIPTA DPI .


It was frequently described as straightforward to operate and easy to use by interview participants .


Ergonomic design , mouthpiece fit , and dose counter visibility and ease of interpretation emerged as frequently cited drivers of preference for the ELLIPTA DPI compared with their current prescribed inhaler .


Of participants with asthma , @ % preferred the ELLIPTA DPI to DISKUS and @ % to metered dose inhalers .


Of participants with COPD , @ % preferred the ELLIPTA DPI to DISKUS , @ % to HandiHaler , and @ % to metered dose inhalers .


Overall average performance scores were > @ ( out of @ ) in participants with asthma and COPD .


The ELLIPTA DPI was associated with high patient satisfaction and was preferred to other inhalers by interview participants with asthma and COPD .


The development of an inhaler that is regarded as easy and intuitive to use may have positive implications for adherence to therapy in asthma and COPD .


Despite the high incidence and the economic impact of the common cold , there are still no effective therapeutic options available .


Although traditional Chinese medicine ( TCM ) is widely used in China to treat the common cold , there is still a lack of high-quality clinical trials .


This article sets forth the protocol for a high-quality trial of a new TCM drug , Baoji Tablets , which is designed to treat the common cold with summer-heat and dampness syndrome ( CCSDS ) .


The trial is evaluating both the efficacy and safety of Baoji Tablets .


This study is designed as a multicenter , phase II , parallel-group , double-blind , double-dummy , randomized and placebo-controlled trial .


A total of @ patients will be recruited from four centers .


The new tablets group are administered Baoji Tablets @ g and dummy Baoji Pills @ g.


The old pills group are administered dummy Baoji Tablets @ g and Baoji Pills @ g.


The placebo control group are administered dummy Baoji Tablets @ g and dummy Baoji Pills @ g. All drugs are taken three times daily for @ days .


The primary outcome is the duration of all symptoms .


Secondary outcomes include the duration of primary and secondary symptoms , changes in primary and secondary symptom scores and cumulative symptom score at day @ , as well as an evaluation of treatment efficacy .


This is the first multicenter , double-blind , double-dummy , randomized and placebo-controlled trial designated to treat CCSDS in an adult population from China .


It will establish the basis for a scientific and objective assessment of the efficacy and safety of Baoji Tablets for treating CCSDS , and provide evidence for a phase III clinical trial .


Diabetes is a chronic disease characterized by elevated blood glucose levels .


The appropriate goals in the management of diabetes include maintaining blood glucose levels as close to the normal range as possible , minimizing the adverse effects of free radicals by enhancing antioxidant defenses .


Supplementation with appropriate vitamins may therefore be of value in the prevention and treatment of diabetes .


A total of @ patients with diabetic neuropathy were enrolled in this randomized controlled study from the general medicine department of a tertiary care hospital .


Patients were randomized into two groups viz. , usual care ( n = @ ) and intervention group ( n = @ ) .


Usual care group patients received pregabalin with oral hypoglycemic agents .


Patients in the intervention group received vitamin-E along with their regular medicines .


Pain intensity and quality of life ( QoL ) of patients were assessed using Neuropathy Pain Score and RAND @ questionnaire .


Blood samples were analyzed for the levels of random blood sugar level and HbA ( @c ) at the baseline and on the @th week .


Significant ( p < @ ) decrease in the random blood sugar level was observed in intervention group when compared with the usual care group and a significant ( p < @ ) reduction in total pain score , and a significant ( p < @ ) improvement in physical health after @ week treatment of vitamin-E was observed .


The study concluded that vitamin-E is a natural antioxidant and it is found to be effective in reducing pain score in diabetic neuropathy patients .


The future studies may be directed towards extended duration of action .


Childbirth is an important experience in a woman 's life , and unfavorable birth experiences have been shown to negatively impact postpartum maternal health .


Aim of this study was to evaluate the effects of music therapy on postpartum pain , anxiety level , satisfaction and early pospartum depression rate .


Totally @ primiparous women were recruited and randomized either music group ( n = @ ) or a control group ( n = @ ) .


Women in the music group listened to self-selected music during labor .


Postpartum pain intensity , anxiety level and satisfaction rate were measured using the visual analog scale ( VAS ) , postpartum depression rate was assessed with Edinburg Postpartum Depression Scale ( EPDS ) at postpartum day one and day eight .


Mothers in the music therapy group had a lower level of postpartum pain and anxiety than the control group and it was statistically significant at all time intervals ( @ , @ , @ , @ and @h , p < @ ) .


A significant difference was observed between the two groups in terms of satisfaction rate ( p < @ ) and postpartum depression rate at postpartum day one and day eight ( p < @ ) .


