Thus , we performed autologous stem cell transplantation for rapid liver regeneration with extensive hepatectomy in hepatocellular cancer patients .


With informed consent , patients aged @ to @ who needed large extensive hepatectomy due to hepatocellular carcinoma were randomly divided into three groups : control , mononuclear cells ( MNCs ) , and CD@ + cells , based on infused cell type .


After portal vein embolization ( PVE ) , mobilized MNCs or CD@ + cells were returned to the patient via the portal vein on mobilization day without manipulation .


Liver volume , liver function , clinical score and Indocyanine green R@ ( ICG-R@ ) were compared before and after PVE .


Total bilirubin , albumin , and clinical score showed significant improvement ( p < @ ) @ week post-infusion , with no significant difference between MNC and CD@ + cell groups .


Four patients ( control , @ ; MNC , @ ; CD@ + , @ ) started at over @ % ICG-R@ but can be overturned after PVE .


Daily hepatic volume growth ( mL/day ) was @ for MNC and @ for CD@ + groups , resulting in significant increase over controls ( @ ; p < @ ) .


We found no correlation between the number of applied CD@ + cells and daily gains in left lateral lobe volume .


Improvements in liver volume , liver function , clinical score and ICG-R@ suggest that autologous stem cell transplantation is a promising method for liver regeneration .


The aim of this study was to investigate the agreement between body composition measurements made with two methods-single-frequency bioelectrical impedance analysis ( SF-BIA ) and bioelectrical impedance spectroscopy ( BIS ) .


The body composition measurements using SF-BIA and BIS were performed seven times during @ months on @ patients ( @ men and @ women ) with metabolic syndrome who were taking part in a dietary intervention study .


The mean -LSB- standard deviation ( SD ) -RSB- fat mass ( FM ) and median -LSB- interquartile range ( IQR ) -RSB- FM % measured with SF-BIA were @ ( @ ) kg and @ ( @-@ @ ) % , respectively , compared with @ ( @ ) kg and @ ( @-@ @ ) % , respectively , using BIS .


The median ( IQR ) fat-free mass ( FFM ) was @ ( @-@ @ ) kg according to SF-BIA and @ ( @-@ @ ) kg according to BIS .


These results obtained with the two methods were significantly different ( P < @ ) .


Still highly significant correlations were found between the results obtained with SF-BIA and BIS for FM and FFM ( all r@ @ , P < @ ) .


Using Bland-Altman analysis , the bias was found to be -@ ( @ ) kg for FM , -@ ( @ ) % for FM % , and @ ( @ ) kg for FFM .


Rather wide limits of agreement were found for FM , FM % , and FFM .


Body composition data obtained using SF-BIA and BIS in subjects with metabolic syndrome were highly correlated but not interchangeable .


FM was systematically lower when using SF-BIA than when using BIS .


Generics have the potential to contain drug therapy costs ; successful implementation of generic substitution policy largely depends on consumers ' willingness to choose generics .


This study aims to analyse the opinions , experiences and preferences of Polish patients towards generic medicines .


The study was performed in Poland .


The survey was conducted in June @ by means of face-to-face interviews .


Respondents were drawn from the general population according to a population structure .


The study covered a representative sample of @,@ Poles ; the results can be generalized to apply to the Polish population at large .


Fifty-two percent of respondents declared to be more often choosing generics , twenty-three percent did not have any specific preferences , and twenty-five percent were more willing to choose brand-name medicines .


Past experience with cheaper generic medicines , secondary or lower education , low income and residence in specific regions of Poland were all significantly associated with an increased willingness to choose generics .


Respondents ' attitudes towards generics were mostly influenced by the opinions of doctors and pharmacists .


According to respondents , attitudes towards generics among doctors , pharmacists , family and friends , and in the mass media were mostly positive .


There was no relationship between the preference of respondents for generics and factors such as their age , life stage , gender , household size or urban/rural locality .


As a result of substituting a brand-name drug with its generic equivalent , @ % of respondents reported that they had not noticed any difference in drug effectiveness ; @ % had experienced a reduced effectiveness of treatment or increased side effects at least once ; and @ % claimed the generic worked better .


The majority of respondents who used cheaper substitutes claimed that generics represented good or very good quality .


The study demonstrates that , when choosing medicines , Poles rely mainly on the opinions of their doctors and pharmacists .


Therefore , it is recommended that : ( @ ) the option of using generics be promoted when writing prescriptions , and ( @ ) the obligation on pharmacists to inform customers of their option to purchase generics be enforced .


Insertion of a nasopharyngeal airway ( NPA ) during endoscopic sedation is only recommended in the event of respiratory problems .


We evaluated the safety and efficacy of routine insertion of an NPA during sedation in gastrointestinal ( GI ) endoscopy .


Between July @ and April @ , patients with colonoscopy or expected longer-lasting or therapeutic upper GI endoscopy were pseudo-randomized in a weekly alternating fashion to perform sedation ( midazolam in combination with propofol ) with or without NPA insertion .


The primary outcome measure was respiratory depression ( oxygen saturation < @ % ) .


Secondary measures included hypotension ( systolic blood pressure < @ mm Hg ) , bradycardia ( heart rate < @ beats/min ) or nasopharyngeal damage after NPA insertion .


@ ( @ females , mean age @ @ years ) were enrolled .


Colonoscopy was performed in @ patients and upper endoscopy in @ patients .


In @ patients an NPA was used ( intervention group ) .


Five ( @ % ) of those patients showed minor nasopharyngeal injury .


Respiratory depression ( @ vs. @ % , p = @ ) and hypotension ( @ vs. @ % , p = @ ) occurred more frequently in the control than in the intervention group .


The routine placement of an NPA can reduce the frequency of hypoxemic events during endoscopic sedation with minor risks for nasopharyngeal injury .


Chronic hypoxia is a risk factor for cardiovascular disease , but its association with blood pressure ( BP ) remains unclear .


We performed this study to clarify the hypothesis that chronic hypoxia is associated with abnormal BP variability in patients with pneumoconiosis .


We recruited @ patients with pneumoconiosis and @ age - and BP level-matched control subjects .


We used simultaneous pulse oximetry and ambulatory BP monitoring for all subjects .


We evaluated their BP levels and variability by determining the SD and coefficient of variation ( CV ) of the BP data .


The dipper pattern was defined as nocturnal BP fall @ % ; the nondipper pattern was defined as nocturnal BP fall @ % but < @ % ; the riser pattern was defined as nocturnal BP fall < @ % .


Pearson and Spearman correlation coefficients were used to calculate the correlations between parameters .


In patients with pneumoconiosis , the daytime systolic BP ( SBP ) level was lower , the CV in @-hour SBP ( P < @ ) and diastolic BP ( P < @ ) were higher than that in control subjects .


And although not statistically significant ( P = @ ) , the odds ratio of riser pattern was @ in patients with pneumoconiosis , and their nighttime pulse rate was significantly higher ( P < @ ) than that in control subjects .


The median daytime pulse oximetry oxygen saturation was inversely associated with mean ( r = -@ ; P < @ ) and SD ( r = -@ ; P < @ ) in daytime SBP .


The median nighttime pulse oximetry oxygen saturation was inversely associated ( r = -@ ; P < @ ) and the mean nighttime pulse rate was associated ( r = @ ; P < @ ) with CV in nighttime SBP .


Partial pressure of oxygen was inversely associated with CV in daytime SBP ( r = -@ ; P < @ ) .


Exaggerated BP variability was seen in patients with pneumoconiosis , and the measures of hypoxia were associated with large fluctuations in ambulatory BP .


Chronic and intermittent hypoxia could be the contributing factors of these findings .


The goal of this study was to investigate the extent to which sample length affected the reliability of total number of words ( TNW ) , number of different words ( NDW ) , and mean length of C-units in morphemes ( MLCUm ) in parent-elicited conversational samples for @-year-olds .


Participants were sixty @-year-olds .


A @-min language sample was collected from each child during free play with the parent in the laboratory .


Samples of @ , @ , @ , and @ min were extracted from the @-min samples .


TNW , NDW , and MLCUm were computed from each shorter sample and the @-min sample .


TNW and NDW were adjusted by number of minutes for comparisons .


The differences and correlations between each shorter sample cut and the @-min sample on MLCUm and adjusted TNW and NDW were computed .


The shorter samples and the @-min samples significantly differed in adjusted TNW and NDW , but not in MLCUm .


TNW reached an acceptable reliability level ( i.e. , r = @ ) in @-min samples .


NDW and MLCUm approached the acceptable reliability level ( rs = @ ) in @-min samples and reached it in @-min samples .


For conversational language samples with similar collection procedures , samples of @ to @ min are desirable for calculating TNW , NDW , and MLCUm in @-year-olds .


Off-midline procedures seem to be the best method of primary wound closure after excision of a pilonidal sinus .


Primary wound closure with a Limberg flap was compared to secondary wound healing .


From January @ to July @ , @ patients with given informed consent ( mean age @ years , men @ % ) who had excision of a pilonidal sinus in three hospitals in Switzerland were randomised to group L ( Limberg flap , n = @ ) or to group E ( excision only , n = @ ) .


Primary endpoint was duration of incapacity for work .


Follow-up was at @ weeks and at @ year postoperative ( @ % follow-up ) .


Both groups were comparable with regard to patient characteristics .


The median ( range ) operation time was @ ( @-@ ) min in group L vs. @ ( @-@ ) min in group E ( p < @ ) .


No significant differences were found in postoperative pain and painkiller intake ; pain , percentage of patients at work and overall satisfaction at @ weeks postoperative ; and overall duration of incapacity for work and overall satisfaction at @-year follow-up .


The complication rate was @ % in group L vs. @ % in group E ( p < @ ) .


Complications in group L were seroma ( @ % ) , wound dehiscence ( @ % ) , skin necrosis ( @ % ) , hematoma ( @ % ) , infection ( @ % ) and recurrent disease ( @ % ) .


Complications in group E were recurrent disease ( @ % ) and wound healing disorder ( @ % ) .


After excision of a pilonidal sinus , primary wound closure with a Limberg flap has no advantage over secondary wound healing .


The main reason for this conclusion is the relatively high complication rate of primary wound closure with a Limberg flap .


To observe capillary blood flow at acupoints during acupuncture treatment of primary dysmenorrhea and gain new insights into its analgesic mechanism .


Patients with primary dysmenorrhea were enrolled and randomly assigned to a treatment or control group .


Subjects ' symptoms were differentiated into various Traditional Chinese Medicine ( TCM ) syndromes and treated for @ sessions with puncturing acupuncture or self-pressing right-hand Hegu ( LI @ ) , adding other acupoints based on syndrome .


Laser speckle was used to compare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu ( LI @ ) before and during the treatment .