We only measured the effect of music therapy on early postpartum depression rate .


Effect of music on late postpartum depression rate should be investigated in future .


Using music therapy during labor decreased postpartum anxiety and pain , increased the satisfaction with childbirth and reduced early postpartum depression rate .


Music therapy can be clinically recommended as an alternative , safe , easy and enjoyable nonpharmacological method for postpartum well-being .


Learners can focus on mastery ( i.e. task orientation ) or on learning relative to others ( i.e. ego orientation ) .


Previous research suggests task orientations are optimal for learning , a benefit usually linked to the suggestion that qualitative comments are better for learning than quantitative comparisons ( i.e. grades ) .


Yet , it is not clear if the observed effects are attributable to the feedback orientation ( i.e. task versus ego ) , feedback format ( i.e. comments versus numerical scores ) , or an interaction between the two .


Here , we aimed to clarify the effects of feedback orientation and feedback format during simulation-based training in endotracheal intubation .


Forty-one medical students were randomly assigned to four feedback conditions : Task-oriented Numerical ; Ego-oriented Numerical ; Task-oriented Comment , and Ego-oriented Comment .


Participants performed a total of @ trials of endotracheal intubation .


Pre-test , post-test and retention test assessments included the use of hand motion analysis and a global rating scale ( GRS ) .


Participants rated feedback credibility , self-assessment and self-confidence using Likert-type scales .


Analyses of variance were used to examine group differences .


Participants ' performance did not differ significantly on the easiest ( p > @ ) or two complex variations of intubation ( p > @ ) .


For the moderately difficult variation , analyses of hand motion and GRS data revealed significant group differences at post-test ( p < @ ) , but no differences on the retention test .


Analysis of participants ' perceptions showed significant interactions whereby the Ego-oriented Numerical group rated feedback credibility ( p < @ ) higher than the Task-oriented Numerical group ; the two Comment groups did not differ .


Some participants recounted negative experiences with the feedback they received .


Medical students responded to feedback in ways that challenge previous education research .


Specifically , students preferred and improved more in the short term ( but not at retention ) when receiving Ego-oriented feedback in Numerical form .


Although learning retention did not differ significantly across feedback conditions , students ' perceptions of themselves and of the teacher and training environment did differ and the implications for trainees ' future learning must be considered .


To evaluate the in situ caries performance and safety of two experimental fluoride dentifrice formulations ( @ ppm fluoride ) with and without @ % isopentane as an excipient , in comparison to a positive control , currently marketed dentifrice ( @ ppm fluoride ) and a negative control dentifrice ( @ ppm fluoride ) .


This was a single-center , examiner-blind , randomized , controlled , four-treatment cross-over study .


During each treatment period , the subject wore a modified mandibular partial denture fitted with two gauze-covered , partially demineralized human enamel specimens , and brushed at home for one timed minute , twice daily , for two weeks .


At the end of each treatment period , the enamel specimens were removed from the dentures for analysis .


During the week between treatment periods , subjects returned to their usual dental hygiene practices for four to five days , received a dental prophylaxis , and used a study-designated non-fluoride dentifrice for two to three days before starting the next treatment .


Treatment effect on enamel specimen remineralization was assessed by surface microhardness ( SMH ) .


Enamel fluoride uptake was assessed using microdrill enamel biopsy .


All fluoride-containing dentifrices demonstrated significant , superior SMH recovery and levels of fluoride uptake compared to the negative control dentifrice .


No significant differences were observed for either efficacy variable between the experimental dentifrice formulations and the positive control dentifrice .


No significant difference was observed between the @ % isopentane dentifrice and the @ % isopentane dentifrice for SMH recovery .


The addition of @ % isopentane did not positively or negatively affect fluoride efficacy in this model .


PBT@ is a metal protein-attenuating compound that might reduce metal-induced aggregation of mutant huntingtin and has prolonged survival in a mouse model of Huntington 's disease .


We aimed to assess the safety , tolerability , and efficacy of PBT@ in patients with Huntington 's disease .


In this @-week , randomised , double-blind , placebo-controlled trial , adults ( @ years old ) with early-stage to mid-stage Huntington 's disease were randomly assigned ( @:@:@ ) by a centralised interactive response system to once daily PBT@ @ mg , PBT@ @ mg , or placebo .


Randomisation was stratified by site with a block size of three .


Participants , carers , the steering committee , site investigators , study staff , and the study sponsor were masked to treatment assignment .


Primary endpoints were safety and tolerability .


The safety population consisted of all participants who were randomly assigned and had at least one dose of study drug .


The principal secondary endpoint was cognition , measured by the change from baseline to week @ in the main composite Z score of five cognitive tests ( Category Fluency Test , Trail Making Test Part B , Map Search , Symbol Digit Modalities Test , and Stroop Word Reading Test ) and scores on eight individual cognitive tests ( the five aforementioned plus the Trail Making Test Part A , Montreal Cognitive Assessment , and the Speeded Tapping Test ) .


The intention-to-treat population comprised participants who were randomly assigned and had at least one efficacy assessment after administration of study drug .


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


Between April @ , @ , and Dec @ , @ , @ participants were randomly assigned to PBT@ @ mg ( n = @ ) , PBT@ @ mg ( n = @ ) , or placebo ( n = @ ) at @ research centres in Australia and the USA .


@ ( @ % ) individuals on PBT@ @ mg , @ ( @ % ) on PBT@ @ mg , and @ ( @ % ) on placebo completed the study .


Six serious adverse events ( acute coronary syndrome , major depression , pneumonia , suicide attempt , viral infection , and worsening of Huntington 's disease ) occurred in five participants in the PBT@ @ mg group , three ( fall with subdural haematoma , suicide attempt , and hospital admission for stabilisation of Huntington 's disease ) occurred in two participants in the PBT@ @ mg group , and one ( increasing aggression ) occurred in a participant in the placebo group .


The site investigators deemed all , except the worsening of Huntington 's disease , as unrelated to study drug .


@ ( @ % ) participants on PBT@ @ mg , @ ( @ % ) on PBT@ @ mg , and @ ( @ % ) on placebo had at least one adverse event .


Compared with placebo , neither PBT@ @ mg ( least-squares mean @ , @ % CI -@ to @ ; p = @ ) nor PBT@ @ mg ( @ , -@ to @ ; p = @ ) significantly improved the main composite cognition Z score between baseline and @ weeks .


Compared with placebo , the Trail Making Test Part B score was improved between baseline and @ weeks in the PBT@ @ mg group ( @ s , @-@ ; p = @ ) but not in the @ mg group ( @ s improvement , -@ to @ ; p = @ ) ; neither dose significantly improved cognition on the other tests .


PBT@ was generally safe and well tolerated in patients with Huntington 's disease .


The potential benefit on executive function will need to be confirmed in a larger study .


A retrospective radiographical study .


To construct a predictive model for pelvic tilt ( PT ) based on the sacrofemoral-pubic ( SFP ) angle in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis ( or AS ) .


PT is a key pelvic parameter in the regulation of spine sagittal alignment that can be used to plan the appropriate osteotomy angle in patients with AS with thoracolumbar kyphosis .


However , it could be difficult to measure PT in patients with femoral heads poorly visualized on lateral radiographs .


Previous studies showed that the SFP angle could be used to evaluate PT in adult patients with scoliosis .


However , this method has not been validated in patients with AS .


A total of @ patients with AS with thoracolumbar kyphosis were included .


Full-length anteroposterior and lateral spine radiographs were all available , with spinal and pelvic anatomical landmarks clearly identified .


PT , SFP angle , and global kyphosis were measured .


The patients were randomly divided into group A ( n = @ ) and group B ( n = @ ) .


In group A , the predictive model for PT was constructed by the results of the linear regression analysis .


In group B , the predictive ability and accuracy of the predictive model were investigated .


In group A , the Pearson correlation analysis revealed a strong correlation between the SFP angle and PT ( r = @ ; P < @ ) .


The predictive model for PT was constructed as PT = @-@ @ ( SFP angle ) .


In group B , PT was predicted by the model with a mean error of @ ( SD = @ ) with a predictive value of @ % .


PT can be accurately predicted by the SFP angle using the current model : PT = @-@ @ ( SFP angle ) , when the femur heads are poorly visualized on lateral radiographs in patients with AS with thoracolumbar kyphosis .


In type @ diabetes , acute hyperglycemia worsens endothelial function and inflammation , while resistance to GLP-@ action occurs .


All these phenomena seem to be related to the generation of oxidative stress .


A Mediterranean diet , supplemented with olive oil , increases plasma antioxidant capacity , suggesting that its implementation can have a favorable effect on the aforementioned phenomena .


In the present study , we test the hypothesis that a Mediterranean diet using olive oil can counteract the effects of acute hyperglycemia and can improve the resistance of the endothelium to GLP-@ action .


Two groups of type @ diabetic patients , each consisting of twelve subjects , participated in a randomized trial for three months , following a Mediterranean diet using olive oil or a control low-fat diet .