Each subject was required to finish the period pain symptoms observation form , verbal rating scales , numerical rating scale , pain rating index , face rating scale , Zung self-rating depression scale , Zung self-rating anxiety scale , and numerical rating scale before and after treatments .


After @ sessions , the symptom scores , pain index ( PI ) , and visual analog scale ( VAS ) decreased significantly in treatment group .


The volume of blood flow in Hegu ( LI @ ) declined slightly .


No significant evidence supported that needling caused capillary contraction , but the capillary vasomotor amplitude at Hegu ( LI @ ) increased remarkably .


Acupuncture can increase the capillary blood flow , thus promoting the flow of Qi and blood in terms ofTCM theory , which facilitates pain relief .


Caring for a family member with dementia is extremely stressful , and contributes to psychiatric and physical illness among caregivers .


Therefore , a comprehensive programme called Resources for Enhancing Alzheimer 's Caregiver Health II ( REACH II ) was developed in the United States to enhance the health of Alzheimer 's caregivers .


REACH II causes a clear reduction of the stress and burdens faced by informal caregivers at home .


The aim of this protocol is to adapt , apply , and evaluate this proven intervention programme in a German-speaking area for the first time .


This newly adapted intervention is called Deutsche Adaption der Resources for Enhancing Alzheimer 's Caregiver Health ( DeREACH ) .


A total of @ informal caregivers at home are recruited in a single-centred , randomised controlled trial .


The intervention ( DeREACH ) consists of nine home visits and three telephone contacts over six months , all of which focus on safety , psychological well-being and self-care , social support , problem behaviour and preventive health-related behaviours .


A complex intervention assessment on effectiveness will be adopted when the primary outcome - namely , the reduction of caregiver burden - and other secondary outcomes , including changes with regard to anxiety and depression , somatisation , health-related quality of life , and perceived social support , are measured at baseline , as well as immediately and three months after the intervention .


The change from baseline to post-intervention assessment with regard to the primary outcome will be compared between treatment and control group using t-tests for independent samples .


It is anticipated that this study will show that DeREACH effectively reduces caregiver burden and therefore works under the conditions of a local German health-care system .


If successful , this programme will provide an effective intervention programme in the German-speaking area to identify and develop the personal capabilities of informal caregivers to cope with the burdens of caring for people with dementia .


Episodes of patient deterioration on hospital units are expected to increasingly contribute to morbidity and healthcare costs .


To determine if real-time alerts sent to the rapid response team ( RRT ) improved patient care .


Randomized , controlled trial .


Eight medicine units ( Barnes-Jewish Hospital ) .


Five hundred seventy-one patients .


Real-time alerts generated by a validated deterioration algorithm were sent real-time to the RRT ( intervention ) or hidden ( control ) .


Intensive care unit ( ICU ) transfer , hospital mortality , hospital duration .


ICU transfer ( @ % vs @ % ; odds ratio : @ ; @ % confidence interval -LSB- CI -RSB- : @-@ @ ) and hospital mortality ( @ % vs @ % ; odds ratio : @ ; @ % CI : @-@ @ ) were similar for the intervention and control groups .


The number of patients requiring transfer to a nursing home or long-term acute care hospital was similar for patients in the intervention and control groups ( @ % vs @ % ; odds ratio : @ ; @ % CI : @-@ @ ) .


Hospital duration ( @ days vs @ days ; P = @ ) was statistically shorter for the intervention group .


The number of RRT calls initiated by the primary care team was similar for the intervention and control groups ( @ % vs @ % ; odds ratio : @ ; @ % CI : @-@ @ ) .


Real-time alerts sent to the RRT did not reduce ICU transfers , hospital mortality , or the need for subsequent long term care .


However , hospital length of stay was modestly reduced .


Insufficient fasting prior to endoscopic procedures performed under sedation may result in potential aspiration of gastric contents .


Fasting as per ASA guidelines is recommended prior to these procedures .


However , the effect of chewing gum on fasting status has been a subject of debate and often leads to procedural delays .


Evaluation of the effect of chewing gum on the gastric volume and pH.


In this randomized controlled prospective observer blinded trail , ASA I-III patients aged more than @ years scheduled for esophagogastroduodenoscopy ( EGD ) or a combined EGD and colonoscopy under conscious sedation were studied .


Patients randomized to the chewing gum group ( Group-C ) were allowed to chew gum until just before the start of their procedure ; the remaining patients were included into Group-NC .


After sedation and endoscope insertion , stomach contents were aspirated under vision of a gastroenterologist ( blinded to groups ) .


Volume and pH of gastric contents aspirated from @ patients ( @ in Group-C and @ in Group-NC ) were analyzed .


The demographic parameters of the groups were comparable .


Gastric volume ( median-interquartile range ) was statistically higher in Group-C ( @ ml ( @-@ @ ) vs Group-NC @ ml ( @-@ @ ) ( P < @ ) -RSB- .


The mean pH in both groups was comparable : @ @ in Group-C and @ @ in Group-NC ( P = @ ) .


Although our results show gastric volume in patients chewing gum was statistically higher , clinical relevance of such a small difference is questionable .


Thus patients who chewed gum inadvertently prior to procedure should not be denied or delayed administration of sedative and anesthetic medications .


Bladder dysfunction influences recovery of urinary continence after radical prostatectomy .


We performed a multicenter , randomized , double-blind study evaluating solifenacin vs placebo on return to continence in patients who were still incontinent @ to @ days after catheter removal after robot-assisted radical prostatectomy .


A wireless personal digital assistant was given to patients the day of catheter removal .


Encrypted answers were transmitted daily to dedicated servers .


After a @ to @-day treatment-free washout period , patients requiring @ to @ pads per day for @ consecutive days were randomized ( @:@ ) to @ mg solifenacin daily or placebo .


The primary end point was time from first dose to continence defined as @ pads per day or a dry security pad for @ consecutive days .


Secondary end points included proportion of patients continent at end of study , average change in pads per day number and quality of life assessments .


A total of @,@ screened patients recorded personal digital assistant information .


Overall @ patients were randomized to solifenacin vs placebo and @ failed to take medication .


There was no difference in time to continence ( p = @ ) .


Continence was achieved by study end in @ of @ ( @ % ) vs @ of @ ( @ % ) , respectively ( p = @ ) .


Pads per day change from baseline was -@ and -@ , respectively ( p = @ ) .


Dry mouth was the only common adverse event seen in @ % and @ % , respectively .


Constipation rates were similar .


The overall rate of continence in the entire population from screening to end of study was @ % .


There was no effect on primary outcome but some secondary end points benefited the solifenacin arm .


The study provides level @B clinical evidence for continence outcomes after robot-assisted radical prostatectomy .


Sickness absence due to poor mental health is a common problem in many Western countries .


To facilitate return to work , it may be important to identify individuals on sick leave and at risk of having a mental disorder and subsequently to offer appropriate treatment .


Psychoeducation alone has not previously been used as a return to work intervention , but may be a promising tool to facilitate return to work .


Therefore , the aim of the study is to evaluate the effectiveness of psychoeducation designed specifically to facilitate return to work for individuals on sick leave and at risk of having a mental disorder .


The psychoeducation was a supplement to the various standard offers provided by the job centres .


The study is a randomised controlled trial , in which individuals on sick leave either receive psychoeducation and standard case management or standard case management alone .


Participants were individuals with mental health symptoms , who had been on sick leave from part-time or full-time work or unemployment for about @-@ weeks .


The psychoeducational intervention was group-based and the course consisted of @ hour sessions once a week for @ weeks .


The course was given by psychiatric nurses , a psychologist , a social worker , a physiotherapist and a person who had previously been on sick leave due to mental health problems .


The sessions focused on stress and work life , and the purpose was to provide individuals on sick leave the skills to understand and improve their mental functioning.The primary outcome is the duration of sickness absence measured by register data .


Secondary outcomes include psychological symptoms , mental health-related quality of life , and locus of control .


These outcomes are measured by questionnaires at the start of the intervention and at @ and @ months follow-up .


On the basis of this trial , the effect of psychoeducation for individuals on sick leave and at risk of having a mental disorder will be studied .


The results will contribute to the continuing research on sickness absence and mental health .


It will primarily show whether psychoeducation can lead to faster and sustainable return to work .


To evaluate if addition of L-carnitine therapy to standard varicocelectomy adds any extra benefit in terms of improvement in semen parameters or deoxyribonucleic acid ( DNA ) damage .


One hundred patients enrolled in this study and were randomly divided into @ groups ( @ patients in each group ) .


In group @ , standard inguinal varicocelectomy and , in group @ , standard inguinal varicocelectomy plus oral antioxidant therapy ( oral L-carnitine , @ mg @ times a day ) were performed for @ months .


For all patients , routine semen analysis and DNA damage test of spermatozoa ( by @ methods of terminal deoxynucleotidyl transferase dUTP nick end labeling and protamine damage assay ) were performed at baseline and at @ and @ months postoperatively .


In both groups , the improvement in semen analysis parameters and DNA damage was observed , but there was not any statistically significant difference between the @ groups in these parameters , although the slope of improvement in DNA damage was slightly better in group @ ( that was not statistically significant ) .


We observed that addition of @ mg of L-carnitine orally daily to standard inguinal varicocelectomy does not add any extra benefit in terms of improvement in semen analysis parameters or DNA damage .


Modulation of immunologic interactions in cancer tissue is a promising therapeutic strategy .


To investigate the immunogenicity of human epidermal growth factor receptor @ ( HER@ ) - positive and triple-negative ( TN ) breast cancers ( BCs ) , we evaluated tumor-infiltrating lymphocytes ( TILs ) and immunologically relevant genes in the neoadjuvant GeparSixto trial .


GeparSixto investigated the effect of adding carboplatin ( Cb ) to an anthracycline-plus-taxane combination ( PM ) on pathologic complete response ( pCR ) .


A total of @ tumors were evaluated before random assignment for stromal TILs and lymphocyte-predominant BC ( LPBC ) .


mRNA expression of immune-activating ( CXCL@ , CCL@ , CD@A , CD@ , CXCL@ , IGKC , CD@ ) as well as immunosuppressive factors ( IDO@ , PD-@ , PD-L@ , CTLA@ , FOXP@ ) was measured in @ tumors .


Increased levels of stromal TILs predicted pCR in univariable ( P < @ ) and multivariable analyses ( P < @ ) .


pCR rate was @ % in LPBC and @ % for non-LPBC ( P < @ ) .


pCR rates @ % were observed in patients with LPBC tumors treated with PMCb , with a significant test for interaction with therapy in the complete ( P = @ ) and HER@-positive ( P = @ ) , but not the TNBC , cohorts .


Hierarchic clustering of mRNA markers revealed three immune subtypes with different pCR rates ( P < @ ) .


All @ immune mRNA markers were predictive for increased pCR .


The highest odds ratios ( ORs ) were observed for PD-L@ ( OR , @ ; @ % CI , @ to @ ; P < @ ) and CCL@ ( OR , @ ; @ % CI , @ to @ ; P < @ ) .


Immunologic factors were highly significant predictors of therapy response in the GeparSixto trial , particularly in patients treated with Cb .


After further standardization , they could be included in histopathologic assessment of BC .


Randomized studies of adjuvant chemotherapy using gemcitabine suggest a survival benefit after resection of pancreatic cancer .


S-@ has also been shown to prolong survival in patients with unresectable pancreatic cancer .


This study compared the effects of adjuvant chemotherapy with S-@ or gemcitabine after resection of pancreatic cancer in a randomized trial .


Patients who had undergone resection of pancreatic cancer were registered in this randomized clinical trial .


The primary endpoint was disease-free survival ( DFS ) .


Expression levels of thymidylate synthase ( TS ) and dihydropyrimidine dehydrogenase ( DPD ) mRNAs in cancer tissues were measured as indicators of fluoropyrimidine sensitivity .


Of @ patients registered , @ were allocated to the S-@ group and @ to gemcitabine .


DFS tended to be better with S-@ ( median @ ( @ per cent c.i. @ to @ ) months versus @ ( @ to @ ) months in the gemcitabine group ; P = @ ) , with a similar pattern for overall survival : @ ( @ per cent c.i. @ to @ ) and @ ( @ to @ ) months respectively ( P = @ ) .


When patients were divided into subgroups based on high or low DPD and TS expression , those with a DPD level below the median of @ or a TS level of at least @ had a significant prolongation of DFS after S-@ treatment compared with gemcitabine ( P = @ and P = @ respectively ) .


Overall , S-@ did not improve DFS compared with gemcitabine after pancreatic cancer resection , but there seemed to be a DFS advantage in patients with low expression of DPD or high expression of TS .


Reference number : UMIN@ ( http://www.umin.ac.jp/ctr/ ) .


We conducted a randomized controlled trial to evaluate the clinical efficacy and safety of intravenous doripenem ( DRPM ) in patients with biliary tract infection requiring biliary drainage in comparison with imipenem/cilastatin ( IPM/CS ) .


After the initial collection of bile , patients were randomly assigned by the registration system of the Clinical Research Organization to receive intravenous drip infusion of DRPM @ g or IPM/CS @ g three times daily in a randomized , open-label manner .


A total of @ patients were enrolled in the trial ( DRPM @ , IPM/CS @ ) .


The characteristics of the @ patients evaluated for efficacy were well balanced , except for the percentage of patients previously receiving antimicrobials , which was higher in the DRPM group than in the IPM/CS group .


The clinical response rate was not significantly different between the DRPM group ( @ % , @/@ patients ) and the IPM/CS group ( @ % , @/@ ) .


Non-inferiority assessment using confidence intervals demonstrated the non-inferiority of DRPM-IPM/CS .


The incidence of adverse events , for which a causal relationship with either treatment was not ruled out , was @ % ( @/@ ) in the DRPM group and @ % ( @/@ ) in the IPM/CS group , and none was serious .


The clinical efficacy of DRPM in treating moderate or severe biliary tract infection requiring drainage was comparable to that of IPM/CS .


DRPM was associated with no serious adverse events and a low incidence of adverse events .


The results of this trial demonstrate that DRPM is a useful therapeutic option for moderate or severe biliary tract infection .


Our randomized trial compared early and delayed intrauterine device ( IUD ) insertion following medical abortion .


In this planned substudy , we explore if endometrial thickness and initial IUD position were associated with IUD expulsion .


We also describe IUD movement within the uterus during the @ months after insertion .


We recruited women undergoing medical abortion and choosing the copper IUD for contraception ( n = @ ) .


Participants were randomly assigned to early insertion @ week after mifepristone or delayed insertion @-@ weeks later .


We measured endometrial thickness by transvaginal sonogram @ week after abortion and IUD distance from the fundal aspect of the endometrial cavity three times : at insertion , @-@ weeks later and at @ months .


We analyzed endometrial thickness in @ women , baseline IUD position in @ women and IUD movement in @ women .


Women who expelled IUDs ( n = @ ) had slightly thicker endometria ( p = @ ) and slightly lower baseline IUD positions ( p = @ ) than those who retained IUDs , but no clear cutoffs emerged in the receiver operating characteristic curve analysis .


Retained IUDs commonly moved up and down throughout the @ months ( from @ mm towards the fundus to @ mm towards the cervix ) .


Overall , retained IUDs moved a median of @mm towards the cervix between insertion and exit ( p < @ ) .


After medical abortion , the risk of IUD expulsion increases with thicker endometria and lower baseline position .


Since no clear cutoffs emerged in the analysis and expulsion remained uncommon even with thicker endometria , we do not recommend restricting IUD insertion based on ultrasound data .


Copper T IUDs often move within the uterus without expelling .


Expulsion is uncommon , and we do not recommend restricting IUD insertion based on ultrasound data .


Previous studies observed the surprising finding that saturated fat was inversely associated with atherosclerosis progression in postmenopausal women , whereas polyunsaturated fat ( PUFA ) and carbohydrates were positively associated .


Whether certain genes modify the association of diet with atherosclerotic progression is unknown .


Using Haplotype-tagging single nucleotide polymorphisms , we evaluated gene-diet interactions with @ preselected genes involved in fatty acid and carbohydrate metabolism : sterol regulatory element binding protein-@ ( SREBP@ ) , insulin-induced gene-@ ( INSIG@ ) , and SREBP cleavage-activating protein ( SCAP ) .


Diet was assessed at baseline .


Quantitative coronary angiography was performed at baseline and after a mean of follow-up of @ years in @,@ coronary segments in @ postmenopausal women .


Global effects of each gene and gene-diet interactions for different fats , total fat , and carbohydrate were evaluated .


Global tests revealed no main effects between SCAP , INSIG@ , and SREBP@ haplotypes and progression of atherosclerosis ( P = @ , P = @ , and P = @ ) .


After correction for @ nutrients evaluated ( Bonferroni-corrected @-tailed = @ ) , no significant gene-nutrient interactions were seen , except for a borderline global interaction between SREBP@ and PUFA intake ( P interaction = @ ) .


This interaction was specific to the G-C haplotype ( frequency @ % ) and was driven by n-@ rather than n-@ PUFA ( P for interaction < @ ) .


The interaction was robust to estimated isocaloric replacement of PUFA with any other nutrient .


Per each @ % energy from n-@ PUFA , a @-mm greater decline in mean minimal coronary artery diameter was seen among women per each copy of the second most frequent haplotype of SREBP@ .


We observed an interaction between SREBP@ and PUFA consumption that might explain the positive association of PUFA with atherosclerosis progression in this cohort .


In spite of the major focus on risky , single-occasion drinking by young people in Australia , little is known about the specific circumstances of risky drinking occasions .


This study examines drinking behaviours and drinking contexts for the most recent risky , single-occasion drinking episode in a representative sample of young risky drinkers in Victoria , Australia .


A representative sample of @ young risky drinkers was recruited across metropolitan Melbourne and surveyed about their drinking and related behaviours .


Specific questions focused on participants ' most recent high-risk ( > @ Australian standard drinks for males , > @ Australian standard drinks for females ) drinking occasion in terms of self-reported amount drunk , alcohol expenditure ( including buying rounds ) and drinking partners for up to @ different drinking settings .


Participants reported drinking a mean of @ Australian standard drinks on their last episode of risky , single-occasion drinking ; for half of the participants , this occurred less than @ days prior to being surveyed .


The majority ( @ % ) of risky single occasion drinking sessions commenced at private homes in the company of close friends ( @ % ) .


Around @ % of the sample reported going to one ( @ % ) or two ( @ % ) drinking locations , and only @ % reported going to more than three drinking locations .


Contrary to public portrayals , a significant amount of risky drinking by young people occurs in private settings .


These contexts are rarely mentioned except in relation to underage drinking .


Further work is needed to understand how these drinking behaviours and contexts link to harm .


We aimed to investigate the influence of perioperative goal-directed fluid therapy ( GDFT ) on the prognosis of elderly patients with gastric cancer and hypertension .


Sixty elderly patients ( > @ years old ) with primary hypertension who received gastric cancer radical surgery and who were American Society of Anesthesiologists ( ASA ) class II or III were enrolled in the current study .


Selected patients were divided randomly into two arms , comprising a conventional intraoperative fluid management arm ( arm C , n = @ ) and a GDFT arm ( arm G , n = @ ) .


Patients in arm C were infused with crystalloids or colloids according to the methods of Miller 's Anesthesia ( @th edition ) , while those in arm G were infused with @ mL hydroxyethyl starch over @ minutes under the FloTrac/Vigileo monitoring system , with stroke volume variation between @ % and @ % .


Hemodynamics and tissue perfusion laboratory indicators in patients were recorded continuously from @ minutes before the operation to @ hours after the operation .


Compared with arm C , the average intraoperative intravenous infusion quantity in arm G was significantly reduced ( @,@ mL versus @,@ mL , P < @ ) , whereas average colloid fluid volume was significantly increased ( @,@ mL versus @ mL , P < @ ) .


In addition , there were more patients exhibiting intraoperatively and postoperatively stable hemodynamics and less patients with low blood pressure in arm G. Postoperative complications were less frequent , and the time of postoperative hospital stay shorter , in arm G. No significant differences were observed in mortality between the two arms .


Our research showed that GDFT stabilized perioperative hemodynamics and reduced the occurrence of postoperative complications in elderly patients who underwent gastric cancer surgery .


Health assessment and medical surveillance of workers exposed to combustion nanoparticles are challenging .


The aim was to evaluate the feasibility of using exhaled breath condensate ( EBC ) from healthy volunteers for ( @ ) assessing the lung deposited dose of combustion nanoparticles and ( @ ) determining the resulting oxidative stress by measuring hydrogen peroxide ( H ( @ ) O ( @ ) ) and malondialdehyde ( MDA ) .


Fifteen healthy nonsmoker volunteers were exposed to three different levels of sidestream cigarette smoke under controlled conditions .


EBC was repeatedly collected before , during , and @ and @hr after exposure .


Exposure variables were measured by direct reading instruments and by active sampling .


The different EBC samples were analyzed for particle number concentration ( light-scattering-based method ) and for selected compounds considered oxidative stress markers .


Subjects were exposed to an average airborne concentration up to @ ( @ ) particles/cm ( @ ) ( average geometric size @-@nm ) .


Up to @ ( @ ) particles/mL could be measured in the collected EBC with a broad size distribution ( @ ( th ) percentile @nm ) , but these biological concentrations were not related to the exposure level of cigarette smoke particles .