Plasma antioxidant capacity , endothelial function , nitrotyrosine , @-iso-PGF@a , IL-@ and ICAM-@ levels were evaluated at baseline and at the end of the study .


The effect of GLP-@ during a hyperglycemic clamp , was also studied at baseline and at the end of the study .


Compared to the control diet , the Mediterranean diet increased plasma antioxidant capacity and improved basal endothelial function , nitrotyrosine , @-iso-PGF@a , IL-@ and ICAM-@ levels .


The Mediterranean diet also reduced the negative effects of acute hyperglycemia , induced by a hyperglycemic clamp , on endothelial function , nitrotyrosine , @-iso-PGF@a , IL-@ and ICAM-@ levels .


Furthermore , the Mediterranean diet improved the protective action of GLP-@ on endothelial function , nitrotyrosine , @-iso-PGF@a , IL-@ and ICAM-@ levels , also increasing GLP-@-induced insulin secretion .


These data suggest that the Mediterranean diet , using olive oil , prevents the acute hyperglycemia effect on endothelial function , inflammation and oxidative stress , and improves the action of GLP-@ , which may have a favorable effect on the management of type @ diabetes , particularly for the prevention of cardiovascular disease .


To investigate the effect of a @-month physical activity intervention on cardiorespiratory fitness and adiposity among prepubertal children .


Prepubertal children ( @ - to @-year-olds , N = @ , @ girls ) were randomly assigned to a @-month physical activity intervention or a control group .


The intervention provided @ minutes ( @ days/week ) of moderate to vigorous physical activity .


Maximum oxygen consumption ( Vo@max percentile ) and dual-energy radiograph absorptiometry measured cardiorespiratory fitness and adiposity , respectively .


Intention-to-treat analysis was performed to assess baseline and follow-up cardiorespiratory fitness , percentage fat mass ( % FM ) , percentage central fat mass ( % CFM ) , and estimated visceral adipose tissue ( VAT ) area .


The intervention group increased in cardiorespiratory fitness ( @ th percentile ; @ % confidence interval -LSB- CI -RSB- , @ to @ ) and decreased in % FM ( -@ % ; @ % CI , -@ to -@ ) and % CFM ( -@ % ; @ % CI , -@ to -@ ) .


Reductions in % FM were evident for both nonoverweight ( -@ % ; @ % CI , -@ to -@ ) and overweight or obese ( -@ % ; @ % CI,-@ @ to -@ ) intervention participants .


Conversely , the control group displayed no change in cardiorespiratory fitness while exhibiting increases in % FM ( @ % ; @ % CI , @ to @ ) , % CFM ( @ ; @ % CI , @ to @ ) , and VAT area ( @ cm ( @ ) ; @ % CI , @ to @ ) .


Nonoverweight control participants increased in % FM ( @ % ; @ % CI , @ to @ ) , and their overweight and obese counterparts increased in VAT ( @ cm ( @ ) ; @ % CI , @ to @ ) .


The physical activity intervention improved cardiorespiratory fitness , reduced % FM , and prevented accumulation of % CFM among prepubertal children with varying adiposity levels .


These findings provide support for daily physical activity recommendations to prevent excess fat mass accumulation in childhood .


Applying a direct renin inhibitor ( DRI ) to advanced stage chronic kidney disease ( CKD ) patients is a matter of controversy .


The purpose of this study was to evaluate the effect of the DRI , aliskiren , in patients with therapy-resistant hypertension undergoing hemodialysis ( HD ) .


The study was a prospective , randomized multicenter trial exploring the antihypertensive effect of aliskiren in comparison with amlodipine , a calcium channel blocker , in patients undergoing HD .


A total of @ participants whose blood pressure ( BP ) had previously been treated with more than one antihypertensive agent and not having achieved the BP goal of < @/@ mmHg were randomly assigned to either aliskiren @ mg or amlodipine @ mg as an add-on therapy .


A significant decrease in pre-dialysis clinic BP and home BP was found only in the amlodipine group and not in the aliskiren group .


In contrast , there was a significant decrease in atrial natriuretic peptide ( ANP ) in the aliskiren group but not in the amlodipine group .


N-terminal pro-B-type natriuretic hormone remained unchanged in both groups .


Aliskiren significantly reduced angiotensin I and II , plasma renin activity , and increased plasma renin content .


However , such changes were not observed in the amlodipine group .


Amlodipine , not aliskiren , effectively reduces BP in CKD patients with refractory hypertension undergoing HD .


Aliskiren suppresses the renin-angiotensin system and reduces ANP .


Whether the DRI is beneficial in improving cardiovascular events in patients undergoing HD remains to be elucidated in future studies .