Although H ( @ ) O ( @ ) and MDA concentrations in EBC increased during exposure , only H@O@ showed a transient normalization @hr after exposure and increased afterward .


In contrast , MDA levels stayed elevated during the @hr post exposure .


The use of diffusion light scattering for particle counting proved to be sufficiently sensitive to detect objects in EBC , but lacked the specificity for carbonaceous tobacco smoke particles .


Our results suggest two phases of oxidation markers in EBC : first , the initial deposition of particles and gases in the lung lining liquid , and later the start of oxidative stress with associated cell membrane damage .


Future studies should extend the follow-up time and should remove gases or particles from the air to allow differentiation between the different sources of H ( @ ) O ( @ ) and MDA .


Chronic heart failure ( CHF ) patients often present with ( pre ) diabetes , which negatively influences prognosis .


Unlike the proven effect of exercise on glucose regulation in the general population , its effect in CHF is unclear .


Therefore , this study aimed at investigating the effect of exercise training on glucose regulation in stable CHF patients .


Twenty-two CHF patients were randomized into training ( EX , n = @ ) and control ( CON , n = @ ) groups .


Before and after a @-week training intervention involving endurance and resistance training , glucose tolerance ( @-hour oral glucose tolerance test ) , exercise tolerance ( cardiopulmonary exercise test ) , muscle strength ( isokinetic dynamometer ) , heart function ( echocardiography ) , glycated hemoglobin , body composition ( dual-energy x-ray absorptiometry ) , and quality of life ( EQ@D ) were assessed .


At baseline , glucose levels @ hours after glucose intake were elevated in both groups .


Whereas area under the glucose curve did not change , area under the insulin curve decreased following training ( EX , -@ @ % vs CON , +@ @ % ; P < @ ) .


Changes in the ratio of mitral peak velocity of early filling/early diastolic mitral annular velocity and waist-to-hip fat mass ratio were related to changes in the insulin curve .


Exercise training resulted in improved oxygen uptake at the second ventilatory threshold ( EX , +@ @ % vs CON , -@ @ % ; P < @ ) and isokinetic strength endurance of the upper leg ( EX , +@ @ % vs CON , -@ @ % ; P < @ ) .


Lean body tissue was increased by @ @ % in EX versus @ @ % in CON ( P < @ ) .


Our data suggest that exercise training attenuates worsening of glucose regulation typically seen in a stable CHF population .


Low systolic blood pressure ( SBP ) is associated with poor outcomes in heart failure and complicates management .


In a post hoc analysis , we investigated the efficacy and safety of ivabradine in the SHIFT population divided by tertiles of baseline SBP .


The analysis comprised @ patients with SBP < @ mmHg , @ with @ SBP < @ mmHg , and @ with SBP @ mmHg .


Patients with low SBP were younger , had lower ejection fraction , and were less likely to be at target beta-blocker dose than patients in the other SBP groups .


Ivabradine was associated with a similar relative risk reduction of the composite outcome in the three SBP groups -LSB- SBP < @ mmHg , hazard ratio ( HR ) = @ , @ % confidence interval ( CI ) @-@ @ ; @ SBP < @ mmHg , HR = @ , @ % CI @ to @ ; SBP @ mmHg , HR = @ , @ % CI @ to @ ; P interaction = @ -RSB- .


Similar results were found for cardiovascular mortality ( P interaction = @ ) , hospitalization because of heart failure ( P interaction = @ ) , all-cause mortality ( P interaction = @ ) , and heart failure mortality ( P interaction = @ ) .


There was no evidence for a difference in safety profile according to SBP group .


The efficacy and safety of ivabradine is independent of SBP .


This may have implications for the management of HF patients with low SBP and elevated heart rate .


Studies demonstrate that lowering low-density lipoprotein cholesterol ( LDL-C ) using a statin is associated with significant reduction in cardiovascular events .


Whether visit-to-visit variability in LDL-C levels affects cardiovascular outcomes is unknown .


This study sought to evaluate the role of visit-to-visit variability in LDL-C levels on cardiovascular outcomes .


We evaluated patients with coronary artery disease and LDL-C < @ mg/dl enrolled in the TNT ( Treating to New Targets ) trial , randomly assigned to receive atorvastatin @ mg/day versus @ mg/day and with at least one post-baseline measurement of LDL-C .


Visit-to-visit LDL-C variability was evaluated from @ months into random assignment through the use of various measurements of LDL-C variability : SD , average successive variability ( ASV ) , coefficient of variation , and variation independent of mean , with the first @ measurements used as the primary measurements .


Primary outcome was any coronary event , and secondary outcomes were any cardiovascular event , death , myocardial infarction , or stroke .


Among @,@ patients , SD and ASV were significantly lower with atorvastatin @ mg/day versus @ mg/day ( SD : @ @ vs. @ @ ; p = @ ; ASV : @ @ vs. @ @ ; p < @ ) .


In the adjusted model , each @-SD increase in LDL-C variability ( by ASV ) increased the risk of any coronary event by @ % ( hazard ratio -LSB- HR -RSB- : @ ; @ % confidence interval -LSB- CI -RSB- : @ to @ ; p < @ ) , any cardiovascular event by @ % ( HR : @ ; @ % CI : @ to @ ; p < @ ) , death by @ % ( HR : @ ; @ % CI : @ to @ ; p < @ ) , myocardial infarction by @ % ( HR : @ ; @ % CI : @ to @ ; p = @ ) , and stroke by @ % ( HR : @ ; @ % CI : @ to @ ; p = @ ) , independent of treatment effect and achieved LDL-C levels .


Results were largely consistent when adjusted for medication adherence .


In subjects with coronary artery disease , visit-to-visit LDL-C variability is an independent predictor of cardiovascular events .


To evaluate whether vagus nerve stimulation ( VNS ) as adjunct to best medical practice ( VNS + BMP ) is superior to BMP alone in improving long-term health-related quality of life ( HRQoL ) .


PuLsE ( Open Prospective Randomized Long-term Effectiveness ) was a prospective , randomized , parallel-group , open-label , and long-term effectiveness study ( conducted at @ sites in Europe and Canada ) .


Adults with pharmacoresistant focal seizures ( n = @ ) received VNS + BMP or BMP ( @:@ ratio ) .


Medications and VNS parameters could be adjusted as clinically indicated for optimal seizure control while minimizing adverse effects .


Primary endpoint was mean change from baseline HRQoL ( using Quality of Life in Epilepsy Inventory-@ total score ; QOLIE-@ ) .


Secondary endpoints included changes in seizure frequency , responder rate ( @ % decrease in seizure frequency ) , Centre for Epidemiologic Studies Depression scale ( CES-D ) , Neurological Disorders Depression Inventory-Epilepsy scale ( NDDI-E ) , Clinical Global Impression-Improvement scale ( CGI-I ) , Adverse Event Profile ( AEP ) , and antiepileptic drug ( AED ) load .


The study was prematurely terminated due to recruitment difficulties prior to completing the planned enrollment of n = @ .


Results for n = @ who had baseline and at least one follow-up QOLIE-@ assessment ( from months @-@ ) were included in this analysis .


Mixed model repeated measures ( MMRM ) analysis of variance was performed on change from baseline for the primary and secondary endpoints .


Significant between-group differences in favor of VNS + BMP were observed regarding improvement in HRQoL , seizure frequency , and CGI-I score ( respective p-values < @ , @ , and @ ) .


More patients in the VNS + BMP group ( @ % ) reported adverse events ( AEs ) versus BMP group ( @ % ) ( p = @ ) , a difference reflecting primarily mostly transient AEs related to VNS implantation or stimulation .


No significant difference between treatment groups was observed for changes in CES-D , NDDI-E , AEP , and AED load .


VNS therapy as a treatment adjunct to BMP in patients with pharmacoresistant focal seizures was associated with a significant improvement in HRQoL compared with BMP alone .


A PowerPoint slide summarizing this article is available for download in the Supporting Information section here .


The MGuard , a bare metal stent covered with a polymer mesh , was designed to reduce distal embolization during percutaneous coronary intervention in ST-segment-elevation myocardial infarction .


In the MGUARD for Acute ST Elevation Reperfusion trial , the primary end point of complete ST-segment resolution was significantly improved with the MGuard compared with control .


We evaluated @-year clinical and angiographic results .


Patients with ST-segment-elevation myocardial infarction @ hours undergoing primary percutaneous coronary intervention of a single de novo native lesion were randomized to the MGuard versus any commercially available metallic stent ( @ % drug-eluting ) .


Clinical follow-up was performed through @ year , and angiography at @ months was planned in @ MGuard patients .


There was no difference in major adverse cardiac events ( @ % versus @ % ; P = @ ) at @ days between the groups .


Major adverse cardiac events at @ year were higher with the MGuard , driven by greater ischemia-driven target lesion revascularization ( @ % versus @ % ; P = @ ) .


Conversely , mortality tended to be lower with the MGuard at @ days ( @ % versus @ % ; P = @ ) and at @ year ( @ % versus @ % ; P = @ ) .


Late lumen loss at @ months in the MGuard was @ mm , and binary restenosis was @ % .


In patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention , a trend toward reduced @-year mortality was present in patients treated with the MGuard stent .


Target lesion revascularization and major adverse cardiac events rates during follow-up were higher in the MGuard group than in the control stent group , and angiographic late loss of the MGuard was consistent with that expected from bare metal stents .


L-ornithine is a non-essential , non-protein amino acid .


Although L-ornithine is contained in various foods , the amount is usually small.Recently , studies have shown that orally administered L-ornithine reduced the stress response in animals.From these findings , we speculated that L-ornithine may play a role in the relieve of stress and improve sleep and fatigue symptoms in humans .


Through a randomised , double-blind , placebo-controlled clinical study , we asked if L-ornithine could be beneficial to stress and sleep in healthy workers .


Fifty-two apparently healthy Japanese adults who had previously felt slight stress as well as fatigue were recruited to be study participants and were randomly divided into either the L-ornithine ( @ mg/day ) or placebo group .


They orally consumed the respective test substance every day for @ weeks .


Serum was collected for the assessment of cortisol and dehydroepiandrosterone-sulphate ( DHEA-S ) .


Perceived mood and quality of sleep were measured by the Profile of Mood States ( POMS ) , Athens Insomnia Scale ( AIS ) , and Ogri-Shirakawa-Azumi sleep inventory MA version ( OSA-MA ) .


Serum cortisol levels and the cortisol/DHEA-S ratio were significantly decreased in the L-ornithine group in comparison with the placebo group .


Also , anger was reduced and perceived sleep quality was improved in the L-ornithine group .


L-ornithine supplementation has the potential to relieve stress and improve sleep quality related to fatigue , both objectively and subjectively .


Development of new therapies for previously treated small-cell lung cancer ( SCLC ) is a major unmet need .