We determined the feasibility of a definitive trial comparing the effectiveness of group vs individual urotherapy for children with bladder-bowel dysfunction .


Children @ to @ years old with bladder-bowel dysfunction were recruited during the course of @ year .


Feasibility data on screening , eligibility , recruitment and protocol compliance rates were collected .


Patients with high grade hydronephrosis , vesicoureteral reflux or learning disabilities and those who had previously undergone urotherapy were excluded .


Patients were randomized to @-hour group urotherapy or @-minute individual urotherapy .


Symptoms and quality of life were measured using the Vancouver Nonneurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire and the Pediatric Incontinence Questionnaire at baseline and at @ to @ months of followup .


Within/between group comparisons were conducted using t-tests .


Of @ screened children @ were eligible and @ were recruited to participate .


A total of @ patients randomized to group urotherapy and @ randomized to individual urotherapy completed the pilot trial ( @ undergoing group and @ undergoing individual urotherapy withdrew from the study ) .


Symptomology scores between group and individual urotherapy were not different at followup ( mean SD @ @ vs @ @ , p = @ , @ % CI -@ -@ ) .


Quality of life scores between patients undergoing group and individual urotherapy at baseline differed ( mean SD @ @ vs @ @ , p < @ , @ % CI @-@ @ ) but became similar at followup ( @ @ vs @ @ , p = @ , @ % CI -@ -@ ) .


Within group analyses demonstrated improvement in symptomology from baseline to followup in patients undergoing group ( mean SD @ @ , p = @ , @ % CI @-@ @ ) and individual urotherapy ( @ @ , p < @ , @ % CI @-@ @ ) .


Within group quality of life analyses revealed improvement in Pediatric Incontinence Questionnaire scores from baseline to followup in patients undergoing individual urotherapy ( p < @ , @ % CI @-@ @ ) only .


Urotherapy , regardless of modality , effectively improved bladder-bowel dysfunction symptoms .


A definitive randomized controlled trial is feasible , considering that a high recruitment rate ( @ % ) for this population has been established .


To describe changes in and predictors of comfortable gait speed ( GS-C ) after using a foot-drop stimulator ( FDS ; Bioness L@ ; Bioness Inc , Valencia , CA ) for @ weeks in persons who had sustained a stroke .


Secondary analysis of prospective assessments .


Multicenter clinical trial .


A total of @ subjects who had sustained a stroke @ months earlier and who had GS-C @ m/s and drop foot with a mean age of @ years and a poststroke time of @ years .


GS-C was assessed at baseline and at @ weeks with and without use of an FDS ( therapeutic effect ) and at @ , @ , @ , @ , and @ weeks with use of an FDS ( total effect ) .


After subjects participated in @ physical therapy sessions , an FDS was used for ambulation over the course of @ weeks .


Changes in mean GS-C over time , FDS `` responder '' status defined as either @ m/s gain in GS-C ( the minimal clinically important difference -LSB- MCID -RSB- ) or advancing by one Perry Ambulation Category ( PAC ) , and the incidence and nature of adverse events ( AEs ) .


A total of @ ( @ % ) and @ ( @ % ) of @ subjects completed assessments at @ weeks and @ weeks , respectively .


Baseline GS-C was @ m/s without use of an FDS and @ m/s with use of an FDS .


GS-C improved to @ m/s at @ weeks without use of an FDS ( effect size = @ ) and @ , @ , @ , @ , and @ m/s at @ , @ , @ , @ , and @ weeks with use of an FDS , respectively ( effect size @ at @ weeks ) .


Half of the subjects achieved a maximum GS-C by @ weeks .


Approximately @ % were PAC responders and @ % were MCID responders for @-week therapeutic effect , and @ % were PAC responders and @ % were MCID responders for @-week total effect .


After logistic regression , the following factors emerged as the strongest predictors of FDS responders : younger age , faster baseline GS-C and Timed Up and Go , and balance .


At @ weeks , @ % reported a device-related AE ; @ % were mild and @ % were anticipated .


When an FDS was used , GS-C improved progressively over @ weeks , with @ % of patients achieving a clinically meaningful @-week total effect and @ % achieving a maximum GS-C by @ weeks .


Younger patients with greater mobility levels may benefit most from use of an FDS .


AEs were frequent , mild , and reversible .


One of the advantages of Internet-based research is the ability to efficiently recruit large , diverse samples of international participants .


Currently , there is a dearth of information on the behind-the-scenes process to setting up successful online recruitment tools .


The objective of the study was to examine the comparative impact of Spanish - and English-language keywords for a Google AdWords campaign to recruit pregnant women to an Internet intervention and to describe the characteristics of those who enrolled in the trial .