Here , we describe a randomized , phase II trial of weekly topotecan with or without ziv-aflibercept ( VEGF-trap ) in this clinical setting .


Patients with previously treated SCLC ( one line of platinum-based chemotherapy ) , performance status of @ to @ , adequate organ function , treated brain metastases , and no recent vascular events or bleeding diatheses were eligible .


Eligible patients were stratified as platinum-sensitive or platinum-refractory and randomly assigned to receive weekly topotecan @ mg/m ( @ ) intravenously ( IV ) with or without ziv-aflibercept @ mg/kg IV every @ days .


Progression-free survival ( PFS ) at @ months was the primary end point .


In @ randomly assigned patients , treatment arms were well balanced with regard to clinical characteristics .


The @-month PFS was significantly improved with the addition of ziv-aflibercept in patients who had platinum-refractory disease ( @ % v @ % ; P = @ ) but not in patients with platinum-sensitive disease ( @ % v @ % ; P = @ ) .


Although response rate was low , disease control rate was higher with combination therapy than with topotecan alone in patients who had platinum-sensitive disease ( @ % v @ % ; P = @ ) and in those who had platinum-refractory disease ( @ % v @ % ; P = @ ) .


Overall survival ( OS ) was not significantly improved in either strata .


Grades @ to @ toxicities were more common with the addition of ziv-aflibercept .


Ziv-aflibercept improved the @-month PFS in patients who had platinum-refractory SCLC , but its addition increased toxicity .


OS was similar with combined ziv-aflibercept and topotecan compared with topotecan in both strata .


Late enhancement MRI ( LE-MRI ) and cardiac troponin I ( cTnI ) are sensitive methods to detect subclinical myocardial injury .


We sought to investigate the relation between plasma concentrations of cTnI measured with a high-sensitivity assay ( hs-cTnI ) and the development of unrecognized myocardial infarctions ( UMIs ) detected with LE-MRI .


After approval from the ethics committee and written informed consent were obtained , LE-MRI was performed on @ randomly selected community-living @-year-old volunteers and hs-cTnI was determined with a highly sensitive premarket assay .


Five years later these individuals were invited to a second LE-MRI , and @ of them ( @ women , @ men ) , who did not have a hospital diagnosis of MI , constitute the present study population .


LE-MR images were analyzed by @ radiologists independently and in a consensus reading , blinded to any information on previous disease or assessments .


New or larger UMIs were detected in @ participants during follow-up .


Plasma concentrations of hs-cTnI at @ years of age , which were mainly within what is considered to be the reference interval , were related to new or larger UMIs at @ years of age with an odds ratio of @ per @ unit increase in ln-transformed cTnI ( @ % CI , @-@ @ ; P = @ ) .


Plasma concentrations of hs-cTnI at @ years of age were associated with the volumes of the UMIs detected at @ years of age ( P = @ ) .


hs-cTnI in @-year-old community-living women and men was associated with the development of MRI-detected UMIs within @ years .


The Relaxin for the Treatment of Acute Heart Failure ( RELAX-AHF ) trial enrolled @ patients admitted to the hospital for acute heart failure ( AHF ) to evaluate the therapeutic efficacy of serelaxin , a recombinant form of human relaxin-@ .


We characterized how representative RELAX-AHF clinical trial enrollees were to those patients with AHF found in international registries .


We examined @ @ AHF admissions from the Acute Decompensated Heart Failure National Registry-United States and Acute Decompensated Heart Failure National Registry-International registries .


Patients were considered RELAX-AHF-type if they met the following criteria : discharge diagnosis of heart failure , systolic blood pressure > @ mm Hg , dyspnea at rest or with mild exertion , intravenous diuretic use , glomerular filtration rate of @ to @ mL/min per @ m ( @ ) , hemoglobin > @ g/dL , and no use of intravenous inotropes or vasopressors .


Baseline characteristics and treatments of RELAX-AHF-type and non-RELAX-AHF-type patients were compared .


A Cox model was used to evaluate inpatient mortality .


Among both Acute Decompensated Heart Failure National Registry-United States and Acute Decompensated Heart Failure National Registry-International registries , @ % ( n = @ @ ) and @ % ( n = @ ) of patients met basic criteria for RELAX-AHF entry , respectively .


These patients were more likely to be older , be women , have a previous history of hypertension , have preserved ejection fraction , and have better renal function .


In-hospital mortality was lower in RELAX-AHF-type than in non-RELAX-AHF-type patients , even after multivariable adjustment ( hazard ratio , @ ; @ % confidence interval , @-@ @ ; P < @ ) .


Patients potentially eligible for RELAX-AHF represent @ in @ patients with AHF in the United States , Latin America , or Asia-Pacific .


These patients differ significantly from other hospitalized patients based on clinical characteristics and outcomes .


When learning multiple tasks , blocked or random training schedules may be used .


We assessed the effects of blocked and random schedules on the acquisition and retention of laparoscopic skills .


Thirty-six laparoscopic novices were randomized to practice laparoscopic tasks using blocked , random , or no additional training .


Participants performed immediate post-tests , followed by retention tests @ weeks later .


Outcomes included previously validated Fundamentals of Laparoscopic Surgery ( FLS ) and hand-motion efficiency scores .


Both blocked and random groups had significantly higher FLS and hand-motion efficiency scores over baseline on post-tests for each task ( P < @ ) and higher overall FLS scores than controls on retention tests ( P < @ ) .


No difference was seen between the blocked and random groups in the amount of skill acquired or skill retained .


Both blocked and random training schedules can be considered as valid training options to allow programs and learners to tailor training to their individual needs .


We investigated the effects of demographic , lifestyle ( self-reported smoking status and physical activity levels ) , cancer-related treatment factors ( radiation and chemotherapy ) , and diet ( calcium and vitamin D intake ) on bone turnover and the relationship of bone turnover to lumbar spine bone mineral density ( BMD ) Z-scores ( LS-BMD Z-scores ) determined by quantitative computed tomography ( QCT ) in @ @-year survivors of childhood acute lymphoblastic leukemia ( ALL ) .


Bone turnover was assessed by biomarkers including serum bone-specific alkaline phosphatase ( BALP ) , osteocalcin ( OC ) , and urinary N-telopeptide of type I collagen indexed to creatinine ( NTX/Cr ) .


The @ males ranged in age from @ to @ years ( median age @ years ) .


Age and tanner score were inversely associated with all biomarkers ( BALP , OC , NTX/Cr ) ( P < @ ) .


Males had higher BALP and OC than females ( P < @ ) .


Body mass index ( BMI ) was inversely associated with OC and NTX/Cr ( P < @ ) .


There was no significant association of biomarkers with lifestyle related factors , ALL treatment-related factors , dietary calcium , vitamin D , or LS-BMD Z-score .


In this population of long-term survivors of ALL , bone turnover was significantly associated with age , gender , tanner stage , and BMI .


ALL-related treatments did not influence bone turnover and bone turnover was not predictive of volumetric LS-BMD Z-score .


The vaccine efficacy ( VE ) of @ or @ doses of AS@-adjuvanted influenza A ( H@N@ ) vaccine relative to that of @ doses of nonadjuvanted influenza A ( H@N@ ) vaccine in children @ months to < @ years of age in a multinational study conducted during @-@ .


A total of @ children were randomly assigned at a ratio of @:@:@ to receive @ injections @ days apart of A/California/@ / @ ( H@N@ ) - AS@ vaccine at dose @ and saline placebo at dose @ , @ doses @ days apart of A/California/@ / @ ( H@N@ ) - AS@ vaccine ( the Ad@ group ) , or @ doses @ days apart of nonadjuvanted A/California/@ / @ ( H@N@ ) vaccine ( the NAd@ group ) .


Active surveillance for influenza-like illnesses continued from days @ to @ .


Nose and throat samples obtained during influenza-like illnesses were tested for A/California/@ / @ ( H@N@ ) , using reverse-transcriptase polymerase chain reaction .


Immunogenicity , reactogenicity , and safety were assessed .


There were @ cases of confirmed @ pandemic influenza A ( H@N@ ) ( A -LSB- H@N@ -RSB- pdm@ ) infection for the primary relative VE analysis .


The VE in the Ad@ group relative to that in the NAd@ group was @ % ( @ % confidence interval , @ % -@ % ) .


The benefit of the AS@ adjuvant was demonstrated in terms of the greater immunogenicity observed in the Ad@ group , compared with the NAd@ group .


The @-@-fold antigen-sparing adjuvanted pandemic influenza vaccine demonstrated superior and clinically important prevention of A ( H@N@ ) pdm@ infection , compared with nonadjuvanted vaccine , with no observed increase in medically attended or serious adverse events .


These data support the use of adjuvanted influenza vaccines during influenza pandemics .


Clinical Trials Registration .


NCT@ .


To evaluate the efficacy and safety of intravitreal bevacizumab ( IVB ) in eyes with neovascular glaucoma ( NVG ) undergoing Ahmed glaucoma valve ( AGV ) implantation .


This was a multicentre , prospective , randomized clinical trial that enrolled @ patients with uncontrolled neovascular glaucoma that had undergone panretinal photocoagulation and required glaucoma drainage device implantation .


Patients were randomized to receive IVB ( @ mg ) or not during Ahmed valve implant surgery .


Injections were administered intra-operatively , and @ and @ weeks after surgery .


After a mean follow-up of @ @ years ( range @-@ years ) , both groups showed a significant decrease in IOP ( p < @ ) .


There was no difference in IOP between groups except at the @-month interval , when IOP in IVB group was significantly lower ( @ @ mmHg vs. @ @ mmHg - p = @ ) .


There was no difference in survival success rates between groups .


At @ months , there was a trend to patients treated with IVB using less antiglaucoma medications than the control group ( p = @ ) .


Complete regression of rubeosis iridis was significantly more frequent in the IVB group ( @ % ) than in the control group ( @ % ) ( p = @ ) .


Intravitreal bevacizumab may lead to regression of new vessels both in the iris and in the anterior chamber angle in patients with neovascular glaucoma undergoing Ahmed glaucoma valve implantation .


There is a trend to slightly lower IOPs and number of medications with IVB use during AGV implantation for neovascular glaucoma .


EBV-encoded latent membrane protein @ ( EBV-LMP@ ) is an important oncogenic protein for nasopharyngeal carcinoma ( NPC ) and has been shown to engage a plethora of signaling pathways .


Correspondingly , an LMP@-targeted DNAzyme was found to inhibit the growth of NPC cells both in vivo and in vitro by suppressing cell proliferation and inducing apoptosis .


However , it remains unknown whether an LMP@-targeted DNAzyme would affect the vasculature of NPC .


Dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI ) has been applied in the clinical trials of anti-angiogenic drugs for more than ten years , and Ktrans has been recommended as a primary endpoint .


Therefore , the objective of the current study was to use DCE-MRI to longitudinally study the effect of an EBV-LMP@-targeted DNAzyme on the vasculature of patients with NPC .


Twenty-four patients were randomly divided into two groups : a combined treatment group ( radiotherapy + LMP@-targeted DNAzyme ) and a radiotherapy alone group ( radiotherapy + normal saline ) .


DCE-MRI scans were conducted @ ~ @ days before radiotherapy ( Pre-RT ) , during radiotherapy ( RT @ Gy ) , upon completion of radiotherapy ( RT @ Gy ) , and three months after radiotherapy ( @ months post-RT ) .


Parameters of vascular permeability and intra - and extravascular volumes were subsequently obtained ( e.g. , Ktrans , kep , ve ) using nordicICE software .


Both Ktrans and kep values for NPC tumor tissues decreased for both groups after treatment .


Moreover , a statistically significant difference in Ktrans values at the pre-therapy and post-therapy timepoints emerged earlier for the combined treatment group ( RT @ Gy , P = @ ) compared to the radiotherapy alone group ( @ months post-RT , P = @ ) .


For the kep values , the downward trend observed for both the combined treatment group and the radiotherapy alone group were similar .


In contrast , ve values for all of the tumor tissues increased following therapy .


The EBV-LMP@-targeted DNAzyme that was tested was found to accelerate the decline of Ktrans values for patients with NPC .


Correspondingly , the LMP@-targeted DNAzyme treatments were found to affect the angiogenesis and microvascular permeability of NPC .


We aimed at comparing the long-term benefit-risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis .


Long-term follow-up study of patients included in Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis ( EVA-@S ) , a randomized , controlled trial of carotid stenting versus endarterectomy in @ patients with recently symptomatic severe carotid stenosis , conducted in @ centers in France .


The main end point was a composite of any ipsilateral stroke after randomization or any procedural stroke or death .


During a median follow-up of @ years ( interquartile range , @-@ @ years ; maximum @ years ) , the primary end point occurred in @ patients in the stenting group compared with @ patients in the endarterectomy group .


Cumulative probabilities of this outcome were @ % ( @ % confidence interval , @-@ @ ) versus @ % ( @-@ @ ) in the endarterectomy group at the @-year follow-up ( hazard ratio , @ ; @-@ @ ; P = @ ) and @ % ( @-@ @ ) versus @ % ( @-@ @ ; hazard ratio , @ ; @-@ @ ; P = @ ) at the @-year follow-up .


No difference was observed between treatment groups in the rates of ipsilateral stroke beyond the procedural period , severe carotid restenosis ( @ % ) or occlusion , death , myocardial infarction , and revascularization procedures .


The long-term benefit-risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis favored endarterectomy , a difference driven by a lower risk of procedural stroke after endarterectomy .


Both techniques were associated with low and similar long-term risks of recurrent ipsilateral stroke beyond the procedural period .


This work evaluates the effect of adding platelet-derived growth factor to autologous adipose tissue grafts in the treatment of human immunodeficiency virus facial lipoatrophy by means of objective measurements .


This is a randomized clinical trial conducted at the Hospital Clinic of Barcelona .


Patients with facial human immunodeficiency virus atrophy were randomized into two groups , one treated with autologous fat injection ( group A ) , and another treated with autologous fat injection with plasma rich in growth factors ( group B ) .


Before the treatment , structural changes were identified in facial soft tissue by means of computed tomography , and clinical changes were also assessed by means of photographic records .


Posttreatment assessments were repeated after @ and @ months to compare the results .


Posttreatment complications were recorded .


Forty-nine patients ( @ men and @ women ) , with a mean age of @ years , participated in the study .


In both groups , there was a statistically significant average increase of volume in the facial area measured by computed tomography between the baseline and the @ - and @-month posttreatment assessments .


All cases showed an improvement of the clinical facial atrophy grade after treatment , which was statistically significant .


This improvement was related to a statistically significant fat volume increase measured by means of computed tomography .


There was no difference in the volume gain between both groups .


No major complications were observed .


Fat grafting is a safe , effective , and durable treatment for human immunodeficiency virus facial atrophy .


The results of this study show that it is not necessary to add plasma rich in growth factors to the adipose tissue graft to get a better result .


Therapeutic , II .


Longevity of effects and dose equivalence of different botulinum toxin type A ( BoNT-A ) preparations need to be better clarified because BoNT-A units are manufacturer-specific .


These points are of particular importance for new brands emerging in the market .


To assess the field of muscular and anhidrotic effects of @ commercial preparations of BoNT-A ( incobotulinumtoxinA : Xeomin -LSB- XEO -RSB- ; abobotulinumtoxinA : Dysport -LSB- DYS -RSB- ) administered to the upper third of the face .


Patients were randomized for the side of the forehead ( left or right ) in which the products were administered .


All were treated receiving BoNT-A injections in @ points ( @ on each side ) at a dose equivalence of @:@ U ( XEO : DYS ) .


Clinical assessments and Minor test were performed at baseline and Days @ , @ , @ , and @ .


Electromyography was performed at baseline and Days @ and @ , and ultrasound was performed only at baseline .


Eighty patients were enrolled in @ research centers .


Xeomin and DYS presented similar results regarding fields of muscular effects .


However , a larger field of anhidrotic effects was found for DYS .


There was a positive correlation between the muscle thickness and electromyography results .


The results of this study suggest that a lower dose equivalence between DYS and XEO could be established .


In the Surgical Treatment for Ischemic Heart Failure trial , surgical ventricular reconstruction plus coronary artery bypass surgery was not associated with a reduction in the rate of death or cardiac hospitalization compared with bypass alone .


We hypothesized that the absence of viable myocardium identifies patients with coronary artery disease and left ventricular dysfunction who have a greater benefit with coronary artery bypass graft surgery and surgical ventricular reconstruction compared with bypass alone .


Myocardial viability was assessed by single photon computed tomography in @ of the @ patients randomized to bypass or bypass plus surgical ventricular reconstruction in the Surgical Treatment for Ischemic Heart Failure .


Myocardial viability was assessed on a per patient basis and regionally according to prespecified criteria .


At @ years , there was no difference in mortality or the combined outcome of death or cardiac hospitalization between those with and without viability , and there was no significant interaction between the type of surgery and the global viability status with respect to mortality or death plus cardiac hospitalization .


Furthermore , there was no difference in mortality or death plus cardiac hospitalization between those with and without anterior wall or apical scar , and no significant interaction between the presence of scar in these regions and the type of surgery with respect to mortality .


In patients with coronary artery disease and severe regional left ventricular dysfunction , assessment of myocardial viability does not identify patients who will derive a mortality benefit from adding surgical ventricular reconstruction to coronary artery bypass graft surgery .


To prevent salivary dysfunction in thyroid cancer patients who have undergone radioiodine ablation , massaging the parotid gland ( PG ) is presumed to be helpful for the removal of radioiodine .


The purpose of this study was to evaluate the effect of PG massage in the removal of radioiodine from the PG .


Forty-four patients ( female , @ ; @ @ years ) who underwent total thyroidectomy followed by I-@ ablation were included in this prospective study .


Three serial salivary gland scans were performed @h after administration of I-@ in thyroid hormone withdrawal status .


The patients were divided into two groups .


There was a @-min ( or @-min ) interval between the first and second scans for control , followed by the performance of PG massage for @ min ( or @ min ) between the second and third scans .


Changes in uptakes were calculated between the first and second scans ( control ) and between the second and third scans ( massage ) .


The mean change in uptake at the @-min massage was @ @ % , whereas that at the @-min control was @ @ % ( P < @ ) .


The mean change in uptake at the @-min massage was also significantly lower than that at the @-min control ( @ @ vs. -@ @ % , P < @ ) .


However , no statistical difference was observed between the mean changes in uptake after @ - and @-min massages ( P = @ ) .


PG massage reduced the radioiodine uptake in the PG , and the effect of PG massage for @ min was comparable with that of PG massage for @ min .


PG massage can be applied to thyroid cancer patients who receive radioiodine therapy to reduce PG dysfunction .


Executive dysfunction after traumatic brain injury ( TBI ) in children is common and leads to significant short - and long-term problems in functioning across multiple settings .


We hypothesized that improvements in short-term executive function would be maintained to @ months after injury and that improvements would increase over time in a counselor-assisted problem-solving ( CAPS ) intervention .


To evaluate the efficacy of a CAPS intervention administered within @ months of complicated mild to severe TBI compared with an Internet resource condition in improving long-term executive dysfunction .


Multisite , assessor-blinded , randomized clinical trial at @ tertiary pediatric hospitals and @ tertiary general medical centers .


Participants included @ adolescents aged @ to @ years who sustained a moderate to severe TBI @ to @ months before study enrollment .


Web-based CAPS intervention .


The primary outcome was the parent-reported Global Executive Composite ( GEC ) of the Behavior Rating Inventory of Executive Function .


Secondary outcomes included the Behavioral Regulation Index ( BRI ) and Metacognition Index ( MI ) of the GEC .


In older ( > @ to @ years ) adolescents , the CAPS intervention was associated with lower GEC ratings at @ ( = -@ ; P = @ ) and @ ( = -@ ; P = @ ) months after enrollment .


Trends were also observed for older adolescents toward lower GEC ratings at @ months ( = -@ ; P = @ ) , lower BRI ratings at @ ( = -@ ; P = @ ) and @ ( = -@ ; P = @ ) months , and lower MI ratings at @ ( = -@ ; P = @ ) , @ ( = -@ ; P = @ ) , and @ ( = -@ ; P = @ ) months .


In younger ( @-@ years ) adolescents , no group differences were found on the GEC , BRI , or MI ratings .


Delivery of the CAPS intervention early after TBI in older adolescents improves long-term executive function .


This trial is , to our knowledge , one of the few large , randomized clinical treatment trials performed in pediatric TBI to demonstrate the efficacy of an intervention for management of executive dysfunction and long-term benefits of an intervention delivered soon after injury .


Use of the CAPS intervention clinically should be considered ; however , further research should explore ways to optimize delivery .


Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures , since analgesia could only offer limited relief from severe pain .


A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures .


A total of @ inpatients were recruited and allocated to two groups , receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal ( TI ) needles placed upon the skin surface as a control , respectively , via novel acupuncture modality once daily for three consecutive days .


The effect of pain relief was evaluated during activities that induce pain , and sustained maximal inspiration ( SMI ) lung volumes and sleep quality were assessed .


The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing , coughing , and turning over the body ( p < @ ) , and the effect persisted for at least @ h in most patients .


Sustained maximal inspiration lung volumes and sleep quality did not show improvement through every acupuncture intervention , and they could not respond accurately to pain relief via acupuncture .