Spanish - and English-language Google AdWords campaigns were created to advertise and recruit pregnant women to a Web-based randomized controlled trial for the prevention of postpartum depression , the Mothers and Babies/Mams y Bebs Internet Project .


Search engine users who clicked on the ads in response to keyword queries ( eg , pregnancy , depression and pregnancy ) were directed to the fully automated study website .


Data on the performance of keywords associated with each Google ad reflect Web user queries from February @ to June @ .


Demographic information , self-reported depression symptom scores , major depressive episode status , and Internet use data were collected from enrolled participants before randomization in the intervention study .


The Google ads received high exposure ( @,@,@ impressions ) and interest ( @,@ clicks ) from a global sample of Web users ; @ pregnant women consented to participate and @ completed enrollment in the intervention study .


Keywords that were descriptive of pregnancy and distress or pregnancy and health resulted in higher consent and enrollment rates ( i.e. , high-performing ads ) .


In both languages , broad keywords ( eg , pregnancy ) had the highest exposure , more consented participants , and greatest cost per consent ( up to US $ @ per consent ) .


The online ads recruited a predominantly Spanish-speaking sample from Latin America of Mestizo racial identity .


The English-speaking sample was also diverse with most participants residing in regions of Asia and Africa .


Spanish-speaking participants were significantly more likely to be of Latino ethnic background , not married , completed fewer years of formal education , and were more likely to have accessed the Internet for depression information ( P < @ ) .


The Internet is an effective method for reaching an international sample of pregnant women interested in online interventions to manage changes in their mood during the perinatal period .


To increase efficiency , Internet advertisements need to be monitored and tailored to reflect the target population 's conceptualization of health issues being studied .


Excessive systemic inflammatory response remains as a major problem underlying severe burns .


This study aimed to assess the effect of low-dose glucocorticoid treatment in downregulating systemic inflammation in severely burned patients .


A prospective study from @ to @ at our hospital was conducted to compare the patients who received low-dose glucocorticoid during the acute phase with those who did not .


Patients with burns @ % or greater of their total body surface area were included , and their plasma levels of inflammatory cytokines and clinical outcomes were compared .


A total of @ patients were included in this study , with @ patients receiving glucocorticoid treatment and the others not .


Patient demographics including age , burn size , and incidence of inhalation injury were similar in both groups .


The incidence of pulmonary infection and stress ulcer ( and/or hemorrhage ) was @ % and @ % in the treatment group , respectively , significantly lower than @ % and @ % of the control group ( P < @ ) .


Length of hospital stay was almost @ days shorter in the treatment group ( P < @ ) , whereas there was no significant difference in the overall mortality , duration of mechanical ventilation , and incidence of sepsis between the @ groups .


The enzyme-linked immunosorbent assay results confirmed that the plasma levels of C-reactive protein , tumor necrosis factor - , interleukin-@ , and interleukin-@ were significantly lower in the treatment group ( P < @ ) .


Low dose of glucocorticoid treatment during the acute phase could reduce the levels of proinflammatory cytokines in severely burned patients and subsequently decrease the incidence of pulmonary infection and stress ulcer , as well as the length of hospital stay .


To compare the effectiveness and safety of add on therapy of bromocriptine with metformin in type @ diabetes mellitus ( DM ) patients .


Adult type @ DM patients fulfilling the inclusion criteria were randomized in three groups .


Group A received metformin ( @ mg / day ) , while group B patients were treated with metformin ( @ mg/day ) plus bromocriptine ( @ mg/day ) and group C received metformin ( @ mg/day ) plus bromocriptine ( @ mg/day ) for @ weeks .


Fasting plasma glucose ( FPG ) , postprandial plasma glucose ( PPPG ) , and body weight were measured at week @ , @ , and @ visits and glycosylated hemoglobin ( HbA ( @C ) ) at week @ visit .


Metformin alone and in combination with bromocriptine in escalating dose ( @ mg/day and @ mg/day ) significantly ( P < @ ) decreased FPG and PPPG levels at weeks @ , @ , and @ compared with pretreatment values .


HbA ( @C ) level in all three treatment groups significantly ( P < @ ) decreased at week @ as compared with pretreatment baseline value .


HbA@C level in groups B and C significantly ( P < @ ) decreased as compared with group A at week @ .


Addition of bromocriptine to metformin also significantly ( P < @ ) decreased FPG and PPPG levels in a dose-dependent manner as compared with metformin alone .


Intergroup analysis did not show any statistically significant change in weight of study subjects at different intervals .


The combination of bromocriptine with metformin significantly decreased FPG , PPPG , and HbA@C compared with metformin alone in type @ DM patients in a dose-dependent manner .