The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures .


This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures .


Impaired glucose tolerance ( IGT ) is a pre-diabetic state of hyperglycemia that is associated with insulin resistance , increased risk of type II diabetes , and cardiovascular pathology .


Recently , investigators hypothesized that decreased vagus nerve activity may be the underlying mechanism of metabolic syndrome including obesity , elevated glucose levels , and high blood pressure .


In this pilot randomized clinical trial , we compared the efficacy of transcutaneous auricular vagus nerve stimulation ( taVNS ) and sham taVNS on patients with IGT .


@ participants with IGT were single-blinded and were randomly allocated by computer-generated envelope to either taVNS or sham taVNS treatment groups .


In addition , @ IGT adults were recruited as a control population and not assigned treatment so as to monitor the natural fluctuation of glucose tolerance in IGT patients .


All treatments were self-administered by the patients at home after training at the hospital .


Patients were instructed to fill in a patient diary booklet each day to describe any side effects after each treatment .


The treatment period was @weeks in duration .


Baseline comparison between treatment and control group showed no difference in weight , BMI , or measures of systolic blood pressure , diastolic blood pressure , fasting plasma glucose ( FPG ) , @-hour plasma glucose ( @hPG ) , or glycosylated hemoglobin ( HbAlc ) .


@ participants completed the study and were included in data analysis .


Two female patients ( one in the taVNS group , one in the sham taVNS group ) dropped out of the study due to stimulation-evoked dizziness .


The symptoms were relieved after stopping treatment .


Compared with sham taVNS , taVNS significantly reduced the two-hour glucose tolerance ( F ( @ ) = @ , p = @ ) .


In addition , we found that taVNS significantly decreased ( F ( @ ) = @ , p = @ ) systolic blood pressure over time compared with sham taVNS .


Compared with the no-treatment control group , patients receiving taVNS significantly differed in measures of FPG ( F ( @ ) = @ , p < @ ) , @hPG F ( @ ) = @ , p < @ ) and HbAlc ( F ( @ ) = @ , p = @ ) over the course of the @week treatment period .


Our study suggests that taVNS is a promising , simple , and cost-effective treatment for IGT / pre-diabetes with only slight risk of mild side-effects .


South Africa has @ million adults over the age of @ living with HIV .


Gender inequality issues continue to drive the HIV epidemic in South Africa , where Black African women bear the greatest HIV burden .


Limited access to services ; little capacity to negotiate sex and condom use ; and other legal , social , and economic inequities make women highly vulnerable to HIV infection .


Behavioral interventions have been shown to decrease risk behaviors , but they have been less successful in reducing HIV incidence .


Conversely , biomedical prevention strategies have proven to be successful in reducing HIV incidence , but require behavioral interventions to increase uptake and adherence .


Consequently , there is a need for integrated approaches that combine biomedical and behavioral interventions .


Effective combination prevention efforts should comprise biomedical , behavioral , and structural programming proven in randomized trials that focuses on the driving forces and key populations at higher risk of HIV infection and transmission .


This prospective , geographically clustered randomized field experiment is enrolling participants into two arms : a control arm that receives standard HIV testing and referral for treatment ; and an intervention arm that receives an evidence-based , woman-focused behavioral intervention that emphasizes risk reduction and retention , the Women 's Health CoOp .


We divided the city of Pretoria into @ mutually exclusive geographic zones and randomized these zones into either the control arm or the intervention arm .


Outreach workers are recruiting drug-using women from each zone .


At baseline , eligible participants complete a questionnaire and biological testing for HIV , recent drug use , and pregnancy .


Follow-up interviews are completed at @ and @months .


The biobehavioral intervention in this study merges an efficacious behavioral HIV prevention intervention for women with biomedical prevention through HIV treatment as prevention using a Seek , Test , Treat and Retain strategy .


This combination biobehavioral intervention is designed to ( @ ) improve the quality of life and reduce HIV infectiousness among women who are HIV positive , and ( @ ) reduce HIV risk behaviors among women regardless of their HIV status .


If efficacious , this intervention could help control the HIV epidemic in South Africa .


Delirium occurs frequently in older hospitalised patients and is associated with several adverse outcomes .


Ignorance among healthcare professionals and a failure to recognise patients suffering from delirium have been identified as the possible causes of poor care .


The objective of the study was to determine whether e-learning can be an effective means of improving implementation of a quality improvement project in delirium care .


This project aims primarily at improving the early recognition of older patients who are at risk of delirium .


In a stepped wedge cluster randomised trial an e-learning course on delirium was introduced , aimed at nursing staff .


The trial was conducted on general medical and surgical wards from @ Dutch hospitals .


The primary outcome measure was the delirium risk screening conducted by nursing staff , measured through monthly patient record reviews .


Patient records from patients aged @ and over admitted onto wards participating in the study were used for data collection .


Data was also collected on the level of delirium knowledge of these wards ' nursing staff .


Records from @,@ older patients were included during the control phase and from @,@ patients during the intervention phase .


The e-learning course on delirium had a significant positive effect on the risk screening of older patients by nursing staff ( OR @ , p-value < @ ) , as well as on other aspects of delirium care .


The number of patients diagnosed with delirium was reduced from @ % in the control phase to @ % in the intervention phase ( p = @ ) .


The e-learning course also showed a significant positive effect on nurses ' knowledge of delirium .


Nurses who undertook a delirium e-learning course showed a greater adherence to the quality improvement project in delirium care .


This improved the recognition of patients at risk and demonstrated that e-learning can be a valuable instrument for hospitals when implementing improvements in delirium care .


Smoking now represents one of the biggest modifiable risk factors for disease and mortality in people living with HIV ( PLHIV ) .


To produce significant changes in smoking rates among this population , treatments will need to be both acceptable to the larger segment of PLHIV smokers and feasible to implement in busy HIV clinics .


The purpose of this study was to evaluate the feasibility and effects of a novel proactive algorithm-based intervention in an HIV/AIDS clinic .


PLHIV smokers ( N = @ ) were proactively identified through their electronic medical records and were subsequently randomized at baseline to receive a @-week pharmacotherapy-based algorithm treatment or treatment as usual .


Participants were tracked in-person for @ weeks .


Participants provided information on smoking behaviors and associated constructs of cessation at each follow-up session .


The findings revealed that many smokers reported using prescribed medications when provided with a supply of cessation medication as determined by an algorithm .


Compared with smokers receiving treatment as usual , PLHIV smokers prescribed these medications reported more quit attempts and greater reduction in smoking .


Proxy measures of cessation readiness ( eg , motivation , self-efficacy ) also favored participants receiving algorithm treatment .


This algorithm-derived treatment produced positive changes across a number of important clinical markers associated with smoking cessation .


Given these promising findings coupled with the brief nature of this treatment , the overall pattern of results suggests strong potential for dissemination into clinical settings and significant promise for further advancing clinical health outcomes in this population .


To assess efficacy and safety of post-operative intra-peritoneal wash with lactated Ringer 's for @h after myomectomy in reduction of adhesions compared to routine intra-operative irrigation .


Study design A prospective , randomized trial that included @ eligible participants who had undergone abdominal myomectomy .


Participants were randomly allocated to a treatment group ( n = @ ) which was subjected to continuous peritoneal wash for @h via two intraperitoneal drains , and a control group ( n = @ ) .


The incidence of de novo adhesions and their severity and extent were scored at a second-look laparoscopy @-@ weeks postoperatively .


Adhesions were graded using the local adhesion barrier scoring system score .


Adverse effects were also assessed and reported .


There was no statistically significant difference in duration of hospital stay or in the incidence of adverse events .


A significantly higher proportion of adhesion-free patients was found in the treatment group -LSB- @/@ , @ % -RSB- compared to the control group -LSB- @/@ , @ % -RSB- ( P < @ ) .


The mean number of pelvic sites covered by adhesions was significantly lower in the treatment group than in the control group ( @ versus @ , P < @ ) .


The total adhesion score was significantly lower in the treatment group than in the control group ( @ versus @ , P < @ ) and the adhesion score was significantly lower at most of the individual anatomical sites .


Application of postoperative intraperitoneal wash with lactated Ringer 's solution for @h may have reasonable safety and efficacy in minimizing postoperative pelvic de novo adhesions following abdominal myomectomy .


In the AXIS trial , axitinib prolonged progression-free survival ( PFS ) vs sorafenib in patients with advanced renal cell carcinoma ( RCC ) previously treated with sunitinib or cytokines .


In post hoc analyses , patients were grouped by objective response to prior therapy ( yes vs no ) , prior therapy duration ( < vs median ) , and tumour burden ( baseline sum of the longest diameter < vs median ) .


PFS and overall survival ( OS ) , and safety by type and duration of prior therapy were evaluated .


Response to prior therapy did not influence outcome with second-line axitinib or sorafenib .


PFS was significantly longer in axitinib-treated patients who received longer prior cytokine treatment and sorafenib-treated patients with smaller tumour burden following sunitinib .


Overall survival with the second-line therapy was longer in patients who received longer duration of prior therapy , although not significant in the sunitinib-to-axitinib sequence subgroup ; OS was also longer in patients with smaller tumour burden , but not significant in the cytokine-to-axitinib sequence subgroup .


Safety profiles differed modestly by type and duration of prior therapy .


AXIS data suggest that longer duration of the first-line therapy generally yields better outcome with the second-line therapy and that lack of response to first-line therapy does not preclude positive clinical outcomes with a second-line vascular endothelial growth factor-targeted agent in patients with advanced RCC .


To examine baseline predictors of moderate-to-vigorous intensity physical activity ( MVPA ) at the @-week follow-up in a sample of adults with arthritis participating in a self-directed , multicomponent exercise program .


Pretest-posttest .


Analyses were limited to those randomized to the exercise intervention .


Participants ( n = @ ) completed a survey assessing demographic , health-related , and arthritis-related factors , and completed anthropometric and functional measurements at baseline .


Self-reported MVPA was assessed at baseline and @ weeks .


Participants were classified as engaging in @ or < @ h/week of MVPA at the @-week follow-up .


Baseline demographic , health-related , arthritis-related , and functional factors were examined as predictors of engaging in @ h of MVPA .


At the @-week follow-up , @ % ( n = @ ) of participants engaged in @ h/week of MVPA .


Those with a higher body mass index , more days with poor physical health , a greater number of health conditions , self-reported hypertension , self-reported high cholesterol , and greater pain and stiffness were less likely to engage in @ h of MVPA at the @-week follow-up ; those with greater arthritis self-efficacy and better performance on the @ minute walk test were more likely .


None of the other factors examined were associated with MVPA .


This study uncovered health-related , arthritis-related , and functional factors associated with MVPA that may help guide intervention strategies .


Participants with less severe symptoms , better functional performance and fewer comorbidities at baseline were more likely to achieve the recommended MVPA level at @ weeks ; therefore self-directed PA interventions may be best suited for those with relatively good health status despite arthritis , while those with worse symptoms and health status may benefit more from other intervention delivery modalities such as structured , individualized programs where additional support for managing arthritis symptoms and comorbidity can be addressed .


The relative effects of radiation dose escalation ( RDE ) and androgen suppression ( AS ) duration on local prostatic progression ( LP ) remain unclear .


We addressed this in the TROG @ RADAR trial by incorporating a RDE programme by stratification at randomisation .


Men were allocated @ or @ months AS@ months zoledronate ( Z ) .


The main endpoint was a composite of clinically diagnosed LP or PSA progression with a PSA doubling time @ months .


Fine and Gray competing risk modelling with adjustment for site clustering produced cumulative incidence estimates at @ years for each RDE group .


Composite LP declined coherently in the @ , @ and @ Gy external beam dosing groups and was lowest in the high dose rate brachytherapy boost ( HDRB ) group .


At @ years , adjusted cumulative incidences were @ % , @ % , @ % and @ % respectively .


Compared to @ months AS , @ months AS also significantly reduced LP ( p < @ ) .


Post-radiation urethral strictures were documented in @ subjects and increased incrementally in the dosing groups .


Crude incidences were @ % , @ % , @ % and @ % respectively .


RDE and increasing AS independently reduce LP and increase urethral strictures .


The risks and benefits to the individual must be balanced when selecting radiation dose and AS duration .


A randomised , parallel group , pragmatic trial .


A large UK maternity hospital .


Term infants < @ weeks old with a mild or moderate degree of tongue-tie , and their mothers who were having difficulties breastfeeding .


To determine if immediate frenotomy was better than standard breastfeeding support .


Participants were randomised to an early frenotomy intervention group or a ` standard care ' comparison group .


Primary outcome was breastfeeding at @ days , with secondary outcomes of breastfeeding self-efficacy and pain on feeding .


Final assessment was at @ weeks ; @ also had qualitative interviews .


Researchers assessing outcomes , but not participants , were blinded to group assignment .


@ infants were randomised , @ to the intervention group and @ to the comparison group .


Five-day outcome measures were available for @ ( @ % ) of the intervention group and @ ( @ % ) of the comparison group , and intention-to-treat analysis showed no difference in the primary outcome-Latch , Audible swallowing , nipple Type , Comfort , Hold score .


Frenotomy did improve the tongue-tie and increased maternal breastfeeding self-efficacy .


At @ days , there was a @ % increase in bottle feeding in the comparison group compared with a @ % increase in the intervention group .


After the @-day clinic , @ of the comparison group had requested a frenotomy ; by @ weeks only @ ( @ % ) were breastfeeding without a frenotomy .


At @ weeks , there were no differences between groups in the breastfeeding measures or in the infant weight .


No adverse events were observed .


Early frenotomy did not result in an objective improvement in breastfeeding but was associated with improved self-efficacy .


The majority in the comparison arm opted for the intervention after @ days .


To investigate the effect of anti-inflammatory therapy on selective laser trabeculoplasty ( SLT ) outcomes .


Randomized , double-masked , placebo-controlled trial .


Patients with primary open-angle or pseudo-exfoliation glaucoma .


Patients undergoing SLT were randomized to receive placebo ( artificial tears ) , prednisolone acetate @ % , or ketorolac tromethamine @ % eye drops @ times per day for @ days commencing immediately after SLT .


Change in intraocular pressure ( IOP ) from baseline to the @-month post-SLT visit .


Mean change in IOP at the @-month primary outcome time point , as well as all other time points , was not significantly different among groups ( P = @ ) .


Likewise , a repeated-measures , mixed-effects model did not find significant differences in IOP outcome at the @-month time point ( P = @ ) .


The IOP was reduced in all groups at the @-month post-SLT time point and all other time points , and no significant differences were found between groups using separate unadjusted cross-sectional analyses of variance ( P > @ for analyses at all time points ) .


Treatment failure rates were not different among groups ( P = @ ) , and at @ year after SLT , the percentage of patients maintaining a @ % IOP reduction ranged from @ % to @ % in the @ study groups .


Anti-inflammatory therapy after SLT does not seem to substantially influence the IOP-lowering effect of SLT .


In this study of patients with low baseline IOP , SLT showed limited efficacy in achieving a sustained reduction in IOP .


The aim of the present randomized study was to evaluate the efficacy of intermaxillary fixation screw ( IMFS ) versus eyelet interdental wiring for intermaxillary fixation ( IMF ) in minimally displaced mandibular fractures .


A total of @ patients with a minimally displaced mandibular fracture were enrolled , with @ patients randomly selected for each group .


In group I ( study group , n = @ ) , the patients were treated using IMFS , and in group II ( control group , n = @ ) , they received eyelet interdental wiring .


Both techniques were assessed for the following parameters : time required for placement and removal of each type of IMF technique , time required for placement of IMF wires , postoperative occlusion , stability of the IMF wire , local anesthesia requirement during removal of each fixation type , oral hygiene status , glove perforation rate , and complications associated with both techniques .


The collected data were analyzed using Student 's unpaired t test or @ test .


P < @ was considered significant and the Statistical Package for Social Sciences software , version @ , was used for analysis .


The average time required for placement in groups I and II was @ and @ minutes , respectively ( P = @ ) .


The time required for placement of the IMF wire in group I was @ minutes and in group II was @ minutes .


The oral hygiene status was assessed , and the mean plaque index score for groups I and II was @ and @ , respectively ( P = @ ) .


The glove perforation rate was much less in group I than in group II .


Finally , the most common complication in both groups was mucosal growth .


The results established the supremacy of IMFS compared with eyelet interdental wiring .


Thus , we have concluded that IMFS , in the present scenario , is a safe and time-saving technique .


IMFS is a cost-effective , straightforward , and viable alternative to cumbersome eyelet interdental and other wiring techniques for providing IMF , with satisfactory occlusion during closed reduction or intraoperative open reduction internal fixation of fractures .


In addition , oral hygiene can be maintained , and the glove perforation rate was very low using IMFS .


The relatively small sample size and limited follow-up period were the study limitations .


This study compares the effects of neutral temperature , cold and ice-slush beverages , with and without @ % menthol on cycling performance , core temperature ( Tco ) and stress responses in a tropical climate ( hot and humid conditions ) .


Twelve trained male cyclists/triathletes completed six @-km exercise trials against the clock in @ C@ @ C and @ % @ % relative humidity .


Before and after warm-up , and before exercise and every @ km during exercise , athletes drank @ mL of either aromatized ( i.e. , with @ mL of menthol ( @ gr/L ) ) or a non-aromatized beverage ( neutral temperature : @C@ @ C , cold : @C@ @ C , or ice-slush : -@ C@ @ C ) .


During the trials , heart rate ( HR ) was continuously monitored , whereas core temperature ( Tco ) , thermal comfort ( TC ) , thermal sensation ( TS ) and rate of perceived exertion ( RPE ) were measured before and after warm-up , every @ km of exercise , and at the end of exercise and after recovery .


Both the beverage aroma ( P < @ ) and beverage temperature ( P < @ ) had significant and positive effects on performance , which was considerably better with ice-slush than with a neutral temperature beverage , whatever the aroma ( P < @ ) , and with menthol vs non-menthol ( P < @ ) .


The best performances were obtained with ice-slush/menthol and cold/menthol , as opposed to neutral/menthol .


No differences were noted in HR and Tco between trials .


Cold water or ice-slush with menthol aroma seems to be the most effective beverage for endurance exercise in a tropical climate .


Further studies are needed to explore its effects in field competition .


Artemisinin resistance in Plasmodium falciparum has emerged in Southeast Asia and now poses a threat to the control and elimination of malaria .


Mapping the geographic extent of resistance is essential for planning containment and elimination strategies .


Between May @ and April @ , we enrolled @ adults and children with acute , uncomplicated falciparum malaria in an open-label trial at @ sites in @ countries ( @ in Asia and @ in Africa ) .


Patients received artesunate , administered orally at a daily dose of either @ mg per kilogram of body weight per day or @ mg per kilogram , for @ days , followed by a standard @-day course of artemisinin-based combination therapy .


Parasite counts in peripheral-blood samples were measured every @ hours , and the parasite clearance half-lives were determined .


The median parasite clearance half-lives ranged from @ hours in the Democratic Republic of Congo to @ hours at the Thailand-Cambodia border .


Slowly clearing infections ( parasite clearance half-life > @ hours ) , strongly associated with single point mutations in the `` propeller '' region of the P. falciparum kelch protein gene on chromosome @ ( kelch@ ) , were detected throughout mainland Southeast Asia from southern Vietnam to central Myanmar .


The incidence of pretreatment and post-treatment gametocytemia was higher among patients with slow parasite clearance , suggesting greater potential for transmission .


In western Cambodia , where artemisinin-based combination therapies are failing , the @-day course of antimalarial therapy was associated with a cure rate of @ % ( @ % confidence interval , @ to @ ) at @ days .


Artemisinin resistance to P. falciparum , which is now prevalent across mainland Southeast Asia , is associated with mutations in kelch@ .


Prolonged courses of artemisinin-based combination therapies are currently efficacious in areas where standard @-day treatments are failing .


( Funded by the U.K. Department of International Development and others ; ClinicalTrials.gov number , NCT@ . )


Benzodiazepines ( BDZs ) are the gold standard in the treatment of alcohol withdrawal syndrome ( AWS ) .


Sodium oxybate ( SMO ) has been tested as a treatment for AWS with encouraging results .


The aim of this phase IV , multicenter , randomized , double-blind , double-dummy study was to evaluate the efficacy of SMO in comparison with oxazepam in the treatment of uncomplicated AWS .


Alcohol-dependent outpatients ( n = @ ) affected by uncomplicated AWS according to the Clinical Institute Withdrawal Assessment for Alcohol-revised ( CIWA-Ar ) scale were enrolled in the study and randomized in two groups : @ patients received SMO and @ patients received oxazepam for @ days .


The primary endpoint was the reduction of symptoms of AWS measured by the change in the total CIWA-Ar score from baseline ( day @ ) to the end of the study ( day @ ) .


This study is registered with ClinicalTrials.gov , number : NCT@ RESULTS : A significant decrease of the mean total CIWA-Ar score from baseline to the end of the study was found in both the SMO ( p < @ ) and the oxazepam group ( p < @ ) , with no significant differences between the two treatments ( p = @ ) .


Treatment with SMO and oxazepam resulted in a marked decrease in the severity of the mean CIWA subscales , i.e. sweating , tremor , and anxiety , with no significant differences between the two treatments .


Both drugs were well tolerated and no severe side effects were reported .