Nowadays , conventional analgesic agents , which are widely used for pain relief after cesarean section , provide suboptimal analgesia with occasional serious side effects .


We designed a randomized , double-blind , placebo-controlled study to evaluate the analgesic efficacy of intrathecal ketamine added to bupivacaine after cesarean section .


Sixty patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the two groups to receive either bupivacaine @ mg combined with @ mg/kg ketamine , or bupivacaine @ mg combined with @ mL distilled water intrathecally .


The time to the first analgesic request , analgesic requirement in the first @ hours after surgery , onset times of sensory and motor blockades , the durations of sensory and motor blockades , and the incidences of adverse effects such as hypotension , ephedrine requirement , bradycardia , and hypoxemia , were recorded .


Patients who received ketamine had a significantly prolonged duration of anesthesia compared with those who did not in the control group -LSB- @ % confidence intervals ( CI ) @-@ ; p = @ -RSB- .


The mean time to the first analgesic request was also significantly longer in ketamine group ( @ % CI @-@ ; p < @ ) .


The total analgesic consumption in the @ hours following surgery significantly lessened in the ketamine group compared with that of the control group ( @ % CI @-@ @ ; p < @ ) .


The two groups did not differ significantly in intraoperative and postoperative side effects .


Intrathecal ketamine @ mg/kg co-administered with spinal bupivacaine elongated the time to the first analgesic request and lessened the total analgesic consumption in the first @ postoperative hours in comparison with bupivacaine alone in the control group following elective cesarean delivery .


To measure the effects of participating in structured oral presentation evaluation sessions early in pediatric clerkships on students ' subsequent presentations .


We conducted a single-blind , @-arm , cluster randomized controlled trial during pediatric clerkships at Boston University School of Medicine , University of Maryland School of Medicine , Oregon Health & Science University , and Case Western Reserve University School of Medicine .


Blocks of students at each school were randomly assigned to experience either ( @ ) no formal presentation feedback ( control ) or a small-group presentation feedback session early in pediatric clerkships in which students gave live presentations and received feedback from faculty who rated their presentations by using a ( @ ) single-item ( simple ) or ( @ ) @-item ( detailed ) evaluation form .


At the clerkship end , overall quality of subjects ' presentations was rated by faculty blinded to randomization status , and subjects reported whether their presentations had improved .


Analyses included multivariable linear and logistic regressions clustered on clerkship block that controlled for medical school .


A total of @ participants were evenly divided into the @ arms , which had similar characteristics .


Compared with controls , presentation quality was significantly associated with participating in detailed ( coefficient : @ ; @ % confidence interval -LSB- CI -RSB- : @-@ @ ) but not simple ( coefficient : @ ; @ % CI : -@ -@ ) feedback sessions .


Similarly , student self-report of presentation improvement was significantly associated with participating in detailed ( odds ratio : @ ; @ % CI : @-@ @ -RSB- but not simple ( odds ratio : @ ; @ % CI : @-@ @ ) feedback sessions .


Small-group presentation feedback sessions led by faculty using a detailed evaluation form resulted in clerkship students delivering oral presentations of higher quality compared with controls .


Stroke is a major cause of death and disability in the world , and the prevalence of stroke tends to increase with age .


Despite advances in acute care and secondary preventive strategies , primary prevention should play the most significant role in the reduction of the burden of stroke .


As an important component of traditional Chinese Qigong , Baduanjin exercise is a simple , safe exercise , especially suitable for older adults .


However , current evidence is insufficient to inform the use of Baduanjin exercise in the prevention of stroke.The aim of this trail is to systematically evaluate the prevention effect of Baduanjin exercise on ischemic stroke in the community elder population with high risk factors .


A total of @ eligible participants from the community elder population will be randomly allocated into the Baduanjin exercise group and usual physical activity control group in a @:@ ratio .


Besides usual physical activity , participants in the Baduanjin exercise group will accept a @-week Baduanjin exercise training with a frequency of five days a week and @ minutes a day .


Primary and secondary outcomes will be measured at baseline , @ weeks ( at end of intervention ) and @ weeks ( after additional @-week follow-up period ) .


This study will be the randomized trial to evaluate the effectiveness of Baduanjin exercise for primary prevention of stroke in community elder population with high risk factors of stroke .


The results of this trial will help to establish the optimal approach for primary prevention of stroke .


Oak moss absolute , an extract from the lichen Evernia prunastri , is a valued perfume ingredient but contains extreme allergens .


To compare the elicitation properties of two preparations of oak moss absolute : ` classic oak moss ' , the historically used preparation , and ` new oak moss ' , with reduced contents of the major allergens atranol and chloroatranol .


The two preparations were compared in randomized double-blinded repeated open application tests and serial dilution patch tests in @ oak moss-sensitive volunteers and @ non-allergic control subjects .


In both test models , new oak moss elicited significantly less allergic contact dermatitis in oak moss-sensitive subjects than classic oak moss .


The control subjects did not react to either of the preparations .


New oak moss is still a fragrance allergen , but elicits less allergic contact dermatitis in previously oak moss-sensitized individuals , suggesting that new oak moss is less allergenic to non-sensitized individuals .


This study sought to evaluate the long-term safety and efficacy of everolimus-eluting stents ( EES ) and paclitaxel-eluting stents ( PES ) in patients with obstructive coronary artery disease .


The use of EES compared to PES has been shown to result in improved clinical outcomes in patients undergoing PCI .


However , there have been concerns regarding the durability of these benefits over longer-term follow-up .


SPIRIT III was a prospective , multicenter trial in which @,@ patients were randomized @:@ to EES versus PES .


Endpoints included ischemia-driven target vessel failure ( TVF ) ( death , myocardial infarction ( MI ) , or ischemia-driven target vessel revascularization -LSB- TVR -RSB- ) , the pre-specified primary endpoint ) , target lesion failure ( TLF ) ( cardiac death , target-vessel MI , or ischemia-driven target lesion revascularization -LSB- TLR -RSB- ) , major adverse cardiac events ( MACE ) ( cardiac death , MI , or ischemia-driven TLR ) , their individual components and stent thrombosis .


Five-year follow-up was available in @ % of patients .


Treatment with EES versus PES resulted in lower @-year Kaplan-Meier rates of TVF ( @ % vs. @ % , p = @ ) , TLF ( @ % vs. @ % , p = @ ) , and MACE ( @ % vs. @ % , p = @ ) .


EES also resulted in reduced rates of all-cause death ( @ % vs. @ % , p = @ ) , with nonsignificantly different rates of MI , stent thrombosis , and TLR , and no evidence of late catch-up of TLR over time .


At @ years after treatment , EES compared to PES resulted in durable benefits in composite safety and efficacy measures as well as all-cause mortality .


Additionally , the absolute difference in TLR between devices remained stable over time without deterioration of effect during late follow-up .


Neuropeptide S Receptor ( NPSR@ ) gene has been associated with multiple allergic phenotypes in several patient populations .


We analysed the effect of the NPSR@ genotypes in the development of asthma , rhinitis , eczema , or food allergy in children randomly receiving either probiotic or placebo treatment .


@ children born to families at high risk for allergic diseases were examined by a paediatrician at the age of three months , six months , two years , and five years .


Asthma , rhinitis , eczema , and food allergy were diagnosed according to international guidelines .


Treatment with probiotics ( double-blinded and placebo controlled ) was begun with mothers at @ weeks of gestation age and continued after the birth of infants up to the age of six months .


Association and additive inheritance models were used in genetic analyses .


Distribution of the hopo@ was suggestive in the group of patients with atopic eczema at two years .


The hopo@_G was found more often in those with eczema in the placebo group ( p = @ , after Bonferroni correction ) and the hopo@_A was found more often in those with eczema and probiotics compared to those with eczema and placebo treatment .


None of the NPSR@ tagging SNPs was associated with asthma , IgE-mediated asthma , or sensitisation .


Allergic disease in both parents doubled the risk for IgE-mediated allergic disease ( OR @ ) .


The NPSR@ gene SNP hopo@ showed a suggestive association for high IgE-associated atopic eczema at two years .


Abundant literature regarding the use of intravenous tranexamic acid ( TXA ) in primary total knee replacement is available .


Randomized controlled trials have confirmed the efficacy of topical TXA compared with placebo , but the comparison between topical and intravenous TXA is unclear .


The present study was designed to verify noninferior efficacy and safety of topical intra-articular TXA compared with intravenous TXA in primary total knee replacement with cemented implants .


A Phase-III , single-center , double-blind , randomized , controlled clinical trial was performed to compare topical intra-articular TXA ( @ g of TXA in @ mL of physiological saline solution ) with two intravenous doses of TXA ( @ mg/kg in @ mL of physiological saline solution , one dose before tourniquet release and another three hours after surgery ) in a multimodal protocol for blood loss prevention .


The primary outcome was the blood transfusion rate , and the secondary outcomes included visible blood loss ( as measured in the drain ) at twenty-four hours postoperatively and invisible blood loss ( as estimated from the Nadler formula ) at forty-eight hours postoperatively .